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Background: Clinicians' behaviours require deliberate decision-making in complex contexts and may involve both impulsive (automatic) and reflective (motivational and volitional) processes. Purpose: The purpose of this study was to test a dual process model applied to clinician behaviours in their management of type 2 diabetes. Methods: The design used six nested prospective correlational studies. Questionnaires were sent to general practitioners and nurses in 99 UK primary care practices, measuring reflective (intention, action planning and coping planning) and impulsive (automaticity) predictors for six guideline-recommended behaviours: blood pressure prescribing ( N = 335), prescribing for glycemic control ( N = 288), providing diabetes-related education ( N = 346), providing weight advice ( N = 417), providing self-management advice ( N = 332) and examining the feet ( N = 218). Results: Respondent retention was high. A dual process model was supported for prescribing behaviours, weight advice, and examining the feet. A sequential reflective process was supported for blood pressure prescribing, self-management and weight advice, and diabetes-related education. Conclusions: Reflective and impulsive processes predict behaviour. Quality improvement interventions should consider both reflective and impulsive approaches to behaviour change. [ABSTRACT FROM AUTHOR]

Background: Theories of action control emphasise the importance of planning, but plans are not universally beneficial. Purpose: The present study investigates whether the effectiveness of plans depends upon the skill of the planner. Methods: Study 1 prospectively predicted changes in unhealthy snacking behaviour over 1 week from intentions, action planning and performance on a standardised cognitive test of planning skill ( n = 72). Study 2 experimentally randomised skilled and poor planners to receive (or not) a planning intervention before completing an online food diary ( n = 144) Results: Spontaneously generated action plans about snacking explained significantly more variance in subsequent snacking if produced by a skilled rather than a poor planner. The planning intervention (implementation intention) significantly improved goal attainment but only in poor planners. Conclusions: Plans are only as good as the people who make them. Poor planners' plans do not help achieve goals. Planning interventions can compensate for a lack of planning skill. [ABSTRACT FROM AUTHOR]