Appealing to Faculty Gatekeepers: Motivational Processes for Intentions to Adopt an Evidence-B ased Intervention.
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ABSTRACT:
SUBMITTER: McPartlan P
PROVIDER: S-EPMC9236873 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Intentions play a central role in numerous empirically supported theories of behavior and behavior change and have been identified as a potentially important antecedent to successful evidence-based treatment (EBT) implementation. Despite this, few measures of mental health clinicians' EBT intentions exist and available measures have not been subject to thorough psychometric evaluation or testing. This paper evaluates the psychometric properties of the evidence-based treatment intentions (EBTI) scale, a new measure of mental health clinicians' intentions to adopt EBTs.The study evaluates the reliability and validity of inferences made with the EBTI using multi-method, multi-informant criterion variables collected over 12 months from a sample of 197 mental health clinicians delivering services in 13 mental health agencies. Structural, predictive, and discriminant validity evidence is assessed.Findings support the EBTI's factor structure (χ (2) = 3.96, df = 5, p = .556) and internal consistency reliability (α = .80). Predictive validity evidence was provided by robust and significant associations between EBTI scores and clinicians' observer-reported attendance at a voluntary EBT workshop at a 1-month follow-up (OR = 1.92, p < .05), self-reported EBT adoption at a 12-month follow-up (R (2) = .17, p < .001), and self-reported use of EBTs with clients at a 12-month follow-up (R (2) = .25, p < .001). Discriminant validity evidence was provided by small associations with clinicians' concurrently measured psychological work climate perceptions of functionality (R (2) = .06, p < .05), engagement (R (2) = .06, p < .05), and stress (R (2) = .00, ns).The EBTI is a practical and theoretically grounded measure of mental health clinicians' EBT intentions. Scores on the EBTI provide a basis for valid inferences regarding mental health clinicians' intentions to adopt EBTs. Discussion focuses on research and practice applications.
| S-EPMC4857292 | biostudies-other
Project description:BackgroundWidespread dissemination and implementation of evidence-based human immunodeficiency virus (HIV) linkage-to-care (LTC) interventions is essential for improving HIV-positive patients' health outcomes and reducing transmission to uninfected others. To date, however, little work has focused on identifying factors associated with intentions to adopt LTC interventions among policy makers, including city, state, and territory health department AIDS directors who play a critical role in deciding whether an intervention is endorsed, distributed, and/or funded throughout their region.MethodsBetween December 2010 and February 2011, we administered an online questionnaire with state, territory, and city health department AIDS directors throughout the United States to identify factors associated with intentions to adopt an LTC intervention. Guided by pertinent theoretical frameworks, including the Diffusion of Innovations and the "push-pull" capacity model, we assessed participants' attitudes towards the intervention, perceived organizational and contextual demand and support for the intervention, likelihood of adoption given endorsement from stakeholder groups (e.g., academic researchers, federal agencies, activist organizations), and likelihood of enabling future dissemination efforts by recommending the intervention to other health departments and community-based organizations.ResultsForty-four participants (67% of the eligible sample) completed the online questionnaire. Approximately one-third (34.9%) reported that they intended to adopt the LTC intervention for use in their city, state, or territory in the future. Consistent with prior, related work, these participants were classified as LTC intervention "adopters" and were compared to "nonadopters" for data analysis. Overall, adopters reported more positive attitudes and greater perceived demand and support for the intervention than did nonadopters. Further, participants varied with their intention to adopt the LTC intervention in the future depending on endorsement from different key stakeholder groups. Most participants indicated that they would support the dissemination of the intervention by recommending it to other health departments and community-based organizations.ConclusionsFindings from this exploratory study provide initial insight into factors associated with public health policy makers' intentions to adopt an LTC intervention. Implications for future research in this area, as well as potential policy-related strategies for enhancing the adoption of LTC interventions, are discussed.
