A nudge in the right direction: developing guidance on changing behaviour

Swann, Catherine; Owen, Lesley; Carmona, Chris; Kelly, Michael P.; Wohlgemuth, Clare; Huntley, Jane

doi:10.1093/acprof:oso/9780199563623.003.024

Cited by 2 publications

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“…The NBHW used its standard guideline development model with small adjustments to fit the prevention focus. The unusually complex development process that respondents found frustrating might reflect difficulties that come with matching public health interventions to the prevailing medical evidence system [ 8 , 40 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

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Addressing implementation challenges during guideline development – a case study of Swedish national guidelines for methods of preventing disease

Sundberg

Kardakis

Weinehall

et al. 2015

BMC Health Serv Res

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BackgroundMany of the world’s life threatening diseases (e.g. cancer, heart disease, stroke) could be prevented by eliminating life-style habits such as tobacco use, unhealthy diet, physical inactivity and excessive alcohol use. Incorporating evidence-based research on methods to change unhealthy lifestyle habits in clinical practice would be equally valuable. However gaps between guideline development and implementation are well documented, with implications for health care quality, safety and effectiveness. The development phase of guidelines has been shown to be important both for the quality in guideline content and for the success of implementation. There are, however, indications that guidelines related to general disease prevention methods encounter specific barriers compared to guidelines that are diagnosis-specific. In 2011 the Swedish National board for Health and Welfare launched guidelines with a preventive scope. The aim of this study was to investigate how implementation challenges were addressed during the development process of these disease preventive guidelines.MethodsSeven semi-structured interviews were conducted with members of the guideline development management group. Archival data detailing the guideline development process were also collected and used in the analysis. Qualitative data were analysed using content analysis as the analytical framework.ResultsThe study identified several strategies and approaches that were used to address implementation challenges during guideline development. Four themes emerged from the analysis: broad agreements and consensus about scope and purpose; a formalized and structured development procedure; systematic and active involvement of stakeholders; and openness and transparency in the specific guideline development procedure. Additional factors concerning the scope of prevention and the work environment of guideline developers were perceived to influence the possibilities to address implementation issues.ConclusionsThis case study provides examples of how guideline developers perceive and approach the issue of implementation during the development and early launch of prevention guidelines. Models for guideline development could benefit from an initial assessment of how the guideline topic, its target context and stakeholders will affect the upcoming implementation.

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Section: Discussionmentioning

confidence: 99%

“…Community-level interventions may show significant effects in large populations, but small effects on the individual level. In preventive studies, many RCTs lack adequate power, leading to relatively weak evidence and uncertainty about outcomes [ 4 , 40 , 41 ].…”

Section: Introductionmentioning

confidence: 99%

Addressing implementation challenges during guideline development – a case study of Swedish national guidelines for methods of preventing disease

Sundberg

Kardakis

Weinehall

et al. 2015

BMC Health Serv Res

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“…On the one hand an incentive can be seen as rewarding bad behavior and on the other a disincentive can have the effect of alienating the group it is intended to reach. In healthcare goal setting and rewards have been shown to influence behavior at department or ward level [15] yet these changes can be short lived after the reward has been provided. Involving staff in appropriate rewards for changes in systems or practice can be beneficial.…”

Section: Discussionmentioning

confidence: 99%

Facilitating Sustainable Waste Management Behaviors Within the Health Sector: A Case Study of the National Health Service (NHS) in Southwest England, UK

et al. 2012

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Waste costs the National Health Service (NHS) £71.2 million in 2007/2008; recycling all papers, newspapers and cardboard produced by the NHS in England and Wales could save up to 42,000 tonnes of CO 2. As the largest employer in the UK, the NHS is in a prime position to both lead the way towards a sustainable future, but also act as a test bed for organizational change and provide evidence of what works at an individual level to change attitudes and behavior. However these require changes in mindset, including values, attitudes, norms and behaviors which are required along with clear definitions of the problems faced in terms of economics, society and culture. Initial investigations of the literature indicate that behavior change theory may provide a feasible means of achieving constructive changes in clinical waste management; such approaches require further investigation. This paper describes a feasibility study designed to examine issues that might affect the introduction of a behavior change strategy and improve waste management in a healthcare setting. Guided by the evidence gained from our systematic review, 20 interviews were carried out with senior managers, clinicians and support staff involved in the management of healthcare waste from a broad range of agencies in South West England. Interviews were audio-recorded and transcribed for analysis. Thematic content analysis was conducted in order to identify key issues and actions. Data extraction, coding and analysis were cross checked independently by the four members of the research OPEN ACCESSSustainability 2012, 4 631 team. Initial findings suggest tensions, between Government and local policies, between packaging and storage space at ward level and, and between the operational requirements of infection control and maintaining appropriate and ethical patient care. These tensions increase pressures on staff already trying to maintain high quality care in a resource restricted and changing environment.

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A nudge in the right direction: developing guidance on changing behaviour

Cited by 2 publications

References 0 publications

Addressing implementation challenges during guideline development – a case study of Swedish national guidelines for methods of preventing disease

Addressing implementation challenges during guideline development – a case study of Swedish national guidelines for methods of preventing disease

Facilitating Sustainable Waste Management Behaviors Within the Health Sector: A Case Study of the National Health Service (NHS) in Southwest England, UK

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