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

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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 2adj  = 0.15), large and medium amount of variance for two intention measures (median R 2adj  = 0.66; 0.34), and small amount of variance for simulated behavior (median R 2adj  = 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.

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Acknowledgments

The research was supported by a Grant from Diabetes UK (http://www.diabetes.org.uk/). JMG holds a Canada Research Chair in Health Knowledge Transfer and Uptake. JJF is funded by the Chief Scientist Office of the Scottish Government Health Directorates. The authors would like to thank the clinicians involved for their participation.

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Authors and Affiliations

  1. Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK

    Justin Presseau, Susan Hrisos, Elaine Stamp, Nick Steen, Margaret Hunter & Martin P. Eccles

  2. College of Life Sciences and Medicine, University of Aberdeen, Aberdeen, UK

    Marie Johnston

  3. School of Health Sciences, City University London, London, UK

    Jill J. Francis

  4. The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK

    Gillian Hawthorne

  5. Department of Medicine, University of Ottawa, Ottawa, ON, Canada

    Jeremy M. Grimshaw

  6. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada

    Jeremy M. Grimshaw

  7. National Institute for Health and Welfare, Helsinki, Finland

    Marko Elovainio

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  1. Justin Presseau
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  2. Marie Johnston
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  3. Jill J. Francis
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  4. Susan Hrisos
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  5. Elaine Stamp
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  6. Nick Steen
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  7. Gillian Hawthorne
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  8. Jeremy M. Grimshaw
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  10. Margaret Hunter
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  11. Martin P. Eccles
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Correspondence to Justin Presseau.

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Presseau, J., Johnston, M., Francis, J.J. et al. Theory-based predictors of multiple clinician behaviors in the management of diabetes. J Behav Med 37, 607–620 (2014). https://doi.org/10.1007/s10865-013-9513-x

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  • DOI: https://doi.org/10.1007/s10865-013-9513-x

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