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Applying psychological theories to evidence-based clinical practice

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Applying psychological theories to evidence-based clinical practice : identifying factors predictive of lumbar spine x-ray for low back pain in UK primary care practice. / Grimshaw, Jeremy M.; Eccles, Martin P.; Steen, Nick; Johnston, Marie; Pitts, Nigel B.; Glidewell, Liz; Maclennan, Graeme; Thomas, Ruth; Bonetti, Debbie; Walker, Anne.

In: Implementation Science, Vol. 6, 55, 28.05.2011, p. -.

Research output: Contribution to journalArticle

Harvard

Grimshaw, JM, Eccles, MP, Steen, N, Johnston, M, Pitts, NB, Glidewell, L, Maclennan, G, Thomas, R, Bonetti, D & Walker, A 2011, 'Applying psychological theories to evidence-based clinical practice: identifying factors predictive of lumbar spine x-ray for low back pain in UK primary care practice' Implementation Science, vol 6, 55, pp. -., 10.1186/1748-5908-6-55

APA

Grimshaw, J. M., Eccles, M. P., Steen, N., Johnston, M., Pitts, N. B., Glidewell, L., ... Walker, A. (2011). Applying psychological theories to evidence-based clinical practice: identifying factors predictive of lumbar spine x-ray for low back pain in UK primary care practice. Implementation Science, 6, -. [55]. 10.1186/1748-5908-6-55

Vancouver

Grimshaw JM, Eccles MP, Steen N, Johnston M, Pitts NB, Glidewell L et al. Applying psychological theories to evidence-based clinical practice: identifying factors predictive of lumbar spine x-ray for low back pain in UK primary care practice. Implementation Science. 2011 May 28;6:-. 55. Available from: 10.1186/1748-5908-6-55

Author

Grimshaw, Jeremy M.; Eccles, Martin P.; Steen, Nick; Johnston, Marie; Pitts, Nigel B.; Glidewell, Liz; Maclennan, Graeme; Thomas, Ruth; Bonetti, Debbie; Walker, Anne / Applying psychological theories to evidence-based clinical practice : identifying factors predictive of lumbar spine x-ray for low back pain in UK primary care practice.

In: Implementation Science, Vol. 6, 55, 28.05.2011, p. -.

Research output: Contribution to journalArticle

Bibtex - Download

@article{da6f42f2021548babe6373c1e0644f24,
title = "Applying psychological theories to evidence-based clinical practice: identifying factors predictive of lumbar spine x-ray for low back pain in UK primary care practice",
keywords = "RESPONSE RATES, BEHAVIOR, PROFESSIONALS, INTERVENTIONS, REFERRALS, FEEDBACK, QUALITY, AUDIT, TRIAL",
author = "Grimshaw, {Jeremy M.} and Eccles, {Martin P.} and Nick Steen and Marie Johnston and Pitts, {Nigel B.} and Liz Glidewell and Graeme Maclennan and Ruth Thomas and Debbie Bonetti and Anne Walker",
year = "2011",
doi = "10.1186/1748-5908-6-55",
volume = "6",
pages = "--",
journal = "Implementation Science",
issn = "1748-5908",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Applying psychological theories to evidence-based clinical practice

T2 - identifying factors predictive of lumbar spine x-ray for low back pain in UK primary care practice

A1 - Grimshaw,Jeremy M.

A1 - Eccles,Martin P.

A1 - Steen,Nick

A1 - Johnston,Marie

A1 - Pitts,Nigel B.

A1 - Glidewell,Liz

A1 - Maclennan,Graeme

A1 - Thomas,Ruth

A1 - Bonetti,Debbie

A1 - Walker,Anne

AU - Grimshaw,Jeremy M.

AU - Eccles,Martin P.

AU - Steen,Nick

AU - Johnston,Marie

AU - Pitts,Nigel B.

