Anda I Dragomir1, Cassandre A Julien1, Simon L Bacon2, Vincent Gosselin Boucher1, Kim L Lavoie3. 1. Department of Psychology, Université du Québec à Montréal, Canada; Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l'Ile-de-Montréal (CIUSSS-NIM), Hôpital du Sacré-Coeur de Montréal, Canada. 2. Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l'Ile-de-Montréal (CIUSSS-NIM), Hôpital du Sacré-Coeur de Montréal, Canada; Department of Health, Kinesiology and Applied Physiology, Concordia University, Canada. 3. Department of Psychology, Université du Québec à Montréal, Canada; Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l'Ile-de-Montréal (CIUSSS-NIM), Hôpital du Sacré-Coeur de Montréal, Canada. Electronic address: lavoie.kim@uqam.ca.
Abstract
BACKGROUND: Poor health behaviours (e.g., smoking, physical inactivity) represent major underlying causes of non-communicable chronic diseases (NCDs). Prescriptive behaviour change interventions employed by physicians show limited effectiveness. Physician training in evidence-based behaviour change counselling (BCC) may improve behavioural risk factor management, but the efficacy and feasibility of current programs remains unclear. OBJECTIVE: (1) To systematically review the efficacy of BCC training programs for physicians, and (2) to describe program content, dose and structure, informing better design and dissemination. METHODS: Using PRISMA guidelines, a database search up to January 2018, yielded 1889 unique articles, screened by 2 authors; 9 studies met inclusion criteria and were retained for analysis. RESULTS: 100% of studies reported significant improvements in BCC skills among physicians, most programs targeting provider-patient collaboration, supporting patient autonomy, and use of open questions to elicit "change-talk". Limitation included: poor reporting quality, high program heterogeneity, small sample sizes, 78% of studies having no comparison group, and less than 30% of skills taught being formally assessed. CONCLUSION: Training programs were efficacious, but methodological weaknesses limit the ability to determine content and delivery. Caution is necessary when interpreting the results. PRACTICE IMPLICATIONS: Further research emphasizing rigorous training program development and testing is warranted.
BACKGROUND: Poor health behaviours (e.g., smoking, physical inactivity) represent major underlying causes of non-communicable chronic diseases (NCDs). Prescriptive behaviour change interventions employed by physicians show limited effectiveness. Physician training in evidence-based behaviour change counselling (BCC) may improve behavioural risk factor management, but the efficacy and feasibility of current programs remains unclear. OBJECTIVE: (1) To systematically review the efficacy of BCC training programs for physicians, and (2) to describe program content, dose and structure, informing better design and dissemination. METHODS: Using PRISMA guidelines, a database search up to January 2018, yielded 1889 unique articles, screened by 2 authors; 9 studies met inclusion criteria and were retained for analysis. RESULTS: 100% of studies reported significant improvements in BCC skills among physicians, most programs targeting provider-patient collaboration, supporting patient autonomy, and use of open questions to elicit "change-talk". Limitation included: poor reporting quality, high program heterogeneity, small sample sizes, 78% of studies having no comparison group, and less than 30% of skills taught being formally assessed. CONCLUSION: Training programs were efficacious, but methodological weaknesses limit the ability to determine content and delivery. Caution is necessary when interpreting the results. PRACTICE IMPLICATIONS: Further research emphasizing rigorous training program development and testing is warranted.
Authors: Anda I Dragomir; Vincent Gosselin Boucher; Simon L Bacon; Claudia Gemme; Geneviève Szczepanik; Kimberly Corace; Tavis S Campbell; Michael T Vallis; Gary Garber; Codie Rouleau; Doreen Rabi; Jean G Diodati; William Ghali; Kim L Lavoie Journal: Transl Behav Med Date: 2021-03-16 Impact factor: 3.046
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