Examining the complementarity between the ERIC compilation of implementation strategies and the behaviour change technique taxonomy: a qualitative analysis

Abstract

Background Efforts to generate evidence for implementation strategies are frustrated by insufficient description. The Expert Recommendations for Implementing Change (ERIC) compilation names and defines implementation strategies; however, further work is needed to describe the actions involved. One potentially complementary taxonomy is the behaviour change techniques (BCT) taxonomy. We aimed to examine the extent and nature of the overlap between these taxonomies. Methods Definitions and descriptions of 73 strategies in the ERIC compilation were analysed. First, each description was deductively coded using the BCT taxonomy. Second, a typology was developed to categorise the extent of overlap between ERIC strategies and BCTs. Third, three implementation scientists independently rated their level of agreement with the categorisation and BCT coding. Finally, discrepancies were settled through online consensus discussions. Additional patterns of complementarity between ERIC strategies and BCTs were labelled thematically. Descriptive statistics summarise the frequency of coded BCTs and the number of strategies mapped to each of the categories of the typology. Results Across the 73 strategies, 41/93 BCTs (44%) were coded, with ‘restructuring the social environment’ as the most frequently coded (n=18 strategies, 25%). There was direct overlap between one strategy (change physical structure and equipment) and one BCT (‘restructuring physical environment’). Most strategy descriptions (n=64) had BCTs that were clearly indicated (n=18), and others where BCTs were probable but not explicitly described (n=31) or indicated multiple types of overlap (n=15). For some strategies, the presence of additional BCTs was dependent on the form of delivery. Some strategies served as examples of broad BCTs operationalised for implementation. For eight strategies, there were no BCTs indicated, or they did not appear to focus on changing behaviour. These strategies reflected preparatory stages and targeted collective cognition at the system level rather than behaviour change at the service delivery level. Conclusions This study demonstrates how the ERIC compilation and BCT taxonomy can be integrated to specify active ingredients, providing an opportunity to better understand mechanisms of action. Our results highlight complementarity rather than redundancy. More efforts to integrate these or other taxonomies will aid strategy developers and build links between existing silos in implementation science.

Tracking, naming, specifying, and comparing implementation strategies for person-centred care in a real-world setting: a case study with seven embedded units

“…Moreover, some of the clusters in ERIC [ 40 ] are clearly directed towards the action target (e.g., Train and educate stakeholders or Support clinicians) , making the coding even more challenging. Our observations are in line with other studies that have highlighted some discrepancies concerning the level of detail across different ERIC strategies [ 7 , 54 , 55 ]. We also acknowledge that other ways of clustering ERIC strategies have been applied in other research initiatives to suit different study objectives [ 2 , 7 , 8 , 10 , 54 ].…”

Strategies for de-implementation of low-value care—a scoping review

“…Finally, it is unknown if we would have received other results if we had coded the data based on another taxonomy. Future studies could investigate how de-implementation strategies differ depending on which taxonomy is used to code the strategies (e.g., [109]).…”

Refining Expert Recommendations for Implementing Change (ERIC) strategy surveys using cognitive interviews with frontline providers

“…ERIC includes multifaceted strategies that combine multiple discrete strategies and strategy bundles and ERIC strategies are variably specified (e.g., some include the actor and dose and others do not), which impacted interpretation. While there is a push for focusing on the mechanisms underlying the strategies [ 19 – 22 ], we found that clinicians wanted concrete, relatable activities to respond to. The same strategies can be used for different purposes, and different strategies may be targeting the same mechanism of behavior change.…”