Identifying behaviour change techniques reported in trials of implementation interventions to improve diabetes healthcare

Abstract

Background: Interventions to improve healthcare quality often describe intervention strategies at a level of abstraction that sometimes lacks clarity on what specifically is involved. New taxonomies of behaviour change techniques (BCTs) may provide a novel approach to characterizing the detailed content of such interventions. Aim: identify which BCTs are reported in interventions within an existing systematic review of 142 trials of quality improvement (QI) interventions. Methods: Two psychologists independently coded 142 interventions in trials included in Tricco et al’s (2012) review of diabetes QI interventions, using the BCT taxonomy version 1 (BCTTv1), separately coding BCTs targeting healthcare professional or patient behaviour. Findings: 26/93 healthcare professional-focused BCTs were identified. The five most frequently identified BCTs were: Adding objects to the environment [66 trials], Social support (practical) [57], Instruction on how to perform the behaviour [55], Restructuring the social environment [55], and Prompts and cues [35]. 38/93 patient-focused BCTs were identified. The five most frequently identified BCTs were: Instruction on how to perform the behaviour [94], Information on health consequences [84], Restructuring the social environment [84], Prompts/cues [73], and Adding objects to the environment [57]. Discussion: The BCTTv1 was applicable to both health professional and patient behaviour and provided a feasible approach for characterizing implementation intervention content. The pattern of BCTs highlights a reliance on a subset of possible BCTs in this literature, suggesting opportunities for novel intervention design. Describing implementation interventions at the behaviour change technique level may help to promote better fidelity and replication of interventions designed to improve healthcare.