Centre for Implementation Research, Ottawa Hospital Research Institute - General Campus, Ottawa, Ontario, Canada.
School of Health Sciences, City, University of London, 10 Northampton Square, London, United Kingdom.
JBI Evid Implement. 2023 Jun 1;21(2):115-119. doi: 10.1097/XEB.0000000000000351.
Healthcare professionals provide care to help patients; however, sometimes that care is of low value - at best ineffective and at worst harmful. To address this, recent frameworks provide guidance for developing and investigating de-implementation interventions; yet little attention has been devoted to identifying what strategies are most effective for de-implementation. In this paper, we discuss Behavior substitution, a strategy whereby an unwanted behavior is replaced with a wanted behavior, thereby making it hypothetically easier to reduce or stop the unwanted behavior. We discuss why Behavior substitution may be a useful de-implementation strategy, and why it may not be suitable for all circumstances. On the basis of the body of knowledge in behavioral science, we propose a list of principles to consider when selecting a substitute behavior for a de-implementation intervention. Applying these principles should increase the likelihood that this technique will be effective in reducing low-value care.
医疗保健专业人员提供护理以帮助患者；然而，有时这种护理的价值很低——充其量是无效的，最坏的情况是有害的。为了解决这个问题，最近的框架为制定和研究取消实施干预措施提供了指导；然而，很少有人关注确定哪些策略对取消实施最有效。在本文中，我们讨论行为替代，这是一种策略，通过这种策略，不想要的行为被想要的行为所取代，从而使减少或停止不想要的行为变得更加容易。我们讨论了为什么行为替代可能是一种有用的取消实施策略，以及为什么它可能不适合所有情况。基于行为科学的知识体系，我们提出了在为取消实施干预措施选择替代行为时需要考虑的一系列原则。应用这些原则应该会增加该技术在减少低价值护理方面的有效性的可能性。
