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

- We trained primary care providers to deliver brief behaviour change counselling.
- The training combined the 5As and a guiding style derived from motivational interviewing.
- We evaluated participant's performance after training and in clinical practice.
- Training resulted in significant adoption of the 5As and a guiding style.
- Training programmes for primary care providers should incorporate this approach.

ObjectiveTo 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.MethodsIt 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.Results123 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).ConclusionTraining PCPs in this approach to BBCC is effective at changing their clinical practice in the short term.Practice implicationsThe training programme should be integrated into the curricula of PCPs, and used in continuing professional development.