A&F design elements, frequencies (n (%)) and examples of who the A&F was delivered to, what A&F information was delivered, when, why and how much
| Elements | Frequency | Examples |
|---|---|---|
| Who the A&F was delivered to (2) | ||
| 1. Was it delivered to | ||
| Individual providers only | Yes: 72 (51%) | Sent to individual physicians by mail |
| Groups of providers only | Yes: 25 (18%) | Given to practice group at a meeting |
| Individuals and groups of providers | Yes: 23 (16%) | Sent to both |
| Unclear: 20 (14%) | ||
| 2. Was the A&F given to the person in whom the practice change was desired? | Yes: 130 (92%) No: 6 (5%) Unclear: 4 (3%) | Given to service provider (yes) vs to directors of services or a hospital administrator (no) |
| What A&F information was delivered? (10) | ||
| 3. Processes of care? | Yes: 111 (79%) No: 9 (6%) Unclear: 20 (15%) | Prescription rates, vaccination rates, compliance with guidelines |
| 4. Patient outcomes? | Yes: 20 (14%) No: 102 (73%) Unclear: 18 (13%) | Identification of patients with stroke, patient compliance |
| 5. Other? | Yes: 45 (32%) No: 95 (68%) | Costs of laboratory tests ordered |
| 6. Performance of individual provider? | Yes: 81 (58%) No: 50 (36%) Unclear: 9 (6%) | Individual prescription ordering |
| 7. Performance of provider group? | Yes: 90 (64%) No: 38 (27%) Unclear: 12 (9%) | Entire practice group prescription rates |
| 8. Individual patient cases? | Yes: 35 (25%) No: 95 (68%) Unclear: 10 (7%) | Patients identified who did not receive a particular preventive care action |
| 9. Aggregate of patient cases? | Yes: 114 (81%) No: 15 (11%) Unclear: 11 (8%) | Percent of the patients in the practice who did not receive guideline consistent care |
| 10. Was the specific behaviour to be changed identified? | Yes: 124 (89%) No: 9 (6%) Unclear: 7 (5%) | A&F on unnecessary test ordering in order to reduce test ordering (yes) vs A&F on costs of tests in order to reduce unnecessary test ordering (no) |
| 11. What was the comparison provided? | ||
| Others previous performance alone | Yes: 68 (49%) | The average of the group |
| Standardised guideline alone | Yes: 15 (11%) | A guideline |
| Own previous performance alone | Yes: 6 (4%) | Own performance in previous quarter |
| Others previous performance + standardised guideline | Yes: 6 (4%) | Both the average of the group and a guideline |
| Other | Yes: 9 (6%) Unclear: 36 (26%) | Internal standard |
| 12. Graph presented? | Yes: 47 (36%) No: 73 (52%) Unclear: 20 (14%) | Line graph plotting monthly rates of lab test ordering for a practice group |
| When was A&F delivered? (1) | ||
| 13. What was the lag time? | ||
| Days | Yes: 6 (4%) | Data from previous week |
| Weeks | Yes: 22 (16%) | Data from previous month |
| Months | Yes: 46 (33%) | Data from previous year |
| Years | Yes: 3 (2%) | Data from prior to previous year |
| Mix | Yes: 2 (1%) Unclear: 61 (44%) | Mix |
| Why was A&F delivered? (1) | ||
| 14. Rationale for using A&F* | Empirical only: 51 (37%) Intuitive: 39 (28%) No rationale: 37 (26%) Theory: 13 (9%) | A single study or previous Cochrane review of A&F cited Unreferenced statement about A&F being effective A&F appears for the first time in the intervention description Using social cognitive theory constructs to design the intervention |
| How was A&F delivered? (2) | ||
| 15. Face to face? | Yes: 62 (44%) No: 68 (49%) Unclear: 10 (7%) | Ground rounds, seminars, team meetings (compared with a mailout) |
| 16. Providers asked to consider implications of A&F on their practice? | Yes: 32 (23%) No: 108 (77%) | Meetings to make actionable plans based on A&F results |
| How much A&F was delivered? (1) | ||
| 17. How much was given? | ||
| Once | Yes: 33 (24%) | One time mailout |
| Twice | Yes: 21 (15%) | Feedback every 6 months for 1 year |
| Three | Yes: 13 (9%) | Feedback every 2 weeks for 6 weeks |
| Four | Yes: 13 (9%) | Quarterly feedback for 1 year |
| >Four† | Yes: 27 (19%) Unclear: 33 (24%) | Every 2 weeks for 1 year |
Intuitive—general statements that A&F is worthwhile to include but not specified to be based on a named construct or theory; for example, A&F has not been used in this context so we are going to use it.
No rationale—A&F not mentioned until it appears in the intervention.
Theory—a stated theory was used as a rationale for the intervention.
*Empirical only—statement that A&F was chosen based on empirical or synthesis that it is effective. Reference required.
†Range was 5–78.