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Artikel ; Online: The big six: key principles for effective use of Behavior substitution in interventions to de-implement low-value care.

Patey, Andrea M / Grimshaw, Jeremy M / Francis, Jill J

JBI evidence implementation

2023 Band 21, Heft 2, Seite(n) 115–119

Abstract: Abstract: Healthcare professionals provide care to help patients; however, sometimes that care is of low value - at best ineffective and at worst harmful. To address this, recent frameworks provide guidance for developing and investigating de- ... ...

Abstract	Abstract: Healthcare professionals provide care to help patients; however, sometimes that care is of low value - at best ineffective and at worst harmful. To address this, recent frameworks provide guidance for developing and investigating de-implementation interventions; yet little attention has been devoted to identifying what strategies are most effective for de-implementation. In this paper, we discuss Behavior substitution, a strategy whereby an unwanted behavior is replaced with a wanted behavior, thereby making it hypothetically easier to reduce or stop the unwanted behavior. We discuss why Behavior substitution may be a useful de-implementation strategy, and why it may not be suitable for all circumstances. On the basis of the body of knowledge in behavioral science, we propose a list of principles to consider when selecting a substitute behavior for a de-implementation intervention. Applying these principles should increase the likelihood that this technique will be effective in reducing low-value care.
Mesh-Begriff(e)	Humans ; Low-Value Care ; Health Personnel
Sprache	Englisch
Erscheinungsdatum	2023-06-01
Erscheinungsland	United States
Dokumenttyp	Journal Article
ISSN	2691-3321
ISSN (online)	2691-3321
DOI	10.1097/XEB.0000000000000351
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Evaluation of Patient-Facing Mobile Apps to Support Physiotherapy Care: Systematic Review.

Merolli, Mark / Francis, Jill J / Vallance, Patrick / Bennell, Kim L / Malliaras, Peter / Hinman, Rana S

JMIR mHealth and uHealth

2024 Band 12, Seite(n) e55003

Abstract: Background: Mobile health interventions delivered through mobile apps are increasingly used in physiotherapy care. This may be because of the potential of apps to facilitate changes in behavior, which is central to the aims of care delivered by ... ...

Abstract	Background: Mobile health interventions delivered through mobile apps are increasingly used in physiotherapy care. This may be because of the potential of apps to facilitate changes in behavior, which is central to the aims of care delivered by physiotherapists. A benefit of using apps is their ability to incorporate behavior change techniques (BCTs) that can optimize the effectiveness of physiotherapeutic interventions. Research continues to suggest that despite their importance, behavior change strategies are often missing in patient management. Evaluating mobile apps that physiotherapists can use to drive behavior change may inform clinical practice and potentially improve patient outcomes. Examining the quality of apps and exploring their key features that can support behavior change and physiotherapy care are important aspects of such an evaluation. Objective: The primary aim of this study was to describe the range of mobile apps in app stores that are intended for use by patients to support physiotherapy care. The secondary aims were to assess app quality, BCTs, and their behavior change potential. Methods: A systematic review of mobile apps in app stores was undertaken. The Apple App Store and Google Play were searched using a 2-step search strategy, using terms relevant to the physiotherapy discipline. Strict inclusion and exclusion criteria were applied: apps had to be intended for use by patients and be self-contained (or stand-alone) without the requirement to be used in conjunction with a partner wearable device or another plugin. Included apps were coded for BCTs using the Behavior Change Technique Taxonomy version 1. App quality was assessed using the Mobile App Rating Scale, and the App Behavior Change Scale was used to assess the app's potential to change behavior. Results: In total, 1240 apps were screened, and 35 were included. Of these 35 apps, 22 (63%) were available on both the Apple App Store and Google Play platforms. In total, 24 (69%) were general in their focus (eg, not condition-specific), with the remaining 11 (31%) being more specific (eg, knee rehabilitation and pelvic floor training). The mean app quality score (Mobile App Rating Scale) was 3.7 (SD 0.4) of 5 (range 2.8-4.5). The mean number of BCTs identified per app was 8.5 (SD 3.6). BCTs most frequently included in the apps were instruction on how to perform a behavior (n=32), action planning (n=30), and self-monitoring of behavior (n=28). The mean behavior change potential score (App Behavior Change Scale) was 8.5 (SD 3.1) of 21 (range 3-15). Conclusions: Mobile apps available to support patient care received from a physiotherapist are of variable quality. Although they contain some BCTs, the potential for behavior change varied widely across apps. International registered report identifier (irrid): RR2-10.2196/29047.
Mesh-Begriff(e)	Humans ; Behavior Therapy ; Mobile Applications ; Patients ; Telemedicine
Sprache	Englisch
Erscheinungsdatum	2024-03-04
Erscheinungsland	Canada
Dokumenttyp	Systematic Review ; Journal Article
ZDB-ID	2719220-9
ISSN	2291-5222 ; 2291-5222
ISSN (online)	2291-5222
ISSN	2291-5222
DOI	10.2196/55003
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Implementation of an intervention to reduce urine dipstick testing in aged care homes: a qualitative study of enablers and barriers, and strategies to enhance delivery.

