Evaluation of a training programme for primary care providers to offer brief behaviour change counselling on risk factors for non-communicable diseases in South Africa
Abstract
Objective To evaluate the effect on clinical practice of training primary care providers (PCPs) in an approach to brief behaviour change counselling (BBCC), integrating the 5As (ask, alert, assess, assist, arrange) with a guiding style derived from motivational interviewing in the South African context. BBCC was focused on the four risky behaviours (unhealthy eating, tobacco smoking, physical inactivity, harmful alcohol use) for non-communicable diseases.Methods It was a before-and-after design, recording BBCC skills at baseline, directly after training and 6-weeks later. We evaluated each recording for adherence to the guiding style and delivery of the 5As using the Motivational Interviewing Treatment Integrity 3.1.1. tool, and a tool based on the 5As training design.Results 123 recordings were collected from 41 PCPs. Results showed a significant improvement in adoption of the guiding style (e.g. global score at baseline 2.0 (2.0-2.6) and in clinical practice 3.0 (2.7-3.3) p<0.001) and completion of the 5A steps (e.g. assist score at baseline 1.26 (1.12-1.4) and in clinical practice 1.75 (1.61-1.89) p<0.001).Conclusion Training PCPs in this approach to BBCC is effective at changing their clinical practice in the short term.Practice implications The training programme should be integrated into the curricula of PCPs, and used in continuing professional development.
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All studies reported improvements in knowledge and adoption of BIs.
“All studies reported improvements in knowledge and adoption of BIs [109–112].”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [109]
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- Authors
- Malan, Z., Mash, B., & Everett-Murphy, K.
- Affiliations
- Stellenbosch University (ZA)
- Corresponding author
- Malan, Zelra
- ORCID
- Malan, Zelra
- Venue
- Patient Education and Counseling
- Publisher
- Elsevier BV
- Published
- 2016-01
- Volume
- 99
- Issue
- 1
- Pages
- 125-131
- ISSN
- 0738-3991 (ISSN-L)
- OpenAlex
- W1445776980
- Cited by
- 29
- References
- 37
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 4 · 2023: 3 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 4 · 2018: 3 · 2017: 1 · 2016: 2 · 2015: 2
- FWCI
- 4.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Patient Education and Counseling (publishedVersion)
- PubMed (publishedVersion)
- Funders
- CDIA (Chronic Disease Initiative for Africa)
- Topics
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Keywords
- primary care providers, motivational interviewing, non-communicable diseases, risk-taking, unhealthy diet, smoking, physical inactivity, hazardous drinking, provider training, clinical practice change, implementation fidelity, continuing professional development
- MeSH terms
- Clinical Competence, Education, Medical, Continuing, Health Promotion, Humans, Primary Health Care, South Africa, Program Evaluation, Health Behavior, Directive Counseling, Motivational Interviewing
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