The psychometric properties of a tool to assess brief behaviour change counselling in South Africa

Abstract

Background Primary care providers should be competent in brief behaviour change counselling (BBCC). A new model of BBCC was developed in South Africa. Tools are needed for training and research to evaluate BBCC. Aim To evaluate the validity and reliability of a tool to assess BBCC. Setting Primary care providers in Western Cape, South Africa. Methods Exploratory sequential mixed methods included initial qualitative feedback from an expert panel to assess validity, followed by quantitative analysis of internal consistency, inter- and intra-rater reliability. Six raters assessed 33 randomly selected audiotapes from a repository of 123 tapes of BBCC at baseline and 1 month later. Results Changes to the existing tool involved item changes, added items and grammatical as well as layout changes. The ‘Assessment of Brief Behavioural Change Counselling’ tool (ABC tool) had good overall internal consistency (Cronbach’s alpha 0.955), inter-rater (intra-class correlation coefficient [ICC] 0.813 at follow-up) and intra-rater reliability (Pearson’s correlation 0.899 and p < 0.001). Sub-scores for the Assist (ICC 0.784) and Arrange (ICC 0.704) stages had lower inter-rater reliability than the sub-scores for Ask (ICC 0.920), Alert (ICC 0.925) and Assess (ICC 0.931) stages. Conclusion The ABC tool is sufficiently reliable for the assessment of BBCC. Minor revisions may further improve the reliability of the tool, particularly for the sub-scores measuring Assist and Arrange. The ABC tool can be used in clinical training or research studies to assess fidelity to this model of BBCC.

Electronic distance based clinical skills training development in family medicine in Namibia

“…Students who completed the Brief Behaviour Change Counselling (BBCC) online training were asked to peerreview each other with the validated ABC tool. 5 Lastly, we realised that internet and/or cell phone coverage is not widely available. The cost saving for not having to print logbooks enabled us to provide each student with a N$ 100.00 (Namibian dollar) data voucher.…”

“…Students who completed the Brief Behaviour Change Counselling (BBCC) online training were asked to peer-review each other with the validated ABC tool. 5 …”

Undergraduate teaching in family medicine within the PRIMAFAMED network

“…Stellenbosch University and University of Namibia were also using the Assessment of Brief Behaviour Change Counselling (ABC) tool. 3 Having separate, summative examinations in family medicine could be burdensome, and more integrated examinations might just include a component from family medicine. Some programmes, however, continued to offer a final family medicine examination with Multiple Choice Questions (MCQs), Objective Structured Clinical Examinations (OSCEs), and oral examinations.…”

Creating a learning environment in your practice or facility

“…The family physician should be familiar with tools that can facilitate learning such as the mini-clinical examination tool (mini-CEX) for observing consultations, 14 the tool for directly observed procedural skills (DOPS) 15 or the tool for assessing brief behaviour change counselling (the ABC tool). 16 Giving effective feedback is again an essential skill, and various models have been recommended, such as the Pendleton principles (Figure 2). 9 In a situation where the family physician may not be an expert on every clinical condition, symptom or learning need, it may be reassuring that one's primary role is to facilitate learning rather than to have an answer for everything.…”