Table 1

 Theoretical domains, component constructs, and eliciting questions for investigating the implementation of evidence-based practice

Domains*ConstructsInterview questions
*Corresponding constructs from Fishbein et al16 shown in parentheses.
(1) KnowledgeKnowledgeDo they know about the guideline?
Knowledge about condition/scientific rationaleWhat do they think the guideline says?
Schemas+mindsets+illness representationsWhat do they think the evidence is?
Procedural knowledgeDo they know they should be doing x?
Do they know why they should be doing x?
(2) Skills (Skills)SkillsDo they know how to do x?
Competence/ability/skill assessmentHow 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)IdentityWhat is the purpose of the guidelines?
Professional identity/boundaries/roleWhat do they think about the credibility of the source?
Group/social identityDo they think guidelines should determine their behaviour?
Social/group norms Alienation/organisational commitmentIs 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 andHow difficult or easy is it for them to do x? (prompt re. internal and external capabilities/constraints)
social environmentWhat problems have they encountered?
Perceived competenceWhat would help them?
Self-confidence/professional confidenceHow confident are they that they can do x despite the difficulties?
EmpowermentHow capable are they of maintaining x?
Self-esteemHow well equipped/comfortable do they feel to do x?
Perceived behavioural control
(5) Beliefs about consequences (Anticipated outcomes/attitude)Outcome expectancies Anticipated regret Appraisal/evaluation/reviewWhat 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)
ConsequentsWhat are the costs of x and what are the costs of the consequences of x?
AttitudesWhat do they think will happen if they do not do x? (prompts)
ContingenciesDo benefits of doing x outweigh the costs?
Reinforcement/punishment/consequencesHow will they feel if they do/don’t do x? (prompts)
Incentives/rewardsDoes the evidence suggest that doing x is a good thing?
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 intentionHow much do they want to do x?
Goals (autonomous, controlled)How much do they feel they need to do x?
Goal target/settingAre there other things they want to do or achieve that might interfere with x?
Goal priorityDoes the guideline conflict with others?
Intrinsic motivationAre there incentives to do x?
Distal and proximal goals
Transtheoretical model and stages of change
(7) Memory, attention and decision processesMemoryIs x something they usually do?
AttentionWill they think to do x?
Attention controlHow much attention will they have to pay to do x?
Decision makingWill 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 stressorsAre there competing tasks and time constraints?
Person × environment interactionAre the necessary resources available to those expected to undertake x?
Knowledge of task environment
(9) Social influences (Norms)Social supportTo what extent do social influences facilitate or hinder x? (prompts: peers, managers, other professional groups, patients, relatives)
Social/group norms
Organisational developmentWill they observe others doing x (i.e. have role models)?
Team working
Group conformity
Organisational climate/culture
Social pressure
Professional boundaries/roles
Management commitment
Inter-group conflict
Social comparisons
Identity; group/social identity
Organisational commitment/alienation
Conflict—competing demands, conflicting roles
Change management
Crew resource management
Social support: personal/professional/organisational, intra/interpersonal, society/community
Social/group norms: subjective, descriptive, injunctive norms
Learning and modelling
(10) Emotion (Emotion)AffectDoes doing x evoke an emotional response? If so, what?
StressTo what extent do emotional factors facilitate or hinder x?
Anticipated regretHow does emotion affect x?
Cognitive overload/tiredness
Positive/negative affect
(11) Behavioural regulationGoal/target settingWhat preparatory steps are needed to do x? (prompt re individual and organisational)
Implementation intention
Action planningAre there procedures or ways of working that encourage x?
Goal priority
Generating alternatives
Moderators of intention-behaviour gap
Project management
Barriers and facilitators
(12) Nature of the behavioursRoutine/automatic/habitWhat is the proposed behaviour (x)?
Breaking habitWho needs to do what differently when, where, how, how often and with whom?
Direct experience/past behaviourHow do they know whether the behaviour has happened?
Representation of tasksWhat do they currently do?
Stages of change modelIs 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?