To what extent can behaviour change techniques be identified within an adaptable implementation package for primary...

Area of Science:

• Health Services Research
• Behavioral Science
• Primary Care Medicine

Background:

• Evaluating complex interventions requires detailed descriptions of intervention content.
• Implementation packages were developed for primary care to improve quality indicators using available resources.
• The packages were designed to be adaptable for targeting specific behavioral determinants.

Purpose of the Study:

• To develop and verify an adaptable implementation package for primary care.
• To embed behavior change techniques (BCTs) targeting determinants of four key quality indicators.
• To ensure packages could be delivered using typically available primary care resources.

Main Methods:

• A multi-staged process involving evidence-based delivery mechanisms (audit and feedback, educational outreach, computerized prompts).
• Interviews with primary care professionals using the Theoretical Domains Framework to identify behavioral determinants.
• Linking determinants to BCTs, prioritizing content with stakeholder input, and piloting packages.

Main Results:

• Implementation packages included a high proportion of potentially applicable BCTs (27/30), representing 15/16 categories.
• 23 BCTs were common across all four quality indicators, with some unique to specific delivery mechanisms.
• Operationalizing BCTs targeting environmental context and social roles presented challenges.

Conclusions:

• A transparent process for selecting, operationalizing, and verifying BCT content in adaptable primary care implementation packages was demonstrated.
• Core BCTs can be embedded and verified within common primary care delivery mechanisms.
• Different delivery mechanisms offer distinct advantages for BCT implementation (e.g., feedback reports, real-time prompts, tailored outreach).