Methods for designing interventions to change healthcare professionals’ behaviour: a systematic review

Abstract

BackgroundSystematic reviews consistently indicate that interventions to change healthcare professional (HCP) behaviour are haphazardly designed and poorly specified. Clarity about methods for designing and specifying interventions is needed. The objective of this review was to identify published methods for designing interventions to change HCP behaviour.MethodsA search of MEDLINE, Embase, and PsycINFO was conducted from 1996 to April 2015. Using inclusion/exclusion criteria, a broad screen of abstracts by one rater was followed by a strict screen of full text for all potentially relevant papers by three raters. An inductive approach was first applied to the included studies to identify commonalities and differences between the descriptions of methods across the papers. Based on this process and knowledge of related literatures, we developed a data extraction framework that included, e.g. level of change (e.g. individual versus organization); context of development; a brief description of the method; tasks included in the method (e.g. barrier identification, component selection, use of theory).Results3966 titles and abstracts and 64 full-text papers were screened to yield 15 papers included in the review, each outlining one design method. All of the papers reported methods developed within a specific context. Thirteen papers included barrier identification and 13 included linking barriers to intervention components; although not the same 13 papers. Thirteen papers targeted individual HCPs with only one paper targeting change across individual, organization, and system levels. The use of theory and user engagement were included in 13/15 and 13/15 papers, respectively.ConclusionsThere is an agreement across methods of four tasks that need to be completed when designing individual-level interventions: identifying barriers, selecting intervention components, using theory, and engaging end-users. Methods also consist of further additional tasks. Examples of methods for designing the organisation and system-level interventions were limited. Further analysis of design tasks could facilitate the development of detailed guidelines for designing interventions.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-017-0560-5) contains supplementary material, which is available to authorized users.

Applying Theory Informed Global Trends in a Collaborative Model for Organizational Evidence-based Healthcare

“…These findings related to organizational requirements and integration of units across hospitals and healthcare systems have been replicated in experiential and anecdotal reports from the USA [13]. The overriding lesson from published literature is that while focusing on interventions to improve the uptake of EBHC is important, as is individual health professional behavior change to increase readiness for change; the unit based approach is congruent with the structures and functions of hospitals and health care settings, and more aligned with integrated approaches informed by conceptual models for EBHC [2,4,7,10].…”

“…More recent evidence better reflects this complexity, with Colquhoun and colleges identifying that the best approaches to implementation do not study interventions in isolation from barriers to practice change, tailored interventions, theory, and stakeholder engagement [4]. The authors went on to indicate that organizational and system level evidence for implementation of best practice remains limited; with research in to best practice often lacking clarity in the planning and methods [4].…”

“…Briggs Institute Centre of Excellence program for global collaboration, this paper highlights structures and processes supportive of getting evidence in to practice. It describes innovative strategies and solutions for integration of evidence related to the individual clinician within an organizational framework that conceptualizes evidence-based healthcare [4][5][6]. Joanna Briggs Centres of Excellence are a unique organizational structure in the healthcare landscape.…”

Governança corporativa e gestão hospitalar

“…Strategic decision-making comes from the development of human resources, which coexist under various logics in complex organizations, taking into account the professional multiplicity, in which there are various functions, skills, autonomy, and even of interests. (3,4) It is worth remembering that in hospital organizations there are two worlds (the administrative and care spheres) that seldom dialogue and are often contradictory.…”

“…(2) Surely, adopting methods, consolidating performance criteria in their various dimensions and service efficiency could improve the human and economic transactions, ensuring ethics at work. (3) In fact, a balanced governance between stakeholders occurs through the application of guiding principles of good practice. This results from the intelligent use of available resources, which can improve and stimulate production and reduce costs.…”