Cargando…

Use of the Theoretical Domains Framework to evaluate factors driving successful implementation of the Accelerated Chest pain Risk Evaluation (ACRE) project

BACKGROUND: The translation of healthcare research into practice is typically challenging and limited in effectiveness. The Theoretical Domains Framework (TDF) identifies 12 domains of behaviour determinants which can be used to understand the principles of behavioural change, a key factor influenci...

Descripción completa

Detalles Bibliográficos
Autores principales: Skoien, Wade, Page, Katie, Parsonage, William, Ashover, Sarah, Milburn, Tanya, Cullen, Louise
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5062925/
https://www.ncbi.nlm.nih.gov/pubmed/27733174
http://dx.doi.org/10.1186/s13012-016-0500-9
_version_ 1782459876910301184
author Skoien, Wade
Page, Katie
Parsonage, William
Ashover, Sarah
Milburn, Tanya
Cullen, Louise
author_facet Skoien, Wade
Page, Katie
Parsonage, William
Ashover, Sarah
Milburn, Tanya
Cullen, Louise
author_sort Skoien, Wade
collection PubMed
description BACKGROUND: The translation of healthcare research into practice is typically challenging and limited in effectiveness. The Theoretical Domains Framework (TDF) identifies 12 domains of behaviour determinants which can be used to understand the principles of behavioural change, a key factor influencing implementation. The Accelerated Chest pain Risk Evaluation (ACRE) project has successfully translated research into practice, by implementing an intervention to improve the assessment of low to intermediate risk patients presenting to emergency departments (EDs) with chest pain. The aims of this paper are to describe use of the TDF to determine which factors successfully influenced implementation and to describe use of the TDF as a tool to evaluate implementation efforts and which domains are most relevant to successful implementation. METHODS: A 30-item questionnaire targeting clinicians was developed using the TDF as a guide. Questions encompassed ten of the domains of the TDF: Knowledge; Skills; Social/professional role and identity; Beliefs about capabilities; Optimism; Beliefs about consequences; Intentions; Memory, attention and decision processes; Environmental context and resources; and Social influences. RESULTS: Sixty-three of 176 stakeholders (36 %) responded to the questionnaire. Responses for all scales showed that respondents were highly favourable to all aspects of the implementation. Scales with the highest mean responses were Intentions, Knowledge, and Optimism, suggesting that initial education and awareness strategies around the ACRE project were effective. Scales with the lowest mean responses were Environmental context and resources, and Social influences, perhaps highlighting that implementation planning could have benefitted from further consideration of the factors underlying these scales. CONCLUSIONS: The ACRE project was successful, and therefore, a perfect case study for understanding factors which drive implementation success. The overwhelmingly positive response suggests that it was a successful programme and likely that each of these domains was important for the implementation. However, a lack of variance in the responses hampered us from concluding which factors were most influential in driving the success of the implementation. The TDF offers a useful framework to conceptualise and evaluate factors impacting on implementation success. However, its broad scope makes it necessary to tailor the framework to allow evaluation of specific projects. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13012-016-0500-9) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-5062925
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-50629252016-10-24 Use of the Theoretical Domains Framework to evaluate factors driving successful implementation of the Accelerated Chest pain Risk Evaluation (ACRE) project Skoien, Wade Page, Katie Parsonage, William Ashover, Sarah Milburn, Tanya Cullen, Louise Implement Sci Research BACKGROUND: The translation of healthcare research into practice is typically challenging and limited in effectiveness. The Theoretical Domains Framework (TDF) identifies 12 domains of behaviour determinants which can be used to understand the principles of behavioural change, a key factor influencing implementation. The Accelerated Chest pain Risk Evaluation (ACRE) project has successfully translated research into practice, by implementing an intervention to improve the assessment of low to intermediate risk patients presenting to emergency