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Table 1 Summary of intervention design methods and key characteristics

From: Methods for designing interventions to change healthcare professionals’ behaviour: a systematic review

No., author, year
(label if given)
Method summary Generic or specific (described) context Level of change Builds on other methods, tools
yes/no (defined)
Barrier identification
Links barrier to components
Uses theory
Input from users
1. Battles, 2006[18]
(ADDIE method)
1) Analysis: identify the target and needs,
2) Development: define behaviour, and learning outcomes and sequence,
3) Design: specify content and medium of prototype,
4) Implementation
5) Evaluation
Patient safety Ind No Yes Yes Yes No
2. Cabassa, 2001[23] 1) Researchers/stakeholders review and modify intervention
2) Ensure acceptability (focus groups)
3) Modify intervention, plan implementation and training
4) Pilot for feasibility, acceptability, initial effects
5) Rigorous evaluation
Providers: case managers
Setting: outpatient mental health
Clinical condition: serious mental health and cardiovascular disease
Other Yes (IM, Participatory Action methods) No No Yes Yes
3. Chandler, 2014[30] 1) Formative research (observations, interviews, focus groups) with targets
2) Review existing literature for behaviour change strategies and theories
3) Face to face workshop with researchers and experts to review results of first two steps and propose potential theory-based intervention strategies
4) Design intervention
5) Pilot and pre-test, and determine final intervention
Behaviour: use of malaria rapid diagnostic test and adherence to test results
Provider: Tanzanian community health workers and nurses
Setting: Tanzanian community; low resource settings
Clinical condition: malaria
Ind No Yes Yes Yes No
4. Clyne, 2013[24] 1) Development: Literature review of empirical and theoretical evidence to inform potential intervention components. Organise influencing factors from the literature using a model of potential influencing factors (PRECEDE model).
2) Use consensus based methods, case studies, and focus groups to develop and confirm appropriate actions by GPs (treatment algorithms for best practices for prescribing).
3) Finalize intervention, pilot test and conduct interviews with targets regarding feasibility and acceptability of intervention
Behaviour: decreasing inappropriate prescribing in older adults
Provider: general practitioners
Setting: primary care in Ireland
Clinical condition: older adults
Ind Yes (MRC) Yes No No Yes
5. Curran, 2008 [14]
QUERI method
1) Determine site-specific needs/barriers (observations and interviews)
2) Develop the intervention with staff, research experts, and clinical experts (meetings, consulting with others, facilitation by local champions)
Behaviour: implementing a guideline for depression
Provider: all staff
Setting: substance abuse clinic
Clinical condition: depression/substance abuse
(Stetler’s concept of formative evaluation, Rubenstein’s EBQI)
Yes Yes Yes Yes
6. Foy, 2007[28] 1) Specification of target behaviours
2) Select theoretical framework
3) Conduct predictive study
4) Choose variables to target
5) Map variables to behaviour change techniques
6) Choose method of delivery
7) Operationalise intervention components
Behaviour: implementing disclosure behaviours for diagnosing dementia
Providers: mental health teams
Clinical condition: dementia
Ind Yes
Yes Yes Yes Yes
7. French, 2012[21] 1) Who needs to do what differently?
2) Using a theoretical framework, which barriers and enablers need to be addressed?
3) Which intervention components could overcome the modifiable barriers/enablers?
4) How can the behaviour change be measured and understood?
