Development of a behaviour change intervention: a case study on the practical application of theory

Porcheret, Mark; Main, Chris; Croft, Peter; McKinley, Robert; Hassell, Andrew; Dziedzic, Krysia

doi:10.1186/1748-5908-9-42

Cited by 72Health Policy Implementation ScienceBehavioral Health and InterventionsClinical practice guidelines implementation

Development of a behaviour change intervention: a case study on the practical application of theory

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Porcheret, Mark, Main, Chris, Croft, Peter, McKinley, Robert, Hassell, Andrew, Dziedzic, Krysia·2014·Implementation Science

DOI 10.1186/1748-5908-9-42PMC PMC3983864

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Abstract

BACKGROUND: Use of theory in implementation of complex interventions is widely recommended. A complex trial intervention, to enhance self-management support for people with osteoarthritis (OA) in primary care, needed to be implemented in the Managing Osteoarthritis in Consultations (MOSAICS) trial. One component of the trial intervention was delivery by general practitioners (GPs) of an enhanced consultation for patients with OA. The aim of our case study is to describe the systematic selection and use of theory to develop a behaviour change intervention to implement GP delivery of the enhanced consultation. METHODS: The development of the behaviour change intervention was guided by four theoretical models/frameworks: i) an implementation of change model to guide overall approach, ii) the Theoretical Domains Framework (TDF) to identify relevant determinants of change, iii) a model for the selection of behaviour change techniques to address identified determinants of behaviour change, and iv) the principles of adult learning. Methods and measures to evaluate impact of the behaviour change intervention were identified. RESULTS: The behaviour change intervention presented the GPs with a well-defined proposal for change; addressed seven of the TDF domains (e.g., knowledge, skills, motivation and goals); incorporated ten behaviour change techniques (e.g., information provision, skills rehearsal, persuasive communication); and was delivered in workshops that valued the expertise and professional values of GPs. The workshops used a mixture of interactive and didactic sessions, were facilitated by opinion leaders, and utilised 'context-bound communication skills training.' Methods and measures selected to evaluate the behaviour change intervention included: appraisal of satisfaction with workshops, GP report of intention to practise and an assessment of video-recorded consultations of GPs with patients with OA. CONCLUSIONS: A stepped approach to the development of a behaviour change intervention, with the utilisation of theoretical frameworks to identify determinants of change matched with behaviour change techniques, has enabled a systematic and theory-driven development of an intervention designed to enhance consultations by GPs for patients with OA. The success of the behaviour change intervention in practice will be evaluated in the context of the MOSAICS trial as a whole, and will inform understanding of practice level and patient outcomes in the trial.

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Eleven of the 15 included papers incorporated other approaches, tools, or resources as a component of the intervention design process.
“Eleven of the 15 papers incorporated other approaches, tools, or resources as a component of the intervention design process [14, 19–28].”
From Methods for designing interventions to change healthcare professionals’ behaviour: a systematic review (2017) · cites this paper as [25]
One of the 15 included papers incorporated three published tools.
“and one incorporated three published tools [25].”
From Methods for designing interventions to change healthcare professionals’ behaviour: a systematic review (2017) · cites this paper as [25]
Six of the 15 papers used the structured interview processes outlined in the Theoretical Domains Framework or in Intervention Mapping.
“Six papers used the structured interview processes outlined in the TDF [19, 21, 25] or in Intervention Mapping [20, 26, 27].”
From Methods for designing interventions to change healthcare professionals’ behaviour: a systematic review (2017) · cites this paper as [25]
Three of the 15 included papers incorporated both the Theoretical Domains Framework and the Behaviour Change Technique taxonomy.
“another three incorporated both the TDF and the BCT taxonomy [19, 21, 25]”
From Methods for designing interventions to change healthcare professionals’ behaviour: a systematic review (2017) · cites this paper as [25]
Among the papers that linked barriers to intervention components, methods included mapping TDF barriers to the BCT taxonomy and using the structured approaches described in Intervention Mapping.
“Methods to link barriers to intervention components included mapping TDF-barriers to the BCT taxonomy [19, 21, 25], as well as using the structured approaches described in Intervention Mapping [20, 26, 27].”
From Methods for designing interventions to change healthcare professionals’ behaviour: a systematic review (2017) · cites this paper as [25]

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“In addition, the recent validation and refining of the TDF domains has strengthened the rationale for its methodology, as used in this study, and, with a refined structure, strengthened its use in future studies [23].”
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Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework
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Additional file 1: of Enhancing delivery of osteoarthritis care in the general practice consultation: evaluation of a behaviour change intervention
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Enhancing delivery of osteoarthritis care in the general practice consultation: evaluation of a behaviour change intervention
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Self-citation

Authors: Porcheret, M., Main, C., Croft, P., McKinley, R., Hassell, A., & Dziedzic, K.
Affiliations: Keele University (GB)
Corresponding author: Porcheret, Mark
ORCID: Porcheret, Mark
Main, Chris
Croft, Peter
McKinley, Robert
Dziedzic, Krysia
Venue: Implementation Science
Publisher: Springer Science and Business Media LLC
Published: 2014-04-03
Volume: 9
Issue: 1
Pages: 42-42
ISSN: 1748-5908 (ISSN-L)
DOI: 10.1186/1748-5908-9-42
PMC: PMC3983864
OpenAlex: W1997648943
Cited by: 72
References: 45
Citations by year: 2026: 4 · 2025: 2 · 2024: 6 · 2023: 7 · 2022: 5 · 2021: 3 · 2020: 6 · 2019: 5 · 2018: 6 · 2017: 10 · 2016: 12 · 2015: 6
FWCI: 16.86
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
www.springer.com/tdm (unspecified)
Locations: Implementation Science (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Keele Research Repository (Keele University) (submittedVersion, cc-by)
Funders: National Institute for Health and Care Research (NF-SI-0509-10183, IAT08/I-PF/011, 2008 IPF PORCHERET, WMCLAHRC-2014-1, RP-PG-0407-10386)
Topics: Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Keywords: behaviour change interventions, osteoarthritis, general practitioners, self-management support, Theoretical Domains Framework, behaviour change techniques, adult learning, opinion leaders, intervention development, primary care
MeSH terms: Attitude of Health Personnel, Delivery of Health Care, Humans, Osteoarthritis, Practice Patterns, Physicians', Self Care, Practice Guidelines as Topic, Guideline Adherence

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Development of a behaviour change intervention: a case study on the practical application of theory

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