Faculty of Health and Life Sciences.
School of Social Sciences, Humanities and Law.
Health Psychol. 2021 Dec;40(12):960-973. doi: 10.1037/hea0001100. Epub 2021 Dec 20.
This Strategic Behavioral Analysis aimed to: identify barriers and facilitators to health care professionals' implementation of Making Every Contact Count (MECC); code behavioral components of nationally delivered interventions to improve MECC implementation; assess the extent to which these components are theoretically congruent with identified theoretical domains representing barriers and facilitators. Comparing national interventions that aim to support implementation of behavior change related activity to the barriers and facilitators for the target behavior enables identification of opportunities being missed in practice; thereby, facilitating intervention optimization.
A mixed-method study involving: a systematic review to identify barriers and facilitators to implementing MECC classified using the COM-B model and Theoretical Domains Framework (TDF); a content analysis of national interventions to improve MECC implementation in England using the Behavior Change Wheel (BCW) and Behavior Change Techniques Taxonomy (BCTTv1); linking intervention content to barriers identified in the systematic review.
Across 27 studies, the most frequently reported barriers related to eight TDF domains: Environmental Context and Resources, Beliefs About Capabilities, Knowledge, Beliefs About Consequences, Intentions, Skills, Social Professional Role and Identity, and Emotions. National interventions aimed at supporting MECC implementation included on average 5.1 BCW intervention functions (Education, Modeling, Persuasion, and Training were used in all interventions) and 8.7 BCTs. Only 21% of BCTs potentially relevant to key domains were used across interventions. The majority of BCTs linked to seven of the eight most important domains were not used in any existing interventions.
Intervention developers should seize missed opportunities by incorporating more theoretically relevant BCTs to target barriers to implementing MECC. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
本策略性行为分析旨在：确定医疗保健专业人员实施“每接触必计数”（MECC）的障碍和促进因素；对全国范围内实施干预措施以改善 MECC 实施的行为进行编码；评估这些组成部分在多大程度上与代表障碍和促进因素的既定理论领域理论上一致。将旨在支持实施与行为改变相关活动的行为改变干预措施与目标行为的障碍和促进因素进行比较，可以确定实践中错过的机会；从而促进干预措施的优化。
一项混合方法研究，包括：系统综述，使用 COM-B 模型和理论领域框架（TDF）对实施 MECC 的障碍和促进因素进行分类；对英格兰提高 MECC 实施的国家干预措施进行内容分析，使用行为改变轮（BCW）和行为改变技术分类（BCTTv1）；将干预内容与系统综述中确定的障碍联系起来。
在 27 项研究中，报告最多的障碍与 TDF 的八个领域有关：环境背景和资源、能力信念、知识、后果信念、意图、技能、社会专业角色和身份以及情绪。旨在支持 MECC 实施的国家干预措施平均包括 5.1 个 BCW 干预功能（所有干预措施都使用了教育、建模、说服和培训）和 8.7 个 BCT。只有 21%的 BCT 与关键领域相关。与八个最重要领域中的七个相关的大多数 BCT 未在任何现有干预措施中使用。
干预措施的制定者应该抓住这些机会，将更多与理论相关的 BCT 纳入到针对实施 MECC 的障碍的目标中。（PsycInfo 数据库记录（c）2022 APA，保留所有权利）。
