Information about barriers to planned change

Mazmanian, Paul E.; Daffron, Sandra; Johnson, Raymond E.; Davis, Dave; Kantrowitz, Martin P.

doi:10.1097/00001888-199808000-00013

Cited by 84 publications

(13 citation statements)

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“…We included information about barriers in our CE, yet past findings show that learners who receive such information do not change more than learners who do not 48. Webb and Sheeran49 outlines three classes of factors that may moderate whether an intention to change behavior results in that new behavior.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to enhancing intentions to change, CE programs should elicit commitments to change by having providers explicitly indicate an intention to make a change as a result of an educational activity (e.g., asking providers to indicate whether they would change practice as a result of the CE program). Statements of commitment to change have been advocated to both stimulate and assess the effectiveness of CE programs 37, 48, 52, 53, and might serve to improve the efficacy of the CE program described here. CE programs that include strategies to effectively help providers overcome barriers to managing depression in clinical care are also needed.…”

Section: Discussionmentioning

confidence: 99%

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Theory in practice: Helping providers address depression in diabetes care *

Osborn

Kozak

Wagner

2010

Journal of Continuing Education in the Health Professions

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Introduction A Continuing Education (CE) program based on the theory of planned behavior was designed to understand and improve health care providers’ practice patterns in screening, assessing, and treating and/or referring patients with diabetes for depression treatment. Methods Participants completed assessments of attitudes, confidence, intentions, and behaviors regarding depression management at three time points: immediately prior to the CE program (baseline), immediately after the CE program (posttest) and six-weeks after the CE program (follow-up). Results Ninety eight providers attended the CE program; 71 completed the baseline assessment; 66 completed the posttest assessment, and 37 completed the 6-week follow-up. Compared to baseline, at posttest providers reported significantly more favorable attitudes, fewer negative attitudes, greater confidence, and greater intention to address depression with their diabetes patients. At six weeks follow-up, there was a marginally significant increase in educating patients about depression, but no other depression management practices changed. Intention to change and confidence predicted some depression practice patterns at follow-up. Fewer barriers were a consistent predictor of depression practice patterns at follow-up. Discussion In the short-term, provider attitudes, confidence, and intentions to address depression with their patients improved. Intention, confidence, and especially barriers are important intervention targets. Lessons for Practice Depression is a common comorbidity of diabetes. Healthcare providers must be better prepared to manage depression in their diabetes patients. Educating health professionals is one approach to improving depression care. Healthcare systems must address barriers to providers’ efforts to manage depression. Continuing education programs should aim to enhance providers’ intentions, confidence, and skills to overcome barriers to addressing depression in clinical care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Theory in practice: Helping providers address depression in diabetes care *

Osborn

Kozak

Wagner

2010

Journal of Continuing Education in the Health Professions

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“…It has been used in over 1,000 studies, including more than 200 randomized controlled trials in the health promotion field but also in other contexts. ' 2~1 3 The model guides the participation of credible influential stakeholders through a comprehensive diagnostic process to better understand the nature of the problem of concern (social and epidemiologic concerns), as well as the identification of behavioral and nonbehavioral factors that contribute to the problem or would enable or hinder desired changes. PRECEDE and PRO-CEED are acronyms for determinants of behav-ior change.…”

Section: Theoretical Frameworkmentioning

confidence: 99%

Commitment to change instrument enhances program planning, implementation, and evaluation

White¹,

Grzybowski

Broudo

2004

Journal of Continuing Education in the Health Professions

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“…A previous study has shown that physicians who attended educational lecture were significantly more likely to change their clinical behavior if they indicated an intent to change prior to the lecture [13]. We hypothesized doctors who voluntarily accessed an educational opportunity would already have relatively high motivation to treat patients with depression.…”

Section: Introductionmentioning

confidence: 99%

Attitudes toward depression among Japanese non-psychiatric medical doctors: a cross-sectional study

Ohtsuki

Kodaka

Sakai³

et al. 2012

BMC Res Notes

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BackgroundUnder-recognition of depression is common in many countries. Education of medical staff, focusing on their attitudes towards depression, may be necessary to change their behavior and enhance recognition of depression. Several studies have previously reported on attitudes toward depression among general physicians. However, little is known about attitudes of non-psychiatric doctors in Japan. In the present study, we surveyed non-psychiatric doctors’ attitude toward depression.MethodsThe inclusion criteria of participants in the present study were as follows: 1) Japanese non-psychiatric doctors and 2) attendees in educational opportunities regarding depression care. We conveniently approached two populations: 1) a workshop to depression care for non-psychiatric doctors and 2) a general physician-psychiatrist (G-P) network group. We contacted 367 subjects. Attitudes toward depression were measured using the Depression Attitude Questionnaire (DAQ), a 20-item self-report questionnaire developed for general physicians. We report scores of each DAQ item and factors derived from exploratory factor analysis.ResultsWe received responses from 230 subjects, and we used DAQ data from 187 non-psychiatric doctors who met the inclusion criteria. All non-psychiatric doctors (n = 187) disagreed with "I feel comfortable in dealing with depressed patients' needs," while 60 % (n = 112) agreed with "Working with depressed patients is heavy going." Factor analysis indicated these items comprised a factor termed "Depression should be treated by psychiatrists" - to which 54 % of doctors (n = 101) agreed. Meanwhile, 67 % of doctors (n = 126) thought that nurses could be useful in depressed patient support. The three factors derived from the Japanese DAQ differed from models previously derived from British GP samples. The attitude of Japanese non-psychiatric doctors concerning whether depression should be treated by psychiatrists was markedly different to that of British GPs.ConclusionsJapanese non-psychiatric doctors believe that depression care is beyond the scope of their duties. It is suggested that educational programs or guidelines for depression care developed in other countries such as the UK are not directly adaptable for Japanese non-psychiatric doctors. Developing a focused educational program that motivates non-psychiatric doctors to play a role in depression care is necessary to enhance recognition and treatment of depression in Japan.

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Information about barriers to planned change

Cited by 84 publications

References 0 publications

Theory in practice: Helping providers address depression in diabetes care *

Theory in practice: Helping providers address depression in diabetes care *

Commitment to change instrument enhances program planning, implementation, and evaluation

Attitudes toward depression among Japanese non-psychiatric medical doctors: a cross-sectional study

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