Evaluating the effectiveness of brief behaviour change counselling in a primary care facility

Journal Title
Journal ISSN
Volume Title
Stellenbosch : Stellenbosch University
ENGLISH SUMMARY: Introduction Non-communicable diseases are associated with four risky behaviours, an unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. A new model of brief behaviour change counselling (BBCC) was developed in South Africa for primary care providers. There is South African evidence that BBCC can be effective with harmful use of alcohol and tobacco, but no local evidence with regard to unhealthy diet and physical inactivity. Aim The aim of the study was to evaluate the effect of BBCC on diet and physical activity in patients with overweight/obesity and a moderate to high cardiovascular disease (CVD) risk. The primary outcome of the study was for at least 15% of patients to achieve either a 20% improvement in dietary score or a 20% improvement in the metabolic equivalent of task (MET) minutes score Setting A primary care clinic within the Cape Winelands district in the Western Cape, South Africa Methods This was a before-and-after quantitative study that measured change in diet, physical activity and body mass index (BMI) associated with BBCC delivered by primary care providers to 145 patients. Participants completed physical activity and diet questionnaires as well as measures of blood pressure, weight and BMI at baseline and 4-8 months later. Two sessions of BBCC were given over a period of 2-4 months. Data was analysed with the Statistical Package for the Social Sciences. Results Paired data was obtained from 139 patients, mean age was 53.5 years (SD ±10.0), and 75.9% were female with a mean BMI of 36.6 kg/m2 (SD ±8.0). Overall 78.5% of patients achieved the primary outcome, 77.0% improved their diet score by >20% and 8.9% improved their MET minutes score by >20%. The mean diet score and mean MET minutes score also significantly improved (p<0.001). There were no significant changes in BMI, weight or blood pressure Conclusion This study shows the potential of BBCC in the primary care setting and adds to the evidence for the effectiveness of BBCC across all four key risk behaviours for non-communicable diseases. Training of primary care providers in BBCC should continue and further clinical trials to assess the effect of this model of BBCC in our context are needed.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
Thesis (MFamMed)--Stellenbosch University, 2020.
Primary care (Medicine) -- South Africa, Brief therapy (Psychotherapy) -- South Africa, Brief psychotherapy -- South Africa, Primary health care -- South Africa, UCTD