Aligning intuition and theory: enhancing the replicability of behaviour change interventions in cancer genetics
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(2020) 1:90
Implementation Science Communications
RESEARCH
Open Access
Aligning intuition and theory: enhancing the replicability of behaviour change interventions in cancer genetics Natalie Taylor1,2* , Emma Healey3,4, April Morrow1,2, Sian Greening4, Claire E. Wakefield5,6, Linda Warwick7, Rachel Williams3,8 and Katherine M. Tucker3,8
Abstract Background: Despite considerable encouragement for healthcare professionals to use or be clear about the theory used in their improvement programmes, the uptake of these approaches to design interventions or report their content is lacking. Recommendations suggest healthcare practitioners work with social and/or behavioural scientists to gain expertise in programme theory, ideally before, but even during or after the work is done. We aim to demonstrate the extent to which intuitive intervention strategies designed by healthcare professionals to overcome patient barriers to communicating genetic cancer risk information to family members align with a theoretical framework of behaviour change. Methods: As part of a pre-post intervention study, a team of genetic counsellors aimed to understand, and design interventions to overcome, the major barriers a group of familial cancer patients face around communicating hereditary cancer risk information to their relatives. A behavioural change specialist worked with the team to review and recode barriers and interventions according to the Theoretical Domains Framework (TDF) and 93 behaviour change techniques (BCTs). Resulting BCTs were cross-referenced against the Theory and Techniques Tool to examine whether evidence-based mechanistic links have been established to date. Results: Five themes emerged from the genetic counsellor coded barriers, which when recoded according to the TDF represented seven domains of behaviour change. Forty-five experiential and intuitive interventions were used to tackle key barriers. These were represented by 21 BCTs, which were found to be used on 131 occasions. The full mapping exercise is presented, resulting in a suite of intervention strategies explicitly linked to a theoretical framework. Structured, written reflections were provided retrospectively by the core clinical team. (Continued on next page)
* Correspondence: [email protected] 1 Cancer Research Division, Cancer Council New South Wales, Sydney, New South Wales 2011, Australia 2 Faculty of Medicine and Health, University of Sydney, Camperdown, Sydney, NSW 2006, Australia Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, u
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