Guiding the design and selection of interventions to influence the implementation of evidence-based practice: an experimental simulation of a complex intervention trial

Bonetti, Debbie; Eccles, Martin; Johnston, Marie; Steen, Nick; Grimshaw, Jeremy; Baker, Rachel; Walker, Anne; Pitts, Nigel

doi:10.1016/j.socscimed.2004.08.072

Cited by 93 publications

(98 citation statements)

References 17 publications

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“…24 Modelling process and outcomes: Modelling a complex intervention prior to a full scale evaluation can provide important information about the design of both the intervention and the evaluation (Case study 1). [25][26][27][28] One useful approach to modelling is to undertake a pre-trial economic evaluation. [29][30][31] This may identify weaknesses and lead to refinements, or it may show that a full-scale evaluation is unwarranted, for example because the effects are so small that a trial would have to infeasibly large (Case study 2).…”

Section: Figure 1 Key Elements Of the Development And Evaluation Processmentioning

confidence: 99%

Pragmatic Trials

2016

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Section: Figure 1 Key Elements Of the Development And Evaluation Processmentioning

confidence: 99%

Pragmatic Trials

2016

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“…Intervention modelling experiments (IMEs) are one way of doing this exploratory work [7] with some of the present study's authors (DB, MPE, JJF and NBP) involved in their development. In an IME key elements of the intervention are delivered, using a randomised design, in a manner that approximates the real world but where the measured outcome is generally an interim outcome, a proxy for the behaviour of interest.…”

Section: Introductionmentioning

confidence: 99%

A primary care Web-based Intervention Modeling Experiment replicated behavior changes seen in earlier paper-based experiment

Treweek

Francis

Bonetti

et al. 2016

Journal of Clinical Epidemiology

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Objectives: Intervention Modelling Experiment (IMEs) are a way of developing and testing behaviour change interventions prior to a trial. We aimed to test this methodology in a web-based IME that replicated the trial component of an earlier, paper-based IME.Study design and setting: Three-arm, web-based randomised evaluation of two interventions (persuasive communication and action plan) and a 'no intervention' comparator. The interventions were designed to reduce the number of antibiotic prescriptions in the management of uncomplicated upper respiratory tract infection.General practitioners (GPs) were invited to complete an online questionnaire and eight clinical scenarios where an antibiotic might be considered.Results: 129 GPs completed the questionnaire. GPs receiving the persuasive communication did not prescribe an antibiotic in 0.70 more scenarios (95% confidence interval = 0.17 to 1.24) than those in the control arm. For the action plan, GPs did not prescribe an antibiotic in 0.63 (95% CI = 0.11 to 1.15) more scenarios than those in the control arm. Unlike the earlier IME, behavioural intention was unaffected by the interventions; this may be due to a smaller sample size than intended. Conclusions:A web-based IME largely replicated the findings of an earlier paperbased study, providing some grounds for confidence in the IME methodology. prescribing behavior . The web-based IME did not replicate findings linked to behavioural intention.• Intervention effects were consistent across different modes of intervention What this adds to what is known• Replication studies are relatively rare. Using different modes of delivery, general practitioners from a different part of the UK and done seven years after the original study, this replication experiment demonstrated that the IME methodology can produce consistent results. What is the implication?• The IME methodology may potentially be considered as a way of developing theory-based behaviour change interventions prior to evaluation in a full-scale 8 of 21A CCEPTED MANUSCRIPT trial.

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“…The vignettes were designed to represent people with acute LBP who would typically present to physiotherapists. Vignettes for patients were based on the clinical presentation of acute LBP derived from the guideline, the Victorian evaluation of a media campaign for LBP [12] and from the North-East X-ray Utilisation (NEXUS) study in the UK, that evaluated the effectiveness of audit, feedback and educational reminders on ordering of lumbar spine and knee X-rays by GPs [13]. The physiotherapist and patient roles were designed to contextualise the vignettes.…”

Section: Survey Instrumentmentioning

confidence: 99%