scholarly journals Use of the theoretical domains framework and behaviour change wheel to develop a novel intervention to improve the quality of multidisciplinary cancer conference decision-making

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Christine Fahim ◽  
Anita Acai ◽  
Meghan M. McConnell ◽  
Frances C. Wright ◽  
Ranil R. Sonnadara ◽  
...  
Keyword(s):  
Decision Making ◽  
Behaviour Change ◽  
Theoretical Domains Framework ◽  
Behaviour Change Wheel

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.

Oral health promotion apps: an assessment of message and behaviour change potential

2020 ◽  
Author(s):  
Katherine H KACZMARCZYK ◽  
Kara A GRAY-BURROWS ◽  
Karen VINALL-COLLIER ◽  
Peter F DAY
Keyword(s):  
Health Promotion ◽  
Oral Health ◽  
Behaviour Change ◽  
Theoretical Domains Framework ◽  
Health Messages ◽  
Behaviour Change Technique ◽  
Oral Health Promotion ◽  
Health Apps ◽  
Change Technique

Abstract Background Oral health worldwide needs improving: untreated dental caries is the most common health condition affecting people globally. Mobile applications (apps) have potential to provide preventative oral health interventions. This study aimed to investigate the quality of available oral health promotion apps, assessing information provided and the barriers to oral health addressed using psychological frameworks. Methods A content assessment of oral health promotion apps targeted at adults in the UK iTunes store was conducted. The quality of 22 apps was assessed against 3 objective indices derived from the Delivering Better Oral Health toolkit, Theoretical Domains Framework and Behaviour Change Technique Taxonomy. Index scores were calculated and descriptive analyses were completed. Results On average, four Delivering Better Oral Health messages, seven Theoretical Domains Framework components and eight Behaviour Change Technique Taxonomy components were addressed per app. The most common components were: ‘take at least two minutes to brush’ for the Delivering Better Oral Health index, ‘goals’ and ‘intentions’ for the Theoretical Domains Framework index and ‘goal setting (behaviour)’ for the Behaviour Change Technique Taxonomy index. Conclusion The quality of information available in oral health apps requires improvement with the majority addressing only a few barriers to oral health. Currently, there is no recognized scale for evaluating oral health apps: this study provides a suggested method for future app evaluation. There is opportunity for a new app to be created based on health behaviour change theory which includes all the Delivering Better Oral Health messages.

scholarly journals A theory-based exploration of antibiotic use in primary healthcare in Gezira state, Sudan

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Anna-Leena Lohiniva ◽  
Einas Elwali ◽  
Duha Abuobaida ◽  
Ashwag Abdulrahim ◽  
Paul Bukuluki ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Primary Healthcare ◽  
Theoretical Domains Framework ◽  
Antibiotic Use ◽  
Local Context ◽  
Change Strategy ◽  
Qualitative Research Study ◽  
Inappropriate Use ◽  
Healthcare Settings ◽  
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.

scholarly journals Designing interventions to change eating behaviours

2015 ◽  
Vol 74 (2) ◽  
pp. 164-170 ◽  
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.

scholarly journals The impact of Healthy Conversation Skills training on health professionals’ barriers to having behaviour change conversations: a pre-post survey using the Theoretical Domains Framework

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jenna L. Hollis ◽  
Lucy Kocanda ◽  
Kirsty Seward ◽  
Clare Collins ◽  
Belinda Tully ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Health Behaviour ◽  
Health Professionals ◽  
Theoretical Domains Framework ◽  
Clinical Settings ◽  
Conversation Skills ◽  
Health Behaviour Change ◽  
The Impact

