Anthony Jerant1, Melissa Lichte2, Richard L Kravitz3, Daniel J Tancredi4, Elizabeth M Magnan5, Andrew Hudnut6, Peter Franks7. 1. Department of Family and Community Medicine, University of California Davis, Sacramento, USA. Electronic address: afjerant@ucdavis.edu. 2. Department of Family and Community Medicine, University of California Davis, Sacramento, USA. Electronic address: mlichte@ucdavis.edu. 3. Department of Internal Medicine, University of California Davis, Sacramento, USA. Electronic address: rlkravitz@ucdavis.edu. 4. Department of Pediatrics and Center for Healthcare Policy and Research, University of California Davis, Sacramento, USA. Electronic address: djtancredi@ucdavis.edu. 5. Department of Family and Community Medicine, University of California Davis, Sacramento, USA. Electronic address: emagnan@ucdavis.edu. 6. Sutter Medical Foundation, Sacramento, USA. Electronic address: HudnutA@Sutterhealth.org. 7. Department of Family and Community Medicine, University of California Davis, Sacramento, USA. Electronic address: pfranks@ucdavis.edu.
Abstract
OBJECTIVE: To explore how physician training in self-efficacy enhancing interviewing techniques (SEE IT) affects patient psychological health behavior change mediators (HBCMs). METHODS: We analyzed data from 131 patients visiting primary care physicians ≥4 months after the physicians participated in a randomized controlled trial. Experimental arm physicians (N=27) received SEE IT training during three ≤20min standardized patient instructor (SPI) visits. Control physicians (N=23) viewed a diabetes medications video during one SPI visit. Physicians were blinded to patient participation. Outcomes were self-care self-efficacy, readiness, and health locus of control (Internal, Chance, Powerful Others), examined as a summary HBCM score (average of standardized means) and individually. Analyses adjusted for pre-visit values of the dependent variables. RESULTS: Patients visiting SEE IT-trained physicians had higher summary HBCM scores (+0.42, 95% CI 0.07-0.77; p=0.021). They also had greater self-care readiness (AOR 3.04, 95% CI 1.02-9.03, p=0.046) and less Chance health locus of control (-0.27 points, 95% CI -0.50-0.04, p=0.023), with no significant differences in other HBCMs versus controls. CONCLUSION: Improvement in psychological HBCMs occurred among patients visiting SEE IT-trained physicians, PRACTICE IMPLICATIONS: If further research shows the observed HBCM effects improve health behaviors and outcomes, SEE IT training might be offered widely to physicians.
RCT Entities:
OBJECTIVE: To explore how physician training in self-efficacy enhancing interviewing techniques (SEE IT) affects patient psychological health behavior change mediators (HBCMs). METHODS: We analyzed data from 131 patients visiting primary care physicians ≥4 months after the physicians participated in a randomized controlled trial. Experimental arm physicians (N=27) received SEE IT training during three ≤20min standardized patient instructor (SPI) visits. Control physicians (N=23) viewed a diabetes medications video during one SPI visit. Physicians were blinded to patient participation. Outcomes were self-care self-efficacy, readiness, and health locus of control (Internal, Chance, Powerful Others), examined as a summary HBCM score (average of standardized means) and individually. Analyses adjusted for pre-visit values of the dependent variables. RESULTS:Patients visiting SEE IT-trained physicians had higher summary HBCM scores (+0.42, 95% CI 0.07-0.77; p=0.021). They also had greater self-care readiness (AOR 3.04, 95% CI 1.02-9.03, p=0.046) and less Chance health locus of control (-0.27 points, 95% CI -0.50-0.04, p=0.023), with no significant differences in other HBCMs versus controls. CONCLUSION: Improvement in psychological HBCMs occurred among patients visiting SEE IT-trained physicians, PRACTICE IMPLICATIONS: If further research shows the observed HBCM effects improve health behaviors and outcomes, SEE IT training might be offered widely to physicians.
Keywords:
Continuing professional development; Health behavior; Interviews as topic; Locus of control; Motivation; Patient engagement; Primary care; Self-efficacy; Stages of change
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