Towards a taxonomy of behavior change techniques for promoting shared decision making
Towards a taxonomy of behavior change techniques for promoting shared decision making
复制标题
DOI：
10.1186/s13012-020-01015-w
复制
发表时间：
2020-08-20
影响因子：
7.2
通讯作者：
Legare, France
中科院分区：
文献类型：
--
作者：
Agbadje, Titilayo Tatiana;Elidor, Helene;Legare, France
背景关于在临床实践中实施共享决策(SDM)所需的功能和行为改变技术(BCT)的信息很少。为了指导未来的实施举措，我们试图为可持续发展管理实施干预制定一种最佳做法分类。方法这项研究是对2018年Cochrane关于增加医疗专业人员使用共享决策的干预措施的审查的二次分析。我们审查了包括在审查中的所有87项研究。我们将每项研究干预的相关信息提取到电子表格中。编码员参加了关于干预功能的培训讲习班和关于最佳技术分类版本1(BCTTv1)的在线培训。我们进行了功能和BCT编码试验，并确定了编码规则。我们使用Michie的行为改变干预设计指南来编码干预中使用的功能和BCT。编码员开会比较编码，并讨论了差异，直到达成共识。使用简单的描述性统计对数据进行分析。结果87项SDM实施干预共使用7项功能、24项功能组合和32项BCT。平均每次干预功能为2.5次，平均每次BCT为3.7次。没有发现强制和制约的功能。最常见的功能是教育(73项研究)。最常见的三种功能组合(例如：教育+劝导，在10项研究中使用)。与更有效的可持续发展管理实施干预相关的职能是建模和培训。最有效的功能组合是教育+培训+建模+支持。最常用的BCT是关于如何执行行为的指导(43项研究)。与更有效的SDM实施干预相关的BCT是：如何执行行为的指导、行为示范、行为反馈、药物支持、物质奖励和生物反馈。25项BCT与不太有效的可持续发展管理实施干预措施有关。确定了四个新的BCT：支持行为的一般信息、量身定做、从概念上为行为做准备的练习，以及经验分享和学习。结论我们建立了特定于SDM领域的BCT分类，以指导未来的SDM实施干预。应向BCTTv1添加四个新的BCT。
Background There is little information about the functions and behavior change techniques (BCTs) needed to implement shared decision making (SDM) in clinical practice. To guide future implementation initiatives, we sought to develop a BCT taxonomy for SDM implementation interventions. Methods This study is a secondary analysis of a 2018 Cochrane review on interventions for increasing the use of shared decision making by healthcare professionals. We examined all 87 studies included in the review. We extracted relevant information on each study intervention into a spreadsheet. Coders had undergone a training workshop on intervention functions and online training on BCT Taxonomy version 1 (BCTTv1). We performed functions and BCTs coding trials, and identified coding rules. We used Michie's guide for designing behavior change interventions to code the functions and BCTs used in the interventions. Coders met to compare coding and discrepancies were discussed until consensus was reached. Data was analyzed using simple descriptive statistics. Results Overall, 7 functions, 24 combinations of functions and 32 BCTs were used in the 87 SDM implementation interventions. The mean of functions per intervention was 2.5 and the mean of BCTs per intervention was 3.7. The functions Coercion and Restriction were not found. The most common function was Education (73 studies). Three combinations of functions were most common (e.g: Education + Persuasion, used in 10 studies). The functions associated with more effective SDM implementation interventions were Modeling and Training. The most effective combination of functions was Education + Training + Modeling + Enablement. The most commonly used BCT was Instruction on how to perform the behavior (43 studies). BCTs associated with more effective SDM implementation interventions were: Instruction on how to perform the behavior, Demonstration of the behavior, Feedback on behavior, Pharmacological support, Material reward, and Biofeedback. Twenty-five BCTs were associated with less effective SDM implementation interventions. Four new BCTs were identified: General information to support the behavior, Tailoring, Exercises to conceptually prepare for the behavior, and Experience sharing and learning. Conclusions We established a BCT taxonomy specific to the field of SDM to guide future SDM implementation interventions. Four new BCTs should be added to BCTTv1.