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Reflective and Automatic Processes in Health Care Professional Behaviour: a Dual Process Model Tested Across Multiple Behaviours |
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| Authors: | Justin Presseau PhD Marie Johnston PhD Tarja Heponiemi PhD Marko Elovainio PhD Jill J Francis PhD Martin P Eccles MBBS MD FMedSci FRCP Nick Steen PhD Susan Hrisos MPhil Elaine Stamp MMathStat Jeremy M Grimshaw MBChB PhD FRCGP FCAHS Gillian Hawthorne MBBCH PhD FRCP Falko F Sniehotta PhD |
| Institution: | 1. Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK 2. Institute of Applied Health Sciences, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, UK 3. National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland 4. Institute of Behavioural Sciences, University of Helsinki, P.O Box 9, 00014, Helsinski, Finland 5. School of Health Sciences, City University London, Northampton Square, London, EC1V 0HB, UK 6. Clinical Epidemiology Program, Ottawa Hospital Research Institute and Department of Medicine, University of Ottawa, The Ottawa Hospital - General Campus, 501 Smyth Road, Box 711, Ottawa, ON, K1H 8L6, Canada 7. Fuse, The UK Clinical Research Collaboration Centre of Excellence in Translational Research in Public Health, Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK |
| Abstract: | BackgroundClinicians’ behaviours require deliberate decision-making in complex contexts and may involve both impulsive (automatic) and reflective (motivational and volitional) processes.PurposeThe purpose of this study was to test a dual process model applied to clinician behaviours in their management of type 2 diabetes.MethodsThe design used six nested prospective correlational studies. Questionnaires were sent to general practitioners and nurses in 99 UK primary care practices, measuring reflective (intention, action planning and coping planning) and impulsive (automaticity) predictors for six guideline-recommended behaviours: blood pressure prescribing (N?=?335), prescribing for glycemic control (N?=?288), providing diabetes-related education (N?=?346), providing weight advice (N?=?417), providing self-management advice (N?=?332) and examining the feet (N?=?218).ResultsRespondent retention was high. A dual process model was supported for prescribing behaviours, weight advice, and examining the feet. A sequential reflective process was supported for blood pressure prescribing, self-management and weight advice, and diabetes-related education.ConclusionsReflective and impulsive processes predict behaviour. Quality improvement interventions should consider both reflective and impulsive approaches to behaviour change. |
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