Evaluation of a staff behaviour change intervention to increase the use of ward-based practice books and active practice during inpatient stroke rehabilitation: a phase-1 pre–post observational study

2020 ◽  
Vol 34 (5) ◽  
pp. 607-616
Author(s):  
Claire Stewart ◽  
Emma Power ◽  
Annie McCluskey ◽  
Suzanne Kuys ◽  
Meryl Lovarini
Keyword(s):  
Observational Study ◽  
Behaviour Change ◽  
Phase 1 ◽  
Inpatient Rehabilitation ◽  
Support Staff ◽  
Audit And Feedback ◽  
Behaviour Change Intervention ◽  
Post Intervention ◽  
Audit Data ◽  
Medical Record Audit

Objective: The aim of this study was to evaluate a staff behaviour change intervention to increase the use of ward-based practice books and active practice by stroke inpatients. Design: This is a pre–post observational study. Setting: This study was conducted in a inpatient rehabilitation unit in Australia. Subjects: Stroke inpatients participated in the study. Intervention: A staff behaviour change intervention was designed to support staff to implement practice books. The intervention included staff training on motivation and coaching, and weekly audit and feedback for six months. The environment was restructured to bring staff together weekly at the bedside to review audit data and share skills. Main measures: Medical record audit and behavioural mapping were used to compare the number of stroke participants with/using a practice book pre- and post-intervention. Pre- and post-intervention, the percentage of observations where a stroke participant was actively practising, repetitions of practice recorded and type of supervision were compared. Results: A total of 24 participants were observed ( n = 12 pre, n = 12 post). Post-intervention, the number of participants with practice books increased from one to six (OR = 11, 95% CI = (0.9, 550.7)), but this change was not statistically significant ( P = 0.069). Five participants recorded repetitions in their practice books post-intervention, three were observed using practice books. There was no change in median repetitions recorded ( rpbs = 0.00, 95% CI = (−0.4, 0.4), P = 1.000) or observed active practice ( rpbs = –0.02, 95% CI = (−0.4, 0.4), P = 0.933). Active practice was often fully supervised by a therapist. Conclusion: A staff behaviour change intervention has the potential to increase the number of stroke survivors receiving ward-based practice books but did not increase active practice.

Supporting mental health during COVID-19 using a digital behaviour change intervention: an open-label, single-arm, pre-post intervention research study (Preprint)

2021 ◽  
Author(s):  
Charlotte Summers ◽  
Philip Wu
Keyword(s):  
Mental Health ◽  
Behaviour Change ◽  
Perceived Stress ◽  
Digital Health ◽  
Mental Wellbeing ◽  
Behaviour Change Intervention ◽  
Open Label ◽  
Post Intervention ◽  
Convenience Sample ◽  
Health Technologies

BACKGROUND COVID-19 is taking its toll on people's mental health, particularly as people are advised to adhere to social distancing, self-isolation measures and government imposed national lockdowns. Digital health technologies have an important role to play in keeping people connected and supporting mental health and wellbeing. Particularly in the wake of the COVID-19 pandemic as even before this unprecedented time, mental health and social services were already stretched. OBJECTIVE Our objective was to evaluate the 12-week outcomes of the digitally delivered Gro Health platform, a digital behaviour change intervention for self-management of mental wellbeing, sleep, activity, and nutrition. METHODS The study used a quasi-experimental research design consisting of an open-label, single-arm, pre-post intervention engagement using a convenience sample. From adults who had joined the intervention and had a complete baseline dataset (GAD-7 Anxiety Test Questionnaire, Perceived Stress Scale, PHQ-9 Patient Health Questionnaire), we followed all users for 12 weeks (N=273), including 33 (12.1%) who reported a positive COVID-19 diagnosis during the study period. Users engagement with the Gro Health platform was tracked by active minutes. RESULTS Of the 347 study participants, 273 (78.67%) completed both baseline and follow up surveys. Change in scores for anxiety, perceived stress and depression was predicted by app engagement with the strongest effect being seen in change perceived stress scores F(1,271)=251.397, p<0.001, with an R2 of .479. CONCLUSIONS A digital behaviour change platform that provides remote mental wellbeing support can be effective in managing depression, anxiety, and perceived stress during times of crisis such as the current COVID-19 pandemic. CLINICALTRIAL Approved by Royal Holloway, University of London Ethics Board.

