Evaluation of the B.strong Queensland Indigenous Health Worker Brief Intervention Training Program for Multiple Health Risk Behaviours

Abstract

Queensland’s B.strong brief intervention training program was a complex intervention developed for Aboriginal and Torres Strait Islander health workers to assist clients address multiple health risks of smoking, poor nutrition and physical inactivity. This study evaluates program effectiveness by applying the Kirkpatrick four-level evaluation model: (1) Reaction, participants’ satisfaction; (2) Learning, changes in participants’ knowledge, confidence, attitudes, skills and usual practice; (3) Behaviour, application of learning to practice; and (4) Results, outcomes resulting from training. A retrospective analysis was conducted on data for respondents completing pre-training, post-workshop and follow-up surveys. Changes in domains such as training participant knowledge, confidence, attitudes, and practices between survey times were assessed using paired-samples t-tests. From 2017–2019, B.strong trained 1150 health professionals, reaching targets for workshop and online training. Findings showed statistically significant improvements from baseline to follow-up in: participants’ knowledge, confidence, and some attitudes to conducting brief interventions in each domain of smoking cessation, nutrition and physical activity; and in the frequency of participants providing client brief interventions in each of the three domains. There was a statistically significant improvement in frequency of participants providing brief interventions for multiple health behaviours at the same time from pre-workshop to follow-up. Indigenous Queenslander telephone counselling referrals for smoking cessation increased during the program period. B.strong improved practitioners’ capacity to deliver brief interventions addressing multiple health risks with Indigenous clients.

Impact of an Aboriginal and Torres Strait Islander brief intervention training program on health staff participants' own health behaviours: Smoking, nutrition and physical activity

“…This study was conducted as part of the wider monitoring and evaluation of the B.strong program. A Logic Model was developed to guide the evaluation and has been published elsewhere 11 . It depicts the interconnections of inputs, activities, outputs and outcomes of the training program and indicates how the aims and objectives of the B.strong program were to be met across the duration of the project 11 .…”

“…A mixed‐methods evaluation of the B.strong program used the Kirkpatrick model to assess the training program impact from 2017 to 2019 11,14 . This work examined the impact of the program on trainees' knowledge, confidence, attitudes and usual practices in conducting brief interventions with Aboriginal and Torres Strait Islander clients.…”

“…Details of the development, implementation and evaluation of the B.strong program have been published elsewhere. 11 B.strong was an evidence-based, culturally appropriate program provided at no cost to participants. It delivered a 1-day face-to-face workshop, six online modules, practitioner materials and a set of client resources for trained health staff to use with their clients.…”

Role of organisational factors on uptake and implementation of the B.strong brief intervention training program in Queensland Indigenous primary health care services

“…8 A number of PHC level organisational factors have been identified as key to successful uptake and implementation of BI training programs including: support from PHC service management and engagement of workers from the start, incorporation of the intervention as a standard component of health professionals' roles, adapting the program to suit the service's characteristics and adoption of the intervention into routine client care. 11 However, previous evaluations of Indigenous BI training programs in Australia, [7][8][9][10] contain little information on the organisational factors of Indigenous PHC services that supported the program's uptake and implementation in those services. The current study adds to the mixed-methods evaluation of the B.strong program, 10 and fills a gap in knowledge by applying in-depth qualitative methods to identify organisational factors that impacted on the uptake and implementation of B.strong in Indigenous PHC services, thereby providing further insights on how to design and implement similar programs in the future.…”

“…A number of PHC level organisational factors have been identified as key to successful uptake and implementation of BI training programs including: support from PHC service management and engagement of workers from the start, incorporation of the intervention as a standard component of health professionals’ roles, adapting the program to suit the service's characteristics and adoption of the intervention into routine client care 11 . However, previous evaluations of Indigenous BI training programs in Australia, 7‐10 contain little information on the organisational factors of Indigenous PHC services that supported the program's uptake and implementation in those services.…”