Changing Behavior - Oh So Difficult

This article in BMC Medical Education reminds us that the task of familiarizing health care professionals in the 'nuts and bolts' of EBP is one thing. Achieving behavior changes after this familiarization has occurred is yet another. The task is formidable, but it can be done.

Download McCluskey-BMCMedEduc-2005-EBPNoBehaviorChange.pdf

John

Comments

[Jon Newman]

The conclusion of the study seem not unlike the type of problem we have with 'non-compliant' patients seen in the clinic. Perhaps the arbitrary time frames for the behavior changes we try to help certain patients with is not realistic.

[JW Matheson]

This reminded me of the 1999 study by Turner and Whitford.

(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9238748&query_hl=1&itool=pubmed_docsum)

At the time of the study, 90% of the respondants chose their initial education expriences as the primary predictor of what treatment intervention to use. They also ranked reviewing the literature lowest when determining appropriate interventions. Has much changed in 6 years?

[Jon Newman]

Another possibility is that perhaps simply delivering information (education as education) is insufficient for the purposes of assisting with behavior change. Another case in point is the yoga study in a separate blog entry here. The ed. only group didn't do as well as other groups despite what seemed like reasonable advice. Perhaps there is an element of communication missing when one is trying to help with behavior change versus education for didactic purposes.

[Dale Avers]

John et al,
When I read the article on changing practice - I was reminded about the ineffectiveness of traditional classroom teaching when teaching a skill or behavior change. I have come to realize after teaching EBP for several years that modeling EBP behavior is required to change behavior in early adopters. Change occurs in an S-shape (Rogers, 1995), starting "low and slow" and gradually gaining momentum until we reach the "tipping point" (Gladwell, 2000). This blog is a great example of such modeling. The slow momentum of change just means we must all model EBP and keep the faith that EBP will catch on and therapists and health care providers in general will come to value evidence that informs individual experience. I have less faith for third party payors such as Humpty Dumpty.