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

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

    Research output: Contribution to journalArticle

    77 Citations (Scopus)

    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 R2=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 languageEnglish
    Pages (from-to)1889-1899
    Number of pages11
    JournalSocial Science and Medicine
    Volume63
    Issue number7
    DOIs
    Publication statusPublished - 2006

    Fingerprint

    Psychological Theory
    psychological theory
    Evidence-Based Practice
    Operant Conditioning
    cognitive theory
    evidence
    Psychology
    self-regulation
    conditioning
    Choice Behavior
    Fees and Charges
    methodology
    Proxy
    social behavior
    fee
    General Practitioners
    Tooth
    Clinical Practice
    Radiographs
    Databases

    Keywords

    • Evidence-based practice
    • Social cognitive theory
    • Intra-oral radiographs
    • Psychological frameworks
    • Theory of planned behaviour
    • Self-Regulation model
    • Dentists
    • Scotland

    Cite this

    Bonetti, Debbie ; Pitts, Nigel B. ; Eccles, Martin ; Grimshaw, Jeremy ; Johnston, Marie ; Steen, Nick ; Glidewell, Liz ; Thomas, Ruth ; Maclennan, Graeme ; Clarkson, Jan E. ; Walker, Anne. / Applying psychological theory to evidence-based clinical practice: identifying factors predictive of taking intra-oral radiographs. In: Social Science and Medicine. 2006 ; Vol. 63, No. 7. pp. 1889-1899.
    @article{433840b2554143248663f0efc979bc79,
    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 R2=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 = "Evidence-based practice, Social cognitive theory, Intra-oral radiographs, Psychological frameworks, Theory of planned behaviour, Self-Regulation model, Dentists, Scotland",
    author = "Debbie Bonetti and Pitts, {Nigel B.} and Martin Eccles and Jeremy Grimshaw and Marie Johnston and Nick Steen and Liz Glidewell and Ruth Thomas and Graeme Maclennan and Clarkson, {Jan E.} and Anne Walker",
    note = "dc.publisher: Elsevier",
    year = "2006",
    doi = "10.1016/j.socscimed.2006.04.005",
    language = "English",
    volume = "63",
    pages = "1889--1899",
    journal = "Social Science and Medicine",
    issn = "0277-9536",
    publisher = "Elsevier",
    number = "7",

    }

    Bonetti, D, Pitts, NB, Eccles, M, Grimshaw, J, Johnston, M, Steen, N, Glidewell, L, Thomas, R, Maclennan, G, 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. 1889-1899. https://doi.org/10.1016/j.socscimed.2006.04.005

    Applying psychological theory to evidence-based clinical practice: identifying factors predictive of taking intra-oral radiographs. / Bonetti, Debbie; Pitts, Nigel B.; Eccles, Martin; Grimshaw, Jeremy; Johnston, Marie; Steen, Nick; Glidewell, Liz; Thomas, Ruth; Maclennan, Graeme; Clarkson, Jan E.; Walker, Anne.

    In: Social Science and Medicine, Vol. 63, No. 7, 2006, p. 1889-1899.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Applying psychological theory to evidence-based clinical practice: identifying factors predictive of taking intra-oral radiographs

    AU - Bonetti, Debbie

    AU - Pitts, Nigel B.

    AU - Eccles, Martin

    AU - Grimshaw, Jeremy

    AU - Johnston, Marie

    AU - Steen, Nick

    AU - Glidewell, Liz

    AU - Thomas, Ruth

    AU - Maclennan, Graeme

    AU - Clarkson, Jan E.

    AU - Walker, Anne

    N1 - dc.publisher: Elsevier

    PY - 2006

    Y1 - 2006

    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 R2=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 R2=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 - Evidence-based practice

    KW - Social cognitive theory

    KW - Intra-oral radiographs

    KW - Psychological frameworks

    KW - Theory of planned behaviour

    KW - Self-Regulation model

    KW - Dentists

    KW - Scotland

    U2 - 10.1016/j.socscimed.2006.04.005

    DO - 10.1016/j.socscimed.2006.04.005

    M3 - Article

    VL - 63

    SP - 1889

    EP - 1899

    JO - Social Science and Medicine

    JF - Social Science and Medicine

    SN - 0277-9536

    IS - 7

    ER -