Browse by author
Lookup NU author(s): Professor Jeremy Grimshaw, Professor Martin Eccles, Dr Nick Steen
Background: Psychological models are used to understand and predict behaviour in a wide range of settings, but have not been consistently applied to health professional behaviours, and the contribution of differing theories is not clear. This study explored the usefulness of a range of models to predict an evidence-based behaviour --the placing of fissure sealants. Methods: Measures were collected by postal questionnaire from a random sample of general dental practitioners (GDPs) in Scotland. Outcomes were behavioural simulation (scenario decision-making), and behavioural intention. Predictor variables were from the Theory of Planned Behaviour (TPB), Social Cognitive Theory (SCT), Common Sense Self-regulation Model (CS-SRM), Operant Learning Theory (OLT), Implementation Intention (II), Stage Model, and knowledge (a non-theoretical construct). Multiple regression analysis was used to examine the predictive value of each theoretical model individually. Significant constructs from all theories were then entered into a 'cross theory' stepwise regression analysis to investigate their combined predictive value Results: Behavioural simulation - theory level variance explained was: TPB 31%; SCT 29%; II 7%; OLT 30%. Neither CS-SRM nor stage explained significant variance. In the cross theory analysis, habit (OLT), timeline acute (CS-SRM), and outcome expectancy (SCT) entered the equation, together explaining 38% of the variance. Behavioural intention theory level variance explained was: TPB 30%; SCT 24%; OLT 58%, CS-SRM 27%. GDPs in the action stage had significantly higher intention to place fissure sealants. In the cross theory analysis, habit (OLT) and attitude (TPB) entered the equation, together explaining 68% of the variance in intention. Summary: The study provides evidence that psychological models can be useful in understanding and predicting clinical behaviour. Taking a theory-based approach enables the creation of a replicable methodology for identifying factors that may predict clinical behaviour and so provide possible targets for knowledge translation interventions. Results suggest that more evidence-based behaviour may be achieved by influencing beliefs about the positive outcomes of placing fissure sealants and building a habit of placing them as part of patient management. However a number of conceptual and methodological challenges remain.
Author(s): Bonetti D, Johnston M, Clarkson JE, Grimshaw J, Pitts NB, Eccles M, Steen N, Thomas R, Maclennan G, Glidewell L, Walker A
Publication type: Article
Publication status: Published
Journal: Implementation Science
Year: 2010
Volume: 5
Issue: 1
Pages: 25
Print publication date: 08/04/2010
Date deposited: 26/05/2010
ISSN (print):
ISSN (electronic): 1748-5908
Publisher: BioMed Central Ltd.
URL: http://dx.doi.org/10.1186/1748-5908-5-25
DOI: 10.1186/1748-5908-5-25
Altmetrics provided by Altmetric