Behaviour: implementing better back pain care
Providers: GP’s
Clinical condition: low back pain
Ind Yes
Yes Yes Yes Yes
8. Fretheim, 2004[32] 1) Researchers engage in structured reflection
2) Review relevant evidence
3) Conduct a survey of the targets
4) Engage targets in discussion while piloting the intervention
Behaviour: implementing improved pharmacological management
Providers: GP’s
Clinical condition: hypertension and hypercholesterolaemia
Ind No Yes Yes No Yes
9. Kolehmainen
2012 [22]
1) Identify behaviour change techniques
2) Providers generate evidence-based and context-relevant modes of delivery for the techniques (advisory team and brainstorming)
3) Use theory and BCT taxonomy to create hypotheses about the mechanisms of change
Behaviour: improved caseload management through three specific goal-setting behaviours
Provider: pediatric occupational therapists
Ind Yes
No Yes Yes Yes
10. McDermott, 2010[31] 1) Identify the intervention using evidence and theory
2) Conduct interviews with targets re factors likely to influence
3) Analyse and modify the intervention
4) Conduct ‘think aloud’ interviews with targets re intervention
5) Finalize intervention
Behaviour: implementing guidelines
Provider: general practitioners
Setting: General practices
Clinical condition: stroke and respiratory tract infection
Ind No Yes Yes Yes Yes
11. Porcheret, 2014[25] 1) Clearly define desired change and targets for change
2) Analyse current practice including barriers and facilitators using a structured theory-based approach—TDF
3) Determine intervention strategies based on a taxonomy of behaviour change techniques and theory—Adult Learning Theory
4) Implement
5) Evaluate
Behaviour: enhanced consultation by GP’s for people with OA according to guidelines
Provider: general practitioners
Setting: primary care
Clinical condition: osteoarthritis
Ind Yes
(Implementation of Change Model [41], TDF and BCT)
Yes Yes Yes Yes
12. Sassen, 2012[26] 1) Needs assessment of the population
2) Define performance objectives as they relate to determinants (change objectives)
3) Link the performance objectives to the determinants and suggest intervention methods to change the determinants that are based on theory
4) Develop and pre-test the intervention
5) Adopt, implement, and sustain intervention
Behaviour: encourage patients to engage in physical activity
Provider: nursing or physiotherapy health professionals
Setting: cardiovascular inpatient and outpatient care
Clinical condition: patients with cardiovascular disease
Ind Yes
Yes Yes Yes Yes
13. Schmid, 2010[27] 0) Complete a needs assessment by conducting interviews with providers
1) Set performance objectives that are linked to related determinants and expected change
2) Select a theory-based intervention methodology to determine intervention components that are linked to the objectives set in step 1
3) Design the intervention using all IM steps, and the results of the needs assessment from step 0
4) Tailor the resulting intervention to local needs, adopt, and implement
5) Monitor and evaluate
Behaviour: adherence to stroke prevention guidelines
Provider: entire stroke team physicians, nursing, allied health
Setting: continuum of stroke care
Clinical condition: Stroke
Ind Yes
Yes Yes Yes Yes
14. Taylor, 2013[19]
1) Engage stakeholders
2) Identify target behaviours
3) Identify barriers and facilitators using TDF, focus groups, barrier questionnaire
4) Engage stakeholders to develop local strategies linked to barriers based on BCT plus current literature
5) Support stakeholders to implement
6) Assess feasibility and acceptability
Behaviour: adhere to guideline for reduce risk of feeding into misplaced nasogastric tubes
Provider: setting: acute care
Clinical condition: in-patients with nasogastric tubes
Ind Yes (TDF, BCT) Yes Yes Yes Yes
15. van Bokhoven 2004 [20] 1) Identify problem/target for improvement
2) Problem analysis
3) Design the intervention
4) Pre-test
5) Adopt and implement
6) Evaluate
Quality improvement Ind Yes
Yes Yes Yes Yes
  1. Ind Individual, Org Organization, Sys System, Other Focus on intervention adaptation, ADDIE Analysis, Development, Design, Implementation, Evaluation, IM Intervention Mapping, GP’s General Practitioners, MRC Medical Research Council guidance on the evaluation of complex interventions, QUERI Quality Enhancement Research Initiative, EBQI Evidence Based Quality Improvement, BCT Behaviour Change Technique Taxonomy, TDF Theoretical Domains Framework, TDFI Theoretical Domains Framework Implementation