Making the case for change: what researchers need to consider when designing behaviour change interventions aimed at improving medication dispensing.

There is a growing emphasis on behavior change in intervention development programmes aimed at improving public health and healthcare professionals' practice. A number of frameworks and methodological tools have been established to assist researchers in developing interventions seeking to change healthcare professionals' behaviors. The key features of behavior change intervention design involve specifying the target group (i.e. healthcare professional or patient cohort), the target behavior and identifying mediators (i.e. barriers and facilitators) of behavior change. Once the target behavior is clearly specified and understood, specific behavior change techniques can then be used as the basis of the intervention to target identified mediators of behavior change. This commentary outlines the challenges for pharmacy practice-based researchers in targeting dispensing as a behavior when developing behavior change interventions aimed at pharmacists and proposes a definition of dispensing to consider in future research.

Assessment of Intervention Fidelity and Recommendations for Researchers Conducting Studies on the Diagnosis and Treatment of Chronic Cough in the Adult: CHEST Guideline and Expert Panel Report

BACKGROUND: Successful management of chronic cough has varied in the primary research studies in the reported literature. One of the potential reasons relates to a lack of intervention fidelity to the core elements of the diagnostic and/or therapeutic interventions that were meant to be used by the investigators.

METHODS: We conducted a systematic review to summarize the evidence supporting intervention fidelity as an important methodologic consideration in assessing the effectiveness of clinical practice guidelines used for the diagnosis and management of chronic cough. We developed and used a tool to assess for five areas of intervention fidelity. Medline (PubMed), Scopus, and the Cochrane Database of Systematic Reviews were searched from January 1998 to May 2014. Guideline recommendations and suggestions for those conducting research using guidelines or protocols to diagnose and manage chronic cough in the adult were developed and voted upon using CHEST Organization methodology.

RESULTS: A total of 23 studies (17 uncontrolled prospective observational, two randomized controlled, and four retrospective observational) met our inclusion criteria. These articles included 3,636 patients. Data could not be pooled for meta-analysis because of heterogeneity. Findings related to the five areas of intervention fidelity included three areas primarily related to the provider and two primarily related to the patients. In the area of study design, 11 of 23 studies appeared to be underpinned by a single guideline/protocol; for training of providers, two of 23 studies reported training, and zero of 23 reported the use of an intervention manual; and for the area of delivery of treatment, when assessing the treatment of gastroesophageal reflux disease, three of 23 studies appeared consistent with the most recent guideline/protocol referenced by the authors. For receipt of treatment, zero of 23 studies mentioned measuring concordance of patient-interventionist understanding of the treatment recommended, and zero of 23 mentioned measuring enactment of treatment, with three of 23 measuring side effects and two of 23 measuring adherence. The overall average intervention fidelity score for all 23 studies was poor (20.74 out of 48).

CONCLUSIONS: Only low-quality evidence supports that intervention fidelity strategies were used when conducting primary research in diagnosing and managing chronic cough in adults. This supports the contention that some of the variability in the reporting of patients with unexplained or unresolved chronic cough may be due to lack of intervention fidelity. By following the recommendations and suggestions in this article, researchers will likely be better able to incorporate strategies to address intervention fidelity, thereby strengthening the validity and generalizability of their results that provide the basis for the development of trustworthy guidelines.

Destination Open Access: Getting Researchers On Board

This Open Access (OA) Poster - ‘Destination Open Access: Getting Researchers on Board’, was devised by the Queen’s University Belfast’s OA Team. It outlines the advocacy strategy undertaken to strengthen researchers’ uptake of OA at the University. Research funders, such as the Higher Education Funding Council of England (HEFCE), are increasingly mandating that researchers make their work publically available via an institutional repository. It is therefore imperative that researchers and departments fully engage with open access to ensure future funding.

The team’s advocacy strategy centres around collaboration with the Heads of Schools, Subject Librarians, the Research and Enterprise Office and, most importantly, the researchers themselves. The team regularly organises training sessions and events, on understanding OA, funder compliance and using the institutional repository. We also run outreach activities, such as practical drop-in sessions, promotional give-aways, OA updates to library staff and direct communications to schools. Finally, the team maintain a strong online presence via LibGuides, LibAnswers, the Library Blog and Twitter. We utilise these platforms to highlight topical OA issues, to advertise events, to provide support materials and to interact with researchers.

Statistics indicate that researchers are increasingly engaging with the OA training, communications and outreach events. Since August 2014 over 1200 researchers have attended advocacy sessions. Additionally, the numbers of papers uploaded to the repository each year has steadily increased and there are now over 3, 000 full-text OA research outputs in the Queen’s Research Portal.

This reflects positively on the team’s established approach of working with researchers to develop an OA culture within the University. Whilst it is clear that an open access strategy is essential, support for the open access ethos must come from individual researchers and Schools in order for the University to reach its desired destination of maximum uptake of open access.