Applied Health Sciences (Department)
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Item A primary care Web-based Intervention Modeling Experiment replicated behavior changes seen in earlier paper-based experiment(2016-12) Treweek, Shaun; Francis, Jill J; Bonetti, Debbie; Barnett, Karen; Eccles, Martin P.; Hudson, Jemma; Jones, Claire; Pitts, Nigel B; Ricketts, Ian W; Sullivan, Frank; Weal, Mark; MacLennan, Graeme; University of Aberdeen.Aberdeen Centre for Evaluation; University of Aberdeen.Institute of Applied Health Sciences; University of Aberdeen.Other Applied Health SciencesItem The use of Latin squares and related block designs in implementation research(2014-12) Steen, Ian Nicholas; Campbell, Marion K.; Eccles, Martin P.; Grimshaw, Jeremy M.; Ramsay, Craig R.; Russell, Ian T.; University of Aberdeen.Institute of Applied Health Sciences; University of Aberdeen.Aberdeen Centre for EvaluationItem Explaining clinical behaviors using multiple theoretical models(2012-10-17) Eccles, Martin P.; Grimshaw, Jeremy M.; MacLennan, Graeme; Bonetti, Debbie; Glidewell, Liz; Pitts, Nigel B.; Steen, Nick; Thomas, Ruth Elizabeth; Walker, Anne; Johnston, Marie; University of Aberdeen.Other Applied Health Sciences; University of Aberdeen.Institute of Applied Health SciencesItem Do incentives, reminders or reduced burden improve healthcare professional response rates in postal questionnaires? : two randomised controlled trials(2012-08-14) Glidewell, Liz; Thomas, Ruth; MacLennan, Graeme; Bonetti, Debbie; Johnston, Marie; Eccles, Martin P.; Edlin, Richard; Pitts, Nigel B.; Clarkson, Jan; Steen, Nick; Grimshaw, Jeremy M.; University of Aberdeen.Geosciences; University of Aberdeen.Other Applied Health Sciences; University of Aberdeen.Institute of Applied Health SciencesItem Explaining the effects of an intervention designed to promote evidence-based diabetes care : a theory-based process evaluation of a pragmatic cluster randomised controlled trial(2008-11-19) Francis, Jillian J; Eccles, Martin P.; Johnston, Marie; Whitty, Paula; Grimshaw, Jeremy M; Kaner, Eileen F. S.; Smith, Liz; Walker, Anne; University of Aberdeen.Other Applied Health SciencesItem Using the theory of planned behaviour as a process evaluation tool in randomised trials of knowledge translation strategies : A case study from UK primary care(2010-09-29) Ramsay, Craig R.; Thomas, Ruth E.; Croal, Bernard L.; Grimshaw, Jeremy M.; Eccles, Martin P.; University of Aberdeen.Other Applied Health Sciences; University of Aberdeen.Institute of Applied Health SciencesItem Evidence-based selection of theories for designing behaviour change interventions : using methods based on theoretical construct domains to understand clinicians' blood transfusion behaviour(2009-11) Francis, Jillian; Stockton, Charlotte; Eccles, Martin P.; Johnston, Marie; Cuthbertson, Brian; Grimshaw, Jeremy M.; Hyde, Chris; Tinmouth, Alan; Stanworth, Simon J.; University of Aberdeen.Other Applied Health SciencesItem From Theory to Intervention: Mapping Theoretically Derived Behavioural Determinants to Behaviour Change Techniques(Wiley-Blackwell, 2008) Michie, Susan; Johnston, Marie; Francis, Jillian Joy; Hardeman, Wendy; Eccles, Martin P.Theory provides a helpful basis for designing interventions to change behaviour but offers little guidance on how to do this. This paper aims to illustrate methods for developing an extensive list of behaviour change techniques (with definitions) and for linking techniques to theoretical constructs. A list of techniques and definitions was generated from techniques published in two systematic reviews, supplemented by "brainstorming" and a systematic search of nine textbooks used in training applied psychologists. Inter-rater reliability of extracting the techniques and definitions from the textbooks was assessed. Four experts judged which techniques would be effective in changing 11 theoretical constructs associated with behaviour change. Thirty-five techniques identified in the reviews were extended to 53 by brainstorming and to 137 by consulting textbooks. Agreement for the 53 definitions was 74.7 per cent (15.4% cells completed and 59.3% cells empty for both raters). Agreement about the link between the 35 techniques and theoretical constructs was 71.7 per cent of 385 judgments (12.2% agreement that effective and 59.5% agreement that not effective). This preliminary work demonstrates the possibility of developing a comprehensive, reliable taxonomy of techniques linked to theory. Further refinement is needed to eliminate redundancies, resolve uncertainties, and complete technique definitions.Item Appropriate disclosure of a diagnosis of dementia : identifying the key behaviours of 'best practice'(BioMed Central, 2008-05-01) Lecouturier, Jan; Bamford, Claire; Hughes, Julian C .; Francis, Jillian Joy; Foy, Robbie; Eccles, Martin P.; Johnston, MarieBackground: Despite growing evidence that many people with dementia want to know their diagnosis, there is wide variation in attitudes of professionals towards disclosure. The disclosure of the diagnosis of dementia is increasingly recognised as being a process rather than a one-off behaviour. However, the