TABLE 5

Educational Studies Involving the Primary Care Team

StudyDesignBrief Description of InterventionStudy PopulationSample SizeSummary of Results
P. Appleton, P. Pritchard, A. Pritchard, unpublished work, 1988aSBABehavioral intervention methods; 3-day induction followed by 3 follow-up days, plus access to specialist HVHVs13 HVs and 72 familiesSignificant reductions in mothers' perception of the severity of the problem and mothers' and fathers' GHQ scores pre- and postintervention
Bernard et al, 199960aSBAPreparatory reading and single structured teaching sessions using either vignettes or videoGP trainees61 GPs and 174 patientsScores 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, 198461aSBA3-day workshop and follow-up session 6 wk laterHVs6 HVs5/6 HVs increased scores on case vignettes; Average score pretraining, 10.2; posttraining, 18.7
Davis et al, 199762aCBAParent advisor training vs no trainingHVs and CMOs6 HVs and 3 CMOsSignificant changes in counseling knowledge, perception of self as counselor, self-esteem, overall counseling ability and attending behavior
Hewitt et al, 199137aSBA2-day behavioral workshop on managing children's behavioral problems; Additional in vivo case supervision and trainingHVs9 HVsSignificant 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, 199563RCTOne of 2 communication-skills training courses designed to help physicians address patients' emotional distress vs no-training controlPCCs and their patients69 PCCs, 648 patientsTrained 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, 198864aRCT12-session intervention using behavior modification techniques vs delayedHVs and families on their caseload14 HVs and 205 familiesFew 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, 198865aCBAInstruction in behavior modification (manualized) and group meetingsHVs and children with sleep problemsNumber of HVs unclear, 51 childrenFew 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