| S-EPMC3348078 | biostudies-literature
Project description:Background: Direct-to-consumer (DTC) prescription drug advertisements are thought to induce "boomerang effects," meaning they reduce the perceived effectiveness of a potential alternative option: non-pharmaceutical treatment via lifestyle change. Past research has observed such effects using artificially created, text-only advertisements that may not adequate capture the complex, conflicting portrayal of lifestyle change in real television advertisements. In other risk domains, individual "problem status" often moderates boomerang effects, such that subjects who currently engage in the risky behavior exhibit the strongest boomerang effects. Objectives: We aimed to assess whether priming with real DTC television advertisements elicited boomerang effects on perceptions of lifestyle change and whether these effects, if present, were moderated by individual problem status. Methods: We assembled a sample of real, previously aired DTC television advertisements in order to naturalistically capture the portrayal of lifestyle change in real advertisements. We randomized 819 adults in the United States recruited via Amazon Mechanical Turk to view or not view an advertisement for a prescription drug. We further randomized subjects to judge either lifestyle change or drugs on three measures: general effectiveness, disease severity for a hypothetical patient, and personal intention to use the intervention if diagnosed with the target health condition. Results: Advertisement exposure induced a statistically significant, but weak, boomerang effect on general effectiveness (p = 0.01, partial R2 = 0.007) and did not affect disease severity score (p = 0.32, partial R2 = 0.0009). Advertisement exposure elicited a reverse boomerang effect of similar effect size on personal intentions, such that advertisement-exposed subjects reported comparatively higher intentions to use lifestyle change relative to drugs (p = 0.006, partial R2 = 0.008). Individual problem status did not significantly moderate these effects. Conclusion: In contrast to previous literature finding large boomerang effects using artificial advertisement stimuli, real television advertisements elicited only a weak boomerang effect on perceived effectiveness and elicited an unexpected reverse boomerang effect on personal intentions to use lifestyle change versus drugs. These findings may reflect real advertisements' induction of descriptive norms and self-efficacy; future research could address such possibilities by systematically manipulating advertisement content.
| S-EPMC5045930 | biostudies-literature
Project description:ObjectivesWhile shared decision making (SDM) promotes health-related decisions that are informed, value-based and adhered to, few studies report on theory-based approaches to SDM adoption by healthcare professionals. We aimed to identify the factors influencing dietitians' intentions to adopt two SDM behaviours: 1) present dietary treatment options to patients and 2) help patients clarify their values and preferences.MethodsWe conducted a cross-sectional postal survey based on the Theory of Planned Behaviour among 428 randomly selected dietitians working in clinical practice across the Province of Quebec, Canada. We performed descriptive analyses and multiple regression analyses to determine the variables that explained the variance in intention to perform the behaviours.ResultsA total of 203 dietitians completed the questionnaire. Their ages were from 23 to 66 and they had been practising dietetics for 15.4±11.1 years (mean ± SD). On a scale from 1 to 7 (from strongly disagree to strongly agree), dietitians' intentions to present dietary treatment options and to clarify their patients' values and preferences were 5.00±1.14 and 5.68±0.74, respectively. Perceived behavioural control (??=?0.56, ?<0.0001), subjective norm (??=?0.16, ?<0.05), and moral norm (??=?0.22, ?<0.0001), were the factors significantly predicting the intention to present dietary treatment options, while perceived behavioural control (??=?0.60, ?<0.0001), attitude (??=?0.20, ?<0.05), and professional norm (??=?0.22, ?<0.001), significantly predicted the intention to help patients' clarify their values and preferences.ConclusionOur results showed that dietitians intend to adopt the two SDM behaviours studied. Factors influencing intention were different for each behaviour, except for perceived behavioural control which was common to both behaviours. Thus, perceived behavioural control could be a key factor in interventions aiming to encourage implementation of SDM by dietitians.
