Translating qualitative data into intervention content using the Theoretical Domains Framework and stakeholder co-design: A worked example from a study of cervical screening attendance in older women

Bravington, Alison and Chen, Hong and Dyson, Judith and Jones, Lesley and Dalgliesh, Christopher and Bryan, Amee and Patnick, Julietta and Macleod, Una (2022) Translating qualitative data into intervention content using the Theoretical Domains Framework and stakeholder co-design: A worked example from a study of cervical screening attendance in older women. BMC Health Services Research, 22. p. 610. ISSN 1472-6963

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Background: Previous screening interventions have demonstrated a series of features related to social determinants which have increased uptake in targeted populations, including the assessment of health beliefs and barriers to screening attendance as part of intervention development. Many studies cite the use of theory to identify methods of behaviour change, but fail to describe in detail how theoretical constructs are transformed into intervention content. The aim of this study was to use data from a qualitative exploration of cervical screening in women over fifty in the UK as the basis of intervention co-design with stakeholders using behavioural change frameworks. We describe the identification of behavioural mechanisms from qualitative data, and how these were used to develop content for a service-user leaflet and a video animation for practitioner training. The interventions aimed to encourage sustained commitment to cervical screening among women over fifty, and to increase sensitivity to age-related problems in screening among primary care practitioners.
Methods: Secondary coding of a qualitative data set to extract barriers and facilitators of cervical screening attendance. Barrier and facilitator statements were categorised using the Theoretical Domains Framework (TDF) to identify relevant behaviour change techniques (BCTs). Key TDF domains and associated BCTs were presented in stakeholder focus groups to guide the design of intervention content and mode of delivery.
Results: Behavioural determinants relating to attendance clustered under three domains: beliefs about consequences, emotion and social influences, which mapped to three BCTs respectively: (1) persuasive communication/information provision; (2) stress management; (3) role modelling and encouragement. Service-user stakeholders translated these into three pragmatic intervention components: (i) addressing unanswered questions, (ii) problem-solving practitioner challenges and (iii) peer group communication. Based on (ii), practitioner stakeholders developed a call to action in three areas – clinical networking, history-taking, and flexibility in screening processes. APEASE informed modes of delivery (a service-user leaflet and a cartoon animation for practitioners). Conclusion: The application of the TDF to qualitative data can provide an auditable protocol for the translation of qualitative data into intervention content.

Item Type: Article
Identification Number:
12 April 2022Accepted
6 May 2022Published Online
Uncontrolled Keywords: cervical screening, qualitative, behaviour change, theoretical domains framework, stakeholder involvement, intervention development
Subjects: CAH02 - subjects allied to medicine > CAH02-04 - nursing and midwifery > CAH02-04-01 - nursing (non-specific)
CAH04 - psychology > CAH04-01 - psychology > CAH04-01-02 - applied psychology
Divisions: Faculty of Health, Education and Life Sciences > Centre for Social Care, Health and Related Research (C-SHARR)
Depositing User: Judith Dyson
Date Deposited: 20 Apr 2022 12:27
Last Modified: 13 May 2022 16:05

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