​​​​Division of Family Medicine and Primary Care

P​atie​nt education and counselling​​​

The Division has a number of initiatives in the field of patient education and counselling.

Brief behavior change counselling

ec1.pngDr Zelra Malan (​​zmalan@sun.ac.za) leads our initiative on brief behavior change counselling (BBCC). This is a new model that combines the 5 As (Ask, Alert, Assess, Assist and Arrange) with a guiding style derived from motivational interviewing. There is local evidence to support the effectiveness of this approach. In her PhD, she performed a situational analysis of current training of primary care providers in BBCC, developed the new model of BBCC, developed a training programme for BBCC and showed that training led to change in clinical practice. Subsequent work has validated a tool to measure BBCC. The Division regularly offers training opportunities in BBCC and further research will continue to evaluate the model. Courses are aimed at primary care providers.​

In conjunction with BBCC a series of patient education leaflets were developed on the four commonest risky behaviours linked to non-communicable diseases: unhealthy eating, tobacco smoking, physical inactivity and harmful alcohol use. These were embedded in a campaign called ichange4health and sponsored by Pharmadynamics.​


Mo​​tivational interviewing

ec2.pngMs Loren Human (lorenj@sun.ac.za) leads our initiative on motivational interviewing. Motivational interviewing is an approach to helping people change behavior. Originally developed in the field of addictions it is now used in general medical settings where behavior change is discussed. The Division has had a long history of teaching motivational interviewing and has initiated the Motivational Interviewing Southern Africa network. The Division has produced a variety of educational resources and regularly runs courses for beginners in motivational interviewing. Courses are aimed at a wide variety of practitioners such as psychologists, psychiatrists, social workers, family physicians and others.

In March 2020 we will also be organizing a Training of Trainers in MI and an Advanced Practitioners course with Prof Steve Rollnick one of the founders of MI.


Grou​p empowerment and training (GREAT) for diabetes

ec3.pngDr Joleen Cairncross (jcairncross@sun.ac.za) leads our initiative on implementing GREAT for diabetes. GREAT for diabetes is being implemented nationally in all provinces with a grant from the World Diabetes Foundation and in collaboration with the National Department of Health. Sr Buyelwa Majikela-Dlangamandla from the Chronic Disease Initiative for Africa is assisting with the project. GREAT for diabetes consist of 4 sessions of group education and empowerment that are delivered with a guiding style derived from MI. Click here to download a brochure on the initiative.

Sr Buyelwa Majikela-Dlangamandla has also published a booklet for patients and facilitators of GREAT for diabetes. Click here if you would like to place an order.

Dr Zimbini Ogle will be leading research into the implementation of GREAT for diabetes, with a grant from the Medical Research Council and Global Alliance on Chronic Diseases. This research is due to begin in 2020.

I have prepared this brief video update on Group Empowerment and Training (GREAT) for diabetes for the Global Alliance on Chronic Diseases who are funding the evaluation via the South African Medical Research Council.​ Evaluating Group Empowerment and Training for diabetes in South Africa​

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Comprehensive patient education and counselling for non-communicable diseases

Dr Joleen Cairncross (jcairncross@sun.ac.za​) also leads this project at two health centres, one in the Metropole at Symphony Way, and one in the rural Cape Winelands, at Cloetesville. This project is funded by a grant from the German Federal Ministry in Education and Research and is part of a larger body of work under CEBHA (Collaboration for Evidence-Based health Care and Public Health in Africa). The project explores how to implement individual and group counselling for diabetes, hypertension, asthma and chronic obstructive pulmonary disease in primary care in order to improve self-management and control of these common conditions.​