Planning to be routine: automaticity as a mediator of the planning-behaviour relationship in healthcare professionals

Abstract

Background: Clinicians often have strong intentions to provide evidence-based care to people with type 2 diabetes. Intentions are an important predictor of behaviour, but do not guarantee enactment. Action planning (AP) and coping planning (CP) can help with intention enactment by creating cue-response links that promote automaticity. This study aimed to investigate whether the relationship between AP or CP and clinician behaviour operates indirectly through measures of automaticity. Methods: Prospective correlational design with six nested sub-studies. Physicians and nurses (n = 427 from 99 UK practices) completed measures of AP, CP, and automaticity at baseline and self-reported their enactment of guideline-recommended advising, prescribing and examining behaviours 12 months later. We used bootstrapped mediation analyses. Findings: Eleven of the 12 analyses showed either a full or partial mediation effect. AP operated indirectly on behaviour via automaticity for five of the six behaviours and CP for all six clinician behaviours. Discussion: The mechanism of automaticity creation inherent to planning was supported across six different behaviours and suggests that planning may be an effective strategy for promoting habitual behaviour in clinicians.