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Table 2 Stages in conducting TDF-based implementation research

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

Stage Detail Key considerations
1. Select and specify the target behaviour/s Use documentary analysis or empirical research to identify and specify who should do what differently, to increase the uptake of evidence-based practice May require assessment of the feasibility of measuring the behaviour as an outcome variable
2. Select the study design May involve semi-structured individual interviews, focus group interviews, questionnaires, structured observations, documentary analysis or consensus processes Design should fit the research question and will depend on the stage of investigation through exploration and development to intervention and explanation
3. Develop study materials Although materials from previous studies may be used as templates, materials should be adapted to be appropriate to the specified behaviour/s and context Requires in-depth understanding of the theoretical content of each domain
Requires pilot testing for comprehensibility and clinical sensibility
4. Decide the sampling strategy For exploratory studies, a maximum variation approach is appropriate Key participants are those who will, or should, perform the target behaviour but other stakeholders (e.g. managers, co-workers) may also contribute a valuable perspective
5. Collect the data Published studies have used audio-recorded interviews (face-to-face or telephone; one-to-one or focus group) or questionnaires (paper-based or online) Effective interviewing requires standard interviewer competencies and in-depth understanding of the theoretical content of each domain
6. Analyse the data The objective is to identify the domains that are most relevant to the implementation problem being addressed and to populate those domains with context-relevant and behaviourally specific content Coding in qualitative studies requires in-depth understanding of the theoretical content of each domain
7. Report findings For interview studies, report presents tables that include illustrative quotations, specific beliefs identified (with frequencies, if appropriate) and classification into domains The explanatory text relating to the table of course relates to the study objectives