Action, actor, context, target, time (AACTT): a framework for specifying behaviour

Background Designing implementation interventions to change the behaviour of healthcare providers and other professionals in the health system requires detailed specification of the behaviour(s) targeted for change to ensure alignment between intervention components and measured outcomes. Detailed b...

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Vydáno v:Implementation science : IS Ročník 14; číslo 1; s. 102 - 13
Hlavní autoři: Presseau, Justin, McCleary, Nicola, Lorencatto, Fabiana, Patey, Andrea M., Grimshaw, Jeremy M., Francis, Jill J.
Médium: Journal Article
Jazyk:angličtina
Vydáno: London BioMed Central 05.12.2019
BioMed Central Ltd
Springer Nature B.V
BMC
Témata:
Actors
Analysis
Attitudes
Behavior
Behaviour
Behaviour change
Behaviour specification
Blood pressure
Child behavior
Clinical Competence - standards
Design
Diabetes
Framework
Guideline Adherence - standards
Health Administration
Health care
Health care industry
Health Informatics
Health Personnel - standards
Health Plan Implementation - methods
Health Policy
Health professional behaviour
Health Promotion and Disease Prevention
Health Services Research
Health Services Research - methods
Humans
Intervention
Medical records
Medical research
Medicine
Medicine & Public Health
Methodology
Models, Theoretical
Political parties
Primary care
Public Health
Quality Improvement
TACT
Time
TACT
Behaviour specification
Behaviour
Behaviour change
Framework
Health professional behaviour
ISSN:1748-5908, 1748-5908
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Shrnutí:Background Designing implementation interventions to change the behaviour of healthcare providers and other professionals in the health system requires detailed specification of the behaviour(s) targeted for change to ensure alignment between intervention components and measured outcomes. Detailed behaviour specification can help to clarify evidence-practice gaps, clarify who needs to do what differently, identify modifiable barriers and enablers, design interventions to address these and ultimately provides an indicator of what to measure to evaluate an intervention’s effect on behaviour change. An existing behaviour specification framework proposes four domains (Target, Action, Context, Time; TACT), but insufficiently clarifies who is performing the behaviour (i.e. the Actor). Specifying the Actor is especially important in healthcare settings characterised by multiple behaviours performed by multiple different people. We propose and describe an extension and re-ordering of TACT to enhance its utility to implementation intervention designers, practitioners and trialists: the Action, Actor, Context, Target, Time (AACTT) framework. We aim to demonstrate its application across key steps of implementation research and to provide tools for its use in practice to clarify the behaviours of stakeholders across multiple levels of the healthcare system. Methods and results We used French et al.’s four-step implementation process model to describe the potential applications of the AACTT framework for (a) clarifying who needs to do what differently, (b) identifying barriers and enablers, (c) selecting fit-for-purpose intervention strategies and components and (d) evaluating implementation interventions. Conclusions Describing and detailing behaviour using the AACTT framework may help to enhance measurement of theoretical constructs, inform development of topic guides and questionnaires, enhance the design of implementation interventions and clarify outcome measurement for evaluating implementation interventions.
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ISSN:1748-5908
1748-5908
DOI:10.1186/s13012-019-0951-x