Improving Collaborative Behaviour Planning in Adult Auditory Rehabilitation: Development of the I-PLAN Intervention Using the Behaviour Change Wheel

Abstract

Background The consequences of poorly managed hearing loss can be ameliorated with hearing aid use but rates of use are sub-optimal. The impact of audiologist behaviour on subsequent use, particularly over the long term, is unknown. Purpose This study aimed to describe the role of the behaviour change wheel in developing an intervention to introduce and embed particular clinical behaviours into adult hearing aid fitting consultations, within the framework of the Medical Research Council guidance on complex interventions. Methods Following the steps of the behaviour change wheel, audiologist behaviours that might influence hearing aid use were identified based on a systematic review and qualitative work with audiologists. An analysis, using the COM-B model, identified potential drivers of the target behaviours. This was used to select intervention functions and behaviour change techniques likely to influence behaviour in this context. Results The target behaviours were as follows: giving information about the benefits of hearing aid use and the negative consequences of non-use, providing prompts for use and engaging in collaborative behavioural planning for use. The behavioural analysis suggested that psychological capability, opportunity and motivation were potential drivers of these behaviours. The intervention functions of education, coercion, training, environmental restructuring, modelling and enablement were selected and combined to develop a single complex intervention that seeks to address the target behaviours. Conclusions This is the first study to use the behaviour change wheel to develop a complex intervention in the context of audiology. The theory-based development of the intervention will facilitate evaluation of its feasibility and effectiveness.

‘It's difficult, I think it's complicated’: Health care professionals’ barriers and enablers to providing opportunistic behaviour change interventions during routine medical consultations

“…The COM‐B model comprises six components that are hypothesized to drive behaviour, namely: physical capability (e.g., skills), psychological capability (e.g., knowledge), physical opportunity (e.g., time), social opportunity (e.g., social cues), reflective motivation (e.g., intentions), and automatic motivation (e.g., emotional reactions; Michie et al ., , ). The COM‐B model has been used previously in other areas of health care professional practice (Alexander, Brijnath, & Mazza, ; Barker, de Lusignan, & Cooke, ), but not across disciplines or in the domain of opportunistic behaviour change intervention. Using the COM‐B model to tailor the interview questions allowed us to: (1) obtain a broad understanding of the barriers and enablers to opportunistic behaviour change intervention, (2) use the Theoretical Domains Framework (TDF; described below) to identify the emergent themes that were generated from the data, and (3) link the respective components of the COM‐B model directly to the analytical framework (the TDF) to provide a focused analysis that highlighted the barriers and enablers to this area of professional practice (Cane, O'Connor, & Michie, ).…”

Barriers to and enablers of the implementation of an ICF-based intake tool in clinical otology and audiology practice—A qualitative pre-implementation study

“…Moreover, many of these theories use overlapping constructs and lack guidance for selecting the best one [36]. The Capability Opportunity Motivation-Behavior (COM-B) model was developed by integrating concepts from 19 frameworks of behavior change identified in a systematic review by Michie and colleagues (2011) [28] and has been applied successfully by others in the context of hearing health care [37, 38].…”

Breaking barriers: using the Behavior Change Wheel to develop a tailored intervention to overcome workplace inhibitors to breaking up sitting time

“…Use of these criteria allow researchers to look beyond the BCW and explore feasibility issues before trialling an intervention. Using the BCW to design interventions is becoming more common, and it has been successfully used to understand behaviour change in different contexts, such as sexual counselling [48], medication management [49,50], auditory rehabilitation [51], and physical activity [52]. Development of interventions using the full BCW to reduce workplace sitting however, is limited, with only the Stand More AT Work (SMArT) study found to target hospital office workers [53].…”