Table 5 - Strengths and Weaknesses of Different Methods for Identifying Barriers to Change

Table 5 - Strengths and weaknesses of different methods for identifying barriers to change

Method Strengths Weaknesses Literature review  Provides information about “the state of the art” for  The methods used are often poorly described. identifying factors that influence behaviour tailoring  The efficiency of the different methods is not interventions to change professional practice. examined.  Generates lots of ideas since many different  The published literature gives poor guidance on methods have been used. which methods to use and how to do it in order to  Some of the literature on guideline topics (urinary develop effective interventions. tract infections in women and sore throat) gives specific and useful information about impediments to best practice for these conditions. Guideline development  Convenient to combine people’s engagement in  Many respondents not familiar with these concepts Survey and comments on guideline development with the development of and likely do not use much time reflecting on them. draft guidelines implementation strategies.  We did not receive many comments on perceived barriers or suggested solutions. Brainstorming  Inspiring way to create lots of ideas.  Risk of chaotic and confused process.  Neither resource- nor time-consuming to conduct.  Difficult to tell which ideas that are most important. Focus groups  Rich source of information from various  Resources needed to organise and analyse properly. perspectives.  It is difficult to gather busy practitioners.  A good way to get information from patients.  Quite easy and quick to run. Pilot study  Convenient to collect information about barriers to  Technical and practical problems got more attention change and ways to improve interventions while than identification of barriers to change. conducting the pilot study. Table 5 continued - Strengths and weaknesses of different methods for identifying barriers to change

Workshops with small  The practitioners were able to identify many barriers  The concepts were not familiar and it was necessary group discussions with and suggest solutions based on their own experience to spend time explaining them. GPs and GP assistants and discussion in the small groups.  No extra resources needed.  Potentially both a learning experience for the participants and useful for the process of developing interventions. Interviews during the  Follow-up by phone during the project gives lots of  Great variation in attitudes between practitioners project opportunities for informal interviews. both within and across practices.  Information received throughout the project is useful  Information collected may not be representative. for modifying interventions.  Structure and resources needed to analyse and use information wisely. It is difficult to rebuild an airplane while you are flying.