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Translating qualitative data into intervention content using the Theoretical Domains Framework and stakeholder co-design : a worked example from a study of cervical screening attendance in older women
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Bravington, Alison, Chen, Hong, Dyson, Judith, Jones, Lesley, Dalgliesh, Christopher, Bryan, Amée, Patnick, Julietta and Macleod, Una (2022) Translating qualitative data into intervention content using the Theoretical Domains Framework and stakeholder co-design : a worked example from a study of cervical screening attendance in older women. BMC Health Services Research, 22 (1). 610. doi:10.1186/s12913-022-07926-2 ISSN 1472-6963.
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Official URL: https://doi.org/10.1186/s12913-022-07926-2
Abstract
Background: Previous screening interventions have demonstrated a series of features related to social determinants which have increased uptake in targeted populations, including the assessment of health beliefs and barriers to screening attendance as part of intervention development. Many studies cite the use of theory to identify methods of behaviour change, but fail to describe in detail how theoretical constructs are transformed into intervention content. The aim of this study was to use data from a qualitative exploration of cervical screening in women over 50 in the UK as the basis of intervention co-design with stakeholders using behavioural change frameworks. We describe the identification of behavioural mechanisms from qualitative data, and how these were used to develop content for a service-user leaflet and a video animation for practitioner training. The interventions aimed to encourage sustained commitment to cervical screening among women over 50, and to increase sensitivity to age-related problems in screening among primary care practitioners. Methods: Secondary coding of a qualitative data set to extract barriers and facilitators of cervical screening attendance. Barrier and facilitator statements were categorised using the Theoretical Domains Framework (TDF) to identify relevant behaviour change techniques (BCTs). Key TDF domains and associated BCTs were presented in stakeholder focus groups to guide the design of intervention content and mode of delivery. Results: Behavioural determinants relating to attendance clustered under three domains: beliefs about consequences, emotion and social influences, which mapped to three BCTs respectively: (1) persuasive communication/information provision; (2) stress management; (3) role modelling and encouragement. Service-user stakeholders translated these into three pragmatic intervention components: (i) addressing unanswered questions, (ii) problem-solving practitioner challenges and (iii) peer group communication. Based on (ii), practitioner stakeholders developed a call to action in three areas – clinical networking, history-taking, and flexibility in screening processes. APEASE informed modes of delivery (a service-user leaflet and a cartoon animation for practitioners). Conclusion: The application of the TDF to qualitative data can provide an auditable protocol for the translation of qualitative data into intervention content.
| Item Type: | Journal Article | ||||||
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| Subjects: | B Philosophy. Psychology. Religion > BF Psychology R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine R Medicine > RG Gynecology and obstetrics |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| SWORD Depositor: | Library Publications Router | ||||||
| Library of Congress Subject Headings (LCSH): | Cervix uteri -- Cancer -- Diagnosis, Medical screening, Vaginal smears, Older women -- Health and hygiene, Behavioral assessment | ||||||
| Journal or Publication Title: | BMC Health Services Research | ||||||
| Publisher: | BioMed Central | ||||||
| ISSN: | 1472-6963 | ||||||
| Official Date: | 6 May 2022 | ||||||
| Dates: |
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| Volume: | 22 | ||||||
| Number: | 1 | ||||||
| Article Number: | 610 | ||||||
| DOI: | 10.1186/s12913-022-07926-2 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||
| Date of first compliant deposit: | 7 June 2022 | ||||||
| Date of first compliant Open Access: | 8 June 2022 | ||||||
| RIOXX Funder/Project Grant: |
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