Lim, Lyn-Li / Williams, Kate / Francis, Jill J / Wroth, Melanie / Breen, Juanita

BMJ open

2024 Band 14, Heft 3, Seite(n) e081980

Abstract: Objective: The 'To Dip or Not to Dip' (TDONTD) intervention aims to reduce antibiotic prescribing for urinary tract infection (UTI) by reducing low-value dipstick testing. The aims of this study were to use a qualitative approach to (1) evaluate ... ...

Abstract	Objective: The 'To Dip or Not to Dip' (TDONTD) intervention aims to reduce antibiotic prescribing for urinary tract infection (UTI) by reducing low-value dipstick testing. The aims of this study were to use a qualitative approach to (1) evaluate potential influences on the delivery of the TDONTD intervention in Australian residential aged care homes (RACHs) by identifying perceived barriers and enablers to delivery and acceptance; and (2) propose intervention strategies to address barriers and enhance enablers. Design: A qualitative before-after process evaluation of a multisite implementation study using interviews with nurse and pharmacist implementers. Setting: This study was conducted in 12 Australian RACHs. Participants: Participants included 17 on-site nurse champions and 4 pharmacists (existing contracted providers). Intervention: Resources from England's TDONTD intervention were adapted for an Australian context. Key resources delivered were case-based education, staff training video, clinical pathway and an audit tool. Results: Key barriers to TDONTD were beliefs about nursing capabilities in diagnosing infection, beliefs about consequences (fear of missing infection) and social influences (pressure from family, doctors and hospitals). Key enablers were perceived increased nurse and carer knowledge (around UTI and asymptomatic bacteriuria), resources from a credible source, empowerment of nurse champions to apply knowledge and skills in delivering operational change initiatives, pharmacist-delivered education and organisational policy or process change. Of TDONTD's key components, the clinical pathway substituted dipstick testing in diagnosing UTI, delivery of case-based education was enhanced by their attendance and support of the intervention and the antibiotic audit tool generated feedback that champions shared with staff. Conclusions: Our study confirms the core components of TDONTD and strategies to enhance delivery and overcome barriers. To further reduce barriers to TDONTD, broader advocacy work is required to raise awareness of dipstick testing as a low-value test in older persons and by linking it to healthcare professionals and consumer education.
Mesh-Begriff(e)	Aged ; Humans ; Aged, 80 and over ; Australia ; Homes for the Aged ; Health Personnel ; Qualitative Research ; Anti-Bacterial Agents/therapeutic use
Chemische Substanzen	Anti-Bacterial Agents
Sprache	Englisch
Erscheinungsdatum	2024-03-01
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-081980
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Feasibility of a Nurse-Led Intervention to Reduce Urine Dipstick Testing in Long-Term Residential Aged Care Homes.

Lim, Lyn-Li / Williams, Kate / Francis, Jill / Wroth, Melanie / Breen, Juanita

Journal of the American Medical Directors Association

2024 , Seite(n) 104947

Sprache	Englisch
Erscheinungsdatum	2024-02-28
Erscheinungsland	United States
Dokumenttyp	Letter
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2024.01.016
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Buch: Gardens and gardening in early modern England and Wales, 1560-1660

Francis, Jill

2018

Abstract: The extravagant gardens of the 16th- and 17th-century British aristocracy are well-documented and celebrated, but the more modest gardens of the rural county gentry have rarely been examined. Jill Francis presents new, never-before published material as ...

