Psychological and behavioural theories are widely used to inform interventions aimed at changing healthcare practitioner behaviour. Organisational, cultural and resource contexts may influence how these theories are applied, with implications for implementation feasibility. This review examined the use of behavioural theory across healthcare settings, with particular attention to hierarchy, uncertainty and feasibility. A systematic review with narrative synthesis was conducted of 137 empirical studies published between January 2018 and January 2024. Included studies applied psychological or behavioural theory to healthcare practitioner behaviour across international settings. Hofstede’s cultural dimensions of power distance and uncertainty avoidance were used as an interpretive lens for cross-contextual analysis. Data were extracted on theory use, target behaviour, professional group and cultural contextual influences. The Theoretical Domains Framework, Behaviour Change Wheel, and COM-B model featured in 86
Experiences of intimate partner violence are highly prevalent among people with HIV and linked to adverse HIV care outcomes. Screening for violence can initiate linkage to support services, but little is known about how to best implement screening in HIV care settings. We validated the Capability to Screen for Intimate Partner Violence measure, capturing individual competence, knowledge, and skills to screen people with HIV for intimate partner violence. In 2023–2024, we conducted a cross-sectional survey among 418 individuals whose workplace offered onsite primary HIV care across eight southeastern states. We used confirmatory factor analysis to validate a factor structure for the Consolidated Framework for Implementation Research Capability construct among participants in adult-only (N = 216) and adult/pediatric (N = 202) care settings separately, then multivariate linear regression via structural equation modeling to validate the measure among the whole sample. We validated a single-factor model with five indicators for the Capability construct. The mean Capability to Screen for Intimate Partner Violence score was 3.43 (SD 0.79) with higher scores reflecting higher capability (range 1–5). Higher scores were significantly associated with believing one had the knowledge, skills, and resources necessary to screen (β = 0.447, SE = 0.064) and training in screening patients (β = 0.249, SE = 0.063). Screening experience was significantly associated with greater perceived knowledge/skills/resources (β = 0.484, SE = 0.068), suggesting indirect pathway to higher capability. The Capability to Screen for Intimate Partner Violence measure is reliable, valid, and may be implemented in HIV care settings to identify staff who could effectively implement violence screening or require additional training.
Although randomized control trials are considered the gold standard in efficacy research, implementation and process evaluations are increasingly recognized as an integral, complementary source of information, particularly for the evaluation of multifaceted interventions in complex, real-world settings. They may provide insights into trial processes and outcomes. This protocol paper describes an implementation and process evaluation conducted in parallel with a multisite cluster randomized control trial designed to assess the efficacy of two autism programs, Program for the Education and Enrichment of Relational Skills (PEERS®) and Unstuck and On Target, in public middle school settings. The process of developing this implementation and process evaluation, specific methods employed, and anticipated findings are described. It is expected the evaluation will supplement and inform interpretation of the efficacy findings from the broader trial. Findings from this implementation and process evaluation may guide future efforts conducting similar parallel randomized control trials and implementation and process evaluations.
This study assessed health care professionals’ organizational readiness to implement a food introduction booklet for children aged 0–2 years in Brazilian Primary Health Care and explored barriers and facilitators to its implementation. In this convergent mixed-methods, pre-post study with cluster randomization, physicians, nurses, and dentists from eight Primary Health Care units in Campo Grande, Brazil, completed a validated organizational readiness questionnaire before implementation and three months afterward. Pre-implementation semi-structured interviews were analyzed using the Consolidated Framework for Implementation Research to identify barriers and facilitators. Units were randomly allocated to control, synchronous support, or asynchronous support clusters. Statistical significance was set at 5
Evidence-based interventions to improve maternal and child health are not consistently implemented in Ethiopia. Implementation research can strengthen how proven practices are integrated into routine systems. This study examined the current landscape of implementation research focused on maternal and child health in Ethiopia and identified gaps and practical next steps to expand this research. We used a concurrent design that combined a scoping review with interviews conducted with key informants. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, we reviewed implementation-focused studies published from January 2014 to April 2025. Twelve studies met inclusion criteria and were classified using Nilsen’s taxonomy (Determinant, Process, Evaluation, and Mixed studies). Ten interviews were conducted with individuals from civil society organizations, universities, and government institutions. Interview data were analyzed using the Consolidated Framework for Implementation Research. Half of identified studies focused on determinants while half addressed process or evaluation. Only 42
