Reflective and automatic processes in healthcare professional behavior: A dual process model tested across multiple behaviors

Justin Presseau (Corresponding Author), Marie Johnston, Tarja Heponiemi, Marko Elovainio, Jill J Francis, Martin P Eccles, Nick Steen, Susan Hrisos, Elaine Stamp, Jeremy M Grimshaw, Gillian Hawthorne, Falko F Sniehotta

Research output: Contribution to journalArticle

33 Citations (Scopus)
114 Downloads (Pure)

Abstract

Background
Clinicians’ behaviours require deliberate decision-making in complex contexts and may involve both impulsive (automatic) and reflective (motivational and volitional) processes.
Purpose
The purpose of this study was to test a dual process model applied to clinician behaviours in their management of type 2 diabetes.
Methods
The design used six nested prospective correlational studies. Questionnaires were sent to general practitioners and nurses in 99 UK primary care practices, measuring reflective (intention, action planning and coping planning) and impulsive (automaticity) predictors for six guideline-recommended behaviours: blood pressure prescribing (N = 335), prescribing for glycemic control (N = 288), providing diabetes-related education (N = 346), providing weight advice (N = 417), providing self-management advice (N = 332) and examining the feet (N = 218).
Results
Respondent retention was high. A dual process model was supported for prescribing behaviours, weight advice, and examining the feet. A sequential reflective process was supported for blood pressure prescribing, self-management and weight advice, and diabetes-related education.
Conclusions
Reflective and impulsive processes predict behaviour. Quality improvement interventions should consider both reflective and impulsive approaches to behaviour change.
Original languageEnglish
Article number48
Pages (from-to)347-358
Number of pages12
JournalAnnals of Behavioral Medicine
Volume48
Issue number3
Early online date20 Mar 2014
DOIs
Publication statusPublished - Dec 2014

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Delivery of Health Care
Self Care
Weights and Measures
Foot
Blood Pressure
Education
Quality Improvement
General Practitioners
Type 2 Diabetes Mellitus
Primary Health Care
Decision Making
Nurses
Prospective Studies
Guidelines

Keywords

  • clinician behaviour
  • dual process
  • diabetes
  • motivation
  • volition
  • automaticity

Cite this

Reflective and automatic processes in healthcare professional behavior : A dual process model tested across multiple behaviors. / Presseau, Justin (Corresponding Author); Johnston, Marie; Heponiemi, Tarja; Elovainio, Marko; Francis, Jill J; Eccles, Martin P; Steen, Nick; Hrisos, Susan; Stamp, Elaine; Grimshaw, Jeremy M; Hawthorne, Gillian; Sniehotta, Falko F.

In: Annals of Behavioral Medicine, Vol. 48, No. 3, 48, 12.2014, p. 347-358.

Research output: Contribution to journalArticle

Presseau, J, Johnston, M, Heponiemi, T, Elovainio, M, Francis, JJ, Eccles, MP, Steen, N, Hrisos, S, Stamp, E, Grimshaw, JM, Hawthorne, G & Sniehotta, FF 2014, 'Reflective and automatic processes in healthcare professional behavior: A dual process model tested across multiple behaviors' Annals of Behavioral Medicine, vol. 48, no. 3, 48, pp. 347-358. https://doi.org/10.1007/s12160-014-9609-8
Presseau, Justin ; Johnston, Marie ; Heponiemi, Tarja ; Elovainio, Marko ; Francis, Jill J ; Eccles, Martin P ; Steen, Nick ; Hrisos, Susan ; Stamp, Elaine ; Grimshaw, Jeremy M ; Hawthorne, Gillian ; Sniehotta, Falko F. / Reflective and automatic processes in healthcare professional behavior : A dual process model tested across multiple behaviors. In: Annals of Behavioral Medicine. 2014 ; Vol. 48, No. 3. pp. 347-358.
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N2 - BackgroundClinicians’ behaviours require deliberate decision-making in complex contexts and may involve both impulsive (automatic) and reflective (motivational and volitional) processes.PurposeThe purpose of this study was to test a dual process model applied to clinician behaviours in their management of type 2 diabetes.MethodsThe design used six nested prospective correlational studies. Questionnaires were sent to general practitioners and nurses in 99 UK primary care practices, measuring reflective (intention, action planning and coping planning) and impulsive (automaticity) predictors for six guideline-recommended behaviours: blood pressure prescribing (N = 335), prescribing for glycemic control (N = 288), providing diabetes-related education (N = 346), providing weight advice (N = 417), providing self-management advice (N = 332) and examining the feet (N = 218).ResultsRespondent retention was high. A dual process model was supported for prescribing behaviours, weight advice, and examining the feet. A sequential reflective process was supported for blood pressure prescribing, self-management and weight advice, and diabetes-related education.ConclusionsReflective and impulsive processes predict behaviour. Quality improvement interventions should consider both reflective and impulsive approaches to behaviour change.

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