Paper-based and web-based intervention modeling experiments identified the same predictors of general practitioners' antibiotic-prescribing behavior

Shaun Treweek, Debbie Bonetti, Graeme Maclennan, Karen Barnett, Martin P Eccles, Claire Jones, Nigel B Pitts, Ian W Ricketts, Frank Sullivan, Mark Weal, Jill J Francis

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OBJECTIVES: To evaluate the robustness of the intervention modeling experiment (IME) methodology as a way of developing and testing behavioral change interventions before a full-scale trial by replicating an earlier paper-based IME.

STUDY DESIGN AND SETTING: Web-based questionnaire and clinical scenario study. General practitioners across Scotland were invited to complete the questionnaire and scenarios, which were then used to identify predictors of antibiotic-prescribing behavior. These predictors were compared with the predictors identified in an earlier paper-based IME and used to develop a new intervention.

RESULTS: Two hundred seventy general practitioners completed the questionnaires and scenarios. The constructs that predicted simulated behavior and intention were attitude, perceived behavioral control, risk perception/anticipated consequences, and self-efficacy, which match the targets identified in the earlier paper-based IME. The choice of persuasive communication as an intervention in the earlier IME was also confirmed. Additionally, a new intervention, an action plan, was developed.

CONCLUSION: A web-based IME replicated the findings of an earlier paper-based IME, which provides confidence in the IME methodology. The interventions will now be evaluated in the next stage of the IME, a web-based randomized controlled trial.

Original languageEnglish
Pages (from-to)296-304
Number of pages9
JournalJournal of Clinical Epidemiology
Issue number3
Early online date31 Dec 2013
Publication statusPublished - Mar 2014



  • anti-bacterial agents
  • general practitioners
  • humans
  • inappropriate prescribing
  • internet
  • models, theoretical
  • physician's practice patterns
  • questionnaires
  • research design
  • Scotland
  • self efficacy
  • intervention modeling experiments
  • behavior change
  • randomized controlled trials
  • intervention development
  • prescribing
  • primary care

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