Theories of behaviour change synthesised into a set of theoretical groupings: introducing a thematic series on the theoretical domains framework

Abstract

Behaviour change is key to increasing the uptake of evidence into healthcare practice. Designing behaviour-change interventions first requires problem analysis, ideally informed by theory. Yet the large number of partly overlapping theories of behaviour makes it difficult to select the most appropriate theory. The need for an overarching theoretical framework of behaviour change was addressed in research in which 128 explanatory constructs from 33 theories of behaviour were identified and grouped. The resulting Theoretical Domains Framework (TDF) appears to be a helpful basis for investigating implementation problems. Research groups in several countries have conducted TDF-based studies. It seems timely to bring together the experience of these teams in a thematic series to demonstrate further applications and to report key developments. This overview article describes the TDF, provides a brief critique of the framework, and introduces this thematic series.In a brief review to assess the extent of TDF-based research, we identified 133 papers that cite the framework. Of these, 17 used the TDF as the basis for empirical studies to explore health professionals’ behaviour. The identified papers provide evidence of the impact of the TDF on implementation research. Two major strengths of the framework are its theoretical coverage and its capacity to elicit beliefs that could signify key mediators of behaviour change. The TDF provides a useful conceptual basis for assessing implementation problems, designing interventions to enhance healthcare practice, and understanding behaviour-change processes. We discuss limitations and research challenges and introduce papers in this series.

Comparison of four methods for assessing the importance of attitudinal beliefs: An international Delphi study in intensive care settings

“…The TDF was developed by experts in behaviour change and health services research using a consensus process. The framework integrates overlapping constructs from 33 theories to make theory more useful in applied research and is frequently used to investigate clinical behaviours (Francis, O'Connor, & Curran, 2012) . The topic guide included at least one prompt for eliciting beliefs from each of the 12 theoretical domains in the framework and a range of potential follow-up prompts.…”

An evaluation of three methods of in-hospital cardiac arrest educational debriefing: The cardiopulmonary resuscitation debriefing study

“…[12,13] This process utilised the theoretical domains framework and prioritised the development of interventions that would be deliverable in the UK setting. [14] Interventions were allocated by hospital, based on the character of the hospital and where it was thought they would work most effectively. The focus of each intervention was improvement in CPR delivery.…”

Closing the gap: applying the Theoretical Domains Framework to improve knowledge translation

“…This framework can therefore be used to guide specific interventional strategies to enable behavioural change in practice implementation. 5,10,11 Effectively changing behaviour is critical for the successful implementation of evidence-based practice. 10 Nevertheless, in the past, implementation strategies were often applied with little evidence or rationale.…”

“…5,10,11 Effectively changing behaviour is critical for the successful implementation of evidence-based practice. 10 Nevertheless, in the past, implementation strategies were often applied with little evidence or rationale. 4,5 The need for an approach grounded in sound principles has led to the development of the TDF as a theoretically based framework created by a consensus group of experts, including health psychology theorists, health services researchers, and health psychologists.…”

“…4,5 The need for an approach grounded in sound principles has led to the development of the TDF as a theoretically based framework created by a consensus group of experts, including health psychology theorists, health services researchers, and health psychologists. 5,10 The framework was based on 128 explanatory constructs from 33 psychological theories relevant to changing behaviour. 5,10,11 This framework was more recently refined and validated into 14 domains of behaviour, including knowledge, skills, social/professional role/ identity, beliefs about capabilities, optimism, beliefs about consequences, reinforcement, intention, goals, memory/attention/decision processes, environmental context and resources, social influences, emotion, and behavioural regulation.…”