A qualitative process evaluation using the behaviour change wheel approach: did a whole genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 within UK hospitals operate as anticipated?

Paul Flowers; Ruth Leiser; Fiona Mapp; Julie McLeod; Oliver Stirrup; Christopher J. R. Illingworth; James Blackstone; Judith Breuer

doi:10.1111/bjhp.12666

A qualitative process evaluation using the behaviour change wheel approach: did a whole genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 within UK hospitals operate as anticipated?

Paul Flowers, Ruth Leiser, Fiona Mapp, Julie McLeod, Oliver Stirrup, Christopher J. R. Illingworth, James Blackstone, Judith Breuer

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

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Abstract

Purpose
The aim of this study was to conduct a process evaluation of a whole-genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 through changing infection prevention and control (IPC) behaviours within the COVID-19 pandemic.

Methods
We used a three-staged design. Firstly, we described and theorized the purported content of the SRF using the behaviour change wheel (BCW). Secondly, we used inductive thematic analysis of one-to-one interviews (n = 39) to explore contextual accounts of using the SRF. Thirdly, further deductive analysis gauged support for the intervention working as earlier anticipated.

Results
It was possible to theorize the SRF using the BCW approach and visualize it within a simple logic model. Inductive thematic analyses identified the SRF's acceptability, ease of use and perceived effectiveness. However, major challenges to embedding it in routine practice during the unfolding COVID-19 crisis were reported. Notwithstanding this insight, deductive analysis showed support for the putative intervention functions ‘Education’, ‘Persuasion’ and ‘Enablement’; behaviour change techniques ‘1.2 Problem solving’, ‘2.6 Biofeedback’, ‘2.7 Feedback on outcomes of behaviour’ and ‘7.1 Prompts and cues’; and theoretical domains framework domains ‘Knowledge’ and ‘Behavioural regulation’.

Conclusions
Our process evaluation of the SRF, using the BCW approach to describe and theorize its content, provided granular support for the SRF working to change IPC behaviours as anticipated. However, our complementary inductive thematic analysis highlighted the importance of the local context in constraining its routine use. For SRFs to reach their full potential in reducing nosocomial infections, further implementation research is needed.

Original language	English
Pages (from-to)	1011-1035
Number of pages	25
Journal	British Journal of Health Psychology
Volume	28
Issue number	4
Early online date	1 May 2023
DOIs	https://doi.org/10.1111/bjhp.12666
Publication status	Published - 30 Nov 2023

Funding

We would like to particularly acknowledge the support of NHS Greater Glasgow and Clyde Clinical Research Facility. We also acknowledge the support of the independent members of the Joint Trial Steering Committee and Data Monitoring Committee (TSC‐DMC): Prof Marion Koopmans (Erasmus MC), Prof Walter Zingg (University of Geneva), Prof Colm Bergin (Trinity College Dublin), Prof Karla Hemming (University of Birmingham), Prof Katherine Fielding (LSHTM). As well as TSC‐DMC non‐independent members: Prof Nick Lemoine (NIHR CRN), Prof Sharon Peacock (COG‐UK). We would also thank members of COG‐UK who have directly supported the study: Dr Ewan Harrison (Cambridge University), Dr Katerina Galai (PHE), Dr Francesc Coll (LSHTM), Dr Michael Chapman (HDR‐UK), Prof Thomas Connor and team (Cardiff University) and Prof Nick Loman and team (University of Birmingham). We also thank the COG‐UK Consortium and the UK National Institute for Health Research Clinical Research Network (NIHR CRN). We would like to particularly acknowledge the support of NHS Greater Glasgow and Clyde Clinical Research Facility. We also acknowledge the support of the independent members of the Joint Trial Steering Committee and Data Monitoring Committee (TSC-DMC): Prof Marion Koopmans (Erasmus MC), Prof Walter Zingg (University of Geneva), Prof Colm Bergin (Trinity College Dublin), Prof Karla Hemming (University of Birmingham), Prof Katherine Fielding (LSHTM). As well as TSC-DMC non-independent members: Prof Nick Lemoine (NIHR CRN), Prof Sharon Peacock (COG-UK). We would also thank members of COG-UK who have directly supported the study: Dr Ewan Harrison (Cambridge University), Dr Katerina Galai (PHE), Dr Francesc Coll (LSHTM), Dr Michael Chapman (HDR-UK), Prof Thomas Connor and team (Cardiff University) and Prof Nick Loman and team (University of Birmingham). We also thank the COG-UK Consortium and the UK National Institute for Health Research Clinical Research Network (NIHR CRN).

