Physician training for patient-centered nutrition counseling in a lipid intervention trial
Authors
Ockene, Judith K.Ockene, Ira S.
Quirk, Mark E.
Hebert, James R.
Saperia, Gordon M.
Luippold, Rose S.
Merriam, Philip A.
Ellis, Sarah
UMass Chan Affiliations
Department of Family Medicine and Community HealthDepartment of Medicine, Division of Cardiovascular Medicine
Department of Medicine, Division of Preventive and Behavioral Medicine
Document Type
Journal ArticlePublication Date
1995-11-01Keywords
AdultAlgorithms
Clinical Competence
Counseling
Education, Medical, Continuing
Female
*Health Knowledge, Attitudes, Practice
Health Maintenance Organizations
Humans
Hyperlipidemias
Male
Nutrition Physiology
Patient-Centered Care
Physicians, Family
Questionnaires
Life Sciences
Medicine and Health Sciences
Women's Studies
Metadata
Show full item recordAbstract
BACKGROUND: We examined the effect of a 3-hr training program on physicians' lipid intervention knowledge, attitudes, and skills. The program teaches physicians skills to conduct a brief dietary risk assessment and provide patient-centered counseling to enable patients with elevated lipids to change their dietary patterns. METHOD: The training is part of a randomized trial of lipid-lowering interventions, the Worcester Area Trial for Counseling in Hyperlipidemia. Primary care internists practicing in a health maintenance organization (HMO) were assessed, before and after training using questionnaires and audiotapes to document changes in knowledge about diet, attitudes about intervention, reported nutrition intervention practices, and counseling and assessment skills. Physicians also rated the value that they thought the training program had to them. RESULTS: After completion of the program the physicians' use of dietary counseling steps, as assessed by blinded evaluation of audiotaped physician-patient interactions, significantly increased (mean pre = 5.4, mean post = 9.2; t = 9.9; P < or = 0.001). In this regard, there were instances in the use of 7 of the 14 specific counseling steps. Physicians also demonstrated increases in self-perceived preparedness as measured by a 5-point scale (mean pre = 3.2, mean post = 4.0; t = 4.25; P < 0.001), confidence in having an effect (mean pre = 3.3, mean post = 3.9; t = 3.16; P < 0.01), perception that materials were available to aid intervention (mean pre = 2.7, mean post = 4.0; t = 5.29; P < 0.001), and perception that they have access to a nutritionist (mean pre = 3.5, mean post = 4.0; t = 2.63; P < 0.01). They rated the value of the program between very good and excellent. CONCLUSION: Results of this 3-hr educational program indicate that physicians in an HMO are responsive to the teaching of specialized skills deemed important for promoting health behavior change in their patients.Source
Prev Med. 1995 Nov;24(6):563-70. Link to article on publisher's siteDOI
10.1006/pmed.1995.1090Permanent Link to this Item
http://hdl.handle.net/20.500.14038/50830PubMed ID
8610079Related Resources
Link to article in PubMedae974a485f413a2113503eed53cd6c53
10.1006/pmed.1995.1090