Predicting implementation of an empirically supported treatment for cancer patients using the theory of planned behavior.

Abstract

There is a continuing gap between the availability of cancer control empirically supported treatments (ESTs) to address psychological needs of cancer patients and their dissemination to and implementation by providers in the community. The Theory of Planned Behavior (TPB), with constructs of attitudes, subjective norms, perceived behavioral control, and intentions, is used to understand the pathways to and prediction of providers' behavior, that is, implementation of a cancer control EST and its provision to patients. The purpose of the study was to prospectively test the TPB in predicting providers' usage of a cancer-specific EST, the biobehavioral intervention (BBI). Providers (N = 166) were trained. At training's end, providers completed measures of attitudes, perceived behavioral control, and intentions to use the BBI, and their supervisors completed measures of attitudes operationalized as subjective norms. Providers were followed up and 4 months later reported their usage of the BBI with patients in the last 2 months. Regression-based path analyses tested attitudes, perceived behavioral control, subjective norms, and intentions as predictors of BBI usage and for the possible effect of intentions as a mediator. Provider's BBI usage was high, delivered to 65.6% of patients. Providers' attitudes toward the BBI (b = .006; 95% confidence interval [CI: .002, .010]) and subjective norms (supervisors' attitudes toward providers' EST usage; b = .021; 95% CI [.007, .034]) predicted usage. Intentions predicted usage in univariate analyses but was not a mediator for usage. Use of theory in implementation science can test and identify variables key to implementation success. Here the TPB identified providers' and supervisors' attitudes as predictors of EST usage. (PsycINFO Database Record (c) 2019 APA, all rights reserved).