To evaluate the psychometric properties of a tool used to assess a new model of brief behaviour change counselling in the South African context

Fouche, Jani (2019-12)

Thesis (MMed)--Stellenbosch University, 2019.


ENGLISH SUMMARY : Introduction: Brief behaviour change counselling (BBCC) in primary care can address many of the behavioural risk factors underlying the burden of disease such as unhealthy eating, physical inactivity, tobacco smoking and alcohol use. A new model combined the 5 As (Ask, Alert, Assess, Assist, Arrange) with a guiding style of communication. Training and evaluation of this new model requires a valid and reliable assessment tool. Aim: To evaluate the validity and reliability of a tool used to assess a new model of BBCC in the Western Cape, South Africa. Methods: Exploratory sequential mixed methods included initial qualitative feedback from an expert panel to assess validity, followed by quantitative analysis of internal consistency, inter- and intra- rater reliability. Six raters assessed 33 randomly selected audiotapes from a repository of 123 tapes of BBCC at baseline and 1 month later. Results: Changes to the existing tool involved, item changes, added items, as well as grammatical and layout changes. The ‘ABC tool’ had good overall internal consistency (Cronbach alpha 0.955), inter-rater (Intra-class correlation (ICC) 0.813 at follow up) and intra-rater reliability (Pearson’s correlation 0.899 and p<0.001). Sub-scores for the Assist (ICC 0.784) and Arrange (ICC 0.704) stages had lower inter-rater reliability than the sub-scores for Ask (ICC 0.920), Alert (ICC 0.925) and Assess (ICC 0.931). Conclusion: The ABC tool is sufficiently reliable for the assessment of BBCC in clinical settings or research studies. Minor revisions may further improve the reliability of the tool, particularly for the sub-scores measuring Assist and Arrange.

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