A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems

Lou Atkins, Jill Francis, Rafat Islam, Denise O'Connor, Andrea Patey, Noah Ivers, Robbie Foy, Eilidh M. Duncan, Heather Colquhoun, Jeremy M. Grimshaw, Rebecca Lawton, Susan Michie

Research output: Contribution to journalArticle

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Abstract

Background: Implementing new practices requires changes in the behaviour of relevant actors, and this is facilitated by understanding of the determinants of current and desired behaviours. The Theoretical Domains Framework (TDF) was developed by a collaboration of behavioural scientists and implementation researchers who identified theories relevant to implementation and grouped constructs from these theories into domains. The collaboration aimed to provide a comprehensive, theory-informed approach to identify determinants of behaviour. The first version was published in 2005, and a subsequent version following a validation exercise was published in 2012. This guide offers practical guidance for those who wish to apply the TDF to assess implementation problems and support intervention design. It presents a brief rationale for using a theoretical approach to investigate and address implementation problems, summarises the TDF and its development, and describes how to apply the TDF to achieve implementation objectives. Examples from the implementation research literature are presented to illustrate relevant methods and practical considerations.

Methods: Researchers from Canada, the UK and Australia attended a 3-day meeting in December 2012 to build an international collaboration among researchers and decision-makers interested in the advancing use of the TDF. The participants were experienced in using the TDF to assess implementation problems, design interventions, and/or understand change processes. This guide is an output of the meeting and also draws on the authors' collective experience. Examples from the implementation research literature judged by authors to be representative of specific applications of the TDF are included in this guide.

Results: We explain and illustrate methods, with a focus on qualitative approaches, for selecting and specifying target behaviours key to implementation, selecting the study design, deciding the sampling strategy, developing study materials, collecting and analysing data, and reporting findings of TDF-based studies. Areas for development include methods for triangulating data, e.g. from interviews, questionnaires and observation and methods for designing interventions based on TDF-based problem analysis.

Conclusions: We offer this guide to the implementation community to assist in the application of the TDF to achieve implementation objectives. Benefits of using the TDF include the provision of a theoretical basis for implementation studies, good coverage of potential reasons for slow diffusion of evidence into practice and a method for progressing from theory-based investigation to intervention.

Original languageEnglish
Article number77
Pages (from-to)1-18
Number of pages18
JournalImplementation Science
Volume12
DOIs
Publication statusPublished - 21 Jun 2017

Keywords

  • Theoretical Domains Framework
  • Guide
  • Methods

Cite this

Atkins, L., Francis, J., Islam, R., O'Connor, D., Patey, A., Ivers, N., ... Michie, S. (2017). A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems. Implementation Science, 12, 1-18. [77]. https://doi.org/10.1186/s13012-017-0605-9

A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems. / Atkins, Lou; Francis, Jill; Islam, Rafat; O'Connor, Denise; Patey, Andrea; Ivers, Noah; Foy, Robbie; Duncan, Eilidh M.; Colquhoun, Heather; Grimshaw, Jeremy M.; Lawton, Rebecca; Michie, Susan.

In: Implementation Science, Vol. 12, 77, 21.06.2017, p. 1-18.