Verfasserangabe	Jill Francis
Abstract	"The extravagant gardens of the 16th- and 17th-century British aristocracy are well-documented and celebrated, but the more modest gardens of the rural county gentry have rarely been examined. Jill Francis presents new, never-before published material as well as fresh interpretations of previously examined sources to reveal gardening as a practical activity in which a broad spectrum of society was engaged - from the laborers who dug, manured, and weeded, to the gentleman owners who sought to create gardens that both exemplified their personal tastes and displayed their wealth and status. Enhanced by beautiful and compelling illustrations, this book contributes to a broader understanding of early modern society and its culture by situating the activity of gardening within the wider social and cultural concerns of the age, reflecting the anxieties, hopes, and aspirations of people at the time."--Back cover.
Schlagwörter	Gardening/History ; Gardening. ; England.
Sprache	Englisch
Umfang	xi, 400 pages :, illustrations (some color) ;, 27 cm
Dokumenttyp	Buch
ISBN	030023208X ; 9780300232080
Datenquelle	NAL Katalog (AGRICOLA)

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Artikel ; Online: Application of the theoretical framework of acceptability in a surgical setting: Theoretical and methodological insights.

Paynter, Camille / McDonald, Cassie / Story, David / Francis, Jill J

British journal of health psychology

2023 Band 28, Heft 4, Seite(n) 1153–1168

Abstract: Purpose: Methods for assessing acceptability of healthcare interventions have been inconsistent until the development of the theoretical framework of acceptability (TFA). Despite its rapid adoption in healthcare research, the TFA has rarely been used to ...

Abstract	Purpose: Methods for assessing acceptability of healthcare interventions have been inconsistent until the development of the theoretical framework of acceptability (TFA). Despite its rapid adoption in healthcare research, the TFA has rarely been used to assess acceptability of surgical interventions. We sought to explore the sufficiency of the TFA in this context and provide methodological guidance to support systematic use of this framework in research. Method: Acceptability was assessed in a consecutive sample of 15 patients at least 3 months post-joint replacement surgery via theory-informed semi-structured interviews. A detailed description of the application of the TFA is reported. This includes: development of the interview guide (including questions to assess theoretical sufficiency), analysis of interview data and interpretation of findings. Results: Interview data were substantially codable into the TFA constructs but required the addition of a construct, labelled 'perceived safety and risk', and relabelling and redefining an existing construct (new label: 'opportunity costs and gains'). Methodological recommendations for theory-informed interview studies include producing interview support material to enhance precision of the intervention description, conducting background conversations with a range of stakeholders in the healthcare setting, and conducting first inductive and then deductive thematic analysis. Conclusion: The sufficiency of the TFA could be enhanced for use when assessing interventions with an identifiable risk profile, such as surgery, by the inclusion of an additional construct to capture perceptions of risk and safety. We offer these methodological recommendations to guide researchers and facilitate consistency in the application of the TFA in theory-informed interview studies.
Mesh-Begriff(e)	Humans ; Delivery of Health Care ; Communication
Sprache	Englisch
Erscheinungsdatum	2023-06-24
Erscheinungsland	England
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2026500-1
ISSN	2044-8287 ; 1359-107X
ISSN (online)	2044-8287
ISSN	1359-107X
DOI	10.1111/bjhp.12677
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Development of a theory-informed questionnaire to assess the acceptability of healthcare interventions.

Sekhon, Mandeep / Cartwright, Martin / Francis, Jill J

BMC health services research

2022 Band 22, Heft 1, Seite(n) 279

Abstract: Background: The theoretical framework of acceptability (TFA) was developed in response to recommendations that acceptability should be assessed in the design, evaluation and implementation phases of healthcare interventions. The TFA consists of seven ... ...

