title: Theory-based predictors of multiple clinician behaviors in the management of diabetes.
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.
  
  
  METHODS
  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.
authors.affiliation: Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK, justin.presseau@ncl.ac.uk.
authors.forename: Justin
authors.initials: J
authors.lastname: Presseau
authors.forename: Marie
authors.initials: M
authors.lastname: Johnston
authors.forename: Jill J
authors.initials: JJ
authors.lastname: Francis
authors.forename: Susan
authors.initials: S
authors.lastname: Hrisos
authors.forename: Elaine
authors.initials: E
authors.lastname: Stamp
authors.forename: Nick
authors.initials: N
authors.lastname: Steen
authors.forename: Gillian
authors.initials: G
authors.lastname: Hawthorne
authors.forename: Jeremy M
authors.initials: JM
authors.lastname: Grimshaw
authors.forename: Marko
authors.initials: M
authors.lastname: Elovainio
authors.forename: Margaret
authors.initials: M
authors.lastname: Hunter
authors.forename: Martin P
authors.initials: MP
authors.lastname: Eccles
mesh_terms: D000223:Adaptation, Psychological; D002983:Clinical Competence; D003920:Diabetes Mellitus / Q000523:psychology*; D005260:Female; D006801:Humans; D033182:Intention; D008297:Male; D009726:Nurses / Q000523:psychology*; D016544:Patient Simulation; D010820:Physicians / Q000523:psychology*; D011320:Primary Health Care; D011582:Psychological Theory; D020377:Self Efficacy; D057566:Self Report