Sociocognitive approach to behaviour change for reducing low-value care
Ian A. Scott A B E and Steven M. McPhail
C D
+ Author Affiliations
- Author Affiliations
A Department of Internal Medicine and Clinical Epidemiology, Level 5A, Princess Alexandra Hospital, Ipswich Road, Brisbane, Qld 4102, Australia.
B School of Clinical Medicine, University of Queensland, Translational Research Institute, 31 Trent Street, Woolloongabba, Qld 4102, Australia.
C Australian Centre for Health Services Innovation & Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia. Email: steven.mcphail@qut.edu.au
D Clinical Informatics Directorate, Metro South Health, Ipswich Road, Brisbane, Qld 4102, Australia.
E Corresponding author. Email: ian.scott@health.qld.gov.au
Australian Health Review 45(2) 173-177 https://doi.org/10.1071/AH20209
Submitted: 9 August 2020 Accepted: 3 September 2020 Published: 30 November 2020
Abstract
Social and cognitive factors that predispose to low-value care (LVC), and strategies for countering them, may be underarticulated in campaigns aimed at reducing LVC. A sociocognitive approach, in addition to traditional knowledge translation strategies, may augment understanding and changing clinician behaviour underpinning LVC.
References
[1] Levinson W, Born K, Wolfson D. Choosing Wisely campaigns: a work in progress. JAMA 2018; 319 1975–6.| Choosing Wisely campaigns: a work in progress.Crossref | GoogleScholarGoogle Scholar | 29710232PubMed |
[2] Lin MP, Nguyen T, Probst MA, Richardson LD, Schuur JD. Emergency physician knowledge, attitudes, and behavior regarding ACEP’s Choosing Wisely recommendations: a survey study. Acad Emerg Med 2017; 24 668–75.
| Emergency physician knowledge, attitudes, and behavior regarding ACEP’s Choosing Wisely recommendations: a survey study.Crossref | GoogleScholarGoogle Scholar | 28164409PubMed |
[3] Saposnik G, Redelmeier D, Ruff CC, Tobler PN. Cognitive biases associated with medical decisions: a systematic review. BMC Med Inform Decis Mak 2016; 16 138
| Cognitive biases associated with medical decisions: a systematic review.Crossref | GoogleScholarGoogle Scholar | 27809908PubMed |
[4] Blumenthal-Barby JS, Krieger H. Cognitive biases and heuristics in medical decision-making: a critical review using a systematic search strategy. Med Decis Making 2015; 35 539–57.
| Cognitive biases and heuristics in medical decision-making: a critical review using a systematic search strategy.Crossref | GoogleScholarGoogle Scholar | 25145577PubMed |
[5] Scott IA, Soon J, Elshaug A, Lindner R. Countering cognitive biases in minimising low value care. Med J Aust 2017; 206 407–11.
| Countering cognitive biases in minimising low value care.Crossref | GoogleScholarGoogle Scholar | 28490292PubMed |
[6] Kahneman D. Thinking, fast and slow. New York: Farrar, Straus, and Giroux; 2011.
[7] Thaler RH, Sunstein CR. Nudge: improving decisions about health, wealth, and happiness. New Haven: Yale University Press; 2008.
[8] Lau R, Stevenson F, Ong BN, Dziedzic K, Treweek S, Eldridge S, Everitt H, Kennedy A, Qureshi N, Rogers A, Peacock R, Murray E. Achieving change in primary care – effectiveness of strategies for improving implementation of complex interventions: systematic review of reviews. BMJ Open 2015; 5 e009993
| Achieving change in primary care – effectiveness of strategies for improving implementation of complex interventions: systematic review of reviews.Crossref | GoogleScholarGoogle Scholar | 26700290PubMed |
[9] Campbell SM, Reeves D, Kontopantelis E, Sibbald B, Roland M. Effects of pay for performance on the quality of primary care in England. N Engl J Med 2009; 361 368–78.
| Effects of pay for performance on the quality of primary care in England.Crossref | GoogleScholarGoogle Scholar | 19625717PubMed |
[10] Scott IA, Elshaug A. Foregoing low value care: how much evidence is needed to change beliefs? Intern Med J 2013; 43 107–9.
| Foregoing low value care: how much evidence is needed to change beliefs?Crossref | GoogleScholarGoogle Scholar | 23402482PubMed |
[11] Schünemann HJ, Zhang Y, Oxman AD, Expert Evidence in Guidelines Group Distinguishing opinion from evidence in guidelines. BMJ 2019; 366 l4606
| Distinguishing opinion from evidence in guidelines.Crossref | GoogleScholarGoogle Scholar | 31324659PubMed |
[12] Kluger AN, DeNisi A. The effects of feedback interventions on performance: a historical review, a meta-analysis, and a preliminary feedback intervention theory. Psychol Bull 1996; 119 254–84.
| The effects of feedback interventions on performance: a historical review, a meta-analysis, and a preliminary feedback intervention theory.Crossref | GoogleScholarGoogle Scholar |
[13] Steindl C, Jonas E, Sittenthaler S, Traut-Mattausch E, Greenberg J. Understanding psychological reactance: new developments and findings. Z Psychol 2015; 223 205–14.
| Understanding psychological reactance: new developments and findings.Crossref | GoogleScholarGoogle Scholar | 27453805PubMed |
[14] Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs: Prentice-Hall; 1986.
