Applying psychological theory to evidence-based clinical practice: identifying factors predictive of taking intra-oral radiographs

Debbie Bonetti; Nigel B Pitts; Martin P Eccles; Jeremy M. Grimshaw; Marie Johnston; I Nick Steen; Liz Glidewell; Ruth Thomas; Graeme S MacLennan; Jan E Clarkson; Anne Walker

doi:10.1016/j.socscimed.2006.04.005

Applying psychological theory to evidence-based clinical practice: identifying factors predictive of taking intra-oral radiographs

Debbie Bonetti, Nigel B Pitts, Martin P Eccles, Jeremy M. Grimshaw, Marie Johnston, I Nick Steen, Liz Glidewell, Ruth Thomas, Graeme S MacLennan, Jan E Clarkson, Anne Walker

The Hull York Medical School

Research output: Contribution to journal › Article › peer-review

Abstract

This study applies psychological theory to the implementation of evidence-based clinical practice. The first objective was to see if variables from psychological frameworks (developed to understand, predict and influence behaviour) could predict an evidence-based clinical behaviour. The second objective was to develop a scientific rationale to design or choose an implementation intervention. Variables from the Theory of Planned Behaviour, Social Cognitive Theory, Self-Regulation Model, Operant Conditioning, Implementation Intentions and the Precaution Adoption Process were measured, with data collection by postal survey. The primary outcome was the number of intra-oral radiographs taken per course of treatment collected from a central fee claims database. Participants were 214 Scottish General Dental Practitioners. At the theory level, the Theory of Planned Behaviour explained 13% variance in the number of radiographs taken, Social Cognitive Theory explained 7%, Operant Conditioning explained 8%, Implementation Intentions explained 11%. Self-Regulation and Stage Theory did not predict significant variance in radiographs taken. Perceived behavioural control, action planning and risk perception explained 16% of the variance in number of radiographs taken. Knowledge did not predict the number of radiographs taken. The results suggest an intervention targeting predictive psychological variables could increase the implementation of this evidence-based practice, while influencing knowledge is unlikely to do so. Measures which predicted number of radiographs taken also predicted intention to take radiographs, and intention accounted for significant variance in behaviour (adjusted R(2)=5%: F(1,166)=10.28, p<.01), suggesting intention may be a possible proxy for behavioural data when testing an intervention prior to a service-level trial. Since psychological frameworks incorporate methodologies to measure and change component variables, taking a theory-based approach enabled the creation of a methodology that can be replicated for identifying factors predictive of clinical behaviour and for the design and choice of interventions to modify practice as new evidence emerges.

Original language	English
Pages (from-to)	1889-99
Number of pages	11
Journal	Social science and medicine
Volume	63
Issue number	7
DOIs	https://doi.org/10.1016/j.socscimed.2006.04.005
Publication status	Published - Oct 2006

Keywords

Adult
Cross-Sectional Studies
Dentists
Evidence-Based Medicine
Female
Humans
Male
Practice Patterns, Dentists'
Psychological Theory
Radiography, Dental
Regression Analysis
Scotland
Journal Article
Research Support, Non-U.S. Gov't

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10.1016/j.socscimed.2006.04.005

Cite this

Bonetti, D., Pitts, N. B., Eccles, M. P., Grimshaw, J. M., Johnston, M., Steen, I. N., Glidewell, L., Thomas, R., MacLennan, G. S., Clarkson, J. E., & Walker, A. (2006). Applying psychological theory to evidence-based clinical practice: identifying factors predictive of taking intra-oral radiographs. Social science and medicine, 63(7), 1889-99. https://doi.org/10.1016/j.socscimed.2006.04.005

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title = "Applying psychological theory to evidence-based clinical practice: identifying factors predictive of taking intra-oral radiographs",

abstract = "This study applies psychological theory to the implementation of evidence-based clinical practice. The first objective was to see if variables from psychological frameworks (developed to understand, predict and influence behaviour) could predict an evidence-based clinical behaviour. The second objective was to develop a scientific rationale to design or choose an implementation intervention. Variables from the Theory of Planned Behaviour, Social Cognitive Theory, Self-Regulation Model, Operant Conditioning, Implementation Intentions and the Precaution Adoption Process were measured, with data collection by postal survey. The primary outcome was the number of intra-oral radiographs taken per course of treatment collected from a central fee claims database. Participants were 214 Scottish General Dental Practitioners. At the theory level, the Theory of Planned Behaviour explained 13% variance in the number of radiographs taken, Social Cognitive Theory explained 7%, Operant Conditioning explained 8%, Implementation Intentions explained 11%. Self-Regulation and Stage Theory did not predict significant variance in radiographs taken. Perceived behavioural control, action planning and risk perception explained 16% of the variance in number of radiographs taken. Knowledge did not predict the number of radiographs taken. The results suggest an intervention targeting predictive psychological variables could increase the implementation of this evidence-based practice, while influencing knowledge is unlikely to do so. Measures which predicted number of radiographs taken also predicted intention to take radiographs, and intention accounted for significant variance in behaviour (adjusted R(2)=5%: F(1,166)=10.28, p<.01), suggesting intention may be a possible proxy for behavioural data when testing an intervention prior to a service-level trial. Since psychological frameworks incorporate methodologies to measure and change component variables, taking a theory-based approach enabled the creation of a methodology that can be replicated for identifying factors predictive of clinical behaviour and for the design and choice of interventions to modify practice as new evidence emerges.",

keywords = "Adult, Cross-Sectional Studies, Dentists, Evidence-Based Medicine, Female, Humans, Male, Practice Patterns, Dentists', Psychological Theory, Radiography, Dental, Regression Analysis, Scotland, Journal Article, Research Support, Non-U.S. Gov't",

author = "Debbie Bonetti and Pitts, {Nigel B} and Eccles, {Martin P} and Grimshaw, {Jeremy M.} and Marie Johnston and Steen, {I Nick} and Liz Glidewell and Ruth Thomas and MacLennan, {Graeme S} and Clarkson, {Jan E} and Anne Walker",

