Applying Behavior Change Theories and Qualitative Methods in Substance Misuse Implementation Research: Conceptualizing the Adoption of Breaking Free Online in Real-World Clinical Practice

Abstract

There is insufficient research examining the implementation of complex novel interventions within health care. This may be due to a lack of qualitative research providing subjective insights into these implementation processes. The authors investigate the advantages of applying behavior change theories to conceptualize qualitative data describing the processes of implementation of complex interventions. Breaking Free Online (BFO), a digital treatment intervention for substance misuse, is described as an example of a complex intervention. The authors review previous qualitative research which explored initial diffusion, or spread, of the BFO program, and its subsequent normalization as part of standard treatment for substance misuse within the health and social care charity, "Change, Grow, Live" (CGL). The use of behavior change models to structure qualitative interview findings enabled identification of facilitators and barriers to the use of BFO within CGL. These findings have implications for the development of implementation research in novel health care interventions.

Examining effectiveness of tailorable computer-assisted therapy programmes for substance misuse: Programme usage and clinical outcomes data from Breaking Free Online

“…An MRC-framed evaluation of BFO was initiated in 2012 (e.g. Dugdale et al, 2016a;Elison et al, 2015c;Elison et al, 2015bElison et al, , 2015a, with individual intervention strategies being conceptualised using the Michie et al, (2013) BCT taxonomy (Dugdale et al, 2016b). These intervention strategies are located on the six-domain biopsychosocial 'Lifestyle Balance Model' (LBM: Davies et al, 2015), based on the five-factor model in cognitive-behavioural therapy (Greenberger & Padesky, 1995;Williams & Chellingsworth, 2010).…”

Factors influencing decision making for kidney transplantation among Black and Latino patients on dialysis: A qualitative study applying the social ecological model

“…The application of theory may benefit qualitative research methods by providing an organizational structure for interpreting findings and for conceptualizing multilevel interventions. 12,18 The themes of fear and uncertainty point to the need for individual level interventions that address personal barriers to transplantation. Interventions may address this barrier through increased education efforts that support decision-making.…”

“In my own comfort zone”: Clients' experiences of relational aspects of online therapy for alcohol problems

“…In this rapidly changing context, there is a clear need for evidence on the effectiveness of online interventions for alcohol treatment clients. However, as Dugdale et al (2016) argue, the evidence base, while growing, remains limited. Much research that has been carried out to date has focussed on quantitative indicators (Byaruhanga et al, 2020; Elison et al, 2015).…”