AsthmaImproving Clinician Self-Efficacy Does Not Increase Asthma Guideline Use by Primary Care Clinicians
Section snippets
Methods
Twenty-four pediatric practices (8 urban and 16 private) in central Connecticut completed baseline measures that examined clinician self-efficacy and stages of change related to asthma, in addition to other measures, and were randomized into a control or provider intervention arm (Figure).32, 33
A practice was eligible to participate if the clinicians had been previously trained in the Easy Breathing program, which has been described.34, 35 The Easy Breathing program at this time consisted of 4
Study Participants
Eighty-eight clinicians in 24 practices were randomized either into the provider arm (n = 44 clinicians, 12 practices) or the control arm (Figure; Table 2). Eighteen clinicians (two-thirds were MLPs) left their practice before the end of the study. Their data were used at baseline only. Two thirds of the clinicians were full time physicians and one-third were MLPs. Seventy-five percent of physicians and 40% of MLPs had received their highest degree more than 10 years previously with a mean
Discussion
For all participants in this study, higher asthma-related self-efficacy scores at baseline were associated with greater asthma program-related activity (ie, enrollment in Easy Breathing). Self-efficacy scores and readiness to change increased in clinicians in the intervention arm but these increases were not associated with an increase in program enrollment, in increased development of a written asthma treatment plan, or with greater use of anti-inflammatory therapy for persistent asthma.
The
Acknowledgments
This work was supported by the National Heart Lung and Blood Institute of the National Institutes of Health (RO1 HL 70785-01) (Michelle M. Cloutier).
We are grateful to Ms Pamela Higgins for programmatic support, Ms Trudy Lerer and Ms Autherene Grant for data analysis and entry, and Ms Michelle Morse for administrative support and to the practices, clinicians, and staff who participated in this project.
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Authors confirm there are no conflicts of interest related to this manuscript.