Top

Published in:

Open Access 01-12-2015 | Research

Fast tracking the design of theory-based KT interventions through a consensus process

Authors: André E Bussières, Fadi Al Zoubi, Jeffrey A Quon, Sara Ahmed, Aliki Thomas, Kent Stuber, Sandy Sajko, Simon French, Members of the Canadian Chiropractic Guideline Initiative

Published in: Implementation Science | Issue 1/2015

Abstract

Background

Despite available evidence for optimal management of spinal pain, poor adherence to guidelines and wide variations in healthcare services persist. One of the objectives of the Canadian Chiropractic Guideline Initiative is to develop and evaluate targeted theory- and evidence-informed interventions to improve the management of non-specific neck pain by chiropractors. In order to systematically develop a knowledge translation (KT) intervention underpinned by the Theoretical Domains Framework (TDF), we explored the factors perceived to influence the use of multimodal care to manage non-specific neck pain, and mapped behaviour change techniques to key theoretical domains.

Methods

Individual telephone interviews exploring beliefs about managing neck pain were conducted with a purposive sample of 13 chiropractors. The interview guide was based upon the TDF. Interviews were digitally recorded, transcribed verbatim and analysed by two independent assessors using thematic content analysis. A 15-member expert panel formally met to design a KT intervention.

Results

Nine TDF domains were identified as likely relevant. Key beliefs (and relevant domains of the TDF) included the following: influence of formal training, colleagues and patients on clinicians (Social Influences); availability of educational material (Environmental Context and Resources); and better clinical outcomes reinforcing the use of multimodal care (Reinforcement). Facilitating factors considered important included better communication (Skills); audits of patients’ treatment-related outcomes (Behavioural Regulation); awareness and agreement with guidelines (Knowledge); and tailoring of multimodal care (Memory, Attention and Decision Processes). Clinicians conveyed conflicting beliefs about perceived threats to professional autonomy (Social/Professional Role and Identity) and speed of recovery from either applying or ignoring the practice recommendations (Beliefs about Consequences). The expert panel mapped behaviour change techniques to key theoretical domains and identified relevant KT strategies and modes of delivery to increase the use of multimodal care among chiropractors.

Conclusions

A multifaceted KT educational intervention targeting chiropractors’ management of neck pain was developed. The KT intervention consisted of an online education webinar series, clinical vignettes and a video underpinned by the Brief Action Planning model. The intervention was designed to reflect key theoretical domains, behaviour change techniques and intervention components. The effectiveness of the proposed intervention remains to be tested.

Available only for authorised users

Murray CJ, Abraham J, Ali MK, Alvarado M, Atkinson C, Baddour LM, et al. The state of US health, 1990–2010: burden of diseases, injuries, and risk factors. JAMA. 2013;310:591–606.PubMed

Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2163–96.PubMed

Hoy DG, Protani M, De R, Buchbinder R. The epidemiology of neck pain. Best Pract Res Clin Rheumatol. 2010;24:783–92.PubMed

Coulter ID, Hurwitz EL, Adams AH, Genovese BJ, Hays R, Shekelle PG. Patients using chiropractors in North America: who are they, and why are they in chiropractic care? Spine. 2002;27:291–6.PubMed

Bryans R, Decina P, Descarreaux M, Duranleau M, Marcoux H, Potter B, et al. Evidence-based guidelines for the chiropractic treatment of adults with neck pain. J Manipulative Physiol Ther. 2014;37:42–63.PubMed

Hartvigsen J, Natvig B, Ferreira M. Is it all about a pain in the back? Best Pract Res Clin Rheumatol. 2013;27:613–23.PubMed

Carnes D, Homer KE, Miles CL, Pincus T, Underwood M, Rahman A, et al. Effective delivery styles and content for self-management interventions for chronic musculoskeletal pain: a systematic literature review. Clin J Pain. 2012;28:344–54.PubMed

Canadian Chiropractic Resources Databank (CCRD). National Report. The Canadian Chiropractic Association. A comprehensive inventory of practical information about Canada’s licensed chiropractors. Canada; 2011.

Freburger JK, Carey TS, Holmes GM, Wallace AS, Castel LD, Darter JD, et al. Exercise prescription for chronic back or neck pain: who prescribes it? Who gets it? What is prescribed? Arthritis Care Res. 2009;61:192–200.

