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Table 7 Operationalisation of intervention components

From: Developing a targeted, theory-informed implementation intervention using two theoretical frameworks to address health professional and organisational factors: a case study to improve the management of mild traumatic brain injury in the emergency department

  Stakeholder meeting Local opinion leader Train the trainer Local training workshops Tools and materials to prompt recommended behaviours
Rationale for intervention component Findings from interviews: Organisational and TDF factors Findings from interviews: Organisational factors Cochrane EPOC reviews Findings from interviews: Organisational and TDF factors Cochrane EPOC reviews feasibility information Findings from interviews: Organisational and TDF factors Cochrane EPOC reviews feasibility information Findings from interviews: Organisational and TDF factors Cochrane EPOC reviews feasibility information
Intervention content Provide an opportunity to create buy-in at an organisational level and for senior leadership to express support. Provide opportunity to start conversation with stakeholders within hospital (outside ED) Key recommended behaviours and supporting evidence Recruitment of local opinion leaders (one senior nurse and one medical lead from each participating hospital) to lead the project and train staff Training and education including information/education on the key recommended practices and consequences of performing and not performing the behaviours, persuasive messages, skill development, modelling/demonstration and planning/implementation Information/education on the key recommended practices and consequences of performing and not performing the behaviours, persuasive messages, skill development, modelling/demonstration PTA assessment tool. Evidence-based discharge information sheet in different languages CT clinical decision tools lanyards. Checklist reminder stickers for patient records
Endorsement letters from relevant ED colleges. Practicalities of how these will be implemented including discussion of local pathways and protocols and how to overcome anticipated barriers to implementation   Leadership and change management training (e.g. information on the importance and content of the role of the clinical leads)   Posters providing information on the evidence-based approach to managing patients with mTBI
Characteristics of those delivering the intervention Senior research team clinicians Not applicable Senior research team clinicians Local opinion leaders (nurse and medical) Research team
Clinical opinion leaders
Characteristics of the recipient(s) Local stakeholders (both clinical as well as change management, e.g. ED Director, nominated local opinion leaders and other stakeholders such as occupational therapists or radiologists) Not applicable Local opinion leaders—one senior nurse and one medical lead from each participating hospital Staff in the Emergency Department responsible for the management of mTBI patients. Local opinion leaders and staff in the Emergency Department responsible for the management of mTBI patients.
Setting Participating hospitals Participating hospitals Off-site conference venue Participating hospitals Participating hospitals
Relevant BCTs for PTA behaviour Information regarding behaviour, outcome. Not applicable Information regarding behaviour, outcome Information regarding behaviour, outcome Environmental changes
Health consequences Antecedents Antecedents Information regarding behaviour, outcome
Persuasive communication Health consequences Health consequences  
Social processes of encouragement, pressure, support Goal/target specified behaviour or outcome Graded task, starting with easy tasks
Graded task, starting with easy tasks Increasing skills: problem solving, decision making, goal setting
Increasing skills: problem solving, decision making, goal setting Modelling/demonstration of behaviour of others
Rehearsal of relevant skills Persuasive communication
Modelling/demonstration of behaviour of others Social processes of encouragement, pressure, support
Persuasive communication Pros and Cons
Social processes of encouragement, pressure, support Vicarious reinforcement
Pros and Cons Social and environmental consequences
Vicarious reinforcement Salience of consequences
Social and environmental consequences  
Salience of consequences
Focus on past success
Mode of delivery Face-to-face meeting One medical and nursing lead Mixed, interactive and didactic workshop Face to face workshops (mixed or clinician group specific depending on current training infrastructure in participating hospitals) Printed copies
Online presentations available for those not able to attend workshops Online versions
  CT decision rules provided as lanyards
Intensity or dose One meeting Part-time Two events in different Australian states 1 brief presentation per clinical topic, 1 demonstration session For use with every patient
Number of repeats left to LOLs
Duration One hour in length Duration of the project Full day 10–20 min per session Not applicable