different behaviours that contribute to this process have not been comprehensively defined. No intervention studies to improve diagnostic disclosure in dementia have been reported to date. As part of a larger study to develop an intervention to promote appropriate disclosure, we sought to identify important disclosure behaviours and explore whether supplementing a literature review with other methods would result in the identification of new behaviours. Methods: To identify a comprehensive list of behaviours in disclosure we conducted a literature review, interviewed people with dementia and informal carers, and used a consensus process involving health and social care professionals. Content analysis of the full list of behaviours was carried out. Results: Interviews were conducted with four people with dementia and six informal carers. Eight health and social care professionals took part in the consensus panel. From the interviews, consensus panel and literature review 220 behaviours were elicited, with 109 behaviours over-lapping. The interviews and consensus panel elicited 27 behaviours supplementary to the review. Those from the interviews appeared to be self-evident but highlighted deficiencies in current practice and from the panel focused largely on balancing the needs of people with dementia and family members. Behaviours were grouped into eight categories: preparing for disclosure; integrating family members; exploring the patient's perspective; disclosing the diagnosis; responding to patient reactions; focusing on quality of life and well-being; planning for the future; and communicating effectively. Conclusion: This exercise has highlighted the complexity of the process of disclosing a diagnosis of dementia in an appropriate manner. It confirms that many of the behaviours identified in the literature (often based on professional opinion rather than empirical evidence) also resonate with people with dementia and informal carers. The presence of contradictory behaviours emphasises the need to tailor the process of disclosure to individual patients and carers. Our combined methods may be relevant to other efforts to identify and define complex clinical practices for further study.Item Developing the content of two behavioural interventions : using theory-based interventions to promote GP management of upper respiratory tract infection without prescribing antibiotics #1(BioMed Central, 2008-01-14) Hrisos, Susan; Eccles, Martin P.; Johnston, Marie; Francis, Jillian Joy; Kaner, Eileen F.; Steen, Nick; Grimshaw, JeremyBackground: Evidence shows that antibiotics have limited effectiveness in the management of upper respiratory tract infection (URTI) yet GPs continue to prescribe antibiotics. Implementation research does not currently provide a strong evidence base to guide the choice of interventions to promote the uptake of such evidence-based practice by health professionals. While systematic reviews demonstrate that interventions to change clinical practice can be effective, heterogeneity between studies hinders generalisation to routine practice. Psychological models of behaviour change that have been used successfully to predict variation in behaviour in the general population can also predict the clinical behaviour of healthcare professionals. The purpose of this study was to design two theoretically-based interventions to promote the management of upper respiratory tract infection (URTI) without prescribing antibiotics. Method: Interventions were developed using a systematic, empirically informed approach in which we: selected theoretical frameworks; identified modifiable behavioural antecedents that predicted GPs intended and actual management of URTI; mapped these target antecedents on to evidence-based behaviour change techniques; and operationalised intervention components in a format suitable for delivery by postal questionnaire. Results: We identified two psychological constructs that predicted GP management of URTI: "Self-efficacy," representing belief in one's capabilities, and "Anticipated consequences," representing beliefs about the consequences of one's actions. Behavioural techniques known to be effective in changing these beliefs were used in the design of two paper-based, interactive interventions. Intervention 1 targeted self-efficacy and required GPs to consider progressively more difficult situations in a "graded task" and to develop an "action plan" of what to do when next presented with one of these situations. Intervention 2 targeted anticipated consequences and required GPs to respond to a "persuasive communication" containing a series of pictures representing the consequences of managing URTI with and without antibiotics. Conclusion: It is feasible to systematically develop theoretically-based interventions to change professional practice. Two interventions were designed that differentially target generalisable constructs predictive of GP management of URTI. Our detailed and scientific rationale for the choice and design of our interventions will provide a basis for understanding any effects identified in their evaluation. Trial registration: Clinicaltrials.gov NCT00376142