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. 2003 Apr;53(489):271–277.

A cluster randomised trial to evaluate a nutrition training programme.

Helen Moore 1, Darren Greenwood 1, Timothy Gill 1, Colin Waine 1, Jennifer Soutter 1, Ashley Adamson 1
PMCID: PMC1314568  PMID: 12879826

Abstract

BACKGROUND: The need for training to equip primary care staff with the knowledge and skills to provide dietary advice to the public has been acknowledged. Little is known about the effectiveness of such training at improving the dietary counselling skills of multidisciplinary practice teams. AIM: To evaluate the effectiveness of a nutrition training programme, delivered to primary care teams by a dietitian. DESIGN OF STUDY: A paired-cluster randomised trial. SETTING: Twelve general practices in Sunderland, in the United Kingdom. METHOD: A nutrition training programme, aimed at improving the quality of dietary consultations, was developed and delivered to six primary care teams by a dietitian. Main outcome measures were patients' recall of seven key consulting behaviours. Data were collected from patients in intervention and control practices, pre- and post-intervention. Change in knowledge and attitude of practitioners was also measured. RESULTS: All 12 practices completed the trial. Data were collected from 251 patients pre-intervention and 228 patients post-intervention. Of the seven consulting behaviours targeted in the training, only the proportion of consultations where written information (diet sheets) was provided to patients was significantly higher (13% higher, 95% confidence interval [CI = 4 to 21, P = 0.004) in the intervention practices post-training. Some evidence of improved practitioner knowledge and attitude was detected. CONCLUSION: This evaluation of a nutrition training intervention detected only a limited impact on the behaviour, knowledge, and attitudes of primary care practitioners in dietary consultations.

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Selected References

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  1. Belfield Clive, Thomas Hywel, Bullock Alison, Eynon Rebecca, Wall David. Measuring effectiveness for best evidence medical education: a discussion. Med Teach. 2001 Mar;23(2):164–170. doi: 10.1080/0142150020031084. [DOI] [PubMed] [Google Scholar]
  2. Buttriss J. L. Food and nutrition: attitudes, beliefs, and knowledge in the United Kingdom. Am J Clin Nutr. 1997 Jun;65(6 Suppl):1985S–1995S. doi: 10.1093/ajcn/65.6.1985S. [DOI] [PubMed] [Google Scholar]
  3. Davis D. A., Thomson M. A., Oxman A. D., Haynes R. B. Changing physician performance. A systematic review of the effect of continuing medical education strategies. JAMA. 1995 Sep 6;274(9):700–705. doi: 10.1001/jama.274.9.700. [DOI] [PubMed] [Google Scholar]
  4. DerSimonian R., Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986 Sep;7(3):177–188. doi: 10.1016/0197-2456(86)90046-2. [DOI] [PubMed] [Google Scholar]
  5. Francis J., Roche M., Mant D., Jones L., Fullard E. Would primary health care workers give appropriate dietary advice after cholesterol screening? BMJ. 1989 Jun 17;298(6688):1620–1622. doi: 10.1136/bmj.298.6688.1620. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hooper L., Summerbell C. D., Higgins J. P., Thompson R. L., Capps N. E., Smith G. D., Riemersma R. A., Ebrahim S. Dietary fat intake and prevention of cardiovascular disease: systematic review. BMJ. 2001 Mar 31;322(7289):757–763. doi: 10.1136/bmj.322.7289.757. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hutchinson L. Evaluating and researching the effectiveness of educational interventions. BMJ. 1999 May 8;318(7193):1267–1269. doi: 10.1136/bmj.318.7193.1267. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Kahan M., Wilson L., Becker L. Effectiveness of physician-based interventions with problem drinkers: a review. CMAJ. 1995 Mar 15;152(6):851–859. [PMC free article] [PubMed] [Google Scholar]
  9. Ley P., Bradshaw P. W., Eaves D., Walker C. M. A method for increasing patients' recall of information presented by doctors. Psychol Med. 1973 May;3(2):217–220. doi: 10.1017/s0033291700048558. [DOI] [PubMed] [Google Scholar]
  10. Moore Helen, Adamson Ashley J. Nutrition interventions by primary care staff: a survey of involvement, knowledge and attitude. Public Health Nutr. 2002 Aug;5(4):531–536. doi: 10.1079/PHN2001326. [DOI] [PubMed] [Google Scholar]
  11. Oxman A. D., Thomson M. A., Davis D. A., Haynes R. B. No magic bullets: a systematic review of 102 trials of interventions to improve professional practice. CMAJ. 1995 Nov 15;153(10):1423–1431. [PMC free article] [PubMed] [Google Scholar]
  12. Rollnick S. Behaviour change in practice: targeting individuals. Int J Obes Relat Metab Disord. 1996 Feb;20 (Suppl 1):S22–S26. [PubMed] [Google Scholar]
  13. Rollnick S., Kinnersley P., Stott N. Methods of helping patients with behaviour change. BMJ. 1993 Jul 17;307(6897):188–190. doi: 10.1136/bmj.307.6897.188. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Silagy C., Muir J., Coulter A., Thorogood M., Yudkin P., Roe L. Lifestyle advice in general practice: rates recalled by patients. BMJ. 1992 Oct 10;305(6858):871–874. doi: 10.1136/bmj.305.6858.871. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Thompson S. G., Pyke S. D., Hardy R. J. The design and analysis of paired cluster randomized trials: an application of meta-analysis techniques. Stat Med. 1997 Sep 30;16(18):2063–2079. doi: 10.1002/(sici)1097-0258(19970930)16:18<2063::aid-sim642>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]
  16. Truswell A. S. Family physicians and patients: is effective nutrition interaction possible? Am J Clin Nutr. 2000 Jan;71(1):6–12. doi: 10.1093/ajcn/71.1.6. [DOI] [PubMed] [Google Scholar]
  17. Weinsier R. L. National Dairy Council Award for Excellence in Medical/Dental Nutrition Education Lecture, 1995: medical-nutrition education--factors important for developing a successful program. Am J Clin Nutr. 1995 Oct;62(4):837–840. doi: 10.1093/ajcn/62.4.837. [DOI] [PubMed] [Google Scholar]
  18. Wilson A., McDonald P. Comparison of patient questionnaire, medical record, and audio tape in assessment of health promotion in general practice consultations. BMJ. 1994 Dec 3;309(6967):1483–1485. doi: 10.1136/bmj.309.6967.1483. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Wood D. European and American recommendations for coronary heart disease prevention. Eur Heart J. 1998 Feb;19 (Suppl A):A12–A19. [PubMed] [Google Scholar]

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