title: Experiences of using the Theoretical Domains Framework across diverse clinical environments: a qualitative study.
abstract: BACKGROUND
  The Theoretical Domains Framework (TDF) is an integrative framework developed from a synthesis of psychological theories as a vehicle to help apply theoretical approaches to interventions aimed at behavior change.
  
  
  OBJECTIVE
  This study explores experiences of TDF use by professionals from multiple disciplines across diverse clinical settings.
  
  
  METHODS
  Mixed methods were used to examine experiences, attitudes, and perspectives of health professionals in using the TDF in health care implementation projects. Individual interviews were conducted with ten health care professionals from six disciplines who used the TDF in implementation projects. Deductive content and thematic analysis were used.
  
  
  RESULTS
  Three main themes and associated subthemes were identified including: 1) reasons for use of the TDF (increased confidence, broader perspective, and theoretical underpinnings); 2) challenges using the TDF (time and resources, operationalization of the TDF) and; 3) future use of the TDF.
  
  
  CONCLUSIONS
  The TDF provided a useful, flexible framework for a diverse group of health professionals working across different clinical settings for the assessment of barriers and targeting resources to influence behavior change for implementation projects. The development of practical tools and training or support is likely to aid the utility of TDF.
authors.affiliation: Division of Pharmacy, Flinders Medical Centre, Bedford Park, SA, Australia ; School of Medicine, Flinders University, Adelaide, SA, Australia.
authors.forename: Cameron J
authors.initials: CJ
authors.lastname: Phillips
authors.affiliation: Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Southport, QLD, Australia ; Gold Coast University Hospital, Southport, QLD, Australia.
authors.forename: Andrea P
authors.initials: AP
authors.lastname: Marshall
authors.affiliation: Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, VIC, Australia.
authors.forename: Nadia J
authors.initials: NJ
authors.lastname: Chaves
authors.affiliation: Central Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, Australia ; Institute of Neurosciences, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
authors.forename: Stacey K
authors.initials: SK
authors.lastname: Jankelowitz
authors.affiliation: Western Australian Centre for Rural Health, University of Western Australia, Geraldton, WA, Australia.
authors.forename: Ivan B
authors.initials: IB
authors.lastname: Lin
authors.affiliation: School of Public Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia ; Huntington Diseases Centre, Westmead Hospital, Westmead, NSW, Australia.
authors.forename: Clement T
authors.initials: CT
authors.lastname: Loy
authors.affiliation: Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia.
authors.forename: Gwyneth
authors.initials: G
authors.lastname: Rees
authors.affiliation: Queensland Cerebral Palsy and Rehabilitation Research Centre, University of Queensland, Brisbane, QLD, Australia.
authors.forename: Leanne
authors.initials: L
authors.lastname: Sakzewski
authors.affiliation: Physiotherapy Department, Flinders Medical Centre, Bedford Park, SA, Australia ; International Centre for Allied Health Evidence (iCAHE), School of Health Sciences, University of South Australia, Adelaide, SA, Australia.
authors.forename: Susie
authors.initials: S
authors.lastname: Thomas
authors.affiliation: Pharmacy Department, Austin Health, Heidelberg, VIC, Australia.
authors.forename: The-Phung
authors.initials: TP
authors.lastname: To
authors.affiliation: Mater Research Institute, The University of Queensland, South Brisbane, QLD, Australia ; Department of Nutrition and Dietetics, Mater Health Services, South Brisbane, QLD, Australia.
authors.forename: Shelley A
authors.initials: SA
authors.lastname: Wilkinson
authors.affiliation: University College London Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College, London, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Michie
keywords: Theoretical Domains Framework; barriers and enablers; behavioral change; evidence-based practice; health care; implementation
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