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A primary care Web-based Intervention Modeling Experiment replicated behavior changes seen in earlier paper-based

Shaun Treweek1, Jill J Francis2, Debbie Bonetti3

  • 1Health Services Research Unit, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen AB25 2ZD, UK.

Journal of Clinical Epidemiology
|July 30, 2016
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Summary
This summary is machine-generated.

Web-based Intervention Modeling Experiments (IMEs) successfully replicated earlier findings on reducing antibiotic prescriptions among general practitioners. This supports the validity of the IME methodology for testing behavior change interventions.

Keywords:
Behavior changeIntervention Modeling ExperimentsIntervention developmentPrescribingPrimary careRandomized controlled trials

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Area of Science:

  • Health Services Research
  • Behavioral Science
  • Medical Education

Background:

  • Intervention Modeling Experiments (IMEs) offer a method for pre-trial development and testing of behavior change interventions.
  • Previous research utilized a paper-based IME to evaluate interventions aimed at reducing antibiotic prescriptions for upper respiratory tract infections.

Purpose of the Study:

  • To assess the feasibility and effectiveness of a Web-based IME in replicating the outcomes of a prior paper-based IME.
  • To evaluate two specific interventions: persuasive communication and action planning, designed to decrease antibiotic prescribing by General Practitioners (GPs).

Main Methods:

  • A three-arm, Web-based randomized evaluation was conducted.
  • General Practitioners (GPs) were assigned to receive either persuasive communication, an action plan, or no intervention (control).
  • Participants completed an online questionnaire and eight clinical scenarios involving potential antibiotic prescriptions.

Main Results:

  • GPs receiving persuasive communication prescribed antibiotics in 0.70 more scenarios compared to the control group (95% CI: 0.17-1.24).
  • GPs receiving the action plan prescribed antibiotics in 0.63 more scenarios than the control group (95% CI: 0.11-1.15).
  • Behavioral intention was not significantly affected by the interventions, potentially due to a smaller than intended sample size.

Conclusions:

  • The Web-based IME largely mirrored the results of the earlier paper-based study.
  • This replication provides evidence supporting the reliability and utility of the IME methodology for intervention development and testing.
  • Further research with larger sample sizes may be needed to confirm effects on behavioral intention.