Identifying behaviour change techniques in 287 randomized controlled trials of audit and feedback interventions targeting practice change among healthcare professionals

Background Audit and feedback (A&F) is among the most widely used implementation strategies, providing healthcare professionals with summaries of their practice performance to prompt behaviour change and optimize care. Wide variability in effectiveness of A&F has spurred efforts to explore w...

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Veröffentlicht in:Implementation science : IS Jg. 18; H. 1; S. 63 - 25
Hauptverfasser: Crawshaw, Jacob, Meyer, Carly, Antonopoulou, Vivi, Antony, Jesmin, Grimshaw, Jeremy M., Ivers, Noah, Konnyu, Kristin, Lacroix, Meagan, Presseau, Justin, Simeoni, Michelle, Yogasingam, Sharlini, Lorencatto, Fabiana
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London BioMed Central 21.11.2023
BioMed Central Ltd
Springer Nature B.V
BMC
Schlagworte:
Analysis
Audit and feedback
Audits
Behavior
Behavior Therapy - methods
Behavioral assessment
Behaviour change techniques
Clinical medicine
Clinical trials
Delivery of Health Care
Diabetes
Evaluation
Exercise
Feedback
Health Administration
Health care reform
Health Informatics
Health Policy
Health Promotion and Disease Prevention
Health Services Research
Healthcare professionals
Humans
Implementation
Intervention
Medical personnel
Medicine
Medicine & Public Health
Methods
Patients
Practice change
Professional practice
Professionals
Public Health
Quality improvement
Randomized Controlled Trials as Topic
Social sciences
Systematic review
Taxonomy
Canada
Quality improvement
Behaviour change techniques
Healthcare professionals
Practice change
Audit and feedback
Implementation
ISSN:1748-5908, 1748-5908
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Zusammenfassung:Background Audit and feedback (A&F) is among the most widely used implementation strategies, providing healthcare professionals with summaries of their practice performance to prompt behaviour change and optimize care. Wide variability in effectiveness of A&F has spurred efforts to explore why some A&F interventions are more effective than others. Unpacking the variability of the content of A&F interventions in terms of their component behaviours change techniques (BCTs) may help advance our understanding of how A&F works best. This study aimed to systematically specify BCTs in A&F interventions targeting healthcare professional practice change. Methods We conducted a directed content analysis of intervention descriptions in 287 randomized trials included in an ongoing Cochrane systematic review update of A&F interventions (searched up to June 2020). Three trained researchers identified and categorized BCTs in all trial arms (treatment & control/comparator) using the 93-item BCT Taxonomy version 1. The original BCT definitions and examples in the taxonomy were adapted to include A&F-specific decision rules and examples. Two additional BCTs (‘Education (unspecified)’ and ‘Feedback (unspecified)’) were added, such that 95 BCTs were considered for coding. Results In total, 47/95 BCTs (49%) were identified across 360 treatment arms at least once (median = 5.0, IQR  = 2.3, range = 1-29). The most common BCTs were ‘Feedback on behaviour’ (present 89% of the time; e.g. feedback on drug prescribing), ‘Instruction on how to perform the behaviour’ (71%; e.g. issuing a clinical guideline), ‘Social comparison’ (52%; e.g. feedback on performance of peers), ‘Credible source’ (41%; e.g. endorsements from respected professional body), and ‘Education (unspecified)’ (31%; e.g. giving a lecture to staff). A total of 130/287 (45%) control/comparator arms contained at least one BCT (median = 2.0, IQR  = 3.0, range = 0–15 per arm), of which the most common were identical to those identified in treatment arms. Conclusions A&F interventions to improve healthcare professional practice include a moderate range of BCTs, focusing predominantly on providing behavioural feedback, sharing guidelines, peer comparison data, education, and leveraging credible sources. We encourage the use of our A&F-specific list of BCTs to improve knowledge of what is being delivered in A&F interventions. Our study provides a basis for exploring which BCTs are associated with intervention effectiveness. Trial registrations N/A.
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ISSN:1748-5908
1748-5908
DOI:10.1186/s13012-023-01318-8