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Breare H, Mullan B, Kerr DA, Maxwell-Smith C. Training Australian Dietitians in Behavior Change Techniques Through Educational Workshops: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e49723. [PMID: 38048151 PMCID: PMC10728788 DOI: 10.2196/49723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/20/2023] [Accepted: 09/05/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND The use of education alone as a technique to change behavior in interventions is usually insufficient, particularly in health interventions. Behavior change techniques have been shown to be effective in fostering positive changes in health behaviors such as diet and physical activity. The upskilling of health professionals can increase perceived capability and motivation toward eliciting change in clients' behaviors. However, to date, dietitians have received limited training in behavior change and have expressed a need for continuous professional development. OBJECTIVE The study objectives are to (1) develop and evaluate the effectiveness and acceptability of two 2-hour behavior change workshops on changing dietitians behavior (ie, range of behavior change techniques used and frequency of use) across 3 time points; (2) determine if participation in these workshops will elicit changes in dietitians' perceived capability, opportunity, and motivation toward using behavior change techniques; and (3) determine the acceptability of the training and its application in practice by dietitians. METHODS We will recruit registered dietitians (N=140) in Australia to participate in this randomized controlled trial. Participants will be randomly assigned to either the intervention or 3-month waitlist control condition and complete outcome measures at 3 time points: baseline, after the workshop, and follow-up at 3 months. Both groups will complete 2 workshops on behavior change that are guided by the COM-B (Capability, Opportunity, Motivation, and Behavior) Model and embedded with behavior change techniques. The primary outcome is changes in behavior, (ie, the range of behavior change techniques used and their frequency of use). Secondary outcomes include changes in perceived capability, opportunity, motivation, and preparedness as a health professional toward delivering behavior change techniques. The acceptability of the workshops will also be assessed after the workshop through the postworkshop survey and semistructured interviews. A series of 2-way repeated measures ANOVAs and regressions will be used. Qualitative data will be analyzed using thematic analysis. RESULTS Participant recruitment commenced in June 2023. The results of the study are expected to be published in November 2024. The results will allow us to assess comparisons between the intervention and waitlist control groups, as well as changes in perceived capability, opportunity, motivation, and preparedness over a 3-month period. It will also provide an understanding of the acceptability of the training as a form of continuous professional development for dietitians. CONCLUSIONS If found to be effective, the results of this 2-arm randomized controlled trial will guide future training and continuous professional development for health professionals in changing behavior in practice. Our findings will contribute to our understanding of the application of behavior change techniques in practice with clients and identify components of COM-B where dietitians may need future support. TRIAL REGISTRATION ACTRN12623000525684; https://www.anzctr.org.au/ACTRN12623000525684.aspx. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/49723.
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Affiliation(s)
- Hayley Breare
- School of Population Health, Curtin University, Bentley, Australia
- Behavioural Science and Health Research Group, Curtin University, Bentley, Australia
| | - Barbara Mullan
- School of Population Health, Curtin University, Bentley, Australia
- Behavioural Science and Health Research Group, Curtin University, Bentley, Australia
| | - Deborah A Kerr
- Behavioural Science and Health Research Group, Curtin University, Bentley, Australia
| | - Chloe Maxwell-Smith
- School of Population Health, Curtin University, Bentley, Australia
- Behavioural Science and Health Research Group, Curtin University, Bentley, Australia
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Dawson S, Rodham K, Taylor J, Dewar J, Wildman M. "I think most people feel like healthcare professionals tell them to take their treatments and judge them for not taking them": reflexive thematic analysis of the views of adults with cystic fibrosis on how treatment adherence is discussed in healthcare. Psychol Health 2023:1-23. [PMID: 37667520 DOI: 10.1080/08870446.2023.2254318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 08/23/2023] [Accepted: 08/27/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE Previous research exploring patient-practitioner communication in relation to adherence in cystic fibrosis (CF) is limited. This UK study explored the views of adults with CF on how treatment adherence (related to all CF treatments) is discussed in routine CF care. METHODS 12 White British adults (ten females; aged 20-37 years; mean 30.1 years) with CF participated in semi-structured interviews. RESULTS Three overarching themes were developed through reflexive thematic analysis: (1) 'The power of language'; (2) 'Healthcare professionals do not recognise the importance of context'; and (3) '"Admitting" non-adherence is difficult'. The way in which adherence is discussed in adult CF care is viewed as paternalistic and infantilising. Participants reported that healthcare professionals do not always consider the desire to balance treatment-taking with living a normal life. Unwelcome responses from healthcare professionals, and the inability to accurately self-report the amount of treatment taken made it difficult to 'admit' non-adherence. CONCLUSIONS A culture change is needed in CF care such that people who struggle to take their treatments are not labelled as disobedient, wilfully disobeying orders from healthcare professionals in positions of authority. Instead, an open, honest, non-judgemental approach, as recommended by healthcare agencies for over a decade, should be adopted.
