Translating clinicians' beliefs into implementation interventions (TRACII): A protocol for an intervention modeling experiment to change clinicians' intentions to implement evidence-based practice
Translating clinicians' beliefs into implementation interventions (TRACII): A protocol for an intervention modeling experiment to change clinicians' intentions to implement evidence-based practice
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DOI：
10.1186/1748-5908-2-27
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发表时间：
2007-01-01
影响因子：
7.2
通讯作者：
Kaner, Eileen F.
中科院分区：
文献类型：
--
作者：
Eccles, Martin P.;Johnston, Marie;Kaner, Eileen F.
背景：生物医学研究不断产生新的发现，但这些发现通常不会被纳入卫生保健实践。目前，已有一系列干预措施可用于促进对新出现的证据的吸收。虽然它们的有效性已经在实际试验中得到了测试，但这些试验并不构成将其推广到常规护理环境的基础。实施研究是对各种方法的科学研究，以促进对研究结果的理解，从而减少不适当的护理。由于临床实践是人类行为的一种形式，已被证明在其他环境中有用的人类行为理论为制定选择干预措施的科学理由提供了基础。目的：本协议的目的是：1)开发干预措施，以改变已经被确定为喉咙痛的抗生素处方的先决条件的信念；2)对这些干预措施进行实验评估，以确定那些对行为意图和行为模拟有最大影响的干预措施。设计：这项工作的临床重点将是在一般实践中对简单喉咙痛的治疗。上呼吸道感染症状是初级保健的常见表现特征。他们经常接受抗生素治疗，研究证据清楚地表明，抗生素治疗对其他健康的成年患者几乎没有好处。在社区中，通过“谨慎”使用抗生素来减少抗生素处方被视为减缓抗生素耐药性上升的一种方法，而且似乎是安全的，至少在儿童中是这样。然而，我们对如何做到这一点的了解是有限的。参与者将是普通科医生。将设计两种基于理论的干预措施，以解决使用经验性资源开出治疗喉咙痛的抗生素的歧视信念。这些干预措施将在邮寄问卷调查中提供的2×2因子随机对照试验中进行评估。将评估两种结果衡量标准：行为意向和行为模拟。
Background: Biomedical research constantly produces new findings, but these are not routinely incorporated into health care practice. Currently, a range of interventions to promote the uptake of emerging evidence are available. While their effectiveness has been tested in pragmatic trials, these do not form a basis from which to generalise to routine care settings. Implementation research is the scientific study of methods to promote the uptake of research findings, and hence to reduce inappropriate care. As clinical practice is a form of human behaviour, theories of human behaviour that have proved to be useful in other settings offer a basis for developing a scientific rationale for the choice of interventions.Aims: The aims of this protocol are 1) to develop interventions to change beliefs that have already been identified as antecedents to antibiotic prescribing for sore throats, and 2) to experimentally evaluate these interventions to identify those that have the largest impact on behavioural intention and behavioural simulation.Design: The clinical focus for this work will be the management of uncomplicated sore throat in general practice. Symptoms of upper respiratory tract infections are common presenting features in primary care. They are frequently treated with antibiotics, and research evidence is clear that antibiotic treatment offers little or no benefit to otherwise healthy adult patients.Reducing antibiotic prescribing in the community by the "prudent" use of antibiotics is seen as one way to slow the rise in antibiotic resistance, and appears safe, at least in children. However, our understanding of how to do this is limited.Participants will be general medical practitioners. Two theory-based interventions will be designed to address the discriminant beliefs in the prescribing of antibiotics for sore throat, using empirically derived resources. The interventions will be evaluated in a 2 x 2 factorial randomised controlled trial delivered in a postal questionnaire survey. Two outcome measures will be assessed: behavioural intention and behavioural simulation.