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Volume 27 (4)

Volume 27, Issue 4, Fall 2007line
J Contin Educ Health Prof 2007; 27(4):201
RESEARCH ARTICLE

Adopting health behavior change theory throughout the clinical practice guideline process
Natalie E. Ceccato, Lorraine E. Ferris, Douglas Manuel, Jeremy M. Grimshaw

A b s t r a c t

Adopting a theoretical framework throughout the clinical practice guideline (CPG) process (development, dissemination, implementation, and evaluation) can be useful in systematically identifying, addressing, and explaining behavioral influences impacting CPG uptake and effectiveness. This article argues that using a theoretical framework should increase the utility and probably the implementation of a CPG. A hypothetical scenario is provided using the theory of planned behavior (TPB) to aid in our explanation. While other theories may be viable, the TPB is chosen because it accounts for a wide spectrum of behavioral factors known to influence physician behavior, and because its flexibility allows it to be used for different populations (e.g., specialists), behaviors, and contexts (e.g., hospital, private clinic). In addition, evidence has indicated that the TPB can influence physician behavior. Empirical research examining whether CPG utility can be significantly improved by appropriately selecting and implementing theory throughout the CPG process is warranted.

Lessons for Practice
  • Theory can be used to develop guidelines that are relevant to the targeted audience, behavior, and context.
  • Theory can be used to identify and develop dissemination and intervention strategies that target factors influencing the likelihood of guideline adoption and subsequent intended behavior change.
  • Theory can be an effective tool for allowing evidence-based evaluations of guidelines.
  • Overall theory can unify the components of guidelines, potentially increasing the likelihood of guideline implementation.

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