The development, implementation and evaluation of a training intervention for primary health care providers on brief behaviour change counselling, and assessment of the provider’s competency in delivering this counselling intervention

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Stellenbosch : Stellenbosch University
ENGLISH ABSTRACT: Unhealthy behaviour is a key modifiable factor that underlies much of the South African (SA) burden of disease and primary care morbidity. Chronic diseases such as heart disease, type 2 diabetes, lung diseases and some cancers are linked to underlying behavioural issues such as tobacco smoking, alcohol abuse, physical inactivity and unhealthy eating. Evidence shows that brief behaviour change counselling by primary care providers can be effective in helping patients to change risky lifestyle behaviours. However, the capacity of South African primary care providers to educate and counsel patients on lifestyle modification is generally poor. The need for primary care provider training in lifestyle counselling, is stated as a critical objective in ‘re-orientating’ the primary health care system to effectively address NCDs in the National Strategic Plan for the Prevention and Control of NCDs and their risk factors in SA. The overall aim of this research was to develop, implement and evaluate the effectiveness of a training intervention for primary care providers in the South African setting, which is based on teaching best practice, behaviour change counselling (BBCC) methods that can be used for patients with risky lifestyle behaviours associated with non-communicable diseases (NCDs). “Effectiveness” relates to the effect of the training on PCPs adoption of a patient centred approach, and skills acquisition after the training, and not the effectiveness in changing, or improving patient outcomes. The sequence of the abstracts of the four articles that were published from this research, gives an overview of the process.
AFRIKAANSE OPSOMMING: Ongesonde lewenstyl kan gekoppel word aan die meeste chroniese siektes wereldwyd, en dra grootliks by tot die las van primere sorg morbiditeit, asook in Suid Afrika. Rook, ongesonde dieet, fisiese onaktiwiteit, en alkohol misbruik word beskou as die onderliggende risiko faktore wat verantwoordelik is vir die ontwikkeling van kardiovaskulere siektes, tipe 2 diabetes, respiratoriese siektes, sowel as sommige kankers. Navorsing het bewys dat primere gesondheidsorg werkers effektief kan wees om pasiente te help om hierdie gewoontes te bekamp. Nieteenstaande hierdie bewyse, is die huidige kapasiteit van primere sorg dokters en verpleegsters in Suid-Afrika nie voldoende om sodanige diens te verskaf nie. In die Nationale Strategiese Plan vir die beheer van chroniese siektes, word opleiding vir primere gesondheidsorg werkers geprioritiseer as n kritiese uitkomste vir die beheer van chroniese siektes, en die onderliggende risiko faktore. Dit is dus duidelik dat daar n behoefte is om sodanige opleidingprogramme te ontwikkel. Die doel van hierdie navorsing was om n bewysgebaseerde opleidingsprogram te ontwikkel, te implementeer, en die effektiwiteit daarvan te evalueer in ons unieke primere gesondheidsorg sisteem in Suid-Afrika. Die opleidingsprogram moes ontwikkel word, vir beide primere sorg dokters en verpleegsters, sodat dit hulle in staat kan stel om pasiente te beraad oor enige van die vier risiko faktore.
Thesis (PhD)--Stellenbosch University, 2015.
UCTD, Health promotion -- South Africa, Health behavior -- South Africa, Lifestyles -- Health aspects-- South Africa, Medicine, Preventitive -- South Africa, Health counseling -- South Africa