scholarly journals Determinants of usefulness in professional behaviour change interventions: observational study of a 15-year national program

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038016
Author(s):  
Andre Q Andrade ◽  
Vanessa T LeBlanc ◽  
Lisa M Kalisch-Ellett ◽  
Nicole L Pratt ◽  
Anna Moffat ◽  
...  
Keyword(s):  
Observational Study ◽  
Goal Setting ◽  
Behaviour Change ◽  
Educational Material ◽  
Perceived Usefulness ◽  
Audit And Feedback ◽  
Behaviour Change Techniques ◽  
Professional Behaviour ◽  
Behaviour Change Interventions ◽  
Feedback Interventions

ObjectiveEducational, and audit and feedback interventions are effective in promoting health professional behaviour change and evidence adoption. However, we lack evidence to pinpoint which particular features make them most effective. Our objective is to identify determinants of quality in professional behaviour change interventions, as perceived by participants.DesignWe performed a comparative observational study using data from the Veterans’ Medicines Advice and Therapeutics Education Services program, a nation-wide Australian Government Department of Veterans’ Affairs funded program that provides medicines advice and promotes physician adoption of best practices by use of a multifaceted intervention (educational material and a feedback document containing individual patient information).SettingPrimary care practices providing care to Australian veterans.ParticipantsGeneral practitioners (GPs) targeted by 51 distinct behaviour change interventions, implemented between November 2004 and June 2018.Primary and secondary outcome measuresWe extracted features related to presentation (number of images, tables and characters), content (polarity and subjectivity using sentiment analysis, number of external links and medicine mentions) and the use of five behaviour change techniques (prompt/cues, goal setting, discrepancy between current behaviour and goal, information about health consequences, feedback on behaviour). The main outcome was perceived usefulness, extracted from postintervention survey.ResultsOn average, each intervention was delivered to 9667 GPs. Prompt and goal setting strategies in the audit and feedback were independently correlated to perceived usefulness (p=0.030 and p=0.005, respectively). The number of distinct behaviour change techniques in the audit and feedback was correlated with improved usefulness (Pearson’s coefficient 0.45 (0.19, 0.65), p=0.001). No presentation or content features in the educational material were correlated with perceived usefulness.ConclusionsThe finding provides additional evidence encouraging the use of behaviour change techniques, in particular prompt and goal setting, in audit and feedback interventions.

scholarly journals Enhancing the Behaviour Change Wheel with synthesis, stakeholder involvement and decision-making: a case example using the ‘Enhancing the Quality of Psychological Interventions Delivered by Telephone’ (EQUITy) research programme

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Cintia L. Faija ◽  
Judith Gellatly ◽  
Michael Barkham ◽  
Karina Lovell ◽  
Kelly Rushton ◽  
...  
Keyword(s):  
Decision Making ◽  
Los Angeles ◽  
Behaviour Change ◽  
Evidence Synthesis ◽  
Phase 1 ◽  
Stakeholder Involvement ◽  
Behaviour Change Intervention ◽  
Behaviour Change Wheel ◽  
Three Phase

