Physician training in self-efficacy enhancing interviewing techniques (SEE IT): Effects on patient psychological health behavior change mediators

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 ≤20 minute 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.

Pilot randomized controlled trial Protocol: Life context-informed pre-visit planning to improve care plans for primary care patients with multiple chronic conditions including diabetes

“…The PCPs (both study arms) will be assessed for their perception of the hassle and the helpfulness of participating in the study, using a modification of a 12-item survey developed by our team for a recent study on a primary care intervention for chronic condition management. 33 The CI-PVP nurse and 5 of the PCPs in the intervention arm will also complete a brief semi-structured interview (10 minutes) on their experiences with the trial and any PVP (either standard PVP or the intervention CI-PVP), as well as their observations on patient reaction to the CI-PVP and discussion of life context during the office visit. All PCPs also will be surveyed for visit difficulty 34 after a single MCC visit prior to the intervention period, 1 and 3 months into the intervention period, and post-intervention period, to ensure CI-PVP does not add to visit burden compared to standard PVP.…”

Detecting the effects of physician training in self-care interviewing skills: Coding of standardized patient (SP) visit recordings versus SP post-visit ratings

“…We found that both SP post-visit ratings and coder ratings of SP visit recordings performed moderately well in detecting physicians who had received training in SEE IT [9, 10], with no significant difference in detection ability between methods. The findings question the need for coder ratings of SP visit recordings to assess physician interviewing behaviors.…”

“…We previously reported the details of our RCT of SEE IT training for PCPs [9, 10]. Briefly, we randomized family physicians and general internists (N=50) from 12 primary care offices in the Sacramento, California area, drawn from the UCD and Sutter health systems.…”

Tips for permanent education in mental health in primary care guided by the Institutional Socio-clinic

“…Although there is this need for training, most of the international studies point to a formative logic still focused on the traditional training and capacities, with measurements of their impacts in the daily work ( 13 - 17 ) .…”