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Table 3 Comparison of key belief and attitude themes for high and low implementers

From: "Should I and Can I?": A mixed methods study of clinician beliefs and attitudes in the management of lifestyle risk factors in primary health care

Theme High Implementers Low Implementers
Congruence with clinician role ▪Risk factors perceived to be relevant to the presenting issues and types of clients seen.
▪Opportunity to address as part of routine care.
▪Risk factors perceived to be less relevant to the clinicians' role and reason for seeing the client.
▪Confusion over role boundaries, uncertainty about whether risk factors should be addressed by another health professional.
Perception of client acceptability ▪Opportunity to develop rapport with clients.
▪Linked discussion of risk factors to the presenting issue.
▪Undertook screening for risk factors as part of standard assessment.
▪Flexible approach to intervention.
▪Less able to link discussion of risk factors to presenting issue.
▪Concerned about being seen as judgemental, receiving a negative reaction from clients and damaging clinician-client relationship.
Beliefs about capabilities ▪High perceived confidence and comfort in addressing risk factors. ▪Expressed a lack of knowledge, skills or confidence in addressing risk factor issues in an appropriate way.
Perceived Effectiveness of risk factor intervention ▪Low perceived effectiveness but responsibility to provide intervention as part of the role.
▪Value of intervention recognised but difficulty in assessing and measuring outcomes.
▪Low perceived effectiveness of risk factor intervention.
Clinicians' own lifestyle ▪Own lifestyle habits acted as an enabler for some (eg ex-smoker) or did not influencing risk factor management practices ▪Own lifestyle habits identified as a barrier for some in addressing risk factor issues with clients.