title: Theory in practice: helping providers address depression in diabetes care.
abstract: BACKGROUND
  A continuing education (CE) program based on the theory of planned behavior was designed to understand and improve health care providers' practice patterns in screening, assessing, and treating and/or referring patients with diabetes for depression treatment.
  
  
  METHODS
  Participants completed assessments of attitudes, confidence, intentions, and behaviors regarding depression management at 3 time points: immediately prior to the CE program (baseline), immediately after the CE program (posttest) and 6 weeks after the CE program (follow-up).
  
  
  RESULTS
  Ninety-eight providers attended the CE program: 71 completed the baseline assessment, 66 completed the posttest assessment, and 37 completed the 6-week follow-up. Compared to baseline, at posttest providers reported significantly more favorable attitudes, fewer negative attitudes, greater confidence, and greater intention to address depression with their diabetes patients. At the 6-week follow-up, participants reported a marginally significant increase in educating patients about depression, but no other depression management practices changed. Intention to change and confidence predicted some depression practice patterns at follow-up. Fewer barriers were a consistent predictor of depression practice patterns at follow-up.
  
  
  CONCLUSIONS
  In the short term, provider attitudes, confidence, and intentions to address depression with their patients improved. Intentions, confidence, and especially barriers are important intervention targets.
authors.affiliation: Division of General Internal Medicine and Public Health, Vanderbilt Eskind Diabetes Center, Vanderbilt University Medical Center, USA.
authors.forename: Chandra Y
authors.initials: CY
authors.lastname: Osborn
authors.forename: Cindy
authors.initials: C
authors.lastname: Kozak
authors.forename: Julie
authors.initials: J
authors.lastname: Wagner
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003863:Depression / Q000628:therapy*; D003920:Diabetes Mellitus / Q000523:psychology* / Q000628:therapy; D004496:Education, Continuing; D005260:Female; D005500:Follow-Up Studies; D006282:Health Personnel / Q000193:education* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010818:Practice Patterns, Physicians'; D015397:Program Evaluation