From single to multiple behaviour change approaches in implementation science

Justin Presseau, PhD
University of Ottawa

ABSTRACT:
Behaviour change theory-informed implementation intervention development and evaluation often focuses on improving sub-optimally performed clinical practice, redressing variations in care, or de-implementing lower-value care. In many instances, such approaches focus on a given clinical action as the target for change. However, the professional context of those delivering healthcare and the lived experience of those receiving healthcare are characterised by navigating contexts involving engaging in multiple behaviours; where engaging in a given action may impact on other competing demands and/or the actions of others. Predominant methodological approaches and theoretical lenses used in implementation science may not yet be accounting for this system of multiple behaviours. This talk will explore the challenges and opportunities of shifting from a single behaviour to a multiple behaviour approach in implementation science. With examples of implementation research across a variety of chronic disease topic areas, this talk will explore the implications and opportunities for shifting to a multiple behaviour change approach for: identifying gaps in care and selecting focal behaviour(s), identifying theory-informed barriers/enablers to change, selecting intervention strategies and change techniques, and evaluating implementation strategies.