AU - Glidewell,Liz

AU - Maclennan,Graeme

AU - Thomas,Ruth

AU - Bonetti,Debbie

AU - Walker,Anne

PY - 2011/5/28

Y1 - 2011/5/28

N2 - <p>Background: Psychological models predict behaviour in a wide range of settings. The aim of this study was to explore the usefulness of a range of psychological models to predict the health professional behaviour 'referral for lumbar spine x-ray in patients presenting with low back pain' by UK primary care physicians.</p><p>Methods: Psychological measures were collected by postal questionnaire survey from a random sample of primary care physicians in Scotland and north England. The outcome measures were clinical behaviour (referral rates for lumbar spine x-rays), behavioural simulation (lumbar spine x-ray referral decisions based upon scenarios), and behavioural intention (general intention to refer for lumbar spine x-rays in patients with low back pain). Explanatory variables were the constructs within the Theory of Planned Behaviour (TPB), Social Cognitive Theory (SCT), Common Sense Self-Regulation Model (CS-SRM), Operant Learning Theory (OLT), Implementation Intention (II), Weinstein's Stage Model termed the Precaution Adoption Process (PAP), and knowledge. For each of the outcome measures, a generalised linear model was used to examine the predictive value of each theory individually. Linear regression was used for the intention and simulation outcomes, and negative binomial regression was used for the behaviour outcome. Following this 'theory level' analysis, a 'cross-theoretical construct' analysis was conducted to investigate the combined predictive value of all individual constructs across theories.</p><p>Results: Constructs from TPB, SCT, CS-SRM, and OLT predicted behaviour; however, the theoretical models did not fit the data well. When predicting behavioural simulation, the proportion of variance explained by individual theories was TPB 11.6%, SCT 12.1%, OLT 8.1%, and II 1.5% of the variance, and in the cross-theory analysis constructs from TPB, CS-SRM and II explained 16.5% of the variance in simulated behaviours. When predicting intention, the proportion of variance explained by individual theories was TPB 25.0%, SCT 21.5%, CS-SRM 11.3%, OLT 26.3%, PAP 2.6%, and knowledge 2.3%, and in the cross-theory analysis constructs from TPB, SCT, CS-SRM, and OLT explained 33.5% variance in intention. Together these results suggest that physicians' beliefs about consequences and beliefs about capabilities are likely determinants of lumbar spine x-ray referrals.</p><p>Conclusions: The study provides evidence that taking a theory-based approach enables the creation of a replicable methodology for identifying factors that predict clinical behaviour. However, a number of conceptual and methodological challenges remain.</p>

AB - <p>Background: Psychological models predict behaviour in a wide range of settings. The aim of this study was to explore the usefulness of a range of psychological models to predict the health professional behaviour 'referral for lumbar spine x-ray in patients presenting with low back pain' by UK primary care physicians.</p><p>Methods: Psychological measures were collected by postal questionnaire survey from a random sample of primary care physicians in Scotland and north England. The outcome measures were clinical behaviour (referral rates for lumbar spine x-rays), behavioural simulation (lumbar spine x-ray referral decisions based upon scenarios), and behavioural intention (general intention to refer for lumbar spine x-rays in patients with low back pain). Explanatory variables were the constructs within the Theory of Planned Behaviour (TPB), Social Cognitive Theory (SCT), Common Sense Self-Regulation Model (CS-SRM), Operant Learning Theory (OLT), Implementation Intention (II), Weinstein's Stage Model termed the Precaution Adoption Process (PAP), and knowledge. For each of the outcome measures, a generalised linear model was used to examine the predictive value of each theory individually. Linear regression was used for the intention and simulation outcomes, and negative binomial regression was used for the behaviour outcome. Following this 'theory level' analysis, a 'cross-theoretical construct' analysis was conducted to investigate the combined predictive value of all individual constructs across theories.</p><p>Results: Constructs from TPB, SCT, CS-SRM, and OLT predicted behaviour; however, the theoretical models did not fit the data well. When predicting behavioural simulation, the proportion of variance explained by individual theories was TPB 11.6%, SCT 12.1%, OLT 8.1%, and II 1.5% of the variance, and in the cross-theory analysis constructs from TPB, CS-SRM and II explained 16.5% of the variance in simulated behaviours. When predicting intention, the proportion of variance explained by individual theories was TPB 25.0%, SCT 21.5%, CS-SRM 11.3%, OLT 26.3%, PAP 2.6%, and knowledge 2.3%, and in the cross-theory analysis constructs from TPB, SCT, CS-SRM, and OLT explained 33.5% variance in intention. Together these results suggest that physicians' beliefs about consequences and beliefs about capabilities are likely determinants of lumbar spine x-ray referrals.</p><p>Conclusions: The study provides evidence that taking a theory-based approach enables the creation of a replicable methodology for identifying factors that predict clinical behaviour. However, a number of conceptual and methodological challenges remain.</p>

KW - RESPONSE RATES

KW - BEHAVIOR

KW - PROFESSIONALS

KW - INTERVENTIONS

KW - REFERRALS

KW - FEEDBACK

KW - QUALITY

KW - AUDIT

KW - TRIAL

U2 - 10.1186/1748-5908-6-55

DO - 10.1186/1748-5908-6-55

M1 - Article

JO - Implementation Science

JF - Implementation Science

SN - 1748-5908

VL - 6

SP - -

ER -

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