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

Lookup NU author(s): Dr Justin Presseau, Professor Marie Johnston, Dr Jill Francis, Dr Susan Moloney, Elaine Stamp, Dr Nick Steen, Dr Gillian Hawthorne, Professor Jeremy Grimshaw, Professor Martin Eccles


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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.

Publication metadata

Author(s): Presseau J, Johnston M, Francis JJ, Hrisos S, Stamp E, Steen N, Hawthorne G, Grimshaw JM, Elovainio M, Hunter M, Eccles MP

Publication type: Article

Publication status: Published

Journal: Journal of Behavioral Medicine

Year: 2013

Volume: 37

Issue: 4

Pages: 607-620

Print publication date: 14/05/2013

ISSN (print): 0160-7715

ISSN (electronic): 1573-3521

Publisher: Springer


DOI: 10.1007/s10865-013-9513-x


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