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Table 6 Factors which influence and enhance behaviour change to implement JCs

From: Factors that influence the sustainability of structured allied health journal clubs: a qualitative study

COM-B Domain and associated factor Behaviour Change Wheel
Intervention Functions
Implementation strategies
Motivation
 Perceived relevance of topics linking to clinical practice Enablement
Environmental restructure
• Ensure group engagement during prioritisation of topics (consider topics that relate to current clinical service priorities or Quality Improvement projects)
• Longer time dedicated to discussion of application of evidence in each session.
• Skilled JC member facilitates discussion
 Clinician ownership, sense of responsibility & accountability Modelling • Identify 2–3 clinicians to co-facilitate JC and holder of “JC portfolio”
• Presenting clinicians to follow up the action items & feedback at future JC sessions
 Perceived benefit of format Persuasion
Incentivisation
• JC members familiar with TREAT to share positive experiences with others
 Belief that participation in JC improves knowledge and skills in EBP Persuasion
Education
• Use of positive experience stories to encourage belief that capability increases with ongoing JC attendance and engagement
 Other clinicians encourage attendance prior to meeting Persuasion • Use of email reminders prior and electronic reminders in electronic calendars to prompt attendance and reduce double-bookings
Opportunity
 Staff changes including planned changes (eg rotations, planned leave & staffing availability) & emergent leave (eg sick leave & workforce shortages) Education
Training
• Consider upskilling non-rotational staff to improve resilience during rotations (i.e. upskilling senior staff who do not rotate)
• Increase number of staff exposed to JC, in order to saturate skills across the workforce
 Competing demands leading to JC deprioritised due to clinical demands Environmental restructuring
Enablement
• Timetable of presenters with consistent time and place booked in clinicians’ calendars (updated electronically)
• Manager encouragement to engage in JC as part of professional responsibility
 Logistical administration of JC is established (time, venue, recurrent booking) Enablement • Allocate a set time, use of regular room and time to reduce clashes
• Tie in meeting with another meeting,
 Manager expectation holds staff to account to prioritise JC attendance Coercion
Persuasion
• Departmental leadership to advocate and value JC attendance and see as core business
 Team culture values EBP Modelling • Ensure consistent message of value of EBP via members & managers, including new starter orientation
 Increased participation by all JC members during group discussion Modelling • Facilitator to encourage participation from all group members during group appraisal, where possible have face to face rather than VC to facilitate interaction
 Support from other clinicians in team Enablement • Regularly review topic choice to check relevance of topic to current practice
Capability
 Awareness of how to access Library & academics Education • Ensure Librarians available and engaged, to meet with JC and raise awareness of services available to JC members
 Knowledge from academic needs to be pitched at right level Enablement • Academic must be skilled in ascertaining and monitoring learners in order to pitch information at a level appropriate to the skills and need of the JC members
 JC members guided to choose topics relevant to all members Education • Provide support or education regarding how to prioritise topics and integrate into practice (i.e., relate to QI)
 Skill development (e.g., in critical appraisal, EBP and stats training, statistics, identifying study design) Training • Access to regular training opportunities to ensure all staff have access to basic EBP training as they join a JC
• Academic mentor attends initially to facilitate session then assists JC portfolio holders to facilitate using “cognitive apprentice model” (particularly upskill in facilitation of club)
• Resources to support interpretation of study design and selection of CASP appraisal tool
• Through building depth of clinician skill, wider numbers of JC members will have opportunity to build skills and confidence in application of skills
 Access to academic or EBP-skilled clinician Modelling
Enablement
• Academic or skilled clinician available to support JC members in provision of relevant knowledge on-demand.
• By providing direct guidance learner can be supported to move from peripheral to full participation. Guide must be able to ascertain readiness of the learner and be monitoring the learner’s development.