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

• DOI: 10.1007/s10865-013-9513-x
• Publication Date: 2013-05-13T09:37:36Z
• Authors: 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
• Keywords: Male; multiple behaviors; Nurses; Intention; R Medicine; clinician behaviour; SDG 3 - Good Health and Well-being; Physicians; Adaptation, Psychological; Diabetes Mellitus; Humans; 0501 psychology and cognitive sciences; habit; Primary Health Care; 05 social sciences; R; Self Efficacy; 3. Good health; Patient Simulation; intention; Female; Clinical Competence; Self Report; planning; Psychological Theory; self-efficacy

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.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.