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To what extent can behaviour change techniques be identified within an adaptable implementation package for primary care? A prospective directed content analysis

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To what extent can behaviour change techniques be identified within an adaptable implementation package for primary care? A prospective directed content analysis. / ASPIRE programme team.

In: Implementation Science, Vol. 13, No. 1, 32, 17.02.2018.

Research output: Contribution to journalArticle

Harvard

ASPIRE programme team 2018, 'To what extent can behaviour change techniques be identified within an adaptable implementation package for primary care? A prospective directed content analysis', Implementation Science, vol. 13, no. 1, 32. https://doi.org/10.1186/s13012-017-0704-7

APA

ASPIRE programme team (2018). To what extent can behaviour change techniques be identified within an adaptable implementation package for primary care? A prospective directed content analysis. Implementation Science, 13(1), [32]. https://doi.org/10.1186/s13012-017-0704-7

Vancouver

ASPIRE programme team. To what extent can behaviour change techniques be identified within an adaptable implementation package for primary care? A prospective directed content analysis. Implementation Science. 2018 Feb 17;13(1). 32. https://doi.org/10.1186/s13012-017-0704-7

Author

ASPIRE programme team. / To what extent can behaviour change techniques be identified within an adaptable implementation package for primary care? A prospective directed content analysis. In: Implementation Science. 2018 ; Vol. 13, No. 1.

Bibtex - Download

@article{c7aaf3d9437d4d81910e5d48cefc7166,
title = "To what extent can behaviour change techniques be identified within an adaptable implementation package for primary care? A prospective directed content analysis",
abstract = "Background: Interpreting evaluations of complex interventions can be difficult without sufficient description of key intervention content. We aimed to develop an implementation package for primary care which could be delivered using typically available resources and could be adapted to target determinants of behaviour for each of four quality indicators: diabetes control, blood pressure control, anticoagulation for atrial fibrillation and risky prescribing. We describe the development and prospective verification of behaviour change techniques (BCTs) embedded within the adaptable implementation packages. Methods: We used an over-lapping multi-staged process. We identified evidence-based, candidate delivery mechanisms-mainly audit and feedback, educational outreach and computerised prompts and reminders. We drew upon interviews with primary care professionals using the Theoretical Domains Framework to explore likely determinants of adherence to quality indicators. We linked determinants to candidate BCTs. With input from stakeholder panels, we prioritised likely determinants and intervention content prior to piloting the implementation packages. Our content analysis assessed the extent to which embedded BCTs could be identified within the packages and compared them across the delivery mechanisms and four quality indicators. Results: Each implementation package included at least 27 out of 30 potentially applicable BCTs representing 15 of 16 BCT categories. Whilst 23 BCTs were shared across all four implementation packages (e.g. BCTs relating to feedback and comparing behaviour), some BCTs were unique to certain delivery mechanisms (e.g. 'graded tasks' and 'problem solving' for educational outreach). BCTs addressing the determinants 'environmental context' and 'social and professional roles' (e.g. 'restructuring the social and 'physical environment' and 'adding objects to the environment') were indicator specific. We found it challenging to operationalise BCTs targeting 'environmental context', 'social influences' and 'social and professional roles' within our chosen delivery mechanisms. Conclusion: We have demonstrated a transparent process for selecting, operationalising and verifying the BCT content in implementation packages adapted to target four quality indicators in primary care. There was considerable overlap in BCTs identified across the four indicators suggesting core BCTs can be embedded and verified within delivery mechanisms commonly available to primary care. Whilst feedback reports can include a wide range of BCTs, computerised prompts can deliver BCTs at the time of decision making, and educational outreach can allow for flexibility and individual tailoring in delivery.",
keywords = "Audit and feedback, Behaviour change techniques, Clinical reminders, Computerised prompts, Discriminant content analysis, Educational outreach, Implementation intervention, Theoretical Domains Framework",
author = "{ASPIRE programme team} and Liz Glidewell and Willis, {Thomas A.} and Duncan Petty and Rebecca Lawton and McEachan, {Rosemary R.C.} and Emma Ingleson and Peter Heudtlass and Andrew Davies and Tony Jamieson and Cheryl Hunter and Suzanne Hartley and Kara Gray-Burrows and Susan Clamp and Paul Carder and Sarah Alderson and Farrin, {Amanda J.} and Robbie Foy and Vicky Ward and Robert West and Martin Rathfelder and Claire Hulme and Judith Richardson and Tim Stokes and Ian Watt",
year = "2018",
month = feb,
day = "17",
doi = "10.1186/s13012-017-0704-7",
language = "English",
volume = "13",
journal = "Implementation Science",
issn = "1748-5908",
publisher = "BioMed Central",
number = "1",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - To what extent can behaviour change techniques be identified within an adaptable implementation package for primary care? A prospective directed content analysis

AU - ASPIRE programme team

AU - Glidewell, Liz

AU - Willis, Thomas A.

AU - Petty, Duncan

AU - Lawton, Rebecca

AU - McEachan, Rosemary R.C.

AU - Ingleson, Emma

AU - Heudtlass, Peter

AU - Davies, Andrew

AU - Jamieson, Tony

AU - Hunter, Cheryl

AU - Hartley, Suzanne

AU - Gray-Burrows, Kara

AU - Clamp, Susan

AU - Carder, Paul

AU - Alderson, Sarah

AU - Farrin, Amanda J.