Abstract Background Changing people’s behaviour by giving advice and instruction, as traditionally provided in healthcare consultations, is usually ineffective. Healthy Conversation Skills (HCS) training enhances health professionals’ communication skills and ability to empower and motivate people in health behaviour change. Guided by the Theoretical Domains Framework (TDF), this study examined the impact of HCS training on health professional barriers to conducting behaviour change conversations in both clinical and non-clinical settings. Secondary aims were to i) identify health professionals’ barriers to having behaviour change conversations, and explore the ii) effect of HCS training on health professionals’ competence and attitudes to adopting HCS, iii) feasibility, acceptability and appropriateness of using HCS in their clinical and non-clinical roles, and iv) acceptability and quality of HCS training. Methods HCS training was conducted in October-November 2019 and February 2020. Pre-training (T1), post-training (T2) and follow-up (T3; 6-10 weeks post-training) surveys collected data on demographics and changes in competence, confidence, importance and usefulness (10-point Likert scale, where 10 = highest score) of conducting behaviour change conversations. Validated items assessing barriers to having these conversations were based on eight TDF domains. Post-training acceptability and quality of training was assessed. Data were summarised using descriptive statistics, and differences between TDF domain scores at the specific time points were analysed using Wilcoxon matched-pairs signed-rank tests. Results Sixty-four participants consented to complete surveys (97% women; 16% identified as Aboriginal), with 37 employed in clinical settings and 27 in non-clinical settings. The training improved scores for the TDF domains of skills (T1: median (interquartile range) = 4.7(3.3-5.3); T3 = 5.7(5.3-6.0), p < 0.01), belief about capabilities (T1 = 4.7(3.3-6.0); T3 = 5.7(5.0-6.0), p < 0.01), and goals (T1 = 4.3(3.7-5.0); T3 = 4.7(4.3-5.3), p < 0.01) at follow-up. Competence in using ‘open discovery questions’ increased post-training (T1 = 25% of responses; T2 = 96% of responses; T3 = 87% of responses, p < 0.001), as did participants’ confidence for having behaviour change conversations (T1 = 6.0(4.7-7.6); T2 = 8.1(7.1-8.8), p < 0.001), including an increased confidence in having behaviour change conversations with Aboriginal clients (T1 = 5.0(2.7-6.3); T2 = 7.6(6.4-8.3), p < 0.001). Conclusions Provision of additional support strategies to address intentions; memory, attention and decision processes; and behavioural regulation may enhance adoption and maintenance of HCS in routine practice. Wider implementation of HCS training could be an effective strategy to building capacity and support health professionals to use a person-centred, opportunistic approach to health behaviour change.

scholarly journals Orthodontic apps: an assessment of quality (using the Mobile App Rating Scale (MARS)) and behaviour change techniques (BCTs)

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
N. R. Siddiqui ◽  
S. J. Hodges ◽  
M. O. Sharif
Keyword(s):  
Behaviour Change ◽  
Rating Scale ◽  
Mobile App ◽  
Behaviour Change Techniques ◽  
List Type ◽  
Behaviour Change Wheel ◽  
Current Availability ◽  
The Uk ◽  
Google Play

Abstract Background Apps have been shown to be an effective tool in changing patients’ behaviours in orthodontics and can be used to improve their compliance with treatment. The Behaviour Change Techniques (BCTs) and quality (using MARS) within these apps have previously not been published. Objectives To evaluate the quality of these apps aiming to change behaviour. To assess BCTs used in patient focused orthodontic apps. Methods The UK Google Play and Apple App Stores were searched to identify all orthodontic apps and 305 apps were identified. All 305 apps were assessed for the presence of BCTs using an accepted taxonomy of BCTs (Behaviour Change Wheel (BCW)), widely utilised in healthcare. Of those containing BCTs, the quality was assessed using the Mobile App Rating Scale (MARS), a validated and multi-dimensional tool which rates apps according to 19 objective criteria. Data collection was carried out by two calibrated, independent assessors and repeated after 6 weeks for 25% of the apps by both assessors. Results BCTs were found in 31 apps, although only 18 of them were analysed for quality and 13 apps were excluded. Six different BCTs were identified: these were most commonly ‘prompts/cues’, and ‘information about health consequences’. All apps were shown to be of moderate quality (range 3.1–3.7/5). Inter-rater and intra-rater reliability for BCT and quality assessment were excellent. Conclusions The current availability of orthodontic apps of sufficient quality to recommend to patients is very limited. There is therefore a need for high-quality orthodontic apps with appropriate BCTs to be created, which may be utilised to improve patients’ compliance with treatment.

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

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.

scholarly journals 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 ◽  
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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