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Affiliation(s)
- Sophie Dawson
- Wolfson Adult Cystic Fibrosis Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
- Staffordshire Centre for Psychological Research, School of Health, Science and Wellbeing, Staffordshire University, Stoke-on-Trent, UK
| | - Karen Rodham
- Staffordshire Centre for Psychological Research, School of Health, Science and Wellbeing, Staffordshire University, Stoke-on-Trent, UK
- Institute of Psychology, Business and Human Sciences, University of Chichester, Chichester, UK
| | - Jennifer Taylor
- Staffordshire Centre for Psychological Research, School of Health, Science and Wellbeing, Staffordshire University, Stoke-on-Trent, UK
| | - Jane Dewar
- Wolfson Adult Cystic Fibrosis Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Martin Wildman
- Sheffield Adult Cystic Fibrosis Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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Meade O, O'Brien M, Noone C, Lawless A, McSharry J, Deely H, Hart J, Hayes CB, Keyworth C, Lavoie K, McGowan O, Murphy AW, Murphy PJ, O'Reilly O, Byrne M. Exploring barriers and enablers to the delivery of Making Every Contact Count brief behavioural interventions in Ireland: A cross-sectional survey study. Br J Health Psychol 2023; 28:753-772. [PMID: 36843183 DOI: 10.1111/bjhp.12652] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 01/24/2023] [Indexed: 02/28/2023]
Abstract
OBJECTIVES The public health impact of the Irish Making Every Contact Count (MECC) brief intervention programme is dependent on delivery by health care professionals. We aimed to identify enablers and modifiable barriers to MECC intervention delivery to optimize MECC implementation. DESIGN Online cross-sectional survey design. METHODS Health care professionals (n = 4050) who completed MECC eLearning were invited to complete an online survey based on the Theoretical Domains Framework (TDF). Multiple regression analysis identified predictors of MECC delivery (logistic regression to predict delivery or not; linear regression to predict frequency of delivery). Data were visualized using Confidence Interval-Based Estimates of Relevance (CIBER). RESULTS Seventy-nine per cent of participants (n = 283/357) had delivered a MECC intervention. In the multiple logistic regression (Nagelkerke's R2 = .34), the significant enablers of intervention delivery were 'professional role' (OR = 1.86 [1.10, 3.15]) and 'intentions/goals' (OR = 4.75 [1.97, 11.45]); significant barriers included 'optimistic beliefs about consequences' (OR = .41 [.18, .94]) and 'negative emotions' (OR = .50 [.32, .77]). In the multiple linear regression (R2 = .29), the significant enablers of frequency of MECC delivery were 'intentions/goals' (b = 10.16, p = .02) and professional role (b = 6.72, p = .03); the significant barriers were 'negative emotions' (b = -4.74, p = .04) and 'barriers to prioritisation' (b = -5.00, p = .01). CIBER analyses suggested six predictive domains with substantial room for improvement: 'intentions and goals', 'barriers to prioritisation', 'environmental resources', 'beliefs about capabilities', 'negative emotions' and 'skills'. CONCLUSION Implementation interventions to enhance MECC delivery should target intentions and goals, beliefs about capabilities, negative emotions, environmental resources, skills and barriers to prioritization.
