Health care practitioners' motivation for tobacco-dependence counseling

Williams, Geoffrey; Lévesque, Chantal; Zeldman, Allan; Wright, Scott M.; Deci, Edward L.

doi:10.1093/her/cyf042

Cited by 43 publications

(35 citation statements)

References 16 publications

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“…The maximum score possible on the Perceived Autonomy Scale [35] was 28 and scores for this study ranged from 18 to 28 with higher scores indicating greater perceived autonomy to facilitate behavior change among patients in routine care.…”

Section: Perceived Autonomymentioning

confidence: 89%

“…The Perceived Autonomous Motivation Scale [35] measured practitioners' level of perceived internal motivation to pursue behavior change counseling among their patients. The scale is validated and reliable and has been used in a recent study investigating physician motivation to counsel tobacco dependent patients to quit [35].…”

Section: Perceived Autonomous Motivation Scalementioning

confidence: 99%

“…The scale is validated and reliable and has been used in a recent study investigating physician motivation to counsel tobacco dependent patients to quit [35]. This scale was adapted to reflect behavior counseling in clinical practice.…”

Section: Perceived Autonomous Motivation Scalementioning

confidence: 99%

“…For example, in the work by Williams et al [35], who studied both physicians and non-physicians' predictors and motivations to counsel patients about smoking cessation, the authors reported that improvements in perceived competence and perceived autonomy predicted changes in counseling behavior [35]. Perceived autonomy is of particular significance as the self-determination theory [40] proposes that a change in perceived competence only affects motivation when the changes are experienced as autonomous [35]. Therefore, the results of this study suggest that after the MI/CALC workshop, participants felt more autonomously motivated to engage in behavior change conversations with patients and thus, may engage in this activity more often.…”

Section: Practice Implicationsmentioning

confidence: 99%

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The Impact of a One-Day Applied Training in Motivational Interviewing on Health Practitioners? Perceived Competence, Autonomy, Efficacy, and Attitudes to Facilitate Behavior Change: A Pilot Study

Wiley

Morrow²,

Irwin³

2011

J Community Med Health Educ

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Objective: Because the practical application of motivational interviewing (MI) for health practitioners has been highlighted as a limitation to the approach, the purpose of this pilot study was to assess the impact of a one-day training workshop in MI applied through Co-Active life coaching (CALC) skills on health care practitioners' perceived competence, autonomy and attitudes toward facilitating health-behavior changes. Methods:A pre-test/post-test multiple baseline design was used with 10 health care practitioners. Data was collected beginning 25 days prior and for 4 weeks post-training. Participants received a 7.5 hour interactive workshop in January 2011. The Perceived Competence Scale, the Perceived Autonomous Motivation Scale and the Nutrition in Patient care Survey were adapted and administered to assess attitudes toward facilitating health-behavior changes in clinical care. Results Conclusion:Participation in this applied workshop was effective and should be explored further with a larger group.Practice Implications: This training improved practitioners' comfort to counsel behavior changes and may be a useful training model for health professionals.

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Section: Perceived Autonomymentioning

confidence: 89%

Section: Perceived Autonomous Motivation Scalementioning

confidence: 99%

Section: Perceived Autonomous Motivation Scalementioning

confidence: 99%

Section: Practice Implicationsmentioning

confidence: 99%

See 2 more Smart Citations

The Impact of a One-Day Applied Training in Motivational Interviewing on Health Practitioners? Perceived Competence, Autonomy, Efficacy, and Attitudes to Facilitate Behavior Change: A Pilot Study

Wiley

Morrow²,

Irwin³

2011

J Community Med Health Educ

View full text Add to dashboard Cite

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“…A recent study, however, supports the view that SDT can help explain provider behavior with other preventive counseling topics (eg, tobacco cessation). 40 We also note that the members of our practice-based research network are all in one state and practice in settings that differ from those of many primary care clinicians. It is possible that these practice characteristics create circumstances that make SDT seem more relevant to clinician decisions.…”

Section: Limitationsmentioning

confidence: 99%

Self Determination Theory and Preventive Care Delivery: A Research Involving Outpatient Settings Network (RIOS Net) Study