departments (EDs) with chest pain. The aims of this paper are to describe use of the TDF to determine which factors successfully influenced implementation and to describe use of the TDF as a tool to evaluate implementation efforts and which domains are most relevant to successful implementation. METHODS: A 30-item questionnaire targeting clinicians was developed using the TDF as a guide. Questions encompassed ten of the domains of the TDF: Knowledge; Skills; Social/professional role and identity; Beliefs about capabilities; Optimism; Beliefs about consequences; Intentions; Memory, attention and decision processes; Environmental context and resources; and Social influences. RESULTS: Sixty-three of 176 stakeholders (36 %) responded to the questionnaire. Responses for all scales showed that respondents were highly favourable to all aspects of the implementation. Scales with the highest mean responses were Intentions, Knowledge, and Optimism, suggesting that initial education and awareness strategies around the ACRE project were effective. Scales with the lowest mean responses were Environmental context and resources, and Social influences, perhaps highlighting that implementation planning could have benefitted from further consideration of the factors underlying these scales. CONCLUSIONS: The ACRE project was successful, and therefore, a perfect case study for understanding factors which drive implementation success. The overwhelmingly positive response suggests that it was a successful programme and likely that each of these domains was important for the implementation. However, a lack of variance in the responses hampered us from concluding which factors were most influential in driving the success of the implementation. The TDF offers a useful framework to conceptualise and evaluate factors impacting on implementation success. However, its broad scope makes it necessary to tailor the framework to allow evaluation of specific projects. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13012-016-0500-9) contains supplementary material, which is available to authorized users. BioMed Central 2016-10-12 /pmc/articles/PMC5062925/ /pubmed/27733174 http://dx.doi.org/10.1186/s13012-016-0500-9 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Skoien, Wade
Page, Katie
Parsonage, William
Ashover, Sarah
Milburn, Tanya
Cullen, Louise
Use of the Theoretical Domains Framework to evaluate factors driving successful implementation of the Accelerated Chest pain Risk Evaluation (ACRE) project
title Use of the Theoretical Domains Framework to evaluate factors driving successful implementation of the Accelerated Chest pain Risk Evaluation (ACRE) project
title_full Use of the Theoretical Domains Framework to evaluate factors driving successful implementation of the Accelerated Chest pain Risk Evaluation (ACRE) project
title_fullStr Use of the Theoretical Domains Framework to evaluate factors driving successful implementation of the Accelerated Chest pain Risk Evaluation (ACRE) project
title_full_unstemmed Use of the Theoretical Domains Framework to evaluate factors driving successful implementation of the Accelerated Chest pain Risk Evaluation (ACRE) project
title_short Use of the Theoretical Domains Framework to evaluate factors driving successful implementation of the Accelerated Chest pain Risk Evaluation (ACRE) project
title_sort use of the theoretical domains framework to evaluate factors driving successful implementation of the accelerated chest pain risk evaluation (acre) project
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5062925/
https://www.ncbi.nlm.nih.gov/pubmed/27733174
http://dx.doi.org/10.1186/s13012-016-0500-9
work_keys_str_mv AT skoienwade useofthetheoreticaldomainsframeworktoevaluatefactorsdrivingsuccessfulimplementationoftheacceleratedchestpainriskevaluationacreproject
AT pagekatie useofthetheoreticaldomainsframeworktoevaluatefactorsdrivingsuccessfulimplementationoftheacceleratedchestpainriskevaluationacreproject
AT parsonagewilliam useofthetheoreticaldomainsframeworktoevaluatefactorsdrivingsuccessfulimplementationoftheacceleratedchestpainriskevaluationacreproject
AT ashoversarah useofthetheoreticaldomainsframeworktoevaluatefactorsdrivingsuccessfulimplementationoftheacceleratedchestpainriskevaluationacreproject
AT milburntanya useofthetheoreticaldomainsframeworktoevaluatefactorsdrivingsuccessfulimplementationoftheacceleratedchestpainriskevaluationacreproject
AT cullenlouise useofthetheoreticaldomainsframeworktoevaluatefactorsdrivingsuccessfulimplementationoftheacceleratedchestpainriskevaluationacreproject