15
Table 10. Theoretical Domains Framework (TDF)
• Initially developed to conduct research on the behavior of HCP related to
implementation of evidence-based practices
2
• 14 domains to identify relevant cognitive, affective, social, and environmental
influences
1
• Used to understand and influence behaviors of HCP, patients, and populations
4
• Commonly uses qualitative methods (e.g., surveys, interviews, or focus groups)
1
• Has been linked to and combined with the COM-B model and other frameworks
9,10
14 domains explaining behavior change:
1,2
1. Knowledge
2. Skills
3. Social/professional role and identity
4. Beliefs about capabilities
5. Optimism
6. Beliefs about consequences
7. Reinforcement
8. Intentions
9. Goals
10. Memory, attention, and decision
process
11. Environmental context and resources
12. Social influences
13. Emotion
14. Behavioral regulation
Steps for developing a theory-informed implementation intervention:
8
1. Who needs to do what, differently?
2. Using a theoretical framework, which barriers and enablers need to be addressed?
3. Which intervention components could overcome the barriers and enhance enablers?
4. How can behavior change be measured and understood?
Settings that have applied TDF:
• Inpatient
• Primary care
• Perioperative
• Ambulatory
• Individual and community-based
behaviors
Interventions implemented with TDF:
• Diabetes management
• Pregnancy weight management
• ICU blood transfusion
• Selective GI tract decontamination
• Preoperative testing
• Spine imaging
• Hand hygiene
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