Planning to be routine

habit as a mediator of the planning-behaviour relationship in healthcare professionals

Sebastian Potthoff, Justin Presseau, Falko F Sniehotta, Marie Johnston, Marko Elovainio, Leah Avery

Research output: Contribution to journalArticle

11 Citations (Scopus)
5 Downloads (Pure)

Abstract

Background
Gaps in the quality of care provided to people with type 2 diabetes are regularly identified. Healthcare professionals often have a strong intention to follow practice guidelines during consultations with people with type 2 diabetes; however, this intention does not always translate into action. Action planning (planning when, where and how to act) and coping planning (planning how to overcome pre-identified barriers) have been hypothesised to help with the enactment of intentions by creating mental cue-response links that promote habit formation. This study aimed to investigate whether habit helps to better understand how action and coping planning relate to clinical behaviour in the context of type 2 diabetes care.

Methods
The study utilised a prospective correlational design with six nested sub-studies. General practitioners and practice nurses (n = 427 from 99 UK primary care practices) completed measures of action planning, coping planning and habit at baseline and then self-reported their enactment of guideline-recommended advising, prescribing and examining behaviours 12 months later. Bootstrapped mediation analyses were used to test the indirect effect of action and coping planning on healthcare professionals’ clinical behaviour via their relationship with habit.

Results
Healthcare professionals who reported higher degrees of action or coping planning for performing six guideline recommended behaviours in the context of type 2 diabetes care were more likely to report performing these behaviours in clinical practice. All 12 bootstrapped mediation analyses showed that the positive relationship between planning (action and coping planning) and healthcare professionals’ clinical behaviour operated indirectly through habit.

Conclusions
These findings suggest that habit mediates the relationship between planning (action and coping planning) and healthcare professional behaviour. Promoting careful action and coping planning may support routinised uptake of guideline-recommended care by healthcare professionals in the primary care setting. Given the competing demands on healthcare professionals, exploring the behavioural processes involved in promoting more routinisation of behaviours where possible and appropriate could free up cognitive capacity for clinical behaviours that rely on more deliberation.
Original languageEnglish
Article number24
JournalImplementation Science
Volume12
DOIs
Publication statusPublished - 21 Feb 2017

Fingerprint

Habits
Delivery of Health Care
Type 2 Diabetes Mellitus
Guidelines
Primary Health Care
Quality of Health Care
Practice Guidelines
General Practice
General Practitioners
Cues
Referral and Consultation
Nurses

Keywords

  • habit
  • intention
  • action planning
  • coping planning
  • healthcare professionals
  • implementation intentions
  • automaticity
  • primary care
  • type 2 diabetes

Cite this

Planning to be routine : habit as a mediator of the planning-behaviour relationship in healthcare professionals. / Potthoff, Sebastian; Presseau, Justin; Sniehotta, Falko F; Johnston, Marie; Elovainio, Marko; Avery, Leah.

In: Implementation Science, Vol. 12, 24, 21.02.2017.

Research output: Contribution to journalArticle

Potthoff, Sebastian ; Presseau, Justin ; Sniehotta, Falko F ; Johnston, Marie ; Elovainio, Marko ; Avery, Leah. / Planning to be routine : habit as a mediator of the planning-behaviour relationship in healthcare professionals. In: Implementation Science. 2017 ; Vol. 12.
@article{98e66d13d67e4ffb848f5101683aec49,
title = "Planning to be routine: habit as a mediator of the planning-behaviour relationship in healthcare professionals",
abstract = "BackgroundGaps in the quality of care provided to people with type 2 diabetes are regularly identified. Healthcare professionals often have a strong intention to follow practice guidelines during consultations with people with type 2 diabetes; however, this intention does not always translate into action. Action planning (planning when, where and how to act) and coping planning (planning how to overcome pre-identified barriers) have been hypothesised to help with the enactment of intentions by creating mental cue-response links that promote habit formation. This study aimed to investigate whether habit helps to better understand how action and coping planning relate to clinical behaviour in the context of type 2 diabetes care.MethodsThe study utilised a prospective correlational design with six nested sub-studies. General practitioners and practice nurses (n = 427 from 99 UK primary care practices) completed measures of action planning, coping planning and habit at baseline and then self-reported their enactment of guideline-recommended advising, prescribing and examining behaviours 12 months later. Bootstrapped mediation analyses were used to test the indirect effect of action and coping planning on healthcare professionals’ clinical behaviour via their relationship with habit.ResultsHealthcare professionals who reported higher degrees of action or coping planning for performing six guideline recommended behaviours in the context of type 2 diabetes care were more likely to report performing these behaviours in clinical practice. All 12 bootstrapped mediation analyses showed that the positive relationship between planning (action and coping planning) and healthcare professionals’ clinical behaviour operated indirectly through habit.ConclusionsThese findings suggest that habit mediates the relationship between planning (action and coping planning) and healthcare professional behaviour. Promoting careful action and coping planning may support routinised uptake of guideline-recommended care by healthcare professionals in the primary care setting. Given the competing demands on healthcare professionals, exploring the behavioural processes involved in promoting more routinisation of behaviours where possible and appropriate could free up cognitive capacity for clinical behaviours that rely on more deliberation.",
keywords = "habit, intention, action planning, coping planning, healthcare professionals, implementation intentions, automaticity, primary care, type 2 diabetes",
author = "Sebastian Potthoff and Justin Presseau and Sniehotta, {Falko F} and Marie Johnston and Marko Elovainio and Leah Avery",
note = "The research was supported by a grant from Diabetes UK (06/0003342). SP holds a Health Foundation Improvement Science Doctoral Fellowship.",
year = "2017",
month = "2",
day = "21",
doi = "10.1186/s13012-017-0551-6",
language = "English",
volume = "12",
journal = "Implementation Science",
issn = "1748-5908",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Planning to be routine

