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 an Evidence-Based Behavior Change Strategy to Promote Antibiotic Use in Primary Healthcare in Gezira State, Sudan

2020 ◽  
Author(s):  
Anna-Leena Lohiniva ◽  
Einas S. Elwali ◽  
Duha Abuobaida ◽  
Ashwag Abdulrahim ◽  
Paul Bukuluki ◽  
...  
Keyword(s):  
Behavior Change ◽  
Primary Healthcare ◽  
Social Influences ◽  
Theoretical Domains Framework ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Behavior Change Techniques ◽  
Change Strategy ◽  
Appropriate Behavior ◽  
Intention To Change

Abstract Background: Abuse of antibiotics is a major contributing factor to the emergence of antibiotic resistance (ABR) globally. Misuse and overuse of antibiotics is common also in Sudan. Addressing antibiotic use is a key component of AMR response.Objectives: The project aimed to develop a theory driven behavior change strategy based on local understanding of drivers of antibiotic use at primary healthcare settings in Gezira State in Sudan. The strategy is needed to enhance the prescribers’ appropriate prescription of antibiotics and to reduce the patient’s demand towards unnecessary antibiotics.Methods: The strategy was designed based on the Theoretical Domains Framework (TDF) to identify behavioral barriers and the Behavior Change Wheel to select appropriate behavior change techniques (BCTs). The process included two major elements (1) a formative qualitative research study using focus group discussions and in-depth interviews targeting prescribers and patients. (2) a knowledge co-production workshop that utilized the results of the qualitative study and aimed to design a salient, legitimate and credible behavior change strategy identifying relevant behavior change techniques (BCTs) to overcome key barriers.Results: The main TDF domains that emerged from the discussions with prescribers were knowledge of antibiotics and AMR, skills to answer patient demand on antibiotics, prescription habits and work exhaustion, social influences, intention to change prescription practices and environmental factors. The main TDF domains that emerged through discussions with patients were antibiotic use habits, social influences, professional role belief in capabilities and intention to change. The workshop discussions resulted in the selection of five BTCs that included education, training, modeling, enablement and persuasion.Conclusion: This study, using the TDF and BCW taxonomy, explored the fact that antibiotic prescribing is influenced by many social and contextual factors. Knowledge co- production offered real benefits in addressing these complexities to come up with a set of context appropriate behavior change interventions.

scholarly journals Designing an Evidence-Based Behavior Change Strategy to Promote Antibiotic Use in Primary Healthcare in Gezira State, Sudan

2020 ◽  
Author(s):  
Anna-Leena Lohiniva ◽  
Einas S. Elwali ◽  
Duha Abuobaida ◽  
Ashwag Abdulrahim ◽  
Paul Bukuluki ◽  
...  
Keyword(s):  
Behavior Change ◽  
Primary Healthcare ◽  
Social Influences ◽  
Theoretical Domains Framework ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Behavior Change Techniques ◽  
Change Strategy ◽  
Appropriate Behavior ◽  
Intention To Change

Abstract Background: Abuse of antibiotics is a major contributing factor to the emergence of antibiotic resistance (ABR) globally. Misuse of antibiotics is common also in Sudan. Objectives: The project aimed to develop a theory driven behavior change strategy based on local understanding of drivers of antibiotic use at primary healthcare settings in Gezira State in Sudan. Methods: The strategy was designed based on the Theoretical Domains Framework to identify behavioral barriers and the Behavior Change Wheel to select appropriate behavior change techniques The process included (1) a formative qualitative research study (2) a knowledge co-production workshop that utilized the results of the qualitative study and aimed to design a salient, legitimate and credible behavior change strategy identifying relevant behavior change techniques (BCTs) to overcome key barriers. Results: The main TDF domains that emerged from the discussions were knowledge of antibiotics and AMR, skills to answer patient demand on antibiotics, prescription habits and work exhaustion, social influences, intention to change prescription practices and environmental factors. The main TDF domains that emerged through discussions with patients were antibiotic use habits, social influences, professional role belief in capabilities and intention to change. The workshop discussions resulted in the selection of five BTCs that included education, training, modeling, enablement and persuasion. Conclusion: This study, using the TDF and BCW taxonomy, identified that antibiotic prescribing is influenced by social and contextual factors. Knowledge co- production offered real benefits in addressing these complexities to come up with a set of context appropriate behavior change interventions.

