Improving clinician self-efficacy does not increase asthma guideline use by primary care clinicians.
Improving clinician self-efficacy does not increase asthma guideline use by primary care clinicians.
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DOI：
10.1016/j.acap.2012.04.004
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发表时间：
2012-07
影响因子：
3.1
通讯作者：
Hall, Charles B.
中科院分区：
文献类型：
--
作者：
Cloutier, Michelle M.;Tennen, Howard;Wakefield, Dorothy B.;Brazil, Kevin;Hall, Charles B.
关键词：
The association between changes in clinician self-efficacy and readiness to change and implementation of an asthma management program (Easy Breathing©) was examined. 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. 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 1.04, 1.72), p=0.04) but not treatment plan development (RR 0.63 (0.29, 1.35), p=.23) or anti-inflammatory use (RR 1.76 (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=0.01) and more clinicians were in an action stage of change (p=0.001) but these changes were not associated with changes in primary or secondary outcomes. 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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影响因子：
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作者：
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通讯作者：
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影响因子：
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COHEN, SJ;HALVORSON, HW;GOSSELINK, CA
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GOSSELINK, CA
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作者：
Cowen, Melissa K.;Wakefield, Dorothy B.;Cloutier, Michelle M.
通讯作者：
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