Answering the call for evidence-based telephone support: an intervention development study

Abstract

Background: Behaviour change strategies may fall at the first hurdle if recipients fail to engage with intervention materials. One approach to increasing engagement is to incorporate telephone support as a co-intervention. We developed a theory-based online toolkit intervention to support hospital transfusion teams responding to feedback about their transfusion practice, delivered within a cluster-randomised controlled trial. To encourage engagement with the online toolkit, a telephone support co-intervention was developed to prompt staff to login and to facilitate toolkit usage. This study describes the development, content and delivery of the telephone support co-intervention. Method: A Behaviour Change Technique (BCT) taxonomy was used to specify intervention components. BCT coding of a) face-to-face demonstrations to support toolkit usage; b) descriptions of existing telephone-based co-interventions, identified via scoping searches, were used to shortlist BCTs. A consensus approach was used to select BCTs for the co-intervention. A co-intervention flowchart and manual were developed to maximise fidelity of delivery and prompt BCT delivery. The manual, including if-then scenarios, was used for training intervention facilitators. Telephone support was intended to be delivered to all hospitals receiving the toolkit intervention (N=71). Findings: Selected BCTs were ‘prompts/cues,’ ‘credible-source,’ ‘social-support (practical),’ ‘information on social and environmental consequences,’ ‘instruction on how to perform the behaviour,’ ‘action-planning,’ ‘problem-solving,’ ‘social-support (unspecified)’. Telephone support was successfully delivered to 63 hospital contacts (89%), with 51 (72%) logging into the toolkit during the call. Conclusions: We describe methods for developing evidence-based telephone support co-interventions with potential to be replicated beyond this context to enhance intervention engagement.