Abstract	Background: The theoretical framework of acceptability (TFA) was developed in response to recommendations that acceptability should be assessed in the design, evaluation and implementation phases of healthcare interventions. The TFA consists of seven component constructs (affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy) that can help to identify characteristics of interventions that may be improved. The aim of this study was to develop a generic TFA questionnaire that can be adapted to assess acceptability of any healthcare intervention. Methods: Two intervention-specific acceptability questionnaires based on the TFA were developed using a 5-step pre-validation method for developing patient-reported outcome instruments: 1) item generation; 2) item de-duplication; 3) item reduction and creation; 4) assessment of discriminant content validity against a pre-specified framework (TFA); 5) feedback from key stakeholders. Next, a generic TFA-based questionnaire was developed and applied to assess prospective and retrospective acceptability of the COVID-19 vaccine. A think-aloud method was employed with two samples: 10 participants who self-reported intention to have the COVID-19 vaccine, and 10 participants who self-reported receiving a first dose of the vaccine. Results: 1) The item pool contained 138 items, identified from primary papers included in an overview of reviews. 2) There were no duplicate items. 3) 107 items were discarded; 35 new items were created to maximise coverage of the seven TFA constructs. 4) 33 items met criteria for discriminant content validity and were reduced to two intervention-specific acceptability questionnaires, each with eight items. 5) Feedback from key stakeholders resulted in refinement of item wording, which was then adapted to develop a generic TFA-based questionnaire. For prospective and retrospective versions of the questionnaire, no participants identified problems with understanding and answering items reflecting four TFA constructs: affective attitude, burden, perceived effectiveness, opportunity costs. Some participants encountered problems with items reflecting three constructs: ethicality, intervention coherence, self-efficacy. Conclusions: A generic questionnaire for assessing intervention acceptability from the perspectives of intervention recipients was developed using methods for creating participant-reported outcome measures, informed by theory, previous research, and stakeholder input. The questionnaire provides researchers with an adaptable tool to measure acceptability across a range of healthcare interventions.
Mesh-Begriff(e)	COVID-19 ; COVID-19 Vaccines ; Delivery of Health Care ; Humans ; Patient Acceptance of Health Care ; Prospective Studies ; Reproducibility of Results ; Retrospective Studies ; SARS-CoV-2 ; Surveys and Questionnaires
Chemische Substanzen	COVID-19 Vaccines
Sprache	Englisch
Erscheinungsdatum	2022-03-01
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-022-07577-3
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Why is advance care planning underused in oncology settings? A systematic overview of reviews to identify the benefits, barriers, enablers, and interventions to improve uptake.

Guccione, Lisa / Fullerton, Sonia / Gough, Karla / Hyatt, Amelia / Tew, Michelle / Aranda, Sanchia / Francis, Jill

Frontiers in oncology

2023 Band 13, Seite(n) 1040589

Abstract: Background: Advance care planning (ACP) centres on supporting people to define and discuss their individual goals and preferences for future medical care, and to record and review these as appropriate. Despite recommendations from guidelines, rates of ... ...

Abstract	Background: Advance care planning (ACP) centres on supporting people to define and discuss their individual goals and preferences for future medical care, and to record and review these as appropriate. Despite recommendations from guidelines, rates of documentation for people with cancer are considerably low. Aim: To systematically clarify and consolidate the evidence base of ACP in cancer care by exploring how it is defined; identifying benefits, and known barriers and enablers across patient, clinical and healthcare services levels; as well as interventions that improve advance care planning and are their effectiveness. Methods: A systematic overview of reviews was conducted and was prospectively registered on PROSPERO. PubMed, Medline, PsycInfo, CINAHL, and EMBASE were searched for review related to ACP in cancer. Content analysis and narrative synthesis were used for data analysis. The Theoretical Domains Framework (TDF) was used to code barriers and enablers of ACP as well as the implied barriers targeted by each of the interventions. Results: Eighteen reviews met the inclusion criteria. Definitions were inconsistent across reviews that defined ACP (n=16). Proposed benefits identified in 15/18 reviews were rarely empirically supported. Interventions reported in seven reviews tended to target the patient, even though more barriers were associated with healthcare providers (n=40 versus n=60, respectively). Conclusion: To improve ACP uptake in oncology settings; the definition should include key categories that clarify the utility and benefits. Interventions need to target healthcare providers and empirically identified barriers to be most effective in improving uptake. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?, identifier CRD42021288825.
Sprache	Englisch
Erscheinungsdatum	2023-04-28
Erscheinungsland	Switzerland
Dokumenttyp	Systematic Review
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2023.1040589
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Changing behaviour, 'more or less': do implementation and de-implementation interventions include different behaviour change techniques?

Patey, Andrea M / Grimshaw, Jeremy M / Francis, Jill J

Implementation science : IS

2021 Band 16, Heft 1, Seite(n) 20

Abstract: Background: Decreasing ineffective or harmful healthcare practices (de-implementation) may require different approaches than those used to promote uptake of effective practices (implementation). Few psychological theories differentiate between processes ...

