TABLE 5

Educational Studies Involving the Primary Care Team

Study	Design	Brief Description of Intervention	Study Population	Sample Size	Summary of Results
P. Appleton, P. Pritchard, A. Pritchard, unpublished work, 1988^a	SBA	Behavioral intervention methods; 3-day induction followed by 3 follow-up days, plus access to specialist HV	HVs	13 HVs and 72 families	Significant reductions in mothers' perception of the severity of the problem and mothers' and fathers' GHQ scores pre- and postintervention
Bernard et al, 1999⁶⁰^a	SBA	Preparatory reading and single structured teaching sessions using either vignettes or video	GP trainees	61 GPs and 174 patients	Scores in 5/6 attitude/competence questions increased post-training; Small but significant increase in knowledge quiz scores; Significant increase in diagnostic accuracy in subsample of GPs
Bowler et al, 1984⁶¹^a	SBA	3-day workshop and follow-up session 6 wk later	HVs	6 HVs	5/6 HVs increased scores on case vignettes; Average score pretraining, 10.2; posttraining, 18.7
Davis et al, 1997⁶²^a	CBA	Parent advisor training vs no training	HVs and CMOs	6 HVs and 3 CMOs	Significant changes in counseling knowledge, perception of self as counselor, self-esteem, overall counseling ability and attending behavior
Hewitt et al, 1991³⁷^a	SBA	2-day behavioral workshop on managing children's behavioral problems; Additional in vivo case supervision and training	HVs	9 HVs	Significant increase in ratings of appropriateness post-training; No differences in ratings of difficulty in dealing with problems post-training; No effect of training on methods of case identification
Roter et al, 1995⁶³	RCT	One of 2 communication-skills training courses designed to help physicians address patients' emotional distress vs no-training control	PCCs and their patients	69 PCCs, 648 patients	Trained physicians reported more psychosocial problems, engaged in more strategies for managing emotional problems with actual patients, scored higher in clinical proficiency with simulated patients; Patients of trained physicians reported reduction in emotional distress for as long as 6 months.
Stevenson et al, 1988⁶⁴^a	RCT	12-session intervention using behavior modification techniques vs delayed	HVs and families on their caseload	14 HVs and 205 families	Few changes in child behavior in either analysis, although those changes that were significant suggested that the delay group were less effective post-training; No differences in resolution of target behaviors; No significant changes in maternal GHQ score.
Weir and Dinnick, 1988⁶⁵^a	CBA	Instruction in behavior modification (manualized) and group meetings	HVs and children with sleep problems	Number of HVs unclear, 51 children	Few differences in outcomes between intervention and control, using either clinical or health visitor ratings, although more children in control group referred to other agencies (8% vs 41%)

SBA indicates simple before and after study; HV, health visitor; GP, general practitioner; GHQ, general health questionnaire; CBA, controlled before and after study; CMO, community medical officer; RCT, randomized. controlled trial.
↵a Studies are taken from Bower et al.²⁴