The development of a theory-based intervention to promote appropriate disclosure of a diagnosis of dementia

Background: The development and description of interventions to change professional practice are often limited by the lack of an explicit theoretical and empirical basis. We set out to develop an intervention to promote appropriate disclosure of a diagnosis of dementia based on theoretical and empirical work. Methods: We identified three key disclosure behaviours: finding out what the patient already knows or suspects about their diagnosis; using the actual words 'dementia' or 'Alzheimer's disease' when talking to the patient; and exploring what the diagnosis means to the patient. We conducted a questionnaire survey of older peoples' mental health teams (MHTs) based upon theoretical constructs from the Theory of Planned Behaviour (TPB) and Social Cognitive Theory (SCT) and used the findings to identify factors that predicted mental health professionals' intentions to perform each behaviour. We selected behaviour change techniques likely to alter these factors. Results: The change techniques selected were: persuasive communication to target subjective norm; behavioural modelling and graded tasks to target self-efficacy; persuasive communication to target attitude towards the use of explicit terminology when talking to the patient; and behavioural modelling by MHTs to target perceived behavioural control for finding out what the patient already knows or suspects and exploring what the diagnosis means to the patient. We operationalised these behaviour change techniques using an interactive 'pen and paper' intervention designed to increase intentions to perform the three target behaviours. Conclusion : It is feasible to develop an intervention to change professional behaviour based upon theoretical models, empirical data and evidence based behaviour change techniques. The next step is to evaluate the effect of such an intervention on behavioural intention. We argue that this approach to development and reporting of interventions will contribute to the science of implementation by providing replicable interventions that illuminate the principles and processes underlying change.This project is funded by UK Medical Research Council, Grant reference number G0300999. Jeremy Grimshaw holds a Canada Research Chair in Health Knowledge Transfer and Uptake. Jill Francis is funded by the Chief Scientist Office of the Scottish Government Health Directorate. The views expressed in this study are those of the authors

From lists of behaviour change techniques (BCTs) to structured hierarchies: comparison of two methods of developing a hierarchy of BCTs

Objectives Behaviour change technique (BCT) Taxonomy v1 is a hierarchically grouped, consensus-based taxonomy of 93 BCTs for reporting intervention content. To enhance the use and understanding of BCTs, the aims of the present study were to (1) quantitatively examine the ‘bottom-up’ hierarchical structure of Taxonomy v1, (2) identify whether BCTs can be reliably mapped to theoretical domains using a ‘top-down’ theoretically driven approach, and (3) identify any overlap between the ‘bottom-up’ and ‘top-down’ groupings. Methods and design The ‘bottom-up’ structure was examined for higher-order groupings using a dendrogram derived from hierarchical cluster analysis. For the theory-based ‘top-down’ structure, 18 experts sorted BCTs into 14 theoretical domains. Discriminant Content Validity was used to identify groupings, and chi-square tests and Pearson's residuals were used to examine the overlap between groupings. Results Behaviour change techniques relating to ‘Reward and Punishment’ and ‘Cues and Cue Responses’ were perceived as markedly different to other BCTs. Fifty-nine of the BCTs were reliably allocated to 12 of the 14 theoretical domains; 47 were significant and 12 were of borderline significance. Thirty-four of 208 ‘bottom-up’ × ‘top-down’ pairings showed greater overlap than expected by chance. However, only six combinations achieved satisfactory evidence of similarity. Conclusions The moderate overlap between the groupings indicates some tendency to implicitly conceptualize BCTs in terms of the same theoretical domains. Understanding the nature of the overlap will aid the conceptualization of BCTs in terms of theory and application. Further research into different methods of developing a hierarchical taxonomic structure of BCTs for international, interdisciplinary work is now required. Statement of contribution What is already known on this subject? * Behaviour change interventions are effective in improving health care and health outcomes