Keywords

behaviour change
behaviour change wheel
Covid-19
hospital
infection prevention and control
sequence report form

Access to Document

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Flowers-etal-BJHP-2023-A-qualitative-process-evaluation-using-the-behaviour-change-wheel-approachFinal published version, 1.69 MBLicence: CC BY-NC 4.0

Cite this

Flowers, P., Leiser, R., Mapp, F., McLeod, J., Stirrup, O., Illingworth, C. J. R., Blackstone, J., & Breuer, J. (2023). A qualitative process evaluation using the behaviour change wheel approach: did a whole genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 within UK hospitals operate as anticipated? British Journal of Health Psychology, 28(4), 1011-1035. https://doi.org/10.1111/bjhp.12666

@article{018ef28182db442c976ad8b7a24cb244,

title = "A qualitative process evaluation using the behaviour change wheel approach: did a whole genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 within UK hospitals operate as anticipated?",

abstract = "PurposeThe aim of this study was to conduct a process evaluation of a whole-genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 through changing infection prevention and control (IPC) behaviours within the COVID-19 pandemic.MethodsWe used a three-staged design. Firstly, we described and theorized the purported content of the SRF using the behaviour change wheel (BCW). Secondly, we used inductive thematic analysis of one-to-one interviews (n = 39) to explore contextual accounts of using the SRF. Thirdly, further deductive analysis gauged support for the intervention working as earlier anticipated.ResultsIt was possible to theorize the SRF using the BCW approach and visualize it within a simple logic model. Inductive thematic analyses identified the SRF's acceptability, ease of use and perceived effectiveness. However, major challenges to embedding it in routine practice during the unfolding COVID-19 crisis were reported. Notwithstanding this insight, deductive analysis showed support for the putative intervention functions {\textquoteleft}Education{\textquoteright}, {\textquoteleft}Persuasion{\textquoteright} and {\textquoteleft}Enablement{\textquoteright}; behaviour change techniques {\textquoteleft}1.2 Problem solving{\textquoteright}, {\textquoteleft}2.6 Biofeedback{\textquoteright}, {\textquoteleft}2.7 Feedback on outcomes of behaviour{\textquoteright} and {\textquoteleft}7.1 Prompts and cues{\textquoteright}; and theoretical domains framework domains {\textquoteleft}Knowledge{\textquoteright} and {\textquoteleft}Behavioural regulation{\textquoteright}.ConclusionsOur process evaluation of the SRF, using the BCW approach to describe and theorize its content, provided granular support for the SRF working to change IPC behaviours as anticipated. However, our complementary inductive thematic analysis highlighted the importance of the local context in constraining its routine use. For SRFs to reach their full potential in reducing nosocomial infections, further implementation research is needed.",

keywords = "behaviour change, behaviour change wheel, Covid-19, hospital, infection prevention and control, sequence report form",

author = "Paul Flowers and Ruth Leiser and Fiona Mapp and Julie McLeod and Oliver Stirrup and Illingworth, {Christopher J. R.} and James Blackstone and Judith Breuer",

year = "2023",

month = nov,

day = "30",

doi = "10.1111/bjhp.12666",

language = "English",

volume = "28",

pages = "1011--1035",

journal = "British Journal of Health Psychology",

issn = "1359-107X",

publisher = "Wiley-Blackwell",

number = "4",

}

Flowers, P , Leiser, R, Mapp, F, McLeod, J, Stirrup, O, Illingworth, CJR, Blackstone, J & Breuer, J 2023, 'A qualitative process evaluation using the behaviour change wheel approach: did a whole genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 within UK hospitals operate as anticipated?', British Journal of Health Psychology, vol. 28, no. 4, pp. 1011-1035. https://doi.org/10.1111/bjhp.12666

A qualitative process evaluation using the behaviour change wheel approach: did a whole genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 within UK hospitals operate as anticipated? / Flowers, Paul ; Leiser, Ruth; Mapp, Fiona et al.
In: British Journal of Health Psychology, Vol. 28, No. 4, 30.11.2023, p. 1011-1035.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - A qualitative process evaluation using the behaviour change wheel approach

T2 - did a whole genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 within UK hospitals operate as anticipated?

