Adapting the determinants of implementation behavior questionnaire to evaluate implementation of a structured low...

Area of Science:

• Health Services Research
• Implementation Science
• Behavioral Science

Background:

• Best-practice low back pain (LBP) programs require effective implementation strategies.
• The Theoretical Domains Framework (TDF) guides implementation, and the Determinants of Implementation Behavior Questionnaire (DIBQ) assesses related determinants.
• Existing DIBQ requires adaptation and validation for specific contexts, such as LBP primary care programs.

Purpose of the Study:

• To translate and tailor the DIBQ for evaluating LBP primary care programs in Sweden and Denmark.
• To assess the content validity, feasibility, and construct validity of the tailored DIBQ (DIBQ-t).

Main Methods:

• A mixed-methods design was employed, including forward translation of the DIBQ.
• Qualitative face validity and quantitative content validity were used for adaptation into DIBQ-t.
• Confirmatory factor analyses were conducted on data from 598 clinicians to test feasibility and construct validity.

Main Results:

• The final DIBQ-t comprises 28 items across 10 TDF domains and demonstrated feasibility with high response rates.
• Confirmatory factor analyses indicated a good model fit, confirming the construct validity of DIBQ-t.
• Clinicians' expectations suggest determinants facilitating implementation outweigh barriers.

Conclusions:

• A feasible and valid DIBQ-t was developed for evaluating implementation determinants of best-practice LBP primary care programs.
• The DIBQ-t provides a valuable tool for understanding and optimizing the implementation of LBP interventions.