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Table 6 The problem of a lack of an explicit theoretical framework

From: Designing theoretically-informed implementation interventions

The intervention (see Table 4) using an educational component summarising recent relevant research evidence about cholesterol-lowering therapy and the presentation of prevalence data of the drug side-effects and their consequences, is found to have no effect on primary care physicians' prescribing behaviour.

However, measurement of the proposed mediating variables (knowledge of recent research evidence about cholesterol-lowering therapy and concerns about serious drug side-effects) indicates that the educational intervention did change both knowledge and physicians' concerns about side-effects. Therefore, at one level the intervention was successful, but it is now known that changing these two variables is not sufficient in itself to change the behaviour. This focuses the next phase of the research on other barriers that may not have been identified by the earlier interview study.

Conversely, in a parallel study, the educational intervention did not alter knowledge and concerns. Therefore, the possibility still holds that changing these variables will change behaviour, but it is clear that the educational strategy was insufficient to alter knowledge and opinions.