Sussman

Williams²,

Leverence³

et al. 2008

The Journal of the American Board of Family Medicine

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on Behalf of RIOS Net CliniciansPurpose: Traditional approaches to improving preventive care have had limited success. In response, researchers have adopted new ways of examining the primary care environment and clinical encounters to better understand the factors that impact care delivery. We examined how clinicians make preventive counseling decisions to ascertain if self-determination theory (SDT) may further clarify influences on clinicians' decisions to take time for preventive counseling.Methods: We studied clinical decision making through a mixed-method approach using obesity counseling as an example of preventive counseling. We conducted in-depth interviews and focus groups with 30 primary care clinicians in RIOS Net, a Southwestern US practice-based research network and distributed a survey, which was completed by 75% of 195 network members. We then used the components of SDT autonomy, competence, and relatedness to organize the factors that clinicians identified as most influential in their preventive counseling decisions.Results: We found that SDT provides an organizing structure for understanding some of the psychology of clinicians' decisions to provide preventive counseling in the brief primary care encounter. In the specific case of obesity counseling clinicians expressed a high degree of autonomy, but barriers to competence and generally low levels of relatedness with professional colleagues seemed to limit their delivery of preventive counseling.Conclusion Despite advances that make it easier to disseminate information, streamline office systems, and implement quality improvement efforts, several indicators reveal little change in the overall delivery of preventive care. [1][2][3][4][5][6][7][8] Previous efforts to improve the delivery of preventive care have typically focused on enhancing the performance of various individual components within the primary health care system or have aimed to optimize the functioning of the entire system. Not withstanding these comprehensive efforts at system-level modification, results have generally been disappointing. 9 -11 Such outcomes have led researchers to look beyond broad system-level influences on preventive care delivery to consider determinants at other levels of the care delivery process. 12-14Recent research aimed at improving preventive care delivery has been focused at the level of the individual primary care practice. We recently began to examine influences on preventive care that operate at a third level, that of the individual clinician patient encounter. 19 We identified factors in the encounter that seem to affect clinicians' decisions to deliver, in this case, obesity counseling when faced with the many competing demands present in the brief patient encounter. Both relatively stable factors (such as available community resources) and more dynamic, situational factors (such as the patient's agenda for the visit) seem to influence whether and to what extent obesity counseling is provided.Further analysis of these data led to an examination of...

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Procedural skill maintenance: Perspectives and motivations of pediatric emergency medicine faculty

Lin‐Martore

Kant

O’Brien

2021

AEM Education and Training

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Background: Pediatric emergency medicine (PEM) physicians receive training in critical procedures, but these procedures are rare in practice. The literature on maintenance of procedural skills focuses on ways to practice (e.g., via simulation) and pays little attention to motivation's role. Understanding what motivates PEM physicians to maintain procedural skills can inform the design of supportive policies and interventions. Our study explores how PEM physicians conceptualize maintenance of procedural skills, what motivates them to maintain procedural skills, and barriers to procedural skill maintenance. Methods: This was a qualitative study of 12 PEM faculty guided by the selfdetermination theory (SDT) of motivation. SDT describes a typology that distinguishes extrinsic and intrinsic motivation, with intrinsic motivation based on autonomy, competence, and relatedness. Interviews were transcribed and coded using constantcomparative technique, and interviews continued until thematic sufficiency was achieved.Results: Participants had difficulty defining procedural skill maintenance by specific criteria and expressed ambivalence about external standards for competence, noting the need to account for individual and local practice factors. Three themes characterizing participants' motivation for procedural skills maintenance included: (1) desire to provide optimal patient care and fear of unsuccessful performance (competence),(2) procedural competence as part of the identity of a PEM physician who teaches and performs procedures (competence and relatedness), and (3) desire for accessibility and choice of options in maintaining procedural skills (autonomy). Participants identified lack of opportunities, time, and support as barriers to motivation and skills maintenance. Conclusion:SDT concepts were integral to understanding faculty motivation, and this highlights the need for prioritizing faculty autonomy, competence, and relatedness in designing supports for procedural skill maintenance. Our findings regarding the difficulty in defining maintenance of skills emphasize the need for further discussion and study of this topic.

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Health care practitioners' motivation for tobacco-dependence counseling

Cited by 43 publications

References 16 publications

The Impact of a One-Day Applied Training in Motivational Interviewing on Health Practitioners? Perceived Competence, Autonomy, Efficacy, and Attitudes to Facilitate Behavior Change: A Pilot Study

The Impact of a One-Day Applied Training in Motivational Interviewing on Health Practitioners? Perceived Competence, Autonomy, Efficacy, and Attitudes to Facilitate Behavior Change: A Pilot Study

Self Determination Theory and Preventive Care Delivery: A Research Involving Outpatient Settings Network (RIOS Net) Study

Procedural skill maintenance: Perspectives and motivations of pediatric emergency medicine faculty

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