The case for behavioural change counselling for the prevention of NCDs and improvement of self-management of chronic conditions

Abstract

Brief behaviour change counselling (BBCC) that is integrated into routine health care has been shown to be effective in helping patients modify risk behaviours for non-communicable disease (NCD), improve self-management of chronic conditions, as well as produce clinically meaningful improvements in biological outcomes. Capacitating healthcare providers to effectively assist patients in lifestyle modification and self-management has been recognised by the South African Department of Health as an important strategic objective in its stated intention to ‘re-orientate’ the primary health care system to prevent NCDs more effectively and improve the quality of care for chronic conditions. However, primary care providers in South Africa are currently poorly trained for behaviour change counselling. The University of Stellenbosch, in partnership with the Chronic Disease Initiative for Africa (CDIA), has recently developed a training course for doctors and nurses that is offered as a CPD accredited course every year at the university. In addition, a resource package has been produced, consisting of a training manual and comprehensive patient education materials on smoking, diet, alcohol and physical activity. The approaches to behaviour change counselling that are taught in this course and described in the manual are Motivational Interviewing (MI) and the 5 A’s Clinical Practice Guideline.