| S-EPMC3659101 | biostudies-literature
Project description:BackgroundAlthough researchers are giving increased attention to blockchain-based personal health records (PHRs) and data sharing, the majority of research focuses on technical design. Very little is known about health care consumers' intentions to adopt the applications.ObjectiveThis study aims to explore the intentions and concerns of health care consumers regarding the adoption of blockchain-based personal health records and data sharing.MethodsThree focus groups were conducted, in which 26 participants were shown a prototype of a user interface for a self-sovereign blockchain-based PHR system (ie, a system in which the individual owns, has custody of, and controls access to their personal health information) to be used for privacy and secure health data sharing. A microinterlocutor analysis of focus group transcriptions was performed to show a descriptive overview of participant responses. NVivo 12.0 was used to code the categories of the responses.ResultsParticipants did not exhibit a substantial increase in their willingness to become owners of health data and share the data with third parties after the blockchain solution was introduced. Participants were concerned about the risks of losing private keys, the resulting difficulty in accessing care, and the irrevocability of data access on blockchain. They did, however, favor a blockchain-based PHR that incorporates a private key recovery system and offers a health wallet hosted by government or other positively perceived organizations. They were more inclined to share data via blockchain if the third party used the data for collective good and offered participants nonmonetary forms of compensation and if the access could be revoked from the third party.ConclusionsHealth care consumers were not strongly inclined to adopt blockchain-based PHRs and health data sharing. However, their intentions may increase when the concerns and recommendations demonstrated in this study are considered in application design.
| S-EPMC7677023 | biostudies-literature
Project description:Background and objectiveVaccine uptake during pregnancy remains low. Our objectives were to describe 1) development and adaptation of a clinician communication training intervention for maternal immunizations and 2) obstetrics and gynecology (ob-gyn) clinician and staff perspectives on the intervention and fit for the prenatal care context.MethodsDesign of the Motivational Interviewing for Maternal Immunizations (MI4MI) intervention was based on similar communication training interventions for pediatric settings and included presumptive initiation of vaccine recommendations ("You're due for two vaccines today") combined with motivational interviewing (MI) for hesitant patients. Interviews and focus group discussions were conducted with ob-gyn clinicians and staff in five Colorado clinics including settings with obstetric physicians, certified nurse midwives (CNMs), and clinician-trainees. Participants were asked about adapting training to the ob-gyn setting and their implementation experiences. Feedback was incorporated through iterative changes to training components.ResultsInterview and focus group discussion results from participants before (n = 3), during (n = 11) and after (n = 25) implementation guided intervention development and adaptation. Three virtual, asynchronous training components were created: a video and two interactive modules. This virtual format was favored due to challenges attending group meetings; however, participants noted opportunities to practice skills through role-play were lacking. Training modules were adapted to include common challenging vaccine conversations and live-action videos. Participants liked interactive training components and use of adult learning strategies. Some participants initially resisted the presumptive approach but later found it useful after applying it in their practices. Overall, participants reported that MI4MI training fit well with the prenatal context and recommended more inclusion of non-clinician staff.ConclusionsMI4MI training was viewed as relevant and useful for ob-gyn clinicians and staff. Suggestions included making training more interactive, and including more complex scenarios and non-clinician staff.
| S-EPMC9729433 | biostudies-literature
Project description:Although microenterprises constitute a significant part of Morocco's economy, they encounter financing difficulties which represent the biggest obstacles to their growth, therefore, Islamic financial institutions can take a prominent role in fostering financial inclusion in Morocco. Accordingly, this article aims to explore the determinants of intention to adopt Islamic financing in micro-business. For this purpose, this study utilizes data collected from a selected sample of Moroccan micro-business owner-managers using face-to-face interviews during March 2021. The results from the partial least squares analysis indicate that religious obligation and Islamic financing reputation positively affect attitude towards Islamic financing. Findings also reveal the positive and significant influence of subjective norms, attitude towards Islamic financing, and perceived behavioral control on intention to adopt Islamic financing.•This method article can be used to explore the antecedent of Islamic financing adoption in micro-business.•Access to this method article may help Islamic bank managers to set up marketing policies in order to strengthen the micro-business owners' intention to adopt Islamic financing.