Abstract Background Using frameworks such as the Behaviour Change Wheel to develop behaviour change interventions can be challenging because judgement is needed at various points in the process and it is not always clear how uncertainties can be resolved. We propose a transparent and systematic three-phase process to transition from a research evidence base to a behaviour change intervention. The three phases entail evidence synthesis, stakeholder involvement and decision-making. We present the systematic development of an intervention to enhance the quality of psychological treatment delivered by telephone, as a worked example of this process. Method In phase 1 (evidence synthesis), we propose that the capabilities (C), opportunities (O) and motivations (M) model of behaviour change (COM-B) can be used to support the synthesis of a varied corpus of empirical evidence and to identify domains to be included in a proposed behaviour change intervention. In phase 2 (stakeholder involvement), we propose that formal consensus procedures (e.g. the RAND Health/University of California-Los Angeles Appropriateness Methodology) can be used to facilitate discussions of proposed domains with stakeholder groups. In phase 3 (decision-making), we propose that behavioural scientists identify (with public/patient input) intervention functions and behaviour change techniques using the acceptability, practicability, effectiveness/cost-effectiveness, affordability, safety/side-effects and equity (APEASE) criteria. Results The COM-B model was a useful tool that allowed a multidisciplinary research team, many of whom had no prior knowledge of behavioural science, to synthesise effectively a varied corpus of evidence (phase 1: evidence synthesis). The RAND Health/University of California-Los Angeles Appropriateness Methodology provided a transparent means of involving stakeholders (patients, practitioners and key informants in the present example), a structured way in which they could identify which of 93 domains identified in phase 1 were essential for inclusion in the intervention (phase 2: stakeholder involvement). Phase 3 (decision-making) was able to draw on existing Behaviour Change Wheel resources to revisit phases 1 and 2 and facilitate agreement among behavioural scientists on the final intervention modules. Behaviour changes were required at service, practitioner, patient and community levels. Conclusion Frameworks offer a foundation for intervention development but require additional elucidation at each stage of the process. The decisions adopted in this study are designed to provide an example on how to resolve challenges while designing a behaviour change intervention. We propose a three-phase process, which represents a transparent and systematic framework for developing behaviour change interventions in any setting.

scholarly journals Evaluating a large-scale online behaviour change intervention aimed at wildlife product consumers in Singapore

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248144
Author(s):  
Hunter Doughty ◽  
E. J. Milner-Gulland ◽  
Janice Ser Huay Lee ◽  
Kathryn Oliver ◽  
L. Roman Carrasco ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Large Scale ◽  
Species Conservation ◽  
Population Level ◽  
Target Audience ◽  
Wildlife Trade ◽  
Behaviour Change Intervention ◽  
Post Intervention ◽  
Online Behaviour ◽  
Intervention Message

Interventions to shift the behaviour of consumers using unsustainable wildlife products are key to threatened species conservation. Whether these interventions are effective is largely unknown due to a dearth of detailed evaluations. We previously conducted a country-level online behaviour change intervention targeting consumers of the Critically Endangered saiga antelope (Saiga tatarica) horn in Singapore. To evaluate intervention impact, we carried out in-person consumer surveys with >2,000 individuals pre- and post-intervention (2017 and 2019), and 93 in-person post-intervention surveys with traditional Chinese medicine (TCM) shopkeepers (2019). The proportion of self-reported high-usage saiga horn consumers in the target audience (Chinese Singaporean women aged 35–59) did not change significantly from pre- to post-intervention (24.4% versus 22.6%). However, post-intervention the target audience was significantly more likely than the non-target audience to accurately recall the intervention message and to report a decrease in saiga horn usage (4% versus 1% reported a behaviour change). Within the target audience, high-usage consumers were significantly more likely than lower-usage consumers to recall the message and report a behaviour change. Across respondents who reported a decrease in saiga horn usage, they cited the intervention message as a specific reason for their behaviour change significantly more than other reasons. Additionally, across all respondents, the belief that saiga is a common species in the wild decreased significantly from pre- to post-intervention. TCM shopkeepers, however, cited factors such as price and availability as the strongest influences on saiga horn sales. In sum, the intervention did significantly influence some consumers but the reduction of high-usage consumer frequency was not significant at the population level. We explore reasons for these findings, including competing consumer influences, characteristics of the intervention, and evaluation timing. This work suggests our intervention approach has potential, and exemplifies a multi-pronged in-person evaluation of an online wildlife trade consumer intervention.

