scholarly journals Mobilizing knowledge in behaviour change to promote health; the case of the Behaviour Change Wheel

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Belanger-Gravel
Keyword(s):  
Public Health ◽  
Behaviour Change ◽  
Scientific Evidence ◽  
Intervention Development ◽  
Behaviour Change Techniques ◽  
Knowledge Mobilization ◽  
Behaviour Change Wheel ◽  
Health Practitioners ◽  
Public Health Practitioners ◽  
Behavioural Sciences

Abstract Issue/problem Over the past decades, researchers from many fields have built an impressive body of knowledge regarding behaviour change. However, the use of this knowledge for accurately designing/delivering/executing behaviour change programs is challenging for many public health practitioners. Description of the problem To support effective knowledge mobilization in behaviour change and to build a coherent and useful body of scientific evidence, leading researchers in behavioural sciences have developed and refined a number of tools for designing interventions. Among these tools, the Behaviour Change Wheel (BCW) was built on an impressive effort to synthetize available evidence regarding intervention development frameworks, behaviour change theories, and behaviour change techniques. However, studies highlighted some issues associated with the use of these methodological innovations. Working with our public health partners in the field of health communication, we realized that applying models such as the BCW is far from being mundane practices. To support optimal knowledge mobilization in behavioural sciences, we are developing a research agenda to understand perceptions and motivations of public health practitioners toward innovations such as the BCW and to develop and evaluate knowledge mobilization strategies. Results The initiative will contribute to the development of new scientific knowledge regarding mechanisms underlying effective knowledge mobilization in behaviour change and will further support the adoption of these evidence-based practices within the field of public health. Lessons Although rapidly adopted by the community of researchers, it is not clear whether or not public health practitioners would be as willing, or capable of using the BCW to design and deliver programs. Issues regarding knowledge mobilization in behaviour change should be addressed to improve the uptake of this knowledge in practice.

scholarly journals Developing a theory-informed complex intervention to improve nurse–patient therapeutic engagement employing Experience-based Co-design and the Behaviour Change Wheel: an acute mental health ward case study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e047114
Author(s):  
Sarah McAllister ◽  
Alan Simpson ◽  
Vicki Tsianakas ◽  
Nick Canham ◽  
Vittoria De Meo ◽  
...  
Keyword(s):  
Mental Health ◽  
Behaviour Change ◽  
Design Process ◽  
Complex Interventions ◽  
Intervention Development ◽  
Behaviour Change Techniques ◽  
Service Users ◽  
Therapeutic Engagement ◽  
Behaviour Change Wheel

ObjectivesOur objectives were threefold: (1) describe a collaborative, theoretically driven approach to co-designing complex interventions; (2) demonstrate the implementation of this approach to share learning with others; and (3) develop a toolkit to enhance therapeutic engagement on acute mental health wards.Design and participantsWe describe a theory-driven approach to co-designing an intervention by adapting and integrating Experience-based Co-design (EBCD) with the Behaviour Change Wheel (BCW). Our case study was informed by the results of a systematic integrative review and guided by this integrated approach. We undertook 80 hours of non-participant observations, and semistructured interviews with 14 service users (7 of which were filmed), 2 carers and 12 clinicians from the same acute ward. The facilitated intervention co-design process involved two feedback workshops, one joint co-design workshop and seven small co-design team meetings. Data analysis comprised the identification of touchpoints and use of the BCW and behaviour change technique taxonomy to inform intervention development.SettingThis study was conducted over 12 months at an acute mental health organisation in England.ResultsThe co-designed Let’s Talk toolkit addressed four joint service user/clinician priorities for change: (1) improve communication with withdrawn people; (2) nurses to help service users help themselves; (3) nurses to feel confident when engaging with service users; (4) improving team relations and ward culture. Intervention functions included training, education, enablement, coercion and persuasion; 14 behaviour change techniques supported these functions. We detail how we implemented our integrated co-design-behaviour change approach with service users, carers and clinicians to develop a toolkit to improve nurse–patient therapeutic engagement.ConclusionsOur theory-driven approach enhanced both EBCD and the BCW. It introduces a robust theoretical approach to guide intervention development within the co-design process and sets out how to meaningfully involve service users and other stakeholders when designing and implementing complex interventions.

scholarly journals The Let's Talk toolkit: developing a theory-informed complex intervention to improve nurse-patient therapeutic engagement on an acute mental health ward by employing Experience-based Co-design and the Behaviour Change Wheel

