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

Background: Implementing new practices requires changes in the behaviour of relevant actors, and this is facilitated by understanding of the determinants of current and desired behaviours. The Theoretical Domains Framework (TDF) was developed by a collaboration of behavioural scientists and implementation researchers who identified theories relevant to implementation and grouped constructs from these theories into domains. The collaboration aimed to provide a comprehensive, theory-informed approach to identify determinants of behaviour. The first version was published in 2005, and a subsequent version following a validation exercise was published in 2012. This guide offers practical guidance for those who wish to apply the TDF to assess implementation problems and support intervention design. It presents a brief rationale for using a theoretical approach to investigate and address implementation problems, summarises the TDF and its development, and describes how to apply the TDF to achieve implementation objectives. Examples from the implementation research literature are presented to illustrate relevant methods and practical considerations. Methods: Researchers from Canada, the UK and Australia attended a 3-day meeting in December 2012 to build an international collaboration among researchers and decision-makers interested in the advancing use of the TDF. The participants were experienced in using the TDF to assess implementation problems, design interventions, and/or understand change processes. This guide is an output of the meeting and also draws on the a uthors' collective experience. Examples from the implementation research literature judged by authors to be representative of specific applications of the TDF are included in this guide. Results: We explain and illustrate methods, with a focus on qualitative approaches, for selecting and specifying target behaviours key to implementation, selecting the study design, deciding the sampling strategy, developing study materials, collecting and analysing data, and reporting findings of TDF-based studies. Areas for development include methods for triangulating data, e.g. from interviews, questionnaires and observation and methods for designing interventions based on TDF-based problem analysis. Conclusions: We offer this guide to the implementation community to assist in the application of the TDF to achieve implementation objectives. Benefits of using the TDF include the provision of a theoretical basis for implementation studies, good coverage of potential reasons for slow diffusion of evidence into practice and a method for progressing from theory-based investigation to intervention

Back to basics: Percentage agreement measures are adequate, but there are easier ways

Percentage agreement measures of interobserver agreement or “reliability” have traditionally been used to summarize observer agreement from studies using interval recording, time-sampling, and trial-scoring data collection procedures. Recent articles disagree on whether to continue using these percentage agreement measures, and on which ones to use, and what to do about chance agreements if their use is continued. Much of the disagreement derives from the need to be reasonably certain we do not accept as evidence of true interobserver agreement those agreement levels which are substantially probable as a result of chance observer agreement. The various percentage agreement measures are shown to be adequate to this task, but easier ways are discussed. Tables are given to permit checking to see if obtained disagreements are unlikely due to chance. Particularly important is the discovery of a simple rule that, when met, makes the tables unnecessary. If reliability checks using 50 or more observation occasions produce 10% or fewer disagreements, for behavior rates from 10% through 90%, the agreement achieved is quite improbably the result of chance agreement

Control of responding by the elements of a compound discriminative stimulus and by the elements as individual discriminative stimuli

In the first of two studies, the responding of four albino rats was differentially reinforced in the presence of noise and light together and then tested in the presence of the noise and the light separately during extinction. The light exercised substantially more control of responding than did the noise. In the second study the responding of a similar group of four rats was differentially reinforced in the presence of the noise and the light separately. Control of responding by the light developed more rapidly than control by the noise. Results suggest that levels of control by stimuli after differential reinforcement with respect to the stimuli together can be predicted by the rates of development of control during differential reinforcement with respect to the stimuli separately

Compounding of discriminative stimuli that maintain responding on separate response levers

In Experiment 1, rats' responses were reinforced on a fixed-interval 30-sec schedule in the presence of either a light or a tone and were not reinforced in their absence. Each stimulus was correlated with its own response lever, with only one lever present during a session. When light and tone were compounded in the presence of the tone-correlated lever, no change in responding occurred. However, when tone was compounded with light in the presence of the light-correlated lever, level of responding was greater than to light alone (response summation). Summation was also found when each stimulus was correlated with the same lever. Next, light and tone were again correlated with separate levers, but both levers were always simultaneously present. Compounding produced both summation and emission of most responses on the light-correlated lever. This prepotency of light was reduced (1) by leaving a houselight on throughout the session; and (2) by correlating each stimulus with a different schedule (either fixed-interval 4.7-sec or fixed-interval 30-sec). With a medium- and high-intensity houselight and with the different reinforcement schedules, similar results were obtained during compounding, regardless of whether compounding occurred in the presence of the light- or tone-correlated lever