Supporting mental health during COVID-19 using a digital behaviour change intervention: an open-label, single-arm, pre-post intervention research study (Preprint)

2021 ◽  
Author(s):  
Charlotte Summers ◽  
Philip Wu ◽  
Alisdair J G Taylor
Keyword(s):  
Mental Health ◽  
Behaviour Change ◽  
Perceived Stress ◽  
Digital Health ◽  
Mental Wellbeing ◽  
Behaviour Change Intervention ◽  
Open Label ◽  
Post Intervention ◽  
Convenience Sample ◽  
Health Technologies

BACKGROUND COVID-19 is taking its toll on people's mental health, particularly as people are advised to adhere to social distancing, self-isolation measures and government imposed national lockdowns. Digital health technologies have an important role to play in keeping people connected and supporting mental health and wellbeing. Particularly in the wake of the COVID-19 pandemic as even before this unprecedented time, mental health and social services were already stretched. OBJECTIVE Our objective was to evaluate the 12-week outcomes of the digitally delivered Gro Health platform, a digital behaviour change intervention for self-management of mental wellbeing, sleep, activity, and nutrition. METHODS The study used a quasi-experimental research design consisting of an open-label, single-arm, pre-post intervention engagement using a convenience sample. From adults who had joined the intervention and had a complete baseline dataset (GAD-7 Anxiety Test Questionnaire, Perceived Stress Scale, PHQ-9 Patient Health Questionnaire), we followed all users for 12 weeks (N=273), including 33 (12.1%) who reported a positive COVID-19 diagnosis during the study period. Users engagement with the Gro Health platform was tracked by active minutes. RESULTS Of the 347 study participants, 273 (78.67%) completed both baseline and follow up surveys. Change in scores for anxiety, perceived stress and depression was predicted by app engagement with the strongest effect being seen in change perceived stress scores F(1,271)=251.397, p<0.001, with an R2 of .479. CONCLUSIONS A digital behaviour change platform that provides remote mental wellbeing support can be effective in managing depression, anxiety, and perceived stress during times of crisis such as the current COVID-19 pandemic.

scholarly journals Evidence-Based Behaviour Change Intervention on Saiga Horn Medicine in Singapore: Research Brief

2021 ◽  
Author(s):  
Hunter Doughty ◽  
Diogo Veríssimo ◽  
Janice Ser Huay Lee ◽  
L Roman Carrasco ◽  
Joss Wright ◽  
...  
Keyword(s):  
Behaviour Change ◽  
News Coverage ◽  
Intervention Development ◽  
Past Research ◽  
Online News ◽  
Wildlife Trade ◽  
Evidence Based ◽  
Behaviour Change Intervention ◽  
Post Intervention ◽  
Intervention Message

Key Points: 1. A rare example of a wildlife trade initiative that covers all stages of an evidence-based behaviour change intervention. 2. Intervention development involved combining extensive consumer research with human behaviour theory and past research. 3. Intervention used a cutting-edge, powerful combination of online news coverage and targeted advertising. 4. Post-intervention, 4% of the target audience changed their behaviour (vs 1% of non-target) and the intervention message was shown as the key cause; but high-level users did not decrease significantly pre-to post-intervention.

scholarly journals Promoting HIV indicator condition-guided testing in hospital settings (PROTEST 2.0): study protocol for a multicentre interventional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saskia J. Bogers ◽  
Maarten F. Schim van der Loeff ◽  
Udi Davidovich ◽  
Anders Boyd ◽  
Marc van der Valk ◽  
...  
Keyword(s):  
The Netherlands ◽  
Hiv Testing ◽  
Quantitative Methods ◽  
Hospital Setting ◽  
Audit And Feedback ◽  
Interventional Study ◽  
Hiv Diagnosis ◽  
Post Intervention ◽  
Hiv Test ◽  
Undiagnosed Hiv