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Affiliation(s)
- Oonagh Meade
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Ireland
| | - Maria O'Brien
- Office of the Chief Clinical Officer, Health Services Executive, Cork, Ireland
| | - Chris Noone
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Ireland
| | - Agatha Lawless
- Making Every Contact Count, Health & Wellbeing, Strategy & Research, Health Services Executive, Waterford, Ireland
| | - Jenny McSharry
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Ireland
| | - Helen Deely
- Strategy & Research, Healthcare Strategy, Health Service Exectutive, Dublin, Ireland
| | - Jo Hart
- University of Manchester, Manchester, UK
| | - Catherine B Hayes
- Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Dublin, Ireland
| | | | - Kim Lavoie
- University of Quebec at Montreal (UQAM) & Montréal Behavioural Medicine Centre, CIUSSS-NIM, Montréal, Canada
| | - Orla McGowan
- Health Service Executive Health and Wellbeing, Dublin, Ireland
| | - Andrew W Murphy
- Health Research Board Primary Care Clinical Trials Network Ireland, University of Galway, Galway, Ireland
| | - Patrick J Murphy
- Health Research Board Primary Care Clinical Trials Network Ireland, Discipline of General Practice, University of Galway, Galway, Ireland
| | - Orlaith O'Reilly
- Office of the Chief Clinical Officer, Health Services Executive, Kilkenny, Ireland
| | - Molly Byrne
- Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Ireland
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Regan Á, Burrell A, McKernan C, Martin H, Benson T, McAloon C, Manzanilla EG, Dean M. Behaviour change interventions for responsible antimicrobial use on farms. Ir Vet J 2023; 76:8. [PMID: 37009876 PMCID: PMC10068206 DOI: 10.1186/s13620-023-00236-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/13/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND In the coming years, major governance changes in the form of policy directives and regulations will catalyse major top-down change with respect to animal health on European farms in an effort to combat the OneHealth threat of antimicrobial resistance. This top-down approach must be met with bottom-up strategies to ensure target actors (namely, farmers and vets) are supported and motivated to change their practices, thus, avoiding unintended consequences of forced change. Although much behavioural research has explored the factors influencing antimicrobial practices on farms, a gap exists translating these findings into evidence-based behaviour change interventions that can be put into practice. The current study aims to fill this gap. It provides insights into identifying, understanding, and changing the behaviours of farmers and veterinarians with respect to the responsible use of antimicrobials in farming. RESULTS Through an inter-disciplinary and multi-actor approach, the study combines scientific knowledge from the behavioural sciences and animal health sciences, coupled with tacit knowledge from a co-design, participatory approach to recommend seven behaviour change interventions that can help to support good practices amongst farmers and vets, with respect to animal health, and reduce the use of antimicrobials on farms. The behaviour change interventions include message framing; OneHealth awareness campaign; specialised communications training; on-farm visual prompts and tools; social support strategies (for both farmers and vets); and antimicrobial use monitoring. The study details each intervention with respect to their evidence base and scientific concept, grounded in behavioural science, along with stakeholder feedback on design and delivery of the interventions. CONCLUSIONS These behaviour change interventions can be taken, adapted, and put into practice by the agri-food community to support good animal health practices and responsible antimicrobial use on farms.
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Affiliation(s)
- Áine Regan
- Department of Agri-Food Business & Spatial Analysis, Teagasc Mellows Campus, Athenry, H65 R718, Co. Galway, Ireland.
| | - Alison Burrell
- Animal Health Ireland, 2 - 5 The Archways, Carrick-On-Shannon, N41 WN27, Co.Leitrim, Ireland
| | - Claire McKernan
- Institute for Global Food Security, Biological Sciences, Queen's University Belfast, 19 Chlorine Gardens, Belfast, BT9 5DL, Ireland
| | - Hannah Martin
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Tony Benson
- Institute for Global Food Security, Biological Sciences, Queen's University Belfast, 19 Chlorine Gardens, Belfast, BT9 5DL, Ireland
| | - Conor McAloon
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Edgar Garcia Manzanilla
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
- Pig Development Department, Teagasc Animal and Grassland Research and Innovation Centre, Moorepark, Fermoy, Co. Cork, Ireland
| | - Moira Dean
- Institute for Global Food Security, Biological Sciences, Queen's University Belfast, 19 Chlorine Gardens, Belfast, BT9 5DL, Ireland
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Harrison D, Wilson R, Graham A, Brown K, Hesselgreaves H, Ciesielska M. Making every contact count with seldom-heard groups? A qualitative evaluation of voluntary and community sector (VCS) implementation of a public health behaviour change programme in England. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3193-e3206. [PMID: 35218264 PMCID: PMC9544506 DOI: 10.1111/hsc.13764] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/19/2021] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
Making Every Contact Count (MECC) is a national, long-term public health strategy in England. It supports public-facing workers to use opportunities during routine contacts to enable healthy lifestyle changes. This paper reports the findings from an external evaluation of voluntary and community sector (VCS) delivery of MECC in the North East of England, which focused on engaging under-represented client groups. The study aimed to (a) Establish if (and how) MECC had impacted the workforce, including changes to staff knowledge, confidence and behaviour; (b) Identify benefits, challenges and unintended consequences; and (c) Explore outcomes for service users. A multi-stage qualitative design focused on understanding both process and outcomes. The study utilised three data collection methods, including a journey mapping workshop (n = 20), semi-structured interviews with delivery leads, VCS workers and volunteers who had accessed MECC training (n = 11), and focus group discussions with clients (n = 22). The findings illustrated positive early outcomes, including improvements in self-reported staff knowledge and confidence as well as emerging examples of organisational culture shift and individual behaviour change. Alongside this, the data provided a rich picture of barriers and challenges which are examined at different levels-national programme, local programme, VCS sector, partner organisation, worker and client. The research highlights clear successes of the VCS delivery model. However, it is presented as a 'double-edged sword,' in light of associated challenges such as sector-level funding uncertainty and accessibility of MECC resources to diverse client groups. The discussion considers issues related to the measurement and attribution of behaviour change outcomes for brief interventions, as well as fidelity, legacy and long-term sustainability challenges. The recommendations call for system-level analysis and comparison of different MECC implementation models, to improve our understanding of challenges, opportunities and programme reach for behaviour change intervention programmes-particularly in relation to seldom-heard client groups.
