scholarly journals Breaking through the barriers to recruit research participants in community settings: a qualitative exploration using the Theoretical Domains Framework and Behaviour Change Wheel

2020 ◽  
Author(s):  
Jennie Rose ◽  
Jane Akister ◽  
Fiona Maxton ◽  
Sarah Anne Redsell
Keyword(s):  
Behaviour Change ◽  
Service User ◽  
Theoretical Domains Framework ◽  
Professional Role ◽  
Service Users ◽  
Barriers And Enablers ◽  
Behaviour Change Wheel ◽  
Health Visitors ◽  
Community Midwives ◽  
Specific Barriers

Abstract Background Recruitment of pregnant or postnatal women and young families into health research is a challenge. Community midwives and health visitors are well placed to invite service users to participate, but evidence suggests that they do not always invite all potentially eligible service users. Our aim was to use the Theoretical Domains Framework to explore health visitors’ and community midwives’ perceived barriers and enablers to approaching service users about participation in research and to use the Behaviour Change Wheel to suggest theory-based strategies to improve future recruitment. Methods Health visitors and community midwives working in four NHS Trusts and one community partnership in England were invited to complete an anonymous, online survey. The sample comprised health visitors (n=39) and community midwives (n=22). Qualitative data from open-ended questions about recruitment behaviour informed by the Theoretical Domains Framework were analysed using directed content analysis and inductive coding to identify salient Theoretical Domains Framework domains and specific barriers and enablers. Strategies to address these barriers and enablers were identified using the Behaviour Change Wheel. Results Six key Theoretical Domains Framework domains were identified as salient to service user approach: (a) environmental context and resources; (b) social/professional role and identity; (c) social influences; (d) goals; (e) beliefs about capabilities; (f) knowledge. Intervention strategies were identified to address specific barriers (insufficient time and staff capacity, inadequate study materials, rejection of the study’s relevance to practitioners’ role, negative influence of researchers and managers, and competing priorities) and to leverage specific enablers (additional staff resource, the relevance of service user approach to professional role, positive influence of team members, managers and researchers, and a belief in the link between service user approach and improvements in healthcare). Conclusions This study provides new insights into why community midwives and health visitors do, and do not, invite service users to participate in research. Using the Theoretical Domains Framework and the Behaviour Change Wheel we identified that resourcing and social support for staff together with education and communication about the health benefits of approaching service users about research participation are key to improving research recruitment involving these health professionals.

scholarly journals Making Every Contact Count and Healthy Conversation Skills as very brief or brief behaviour change interventions: a scoping review

2021 ◽  
Author(s):  
Amelia Parchment ◽  
Wendy Lawrence ◽  
Rachel Perry ◽  
Em Rahman ◽  
Nick Townsend ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Scoping Review ◽  
Service User ◽  
Statistical Significance ◽  
Theoretical Domains Framework ◽  
Skills Training ◽  
Dietary Quality ◽  
Service Users ◽  
Conversation Skills ◽  
Positive Effects

Abstract Aim To identify and map the available evidence regarding the implementation of Making Every Contact Count and/or Healthy Conversation Skills for both staff delivering and service users receiving the brief or very brief intervention/s. Methods A scoping review approach was used to rapidly map and provide an overview of the relevant literature, identify gaps in knowledge, and inform further, related research. Articles investigating experiences, perceptions and impact of Making Every Contact Count and/or Healthy Conversation Skills were included. Quantitative, qualitative, and mixed methods studies were eligible for inclusion, as were reviews and reports. Results Twenty-two articles were included in total. Healthy Conversation Skills training was found to be acceptable, and had a positive impact on staff confidence and competence in supporting behaviour change, across studies. Some positive effects of intervention exposure on the sedentary behaviour and dietary quality of service users were evidenced. Changes in confidence following Making Every Contact Count training were varied, as was perceived acceptability of the intervention for staff. Two studies highlighted positive impacts of the intervention on service user health; however, statistical significance was not reported. The perceived barriers and facilitators of implementation for both interventions mapped mostly to ‘Environmental Context and Resources’ on the Theoretical Domains Framework. Conclusion Healthy Conversation Skills is an acceptable and effective behaviour change intervention that could provide a consistent approach to Making Every Contact Count training and evaluation. Further research is warranted to evaluate this approach for more staff and service user groups.

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 Community midwives’ and health visitors’ experiences of research recruitment: a qualitative exploration using the Theoretical Domains Framework

2021 ◽  
Vol 22 ◽  
Author(s):  
Jennie Rose ◽  
Kieran Lynn ◽  
Jane Akister ◽  
Fiona Maxton ◽  
Sarah A. Redsell
Keyword(s):  
Online Survey ◽  
Resource Constraints ◽  
Social Influences ◽  
Theoretical Domains Framework ◽  
Positive Influence ◽  
Research Recruitment ◽  
Health Visitors ◽  
Community Midwives ◽  
Postnatal Women ◽  
Qualitative Exploration

Abstract Background: Successful research is frequently hampered by poor study recruitment, especially in community settings and with participants who are women and their children. Health visitors (HVs) and community midwives (CMs) are well placed to invite young families, and pregnant and postnatal women to take part in such research, but little is known about how best to support these health professionals to do this effectively. Aim: This study uses the Theoretical Domains Framework (TDF) to explore the factors that influence whether HVs and CMs invite eligible patients to take part in research opportunities. Method: HVs (n = 39) and CMs (n = 22) working in four NHS Trusts and one community partnership in England completed an anonymous, online survey with open-ended questions about their experiences of asking eligible patients to take part in the research. Qualitative data were analysed using directed content analysis and inductive coding to identify specific barriers and enablers to patient recruitment within each of the 14 theoretical domains. Findings: Six key TDF domains accounted for 81% of all coded responses. These were (a) environmental context and resources; (b) beliefs about capabilities; (c) social/professional role and identity; (d) social influences; (e) goals; (f) knowledge. Key barriers to approaching patients to participate in the research were time and resource constraints, perceived role conflict, conflicting priorities, and particularly for HVs, negative social influences from patients and researchers. Enablers included feeling confident to approach patients, positive influence from peers, managers and researchers, beliefs in the relevance of this behaviour to health care and practice and good knowledge about the study procedures, its rationale and the research topic. The findings suggest that to improve research recruitment involving HVs and CMs, a package of interventions is needed to address the barriers and leverage the enablers to participant approach.

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.

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