Skip to main content

Table 10 Linking TDF to a theoretical model to maximise coverage of domains under time constraints

From: A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems

Study title
 Factors Influencing Variation in Physician Adenoma Detection Rates: a Theory-Based Approach for Performance Improvement.
Rationale for changing behaviour
 Interventions to improve physician adenoma detection rates (ADRs) for colonoscopy have generally not been successful. There is limited understanding of which factors influence variation which might be appropriate targets for intervention.
Study design and materials
 Three focus groups of gastroenterologists and three of endoscopy nurses were conducted at medical centres in Northern California. As participants were available for a limited time (45–60 minutes), an adaptive interviewing method was used. First, participants were asked questions covering the three components of the COM-B model (capability, opportunity and motivation) to identify factors relevant in explaining ADR variation. Then for each relevant COM-B component, participants were asked questions covering the related domains of the TDF. For example, to investigate participants’ capabilities to perform a behaviour, they were asked “would you be more/less likely to do ‘X’ if you had greater physical and/or psychological ability?” If they responded positively, the researcher asked further questions structured by TDF domains representing capability, i.e. knowledge; physical skills; memory, attention and decision processes and behavioural regulation.
Findings and conclusions
 This adaptive interviewing method optimised the time available with higher level COM-B questions acting as a filter to potentially relevant TDF domains.
Study outputs
 Atkins et al. [81]