10.

Grol R. Successes and failures in the implementation of evidence-based guidelines for clinical practice. Med Care. 2001;39(8 Suppl 2):1146–54.

11.

Schuster MA, Elizabeth A, McGlynn R, Brook H. How good is the quality of health care in the United States? Milbank Q. 2005;83:843–95.PubMedPubMedCentral

12.

Campbell M, Fitzpatrick R, Haines A, Kinmonth A, Sandercock P, Spiegelhalter D, et al. Framework for design and evaluation of complex interventions to improve health. BMJ. 2000;321:694–6.PubMedPubMedCentral

13.

Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008;337:a1655.PubMedPubMedCentral

14.

Michie S, Abraham C, Eccles M, Francis J, Hardeman W, Johnston M. Strengthening evaluation and implementation by specifying components of behaviour change interventions: a study protocol. Implement Sci. 2011;6:10.PubMedPubMedCentral

15.

Squires JE, Sullivan K, Eccles MP, Worswick J, Grimshaw JM. Are multifaceted interventions more effective than single-component interventions in changing health-care professionals’ behaviours? An overview of systematic reviews. Implement Sci. 2014;9:152.PubMedPubMedCentral

16.

Sharon Straus, Jacqueline Tetroe, Ian D. Graham (Eds). Knowledge translation in health care: moving from evidence to practice, 2nd Edition. ISBN: 978-1-118-41354-8. BMJ. 2013;424.

17.

French S, Green S, O’Connor D, McKenzie J, Francis J, Michie S, et al. Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework. Implement Sci. 2012;7:38.PubMedPubMedCentral

18.

Grol R, Bosch MC, Hulscher MEJL, Eccles MP, Wensing M. Planning and studying improvement in patient care: the use of theoretical perspectives. Milbank Q. 2007;85:93–138.PubMedPubMedCentral

19.

Webb T, Joseph J, Yardley L, Michie S. Using the Internet to promote health behavior change: a systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. J Med Internet Res. 2010;12:e4.PubMedPubMedCentral

20.

Walker A, Grimshaw J, Armstrong E. Salient beliefs and intentions to prescribe antibiotics for patients with a sore throat. Br J Health Psychol. 2001;6:347–60.PubMed

21.

Bonetti D, Eccles M, Johnston M, Steen I, Grimshaw J, Baker R, et al. Guiding the design and selection of interventions to influence the implementation of evidence-based practice: an experimental simulation of a complex intervention trial. Soc Sci Med. 2005;60:2135–47.PubMed

22.

Eccles M, Grimshaw JM, Johnston M, Steen N, Pitts NB, Thomas R, et al. Applying psychological theories to evidence-based clinical practice: Identifying factors predictive of managing upper respiratory tract infections without antibiotics. Implement Sci. 2007;2:26.PubMedPubMedCentral

23.

Bonetti D, Johnston M, Clarkson J, Grimshaw J, Pitts N, Eccles M, et al. Applying psychological theories to evidence-based clinical practice: identifying factors predictive of placing preventive fissure sealants. Implement Sci. 2010;5:2–14.

24.

Bussières A, Patey A, Francis J, Sales A, Grimshaw J, Team tCPP. Identifying factors likely to influence compliance with diagnostic imaging guideline recommendations for spine disorders among chiropractors in North America: a focus group study using the Theoretical Domains Framework. Implement Sci. 2012;7:82.PubMedPubMedCentral

25.

McKenzie J, O’Connor D, Page M, Mortimer D, French S, Walker B, et al. Improving the care for people with acute low-back pain by allied health professionals (the ALIGN trial): a cluster randomised trial protocol. Implement Sci. 2010;5:86.PubMedPubMedCentral

26.

Kirkevold M, Bronken BA, Martinsen R, Kvigne K. Promoting psychosocial well-being following a stroke: developing a theoretically and empirically sound complex intervention. Int J Nurs Stud. 2012;49:386–97.PubMed

27.

McKenzie J, French S, O’Connor D, Grimshaw J, Mortimer D, Michie S, et al. IMPLEmenting a clinical practice guideline for acute low back pain evidence-based manageMENT in general practice (IMPLEMENT): cluster randomised controlled trial study protocol. Implement Sci. 2008;3:11.PubMedPubMedCentral

28.

Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A, et al. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care. 2005;14:26–33.PubMedPubMedCentral

29.

Francis J, O’Connor D, Curran J. Theories of behaviour change synthesised into a set of theoretical groupings: introducing a thematic series on the theoretical domains framework. Implement Sci. 2012;7:35.PubMedPubMedCentral

30.

Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci. 2012;7:37.PubMedPubMedCentral

31.

Bussières A, Stuber K. The Clinical Practice Guideline Initiative: a joint collaboration designed to improve the quality of care delivered by doctors of chiropractic. J Can Chiropr Assoc. 2013;57:279–84.PubMedPubMedCentral

32.

Jordan J, Holden M, Mason E, Foster N. Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev. 2010;1, CD005956.PubMed

33.

Sutton D, Côté P, Wong JJ, Varatharajan S, Randhawa K, Yu H, et al. Is multimodal care effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Spine J. 2014;S1529-9430(14):00650–0. doi:10.1016/j.spinee.2014.06.019.

34.

Espeland A, Baerheim A. Factors affecting general practitioners’ decisions about plain radiography for back pain: implications for classification of guideline barriers - a qualitative study. BMC Health Serv Res. 2003;3:8.PubMedPubMedCentral

35.

Bishop A, Thomas E, Foster NE. Health care practitioners’ attitudes and beliefs about low back pain: a systematic search and critical review of available measurement tools. Pain. 2007;132:91–101.PubMed

36.

Pincus T, Foster NE, Vogel S, Santos R, Breen A, Underwood M. Attitudes to back pain amongst musculoskeletal practitioners: a comparison of professional groups and practice settings using the ABS-mp. Man Ther. 2007;12:167–75.PubMed

37.

Biggs L, Mierau D, Hay D. Measuring philosophy: a philosophy index. J Can Chiropr Assoc. 2002;46:173–84.PubMedCentral

38.

Grol R, Wensing M, Eccles M. Improving patient care. The implementation of change in clinical practice. Edinburgh. New York: Elsevier Butterworth Heinemann; 2005.

39.

Francis J, Stockton C, Eccles M, Cuthbertson B, Grimshaw J, Hyde C, et al. Evidence based selection of theories for designing behaviour change interventions: using methods based on theoretical construct domains to understand clinicians’ blood transfusion behaviour. Br J Health Psychol. 2009;14:625–46.PubMed

40.

Francis J, Tinmouth A, Stanworth S, Grimshaw J, Johnston M, Hyde C, et al. Using theories of behaviour to understand transfusion prescribing in three clinical contexts in two countries: development work for an implementation trial. Implement Sci. 2009;4:70.PubMedPubMedCentral

41.

Bogdan R, Biklen SK. Fieldwork. In: International, editor. Qualitative research for education: an introduction to theories and methods. 5th ed. Boston: Pearson Higher Education; 2007. p. 320.

42.

Michie S, Johnston M, Francis J, Hardeman W, Eccles M. From theory to intervention: mapping theoretically derived behavioural determinants to behaviour change techniques. Appl Psychol. 2008;57:660–80.

43.

Cook D, Levinson AJ, Garside S, Dupras DM, Erwin PJ, Montori VM. Internet-based learning in the health professions: a meta-analysis. JAMA. 2008;300:1181–96.PubMed

44.

Cook DA, Levinson AJ, Garside S. Time and learning efficiency in Internet-based learning: a systematic review and meta-analysis. Adv Health Sci Educ Theory Pract. 2010;15:755–70.PubMed

45.

van der Wees P, Jamtvedt G, Rebbeck T, de Bie R, Dekker J, Hendriks E. Multifaceted strategies may increase implementation of physiotherapy clinical guidelines: a systematic review. Aust J Physiother. 2008;54:233–41.PubMed

46.

Hrisos S, Eccles M, Johnston M, Francis J, Kaner E, Steen N, et al. Developing the content of two behavioural interventions: using theory-based interventions to promote GP management of upper respiratory tract infection without prescribing antibiotics #1. BMC Health Serv Res. 2008;8:11.PubMedPubMedCentral

47.

