{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:04:20Z","timestamp":1790172260657,"version":"4.1.0"},"reference-count":63,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004144","name":"Liverpool John Moores University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004144","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bpspsychub.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["British J Health Psychol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Healthcare professionals' behaviours are central to effective multimorbidity management yet remain underexplored in behavioural medicine. Co\u2010existing type 2 diabetes (T2D) and cardiovascular disease (CVD) present intertwined behavioural and biomedical challenges; however, the organizational and professional factors that shape integrated care are poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The objective of this study was to identify behavioural and organizational determinants of integrated T2D\u2013CVD care and to apply behaviour change theory to provider practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Sixteen healthcare professionals in North\u2010West England participated in semi\u2010structured interviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were analysed inductively using reflexive thematic analysis within a critical realist framework. The COM\u2010B model (capability, opportunity, motivation, behaviour) informed interpretation of these inductive findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three interconnected themes: Compartmentalized conditions; inhibition of meaningful interactions; and gap between understanding and supporting illustrate how limitations in capability (confidence and training), opportunity (siloed records, absence of psychological pathways) and motivation (risk aversion and entrenched norms) collectively reinforce fragmented biomedical care. These mechanisms operate across organizational and cultural boundaries and explain persistent gaps in risk communication, cross\u2010disciplinary collaboration and limited psychological support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provides a theory\u2010informed qualitative application of the COM\u2010B model to healthcare professional behaviour in multimorbidity care, demonstrating how system design and professional culture shape interacting determinants. Conceptualizing cardiometabolic care as a behavioural and communicative system identifies priority intervention targets: staff training, service redesign, interoperable records and leadership development. These support practitioner well\u2010being, interdisciplinary collaboration and patient engagement. The findings reframe integrated T2D\u2013CVD care as a multidirectional capability model, informing policy and practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bjhp.70091","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T05:24:33Z","timestamp":1783747473000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transforming multimorbidity care: Organizational barriers and provider behaviour in type 2 diabetes and cardiovascular disease"],"prefix":"10.1111","volume":"31","author":[{"given":"Jessica Emily","family":"Brown","sequence":"first","affiliation":[{"name":"School of Psychology Liverpool John Moores University  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick Kanayo","family":"Umeh","sequence":"additional","affiliation":[{"name":"School of Psychology Liverpool John Moores University  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Lotto","sequence":"additional","affiliation":[{"name":"School of Nursing and Advanced Practice Liverpool John Moores University  Liverpool UK"},{"name":"Liverpool Centre for Cardiovascular Science  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reda","family":"Madroumi","sequence":"additional","affiliation":[{"name":"School of Psychology Liverpool John Moores University  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Jones","sequence":"additional","affiliation":[{"name":"School of Nursing and Advanced Practice Liverpool John Moores University  Liverpool UK"},{"name":"Liverpool Centre for Cardiovascular Science  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amineh","family":"Rashidi","sequence":"additional","affiliation":[{"name":"School of Nursing, Faculty of Health Sciences Curtin University  Bentley Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5874-8762","authenticated-orcid":false,"given":"Lisa","family":"Newson","sequence":"additional","affiliation":[{"name":"School of Psychology Liverpool John Moores University  Liverpool UK"},{"name":"Liverpool Centre for Cardiovascular Science  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010017\u20100605\u20109"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1468794112468475"},{"key":"e_1_2_11_4_1","volume-title":"A realist theory of science","author":"Bhaskar R.","year":"1978"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/2159676X.2019.1628806"},{"key":"e_1_2_11_6_1","first-page":"87","volume-title":"Thematic analysis: A practical guide","author":"Braun V.","year":"2022"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/02692163241234800"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/14780887.2024.2382244"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1369\u20107625.2012.00795.x"},{"key":"e_1_2_11_10_1","unstructured":"Brown J. 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