2020 ◽  
Author(s):  
Sarah McAllister ◽  
Alan Simpson ◽  
Vicki Tsianakas ◽  
Nick Canham ◽  
Vittoria De Meo ◽  
...  
Keyword(s):  
Mental Health ◽  
Behaviour Change ◽  
Design Process ◽  
Complex Interventions ◽  
Intervention Development ◽  
Behaviour Change Techniques ◽  
Service Users ◽  
Therapeutic Engagement ◽  
Behaviour Change Wheel ◽  
Design Behaviour

Abstract Background Lack of high-quality nurse-patient therapeutic engagement is a longstanding problem on acute mental health wards, with a dearth of interventions to address this. A collaborative, theory-driven approach to developing and implementing complex interventions is more likely to be effective and sustainable. This paper describes an integrated co-design-behaviour change approach which developed the Let’s Talk intervention toolkit for improving the quality of therapeutic engagement on acute mental health wards. Methods We describe a theory-driven approach to co-designing an intervention by adapting and integrating Experience-based Co-design (EBCD) with the Behaviour Change Wheel (BCW). Fieldwork was informed by the results of a systematic integrative review and was guided by our co-design-behaviour change approach. It was conducted over 12-months at an acute mental health organisation in England. We undertook semi-structured interviews with 14 service users (seven of which were filmed), two carers and 12 clinicians, 80 hours of non-participant observations and a facilitated intervention co-design process that involved two feedback workshops, one joint co-design workshop and seven small co-design team meetings. Data analysis comprised the identification of touchpoints and use of the BCW and behaviour change technique taxonomy to inform intervention development. Results The co-designed Let’s Talk toolkit addressed four joint priorities for change: 1) improve communication with withdrawn people; 2) nurses to help service users help themselves; 3) nurses to feel confident when engaging with service users; 4) improving team relations and ward culture. Intervention functions included training, education, enablement, coercion and persuasion; 14 behaviour change techniques supported these functions. We detail how we implemented our integrated co-design-behaviour change approach with service users, carers and clinicians to co-design the toolkit to improve nurse-patient therapeutic engagement. Conclusions Our theory-driven approach enhances both EBCD and the BCW. It introduces a robust theoretical approach to guide intervention development within the co-design process and sets out how to meaningfully involve service users and other stakeholders when designing and implementing complex interventions.

scholarly journals Applying translational behavioural science to improve people’s health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Nagyova
Keyword(s):  
Public Health ◽  
Behaviour Change ◽  
Positive Impact ◽  
Behaviour Change Techniques ◽  
Knowledge Mobilization ◽  
Behavioural Science ◽  
Holistic View ◽  
Change Models ◽  
The Individual ◽  
Behavioural Aspects

Abstract Background The rising burden of chronic diseases poses a challenge for the whole public health system, and to deal with this we need to address the socioeconomic, cultural, and behavioural aspects of health and its determinants. While a change in individual 'lifestyle' factors, such as diet, exercise, smoking, and alcohol are often the target of intervention design, there needs to be an acknowledgement that behavioural science is much more than just 'lifestyle choice' on the individual level. Governments worldwide are increasingly incorporating the behavioural insights approach into policymaking. There has been an increasing interest in 'choice architecture' and 'nudging' to facilitate behaviour (change), often by manipulating elements of the environment. Designing interventions that target the most important determinants of behaviour, based on research evidence in the field of behavioural science, provide the best chance of changing behaviour and demonstrating a positive impact in terms of health outcomes and cost-effectiveness. However, knowing what works and how to apply it presents an ongoing challenge. Results The COM-B, EAST, and MOST are behaviour change models that were built on an impressive effort to synthesize available evidence regarding intervention development frameworks, behaviour change theories, and behaviour change techniques. They tackle determinants of behaviour in terms of capability, opportunity, and motivation on the level of the individual (micro level), alongside ways in which to intervene, at mezzo level (intervention functions) and macro level (policy categories). Conclusions These approaches take a holistic view of interventions and can contribute to the development of new scientific knowledge regarding mechanisms underlying effective knowledge mobilization in behaviour change. They are also expected to further support the adoption of the evidence-based practices within the field of public health.

scholarly journals Facilitators and barriers to fitness bootcamp participation using the Behaviour Change Wheel

