A Oakley

Bernard L Croal

CJ Armitage

CR May

Craig R Ramsay

G Godin

I Ajzen

J Grimshaw

Jeremy M Grimshaw

JJ Francis

JM Grimshaw

JS Long

JV Cook

KJ Preacher

L Kish

Martin P Eccles

MP Eccles

P Davies

RE Thomas

Ruth E Thomas

S Michie

SM Kerry

TL Webb

Implementation Science

English

PubMed

Abstract Background Randomised trials of knowledge translation strategies for professional behaviour change can provide robust estimates of effectiveness, but offer little insight into the causal mechanisms by which any change is produced. To illustrate the applicability of causal methods within randomised trials, we undertook a theory-based process evaluation study within an implementation trial to explore whether the cognitions of primary care doctors' predicted their test requesting behaviours and, secondly, whether the trial results were mediated by the theoretical constructs. Methods The process evaluation comprised a cross-sectional questionnaire survey of a random 50% sample of the randomised groups of primary care practices in Grampian (NHS Grampian), UK, who took part in a trial of the effect of enhanced feedback and brief educational reminders on test requesting behaviour. The process evaluation was based upon the Theory of Planned Behaviour and focussed on three of the test requesting behaviours that were targeted in the trial -- ferritin, follicle stimulating hormone (FSH), and Helicobacter Pylori serology (HPS). Results The questionnaire was completed by 131 primary care doctors (56%) from 42 (98%) of the sampled practices. Behavioural intention, attitude, and subjective norm were highly correlated for all the tests. There was no evidence that perceived behavioural control was correlated with any of the other measures. Simple linear regression analysis of the rate of test requests on minimum behavioural intentions had R2 of 11.1%, 12.5%, and 0.1% for ferritin, FSH, and HPS requesting, respectively. Mediational analysis showed that the trial results for ferritin and FSH were partially mediated (between 23% and 78% mediation) through intentions. The HPS trial result was not mediated through intention. Conclusions This study demonstrated that a theory-based process evaluation can provide useful information on causal mechanisms that aid not only interpretation of the trial but also inform future evaluations and intervention development.</p

Grimshaw Jeremy M

Croal Bernard L

Thomas Ruth E

Ramsay Craig R

Eccles Martin P

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Using the theory of planned behaviour as a process evaluation tool in randomised trials of knowledge translation strategies: A case study from UK primary care

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Ramsay, Craig R.

Thomas, Ruth E.

Croal, Bernard L.

Grimshaw, Jeremy M.

Eccles, Martin P.

Research Archive

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Using the theory of planned behaviour as a process evaluation tool in randomised trials of knowledge translation strategies : A case study from UK primary care

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Using the theory of planned behaviour as a process evaluation tool in randomised trials of knowledge translation strategies : A case study from UK primary care

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Directory of Open Access Journals

Springer - Publisher Connector

Crossref

Research Archive

Springer - Publisher Connector