Francis J, Johnston M, Robertson C, Glidewell L, Entwistle V, Eccles M, et al. What is an adequate sample size? Operationalising data saturation for theory-based interview studies. Psychol Health. 2010;25:1229–45.PubMed

48.

Hsieh H, Shannon S. Three approaches to qualitative content analysis. Qual Health Res. 2005;15:1277–88.PubMed

49.

Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013;46:81–95.PubMed

50.

Flodgren G, Parmelli E, Doumit G, Gattellari M, O’Brien M, Grimshaw J, et al. Local opinion leaders: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2011;8, CD000125.PubMed

51.

Baskerville NB, Liddy C, Hogg W. Systematic review and meta-analysis of practice facilitation within primary care settings. Ann Fam Med. 2012;10:63–74.PubMedPubMedCentral

52.

MacDermid J, Miller J, Gross A. Knowledge translation tools are emerging to move neck pain research into practice. Open Orthop J. 2013;7:582–93.PubMedPubMedCentral

53.

Petzold A, Korner-Bitensky N, Salbach N, Ahmed S, Menon A, Ogourtsova T. Increasing knowledge of best practices for occupational therapists treating post-stroke unilateral spatial neglect: results of a knowledge-translation intervention study. J Rehabil Med. 2012;44:118–24.PubMed

54.

Richards J, Hillsdon M, Thorogood M, Foster C. Face-to-face interventions for promoting physical activity. Cochrane Database Syst Rev. 2013;9, CD010392.PubMed

55.

Glynn T, Manley M. How to help your patients stop smoking: a manual for physicians. In: NIH Publication 89–3064 ed. Bethesda (MD): National Cancer Institute. US; 1989.

56.

Vallis M, Piccinini-Vallis H, Sharma AM, Freedhoff Y. Clinical review: modified 5 As: minimal intervention for obesity counseling in primary care. Can Fam Physician. 2013;59:27–31.PubMedPubMedCentral

57.

Franek J. Self-management support interventions for persons with chronic disease: an evidence-based analysis. Ont Health Technol Assess Ser. 2013;13:1–60. eCollection 2013.PubMedPubMedCentral

58.

Gutnick D, Reims K, Davis C, Gainforth H, Jay M, Cole S. Brief action planning to facilitate behavior change and support patient self-management. J Clin Outcomes Manag. 2014;21:17–29.

59.

Villanueva-Russell Y. Evidence-based medicine and its implications for the profession of chiropractic. Soc Sci Med. 2005;60:545–61.PubMed

60.

Villanueva-Russell I. Caught in the crosshairs: identity and cultural authority within chiropractic. Soc Sci Med. 2011;72:1826–37.PubMed

61.

Rycroft-Malone J, Seers K, Titchen A, Harvey G, Kitson A, McCormack B. What counts as evidence in evidence-based practice? J Adv Nurs. 2004;47:81–90.PubMed

62.

Williams J, Williams W, Dusablon T, Blais M, Tregear S, Banks D, et al. Evaluation of a randomized intervention to increase adoption of comparative effectiveness research by community health organizations. J Behav Health Serv Res. 2014;41:308–23.PubMed

63.

Farmer A, Legare F, Turcot L, Grimshaw J, Harvey E, McGowan J, et al. Printed educational materials: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2008;3, CD004398.PubMed

64.

Evans D, Breen A, Pincus T, Underwood M, Vogel S, Foster N. The effectiveness of a posted information package on the beliefs and behavior of musculoskeletal practitioners: the UK Chiropractors, Osteopaths, and Musculoskeletal Physiotherapists Low Back Pain ManagemENT (COMPLeMENT) randomized trial. Spine. 2010;35:858–66.PubMed

65.

Pain K, Magill-Evans J, Darrah J, Hagler P, Warren S. Effects of profession and facility type on research utilization by rehabilitation professionals. J Allied Health. 2004;33:3–9.PubMed

66.

Gerrish K, Clayton J. Promoting evidence-based practice: an organizational approach. J Nurs Manag. 2004;12:114–23.PubMed

67.

Hundley V, Milne J, Leighton-Beck L, Graham W, Fitzmaurice A. Raising research awareness among midwives and nurses: does it work? J Adv Nurs. 2000;31:78–88.PubMed

68.

