Table 2 Illustrative examples of mapping intervention components to intervention functions based on the TDF
From: Co-designing a theory-informed intervention to increase shared decision-making in maternity care
TDF domain (study 2) | Sub-theme from study 2 | Intervention function | BCTs identified using the Theory & Techniques Tool | Example from intervention |
|---|---|---|---|---|
Knowledge | Patients don’t know their options, risks and benefits | Education | 5.1 Information about health consequences | Use online videos to explain options, risks and benefits (intervention 1) |
5.3 Information about social and environmental consequences | Use online video to promote shared record of patient notes (intervention 1) | |||
Skills | Clinicians feel they don’t have the skill or experience to practise SDM but believe experience is the best facilitator of SDM | Training | 4.1 Instruction on how to perform the behaviour 6.1 Demonstration of the behaviour 8.1 Behavioural practice and rehearsal | Clinical champions trained in how to have SDM conversation around pain management in labour for different scenarios (intervention 3) Junior clinicians provided clinical education sessions using the simulation lab to practise using SDM for pain management conversations (intervention 3) |
Environment, context and resources | Stakeholders believe patients need more time to consider their options | Environmental restructuring | 12.5 Adding objects to the environment | Provide access to their record via the patient portal prior to the patient’s first appointment at 18–20 weeks (intervention 1) |
7.1 Prompts/cues | Prompt patients to complete the record using antenatal clinic reception staff (intervention 1) Prompts clinicians to go through the record during their allotted time using the EMR (intervention 1) | |||
Social/professional role and identity | Clinicians believe patients should be involved in decisions about their care, but are uncertain whether their colleagues agree | Persuasion | 9.1 Credible source 6.3 Information about others’ approval | Communications campaign raising awareness of other clinicians agreeing with and using SDM in practice (Intervention 2) |
Clinicians feel supported to practise SDM when there is a clear mission statement promoting SDM | Persuasion | 9.1 Credible source 6.3 Information about others’ approval | Communications campaign raising awareness of health service’s commitment to SDM (intervention 2) | |
Patients believe they should be included in decisions about their care | Persuasion | 9.1 Credible source | Communications campaign raising awareness of SDM and pain management options (intervention 2) | |
Stakeholders believe junior clinicians are not provided adequate role modelling for SDM | Modelling | 6.1 Demonstration of the behaviour 6.2 Social comparison | Clinical champions promoted to the cohort as being able to assist others practising SDM and answering questions (intervention 3) Junior clinicians provided a tool to observe instances of SDM they see in practice (intervention 3) |