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Affiliation(s)
- Deborah Harrison
- Newcastle Business SchoolNorthumbria UniversityNewcastle‐upon‐TyneUK
| | - Rob Wilson
- Newcastle Business SchoolNorthumbria UniversityNewcastle‐upon‐TyneUK
| | - Andy Graham
- Public Health ConsultantLocal GovernmentNorth East EnglandUK
| | - Kristina Brown
- Newcastle Business SchoolNorthumbria UniversityNewcastle‐upon‐TyneUK
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Grey EB, Atkinson L, Chater A, Gahagan A, Tran A, Gillison FB. A systematic review of the evidence on the effect of parental communication about health and health behaviours on children's health and wellbeing. Prev Med 2022; 159:107043. [PMID: 35405179 DOI: 10.1016/j.ypmed.2022.107043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/07/2022] [Accepted: 04/03/2022] [Indexed: 11/16/2022]
Abstract
Parents report feeling unsure how best to talk with their children about sensitive health topics and may avoid such conversations; yet if children have questions or concerns about their health, talking to a parent could enhance their health and wellbeing. We investigated the effects of parental communications about health and health behaviours on children's health and wellbeing, and explored what strategies can encourage parents to communicate about health. We conducted a systematic review and narrative synthesis of research published between January 2008 and April 2020 from five databases. Of 14,007 articles identified, 16 met inclusion criteria focusing on five topics: diet and weight (n = 5), body image (n = 2), sexual health (n = 7), physical activity (n = 1) and bullying (n = 1). Positive child outcomes were associated with positive general parent-child communication characterised by warmth, openness and allowing children choice. Conversely, hostility, negative and inconsistent messaging were associated with poorer outcomes. Interventions to increase parent-child communication could be classified as providing single directive messages, media campaigns or intensive support. Single messages increased communication frequency; media campaigns and intensive interventions showed mixed outcomes. No differences in outcomes were found according to child's gender or socio-economic status. Generally, parents were less confident in initiating, rather than continuing, conversations and were more likely to initiate conversations when they felt they had good topic knowledge. While the relatively small, diverse sample limits the strength of these findings, this review provides provisional support for approaches to promote positive parent-child communication about health that are associated with better child health and wellbeing.
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Affiliation(s)
- E B Grey
- Department for Health, University of Bath, Bath BA2 7AY, UK.
