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International Journal of Behavioral Medicine

, Volume 16, Issue 3, pp 287–293 | Cite as

Knowledge May Not Be the Best Target for Strategies to Influence Evidence-Based Practice: Using Psychological Models to Understand RCT Effects

  • D. BonettiEmail author
  • M. Johnston
  • N. B. Pitts
  • C. Deery
  • I. Ricketts
  • C. Tilley
  • J. E. Clarkson
Article

Abstract

Background

Interventions to enhance the implementation of evidence-based practice have a varied success rate. This may be due to a lack of understanding of the mechanism by which interventions achieve results.

Purpose

Use psychological models to further an understanding of trial effects by piggy-backing on a randomised controlled trial testing 2 interventions (Audit & Feedback and Computer-aided Learning) in relation to evidence-based third molar management.

Method

All participants of the parent trial (64 General Dental Practitioners across Scotland), regardless of intervention group, were invited to complete a questionnaire assessing knowledge and predictive measures from Theory of Planned Behaviour and Social Cognitive Theory. The main outcome was evidence-based extracting behaviour derived from patient records.

Results

Neither intervention significantly influenced behaviour in the parent trial. This study revealed that the interventions did enhance knowledge, but knowledge did not predict extraction behaviour. However, the interventions did not influence variables that did predict extraction behaviour (attitude, perceived behavioural control, self-efficacy). Results suggest both interventions failed because neither influenced possible mediating beliefs for the target behavior.

Conclusion

Using psychology models elucidated intervention effects and allowed the identification of factors associated with evidence based practice, providing the basis for improving future intervention design.

Keywords

Process evaluation Evidence-based practice Intervention Psychology models Theory of planned behavior Dentistry 

Notes

Acknowledgments

Gratefully acknowledged are Maryam Bahrami, Marilyn Laird, and participating dentists. This project was supported by Scottish Executive’s Chief Scientists Office and NHS R&D Programme (Trial R2-64).

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Copyright information

© International Society of Behavioral Medicine 2009

Authors and Affiliations

  • D. Bonetti
    • 1
    Email author
  • M. Johnston
    • 2
  • N. B. Pitts
    • 1
  • C. Deery
    • 3
  • I. Ricketts
    • 4
  • C. Tilley
    • 5
  • J. E. Clarkson
    • 1
  1. 1.Dental Health Services Research UnitUniversity of DundeeDundeeUK
  2. 2.School of PsychologyUniversity of AberdeenAberdeenScotland
  3. 3.Department of School of Clinical DentistryUniversity of SheffieldSheffieldUK
  4. 4.School of ComputingUniversity of DundeeDundeeUK
  5. 5.NHS Education for ScotlandEdinburghScotland

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