McAlister FA, Graham I, Karr GW, Laupacis A. Evidence-based medicine and the practicing clinician. J Gen Intern Med. 1999;14:236–42.PubMedPubMedCentral

69.

Suter E, Verhoef M, O’Beirne M. Assessment of the information needs and use of information resources on complementary and alternative medicine by Alberta family physicians. Clin Invest Med. 2004;27:312–5.PubMed

70.

Jette DU, Bacon K, Batty C, Carlson M, Ferland A, Hemingway RD, et al. Evidence-based practice: beliefs, attitudes, knowledge, and behaviors of physical therapists. Phys Ther. 2003;83:786–805.PubMed

71.

Verstappen WHJM, ter Riet G, Dubois WI, Winkens R, Grol RPTM, van der Weijden T. Variation in test ordering behaviour of GPs: professional or context-related factors? Fam Pract. 2004;21:387–95.PubMed

72.

Hall G. Attitudes of chiropractors to evidence-based practice and how this compares to other healthcare professionals: a qualitative study. Clin Chiropractic. 2011;14:106–11.

73.

Thomas A, Law M. Research utilization and evidence-based practice in occupational therapy: a scoping study. Am J Occup Ther. 2013;67:55–65.

74.

Thomas A, Law M. Evidence-based practice supports among Canadian occupational therapists. Can J Occup Ther. 2014;81:79–92.PubMed

75.

Banzai R, Derby DC, Long CR, Hondras MA. International web survey of chiropractic students about evidence-based practice: a pilot study. Chiropr. Man Ther. 2011;19:6.

76.

Haas M, Leo M, Peterson D, Lefebvre R, Vavrek D. Evaluation of the effects of an evidence-based practice curriculum on knowledge, attitudes, and self-assessed skills and behaviors in chiropractic students. J Manipulative Physiol Ther. 2012;35:701–9.PubMedPubMedCentral

77.

Hoving C, Visser A, Mullen PD, van den Borne B. A history of patient education by health professionals in Europe and North America: from authority to shared decision making education. Patient Educ Couns. 2010;78:275–81.PubMed

78.

Wensing M, Vedsted P, Kersnik J, Peersman W, Klingenberg A, Hearnshaw H, et al. Patient satisfaction with availability of general practice: an international comparison. Int J Qual Health Care. 2002;14:111–8.PubMed

79.

Whitlock EP, Orleans CT, Pender N, Allan J. Evaluating primary care behavioral counseling interventions: an evidence-based approach. Am J Prev Med. 2002;22:267–84.PubMed

80.

Elford R, MacMillan H, Wathen C. Canadian Task Force on Preventive Health Care: counseling for risky health habits: a conceptual framework for primary care practitioners. CTFPHC Technical Report #01-7. London, ON: Canadian Task Force; 2001.

81.

Khan KM, Weiler R, Blair SN. Prescribing exercise in primary care. BMJ. 2011;343:d4141.PubMed

82.

Swedish National Institute of Public Health. Physical activity in the prevention and treatment of disease. Stockholm: Elanders; 2010.

83.

Ockene J, Adams A, Hurley T, Wheeler E, Hebert J. Brief physician- and nurse practitioner-delivered counseling for high-risk drinkers: does it work? Arch Intern Med. 1999;159:2198–205.PubMed

84.

Ockene J, Wheeler E, Adams A, Hurley T, Hebert J. Provider training for patient-centered alcohol counseling in a primary care setting. Arch Intern Med. 1997;157:2334–41.PubMed

85.

Ockene J, Ockene I, Quirk M, Hebert J, Saperia G, Luippold R, et al. Physician training for patient-centered nutrition counseling in a lipid intervention trial. Prev Med. 1995;24:563–70.PubMed

86.

Wilson N, Mansoor O, Simmons D. Diabetes in New Zealand - better information needed. N Z Med J. 1999;112:206–8.PubMed

87.

Heckman C, Egleston B, Hofmann M. Efficacy of motivational interviewing for smoking cessation: a systematic review and meta-analysis. Tob Control. 2010;19:410–6.PubMedPubMedCentral

88.

Jay M, Gillespie C, Schlair S, Savarimuthu S, Sherman S, Zabar S, et al. The impact of primary care resident physician training on patient weight loss at 12 months. Obesity. 2013;21:45–50.PubMed

89.

