Development of a theory-informed implementation intervention to improve the triage, treatment and transfer of stroke patients in emergency departments using the Theoretical Domains Framework (TDF): the T(3) Trial.
Development of a theory-informed implementation intervention to improve the triage, treatment and transfer of stroke patients in emergency departments using the Theoretical Domains Framework (TDF): the T(3) Trial.
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DOI：
10.1186/s13012-017-0616-6
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发表时间：
2017-07-17
期刊：
影响因子：
--
通讯作者：
Middleton S
中科院分区：
文献类型：
--
作者：
Craig LE;Taylor N;Grimley R;Cadilhac DA;McInnes E;Phillips R;Dale S;O'Connor D;Levi C;Fitzgerald M;Considine J;Grimshaw JM;Gerraty R;Cheung NW;Ward J;Middleton S
基于行为改变理论的理论框架和模式越来越多地用于制定执行干预措施。执行干预措施的制定往往基于现有的证据基础和实际问题，即可行性和可接受性。本研究的目的是描述T3试验（急诊科（ED）卒中患者的分诊、治疗和转移）实施干预的发展，使用理论推荐行为改变技术（BCT），并借鉴研究证据基础和可行性和可接受性的实际问题。采用以下步骤采用了一种基于理论、证据和实际问题制定复杂干预措施的分步方法：（1）谁需要做什么，不同的？(2)使用理论框架，需要解决哪些障碍和促进因素？(3)哪些干预组成部分（改变行为的技术和提供方式）可以克服可以改变的障碍并加强促进因素？召开了一个研究小组会议，审查建议使用的BCT清单，并确定最可行和最可接受的技术。参加研讨会的医院工作人员报告了76个障碍（步骤1：研究人员确定了可能影响T3试验临床干预实施的13个TDF域;步骤2：然后，研究小组成员选择了推荐用于艾德临床环境的合适的BCT的三分之一，并且使用使能者研讨会数据，为每一个选定的最佳技术援助制定扶持战略;第3步：最后执行干预措施包括27个最佳技术援助）。TDF成功应用于为T3试验临床干预制定实施干预的所有步骤。使用研究小组的意见是BCT选择过程的重要组成部分，以结合研究证据和专家判断。建议采用这种分步骤的方法（理论、证据和可行性和可接受性的实际问题）来制定高度可报告的实施干预措施。使用公认的实施干预成分对BCT进行分类，将有助于在不同条件和临床环境中进行推广和共享。本文的在线版本（doi：10.1186/s13012-017-0616-6）包含补充材料，可供授权用户使用。
Theoretical frameworks and models based on behaviour change theories are increasingly used in the development of implementation interventions. Development of an implementation intervention is often based on the available evidence base and practical issues, i.e. feasibility and acceptability. The aim of this study was to describe the development of an implementation intervention for the T3 Trial (Triage, Treatment and Transfer of patients with stroke in emergency departments (EDs)) using theory to recommend behaviour change techniques (BCTs) and drawing on the research evidence base and practical issues of feasibility and acceptability. A stepped method for developing complex interventions based on theory, evidence and practical issues was adapted using the following steps: (1) Who needs to do what, differently? (2) Using a theoretical framework, which barriers and enablers need to be addressed? (3) Which intervention components (behaviour change techniques and mode(s) of delivery) could overcome the modifiable barriers and enhance the enablers? A researcher panel was convened to review the list of BCTs recommended for use and to identify the most feasible and acceptable techniques to adopt. Seventy-six barriers were reported by hospital staff who attended the workshops (step 1: thirteen TDF domains likely to influence the implementation of the T3 Trial clinical intervention were identified by the researchers; step 2: the researcher panellists then selected one third of the BCTs recommended for use as appropriate for the clinical context of the ED and, using the enabler workshop data, devised enabling strategies for each of the selected BCTs; and step 3: the final implementation intervention consisted of 27 BCTs). The TDF was successfully applied in all steps of developing an implementation intervention for the T3 Trial clinical intervention. The use of researcher panel opinion was an essential part of the BCT selection process to incorporate both research evidence and expert judgment. It is recommended that this stepped approach (theory, evidence and practical issues of feasibility and acceptability) is used to develop highly reportable implementation interventions. The classifying of BCTs using recognised implementation intervention components will facilitate generalisability and sharing across different conditions and clinical settings. The online version of this article (doi:10.1186/s13012-017-0616-6) contains supplementary material, which is available to authorized users.
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影响因子：
7.2
作者：
Steinmo, Siri;Fuller, Christopher;Michie, Susan
通讯作者：
Michie, Susan
影响因子：
7.2
作者：
Eccles, Martin P.;Johnston, Marie;Kaner, Eileen F.
通讯作者：
Kaner, Eileen F.
DOI：
10.1111/j.1464-0597.2008.00341.x
发表时间：
2008-10-01
影响因子：
7.2
作者：
Michie, Susan;Johnston, Marie;Eccles, Martin
通讯作者：
Eccles, Martin
影响因子：
2.8
作者：
McCullough, Amanda R.;Ryan, Cristin;Hughes, Carmel M.
通讯作者：
Hughes, Carmel M.
DOI：
10.1016/j.aenj.2012.12.002
发表时间：
2013-02-01
期刊：
AUSTRALASIAN EMERGENCY NURSING JOURNAL
影响因子：
--
作者：
Mosley, Ian;Morphet, Julia;Braitberg, George
通讯作者：
Braitberg, George