Translating clinicians' beliefs into implementation interventions (TRACII): A protocol for an intervention modeling experiment to change clinicians' intentions to implement evidence-based practice
1 Centre for Health Services Research, University of Newcastle upon Tyne, 21 Claremont Place Newcastle upon Tyne NE2 4AA, UK
2 School of Psychology, College of Life Sciences and Medicine, William Guild Building, University of Aberdeen, Aberdeen, AB24 2UB, UK
3 Health Services Research Unit, Health Sciences Building, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
4 Clinical Epidemiology Program, Ottawa Health Research Institute, University of Ottawa, 725 Parkdale Ave, Ottawa, ON K1Y 4E9, Canada
Implementation Science 2007, 2:27 doi:10.1186/1748-5908-2-27Published: 16 August 2007
Biomedical research constantly produces new findings, but these are not routinely incorporated into health care practice. Currently, a range of interventions to promote the uptake of emerging evidence are available. While their effectiveness has been tested in pragmatic trials, these do not form a basis from which to generalise to routine care settings. Implementation research is the scientific study of methods to promote the uptake of research findings, and hence to reduce inappropriate care. As clinical practice is a form of human behaviour, theories of human behaviour that have proved to be useful in other settings offer a basis for developing a scientific rationale for the choice of interventions.
The aims of this protocol are 1) to develop interventions to change beliefs that have already been identified as antecedents to antibiotic prescribing for sore throats, and 2) to experimentally evaluate these interventions to identify those that have the largest impact on behavioural intention and behavioural simulation.
The clinical focus for this work will be the management of uncomplicated sore throat in general practice. Symptoms of upper respiratory tract infections are common presenting features in primary care. They are frequently treated with antibiotics, and research evidence is clear that antibiotic treatment offers little or no benefit to otherwise healthy adult patients.
Reducing antibiotic prescribing in the community by the "prudent" use of antibiotics is seen as one way to slow the rise in antibiotic resistance, and appears safe, at least in children. However, our understanding of how to do this is limited.
Participants will be general medical practitioners. Two theory-based interventions will be designed to address the discriminant beliefs in the prescribing of antibiotics for sore throat, using empirically derived resources. The interventions will be evaluated in a 2 × 2 factorial randomised controlled trial delivered in a postal questionnaire survey. Two outcome measures will be assessed: behavioural intention and behavioural simulation.