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      Implementation behavior of communities regarding relatives caring for people with dementia : A quantitative study among German communities Translated title: Implementierungsverhalten von Kommunen in Bezug auf pflegende Angehörige von Menschen mit Demenz : Eine quantitative Studie in deutschen Kommunen

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          Abstract

          Background

          Actors from the community (CAs) play a fundamental role in the support of caring relatives (CRs) of people with dementia (PWD). As their support is not sufficient, the implementation of support services needs to be optimized; however, little is known about the factors associated with the implementation behavior of CAs.

          Aim

          This study aimed to investigate the association of person-related factors with the implementation behavior of CAs.

          Methods

          In a cross-sectional study, 205 CAs from 16 German communities were surveyed with the community implementation behaviour questionnaire (CIBQ), which is based on the theoretical domains framework. Logistic regression analyses were conducted to identify person-related factors associated with the implementation behavior regarding support services for CRs of PWD.

          Results

          Implementing support services for CRs of PWD is positively and significantly ( p < 0.001) associated with the agreement of CAs with the CIBQ domains. Higher scores in the CIBQ increase the chance that CAs implemented support services for the target group.

          Conclusion

          The CIBQ is a tool to determine the status of implementation behavior of communities. This enables an analysis of the areas CAs need to work on in order to optimize the implementation of support services for CRs of PWD or other health and care-related topics.

          Supplementary Information

          The online version of this article (10.1007/s00391-023-02232-w) contains supplementary material, which is available to authorized users.

          Translated abstract

          Hintergrund

          Kommunale AkteurInnen (kA) spielen eine grundlegende Rolle in der Unterstützung pflegender Angehöriger (pA) von Menschen mit Demenz (MmD). Da deren Unterstützung nicht ausreichend ist, sollte die Implementierung von Unterstützungsmaßnahmen optimiert werden. Allerdings ist über Faktoren, die mit dem Implementierungsverhalten der kA zusammenhängen, wenig bekannt.

          Ziel

          Ziel war die Untersuchung des Zusammenhangs von personenbezogenen Faktoren mit dem Implementierungsverhalten von kA.

          Methoden

          In einer Querschnittsstudie wurden 205 kA aus 16 deutschen Kommunen befragt. Dazu wurde der Community Implementation Behaviour Questionnaire (CIBQ) verwendet, der auf dem Theoretical Domains Framework basiert. Logistische Regressionsanalysen wurden genutzt, um personenbezogene Faktoren zu identifizieren, die mit dem Implementierungsverhalten bei Unterstützungsmaßnahmen für pA von MmD in Verbindung stehen.

          Ergebnisse

          Die Umsetzung von Unterstützungsmaßnahmen für pA von MmD ist positiv und signifikant ( p  < 0,001) mit der Übereinstimmung der kA mit den CIBQ-Domänen assoziiert.

          Punktzahlen im CIBQ erhöhen die Chance, dass kA Unterstützungsmaßnahmen für die Zielgruppe implementierten.

          Schlussfolgerung

          Der CIBQ ist ein Instrument zur Bestimmung des Status des Implementierungsverhaltens von Kommunen. Dies ermöglicht eine Analyse der Bereiche, an denen kA arbeiten sollten, um die Implementierung von Unterstützungsmaßnahmen für pA von MmD oder andere gesundheits- und pflegebezogene Themen zu optimieren.

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          Most cited references22

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          Validation of the theoretical domains framework for use in behaviour change and implementation research

          Background An integrative theoretical framework, developed for cross-disciplinary implementation and other behaviour change research, has been applied across a wide range of clinical situations. This study tests the validity of this framework. Methods Validity was investigated by behavioural experts sorting 112 unique theoretical constructs using closed and open sort tasks. The extent of replication was tested by Discriminant Content Validation and Fuzzy Cluster Analysis. Results There was good support for a refinement of the framework comprising 14 domains of theoretical constructs (average silhouette value 0.29): ‘Knowledge’, ‘Skills’, ‘Social/Professional Role and Identity’, ‘Beliefs about Capabilities’, ‘Optimism’, ‘Beliefs about Consequences’, ‘Reinforcement’, ‘Intentions’, ‘Goals’, ‘Memory, Attention and Decision Processes’, ‘Environmental Context and Resources’, ‘Social Influences’, ‘Emotions’, and ‘Behavioural Regulation’. Conclusions The refined Theoretical Domains Framework has a strengthened empirical base and provides a method for theoretically assessing implementation problems, as well as professional and other health-related behaviours as a basis for intervention development.
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            Making psychological theory useful for implementing evidence based practice: a consensus approach.

            Evidence-based guidelines are often not implemented effectively with the result that best health outcomes are not achieved. This may be due to a lack of theoretical understanding of the processes involved in changing the behaviour of healthcare professionals. This paper reports the development of a consensus on a theoretical framework that could be used in implementation research. The objectives were to identify an agreed set of key theoretical constructs for use in (1) studying the implementation of evidence based practice and (2) developing strategies for effective implementation, and to communicate these constructs to an interdisciplinary audience. Six phases of work were conducted to develop a consensus: (1) identifying theoretical constructs; (2) simplifying into construct domains; (3) evaluating the importance of the construct domains; (4) interdisciplinary evaluation; (5) validating the domain list; and (6) piloting interview questions. The contributors were a "psychological theory" group (n = 18), a "health services research" group (n = 13), and a "health psychology" group (n = 30). Twelve domains were identified to explain behaviour change: (1) knowledge, (2) skills, (3) social/professional role and identity, (4) beliefs about capabilities, (5) beliefs about consequences, (6) motivation and goals, (7) memory, attention and decision processes, (8) environmental context and resources, (9) social influences, (10) emotion regulation, (11) behavioural regulation, and (12) nature of the behaviour. A set of behaviour change domains agreed by a consensus of experts is available for use in implementation research. Applications of this domain list will enhance understanding of the behaviour change processes inherent in implementation of evidence-based practice and will also test the validity of these proposed domains.
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              A note on a general definition of the coefficient of determination

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                Author and article information

                Contributors
                Maren-w@t-online.de
                Journal
                Z Gerontol Geriatr
                Z Gerontol Geriatr
                Zeitschrift Fur Gerontologie Und Geriatrie
                Springer Medizin (Heidelberg )
                0948-6704
                1435-1269
                6 September 2023
                6 September 2023
                2024
                : 57
                : 4
                : 296-301
                Affiliations
                [1 ]Institute of Gerontology, Ruprecht-Karls-University of Heidelberg, ( https://ror.org/038t36y30) Bergheimer Straße 20, 69115 Heidelberg, Germany
                [2 ]Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Ruprecht-Karls-University of Heidelberg, Alte Brauerei, ( https://ror.org/038t36y30) Röngtenstraße 7, 68167 Mannheim, Germany
                Article
                2232
                10.1007/s00391-023-02232-w
                11208208
                37674060
                33810962-a327-4879-8671-6b22459985df
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 21 April 2023
                : 3 August 2023
                Funding
                Funded by: Ruprecht-Karls-Universität Heidelberg (1026)
                Categories
                Original Contributions
                Custom metadata
                © Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2024

                cross-sectional study,questionnaire,aged,quantitative study,support services,querschnittsstudie,fragebogen,ältere menschen,quantitative studie,unterstützungsmaßnahmen

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