Table 1 Utilization of the theory of planned behavior (TPB) to understand barriers to having psychiatrists ordering and managing metabolic labs (target behavior)
Domains | Constructs | Barriers to target behavior |
|---|---|---|
Attitudes | ||
Social/professional role and identity | Identity | It’s not my role to manage diabetes if I find an abnormality. |
Motivation and goals | Goal setting | My patients are so sick, diabetes screening is low on the priority list |
Beliefs about capabilities | Control of behavior and environment | My patients are too cognitively impaired to make it to the lab |
Self-confidence | I don’t know how to prescribe medications to treat metabolic abnormalities like diabetes | |
Beliefs about consequences | Outcome expectation | What if these medications to treat metabolic abnormalities cause serious adverse side effects? |
Subjective norms | ||
Social influences | Social/group norms | Nobody else is managing diabetes! |
Environmental context and resources | Resources/materials | The electronic systems are separate, so why bother? |
My medical director won’t want me to do this because we won’t be able to bill for the treatment | ||
Perceived behavioral control | ||
Knowledge | Knowledge | I don’t know exactly what the ADA/APA guidelines recommend |
Skills | Skills | I don’t know how to initiate medications if there are abnormalities |
Environmental context and resources | Resources/materials | I don’t have reminders to get the HgA1c. |
I can’t access primary care, so why bother? | ||