Background
Methods
Study design
Review protocol and registration
Eligibility criteria
Search
Study selection
Data collection process and data items
Synthesis of results
Development of a comprehensive checklist
Results
Study selection
Study characteristics
Synthesis of results—development of the TICD checklist of determinants of practice
Included checklists (first author, year of publication, reference) | The seven domains of factors in the TICD checklist | ||||||
---|---|---|---|---|---|---|---|
Guideline factors | Individual health professional factors | Patient factors | Professional interactions | Incentives and resources | Capacity for organisational change | Social, political and legal factors | |
Cabana 1999 [4] |
Behaviour - guideline factors e.g. guideline characteristics and presence of conflicting guidelines |
Knowledge e.g. familiarity, awareness Attitudes e.g. agreement with the specific guideline and guidelines in general, outcome expectancy, self-efficacy, motivation Behaviour e.g. external barriers, guideline factors, environmental factors |
Behaviour - external barriers e.g. patient factors | Not included |
Behaviour - environmental factors, lack of resources or reimbursement |
Behaviour - environmental factors organisational constraints | Not included |
Cochrane 2007 [14] |
Clinical practice guidelines/evidence barriers e.g. utility, evidence, access, structure, applicability |
Cognitive/ behavioural barriers e.g. knowledge, awareness, skill/ expertise Health care professional barriers
|
Patient barriers e.g. patient adherence |
Health care professional barriers – e.g. peer influence |
Support/resources barriers e.g. time, cost and funding issues, resources |
System/process barriers e.g. organisational, system, workload/ overload |
Health care professional barriers e.g. legal issues |
Damschroder 2009 [15] |
Intervention characteristics e.g. source, evidence strength and quality, relative advantage, adaptability, triability, complexity, cost |
Characteristics of individuals e.g. knowledge and beliefs about the intervention, self-efficacy, individual stage of change, individual identification with organisation |
“Outer setting” e.g. patient needs |
“Inner setting” e.g. network and communications, culture |
“Inner setting” e.g. available resources, incentives, access to knowledge and information “Outer setting” e.g. incentives |
“Inner setting” e.g. learning climate, readiness for implementations, organisational incentives. “Outer setting” e.g. external policies “Process”
| Not included |
Greenhalgh 2004 [17] |
Innovation - inherent attributes (e.g. relative advantage, compatibility, low complexity, trialability, observability), operational attributes (task relevance and usefulness, feasibility, nature of knowledge needed) |
Adopters and adoption - characteristics and needs, meaning of the innovation, nature of the adoption decision, concerns | Not included |
Communication and influence - nature of networks, main agents of social influence |
Inner context organisation’s readiness (dedicated time/resources, broad based support) |
Inner context - structural features of the organisation, organisation’s absorptive capacity for new knowledge, receptive context, organisation’s readiness Outer context Implementation and sustainability External agencies
| Not included |
Gurses 2010 [16] |
Guideline characteristics e.g. relative advantage, compatibility, complexity, trialability, observability, strength of evidence |
Clinician characteristics e.g. awareness, familiarity, agreement, self-efficacy, outcome expectancy, motivation, normative beliefs, subjective norms | Not included |
System characteristics e.g. organisational characteristics (e.g. culture, teamwork, communication) |
Implementation characteristics e.g. funding availability, monitoring and feedback mechanisms |
Implementation characteristics e.g. tension for change, mandate/preparation-planning, leader and middle manager involvement and support, getting ideas from outside the organisation | Not included |
Kitson 2008 [18] |
Evidence – research and clinical experience | Not directly included |
Evidence –patient experience |
Context - context, culture, |
Context – human/financial /technological/ equipment – resources appropriately allocated |
Context - context, leadership, evaluation Facilitation - purpose, role, skills and attributes | Not included |
Mäkelä 1999 [5] | Not included |
Professionals: Knowledge – Skills – Attitudes
|
Environment Social factors support for or discourage-ment of change by others (e.g. patients) |
Environment Social factors - support for or discouragement of change by others (e.g. colleagues at practice site, other members of professional team) |
Economic factors - availability/lack of resources |
Organisational factors – e.g. availability of guidelines at workplace, practicality within existing practice setting or routines, local infrastructures or rules) | Not included |
Michie 2005 [7] |
Nature of the behaviours
|
Knowledge Skills Social/professional role and identity (self-standards) Beliefs about capabilities (self-efficacy) Beliefs about consequences (anticipated outcomes/attitude) Motivation and goals (intention) Memory, attention and decision processes Emotion Behavioural regulation
| Not included |
Social influences (norms)
|
Environmental context and resources (environmental constraints)
|
Environmental context and resources (environmental constraints)
| Not included |
Rainbird 2006 [8] |
The innovation itself - feasibility, credibility, accessibility, attractiveness |
Individual professional - awareness, knowledge, attitude, motivation to change, behavioural routines |
Patient - knowledge skills, attitude, compliance |
Social context - opinion of colleagues, culture of the network, collaboration |
Organisational context – capacities, resources |
Social context – leadership Organisational context – care processes, staff, structures |
Economic and political context - financial arrangements, regulations, policies |
Saillour-Glenisson 2003 [20] |
Clinical practice guideline characteristics - form, topic, compatibility, trialability, scientific basis, observability, adaptability, legal implications |
Physician characteristics - knowledge about the CPG, attitude and agreement to CPG, psychological and socio-demographic and economic characteristics, job satisfaction, training |
Human environment e.g. patient influence, attitude, physician - patient interaction |
Human environment e.g. peer influence |
Oganizational environment – financial context (resources) |
Organisational environment (internal and external environment) |
Organisational environment – External environment |
SURE Collaboration 2011 [19] |
Providers of care - knowledge and skills, attitudes regarding programme acceptability, appropriateness and credibility, motivation to change or adopt new behaviour |
Recipients of care – knowledge, skills and attitudes, motivation to change or adopt new behaviour |
Other stakeholders knowledge, skills, attitudes, motivation to change or adopt new behaviour |
Health system constraints – e.g. accessibility of care, financial resources, human resources, incentives, |
Other stakeholders Knowledge, skills, attitudes, motivation to change or adopt new behavior Health system constraints e.g. internal and external communication, management or leadership, information systems, patient flow processes, bureaucracy, relationship with norms and standards |
Social and political constraints - ideology, short-term thinking, contracts, legislation or regulations, influential people, political stability | |
Wensing [3] | Not included |
Individual level: Cognitive factors Motivational factors Behavioural factors -
| Not included |
Professional interaction: Interaction in professional teams Structure of professional networks
|
Factors related to structures: Financial incentives Regulations-purchaser provider contract relationships |
Organisational level: Organisational structures Organisational processes Organisational resources Factors related to structures: Societal factors
|
Factors related to structures: Regulations
|