| | - L Atkinson
- School of Psychology, Aston University, Birmingham B4 7ET, UK
| | - A Chater
- Institute for Sport and Physical Activity Research (ISPAR), Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK
| | - A Gahagan
- Office for Health Improvement and Disparities, Department of Health and Social Care, 39 Victoria Street, London SW1H 0EU, UK
| | - A Tran
- UK Health Security Agency, Department of Health and Social Care, Noble House, 17 Smith Square, London SW1P 3HX, UK
| | - F B Gillison
- Department for Health, University of Bath, Bath BA2 7AY, UK
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Hen-Herbst L, Ron El Levin M, Senecky Y, Frishman S, Berger A. Nutritionists' Practices and Knowledge about the Risks of Alcohol Consumption during Pregnancy: An Israeli Survey. Nutrients 2022; 14:nu14091885. [PMID: 35565852 PMCID: PMC9100759 DOI: 10.3390/nu14091885] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 02/01/2023] Open
Abstract
Fetal alcohol spectrum disorders (FASDs) are lifelong disabilities and the leading preventable cause of developmental disabilities. Antenatal care providers may influence pregnant women’s dietary practices and their awareness of the risks of alcohol consumption during pregnancy. This study aimed to assess nutritionists’ self-reported knowledge about the risks of drinking alcohol during pregnancy, professional practices in this respect, and self-perceived competence to assess and guide women about alcohol consumption during pregnancy in Israel. A sample of 526 professional nutritionists completed an anonymous online questionnaire. Results showed significant differences between the nutritionists’ knowledge and professional practices scores. About 349 (66.3%) of the sample agreed (to any degree) that they did not have enough knowledge to guide pregnant women regarding drinking alcohol. The number of years of experience, combined with self-perceived competence and the mean knowledge score, explained 18% of the variance in professional practices. Nutritionists and other health professionals may have a crucial role in preventing FASD and should prioritize appropriate screening for prenatal alcohol use. Eliminating alcohol consumption at any point in pregnancy would reduce the risk for FASDs.
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Affiliation(s)
- Liat Hen-Herbst
- Department of Occupational Therapy, Ariel University, Ariel 4077000, Israel
- Correspondence:
| | | | - Yehuda Senecky
- Department of Pediatric Neurology and Child Development, Schneider Children’s Medical Center of Israel, Petach Tikva 4920235, Israel;
| | - Sigal Frishman
- Nutrition Department, Hospital Division, Clalit HMO, Petach Tikva 4941492, Israel;
| | - Andrea Berger
- Department of Psychology and Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel;
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Wong E, Mavondo F, Horvat L, McKinlay L, Fisher J. Healthcare professionals' perspective on delivering personalised and holistic care: using the Theoretical Domains Framework. BMC Health Serv Res 2022; 22:281. [PMID: 35232432 PMCID: PMC8887936 DOI: 10.1186/s12913-022-07630-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 02/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background Interventions to improve personalised and holistic care delivery by healthcare professionals are more likely to be effective if they target the factors influencing specific behaviours. This study reports on the development and testing of a questionnaire to identify perspectives of healthcare professionals’ personalised and holistic care behaviours based on the Theoretical Domains Framework. Methods The study was conducted in public health services in Victoria, Australia. The questionnaire was developed and pilot-tested with behaviour change researchers and healthcare professionals. Doctors, nurses and midwives were recruited via notices and email invitations from Safer Care Victoria's website and mailing lists of healthcare professionals and invited to completed the questionnaire online (hosted on Qualtrics). Health services administrators and allied health professionals were excluded from the study. Confirmatory factor analysis was undertaken to generate the model of best fit and group differences were tested using univariate tests. Results One hundred and four healthcare professionals from public health services in Victoria, Australia, completed the 39-item questionnaire focusing on specific personalised and holistic care behaviours. The final model consisted of 13 factors and 39 items, and CFA produced an acceptable fit, as well as adequate levels of discriminant validity and internal consistency (α = 0.60 to 0.84). Seven domains, “social influence”, “motivation & goals”, “environmental context and resources’, “skills”, ‘beliefs about consequences”, “behaviour regulation” and “nature of behaviour” were identified. Significant differences in the factors influencing these behaviours were found in groups with different years of experience and role seniority. These findings suggest that future interventions need to be targeted to specific groups. Conclusion This study identified the specific behaviours and the factors associated with performance of personalised and holistic care among healthcare professionals. The findings suggest several interventions and policy functions may be taken to improve personalised and holistic care. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07630-1.
