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dc.contributor.authorGlidewell, L.
dc.contributor.authorWillis, T.A.
dc.contributor.authorPetty, Duncan R.
dc.contributor.authorLawton, R.
dc.contributor.authorMcEachan, R.R.C.
dc.contributor.authorIngleson, E.
dc.contributor.authorHeudtlass, P.
dc.contributor.authorDavies, A.
dc.contributor.authorJamieson, T.
dc.contributor.authorHunter, C.
dc.contributor.authorHartley, S.
dc.contributor.authorGray-Burrows, K.
dc.contributor.authorClamp, S.
dc.contributor.authorCarder, P.
dc.contributor.authorAlderson, S.
dc.contributor.authorFarrin, A.J.
dc.contributor.authorFoy, R.
dc.date.accessioned2019-11-12T09:29:53Z
dc.date.accessioned2019-11-27T12:32:31Z
dc.date.available2019-11-12T09:29:53Z
dc.date.available2019-11-27T12:32:31Z
dc.date.issued2018-02
dc.identifier.citationGlidewell L, Willis TA, Petty D et al (2018) To what extent can behaviour change techniques be identified within an adaptable implementation package for primary care? A prospective directed content analysis. Implementation Science. 13: 32.en_US
dc.identifier.urihttp://hdl.handle.net/10454/17515
dc.descriptionYesen_US
dc.description.abstractBackground: Interpreting evaluations of complex interventions can be difficult without sufficient description of key intervention content. We aimed to develop an implementation package for primary care which could be delivered using typically available resources and could be adapted to target determinants of behaviour for each of four quality indicators: diabetes control, blood pressure control, anticoagulation for atrial fibrillation and risky prescribing. We describe the development and prospective verification of behaviour change techniques (BCTs) embedded within the adaptable implementation packages. Methods: We used an over-lapping multi-staged process. We identified evidence-based, candidate delivery mechanisms—mainly audit and feedback, educational outreach and computerised prompts and reminders. We drew upon interviews with primary care professionals using the Theoretical Domains Framework to explore likely determinants of adherence to quality indicators. We linked determinants to candidate BCTs. With input from stakeholder panels, we prioritised likely determinants and intervention content prior to piloting the implementation packages. Our content analysis assessed the extent to which embedded BCTs could be identified within the packages and compared them across the delivery mechanisms and four quality indicators. Results: Each implementation package included at least 27 out of 30 potentially applicable BCTs representing 15 of 16 BCT categories. Whilst 23 BCTs were shared across all four implementation packages (e.g. BCTs relating to feedback and comparing behaviour), some BCTs were unique to certain delivery mechanisms (e.g. ‘graded tasks’ and ‘problem solving’ for educational outreach). BCTs addressing the determinants ‘environmental context’ and ‘social and professional roles’ (e.g. ‘restructuring the social and ‘physical environment’ and ‘adding objects to the environment’) were indicator specific. We found it challenging to operationalise BCTs targeting ‘environmental context’, ‘social influences’ and ‘social and professional roles’ within our chosen delivery mechanisms. Conclusion: We have demonstrated a transparent process for selecting, operationalising and verifying the BCT content in implementation packages adapted to target four quality indicators in primary care. There was considerable overlap in BCTs identified across the four indicators suggesting core BCTs can be embedded and verified within delivery mechanisms commonly available to primary care. Whilst feedback reports can include a wide range of BCTs, computerised prompts can deliver BCTs at the time of decision making, and educational outreach can allow for flexibility and individual tailoring in deliveryen_US
dc.description.sponsorshipUK National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (Grant Reference Number RP-PG-1209-10040).en_US
dc.language.isoenen_US
dc.relation.isreferencedbyhttps://doi.org/10.1186/s13012-017-0704-7en_US
dc.rights© The Author(s). 2018 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en_US
dc.subjectImplementation interventionen_US
dc.subjectBehaviour change techniquesen_US
dc.subjectTheoretical Domains Frameworken_US
dc.subjectDiscriminant content analysisen_US
dc.subjectAudit and feedbacken_US
dc.subjectEducational outreachen_US
dc.subjectComputerised promptsen_US
dc.subjectClinical remindersen_US
dc.titleTo what extent can behaviour change techniques be identified within an adaptable implementation package for primary care? A prospective directed content analysisen_US
dc.status.refereedYesen_US
dc.date.Accepted2017-12-26
dc.date.application2018-02-17
dc.typeArticleen_US
dc.type.versionPublished versionen_US
dc.date.updated2019-11-12T09:30:03Z
refterms.dateFOA2019-11-27T12:33:02Z


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