Supporting Health Behaviour Change in Real World General Practice: An evidence-informed report from Crete, Greece

Christos Lionis, Marilena Anastasaki, Sophia Papadakis

Keywords: health, behaviour, care, General Practice


Health behaviour change is key to the prevention and management of the majority of conditions and diseases seen in general practice. General practitioners (GPs) among others are important intermediaries to influencing behaviour change among patients and families. There is a growing body of evidence to support specific behaviour change techniques that can be integrated into routine practice.

Research questions:

What is the feasibility of adapting and implementinga training program inbehaviour changedeveloped in West Europe/North America for use in Southern European general practice settings?

To what extent are such efforts effective in knowledge, self-efficacy, and practice changes?


We report on key findings and lessons learned from two European research and one Greek collaborative projects focussed on behaviour change in primary care practice settings (TITAN, FRESH-AIR, VACCINATION-PHARMACISTS) which were implemented on Crete (Greece). The qualitative and quantitative findings generated from these projects were examined with a focus on smoking cessation, vaccination and adherence to rehabilitation behaviours. Particular attention has been given on methodological approaches incluing very brief advice (VBA), motivational interviewing, and action planning.


GPs exposed to the TITAN and VBA training intervention documented significant increases in knowledge, self-efficacy, and rates of tobacco treatment delivery between the pre-and post-assessment comparison with a control group. Missed opportunities for prevention in regards tobacco treatment delivery by GPs were highlighted. Screening and referral to pulmonary rehabilitation programmewas found to be feasible and acceptable.


Implementing behaviour change interventions after suitable adaptation for low-resource setting seems feasible and effective. This paper will provide evidence-based information to further integration of health behaviour interventions into research activities and clinical settings.

Points for discussion:

1. What approaches and methods for supporting patientbehavior change could effectively implemented in Southern European General Practice settings?

2. What factors can facilitate or impede the success of these intervention programmes?