Improving Diabetes care through Examining, Advising, and prescribing IDEA: protocol for a theory-based cluster randomised controlled trial of a multiple behaviour change intervention aimed at primary healthcare professionalsReport as inadecuate




Improving Diabetes care through Examining, Advising, and prescribing IDEA: protocol for a theory-based cluster randomised controlled trial of a multiple behaviour change intervention aimed at primary healthcare professionals - Download this document for free, or read online. Document in PDF available to download.

Implementation Science

, 9:61

First Online: 24 May 2014Received: 26 February 2014Accepted: 15 May 2014DOI: 10.1186-1748-5908-9-61

Cite this article as: Presseau, J., Hawthorne, G., Sniehotta, F.F. et al. Implementation Sci 2014 9: 61. doi:10.1186-1748-5908-9-61

Abstract

BackgroundNew clinical research findings may require clinicians to change their behaviour to provide high-quality care to people with type 2 diabetes, likely requiring them to change multiple different clinical behaviours. The present study builds on findings from a UK-wide study of theory-based behavioural and organisational factors associated with prescribing, advising, and examining consistent with high-quality diabetes care.

AimTo develop and evaluate the effectiveness and cost of an intervention to improve multiple behaviours in clinicians involved in delivering high-quality care for type 2 diabetes.

Design-methodsWe will conduct a two-armed cluster randomised controlled trial in 44 general practices in the North East of England to evaluate a theory-based behaviour change intervention. We will target improvement in six underperformed clinical behaviours highlighted in quality standards for type 2 diabetes: prescribing for hypertension; prescribing for glycaemic control; providing physical activity advice; providing nutrition advice; providing on-going education; and ensuring that feet have been examined. The primary outcome will be the proportion of patients appropriately prescribed and examined using anonymised computer records, and advised using anonymous patient surveys at 12 months. We will use behaviour change techniques targeting motivational, volitional, and impulsive factors that we have previously demonstrated to be predictive of multiple health professional behaviours involved in high-quality type 2 diabetes care. We will also investigate whether the intervention was delivered as designed fidelity by coding audiotaped workshops and interventionist delivery reports, and operated as hypothesised process evaluation by analysing responses to theory-based postal questionnaires. In addition, we will conduct post-trial qualitative interviews with practice teams to further inform the process evaluation, and a post-trial economic analysis to estimate the costs of the intervention and cost of service use.

DiscussionConsistent with UK Medical Research Council guidance and building on previous development research, this pragmatic cluster randomised trial will evaluate the effectiveness of a theory-based complex intervention focusing on changing multiple clinical behaviours to improve quality of diabetes care.

Trial registrationISRCTN66498413.

Electronic supplementary materialThe online version of this article doi:10.1186-1748-5908-9-61 contains supplementary material, which is available to authorized users.

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Author: Justin Presseau - Gillian Hawthorne - Falko F Sniehotta - Nick Steen - Jill J Francis - Marie Johnston - Joan Mackintosh

Source: https://link.springer.com/







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