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Table 1 Summary of the theoretical constructs used as predictive measures

From: An intervention modelling experiment to change GPs' intentions to implement evidence-based practice: using theory-based interventions to promote GP management of upper respiratory tract infection without prescribing antibiotics #2

Variables (number of questions)

Example Item(s)

Theory of Planned Behaviour (TPB) (Ajzen, 1991)

 

Behavioural intention (3 & 4). Two summary scores: sum of three and four items

I intend to manage patients with URTIs without prescribing an antibiotic (scored 1 to 7)

Given 10 patients presenting for the first time with an URTI, how many patients would you intend to manage without prescribing an antibiotic? (Scored 1 to 10)

Attitude: Direct (3);

Indirect (8 behavioural beliefs (bb) multiplied by 8 outcome evaluations (oe).

The score was the mean of the summed multiplicatives.)

Direct: In general: The benefits of managing patients with URTI without prescribing antibiotics outweighs the harms;

Indirect: In general, managing a patient with an URTI without prescribing an antibiotic would reassure them (bb) × reassuring the patient is (oe: un/important)

Subjective Norm: I (5 normative beliefs (nb) multiplied by 5 motivation to comply (mtc) items. The score was the mean of the summed multiplicatives).

I feel under pressure to manage patients with an URTI without prescribing an antibiotic: from published literature (nb) × How motivated are you to do what the published literature states that you should (mtc: very much/not at all)

Perceived Behavioural Control: Direct (4)

Indirect (6)

Direct: Whether I manage patients with an URTI without prescribing an antibiotic is entirely up to me

Indirect: I find it difficult to manage patients presenting with an URTI without prescribing an antibiotic who: Expect me to prescribe an antibiotic

Social Cognitive Theory (SCT) (Bandura,1997)

 

Risk Perception (3)

It is highly likely that patients with an URTI will be worse off if I manage them without prescribing an antibiotic.

Outcome Expectancies: Behaviour (8 × 8)

The score was the mean of the summed multiplicatives.

Behaviour: See Attitude (Theory of Planned Behaviour)

Self Efficacy: Specific (6)

Specific: Without an antibiotic: How confident are you in your ability to manage patients with URTIs who have tried to self-medicate

Operant Learning Theory (OLT)[16]

 

Anticipated consequences (3)

If I routinely manage patients with URTIs without prescribing an antibiotic then, on balance, my life as a GP will be easier in the long run

Evidence of habit (2)

When I see patients with URTIs, I automatically consider managing them without prescribing an antibiotic

Additional measures

 

Implementation Intention (Gollwitzer, 1993)

 

Prior planning (1)

Currently, my standard method of managing patients with an URTI involves managing them without prescribing an antibiotic

Action planning (3)

I have a clear plan of how to manage patients with an URTI without prescribing an antibiotic

I have a clear plan of when to manage patients with an URTI without prescribing an antibiotic

I have a clear plan of under what circumstances to manage patients with an URTI without prescribing an antibiotic

Other Measures

 

Demographics

gender, years qualified, trainer status, single or multi-practitioner practice