Solved! Making the case for collaborative problem-solving

This report argues that the ability to solve problems with others is a crucial skill for our young people in the workplace of the future but the current education system does little to support it. Key findings Collaborative problem-solving (CPS) is an increasingly important skill to teach young people in order to prepare them for the future. Despite strong evidence for its impact, CPS is rarely taught in schools but if structured well it can reinforce knowledge and improve attainment. Significant barriers exist for teachers implementing this practice, from behaviour management to curriculum coverage, to task-design. For CPS to gain ground, a concerted shift is needed including teacher training, better resources and system level support. This report is part of Nesta’s ongoing commitment to equipping young people with the skills they need to succeed. It makes a series of recommendations on how organisations and policymakers can help support and embrace the implementation of CPS. Nesta is following this up with a series of small-scale pilots of aligned programmes in order to evaluate impact and explore how CPS can be implemented in a range of practical settings. Policy recommendations Stimulate production of quality collaborative problem-solving (CPS) resources and training, from primary education onwards. Fund existing, aligned programmes to scale and evaluate impact. Educate and involve the out-of-school learning sector and volunteer educators. Develop smarter collaborative problem-solving assessment methods. Help higher education organisations and MOOCs to track what works

Behaviour change techniques: the development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data)

Background Meeting global health challenges requires effective behaviour change interventions (BCIs). This depends on advancing the science of behaviour change which, in turn, depends on accurate intervention reporting. Current reporting often lacks detail, preventing accurate replication and implementation. Recent developments have specified intervention content into behaviour change techniques (BCTs) – the ‘active ingredients’, for example goal-setting, self-monitoring of behaviour. BCTs are ‘the smallest components compatible with retaining the postulated active ingredients, i.e. the proposed mechanisms of change. They can be used alone or in combination with other BCTs’ (Michie S, Johnston M. Theories and techniques of behaviour change: developing a cumulative science of behaviour change. Health Psychol Rev 2012;6:1–6). Domain-specific taxonomies of BCTs have been developed, for example healthy eating and physical activity, smoking cessation and alcohol consumption. We need to build on these to develop an internationally shared language for specifying and developing interventions. This technology can be used for synthesising evidence, implementing effective interventions and testing theory. It has enormous potential added value for science and global health. Objective (1) To develop a method of specifying content of BCIs in terms of component BCTs; (2) to lay a foundation for a comprehensive methodology applicable to different types of complex interventions; (3) to develop resources to support application of the taxonomy; and (4) to achieve multidisciplinary and international acceptance for future development. Design and participants Four hundred participants (systematic reviewers, researchers, practitioners, policy-makers) from 12 countries engaged in investigating, designing and/or delivering BCIs. Development of the taxonomy involved a Delphi procedure, an iterative process of revisions and consultation with 41 international experts; hierarchical structure of the list was developed using inductive ‘bottom-up’ and theory-driven ‘top-down’ open-sort procedures (n = 36); training in use of the taxonomy (1-day workshops and distance group tutorials) (n = 161) was evaluated by changes in intercoder reliability and validity (agreement with expert consensus); evaluating the taxonomy for coding interventions was assessed by reliability (intercoder; test–retest) and validity (n = 40 trained coders); and evaluating the taxonomy for writing descriptions was assessed by reliability (intercoder; test–retest) and by experimentally testing its value (n = 190). Results Ninety-three distinct, non-overlapping BCTs with clear labels and definitions formed Behaviour Change Technique Taxonomy version 1 (BCTTv1). BCTs clustered into 16 groupings using a ‘bottom-up’ open-sort procedure; there was overlap between these and groupings produced by a theory-driven, ‘top-down’ procedure. Both training methods improved validity (both p < 0.05), doubled the proportion of coders achieving competence and improved confidence in identifying BCTs in workshops (both p < 0.001) but did not improve intercoder reliability. Good intercoder reliability was observed for 80 of the 93 BCTs. Good within-coder agreement was observed after 1 month (p < 0.001). Validity was good for 14 of 15 BCTs in the descriptions. The usefulness of BCTTv1 to report descriptions of observed interventions had mixed results. Conclusions The developed taxonomy (BCTTv1) provides a methodology for identifying content of complex BCIs and a foundation for international cross-disciplinary collaboration for developing more effective interventions to improve health. Further work is needed to examine its usefulness for reporting interventions. Funding This project was funded by the Medical Research Council Ref: G0901474/1. Funding also came from the Peninsula Collaboration for Leadership in Applied Health Research and Care

Are language production problems apparent in adults who no longer meet diagnostic criteria for attention-deficit/hyperactivity disorder?

