Using theory to explore facilitators and barriers to delayed prescribing in Australia: a qualitative study using the Theoretical Domains Framework and the Behaviour Change Wheel

Abstract Background Inappropriate use of antibiotics is a major contributing factor to the emergence of antimicrobial resistance globally, including in Sudan. Objectives The project aimed to develop a theory-driven behaviour change strategy addressing both prescribers and patients based on factors that are driving antibiotic use in primary healthcare settings in Gezira state in Sudan. Methods The strategy was designed based on the Theoretical Domains Framework (TDF) to identify behavioural domains and the Behaviour Change Wheel (BCW) to select appropriate intervention functions. The process included (1) a formative qualitative research study and (2) a knowledge co-production workshop that utilized the results of the qualitative study to design a salient, appropriate, and credible behaviour change strategy. Results The TDF domains related to prescribers that emerged from the study included knowledge, skills, and intention. The selected BCW intervention functions included education, training, modelling, and persuasion. The main TDF domains related to patients included social influences and intention. The selected BCW intervention functions included enablement and education. Conclusion Using the TDF and BCW intervention functions, the study identified behavioural domains that influence antibiotic prescription and consumption in rural primary healthcare settings in Gezira state in Sudan and appropriate intervention functions to modify these behaviours. Knowledge co-production ensured that the evidence-based strategy was acceptable and practical in the local context.

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Designing interventions to change eating behaviours

Proceedings of The Nutrition Society ◽

10.1017/s0029665115000075 ◽

2015 ◽

Vol 74 (2) ◽

pp. 164-170 ◽

Cited By ~ 31

Author(s):

Lou Atkins ◽

Susan Michie

Keyword(s):

Behaviour Change ◽

Design Process ◽

Theoretical Domains Framework ◽

Research Literature ◽

Intervention Design ◽

Eating Behaviours ◽

Behavioural Science ◽

Behaviour Change Technique ◽

Behaviour Change Wheel ◽

Intervention Content

Understanding and changing eating behaviours are central to the work of Nutrition Society members working in both research and applied settings. The present paper describes a recently published resource to guide the design of interventions to change behaviour, The Behaviour Change Wheel: A Guide to Designing Interventions (BCW Guide). This is a practical guide to intervention design that brings together recently-developed theory-based tools in behavioural science into a coherent step-by-step design process. It is based on the BCW, a synthesis of nineteen frameworks of behaviour change found in the research literature. The BCW has at its core a model of behaviour known as ‘capability’, ‘opportunity’, ‘motivation’ and ‘behaviour’. The model recognises that behaviour is part of an interacting system involving all these components. The BCW identifies different intervention options that can be applied to changing each of the components and policies that can be adopted to deliver those intervention options. The book shows how the BCW links to theory-based frameworks to understand behaviour such as the Theoretical Domains Framework and the recently developed Behaviour Change Technique Taxonomy v1 for specifying intervention content. In essence, it shows how to link what is understood about a given behaviour to types of intervention likely to be effective and then translate this into a locally relevant intervention. In addition, the present paper sets out some principles of intervention design.

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Using the behaviour change wheel approach to optimise self-sampling packs for sexually transmitted infections and blood borne viruses

10.1101/2021.07.06.21258646 ◽

2021 ◽

Author(s):

Paul Flowers ◽

Gabriele Vojt ◽

Maria Pothoulaki ◽

Fiona Mapp ◽

Melvina Woode-Owusu ◽

...

Keyword(s):

Sexually Transmitted Infections ◽

Behaviour Change ◽

Theoretical Domains Framework ◽

Behaviour Change Techniques ◽

Behaviour Change Technique ◽

Sexually Transmitted ◽

Health Clinics ◽

Behaviour Change Wheel ◽

Qualitative Work ◽

Sexual Health Clinics

Purpose: This paper describes the process of optimising a widely offered intervention - the self-sampling pack for sexually transmitted infections (STIs) and blood born viruses (BBVs). We drew upon the BCW approach, incorporating the theoretical domains framework (TDF) and the behaviour change technique taxonomy (BCTT) to systematically specify potential intervention components that may optimise the packs. Methods: A behaviour change wheel analysis built upon prior thematic analyses of qualitative data collected through focus groups and interviews with members of the public and people recruited from sexual health clinics in Glasgow and London (n=56). Salient barriers and facilitators to specific sequential behavioural domains associated with wider behavioural system of pack-use were subjected to further analyses, coding them in relation to the TDF, the BCWs intervention functions, and finally specifying potential optimisation in relation to behaviour change techniques (BCTs). Results: Our TDF analysis suggested that across the overall behavioural system of pack use the most important theoretical domains were beliefs about consequences and memory, attention and decision-making. BCW analysis on the overall pack suggested useful intervention functions should focus on environmental restructuring, persuasion, enablement, education and modelling. Ways of optimising the intervention were also specified in relation to potentially useful behaviour change techniques (BCTs). Conclusions: A detailed behavioural analysis building on earlier qualitative work using the TDF and the BCW provided a systematic approach to optimising an existing intervention. The approach enabled the specification of highly specific, evidence-based, and theoretically informed recommendations for intervention optimisation.