AU - Foy, Robbie

AU - Ward, Vicky

AU - West, Robert

AU - Rathfelder, Martin

AU - Hulme, Claire

AU - Richardson, Judith

AU - Stokes, Tim

AU - Watt, Ian

PY - 2018/2/17

Y1 - 2018/2/17

N2 - Background: Interpreting evaluations of complex interventions can be difficult without sufficient description of key intervention content. We aimed to develop an implementation package for primary care which could be delivered using typically available resources and could be adapted to target determinants of behaviour for each of four quality indicators: diabetes control, blood pressure control, anticoagulation for atrial fibrillation and risky prescribing. We describe the development and prospective verification of behaviour change techniques (BCTs) embedded within the adaptable implementation packages. Methods: We used an over-lapping multi-staged process. We identified evidence-based, candidate delivery mechanisms-mainly audit and feedback, educational outreach and computerised prompts and reminders. We drew upon interviews with primary care professionals using the Theoretical Domains Framework to explore likely determinants of adherence to quality indicators. We linked determinants to candidate BCTs. With input from stakeholder panels, we prioritised likely determinants and intervention content prior to piloting the implementation packages. Our content analysis assessed the extent to which embedded BCTs could be identified within the packages and compared them across the delivery mechanisms and four quality indicators. Results: Each implementation package included at least 27 out of 30 potentially applicable BCTs representing 15 of 16 BCT categories. Whilst 23 BCTs were shared across all four implementation packages (e.g. BCTs relating to feedback and comparing behaviour), some BCTs were unique to certain delivery mechanisms (e.g. 'graded tasks' and 'problem solving' for educational outreach). BCTs addressing the determinants 'environmental context' and 'social and professional roles' (e.g. 'restructuring the social and 'physical environment' and 'adding objects to the environment') were indicator specific. We found it challenging to operationalise BCTs targeting 'environmental context', 'social influences' and 'social and professional roles' within our chosen delivery mechanisms. Conclusion: We have demonstrated a transparent process for selecting, operationalising and verifying the BCT content in implementation packages adapted to target four quality indicators in primary care. There was considerable overlap in BCTs identified across the four indicators suggesting core BCTs can be embedded and verified within delivery mechanisms commonly available to primary care. Whilst feedback reports can include a wide range of BCTs, computerised prompts can deliver BCTs at the time of decision making, and educational outreach can allow for flexibility and individual tailoring in delivery.

AB - Background: Interpreting evaluations of complex interventions can be difficult without sufficient description of key intervention content. We aimed to develop an implementation package for primary care which could be delivered using typically available resources and could be adapted to target determinants of behaviour for each of four quality indicators: diabetes control, blood pressure control, anticoagulation for atrial fibrillation and risky prescribing. We describe the development and prospective verification of behaviour change techniques (BCTs) embedded within the adaptable implementation packages. Methods: We used an over-lapping multi-staged process. We identified evidence-based, candidate delivery mechanisms-mainly audit and feedback, educational outreach and computerised prompts and reminders. We drew upon interviews with primary care professionals using the Theoretical Domains Framework to explore likely determinants of adherence to quality indicators. We linked determinants to candidate BCTs. With input from stakeholder panels, we prioritised likely determinants and intervention content prior to piloting the implementation packages. Our content analysis assessed the extent to which embedded BCTs could be identified within the packages and compared them across the delivery mechanisms and four quality indicators. Results: Each implementation package included at least 27 out of 30 potentially applicable BCTs representing 15 of 16 BCT categories. Whilst 23 BCTs were shared across all four implementation packages (e.g. BCTs relating to feedback and comparing behaviour), some BCTs were unique to certain delivery mechanisms (e.g. 'graded tasks' and 'problem solving' for educational outreach). BCTs addressing the determinants 'environmental context' and 'social and professional roles' (e.g. 'restructuring the social and 'physical environment' and 'adding objects to the environment') were indicator specific. We found it challenging to operationalise BCTs targeting 'environmental context', 'social influences' and 'social and professional roles' within our chosen delivery mechanisms. Conclusion: We have demonstrated a transparent process for selecting, operationalising and verifying the BCT content in implementation packages adapted to target four quality indicators in primary care. There was considerable overlap in BCTs identified across the four indicators suggesting core BCTs can be embedded and verified within delivery mechanisms commonly available to primary care. Whilst feedback reports can include a wide range of BCTs, computerised prompts can deliver BCTs at the time of decision making, and educational outreach can allow for flexibility and individual tailoring in delivery.

KW - Audit and feedback

KW - Behaviour change techniques

KW - Clinical reminders

KW - Computerised prompts

KW - Discriminant content analysis

KW - Educational outreach

KW - Implementation intervention

KW - Theoretical Domains Framework

UR - http://www.scopus.com/inward/record.url?scp=85042063164&partnerID=8YFLogxK

U2 - 10.1186/s13012-017-0704-7

DO - 10.1186/s13012-017-0704-7

M3 - Article

C2 - 29452582

AN - SCOPUS:85042063164

VL - 13

JO - Implementation Science

JF - Implementation Science

SN - 1748-5908

IS - 1

M1 - 32

ER -

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