2021 ◽  
pp. 001789692110441
Author(s):  
Leo De Winter ◽  
Leslie Morrison Gutman
Keyword(s):  
Physical Activity ◽  
Behaviour Change ◽  
Intervention Development ◽  
Behaviour Change Techniques ◽  
Qualitative Research Design ◽  
Behaviour Change Wheel ◽  
The Social ◽  
Facilitators And Barriers ◽  
The Impact

Objective: Despite its importance for mental and physical health, many adults fail to meet current physical activity recommendations. Furthermore, most adults who begin a physical activity programme revert to being less active or even inactive within the first 6 months. Fitness bootcamps represent a potential intervention for improving physical activity in healthy adults. However, no study to date has examined the influences on long-term participation in fitness bootcamps, which is the first step to developing an effective intervention. Using the Behaviour Change Wheel (BCW) framework, this study identified the facilitators and barriers to long-term (1 year or more) fitness bootcamp participation, which were then linked to behaviour change techniques (BCTs) to facilitate intervention development. Design: Qualitative research design. Setting: Data collection occurred in England. Method: Interviews were conducted with 15 long-term fitness bootcamp participants. Results: Thematic analysis revealed 17 facilitators and 6 barriers to long-term fitness bootcamp participation. Participants highlighted the importance of facilitators such as convenience, being outdoors and enjoyment. The social environment, including having a positive instructor and supportive group members, was further noted as a key influence on participation. While long-term participants faced occasional barriers to their routine such as physical injury, bad weather and competing events, the impact of these could be minimised through appropriate BCTs such as ‘demonstration of the behaviour’ and ‘restructuring the social/physical environment’. Conclusion: Findings from this study highlight the importance of social and environmental factors to promoting long-term fitness bootcamp participation and the inclusion of social and physical environmental restructuring as key intervention components.

scholarly journals What makes a ‘successful’ collaborative research project between public health practitioners and academics? A mixed-methods review of funding applications submitted to a local intervention evaluation scheme

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Peter van der Graaf ◽  
Lindsay Blank ◽  
Eleanor Holding ◽  
Elizabeth Goyder
Keyword(s):  
Public Health ◽  
Health Research ◽  
Collaborative Research ◽  
Online Survey ◽  
Public Health Practice ◽  
Rapid Review ◽  
Success Rates ◽  
Evaluation Scheme ◽  
Health Practitioners ◽  
Public Health Practitioners

Abstract Background The national Public Health Practice Evaluation Scheme (PHPES) is a response-mode funded evaluation programme operated by the National Institute for Health Research School for Public Health Research (NIHR SPHR). The scheme enables public health professionals to work in partnership with SPHR researchers to conduct rigorous evaluations of their interventions. Our evaluation reviewed the learning from the first five years of PHPES (2013–2017) and how this was used to implement a revised scheme within the School. Methods We conducted a rapid review of applications and reports from 81 PHPES projects and sampled eight projects (including unfunded) to interview one researcher and one practitioner involved in each sampled project (n = 16) in order to identify factors that influence success of applications and effective delivery and dissemination of evaluations. Findings from the review and interviews were tested in an online survey with practitioners (applicants), researchers (principal investigators [PIs]) and PHPES panel members (n = 19) to explore the relative importance of these factors. Findings from the survey were synthesised and discussed for implications at a national workshop with wider stakeholders, including public members (n = 20). Results Strengths: PHPES provides much needed resources for evaluation which often are not available locally, and produces useful evidence to understand where a programme is not delivering, which can be used to formatively develop interventions. Weaknesses: Objectives of PHPES were too narrowly focused on (cost-)effectiveness of interventions, while practitioners also valued implementation studies and process evaluations. Opportunities: PHPES provided opportunities for novel/promising but less developed ideas. More funded time to develop a protocol and ensure feasibility of the intervention prior to application could increase intervention delivery success rates. Threats: There can be tensions between researchers and practitioners, for example, on the need to show the 'success’ of the intervention, on the use of existing research evidence, and the importance of generalisability of findings and of generating peer-reviewed publications. Conclusions The success of collaborative research projects between public health practitioners (PHP) and researchers can be improved by funders being mindful of tensions related to (1) the scope of collaborations, (2) local versus national impact, and (3) increasing inequalities in access to funding. Our study and comparisons with related funding schemes demonstrate how these tensions can be successfully resolved.

scholarly journals After Action Review of the 2019 measles outbreak in Clark County, Washington, U.S.A

