Improving Diabetes care through Examining, Advising, and prescribing (IDEA)

protocol for a theory-based cluster randomised controlled trial of a multiple behaviour change intervention aimed at primary healthcare professionals

Justin Presseau, Gillian Hawthorne, Falko F Sniehotta, Nick Steen, Jill J Francis, Marie Johnston, Joan Mackintosh, Jeremy M Grimshaw, Eileen Kaner, Marko Elovainio, Mark Deverill, Tom Coulthard, Heather Brown, Margaret Hunter, Martin P Eccles

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: New clinical research findings may require clinicians to change their behaviour to provide high-quality care to people with type 2 diabetes, likely requiring them to change multiple different clinical behaviours. The present study builds on findings from a UK-wide study of theory-based behavioural and organisational factors associated with prescribing, advising, and examining consistent with high-quality diabetes care.

AIM: To develop and evaluate the effectiveness and cost of an intervention to improve multiple behaviours in clinicians involved in delivering high-quality care for type 2 diabetes.

DESIGN/METHODS: We will conduct a two-armed cluster randomised controlled trial in 44 general practices in the North East of England to evaluate a theory-based behaviour change intervention. We will target improvement in six underperformed clinical behaviours highlighted in quality standards for type 2 diabetes: prescribing for hypertension; prescribing for glycaemic control; providing physical activity advice; providing nutrition advice; providing on-going education; and ensuring that feet have been examined. The primary outcome will be the proportion of patients appropriately prescribed and examined (using anonymised computer records), and advised (using anonymous patient surveys) at 12 months. We will use behaviour change techniques targeting motivational, volitional, and impulsive factors that we have previously demonstrated to be predictive of multiple health professional behaviours involved in high-quality type 2 diabetes care. We will also investigate whether the intervention was delivered as designed (fidelity) by coding audiotaped workshops and interventionist delivery reports, and operated as hypothesised (process evaluation) by analysing responses to theory-based postal questionnaires. In addition, we will conduct post-trial qualitative interviews with practice teams to further inform the process evaluation, and a post-trial economic analysis to estimate the costs of the intervention and cost of service use.

DISCUSSION: Consistent with UK Medical Research Council guidance and building on previous development research, this pragmatic cluster randomised trial will evaluate the effectiveness of a theory-based complex intervention focusing on changing multiple clinical behaviours to improve quality of diabetes care.

TRIAL REGISTRATION: ISRCTN66498413.

Original languageEnglish
Article number61
JournalImplementation Science
Volume9
DOIs
Publication statusPublished - 24 May 2014

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Quality of Health Care
Type 2 Diabetes Mellitus
Primary Health Care
Randomized Controlled Trials
Education
Costs and Cost Analysis
Research
General Practice
England
Cost-Benefit Analysis
Biomedical Research
Foot
Economics
Interviews
Exercise
Hypertension
G-IDEA protocol
Health
Surveys and Questionnaires

Cite this

Improving Diabetes care through Examining, Advising, and prescribing (IDEA) : protocol for a theory-based cluster randomised controlled trial of a multiple behaviour change intervention aimed at primary healthcare professionals. / Presseau, Justin; Hawthorne, Gillian; Sniehotta, Falko F; Steen, Nick; Francis, Jill J; Johnston, Marie; Mackintosh, Joan; Grimshaw, Jeremy M; Kaner, Eileen; Elovainio, Marko; Deverill, Mark; Coulthard, Tom; Brown, Heather; Hunter, Margaret; Eccles, Martin P.

In: Implementation Science, Vol. 9, 61, 24.05.2014.

Research output: Contribution to journalArticle

Presseau, J, Hawthorne, G, Sniehotta, FF, Steen, N, Francis, JJ, Johnston, M, Mackintosh, J, Grimshaw, JM, Kaner, E, Elovainio, M, Deverill, M, Coulthard, T, Brown, H, Hunter, M & Eccles, MP 2014, 'Improving Diabetes care through Examining, Advising, and prescribing (IDEA): protocol for a theory-based cluster randomised controlled trial of a multiple behaviour change intervention aimed at primary healthcare professionals', Implementation Science, vol. 9, 61. https://doi.org/10.1186/1748-5908-9-61
Presseau, Justin ; Hawthorne, Gillian ; Sniehotta, Falko F ; Steen, Nick ; Francis, Jill J ; Johnston, Marie ; Mackintosh, Joan ; Grimshaw, Jeremy M ; Kaner, Eileen ; Elovainio, Marko ; Deverill, Mark ; Coulthard, Tom ; Brown, Heather ; Hunter, Margaret ; Eccles, Martin P. / Improving Diabetes care through Examining, Advising, and prescribing (IDEA) : protocol for a theory-based cluster randomised controlled trial of a multiple behaviour change intervention aimed at primary healthcare professionals. In: Implementation Science. 2014 ; Vol. 9.
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T2 - protocol for a theory-based cluster randomised controlled trial of a multiple behaviour change intervention aimed at primary healthcare professionals

