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Table 1 Components of the implementation strategy described using the TIDieR framework [15]

From: ‘Around the edges’: using behaviour change techniques to characterise a multilevel implementation strategy for a fall prevention programme

 

What

Why

Who

Target behaviour

How, when and how often

Tailoring

Modifications

Component

Rationale

Delivered by

Delivered to

 

Mode and frequency

Planned adaptation

During the study

Organisational level

1. Implementation steering group led by clinical project manager

To ensure ‘successful planning, execution, monitoring, controlling and closing of the project’ (document).

Project manager ‘problem solving’ (I)

Project Manager, coordinator, representative from hospital, community, management

Heads of disciplines, management, MDTs, referrers

Multiple behaviours: ‘supporting implementation of fall risk assessment clinics’

Face to face monthly meetings, ongoing email and telephone contact

‘Communication tailored to the requirements of different audiences’ (D)

 

2. Appointed coordinator and administrator

To create ‘single point of contact’ for referrers, MDTs and clients. Previous efforts failed due to lack of ‘practical support’ (I)

NA

MDTs, referrers, heads of discipline, management

Multiple behaviours: ‘supporting implementation of fall risk assessment clinics’

Ongoing meetings, phone and email contact with MDTs and referrers

Mode of communication ‘depends on the person’ in each clinic (I)

 

3. Set up MDT to deliver assessment

Identify and assemble team of physiotherapist, occupational therapist, nurse

Coordinator

Project manager

1. Head of discipline

2. Line managers

Multiple behaviours: ‘supporting implementation of fall risk assessment clinics’

Face to face meetings and phone contact prior to initiating clinic

No reference

 

Professional: multidisciplinary team

4. Training and ‘coaching’

To provide ‘coaching and mentoring to MDTs’ in conducting assessment to ensure team were ‘comfortable’. (I)

Coordinator

Administrator Specialist fall team

MDT

Delivering risk assessment clinic

Face to face Prior to initiation and during weeks 2–3 of implementation

No reference

Number, timing and duration varied based on knowledge, requests and availability

5. Standard assessment form

Enable standardised assessment and onward referral

Coordinator

Administrator

MDT

Delivering risk assessment clinic

Circulated prior to initiating clinic

No reference

Format and level of information changed during pilot

6. Equipment

To ensure assessment could be conducted

Coordinator

Administrator

MDT

Delivering risk assessment clinic

Prior to initiating clinic

Dependent on existing equipment

 

Professional: referrers

7. Standard referral form

Enable efficient referral to service

Coordinator

Referrers

Refer to clinic

Circulated during initial implement

No reference

Level of information changed during pilot

8. Information meetings with referrers

‘Selling’ clinics to get referrers ‘on board’ and ‘to discuss criteria on who we want (referred) and [ensure] that is very clear’.(I)

Coordinator

Specialists

Project manager

Physicians

ANPs

PHNs

Refer to clinic

Ad-hoc face to face meetings ‘ideally’ before clinic started (I)

Timing depended on clinic being established in that area

Number of meetings increased in areas with low referral rates

9. Screening tool for PHNs

Generate referrals for the clinics among PHNs who ‘would be the first line of contact with the health service.’ (I)

Coordinator

Director of Public Health Nursing

PHNs

Identify eligible clients and refer to clinic

Ad-hoc face to face meetings to introduce and promote use of tool

No reference

Number and timing of meetings varied by area and level of engagement

10. Promotional material

Advertise and inform referrers about clinics

Coordinator

Administrator

Referrers

Pharmacies, Day centres

Refer to clinic

Flyers, posters, monthly mail shot (to GPs)

No reference

 

Patient

11. Invitation letter and information leaflet

To inform clients about appointment, clinic location and how to prepare for their visit, centralising administration to support MDTs.

Coordinator

Administrator

Clients

Attend clinic

Documents provided on receipt of referral and arrangement of appointment

No reference

 
  1. Admin administrator, ANP advanced nurse practitioner, Ax assessment, Comms communication, D document, I interview, IC implementation coordinator, MDT multidisciplinary team, Mgmt management, PHN public health nurse, PM project manager, SG steering group