[15] Hudson D, Singh G. Expert medical decision-making: how the data-frame theory can explain physician sense-making. Stud Health Technol Inform 2017; 234 167–71.
| 28186035PubMed |
[16] Helfrich CD, Rose AJ, Hartmann CW, van Bodegom-Vos L, Graham ID, Wood SJ, Majerczyk BR, Good CB, Pogach LM, Ball SL, Au DH, Aron DC. How the dual process model of human cognition can inform efforts to de-implement ineffective and harmful clinical practices: a preliminary model of unlearning and substitution. J Eval Clin Pract 2018; 24 198–205.
| How the dual process model of human cognition can inform efforts to de-implement ineffective and harmful clinical practices: a preliminary model of unlearning and substitution.Crossref | GoogleScholarGoogle Scholar | 29314508PubMed |
[17] Gupta DM, Boland RJ, Aron DC. The physician’s experience of changing clinical practice: a struggle to unlearn. Implement Sci 2017; 12 28
| The physician’s experience of changing clinical practice: a struggle to unlearn.Crossref | GoogleScholarGoogle Scholar | 28245849PubMed |
[18] Badgery-Parker T, Pearson SA, Dunn S, Elshaug AG. Measuring hospital-acquired complications associated with low-value care. JAMA Intern Med 2019; 179 499–505.
| Measuring hospital-acquired complications associated with low-value care.Crossref | GoogleScholarGoogle Scholar | 30801628PubMed |
[19] Navathe AS, Emanuel EJ. Physician peer comparisons as a nonfinancial strategy to improve the value of care. JAMA 2016; 316 1759–60.
| Physician peer comparisons as a nonfinancial strategy to improve the value of care.Crossref | GoogleScholarGoogle Scholar | 27802553PubMed |
[20] McKeown S, Krause C, Shergill M, Siu A, Sweet D. Gamification as a strategy to engage and motivate clinicians to improve care. Healthc Manage Forum 2016; 29 67–73.
| Gamification as a strategy to engage and motivate clinicians to improve care.Crossref | GoogleScholarGoogle Scholar | 26872801PubMed |
[21] Sukhera J, Wodzinski M, Milne A, Teunissen PW, Lingard L, Watling C. Implicit bias and the feedback paradox: exploring how health professionals engage with feedback while questioning its credibility. Acad Med 2019; 94 1204–10.
| Implicit bias and the feedback paradox: exploring how health professionals engage with feedback while questioning its credibility.Crossref | GoogleScholarGoogle Scholar | 31045605PubMed |
[22] Wang SY, Groene O. The effectiveness of behavioral economics-informed interventions on physician behavioral change: A systematic literature review. PLoS One 2020; 15 e0234149
| The effectiveness of behavioral economics-informed interventions on physician behavioral change: A systematic literature review.Crossref | GoogleScholarGoogle Scholar | 33052942PubMed |
[23] Warner AS, Shah N, Morse A, Lehmann EY, Maurer R, Moyer Z, Lehmann LS. Patient and physician attitudes toward low-value diagnostic tests. JAMA Intern Med 2016; 176 1219–21.
| Patient and physician attitudes toward low-value diagnostic tests.Crossref | GoogleScholarGoogle Scholar | 27367550PubMed |
[24] Linder JA, Meeker D, Fox CR, Friedberg MW, Persell SD, Goldstein NJ, Doctor JN. Effects of behavioural interventions on inappropriate antibiotic prescribing in primary care 12 months after stopping interventions. JAMA 2017; 318 1391–2.
| Effects of behavioural interventions on inappropriate antibiotic prescribing in primary care 12 months after stopping interventions.Crossref | GoogleScholarGoogle Scholar | 29049577PubMed |
[25] Saini V, Garcia-Armesto S, Klemperer D, Paris V, Elshaug AG, Brownlee S, Ioannidis JPA, Fisher ES, Drivers of poor medical care. Lancet 2017; 390 178–90.
| Drivers of poor medical care.Crossref | GoogleScholarGoogle Scholar | 28077235PubMed |
[26] Scott IA, Kallie J, Gavrilidis A. Achieving greater clinician engagement and impact in health care improvement: a neglected imperative. Med J Aust 2020; 212 5–7.
| Achieving greater clinician engagement and impact in health care improvement: a neglected imperative.Crossref | GoogleScholarGoogle Scholar | 31793698PubMed |
