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Randomized Controlled Trial
. 2012 Jul-Aug;12(4):312-8.
doi: 10.1016/j.acap.2012.04.004. Epub 2012 May 26.

Improving clinician self-efficacy does not increase asthma guideline use by primary care clinicians

Michelle M Cloutier  1 , Howard Tennen, Dorothy B Wakefield, Kevin Brazil, Charles B Hall
Affiliations
Randomized Controlled Trial

Improving clinician self-efficacy does not increase asthma guideline use by primary care clinicians

Michelle M Cloutier et al. Acad Pediatr. 2012 Jul-Aug.

Abstract

Objective: The purpose of this study was to show the association between changes in clinician self-efficacy and readiness to change and implementation of an asthma management program (Easy Breathing).

Methods: A 36 month randomized, controlled trial was conducted involving 24 pediatric practices (88 clinicians). Randomized clinicians received interventions designed to enhance clinician self-efficacy and readiness to change which were measured at baseline and 3 years. Interventions consisted of an educational toolbox, seminars, teleconferences, mini-fellowships, opinion leader visits, clinician-specific feedback, and pay for performance. The primary outcome was program utilization (number of children enrolled in Easy Breathing/year); secondary outcomes included development of a written treatment plan and severity-appropriate therapy.

Results: At baseline, clinicians enrolled 149 ± 147 (mean ± SD) children/clinician/year; 84% of children had a written treatment plan and 77% of plans used severity-appropriate therapy. At baseline, higher self-efficacy scores were associated with greater program utilization (relative rate [RR], 1.34; 95% confidence interval [CI], 1.04-1.72; P = .04) but not treatment plan development (RR, 0.63; 95% CI, 0.29-1.35; P = .23) or anti-inflammatory use (RR, 1.76; 95% CI, 0.92-3.35; P = .09). Intervention clinicians participated in 17 interventions over 36 months. At study end, self-efficacy scores increased in intervention clinicians compared to control clinicians (P = .01) and more clinicians were in an action stage of change (P = .001) but these changes were not associated with changes in primary or secondary outcomes.

Conclusions: Self-efficacy scores correlated with program use at baseline and increased in the intervention arm, but these increases were not associated with greater program-related activities. Self-efficacy may be necessary but not sufficient for behavior change.

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Conflict of interest statement

Authors confirm there are no conflicts of interest related to this manuscript.

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References

    1. Rodbard HW, Blonde L, Braithwaite SS, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the management of diabetes mellitus. Endocr Pract. 2007;13(Suppl 1):1–68. - PubMed
    1. Khan NA, McAlister FA, Rabkin SW, et al. The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension: Part II - Therapy. Can J Cardiol. 2006;22(7):583–593. - PMC - PubMed
    1. Green LA, Dickinson WP, Nease DEJ, et al. AAFP guideline for the detection and management of post-myocardial infarction depression. Ann Fam Med. 2009;7(1):71–79. - PMC - PubMed
    1. National Cholesterol Education Program (NCEP) Expert Panel on Detection. Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143–3421. - PubMed
    1. Schiele F, Meneveau N, Seronde MF, et al. Compliance with guidelines and 1-year mortality in patients with acute myocardial infarction: a prospective study. Eur Heart J. 2005;26(9):873–880. - PubMed

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