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doi = "10.1016/j.socscimed.2006.04.005",

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Bonetti, D, Pitts, NB, Eccles, MP, Grimshaw, JM, Johnston, M, Steen, IN, Glidewell, L, Thomas, R, MacLennan, GS, Clarkson, JE & Walker, A 2006, 'Applying psychological theory to evidence-based clinical practice: identifying factors predictive of taking intra-oral radiographs', Social science and medicine, vol. 63, no. 7, pp. 1889-99. https://doi.org/10.1016/j.socscimed.2006.04.005

TY - JOUR

T1 - Applying psychological theory to evidence-based clinical practice

T2 - identifying factors predictive of taking intra-oral radiographs

AU - Bonetti, Debbie

AU - Pitts, Nigel B

AU - Eccles, Martin P

AU - Grimshaw, Jeremy M.

AU - Johnston, Marie

AU - Steen, I Nick

AU - Glidewell, Liz

AU - Thomas, Ruth

AU - MacLennan, Graeme S

AU - Clarkson, Jan E

AU - Walker, Anne

PY - 2006/10

Y1 - 2006/10

N2 - This study applies psychological theory to the implementation of evidence-based clinical practice. The first objective was to see if variables from psychological frameworks (developed to understand, predict and influence behaviour) could predict an evidence-based clinical behaviour. The second objective was to develop a scientific rationale to design or choose an implementation intervention. Variables from the Theory of Planned Behaviour, Social Cognitive Theory, Self-Regulation Model, Operant Conditioning, Implementation Intentions and the Precaution Adoption Process were measured, with data collection by postal survey. The primary outcome was the number of intra-oral radiographs taken per course of treatment collected from a central fee claims database. Participants were 214 Scottish General Dental Practitioners. At the theory level, the Theory of Planned Behaviour explained 13% variance in the number of radiographs taken, Social Cognitive Theory explained 7%, Operant Conditioning explained 8%, Implementation Intentions explained 11%. Self-Regulation and Stage Theory did not predict significant variance in radiographs taken. Perceived behavioural control, action planning and risk perception explained 16% of the variance in number of radiographs taken. Knowledge did not predict the number of radiographs taken. The results suggest an intervention targeting predictive psychological variables could increase the implementation of this evidence-based practice, while influencing knowledge is unlikely to do so. Measures which predicted number of radiographs taken also predicted intention to take radiographs, and intention accounted for significant variance in behaviour (adjusted R(2)=5%: F(1,166)=10.28, p<.01), suggesting intention may be a possible proxy for behavioural data when testing an intervention prior to a service-level trial. Since psychological frameworks incorporate methodologies to measure and change component variables, taking a theory-based approach enabled the creation of a methodology that can be replicated for identifying factors predictive of clinical behaviour and for the design and choice of interventions to modify practice as new evidence emerges.

AB - This study applies psychological theory to the implementation of evidence-based clinical practice. The first objective was to see if variables from psychological frameworks (developed to understand, predict and influence behaviour) could predict an evidence-based clinical behaviour. The second objective was to develop a scientific rationale to design or choose an implementation intervention. Variables from the Theory of Planned Behaviour, Social Cognitive Theory, Self-Regulation Model, Operant Conditioning, Implementation Intentions and the Precaution Adoption Process were measured, with data collection by postal survey. The primary outcome was the number of intra-oral radiographs taken per course of treatment collected from a central fee claims database. Participants were 214 Scottish General Dental Practitioners. At the theory level, the Theory of Planned Behaviour explained 13% variance in the number of radiographs taken, Social Cognitive Theory explained 7%, Operant Conditioning explained 8%, Implementation Intentions explained 11%. Self-Regulation and Stage Theory did not predict significant variance in radiographs taken. Perceived behavioural control, action planning and risk perception explained 16% of the variance in number of radiographs taken. Knowledge did not predict the number of radiographs taken. The results suggest an intervention targeting predictive psychological variables could increase the implementation of this evidence-based practice, while influencing knowledge is unlikely to do so. Measures which predicted number of radiographs taken also predicted intention to take radiographs, and intention accounted for significant variance in behaviour (adjusted R(2)=5%: F(1,166)=10.28, p<.01), suggesting intention may be a possible proxy for behavioural data when testing an intervention prior to a service-level trial. Since psychological frameworks incorporate methodologies to measure and change component variables, taking a theory-based approach enabled the creation of a methodology that can be replicated for identifying factors predictive of clinical behaviour and for the design and choice of interventions to modify practice as new evidence emerges.

KW - Adult

KW - Cross-Sectional Studies

KW - Dentists

KW - Evidence-Based Medicine

KW - Female

KW - Humans

KW - Male

KW - Practice Patterns, Dentists'

KW - Psychological Theory

KW - Radiography, Dental

KW - Regression Analysis

KW - Scotland

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1016/j.socscimed.2006.04.005

DO - 10.1016/j.socscimed.2006.04.005

M3 - Article

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SN - 0277-9536

VL - 63

SP - 1889

EP - 1899

JO - Social science and medicine

JF - Social science and medicine

IS - 7

ER -