Application of the Transtheoretical model to Behavioral Health Professionals' Readiness to Practice Integrated Primary Care

Author

Cerissa Blaney, University of Rhode IslandFollow

Date of Award

2013

Degree Type

Dissertation

Degree Name

Doctor of Philosophy in Psychology

Specialization

Clinical Psychology

Department

Psychology

First Advisor

Colleen A. Redding

Abstract

Integrated primary care (IPC) has received substantial support with its demonstrated ability to improve access to care, quality of care and health outcomes. Although the benefits of IPC are clear, the integration process has met barriers. One barrier is limited understanding of behavioral health professionals’ (BHP) attitudes towards IPC. Better understanding could allow us to improve BHP training and motivation for IPC practice. This study aimed to develop Transtheoretical Model (TTM) measures to assess BHP attitudes toward and readiness to practice IPC using split-half cross-validation procedures. The sample consisted of 319 licensed and practicing BHPs with a stage distribution of Precontemplation 50.6%, Contemplation 2.8%, Preparation 1.6%, Action 6.0%, and Maintenance 39.0%. Exploratory principal components analyses yielded a 2-factor (Pros α = .90; Cons α = .83) 16-item scale for the decisional balance (DCBL) measure, a 1-factor 5-item scale for the self-efficacy (SE) measure (α = .93) and a 2-factor 12-item scale for the IPC Behavior measure (Consultation/Practice Management α = .915; Intervention/Knowledge α = .891). Confirmatory analyses replicated the hypothesized scale structures for DCBL (CFI = .89, AASR = .05, loadings .51-.81), SE (CFI = .90, AASR = .03, loadings .60-.90) and IPC Behavior (CFI = .934, AASR = .04, loadings .63-.91). MANOVA results by stage of change replicated hypothesized patterns for each construct Wilk’s Λ = .55, F(15, 834.09) = 13.55, p < .001, multivariate η² = .18. Follow-up tests found significant stage group differences, accounting for between 7% and 41% of the variance. This study demonstrated the applicability of the TTM to this new and increasingly important area; both measures demonstrated good internal and external validity. Future research should explore these measures longitudinally and investigate methods to improve training to increase BHP readiness to practice IPC.

Recommended Citation

Blaney, Cerissa, "Application of the Transtheoretical model to Behavioral Health Professionals' Readiness to Practice Integrated Primary Care" (2013). Open Access Dissertations. Paper 4.
https://digitalcommons.uri.edu/oa_diss/4