Health Behaviour Change Research Group, School of Psychology, University of Galway, Galway, Ireland.
Office of the Chief Clinical Officer, Health Services Executive, Cork, Ireland.
Br J Health Psychol. 2023 Sep;28(3):753-772. doi: 10.1111/bjhp.12652. Epub 2023 Feb 26.
The public health impact of the Irish Making Every Contact Count (MECC) brief intervention programme is dependent on delivery by health care professionals. We aimed to identify enablers and modifiable barriers to MECC intervention delivery to optimize MECC implementation.
Online cross-sectional survey design.
Health care professionals (n = 4050) who completed MECC eLearning were invited to complete an online survey based on the Theoretical Domains Framework (TDF). Multiple regression analysis identified predictors of MECC delivery (logistic regression to predict delivery or not; linear regression to predict frequency of delivery). Data were visualized using Confidence Interval-Based Estimates of Relevance (CIBER).
Seventy-nine per cent of participants (n = 283/357) had delivered a MECC intervention. In the multiple logistic regression (Nagelkerke's R = .34), the significant enablers of intervention delivery were 'professional role' (OR = 1.86 [1.10, 3.15]) and 'intentions/goals' (OR = 4.75 [1.97, 11.45]); significant barriers included 'optimistic beliefs about consequences' (OR = .41 [.18, .94]) and 'negative emotions' (OR = .50 [.32, .77]). In the multiple linear regression (R = .29), the significant enablers of frequency of MECC delivery were 'intentions/goals' (b = 10.16, p = .02) and professional role (b = 6.72, p = .03); the significant barriers were 'negative emotions' (b = -4.74, p = .04) and 'barriers to prioritisation' (b = -5.00, p = .01). CIBER analyses suggested six predictive domains with substantial room for improvement: 'intentions and goals', 'barriers to prioritisation', 'environmental resources', 'beliefs about capabilities', 'negative emotions' and 'skills'.
Implementation interventions to enhance MECC delivery should target intentions and goals, beliefs about capabilities, negative emotions, environmental resources, skills and barriers to prioritization.
爱尔兰的每一次接触计数（MECC）简短干预计划对公众健康的影响取决于医疗保健专业人员的实施。我们旨在确定 MECC 干预实施的促进因素和可改变的障碍，以优化 MECC 的实施。
在线横断面调查设计。
完成 MECC 电子学习的医疗保健专业人员（n=4050）被邀请根据理论领域框架（TDF）完成在线调查。多元回归分析确定了 MECC 交付的预测因素（逻辑回归预测交付或不交付；线性回归预测交付频率）。使用置信区间基于相关性估计（CIBER）可视化数据。
79%的参与者（n=283/357）实施了 MECC 干预。在多元逻辑回归（Nagelkerke 的 R=0.34）中，干预实施的显著促进因素是“专业角色”（OR=1.86[1.10,3.15]）和“意图/目标”（OR=4.75[1.97,11.45]）；显著障碍包括“对后果的乐观信念”（OR=0.41[0.18,0.94]）和“负面情绪”（OR=0.50[0.32,0.77]）。在多元线性回归（R=0.29）中，MECC 交付频率的显著促进因素是“意图/目标”（b=10.16，p=0.02）和专业角色（b=6.72，p=0.03）；显著障碍是“负面情绪”（b=-4.74，p=0.04）和“优先事项障碍”（b=-5.00，p=0.01）。CIBER 分析表明，有六个具有很大改进空间的预测领域：“意图和目标”、“优先事项障碍”、“环境资源”、“能力信念”、“负面情绪”和“技能”。
为了提高 MECC 的实施，应实施干预措施，以加强 MECC 的实施，针对意图和目标、能力信念、负面情绪、环境资源、技能和优先事项障碍。
