The relationship between habit and healthcare professional behaviour: a systematic review

Abstract

Background: Translating clinical research evidence into routine practice regularly involves healthcare professional behaviour change. Theories used in behavioural science typically assume that healthcare professional behaviour is the result of a reflective decision-making process. The current study aimed to systematically review the literature investigating the influence of automatic processes on healthcare professional behaviour (i.e. habit). Methods: A systematic search of five electronic databases identified 66 potentially relevant papers. Two reviewers independently selected nine studies for inclusion. The same reviewers extracted data using a structured extraction form to capture details of study characteristics; methodological quality; measures of clinical behaviour and habit; and correlation coefficients of the habit-behaviour relationships. Results: Eight of the nine identified studies found a statistically significant correlation between habit and behaviour ranging from r = 0.25-0.68. The overall quality of studies was moderate with considerable variation across studies. Habit was assessed using three different types of self-reported habit measures across the studies. Seven studies made explicit use of theory to predict clinical behaviour. Habit was measured as a construct within Operant Learning Theory or a Dual Process Model. Potential effect modifiers included the type of clinical behaviour, job title, type of habit measure and theory. Discussion: Results suggest that habit is an important predictor of healthcare professional behaviour. Effective behaviour change interventions should target both reflective and impulsive processes that underlie healthcare professional behaviour. Future studies would benefit from the development of objective measures of habit as current measures are limited to self-report.