| S-EPMC8563690 | biostudies-literature
Project description:We conduct and analyze two large surveys of hypothetical annuitization choices. We find that allowing individuals to annuitize a fraction of their wealth increases annuitization relative to a situation where annuitization is an "all or nothing" decision. Very few respondents choose declining real payout streams over flat or increasing real payout streams of equivalent expected present value. Highlighting the effects of inflation increases demand for cost of living adjustments. Frames that highlight flexibility, control, and investment significantly reduce annuitization. A majority of respondents prefer to receive an extra "bonus" payment during one month of the year that is funded by slightly lower payments in the remaining months. Concerns about later-life income, spending flexibility, and counterparty risk are the most important self-reported motives that influence the annuitization decision.
| S-EPMC4061766 | biostudies-literature
Project description:PurposeGrounded in self-determination theory (SDT), the present study tested how students' perceptions of autonomy support from physical education teachers predicts objectively measured moderate-to-vigorous physical activity (MVPA) of adolescents. According to SDT, it was expected that psychological needs and autonomous and controlled forms of motivation would mediate these relationships.MethodsStudents (n = 397) aged from 11 to 15 years in 17 different schools filled in questionnaires regarding SDT variables. In addition, objective MVPA was measured using an accelerometer (ActiGraph GT3X; ActiGraph, Pensacola, FL, USA) for 7 days. Structural equation modelling was used to examine the hypothesized relationships among the study variables.ResultsThe theory-based model showed a good fit with the data: χ2 = 642.464, df = 257; comparative fit index = 0.932; non-normed fit index = 0.921; root mean square error of approximation = 0.062; root mean square error of approximation 90% confidence interval: 0.054-0.067. As hypothesized, there was a significant and positive direct relationship between autonomy support and need satisfaction (β = 0.81, p = 0.001). In turn, need satisfaction positively predicted intrinsic motivation (β = 0.86, p = 0.001). Intrinsic motivation was positively related to MVPA (β = 0.29, p = 0.009). A significant indirect effect (β = 0.20, p = 0.004) supported the mediating role of psychological need satisfaction and intrinsic motivation in the relationship between perceived autonomy support and objectively measured MVPA.ConclusionThe findings of the current study support the applicability of the SDT-based model in explaining the antecedents of objectively measured MVPA of adolescents. To enhance adolescents' daily MVPA, special focus should be put on increasing their intrinsic motivation toward physical education.
| S-EPMC7498624 | biostudies-literature
Project description:BackgroundA significant policy change impacting the availability of nicotine for use in electronic cigarettes (e-cigarettes) in Australia took effect from October 1, 2021. This change meant that nicotine containing liquids for use with e-cigarettes would only be available by prescription from a medical practitioner as part of a smoking cessation plan. This study aimed to explore general practitioners (GPs) perceptions about the role of e-cigarettes, and understand factors informing their intentions to prescribe e-cigarettes as part of a smoking cessation plan.MethodsIn-depth semi-structured interviews were conducted with thirteen GPs. Purposeful sampling was used to recruit participants. Interviews were audio recorded and transcribed verbatim. Thematic analysis was used to classify, describe and report themes in the data. QSR NVivo was used to aid coding, thematic analysis and retrieval of quotes.ResultsParticipants had diverse views on recommending and prescribing e-cigarettes as smoking cessation aids to patients. Some participants were willing to prescribe e-cigarettes to patients if other methods of smoking cessation had not worked but there were concerns, and uncertainty, about the safety and efficacy of e-cigarettes for smoking cessation. There was poor understanding of the current policy and legislation about e-cigarettes in Australia. Mostly the participants in this sample did not feel confident or comfortable to prescribe, or have discussions about e-cigarettes with patients.ConclusionThe participants of this study held diverse attitudes on recommending and prescribing e-cigarettes for smoking cessation. Clarity in guidelines and consumer product information are required to enable GPs to provide consistent and accurate advice to patients that wish to use e-cigarettes as a smoking cessation aid.
| S-EPMC10848430 | biostudies-literature