Do pharmacy practice standards effectively describe behaviour? Reviewing practice standards using a behavioural specificity framework

Designing and psychometric evaluation of pharmacists' attitude toward ethical challenges questionnaire in pharmacy practice: A mixed‑method study

PURPOSE

Knowledge advancement exposes the pharmacists to new ethical and professional challenges in providing pharmaceutical care. The pharmacist's attitude towards the ethical challenges of pharmacy practice could be of great help in assessing pharmacist's ethical sensitivity. This study aimed to design a valid and reliable questionnaire for measuring pharmacists' attitudes.

METHODS

The present study is the second phase of a sequential exploratory mixed‑method study for designing and psychometric evaluation of the questionnaire. In the first phase the questionnaire was developed using semi-structured interviews followed by content analysis. The psychometric evaluation of the questionnaire was performed examining the validity (face, content, and construct), and reliability (internal consistency and Intraclass Correlation Coefficient and Standard Error of Measurement) in a sample of pharmacists practicing in community pharmacies in Tehran and Tabriz, Iran (n = 504). The construct validity of the questionnaire was determined using exploratory and confirmatory factor analysis.

RESULTS

The Scale‑Content Validity Index/Average (S‑CVI/AVE) was calculated at 0.84. The results of exploratory factor analysis supported 22 items in four factors including regulations and rules, professional communications, providing and supplying medicine, and consultation and providing pharmaceutical care that are explained by a total of 49.50% of the variance. Also, confirmatory factor analysis confirmed goodness of fit indices and model fit. Cronbach's alpha Coefficient was 0.919 and ICC was 0.914.

CONCLUSIONS

The psychometric evaluation of the present questionnaire shows a native, valid and reliable instrument to assess pharmacists' attitudes toward ethical challenges which could be a mirror of pharmacists ethical sensitivity.

Applying the Behaviour Change Wheel to UK Local Authority Policy Documents: A Content Analysis in the Context of Financial Behaviour

Local authorities in the UK often try to improve their residents' financial well-being by promoting changes in behaviour. The extent to which these behaviour change activities are based on relevant theory or evidence is unknown. This research aims to retrospectively analyse the content of local authorities' policies to identify opportunities for improvement. The Action, Actor, Context, Target, Time (AACTT) framework was used to assess the specification of target behaviours. The Behaviour Change Wheel (BCW) process was used to assess intervention content. Within the policy documents, target behaviours were not consistently specified in terms of the AACTT criteria. Descriptions of interventions lacked detail with 28% unable to be categorised and there was a reliance on Education (46%) to change financial behaviour. The designing and reporting of interventions to change residents' financial behaviour were not always aligned with behavioural science evidence and utilising systematic frameworks could help local authorities achieve policy objectives.

Behaviours that contribute to pharmacist professionalism: a scoping review

OBJECTIVES

Clearly understanding and describing professional behaviours of pharmacists allows the profession, researchers and policy-makers to observe and monitor the professionalism of pharmacists, and design interventions to improve it where needed. The primary objective of this review was to identify which behaviours are discussed to contribute to professionalism in registered pharmacists in peer-reviewed literature. The secondary objective was to review the identified behaviours using a behavioural specification framework to understand how they are expressed.

DESIGN

A scoping literature review was conducted.

DATA SOURCES

An electronic database search of Scopus, Embase, PsycINFO, PsychArticles, Emcare and Medline limited to articles published in English from 1 January 2000 to 21 October 2022 was conducted.

ELIGIBILITY CRITERIA

Eligible articles contributed behaviourally relevant content with reference to registered pharmacists' professionalism.

DATA EXTRACTION AND SYNTHESIS

Extracted behaviourally relevant content was subject to researcher's familiarisation, then deductive coding to one of two overarching definitions of technical or non-technical behaviour. Data were then inductively coded through assignment of a descriptive code to identify categories of professional behaviour within these two overarching types of behaviour.

RESULTS

Seven articles were identified and included in the final analysis. From the extracted behaviourally relevant content, 18 categories of behaviours were identified. All articles identified behaviours in categories titled 'establishes effective relationships' and 'complies with regulations codes and operating procedures'. Identified behaviours were often broadly described and merged with descriptions of influences on them and broader outcomes that they contribute to.

CONCLUSIONS

Behaviours described to contribute to pharmacists' professionalism in the literature are broad and non-specific.

Dementia Risk Reduction in Primary Care: A Scoping Review of Clinical Guidelines Using a Behavioral Specificity Framework

Background: Primary care practitioners are being called upon to work with their patients to reduce dementia risk. However, it is unclear who should do what with whom, when, and under what circumstances. Objective: This scoping review aimed to identify clinical guidelines for dementia risk reduction (DRR) in primary care settings, synthesize the guidelines into actionable behaviors, and appraise the guidelines for specificity. Methods: Terms related to “dementia”, “guidelines”, and “risk reduction” were entered into two academic databases and two web search engines. Guidelines were included if they referred specifically to clinical practices for healthcare professionals for primary prevention of dementia. Included guidelines were analyzed using a directed content analysis method, underpinned by the Action-Actor-Context-Target-Time framework for specifying behavior. Results: Sixteen guidelines were included in the analysis. Together, the guidelines recommended six distinct clusters of actions for DRR. These were to 1) invite patients to discuss DRR, 2) identify patients with risk factors for dementia, 3) discuss DRR, 4) manage dementia risk factors, 5) signpost to additional support, and 6) follow up. Guidelines recommended various actors, contexts, targets, and times for performing these actions. Together, guidelines lacked specificity and were at times contradictory. Conclusion: Currently available guidelines allow various approaches to promoting DRR in primary care. Primary care teams are advised to draw on the results of the review to decide which actions to undertake and the locally appropriate actors, contexts, targets, and times for these actions. Documenting these decisions in more specific, local guidelines for promoting DRR should facilitate implementation.