Developing theory-informed interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework

Background: There is little systematic operational guidance about how best to develop complex interventions to reduce the gap between practice and evidence. This article is one in a series of articles documenting the development and use of the Theoretical Domains Framework (TDF) to advance the science of implementation research. Methods: The intervention was developed considering three main components: theory, evidence, and practical issues. We used a four-step approach, consisting of guiding questions, to direct the choice of the most appropriate components of an implementation intervention: Who needs to do what, differently? Using a theoretical framework, which barriers and enablers need to be addressed? Which intervention components (behaviour change techniques and mode(s) of delivery) could overcome the modifiable barriers and enhance the enablers? And how can behaviour change be measured and understood? Results: A complex implementation intervention was designed that aimed to improve acute low back pain management in primary care. We used the TDF to identify the barriers and enablers to the uptake of evidence into practice and to guide the choice of intervention components. These components were then combined into a cohesive intervention. The intervention was delivered via two facilitated interactive small group workshops. We also produced a DVD to distribute to all participants in the intervention group. We chose outcome measures in order to assess the mediating mechanisms of behaviour change. Conclusions: We have illustrated a four-step systematic method for developing an intervention designed to change clinical practice based on a theoretical framework. The method of development provides a systematic framework that could be used by others developing complex implementation interventions. While this framework should be iteratively adjusted and refined to suit other contexts and settings, we believe that the four-step process should be maintained as the primary framework to guide researchers through a comprehensive intervention development process

Evidence for Differential Rotation on a T Tauri Star

Five years of photometric monitoring of the T Tauri star HBC 338 in NGC 1333 has revealed that it is a periodic variable, but the period has changed significantly with time. From 2000-2003, a period near 5.6 days was observed, while in the last two seasons, the dominant period is near 4.6 days. No other T Tauri star has been seen to change its period by such a large percentage. We propose a model in which a differentially rotating star is seen nearly equator-on and a high latitude spot has gradually been replaced by a low latitude spot. We show that this model provides an excellent fit to the observed shapes of the light curves at each epoch. The amplitude and sense of the inferred differential rotation is similar to what is seen on the Sun. This may be surprising given the likely high degree of magnetic surface activity on the star relative to the Sun but we note that HBC 338 is clearly an exceptional T Tauri star.Comment: Acepted for publication in PAS

The spiritual revolution and suicidal ideation: an empirical enquiry among 13- to 15-year-old adolescents in England and Wales

The association between conventional religiosity and suicide inhibition has been well explored and documented since the pioneering work of Durkheim. Commentators like Heelas and Woodhead point to ways in which conventional religiosity is giving way in England and Wales to a range of alternative spiritualities, including renewed interest in paranormal phenomena. Taking a sample of 3095 13- to 15-year-old adolescents, the present study examines the association between suicidal ideation and both conventional religiosity and paranormal beliefs, after controlling for individual differences in sex, age and personality (extraversion, neuroticism and psychoticism). The data demonstrate that, while conventional religiosity is slightly associated with lower levels of suicidal ideation, paranormal beliefs are strongly associated with higher levels of suicidal ideation

Seismic vulnerability assessment: Methodological elements and applications to the case of Romania

This paper is intended to present some studies undertaken in order to develop a seismic vulnerability estimation system to fit the needs of development of earthquake scenarios and of development of an integrated disaster risk management system for Romania. Methodological aspects are dealt with, in connection with the criteria of categorization of buildings, with the definition of parameters used for characterizing vulnerability, with the setting up of an inventory of buildings and with the calibration of parameters characterizing vulnerability. Action was initiated along the coordinates referred to in connection with the methodological aspects mentioned above. The approach was made, as far as possible, specific to the conditions of Romania. Some data on results obtained to date are presented.seismic vulnerability, vulnerability estimation, earthquake scenarios, categorization of buildings, inventory of buildings, expected earthquake impact

Using shared goal setting to improve access and equity: a mixed methods study of the Good Goals intervention