Research output: Contribution to journalArticle

Atkins, L, Francis, J, Islam, R, O'Connor, D, Patey, A, Ivers, N, Foy, R, Duncan, EM, Colquhoun, H, Grimshaw, JM, Lawton, R & Michie, S 2017, 'A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems' Implementation Science, vol. 12, 77, pp. 1-18. https://doi.org/10.1186/s13012-017-0605-9
Atkins, Lou ; Francis, Jill ; Islam, Rafat ; O'Connor, Denise ; Patey, Andrea ; Ivers, Noah ; Foy, Robbie ; Duncan, Eilidh M. ; Colquhoun, Heather ; Grimshaw, Jeremy M. ; Lawton, Rebecca ; Michie, Susan. / A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems. In: Implementation Science. 2017 ; Vol. 12. pp. 1-18.
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abstract = "Background: Implementing new practices requires changes in the behaviour of relevant actors, and this is facilitated by understanding of the determinants of current and desired behaviours. The Theoretical Domains Framework (TDF) was developed by a collaboration of behavioural scientists and implementation researchers who identified theories relevant to implementation and grouped constructs from these theories into domains. The collaboration aimed to provide a comprehensive, theory-informed approach to identify determinants of behaviour. The first version was published in 2005, and a subsequent version following a validation exercise was published in 2012. This guide offers practical guidance for those who wish to apply the TDF to assess implementation problems and support intervention design. It presents a brief rationale for using a theoretical approach to investigate and address implementation problems, summarises the TDF and its development, and describes how to apply the TDF to achieve implementation objectives. Examples from the implementation research literature are presented to illustrate relevant methods and practical considerations.Methods: Researchers from Canada, the UK and Australia attended a 3-day meeting in December 2012 to build an international collaboration among researchers and decision-makers interested in the advancing use of the TDF. The participants were experienced in using the TDF to assess implementation problems, design interventions, and/or understand change processes. This guide is an output of the meeting and also draws on the authors' collective experience. Examples from the implementation research literature judged by authors to be representative of specific applications of the TDF are included in this guide.Results: We explain and illustrate methods, with a focus on qualitative approaches, for selecting and specifying target behaviours key to implementation, selecting the study design, deciding the sampling strategy, developing study materials, collecting and analysing data, and reporting findings of TDF-based studies. Areas for development include methods for triangulating data, e.g. from interviews, questionnaires and observation and methods for designing interventions based on TDF-based problem analysis.Conclusions: We offer this guide to the implementation community to assist in the application of the TDF to achieve implementation objectives. Benefits of using the TDF include the provision of a theoretical basis for implementation studies, good coverage of potential reasons for slow diffusion of evidence into practice and a method for progressing from theory-based investigation to intervention.",
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N1 - Acknowledgements NI is supported by New Investigator Awards from the Canadian Institutes of Health Research and the Department of Family and Community Medicine, University of Toronto. JMG holds a Canada Research Chair in Health Knowledge Transfer and Uptake. Funding The collaborative meeting in December 2012 in Ottawa described in the methods which lead to the writing of this guide was funded by the Canadian Institutes of Health Research (planning grant).

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N2 - Background: Implementing new practices requires changes in the behaviour of relevant actors, and this is facilitated by understanding of the determinants of current and desired behaviours. The Theoretical Domains Framework (TDF) was developed by a collaboration of behavioural scientists and implementation researchers who identified theories relevant to implementation and grouped constructs from these theories into domains. The collaboration aimed to provide a comprehensive, theory-informed approach to identify determinants of behaviour. The first version was published in 2005, and a subsequent version following a validation exercise was published in 2012. This guide offers practical guidance for those who wish to apply the TDF to assess implementation problems and support intervention design. It presents a brief rationale for using a theoretical approach to investigate and address implementation problems, summarises the TDF and its development, and describes how to apply the TDF to achieve implementation objectives. Examples from the implementation research literature are presented to illustrate relevant methods and practical considerations.Methods: Researchers from Canada, the UK and Australia attended a 3-day meeting in December 2012 to build an international collaboration among researchers and decision-makers interested in the advancing use of the TDF. The participants were experienced in using the TDF to assess implementation problems, design interventions, and/or understand change processes. This guide is an output of the meeting and also draws on the authors' collective experience. Examples from the implementation research literature judged by authors to be representative of specific applications of the TDF are included in this guide.Results: We explain and illustrate methods, with a focus on qualitative approaches, for selecting and specifying target behaviours key to implementation, selecting the study design, deciding the sampling strategy, developing study materials, collecting and analysing data, and reporting findings of TDF-based studies. Areas for development include methods for triangulating data, e.g. from interviews, questionnaires and observation and methods for designing interventions based on TDF-based problem analysis.Conclusions: We offer this guide to the implementation community to assist in the application of the TDF to achieve implementation objectives. Benefits of using the TDF include the provision of a theoretical basis for implementation studies, good coverage of potential reasons for slow diffusion of evidence into practice and a method for progressing from theory-based investigation to intervention.

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