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What influences practitioners’ readiness to deliver psychological interventions by telephone? A qualitative study of behaviour change using the Theoretical Domains Framework

BMC Psychiatry ◽

10.1186/s12888-020-02761-3 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Cintia L. Faija ◽

Janice Connell ◽

Charlotte Welsh ◽

Kerry Ardern ◽

Elinor Hopkin ◽

...

Keyword(s):

Qualitative Study ◽

Behaviour Change ◽

Theoretical Domains Framework ◽

Psychological Interventions

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Identifying and overcoming barriers to automated external defibrillator use by GoodSAM volunteer first responders in out-of-hospital cardiac arrest using the Theoretical Domains Framework and Behaviour Change Wheel: a qualitative study

BMJ Open ◽

10.1136/bmjopen-2019-034908 ◽

2020 ◽

Vol 10 (3) ◽

pp. e034908

Author(s):

Christopher M Smith ◽

Frances Griffiths ◽

Rachael T Fothergill ◽

Ivo Vlaev ◽

Gavin D Perkins

Keyword(s):

Cardiac Arrest ◽

Behaviour Change ◽

Clinical Importance ◽

Theoretical Domains Framework ◽

First Responders ◽

Public Access ◽

Automated External Defibrillator ◽

Telephone Interviews ◽

Behaviour Change Wheel ◽

External Defibrillator

ObjectivesGoodSAM is a mobile phone app that integrates with UK ambulance services. During a 999 call, if a call handler diagnoses cardiac arrest, nearby volunteer first responders registered with the app are alerted. They can give cardiopulmonary resuscitation (CPR) and/or use a public access automated external defibrillator (AED). We aimed to identify means of increasing AED use by GoodSAM first responders.MethodsWe conducted semistructured telephone interviews, using the Theoretical Domains Framework to identify and classify barriers to AED use. We analysed findings using the Capability, Opportunity, Motivation, Behaviour (COM-B) model and subsequently used the Behaviour Change Wheel to develop potential interventions to improve AED use.SettingLondon, UK.ParticipantsGoodSAM first responders alerted in the previous 7 days about a cardiac arrest.ResultsWe conducted 30 telephone interviews in two batches in July and October 2018. A public access AED was taken to scene once, one had already been attached on scene another time and three participants took their own AEDs when responding. Most first responders felt capable and motivated to use public access AEDs but were concerned about delaying CPR if they retrieved one and frustrated when arriving after the ambulance service. They perceived lack of opportunities due to unavailable and inaccessible AEDs, particularly out of hours. We subsequently developed 13 potential interventions to increase AED use for future testing.ConclusionsGoodSAM first responders used AEDs occasionally, despite a capability and motivation to do so. Those operating volunteer first responder systems should consider our proposed interventions to improve AED use. Of particular clinical importance are: highlighting AED location and providing route/time estimates to the patient via the nearest AED. This would help single responders make appropriate decisions about AED retrieval. As AED collection may extend time to reach the patient, where there is sufficient density of potential responders, systems could send one responder to initiate CPR and another to collect an AED.

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Using the Behaviour Change Wheel (BCW) to Characterise Parenting Interventions to Prevent Intergenerational Child Abuse

International Journal on Child Maltreatment Research Policy and Practice ◽

10.1007/s42448-021-00103-8 ◽

2021 ◽

Author(s):

Fatima Younas ◽

Leslie Morrison Gutman

Keyword(s):

Social Support ◽

Child Abuse ◽

Behaviour Change ◽

Theoretical Domains Framework ◽

Mechanisms Of Change ◽

Parenting Interventions ◽

Framework Analysis ◽

Behaviour Change Technique ◽

Behaviour Change Wheel ◽

History Of

Abstract Research shows that parents with a history of child abuse are at risk of perpetuating the cycle of abuse; however, exploration of intervention content is still a neglected area. This qualitative study identifies intervention components and corresponding mechanisms of change of parenting interventions to prevent intergenerational child abuse. Interviews with ten heads of interventions from the UK and USA were coded using deductive framework analysis. The Behaviour Change Technique (BCT) Taxonomy and Behaviour Change Wheel were used to code intervention components including BCTs and intervention functions. Mechanisms of change were coded using the Theoretical Domains Framework. Twelve BCTs and eight intervention functions were identified including education, enablement and training delivered through BCTs of instruction on how to perform a behaviour, restructuring the environment and social support. Corresponding mechanisms of change include behaviour regulation, knowledge and social influences, among others. This study offers insight into targeting and tailoring services to improve outcomes for parents with a history of child abuse. Findings suggest that there are possible mechanisms through which vulnerable parents can be helped to break the cycle of abuse including promoting social support, regulating parents’ behaviour through trauma-informed approaches and enhancing knowledge, self-esteem and confidence in parenting.

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

Health Education Journal ◽

10.1177/00178969211044180 ◽

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.

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