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Implementation Science
Published in: Implementation Science 1/2017

Open Access 01-12-2017 | Research

Advancing the literature on designing audit and feedback interventions: identifying theory-informed hypotheses

Authors: Heather L. Colquhoun, Kelly Carroll, Kevin W. Eva, Jeremy M. Grimshaw, Noah Ivers, Susan Michie, Anne Sales, Jamie C. Brehaut

Published in: Implementation Science | Issue 1/2017

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Abstract

Background

Audit and feedback (A&F) is a common strategy for helping health providers to implement evidence into practice. Despite being extensively studied, health care A&F interventions remain variably effective, with overall effect sizes that have not improved since 2003. Contributing to this stagnation is the fact that most health care A&F interventions have largely been designed without being informed by theoretical understanding from the behavioral and social sciences. To determine if the trend can be improved, the objective of this study was to develop a list of testable, theory-informed hypotheses about how to design more effective A&F interventions.

Methods

Using purposive sampling, semi-structured 60–90-min telephone interviews were conducted with experts in theories related to A&F from a range of fields (e.g., cognitive, health and organizational psychology, medical decision-making, economics). Guided by detailed descriptions of A&F interventions from the health care literature, interviewees described how they would approach the problem of designing improved A&F interventions. Specific, theory-informed hypotheses about the conditions for effective design and delivery of A&F interventions were elicited from the interviews. The resulting hypotheses were assigned by three coders working independently into themes, and categories of themes, in an iterative process.

Results

We conducted 28 interviews and identified 313 theory-informed hypotheses, which were placed into 30 themes. The 30 themes included hypotheses related to the following five categories: A&F recipient (seven themes), content of the A&F (ten themes), process of delivery of the A&F (six themes), behavior that was the focus of the A&F (three themes), and other (four themes).

Conclusions

We have identified a set of testable, theory-informed hypotheses from a broad range of behavioral and social science that suggest conditions for more effective A&F interventions.
This work demonstrates the breadth of perspectives about A&F from non-healthcare-specific disciplines in a way that yields testable hypotheses for healthcare A&F interventions. These results will serve as the foundation for further work seeking to set research priorities among the A&F research community.
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Metadata
Title
Advancing the literature on designing audit and feedback interventions: identifying theory-informed hypotheses
Authors
Heather L. Colquhoun
Kelly Carroll
Kevin W. Eva
Jeremy M. Grimshaw
Noah Ivers
Susan Michie
Anne Sales
Jamie C. Brehaut
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2017
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/s13012-017-0646-0

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