Marchiori D, Henkin A, Hawk C. Social communication skills of chiropractors: implications for professional practice. J Manipulative Physiol Ther. 2008;31:682–9.PubMed

90.

Grimshaw J, Eccles M, Tetroe J. Implementing clinical guidelines: current evidence and future implications. J Contin Educ Health Prof. 2004;24 Suppl 1:31–7.

91.

Francis J, Eccles M, Johnstonm M, Whitty P, Grimshaw J, Kaner E, et al. Explaining the effects of an intervention designed to promote evidence-based diabetes care: a theory-based process evaluation of a pragmatic cluster randomised controlled trial. Implement Sci. 2008;3:50.PubMedPubMedCentral

92.

Godin G, Belanger-Gravel A, Eccles M, Grimshaw J. Healthcare professionals’ intentions and behaviours: a systematic review of studies based on social cognitive theories. Implement Sci. 2008;3:36.PubMedPubMedCentral

93.

Presseau J, Johnston M, Heponiemi T, Elovainio M, Francis JJ, Eccles MP, et al. Reflective and automatic processes in health care professional behaviour: a dual process model tested across multiple behaviours. Ann Behav Med. 2014;48(3):347–58.PubMed

94.

Gollwitzer PM, Sheeran P. Implementation intentions and goal achievement: a meta-analysis of effects and processes. Adv Exp Soc Psychol. 2006;38:69–119.

95.

Sniehotta F. Towards a theory of intentional behaviour change: plans, planning, and self-regulation. Br J Health Psychol. 2009;14:261–73.PubMed

96.

Reuter T, Ziegelmann JP, Wiedemann AU, Geiser C, Lippke S, Schüz B, et al. Changes in intentions, planning, and self-efficacy predict changes in behaviors: an application of latent true change modeling. J Health Psychol. 2010;15:935–47.PubMed

97.

Zhang Y, Cooke R. Using a combined motivational and volitional intervention to promote exercise and healthy dietary behaviour among undergraduates. Diabetes Res Clin Pract. 2012;95:215–23.PubMed

98.

French DP, Stevenson A, Michie S. An intervention to increase walking requires both motivational and volitional components: a replication and extension. Psychol Health Med. 2012;17:127–35.PubMed

99.

Skinner BF. Contingencies of reinforcement: a theoretical analysis. New York: Appleton-Century-Crofts; 1969.

100.

Skinner BF. Operant behavior. Am Psychol. 1963;18:503–15.

101.

Hinton PM, McLeod R, Broker B, Maclellan CE. Outcome measures and their everyday use in chiropractic practice. J Can Chiropr Assoc. 2010;54:118–31.PubMedPubMedCentral

102.

Ha J, Longnecker N. Doctor-patient communication: a review. Ochsner J. 2010;10:38–43.PubMedPubMedCentral

103.

Presseau J, Francis J, Campbell N, Sniehotta F. Goal conflict, goal facilitation, and health professionals’ provision of physical activity advice in primary care: an exploratory prospective study. Implement Sci. 2011;6:73.PubMedPubMedCentral

Title: Fast tracking the design of theory-based KT interventions through a consensus process
Authors: André E Bussières
Fadi Al Zoubi
Jeffrey A Quon
Sara Ahmed
Aliki Thomas
Kent Stuber
Sandy Sajko
Simon French
Members of the Canadian Chiropractic Guideline Initiative
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: Implementation Science / Issue 1/2015
Electronic ISSN: 1748-5908
DOI: https://doi.org/10.1186/s13012-015-0213-5

At a glance: The STEP trials

Springer Medicine

Fast tracking the design of theory-based KT interventions through a consensus process

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2015

What are effective strategies for the implementation of care bundles on ICUs: a systematic review

See One, Do One, Order One: a study protocol for cluster randomized controlled trial testing three strategies for implementing motivational interviewing on medical inpatient units

Accuracy of using automated methods for detecting adverse events from electronic health record data: a research protocol

Study protocol for “Study of Practices Enabling Implementation and Adaptation in the Safety Net (SPREAD-NET)”: a pragmatic trial comparing implementation strategies

10 years of mindlines: a systematic review and commentary

Research funders’ roles and perceived responsibilities in relation to the implementation of clinical research results: a multiple case study of Swedish research funders