Theory-based predictors of multiple clinician behaviors in the management of diabetes

Justin Presseau, Marie Johnston, Jill J Francis, Susan Hrisos, Elaine Stamp, Nick Steen, Gillian Hawthorne, Jeremy M Grimshaw, Marko Elovainio, Margaret Hunter, Martin P Eccles

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Abstract

Behavioral theory is often tested on one behavior in isolation from other behaviors and theories. We aimed to test the predictive validity of constructs from motivation and action theories of behavior across six diabetes-related clinician behaviors, within the same sample of primary care clinicians. Physicians and nurses (n = 427 from 99 practices in the United Kingdom) completed questionnaires at baseline and 12 months. Primary outcomes: six self-reported clinician behaviors related to advising, prescribing and examining measured at 12 months; secondary outcomes: baseline intention and patient-scenario-based simulated behavior. Across six behaviors, each theory accounted for a medium amount of variance for 12-month behavior (median R adj (2)  = 0.15), large and medium amount of variance for two intention measures (median R adj (2)  = 0.66; 0.34), and small amount of variance for simulated behavior (median R adj (2)  = 0.05). Intention/proximal goals, self-efficacy, and habit predicted all behaviors. Constructs from social cognitive theory (self-efficacy), learning theory (habit) and action and coping planning consistently predicted multiple clinician behaviors and should be targeted by quality improvement interventions.
Original languageEnglish
Pages (from-to)607-620
Number of pages14
JournalJournal of Behavioral Medicine
Volume37
Issue number4
Early online date14 May 2013
DOIs
Publication statusPublished - Aug 2014

Keywords

  • clinician behaviour
  • intention
  • habit
  • multiple behaviors
  • planning
  • self-efficacy

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    Presseau, J., Johnston, M., Francis, J. J., Hrisos, S., Stamp, E., Steen, N., Hawthorne, G., Grimshaw, J. M., Elovainio, M., Hunter, M., & Eccles, M. P. (2014). Theory-based predictors of multiple clinician behaviors in the management of diabetes. Journal of Behavioral Medicine, 37(4), 607-620. https://doi.org/10.1007/s10865-013-9513-x