In this study, we examined sentence production in a sample of adults (N = 21) who had had attention-deficit/hyperactivity disorder (ADHD) as children, but as adults no longer met DSM-IV diagnostic criteria (APA, 2000). This “remitted” group was assessed on a sentence production task. On each trial, participants saw two objects and a verb. Their task was to construct a sentence using the objects as arguments of the verb. Results showed more ungrammatical and disfluent utterances with one particular type of verb (i.e., participle). In a second set of analyses, we compared the remitted group to both control participants and a “persistent” group, who had ADHD as children and as adults. Results showed that remitters were more likely to produce ungrammatical utterances and to make repair disfluencies compared to controls, and they patterned more similarly to ADHD participants. Conclusions focus on language output in remitted ADHD, and the role of executive functions in language production

Expert Information and Expert Evidence: A Preliminary Taxonomy

Federal Rule of Evidence 702 speaks in very general terms. It governs every situation in which scientific, technical or other specialized knowledge will assist the trier of fact, and provides that, in that situation, a witness qualified as an expert by knowledge, skill, experience, or education, may testify thereto in the form of an opinion or otherwise . . . .\u27 In 2000, following a trio of Supreme Court cases interpreting Rule 702, the Rule was amended to include a third requirement, in addition to the helpfulness of the testimony and the qualifications of the witness: reliability. Under Rule 702 as amended, a qualified witness may only provide expert testimony if (1) the testimony is based upon sufficient facts or data, (2) the testimony is the product of reliable principles and methods, and (3) the witness has applied the principles and methods reliably to the facts of the case.

FRAMEWORK FOR DEVELOPING INTELLECTUAL SKILLS USING COLLABORATIVE LEARNING TOOLS: THE EXPERTS’ CONSENSUS

Background and Purpose: Students in higher education need intellectual skills for critical thinking, problem-solving and creating new knowledge. Social interactions during collaborative learning (CL) encourage these cognitive processes. However, instructors lack the skill to develop intellectual skills using appropriate pedagogy and CL tools. Hence, this study seeks to develop a framework for developing intellectual skills. &nbsp; Methodology: The Fuzzy Delphi Method (FDM) was employed to identify and determine consensus on elements to teach intellectual skills among 16 panel of experts in educational technology and continuous professional development. In the first round, semi-structured interviews were conducted among four experts and the themes emerging from the interviews were used to develop the FDM questionnaire. The questionnaire was used in the second round of the FDM to determine consensus among the experts based on calculations of the defuzzification value. &nbsp; Findings: The consensus among the experts is that resources for teaching intellectual skills are videos, interactive slides, animation/graphics and quizzes while the corresponding assessments are student-generated contents (i.e videos, infographic posters, interactive slides and designed products). &nbsp; Contribution: The framework with the instructional strategies, resources and assessment provides a guideline for instructors to plan instruction for developing intellectual skills and generating new knowledge. Keywords: intellectual skills, collaborative learning, collaborative learning tools, Fuzzy Delphi, Merrill’s First Principles of Instruction &nbsp; Cite as: Vasodavan, V., DeWitt, D., &amp; Alias, N. (2021).&nbsp;Framework for developing intellectual skills using collaborative learning tools: The experts’ consensus.&nbsp;&nbsp;Journal of Nusantara Studies, 6(1), 284-308. http://dx.doi.org/10.24200/jonus.vol6iss1pp284-30