Abstract	Background: Decreasing ineffective or harmful healthcare practices (de-implementation) may require different approaches than those used to promote uptake of effective practices (implementation). Few psychological theories differentiate between processes involved in decreasing, versus increasing, behaviour. However, it is unknown whether implementation and de-implementation interventions already use different approaches. We used the behaviour change technique (BCT) taxonomy (version 1) (which includes 93 BCTs organised into 12 groupings) to investigate whether implementation and de-implementation interventions for clinician behaviour change use different BCTs. Methods: Intervention descriptions in 181 articles from three systematic reviews in the Cochrane Library were coded for (a) implementation versus de-implementation and (b) intervention content (BCTs) using the BCT taxonomy (v1). BCT frequencies were calculated and compared using Pearson's chi-squared (χ Results: Twenty-nine and 25 BCTs were identified in implementation and de-implementation interventions respectively. Feedback on behaviour was identified more frequently in implementation than de-implementation (Χ Conclusions: There were some significant differences between BCTs reported in implementation and de-implementation interventions suggesting that researchers may have implicit theories about different BCTs required for de-implementation and implementation. These findings do not imply that the BCTs identified as targeting implementation or de-implementation are effective, rather simply that they were more frequently used. These findings require replication for a wider range of clinical behaviours. The continued accumulation of additional knowledge and evidence into whether implementation and de-implementation is different will serve to better inform researchers and, subsequently, improve methods for intervention design.
Mesh-Begriff(e)	Behavior Therapy ; Humans ; Psychological Theory ; Social Environment
Sprache	Englisch
Erscheinungsdatum	2021-02-25
Erscheinungsland	England
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1748-5908
ISSN (online)	1748-5908
DOI	10.1186/s13012-021-01089-0
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Enablers and barriers to referral and delivery of multidisciplinary prehabilitation in the autologous stem cell transplant population: a theory-based interview study.

Crowe, Jessica / Edbrooke, Lara / Khot, Amit / Denehy, Linda / Francis, Jill J

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

2023 Band 32, Heft 1, Seite(n) 25

Abstract: Purpose: Health care professionals (HCP) play a vital role in effectiveness of prehabilitation programs, but information is limited about what assists HCP deliver an effective service. This study evaluated HCP perceptions of enablers and barriers to two ...

Abstract	Purpose: Health care professionals (HCP) play a vital role in effectiveness of prehabilitation programs, but information is limited about what assists HCP deliver an effective service. This study evaluated HCP perceptions of enablers and barriers to two behaviours: referral for, and delivery of, multidisciplinary prehabilitation prior to autologous stem cell transplant. Methods: Based on the Theoretical Domains Framework (TDF) of behaviour change, we conducted semi-structured interviews, purposively sampling 14 participants (from various healthcare disciplines) at a tertiary cancer centre. Discipline-specific topic guides were created based on the TDF and the behaviours appropriate to each discipline. Interviews were audio-recorded, transcribed verbatim, anonymised, content analysed (grouping, then labelling, thematically similar responses), and classified into theoretical domains. Structured decision rules were used to classify themes as high, medium, or low priority. Results: Fifty enablers and 31 barriers were identified; of these 26 enablers and 16 barriers classified as high priority. Four domains had the most frequent high-priority enablers: Social professional role and identity (e.g. multidisciplinary teamwork); Beliefs about consequences (e.g. patient benefit); Memory, attention, and decision processes (e.g. refer as early as possible); and Environmental context and resources (e.g. electronic medical records are beneficial). High-priority barriers were most frequent in four domains: Memory, attention, and decision processes (e.g. conflicting views about who should be referred); Environmental context and resources (e.g. lack of time); Social influences (e.g. families); and Emotions (e.g. patient distress). Conclusion: Participants reported more enablers than barriers. Findings can support delivery of prehabilitation programs in hospital settings where uptake remains low.
Mesh-Begriff(e)	Humans ; Preoperative Exercise ; Health Personnel ; Referral and Consultation ; Attitude of Health Personnel ; Qualitative Research
Sprache	Englisch
Erscheinungsdatum	2023-12-14
Erscheinungsland	Germany
Dokumenttyp	Journal Article
ZDB-ID	1134446-5
ISSN	1433-7339 ; 0941-4355
ISSN (online)	1433-7339
ISSN	0941-4355
DOI	10.1007/s00520-023-08234-z
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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