Theory in practice: helping providers address depression in diabetes care

A continuing education (CE) program based on the theory of planned behavior was designed to understand and improve health care providers' practice patterns in screening, assessing, and treating and/or referring patients with diabetes for depression treatment.

Participants completed assessments of attitudes, confidence, intentions, and behaviors regarding depression management at 3 time points: immediately prior to the CE program (baseline), immediately after the CE program (posttest) and 6 weeks after the CE program (follow-up).

Ninety-eight providers attended the CE program: 71 completed the baseline assessment, 66 completed the posttest assessment, and 37 completed the 6-week follow-up. Compared to baseline, at posttest providers reported significantly more favorable attitudes, fewer negative attitudes, greater confidence, and greater intention to address depression with their diabetes patients. At the 6-week follow-up, participants reported a marginally significant increase in educating patients about depression, but no other depression management practices changed. Intention to change and confidence predicted some depression practice patterns at follow-up. Fewer barriers were a consistent predictor of depression practice patterns at follow-up.

In the short term, provider attitudes, confidence, and intentions to address depression with their patients improved. Intentions, confidence, and especially barriers are important intervention targets.