AU - Presseau, Justin

AU - Hawthorne, Gillian

AU - Sniehotta, Falko F

AU - Steen, Nick

AU - Francis, Jill J

AU - Johnston, Marie

AU - Mackintosh, Joan

AU - Grimshaw, Jeremy M

AU - Kaner, Eileen

AU - Elovainio, Marko

AU - Deverill, Mark

AU - Coulthard, Tom

AU - Brown, Heather

AU - Hunter, Margaret

AU - Eccles, Martin P

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N2 - BACKGROUND: New clinical research findings may require clinicians to change their behaviour to provide high-quality care to people with type 2 diabetes, likely requiring them to change multiple different clinical behaviours. The present study builds on findings from a UK-wide study of theory-based behavioural and organisational factors associated with prescribing, advising, and examining consistent with high-quality diabetes care.AIM: To develop and evaluate the effectiveness and cost of an intervention to improve multiple behaviours in clinicians involved in delivering high-quality care for type 2 diabetes.DESIGN/METHODS: We will conduct a two-armed cluster randomised controlled trial in 44 general practices in the North East of England to evaluate a theory-based behaviour change intervention. We will target improvement in six underperformed clinical behaviours highlighted in quality standards for type 2 diabetes: prescribing for hypertension; prescribing for glycaemic control; providing physical activity advice; providing nutrition advice; providing on-going education; and ensuring that feet have been examined. The primary outcome will be the proportion of patients appropriately prescribed and examined (using anonymised computer records), and advised (using anonymous patient surveys) at 12 months. We will use behaviour change techniques targeting motivational, volitional, and impulsive factors that we have previously demonstrated to be predictive of multiple health professional behaviours involved in high-quality type 2 diabetes care. We will also investigate whether the intervention was delivered as designed (fidelity) by coding audiotaped workshops and interventionist delivery reports, and operated as hypothesised (process evaluation) by analysing responses to theory-based postal questionnaires. In addition, we will conduct post-trial qualitative interviews with practice teams to further inform the process evaluation, and a post-trial economic analysis to estimate the costs of the intervention and cost of service use.DISCUSSION: Consistent with UK Medical Research Council guidance and building on previous development research, this pragmatic cluster randomised trial will evaluate the effectiveness of a theory-based complex intervention focusing on changing multiple clinical behaviours to improve quality of diabetes care.TRIAL REGISTRATION: ISRCTN66498413.

AB - BACKGROUND: New clinical research findings may require clinicians to change their behaviour to provide high-quality care to people with type 2 diabetes, likely requiring them to change multiple different clinical behaviours. The present study builds on findings from a UK-wide study of theory-based behavioural and organisational factors associated with prescribing, advising, and examining consistent with high-quality diabetes care.AIM: To develop and evaluate the effectiveness and cost of an intervention to improve multiple behaviours in clinicians involved in delivering high-quality care for type 2 diabetes.DESIGN/METHODS: We will conduct a two-armed cluster randomised controlled trial in 44 general practices in the North East of England to evaluate a theory-based behaviour change intervention. We will target improvement in six underperformed clinical behaviours highlighted in quality standards for type 2 diabetes: prescribing for hypertension; prescribing for glycaemic control; providing physical activity advice; providing nutrition advice; providing on-going education; and ensuring that feet have been examined. The primary outcome will be the proportion of patients appropriately prescribed and examined (using anonymised computer records), and advised (using anonymous patient surveys) at 12 months. We will use behaviour change techniques targeting motivational, volitional, and impulsive factors that we have previously demonstrated to be predictive of multiple health professional behaviours involved in high-quality type 2 diabetes care. We will also investigate whether the intervention was delivered as designed (fidelity) by coding audiotaped workshops and interventionist delivery reports, and operated as hypothesised (process evaluation) by analysing responses to theory-based postal questionnaires. In addition, we will conduct post-trial qualitative interviews with practice teams to further inform the process evaluation, and a post-trial economic analysis to estimate the costs of the intervention and cost of service use.DISCUSSION: Consistent with UK Medical Research Council guidance and building on previous development research, this pragmatic cluster randomised trial will evaluate the effectiveness of a theory-based complex intervention focusing on changing multiple clinical behaviours to improve quality of diabetes care.TRIAL REGISTRATION: ISRCTN66498413.

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DO - 10.1186/1748-5908-9-61

M3 - Article

VL - 9

JO - Implementation Science

JF - Implementation Science

SN - 1748-5908

M1 - 61

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