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, P. , Leiser, R., Mapp, F., McLeod, J., Stirrup, O., Illingworth, C. J.R. , Blackstone, J. and 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, (doi: 10.1111/bjhp.12666) (Early Online Publication)

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.

• Item Type: Articles
• Additional Information: This work was supported by funding from the Medical Research Council (MRC) part of UK Research & Innovation (UKRI), the National Institute of Health Research (NIHR) [grant code: MC_PC_19027], and Genome Research Limited, operating as the Wellcome Sanger Institute.
• Status: Early Online Publication
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Flowers, Professor Paul and Illingworth, Dr Chris
• Authors: Flowers, P., Leiser, R., Mapp, F., McLeod, J., Stirrup, O., Illingworth, C. J.R., Blackstone, J., and Breuer, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Virus Research
• Journal Name: British Journal of Health Psychology
• Publisher: Wiley
• ISSN: 1359-107X
• ISSN (Online): 2044-8287
• Published Online: 01 May 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in British Journal of Health Psychology 2023
• Publisher Policy: Reproduced under a Creative Commons License

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