Abstract Background Late presentation remains a key barrier towards controlling the HIV epidemic. Indicator conditions (ICs) are those that are AIDS-defining, associated with a prevalence of undiagnosed HIV > 0.1%, or whose clinical management would be impeded if an HIV infection were undiagnosed. IC-guided HIV testing is an effective strategy in identifying undiagnosed HIV, but opportunities for earlier HIV diagnosis through IC-guided testing are being missed. We present a protocol for an interventional study to improve awareness of IC-guided testing and increase HIV testing in patients presenting with ICs in a hospital setting. Methods We designed a multicentre interventional study to be implemented at five hospitals in the region of Amsterdam, the Netherlands. Seven ICs were selected for which HIV test ratios (proportion of patients with an IC tested for HIV) will be measured: tuberculosis, cervical/vulvar cancer or high-grade cervical/vulvar dysplasia, malignant lymphoma, hepatitis B and C, and peripheral neuropathy. Prior to the intervention, a baseline assessment of HIV test ratios across ICs will be performed in eligible patients (IC diagnosed January 2015 through May 2020, ≥18 years, not known HIV positive) and an assessment of barriers and facilitators for HIV testing amongst relevant specialties will be conducted using qualitative (interviews) and quantitative methods (questionnaires). The intervention phase will consist of an educational intervention, including presentation of baseline results as competitive graphical audit and feedback combined with discussion on implementation and opportunities for improvement. The effect of the intervention will be assessed by comparing HIV test ratios of the pre-intervention and post-intervention periods. The primary endpoint is the HIV test ratio within ±3 months of IC diagnosis. Secondary endpoints are the HIV test ratio within ±6 months of diagnosis, ratio ever tested for HIV, HIV positivity percentage, proportion of late presenters and proportion with known HIV status prior to initiating treatment for their IC. Discussion This protocol presents a strategy aimed at increasing awareness of the benefits of IC-guided testing and increasing HIV testing in patients presenting with ICs in hospital settings to identify undiagnosed HIV in Amsterdam, the Netherlands. Trial registration Dutch trial registry: NL7521. Registered 14 February 2019.

scholarly journals A behaviour change intervention to reduce home exposure to second hand smoke during pregnancy in India and Bangladesh: a theory and evidence-based approach to development

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Veena A. Satyanarayana ◽  
Cath Jackson ◽  
Kamran Siddiqi ◽  
Prabha S. Chandra ◽  
Rumana Huque ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Behaviour Change ◽  
Delphi Survey ◽  
Behaviour Change Techniques ◽  
Evidence Based ◽  
Behaviour Change Intervention ◽  
Behaviour Change Interventions ◽  
Modified Delphi ◽  
Qualitative Interview Study ◽  
At Home

Abstract Background Home exposure to secondhand smoke (SHS) is highly prevalent amongst pregnant women in low- and middle-income countries like India and Bangladesh. The literature on the efficacy of behaviour change interventions to reduce home exposure to SHS in pregnancy is scarce. Methods We employed a theory and evidence-based approach to develop an intervention using pregnant women as agents of change for their husband’s smoking behaviours at home. A systematic review of SHS behaviour change interventions led us to focus on developing a multicomponent intervention and informed selection of behaviour change techniques (BCTs) for review in a modified Delphi survey. The modified Delphi survey provided expert consensus on the most effective BCTs in reducing home exposure to SHS. Finally, a qualitative interview study provided context and detailed understanding of knowledge, attitudes and practices around SHS. This insight informed the content and delivery of the proposed intervention components. Results The final intervention consisted of four components: a report on saliva cotinine levels of the pregnant woman, a picture booklet containing information about SHS and its impact on health as well strategies to negotiate a smoke-free home, a letter from the future baby to their father encouraging him to provide a smoke-free home, and automated voice reminder and motivational messages delivered to husbands on their mobile phone. Intervention delivery was in a single face-to-face session with a research assistant who explained the cotinine report, discussed key strategies for ensuring a smoke-free environment at home and practised with pregnant women how they would share the booklet and letter with their husband and supportive family members. Conclusion A theory and evidence-based approach informed the development of a multicomponent behaviour change intervention, described here. The acceptability and feasibility of the intervention which was subsequently tested in a pilot RCT in India and Bangladesh will be published later.

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