“By creating we think, by living we learn” Patrick Geddes
Medical Reseach Council
Professor Nigel Pitts
Prof M Johnston, University of Aberdeen; Prof M Eccles and Mr N Steen, University of Newcastle-upon-Tyne, Prof J. Grimshaw, Ottawa
The aim of this study was to establish a scientific rationale for interventions
to translate research findings into clinical practice. We identified scientifically
validated models of behaviour that: had been rigorously evaluated; explain behaviour
in terms of factors amenable to change; allow the examination of the influence
of perceived external factors; and d) include non-volitional components.
The objectives were:
1) To amplify and populate these theories with evidence from the experience
of health professionals;
2) To use the theories identified and the evidence gained in (1) as a basis
for developing predictive questionnaires using replicable methods;
3) To identify which elements of the questionnaire (i.e., which theoretical
constructs) predict clinical practice and distinguish between evidence compliant
and non-compliant practice;
4) On the basis of these results, to identify variables (based on theoretical
constructs) that might be prime targets for interventions.
Five studies were conducted, two focused on general medical practice, three focused on general dental practice. In each study, the initial stage involved semi-structured interviews with GPs and GDPs which were then coded and analysed within the theoretical frameworks used in the work. These analyses were used to develop postal surveys to identify which variables (theoretical constructs) predicted clinical practice, as assessed from routinely collected clinical data. These data were primarily analysed using multiple regression techniques.
A systematic review in progress has identified 12 published studies where psychological models have been used to predict clinical behaviour; only five of these used objectively measured rather than self-reported measures of behaviour. This work has doubled the world literature in this area.