TY - JOUR

T1 - Patients' perceptions and experiences of cardiovascular disease and diabetes prevention programmes

T2 - A systematic review and framework synthesis using the Theoretical Domains Framework

AU - Shaw, Rachel L.

AU - Holland, Carol

AU - Pattison, Helen M.

AU - Cooke, Richard

PY - 2016/5/1

Y1 - 2016/5/1

N2 - BACKGROUNDThis review provides a worked example of ‘best fit’ framework synthesis using the Theoretical Domains Framework (TDF) of health psychology theories as an a priori framework in the synthesis of qualitative evidence. Framework synthesis works best with ‘policy urgent’ questions. OBJECTIVEThe review question selected was: what are patients' experiences of prevention programmes for cardiovascular disease (CVD) and diabetes? The significance of these conditions is clear: CVD claims more deaths worldwide than any other; diabetes is a risk factor for CVD and leading cause of death. METHODA systematic review and framework synthesis were conducted. This novel method for synthesizing qualitative evidence aims to make health psychology theory accessible to implementation science and advance the application of qualitative research findings in evidence-based healthcare. RESULTSFindings from 14 original studies were coded deductively into the TDF and subsequently an inductive thematic analysis was conducted. Synthesized findings produced six themes relating to: knowledge, beliefs, cues to (in)action, social influences, role and identity, and context. A conceptual model was generated illustrating combinations of factors that produce cues to (in)action. This model demonstrated interrelationships between individual (beliefs and knowledge) and societal (social influences, role and identity, context) factors. CONCLUSIONSeveral intervention points were highlighted where factors could be manipulated to produce favourable cues to action. However, a lack of transparency of behavioural components of published interventions needs to be corrected and further evaluations of acceptability in relation to patient experience are required. Further work is needed to test the comprehensiveness of the TDF as an a priori framework for ‘policy urgent’ questions using ‘best fit’ framework synthesis.

AB - BACKGROUNDThis review provides a worked example of ‘best fit’ framework synthesis using the Theoretical Domains Framework (TDF) of health psychology theories as an a priori framework in the synthesis of qualitative evidence. Framework synthesis works best with ‘policy urgent’ questions. OBJECTIVEThe review question selected was: what are patients' experiences of prevention programmes for cardiovascular disease (CVD) and diabetes? The significance of these conditions is clear: CVD claims more deaths worldwide than any other; diabetes is a risk factor for CVD and leading cause of death. METHODA systematic review and framework synthesis were conducted. This novel method for synthesizing qualitative evidence aims to make health psychology theory accessible to implementation science and advance the application of qualitative research findings in evidence-based healthcare. RESULTSFindings from 14 original studies were coded deductively into the TDF and subsequently an inductive thematic analysis was conducted. Synthesized findings produced six themes relating to: knowledge, beliefs, cues to (in)action, social influences, role and identity, and context. A conceptual model was generated illustrating combinations of factors that produce cues to (in)action. This model demonstrated interrelationships between individual (beliefs and knowledge) and societal (social influences, role and identity, context) factors. CONCLUSIONSeveral intervention points were highlighted where factors could be manipulated to produce favourable cues to action. However, a lack of transparency of behavioural components of published interventions needs to be corrected and further evaluations of acceptability in relation to patient experience are required. Further work is needed to test the comprehensiveness of the TDF as an a priori framework for ‘policy urgent’ questions using ‘best fit’ framework synthesis.

KW - Attitude to Health

KW - Cardiovascular Diseases/pc [Prevention & Control]

KW - Diabetes Mellitus/pc [Prevention & Control]

KW - Patients/px [Psychology]

KW - Evidence-Based Practice

KW - Humans

KW - Models, Psychological

KW - Program Evaluation

KW - Psychological Theory

KW - Qualitative Research

U2 - 10.1016/j.socscimed.2016.03.015

DO - 10.1016/j.socscimed.2016.03.015

M3 - Journal article

C2 - 27043372

VL - 156

SP - 192

EP - 203

JO - Social Science and Medicine

JF - Social Science and Medicine

SN - 0277-9536

ER -