Planning to be routine: habit as a mediator of the planning-behaviour relationship in healthcare professionals

Potthoff, Sebastian; Presseau, Justin; Sniehotta, Falko F.; Johnston, Marie; Elovainio, Marko; Avery, Leah

doi:10.1186/s13012-017-0551-6

Cited by 82Behavioral Health and InterventionsHealth Policy Implementation ScienceClinical practice guidelines implementation

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Planning to be routine: habit as a mediator of the planning-behaviour relationship in healthcare professionals

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Potthoff, Sebastian, Presseau, Justin, Sniehotta, Falko F., Johnston, Marie, Elovainio, Marko, Avery, Leah·2017·Implementation Science

DOI 10.1186/s13012-017-0551-6PMC PMC5319033

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Abstract

BACKGROUND: Gaps in the quality of care provided to people with type 2 diabetes are regularly identified. Healthcare professionals often have a strong intention to follow practice guidelines during consultations with people with type 2 diabetes; however, this intention does not always translate into action. Action planning (planning when, where and how to act) and coping planning (planning how to overcome pre-identified barriers) have been hypothesised to help with the enactment of intentions by creating mental cue-response links that promote habit formation. This study aimed to investigate whether habit helps to better understand how action and coping planning relate to clinical behaviour in the context of type 2 diabetes care. METHODS: The study utilised a prospective correlational design with six nested sub-studies. General practitioners and practice nurses (n = 427 from 99 UK primary care practices) completed measures of action planning, coping planning and habit at baseline and then self-reported their enactment of guideline-recommended advising, prescribing and examining behaviours 12 months later. Bootstrapped mediation analyses were used to test the indirect effect of action and coping planning on healthcare professionals' clinical behaviour via their relationship with habit. RESULTS: Healthcare professionals who reported higher degrees of action or coping planning for performing six guideline recommended behaviours in the context of type 2 diabetes care were more likely to report performing these behaviours in clinical practice. All 12 bootstrapped mediation analyses showed that the positive relationship between planning (action and coping planning) and healthcare professionals' clinical behaviour operated indirectly through habit. CONCLUSIONS: These findings suggest that habit mediates the relationship between planning (action and coping planning) and healthcare professional behaviour. Promoting careful action and coping planning may support routinised uptake of guideline-recommended care by healthcare professionals in the primary care setting. Given the competing demands on healthcare professionals, exploring the behavioural processes involved in promoting more routinisation of behaviours where possible and appropriate could free up cognitive capacity for clinical behaviours that rely on more deliberation.

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The behaviour change theories most commonly used in research to explain healthcare professionals' behaviours are based on constructs related to the reflective rather than the automatic aspect of behaviour, which could bias the frequency of the reported factors of behaviour change.
“The behaviour change theories most commonly used in research to explain healthcare professionals’ behaviours are based on constructs related to the reflective, rather than the automatic, aspect of behaviour, which could lead to a bias in the frequency of the reported factors to behaviour change [117].”
From Factors influencing the implementation of screening and brief interventions for alcohol use in primary care practices: a systematic review using the COM-B system and Theoretical Domains Framework (2021) · cites this paper as [117]
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Additional file 3 of A systematic review of empirical studies examining mechanisms of implementation in health
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Additional file 5 of Protocol for a hybrid type 2 cluster randomized trial of trauma-focused cognitive behavioral therapy and a pragmatic individual-level implementation strategy
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Additional file 5 of How well do critical care audit and feedback interventions adhere to best practice? Development and application of the REFLECT-52 evaluation tool
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Additional file 3 of Factors influencing the implementation of screening and brief interventions for alcohol use in primary care practices: a systematic review using the COM-B system and Theoretical Domains Framework
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Additional file 4 of How well do critical care audit and feedback interventions adhere to best practice? Development and application of the REFLECT-52 evaluation tool
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Additional file 2 of How well do critical care audit and feedback interventions adhere to best practice? Development and application of the REFLECT-52 evaluation tool
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Authors: Potthoff, S., Presseau, J., Sniehotta, F. F., Johnston, M., Elovainio, M., & Avery, L.
Affiliations: Newcastle University (GB)
University of Ottawa (CA)
University of Aberdeen (GB)
University of Helsinki (FI)
Corresponding author: Potthoff, Sebastian
ORCID: Potthoff, Sebastian
Presseau, Justin
Sniehotta, Falko F.
Johnston, Marie
Elovainio, Marko
Avery, Leah
Venue: Implementation Science
Publisher: Springer Science and Business Media LLC
Published: 2017-02-21
Volume: 12
Issue: 1
Pages: 24-24
ISSN: 1748-5908 (ISSN-L)
DOI: 10.1186/s13012-017-0551-6
PMC: PMC5319033
OpenAlex: W2589391013
Cited by: 82
References: 56
Citations by year: 2026: 5 · 2025: 7 · 2024: 5 · 2023: 6 · 2022: 5 · 2021: 24 · 2020: 12 · 2019: 8 · 2018: 5 · 2017: 4
FWCI: 9.08
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
Locations: Implementation Science (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
TeesRep (Teesside University) (acceptedVersion, cc-by-nc-nd)
Aberdeen University Research Archive (Aberdeen University) (submittedVersion)
Työväentutkimus Vuosikirja (submittedVersion)
uO Research (University of Ottawa) (submittedVersion, public-domain)
Newcastle University ePrints (Newcastle Univesity)
Newcastle University ePrints (Newcastle Univesity) (cc-by)
Funders: Diabetes UK (RD06/0003342)
Topics: Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Keywords: habit, action planning, coping planning, clinical behavior, guideline adherence, healthcare workers, general practitioners, practice nurses, primary care, intention-behavior gap, mediation, behavior change
MeSH terms: Diabetes Mellitus, Type 2, England, Female, Habits, Humans, Male, Patient Care Planning, Practice Patterns, Physicians', Prospective Studies, Quality of Health Care, Intention, Practice Patterns, Nurses', General Practitioners, General Practice

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Planning to be routine: habit as a mediator of the planning-behaviour relationship in healthcare professionals

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