Theoretical domains, component constructs, and eliciting questions for investigating the implementation of evidence-based practice
| Domains* | Constructs | Interview questions |
|---|---|---|
| *Corresponding constructs from Fishbein et al16 shown in parentheses. | ||
| (1) Knowledge | Knowledge | Do they know about the guideline? |
| Knowledge about condition/scientific rationale | What do they think the guideline says? | |
| Schemas+mindsets+illness representations | What do they think the evidence is? | |
| Procedural knowledge | Do they know they should be doing x? | |
| Do they know why they should be doing x? | ||
| (2) Skills (Skills) | Skills | Do they know how to do x? |
| Competence/ability/skill assessment | How easy or difficult do they find performing x to the required standard in the required context? | |
| Practice/skills development | ||
| Interpersonal skills | ||
| Coping strategies | ||
| (3) Social/professional role and identity (Self-standards) | Identity | What is the purpose of the guidelines? |
| Professional identity/boundaries/role | What do they think about the credibility of the source? | |
| Group/social identity | Do they think guidelines should determine their behaviour? | |
| Social/group norms Alienation/organisational commitment | Is doing x compatible or in conflict with professional standards/identity? (prompts: moral/ethical issues, limits to autonomy) | |
| Would this be true for all professional groups involved? | ||
| (4) Beliefs about capabilities (Self-efficacy) | Self-efficacy Control—of behaviour and material and | How difficult or easy is it for them to do x? (prompt re. internal and external capabilities/constraints) |
| social environment | What problems have they encountered? | |
| Perceived competence | What would help them? | |
| Self-confidence/professional confidence | How confident are they that they can do x despite the difficulties? | |
| Empowerment | How capable are they of maintaining x? | |
| Self-esteem | How well equipped/comfortable do they feel to do x? | |
| Perceived behavioural control | ||
| Optimism/pessimism | ||
| (5) Beliefs about consequences (Anticipated outcomes/attitude) | Outcome expectancies Anticipated regret Appraisal/evaluation/review | What do they think will happen if they do x? (prompt re themselves, patients, colleagues and the organisation; positive and negative, short term and long term consequences) |
| Consequents | What are the costs of x and what are the costs of the consequences of x? | |
| Attitudes | What do they think will happen if they do not do x? (prompts) | |
| Contingencies | Do benefits of doing x outweigh the costs? | |
| Reinforcement/punishment/consequences | How will they feel if they do/don’t do x? (prompts) | |
| Incentives/rewards | Does the evidence suggest that doing x is a good thing? | |
| Beliefs | ||
| Unrealistic optimism | ||
| Salient events/sensitisation/critical incidents | ||
| Characteristics of outcome expectancies–physical, social, emotional; | ||
| Sanctions/rewards, proximal/distal, | ||
| valued/not valued, probable/improbable, salient/not salient, perceived risk/threat | ||
| (6) Motivation and goals (Intention) | Intention; stability of intention/certainty of intention | How much do they want to do x? |
| Goals (autonomous, controlled) | How much do they feel they need to do x? | |
| Goal target/setting | Are there other things they want to do or achieve that might interfere with x? | |
| Goal priority | Does the guideline conflict with others? | |
| Intrinsic motivation | Are there incentives to do x? | |
| Commitment | ||
| Distal and proximal goals | ||
| Transtheoretical model and stages of change | ||
| (7) Memory, attention and decision processes | Memory | Is x something they usually do? |
| Attention | Will they think to do x? | |
| Attention control | How much attention will they have to pay to do x? | |
| Decision making | Will they remember to do x? How? | |
| Might they decide not to do x? Why? (prompt: competing tasks, time constraints) | ||
| (8) Environmental context and resources (Environmental constraints) | Resources/material resources (availability and management) | To what extent do physical or resource factors facilitate or hinder x? |
| Environmental stressors | Are there competing tasks and time constraints? | |
| Person × environment interaction | Are the necessary resources available to those expected to undertake x? | |
| Knowledge of task environment | ||
| (9) Social influences (Norms) | Social support | To what extent do social influences facilitate or hinder x? (prompts: peers, managers, other professional groups, patients, relatives) |
| Social/group norms | ||
| Organisational development | Will they observe others doing x (i.e. have role models)? | |
| Leadership | ||
| Team working | ||
| Group conformity | ||
| Organisational climate/culture | ||
| Social pressure | ||
| Power/hierarchy | ||
| Professional boundaries/roles | ||
| Management commitment | ||
| Supervision | ||
| Inter-group conflict | ||
| Champions | ||
| Social comparisons | ||
| Identity; group/social identity | ||
| Organisational commitment/alienation | ||
| Feedback | ||
| Conflict—competing demands, conflicting roles | ||
| Change management | ||
| Crew resource management | ||
| Negotiation | ||
| Social support: personal/professional/organisational, intra/interpersonal, society/community | ||
| Social/group norms: subjective, descriptive, injunctive norms | ||
| Learning and modelling | ||
| (10) Emotion (Emotion) | Affect | Does doing x evoke an emotional response? If so, what? |
| Stress | To what extent do emotional factors facilitate or hinder x? | |
| Anticipated regret | How does emotion affect x? | |
| Fear | ||
| Burn-out | ||
| Cognitive overload/tiredness | ||
| Threat | ||
| Positive/negative affect | ||
| Anxiety/depression | ||
| (11) Behavioural regulation | Goal/target setting | What preparatory steps are needed to do x? (prompt re individual and organisational) |
| Implementation intention | ||
| Action planning | Are there procedures or ways of working that encourage x? | |
| Self-monitoring | ||
| Goal priority | ||
| Generating alternatives | ||
| Feedback | ||
| Moderators of intention-behaviour gap | ||
| Project management | ||
| Barriers and facilitators | ||
| (12) Nature of the behaviours | Routine/automatic/habit | What is the proposed behaviour (x)? |
| Breaking habit | Who needs to do what differently when, where, how, how often and with whom? | |
| Direct experience/past behaviour | How do they know whether the behaviour has happened? | |
| Representation of tasks | What do they currently do? | |
| Stages of change model | Is this a new behaviour or an existing behaviour that needs to become a habit? | |
| Can the context be used to prompt the new behaviour? (prompts: layout, reminders, equipment) | ||
| How long are changes going to take? | ||
| Are there systems for maintaining long term change? | ||