dc.contributor.author |
Haskell, Libby |
|
dc.contributor.author |
Tavender, Emma J |
|
dc.contributor.author |
Wilson, Catherine L |
|
dc.contributor.author |
O'Brien, Sharon |
|
dc.contributor.author |
Babl, Franz E |
|
dc.contributor.author |
Borland, Meredith L |
|
dc.contributor.author |
Cotterell, Elizabeth |
|
dc.contributor.author |
Sheridan, Nicolette |
|
dc.contributor.author |
Oakley, Ed |
|
dc.contributor.author |
Dalziel, Stuart R |
|
dc.contributor.author |
Paediatric Research in Emergency Departments International Collaborative (PREDICT) network, Australasia |
|
dc.coverage.spatial |
England |
|
dc.date.accessioned |
2023-01-17T22:56:05Z |
|
dc.date.available |
2023-01-17T22:56:05Z |
|
dc.date.issued |
2021-08 |
|
dc.identifier.citation |
(2021). BMC Health Services Research, 21(1), 769-. |
|
dc.identifier.issn |
1472-6963 |
|
dc.identifier.uri |
https://hdl.handle.net/2292/62424 |
|
dc.description.abstract |
<h4>Background</h4>Despite international guidelines providing evidence-based recommendations on appropriate management of infants with bronchiolitis, wide variation in practice occurs. This results in infants receiving care of no benefit, with associated cost and is potentially harmful. Theoretical frameworks are increasingly used to develop interventions, utilising behaviour change techniques specifically chosen to target factors contributing to practice variation, with de-implementation often viewed as harder than implementing. This paper describes the stepped process using the Theoretical Domains Framework (TDF) to develop targeted, theory-informed interventions which subsequently successfully improved management of infants with bronchiolitis by de-implementing ineffective therapies. Explicit description of the process and rationale used in developing de-implementation interventions is critical to dissemination of these practices into real world clinical practice.<h4>Methods</h4>A stepped approach was used: (1) Identify evidence-based recommendations and practice variation as targets for change, (2) Identify factors influencing practice change (barriers and enablers) to be addressed, and (3) Identification and development of interventions (behaviour change techniques and methods of delivery) addressing influencing factors, considering evidence of effectiveness, feasibility, local relevance and acceptability. The mode of delivery for the intervention components was informed by evidence from implementation science systematic reviews, and setting specific feasibility and practicality.<h4>Results</h4>Five robust evidence-based management recommendations, targeting the main variation in bronchiolitis management were identified: namely, no use of chest x-ray, salbutamol, glucocorticoids, antibiotics, and adrenaline. Interventions developed to target recommendations addressed seven TDF domains (identified following qualitative clinician interviews (n = 20)) with 23 behaviour change techniques chosen to address these domains. Final interventions included: (1) Local stakeholder meetings, (2) Identification of medical and nursing clinical leads, (3) Train-the-trainer workshop for all clinical leads, (4) Local educational materials for delivery by clinical leads, (5) Provision of tools and materials targeting influencing factors, and prompting recommended behaviours, and (6) Audit and feedback.<h4>Conclusion</h4>A stepped approach based on theory, evidence and issues of feasibility, local relevance and acceptability, was successfully used to develop interventions to improve management of infants with bronchiolitis. The rationale and content of interventions has been explicitly described allowing others to de-implement unnecessary bronchiolitis management, thereby improving care. |
|
dc.format.medium |
Electronic |
|
dc.language |
eng |
|
dc.publisher |
Springer Nature |
|
dc.relation.ispartofseries |
BMC health services research |
|
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
|
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
|
dc.rights.uri |
https://creativecommons.org/licenses/by/4.0/ |
|
dc.subject |
Paediatric Research in Emergency Departments International Collaborative (PREDICT) network, Australasia |
|
dc.subject |
Humans |
|
dc.subject |
Bronchiolitis |
|
dc.subject |
Feedback |
|
dc.subject |
Infant |
|
dc.subject |
Implementation Science |
|
dc.subject |
Behaviour change techniques |
|
dc.subject |
De-implementation |
|
dc.subject |
Intervention |
|
dc.subject |
Theoretical domains framework |
|
dc.subject |
Clinical Research |
|
dc.subject |
7.3 Management and decision making |
|
dc.subject |
7 Management of diseases and conditions |
|
dc.subject |
Science & Technology |
|
dc.subject |
Life Sciences & Biomedicine |
|
dc.subject |
Health Care Sciences & Services |
|
dc.subject |
KNOWLEDGE TRANSLATION |
|
dc.subject |
IMPLEMENTATION |
|
dc.subject |
GUIDELINE |
|
dc.subject |
QUALITY |
|
dc.subject |
0807 Library and Information Studies |
|
dc.subject |
1110 Nursing |
|
dc.subject |
1117 Public Health and Health Services |
|
dc.title |
Development of targeted, theory-informed interventions to improve bronchiolitis management. |
|
dc.type |
Journal Article |
|
dc.identifier.doi |
10.1186/s12913-021-06724-6 |
|
pubs.issue |
1 |
|
pubs.begin-page |
769 |
|
pubs.volume |
21 |
|
dc.date.updated |
2022-12-04T19:56:21Z |
|
dc.rights.holder |
Copyright: The authors |
en |
dc.identifier.pmid |
34344383 (pubmed) |
|
pubs.author-url |
https://www.ncbi.nlm.nih.gov/pubmed/34344383 |
|
pubs.publication-status |
Published |
|
dc.rights.accessrights |
http://purl.org/eprint/accessRights/OpenAccess |
en |
pubs.subtype |
research-article |
|
pubs.subtype |
Journal Article |
|
pubs.elements-id |
861780 |
|
pubs.org-id |
Medical and Health Sciences |
|
pubs.org-id |
School of Medicine |
|
pubs.org-id |
Paediatrics Child & Youth Hlth |
|
dc.identifier.eissn |
1472-6963 |
|
dc.identifier.pii |
10.1186/s12913-021-06724-6 |
|
pubs.number |
769 |
|
pubs.record-created-at-source-date |
2022-12-05 |
|
pubs.online-publication-date |
2021-08-03 |
|