AU - Flowers, Paul

AU - Leiser, Ruth

AU - Mapp, Fiona

AU - McLeod, Julie

AU - Stirrup, Oliver

AU - Illingworth, Christopher J. R.

AU - Blackstone, James

AU - Breuer, Judith

PY - 2023/11/30

Y1 - 2023/11/30

N2 - PurposeThe aim of this study was to conduct a process evaluation of a whole-genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 through changing infection prevention and control (IPC) behaviours within the COVID-19 pandemic.MethodsWe used a three-staged design. Firstly, we described and theorized the purported content of the SRF using the behaviour change wheel (BCW). Secondly, we used inductive thematic analysis of one-to-one interviews (n = 39) to explore contextual accounts of using the SRF. Thirdly, further deductive analysis gauged support for the intervention working as earlier anticipated.ResultsIt was possible to theorize the SRF using the BCW approach and visualize it within a simple logic model. Inductive thematic analyses identified the SRF's acceptability, ease of use and perceived effectiveness. However, major challenges to embedding it in routine practice during the unfolding COVID-19 crisis were reported. Notwithstanding this insight, deductive analysis showed support for the putative intervention functions ‘Education’, ‘Persuasion’ and ‘Enablement’; behaviour change techniques ‘1.2 Problem solving’, ‘2.6 Biofeedback’, ‘2.7 Feedback on outcomes of behaviour’ and ‘7.1 Prompts and cues’; and theoretical domains framework domains ‘Knowledge’ and ‘Behavioural regulation’.ConclusionsOur process evaluation of the SRF, using the BCW approach to describe and theorize its content, provided granular support for the SRF working to change IPC behaviours as anticipated. However, our complementary inductive thematic analysis highlighted the importance of the local context in constraining its routine use. For SRFs to reach their full potential in reducing nosocomial infections, further implementation research is needed.

AB - PurposeThe aim of this study was to conduct a process evaluation of a whole-genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 through changing infection prevention and control (IPC) behaviours within the COVID-19 pandemic.MethodsWe used a three-staged design. Firstly, we described and theorized the purported content of the SRF using the behaviour change wheel (BCW). Secondly, we used inductive thematic analysis of one-to-one interviews (n = 39) to explore contextual accounts of using the SRF. Thirdly, further deductive analysis gauged support for the intervention working as earlier anticipated.ResultsIt was possible to theorize the SRF using the BCW approach and visualize it within a simple logic model. Inductive thematic analyses identified the SRF's acceptability, ease of use and perceived effectiveness. However, major challenges to embedding it in routine practice during the unfolding COVID-19 crisis were reported. Notwithstanding this insight, deductive analysis showed support for the putative intervention functions ‘Education’, ‘Persuasion’ and ‘Enablement’; behaviour change techniques ‘1.2 Problem solving’, ‘2.6 Biofeedback’, ‘2.7 Feedback on outcomes of behaviour’ and ‘7.1 Prompts and cues’; and theoretical domains framework domains ‘Knowledge’ and ‘Behavioural regulation’.ConclusionsOur process evaluation of the SRF, using the BCW approach to describe and theorize its content, provided granular support for the SRF working to change IPC behaviours as anticipated. However, our complementary inductive thematic analysis highlighted the importance of the local context in constraining its routine use. For SRFs to reach their full potential in reducing nosocomial infections, further implementation research is needed.

KW - behaviour change

KW - behaviour change wheel

KW - Covid-19

KW - hospital

KW - infection prevention and control

KW - sequence report form

U2 - 10.1111/bjhp.12666

DO - 10.1111/bjhp.12666

M3 - Article

SN - 1359-107X

VL - 28

SP - 1011

EP - 1035

JO - British Journal of Health Psychology

JF - British Journal of Health Psychology

IS - 4

ER -

Flowers P , Leiser R, Mapp F, McLeod J, Stirrup O, Illingworth CJR et al. A qualitative process evaluation using the behaviour change wheel approach: did a whole genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 within UK hospitals operate as anticipated? British Journal of Health Psychology. 2023 Nov 30;28(4):1011-1035. Epub 2023 May 1. doi: 10.1111/bjhp.12666

A qualitative process evaluation using the behaviour change wheel approach: did a whole genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 within UK hospitals operate as anticipated?

Abstract

Funding

Keywords

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