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

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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 languageEnglish
Pages (from-to)1011-1035
Number of pages25
JournalBritish Journal of Health Psychology
Volume28
Issue number4
Early online date1 May 2023
DOIs
Publication statusPublished - 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

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