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Validation of the theoretical domains framework for use in behaviour change and implementation research

James Cane1, Denise O’Connor2 and Susan Michie3*

Author Affiliations

1 School of Psychology, Keynes College, University of Kent, Canterbury, Kent, CT2 7NP, UK

2 School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia

3 Research Department of Clinical, Centre for Outcomes Research and Effectiveness (CORE), Education and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK

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Implementation Science 2012, 7:37 doi:10.1186/1748-5908-7-37

Published: 24 April 2012

Abstract

Background

An integrative theoretical framework, developed for cross-disciplinary implementation and other behaviour change research, has been applied across a wide range of clinical situations. This study tests the validity of this framework.

Methods

Validity was investigated by behavioural experts sorting 112 unique theoretical constructs using closed and open sort tasks. The extent of replication was tested by Discriminant Content Validation and Fuzzy Cluster Analysis.

Results

There was good support for a refinement of the framework comprising 14 domains of theoretical constructs (average silhouette value 0.29): ‘Knowledge’, ‘Skills’, ‘Social/Professional Role and Identity’, ‘Beliefs about Capabilities’, ‘Optimism’, ‘Beliefs about Consequences’, ‘Reinforcement’, ‘Intentions’, ‘Goals’, ‘Memory, Attention and Decision Processes’, ‘Environmental Context and Resources’, ‘Social Influences’, ‘Emotions’, and ‘Behavioural Regulation’.

Conclusions

The refined Theoretical Domains Framework has a strengthened empirical base and provides a method for theoretically assessing implementation problems, as well as professional and other health-related behaviours as a basis for intervention development.

Keywords:
Theoretical domains framework; Behaviour; Change; Implementation; Validation; Theory