scholarly journals Developing a theory-based behavior change intervention to improve the prescription of surgical prophylaxis

2021 ◽  
Author(s):  
Anna-Leena Lohiniva ◽  
Iman Heweidy ◽  
Samiha Abdu ◽  
Abouelata Omar ◽  
Caroline Ackley ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Theoretical Domains Framework ◽  
Antibiotic Use ◽  
Control Measures ◽  
World Health ◽  
Infection Prevention And Control ◽  
Surgical Prophylaxis ◽  
Prescription Practices ◽  
Health Organization ◽  
Context Specific

Abstract Background: Antimicrobial resistance (AMR) is increasingly pervasive due to multiple, complex prescribing and consuming behaviours. Accordingly, behaviour change is an important component of response to AMR. Little is known about the best approaches to change antibiotic use practices and behaviours. Aim: This project aims to develop a context-specific behaviour change strategy focusing on promoting appropriate prescription practices following the World Health Organization recommendations for surgical prophylaxis. in an orthopaedic surgery unit in Egypt. Methods: The project included a formative qualitative research study was based on the Theoretical Domains Framework (TDF) and an intervention that was developed to following the Behaviour Change Wheel (BCW) in a knowledge co-production workshop that ensured that the theory based intervention was a culturally acceptable, practical and implementable intervention. Results: The prescription of surgical prophylaxis was influenced by five TDF domains including, knowledge, belief in consequences (mistrust towards infection prevention and control measures), environmental factors (lack of prescription guidelines) , professional role and reinforcement (a lack of appropriate follow up actions influenced prescription of surgical prophylaxis). The appropriate set of behaviour change functions of BCW and related activities to improve the current practices included education, enablement, persuasion, environmental restructuring and restriction. Conclusions: The study showed that a theory based and context specific intervention can be created by using the TDF and BCW together with knowledge-co creation to improve the prescription of surgical prophylaxis in and Egyptian orthopaedic unit. The intervention need to piloted and scaled up.

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 Developing a theory-based behavior change intervention to improve the prescription of surgical prophylaxis

2021 ◽  
Author(s):  
Anna Leena Lohiniva ◽  
Iman Heweidy ◽  
Samiha Abdu ◽  
Omar Abouelata ◽  
Caroline Ackley ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Theoretical Domains Framework ◽  
Antibiotic Use ◽  
Control Measures ◽  
World Health ◽  
Infection Prevention And Control ◽  
Surgical Prophylaxis ◽  
Prescription Practices ◽  
Health Organization ◽  
Context Specific

AbstractAntimicrobial resistance (AMR) is increasingly pervasive due to multiple, complex prescribing and consuming behaviours. Accordingly, behaviour change is an important component of response to AMR. Little is known about the best approaches to change antibiotic use practices and behaviours. This project aims to develop a context-specific behaviour change strategy focusing on promoting appropriate prescription practices following the World Health Organization recommendations for surgical prophylaxis. In an orthopaedic surgery unit in Egypt. The project included a formative qualitative research study with 31 in-depth interviews with orthopaedic surgeons that was based on the Theoretical Domains Framework (TDF) and an intervention that was developed to following the Behaviour Change Wheel (BCW) in a knowledge co-production workshop with ten public health experts that ensured that the theory based intervention was a culturally acceptable, practical and implementable intervention. The prescription of surgical prophylaxis was influenced by eight TDF domains from which workshop participants selected five to be included in the behaviour change intervention including, knowledge, belief in consequences (mistrust towards infection prevention and control measures), environmental factors (lack of prescription guidelines), professional role and reinforcement (a lack of appropriate follow up actions influenced prescription of surgical prophylaxis). The appropriate set of behaviour change functions of BCW and related activities to improve the current practices included education, enablement, persuasion, environmental restructuring and restriction. The study showed that a theory based, and context specific intervention can be created by using the TDF and BCW together with knowledge-co creation to improve the prescription of surgical prophylaxis in and Egyptian orthopaedic unit. The intervention needs to piloted and scaled up.

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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