T2 - habit as a mediator of the planning-behaviour relationship in healthcare professionals

AU - Potthoff, Sebastian

AU - Presseau, Justin

AU - Sniehotta, Falko F

AU - Johnston, Marie

AU - Elovainio, Marko

AU - Avery, Leah

N1 - The research was supported by a grant from Diabetes UK (06/0003342). SP holds a Health Foundation Improvement Science Doctoral Fellowship.

PY - 2017/2/21

Y1 - 2017/2/21

N2 - BackgroundGaps in the quality of care provided to people with type 2 diabetes are regularly identified. Healthcare professionals often have a strong intention to follow practice guidelines during consultations with people with type 2 diabetes; however, this intention does not always translate into action. Action planning (planning when, where and how to act) and coping planning (planning how to overcome pre-identified barriers) have been hypothesised to help with the enactment of intentions by creating mental cue-response links that promote habit formation. This study aimed to investigate whether habit helps to better understand how action and coping planning relate to clinical behaviour in the context of type 2 diabetes care.MethodsThe study utilised a prospective correlational design with six nested sub-studies. General practitioners and practice nurses (n = 427 from 99 UK primary care practices) completed measures of action planning, coping planning and habit at baseline and then self-reported their enactment of guideline-recommended advising, prescribing and examining behaviours 12 months later. Bootstrapped mediation analyses were used to test the indirect effect of action and coping planning on healthcare professionals’ clinical behaviour via their relationship with habit.ResultsHealthcare professionals who reported higher degrees of action or coping planning for performing six guideline recommended behaviours in the context of type 2 diabetes care were more likely to report performing these behaviours in clinical practice. All 12 bootstrapped mediation analyses showed that the positive relationship between planning (action and coping planning) and healthcare professionals’ clinical behaviour operated indirectly through habit.ConclusionsThese findings suggest that habit mediates the relationship between planning (action and coping planning) and healthcare professional behaviour. Promoting careful action and coping planning may support routinised uptake of guideline-recommended care by healthcare professionals in the primary care setting. Given the competing demands on healthcare professionals, exploring the behavioural processes involved in promoting more routinisation of behaviours where possible and appropriate could free up cognitive capacity for clinical behaviours that rely on more deliberation.

AB - BackgroundGaps in the quality of care provided to people with type 2 diabetes are regularly identified. Healthcare professionals often have a strong intention to follow practice guidelines during consultations with people with type 2 diabetes; however, this intention does not always translate into action. Action planning (planning when, where and how to act) and coping planning (planning how to overcome pre-identified barriers) have been hypothesised to help with the enactment of intentions by creating mental cue-response links that promote habit formation. This study aimed to investigate whether habit helps to better understand how action and coping planning relate to clinical behaviour in the context of type 2 diabetes care.MethodsThe study utilised a prospective correlational design with six nested sub-studies. General practitioners and practice nurses (n = 427 from 99 UK primary care practices) completed measures of action planning, coping planning and habit at baseline and then self-reported their enactment of guideline-recommended advising, prescribing and examining behaviours 12 months later. Bootstrapped mediation analyses were used to test the indirect effect of action and coping planning on healthcare professionals’ clinical behaviour via their relationship with habit.ResultsHealthcare professionals who reported higher degrees of action or coping planning for performing six guideline recommended behaviours in the context of type 2 diabetes care were more likely to report performing these behaviours in clinical practice. All 12 bootstrapped mediation analyses showed that the positive relationship between planning (action and coping planning) and healthcare professionals’ clinical behaviour operated indirectly through habit.ConclusionsThese findings suggest that habit mediates the relationship between planning (action and coping planning) and healthcare professional behaviour. Promoting careful action and coping planning may support routinised uptake of guideline-recommended care by healthcare professionals in the primary care setting. Given the competing demands on healthcare professionals, exploring the behavioural processes involved in promoting more routinisation of behaviours where possible and appropriate could free up cognitive capacity for clinical behaviours that rely on more deliberation.

KW - habit

KW - intention

KW - action planning

KW - coping planning

KW - healthcare professionals

KW - implementation intentions

KW - automaticity

KW - primary care

KW - type 2 diabetes

U2 - 10.1186/s13012-017-0551-6

DO - 10.1186/s13012-017-0551-6

M3 - Article

VL - 12

JO - Implementation Science

JF - Implementation Science

SN - 1748-5908

M1 - 24

ER -