Background: Access and equity in children’s therapy services may be improved by directing clinicians’ use of resources toward specific goals that are important to patients. A practice-change intervention (titled ‘Good Goals’) was designed to achieve this. This study investigated uptake, adoption, and possible effects of that intervention in children’s occupational therapy services. Methods: Mixed methods case studies (n = 3 services, including 46 therapists and 558 children) were conducted. The intervention was delivered over 25 weeks through face-to-face training, team workbooks, and ‘tools for change’. Data were collected before, during, and after the intervention on a range of factors using interviews, a focus group, case note analysis, routine data, document analysis, and researchers’ observations. Results: Factors related to uptake and adoptions were: mode of intervention delivery, competing demands on therapists’ time, and leadership by service manager. Service managers and therapists reported that the intervention: helped therapists establish a shared rationale for clinical decisions; increased clarity in service provision; and improved interactions with families and schools. During the study period, therapists’ behaviours changed: identifying goals, odds ratio 2.4 (95% CI 1.5 to 3.8); agreeing goals, 3.5 (2.4 to 5.1); evaluating progress, 2.0 (1.1 to 3.5). Children’s LoT decreased by two months [95% CI −8 to +4 months] across the services. Cost per therapist trained ranged from £1,003 to £1,277, depending upon service size and therapists’ salary bands. Conclusions: Good Goals is a promising quality improvement intervention that can be delivered and adopted in practice and may have benefits. Further research is required to evaluate its: (i) impact on patient outcomes, effectiveness, cost-effectiveness, and (ii) transferability to other clinical contexts

Measuring attitude toward theistic faith : assessing the Astley-Francis Scale among Christian, Muslim and secular youth in England

Empirical research within the social scientific study of religion in general and within the psychology of religion in particular remains very conscious of the complex nature of its subject matter. Empirical research in this field needs to take cognisance of the many forms in which religion is expressed (say, Buddhism, Christianity, Hinduism, Islam, Judaism, and Sikhism) and the many facets within the forms (say, beliefs, behaviours and affiliation). Working in the 1970s, Francis (1978a; 1978b) advanced the view that the attitudinal dimension of religion offered a particularly fruitful basis for coordinating empirical enquiry into the correlates, antecedents and consequences of religiosity across the life span

Marriage, religion and human flourishing: how sustainable is the classic Durkheim thesis in contemporary Europe?

This paper draws on the three waves of the European Values Survey across five countries (Great Britain, Italy, the Netherlands, Northern Ireland, Spain and Sweden) to investigate the relationship between indicators of positive psychology (conceptualised as feelings of happiness and satisfaction with life), religiosity (conceptualised as self-assigned religious affiliation and self-reported religious attendance) and marital status. The results demonstrate that religiosity is, in general, positively correlated with both indicators of positive psychology. Further, across all waves and all countries, the pattern emerges that those respondents who are married are likely to report higher levels of happiness and greater satisfaction in life. These data provide contemporary support for the classic Durkheim thesis linking the two institutions of marriage and religion with human flourishing

Survey Instrument for Gender Based Violence

This is a proposal for the design of a survey on gender-based violence across Europe. It introduces the purpose of the survey, which shapes the priorities embedded in the proposed design. It identifies the major issues involved in operationalising the concept of gender-based violence for a survey. It identifies some technical issues and how they are best addressed. The focus is on the questionnaire, largely leaving to one side the design of the survey and its strategy for issues such as sampling. This proposal draws on experience of a wide range of surveys and draws on selected parts of the architecture and questionnaire of the Crime Survey for England and Wales (CSEW), modified to fit the present priorities

Pressure-induced transition from the dynamic to static Jahn-Teller effect in (Ph4_{4}P)2_{2}IC60_{60}

High-pressure infrared transmission measurements on \PhC60 were performed up to 9 GPa over a broad frequency range (200 - 20000 cm$^{-1}$) to monitor the vibrational and electronic/vibronic excitations under pressure. The four fundamental T$_{1u}$ modes of \C60a\ are split into doublets already at the lowest applied pressure and harden with increasing pressure. Several cation modes and fullerene-related modes split into doublets at around 2 GPa, the most prominent one being the G$_{1u}$ mode. The splitting of the vibrational modes can be attributed to the transition from the dynamic to static Jahn-Teller effect, caused by steric crowding at high pressure. Four absorption bands are observed in the NIR-VIS frequency range. They are discussed in terms of transitions between LUMO electronic states in \C60a, which are split because of the Jahn-Teller distortion and can be coupled with vibrational modes. Various distortions and the corresponding symmetry lowering are discussed. The observed redshift of the absorption bands indicates that the splitting of the LUMO electronic states is reduced upon pressure application.Comment: 10 pages, 17 figure