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Development of a behaviour change intervention to increase the delivery of upper limb constraint-induced movement therapy programs to people with stroke and traumatic brain injury
Christie, Lauren Rendell, Reem McCluskey, Annie Fearn, Nicola Hunter, Abigail Lovarini, Meryl
Christie, Lauren
Rendell, Reem
McCluskey, Annie
Fearn, Nicola
Hunter, Abigail
Lovarini, Meryl
Abstract
Purpose: Constraint-induced movement therapy (CIMT) is a recommended intervention for arm recovery after acquired brain injury but is underutilised in practice. The purpose of this study is to describe the development of a behaviour change intervention targeted at therapists, to increase delivery of CIMT.
Methods: A theoretically-informed approach for designing behaviour change interventions was used including identification of which behaviours needed to change (Step 1), barriers and enablers that needed to be addressed (Step 2), and intervention components to target those barriers and enablers (Step 3). Data collection methods included file audits and therapist interviews. Quantitative data (file audits) were analysed using descriptive statistics. Qualitative data analysis (interviews) was informed by the Theoretical Domains Framework (TDF) and Behaviour Change Wheel.
Results: Fifty two occupational therapists, physiotherapists and allied health assistants participated in focus groups (n = 7) or individual interviews (n = 6). Key barriers (n = 20) and enablers (n = 10) were identified across 11 domains of the TDF and perceived to influence CIMT implementation. The subsequent behaviour change intervention included training workshops, nominated team champions, community of practice meetings, three-monthly file audit feedback cycles, poster reminders and drop-in support during CIMT.
Conclusion: This study describes the development of a behaviour change intervention to increase CIMT delivery by clinicians.
Trial registration: Australian New Zealand Clinical Trials Registry, Trial ID: ACTRN12617001147370.
Keywords
Constraint induced movement therapy, behaviour change techniques, implementation, acquired brain injury, rehabilitation, evidence-based medicine, guideline adherence, upper extremity, stroke rehabilitation
Date
2024
Type
Journal article
Journal
Disability and Rehabilitation
Book
Volume
46
Issue
21
Page Range
4931-4942
Article Number
ACU Department
School of Nursing, Midwifery and Paramedicine
Faculty of Health Sciences
Faculty of Health Sciences
Relation URI
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY-NC-ND 4.0
File Access
Open
Notes
Australian New Zealand Clinical Trials Registry, Trial ID: ACTRN12617001147370.
© 2023 the author(s).
This is an open access article distributed under the terms of the Creative Commons attribution-nonCommercial-noDerivatives license (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in anyway. the terms on which this article has been published allow the posting of the accepted Manuscript in a repository by the author(s) or with their consent.
© 2023 the author(s).
This is an open access article distributed under the terms of the Creative Commons attribution-nonCommercial-noDerivatives license (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in anyway. the terms on which this article has been published allow the posting of the accepted Manuscript in a repository by the author(s) or with their consent.