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Stoto ◽  
R Piltch-Loeb ◽  
R Wolfe ◽  
R Albrandt ◽  
A Melnick
Keyword(s):  
Public Health ◽  
Religious Community ◽  
Local Health ◽  
Mutual Aid ◽  
Social Distancing ◽  
Clark County ◽  
After Action Review ◽  
Measles Outbreak ◽  
Health Practitioners ◽  
Public Health Practitioners

Abstract Issue Clark County experienced a measles outbreak that challenged public health authorities. Description of the practice: We conducted a formal After Action Review with state and local health officials, school officials, and others to identify lessons for public health practitioners facing future outbreaks. Results Following the early identification of measles in a child who had recently arrived from Ukraine, active surveillance identified 71 confirmed cases, most in unvaccinated persons under 18 years of age. 4,138 contacts were traced and public health personnel made daily monitoring calls to 816. 53 potential exposure sites in healthcare facilities, schools and other public places were identified and communicated to the public. As a social distancing measure, unvaccinated students, teachers, and staff were excluded from schools in which exposure had occurred. Ascertaining susceptibility status was challenging. The national anti-vaccination sentiment and a parallel outbreak in a New York religious community created challenges in representing community risk while avoiding stigmatization of a community in which the first reported case was identified. Rather than respond to every false claim on social media, the health department developed talking points about emerging issues and engaged the community in dialogue. Lessons Responding to the measles outbreak required innovative approaches to surveillance and contact tracing, social distancing (school exclusions), and emergency risk communication. The response required extensive coordinated efforts of the county and state health departments, school systems, and many other organizations. Mutual aid enabled an influx of resources but managing the surge of responders proved challenging. Key messages Public health emergencies require effective emergency management practices. Carefully conducted After Action Reviews of health emergencies can help public health practitioners identify challenges and innovative practices.

scholarly journals Development of an intervention to increase adherence to nebuliser treatment in adults with cystic fibrosis: CFHealthHub

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
M. A. Arden ◽  
M. Hutchings ◽  
P. Whelan ◽  
S. J. Drabble ◽  
D. Beever ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Development Strategy ◽  
Treatment Adherence ◽  
Behaviour Change ◽  
Multidisciplinary Team ◽  
Treatment Plan ◽  
Controlled Trial ◽  
Intervention Development ◽  
Evidence Base ◽  
Behaviour Change Techniques

Abstract Background Cystic fibrosis (CF) is a life-limiting genetic condition in which daily therapies to maintain lung health are critical, yet treatment adherence is low. Previous interventions to increase adherence have been largely unsuccessful and this is likely due to a lack of focus on behavioural evidence and theory alongside input from people with CF. This intervention is based on a digital platform that collects and displays objective nebuliser adherence data. The purpose of this paper is to identify the specific components of an intervention to increase and maintain adherence to nebuliser treatments in adults with CF with a focus on reducing effort and treatment burden. Methods Intervention development was informed by the Behaviour Change Wheel (BCW) and person-based approach (PBA). A multidisciplinary team conducted qualitative research to inform a needs analysis, selected, and refined intervention components and methods of delivery, mapped adherence-related barriers and facilitators, associated intervention functions and behaviour change techniques, and utilised iterative feedback to develop and refine content and processes. Results Results indicated that people with CF need to understand their treatment, be able to monitor adherence, have treatment goals and feedback and confidence in their ability to adhere, have a treatment plan to develop habits for treatment, and be able to solve problems around treatment adherence. Behaviour change techniques were selected to address each of these needs and were incorporated into the digital intervention developed iteratively, alongside a manual and training for health professionals. Feedback from people with CF and clinicians helped to refine the intervention which could be tailored to individual patient needs. Conclusions The intervention development process is underpinned by a strong theoretical framework and evidence base and was developed by a multidisciplinary team with a range of skills and expertise integrated with substantial input from patients and clinicians. This multifaceted development strategy has ensured that the intervention is usable and acceptable to people with CF and clinicians, providing the best chance of success in supporting people with CF with different needs to increase and maintain their adherence. The intervention is being tested in a randomised controlled trial across 19 UK sites.

Characterizing the acceptability of a vaccine for West Nile virus by public health practitioners

Vaccine ◽  
2010 ◽  
Vol 28 (19) ◽  
pp. 3423-3427 ◽  
Author(s):  
Tasha Epp ◽  
Shannon Waldner ◽  
Judith Wright ◽  
Phil Curry ◽  
Hugh G. Townsend ◽  
...  
Keyword(s):  
Public Health ◽  
West Nile Virus ◽  
West Nile ◽  
Health Practitioners ◽  
Public Health Practitioners
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