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Affiliation(s)
- Eunice Wong
- Monash Sustainable Development Institute, BehaviourWorks Australia, Monash University, Melbourne, Australia. .,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Felix Mavondo
- Department of Marketing, Monash University, Melbourne, Australia
| | - Lidia Horvat
- Safer Care Victoria, Department of Health Victoria, Melbourne, Australia
| | - Louise McKinlay
- Safer Care Victoria, Department of Health Victoria, Melbourne, Australia
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Measuring capacity to use evidence-based interventions in community-based organizations: A comprehensive, scoping review. J Clin Transl Sci 2022; 6:e92. [PMID: 36003212 PMCID: PMC9389281 DOI: 10.1017/cts.2022.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/30/2022] [Accepted: 07/06/2022] [Indexed: 11/14/2022] Open
Abstract
Introduction: Community-based organizations (CBOs) are well-positioned to incorporate research evidence, local expertise, and contextual factors to address health inequities. However, insufficient capacity limits use of evidence-based interventions (EBIs) in these settings. Capacity-building implementation strategies are popular, but a lack of standard models and validated measures hinders progress in the field. To advance the literature, we conducted a comprehensive scoping review. Methods: With a reference librarian, we executed a comprehensive search strategy of PubMed/Medline, Web of Science Core Collection, and EBSCO Global Health. We included articles that addressed implementation science, capacity-building, and CBOs. Of 5527 articles, 99 met our inclusion criteria, and we extracted data using a double-coding process Results: Of the 99 articles, 47% defined capacity explicitly, 31% defined it indirectly, and 21% did not define it. Common concepts in definitions were skills, knowledge/expertise, and resources. Of the 57 articles with quantitative analysis, 48 (82%) measured capacity, and 11 (23%) offered psychometric data for the capacity measures. Of the 99 studies, 40% focused exclusively on populations experiencing inequities and 22% included those populations to some extent. The bulk of the studies came from high-income countries. Conclusions: Implementation scientists should 1) be explicit about models and definitions of capacity and strategies for building capacity, 2) specify expected multi-level implementation outcomes, 3) develop and use validated measures for quantitative work, and 4) integrate equity considerations into the conceptualization and measurement of capacity-building efforts. With these refinements, we can ensure that the necessary supports reach CBO practitioners and critical partners for addressing health inequities.
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Guerreiro MP, Strawbridge J, Cavaco AM, Félix IB, Marques MM, Cadogan C. Development of a European competency framework for health and other professionals to support behaviour change in persons self-managing chronic disease. BMC MEDICAL EDUCATION 2021; 21:287. [PMID: 34016108 PMCID: PMC8136137 DOI: 10.1186/s12909-021-02720-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 04/29/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Healthcare and other professionals are expected to support behaviour change in people living with chronic disease. However, effective behaviour change interventions are largely absent in routine encounters. The Train4Health project, a European strategic partnership for higher education, sought to address this problem. The primary aim of this study, which is part of an early work package, was to develop an interprofessional competency framework for health and other professions to support behaviour change for the self-management of chronic disease at a European level. A secondary aim was to derive a set of behaviour change techniques (BCTs) from an established taxonomy to link with framework competencies. METHODS The study comprised two interlinked parts. Part 1 involved a two-round e-Delphi study with an interprofessional panel of 48 experts across 12 European countries to develop the behaviour change competency framework. Preparatory work included drafting a list of competency statements based on seven existing frameworks. Part 2 involved an expert panel of six behavioural psychologists deriving a set of BCTs to link with framework competencies. Their feedback was based on preparatory work, which focused on seven high priority chronic diseases for self-management, identified through European projects on self-management and identifying five relevant target behaviours from key clinical guidelines. A literature search yielded 29 effective BCTs for the target behaviours in the selected chronic diseases. RESULTS Twenty-seven competency statements, were presented in Round 1 to the Delphi panel. Consensus was achieved for all statements. Based on comments, two statements were removed, one was added, and 14 were modified. All 15 statements subjected to Round 2 were consensus-approved, yielding a total of 12 foundational competencies for behaviour change in self-management of chronic disease and 14 behaviour change competencies. Four behaviour change competencies related to BCTs. Behavioural psychologists' feedback led to a core set of 21 BCTs deemed applicable to the five target behaviours across the seven chronic diseases. CONCLUSIONS A behaviour change competency framework comprising 26 statements for European health and other professionals to support self-management of chronic disease was developed, linked with a core set of 21 BCTs from an established taxonomy.
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Affiliation(s)
- Mara Pereira Guerreiro
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Lisbon, Portugal.
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Monte de Caparica, Portugal.
| | - Judith Strawbridge
- Royal College of Surgeons in Ireland, School of Pharmacy and Biomolecular Sciences, Dublin, Ireland
| | | | - Isa Brito Félix
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Lisbon, Portugal
| | - Marta Moreira Marques
- ADAPT SFI Research Centre & Trinity Centre for Practice and Healthcare Innovation, Trinity College Dublin, Dublin, Ireland
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, Lisbon, Portugal
| | - Cathal Cadogan
- Trinity College Dublin, School of Pharmacy and Pharmaceutical Sciences, Dublin, Ireland
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