Action, actor, context, target, time (AACTT): a framework for specifying behaviour
Action, actor, context, target, time (AACTT): a framework for specifying behaviour
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DOI：
10.1186/s13012-019-0951-x
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发表时间：
2019-12-05
影响因子：
7.2
通讯作者：
Francis, Jill J.
中科院分区：
文献类型：
--
作者：
Presseau, Justin;McCleary, Nicola;Francis, Jill J.
设计实施干预措施以改变卫生系统中医疗保健提供者和其他专业人员的行为，需要详细说明针对变化的行为，以确保干预组成部分与测量结果之间的一致性。详细的行为规范有助于澄清证据与实践之间的差距，澄清谁需要以不同的方式做什么，确定可改变的障碍和促进因素，设计解决这些问题的干预措施，并最终提供一个指标，说明应衡量什么，以评估干预措施对行为改变的影响。现有的行为规范框架提出了四个域（目标，动作，上下文，时间; TACT），但没有充分阐明谁在执行行为（即演员）。在以多个不同的人执行多种行为为特征的医疗环境中，“执行者”尤其重要。我们提出并描述了TACT的扩展和重新排序，以提高其效用的实施干预设计师，从业者和试验：行动，演员，背景，目标，时间（AACTT）框架。我们的目标是展示其在实施研究的关键步骤中的应用，并提供在实践中使用的工具，以澄清医疗系统多个层面的利益相关者的行为。方法和结果我们使用法国等。（a）澄清谁需要做哪些不同的工作，（B）查明障碍和促进因素，（c）选择适合目的的干预战略和组成部分，（d）评价执行干预措施。使用技转中心框架描述和详细说明行为可能有助于加强理论结构的衡量，为主题指南和问卷的制定提供信息，加强执行干预措施的设计，并澄清评价执行干预措施的成果衡量。
Background Designing implementation interventions to change the behaviour of healthcare providers and other professionals in the health system requires detailed specification of the behaviour(s) targeted for change to ensure alignment between intervention components and measured outcomes. Detailed behaviour specification can help to clarify evidence-practice gaps, clarify who needs to do what differently, identify modifiable barriers and enablers, design interventions to address these and ultimately provides an indicator of what to measure to evaluate an intervention's effect on behaviour change. An existing behaviour specification framework proposes four domains (Target, Action, Context, Time; TACT), but insufficiently clarifies who is performing the behaviour (i.e. the Actor). Specifying the Actor is especially important in healthcare settings characterised by multiple behaviours performed by multiple different people. We propose and describe an extension and re-ordering of TACT to enhance its utility to implementation intervention designers, practitioners and trialists: the Action, Actor, Context, Target, Time (AACTT) framework. We aim to demonstrate its application across key steps of implementation research and to provide tools for its use in practice to clarify the behaviours of stakeholders across multiple levels of the healthcare system. Methods and results We used French et al.'s four-step implementation process model to describe the potential applications of the AACTT framework for (a) clarifying who needs to do what differently, (b) identifying barriers and enablers, (c) selecting fit-for-purpose intervention strategies and components and (d) evaluating implementation interventions. Conclusions Describing and detailing behaviour using the AACTT framework may help to enhance measurement of theoretical constructs, inform development of topic guides and questionnaires, enhance the design of implementation interventions and clarify outcome measurement for evaluating implementation interventions.