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Objectives To evaluate the effect of training primary care health professionals in behaviour change counselling on the proportion of patients self reporting change in four risk behaviours (smoking, alcohol use, exercise, and healthy eating).

Design Cluster randomised trial with general practices as the unit of randomisation.

Setting General practices in Wales.

Participants 53 general practitioners and practice nurses from 27 general practices (one each at all but one practice) recruited 1827 patients who screened positive for at least one risky behaviour.

Intervention Behaviour change counselling was developed from motivational interviewing to enable clinicians to enhance patients’ motivation to change health related behaviour. Clinicians were trained using a blended learning programme called Talking Lifestyles.

Main outcome measures Proportion of patients who reported making beneficial changes in at least one of …