Vivi is a Research Fellow for the NIHR Behavioural Science Policy Research Unit (BSc PRU) based at UCL. Vivi’s current research focuses on optimising behaviour change interventions targeting healthcare professionals’ practice and on synthesising evidence to inform health-related recommendations and policies. Her research interests include using behaviour change theory and models for the design and development of effective interventions and the implementation of research evidence into practice with the aim to improve quality of service provision. Prior to working in this post, Vivi was involved in projects designing interventions aiming to change social work and social care professional practice and exploring the effectiveness of training, and in the evaluation of complex interventions in local authority settings. Vivi is a BPS Chartered Psychologist (CPsychol AFBPsS).
Audit and feedback (A&F) is a frequently used quality improvement strategy to improve the implementation of evidence-based practice in healthcare. There is consistent evidence that A&F interventions deliver modest, variable, but significant improvements in clinical outcomes . We are in the process of conducting an updated Cochrane review comprising 293 randomized trials of A&F. As part of this update, we examined intervention content to better understand which components are associated with greater effect sizes. We have used the behaviour change technique (BCT) taxonomy to content analyse the trials and leverage existing behaviour change theories to highlight key constructs relevant to A&F. The aim of the present study was two-fold: (1) to map key constructs of selected behaviour change theories relevant to A&F to BCTs; and (2) to describe the extent to which randomised trials of A&F incorporate theory-informed BCTs.
We selected five behaviour change theories relevant to A&F: Goal Setting theory, Control theory, Feedback Intervention theory, Health Action Process Approach and Social Cognitive theory. For each theory, theoretical constructs were identified and linked to BCTs. For cross-validation, two separate processes were applied: theory experts cross-checked the BCT mapping onto constructs and A&F experts judged these BCTs for their relevance to A&F practice. Theory-informed BCTs were compared with BCTs identified in the analysis of the A&F trials included in the forthcoming Review.
Preliminary results yielded 58 BCTs linked to constructs in one or more theories. The most frequently identified BCTs in theories were: ‘goal setting (behaviour)’, goal setting (outcome)’, ‘action planning’, ‘review behaviour goal’, and ‘review outcome goal’. In contrast, the most frequently identified BCTs in the A&F trials included in the review revealed ‘feedback’, ‘instruction’, and ‘social comparison’ to be the most frequently used.
Methodological considerations as well as implications for A&F research and practice will be discussed.