INFORMATION ABOUT BARRIERS TO PLANNED CHANGE - A RANDOMIZED CONTROLLED TRIAL INVOLVING CONTINUING MEDICAL-EDUCATION LECTURES AND COMMITMENTTO CHANGE

Purpose. To determine whether practicing physicians receiving only cli nical information at a traditional continuing medical education (CME) lecture (control group) and physicians receiving clinical information plus information about barriers to behavioral change (study group) wou ld alter their clinical behaviors at the same rate. Method. In a rando mized controlled trial, the investigators matched 13 pairs of U.S. and Canadian medical schools, assigning one school from each pair to stud y or control conditions. Following the commitment-to-change model, the investigators asked the primary care physicians attending control or study lectures on the management of cardiovascular risks whether they intended to make behavioral changes as a result of participating in th e lectures and, if so, to indicate the specific changes. Thirty to 45 days later, the investigators surveyed the responding physicians to le arn whether they had implemented those changes. Results. Information a bout barriers to change did not increase the likelihood that physician s in the study group would report successful changes; they were no mor e likely to change than those in the control group. However, the physi cians in both study and control groups were significantly more likely to change (47% vs 7%, p<.001) if they indicated an intent to change im mediately following the lecture. Conclusions. Successful change in pra ctice may depend less on clinical and barriers information than on oth er factors that influence physicians' performances. To further develop the commitment-to-change strategy in measuring the effects of planned change, it is important to isolate and learn the powers of individual components of the strategy as well as their collective influence on p hysicians' clinical behaviors.