Emma Doherty1,2,3, Melanie Kingsland1,2,3, John Wiggers1,2,3, Amy E Anderson4, Elizabeth J Elliott5,6, Ian Symonds7, Belinda Tully1,3, Julia Dray2,3, Luke Wolfenden1,2,3. 1. Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia. 2. School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia. 3. Priority Research Centre for Health Behaviour, University of Newcastle, University Drive, Callaghan, NSW, Australia. 4. Hunter Medical Research Institute, New Lambton Heights, NSW, Australia. 5. Faculty of Medicine and Health and Discipline of Child and Adolescent Health, University of Sydney, Sydney, NSW, Australia. 6. Sydney Children's Hospital Network, Kids' Research Institute, Westmead, NSW, Australia. 7. Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Abstract
ISSUE ADDRESSED: The aim of this study was to assess potential barriers to the implementation of clinical guideline recommendations regarding maternal alcohol consumption by antenatal clinicians and managers. METHODS: Cross-sectional surveys of antenatal clinicians and managers employed in a New South Wales Local Health District were undertaken. Survey items were developed based on 11 domains of the Theoretical Domains Framework. Consistent with previous studies, a cut point of less than 4 was applied to mean values of survey items (range: 1-5) to identify domains representing barriers to the implementation. RESULTS: Thirty-three antenatal clinicians and eight managers completed the surveys. For clinicians, the domains with the lowest mean values included "environmental context and resources" (ie, complexity of appointments and availability of supporting systems) (mean: 3.13, SD: 0.93); "social influences" (ie, expectations of others that alcohol will be addressed) (mean: 3.33, SD: 0.68); "beliefs about capabilities" (ie, confidence in providing guideline recommendations) (mean: 3.51, SD: 0.67); and "behavioural regulation" (ie, planning and responding to feedback) (mean: 3.53, SD: 0.64). For managers, "emotion regulation" (ie, stress in managing change) (mean: 2.13, SD: 0.64) and "environmental context and resources" (ie, complexities of managing change) (mean: 3.13, SD: 0.83) were the lowest scoring domains. CONCLUSIONS: The antenatal service environment and availability of resources appear to be primary barriers to both clinicians and managers implementing guidelines for maternal alcohol consumption. SO WHAT?: In the development of interventions to support the delivery of clinical guideline recommendations addressing alcohol consumption during pregnancy, a broad range of potential barriers at both the clinician and manager levels need to be considered and targeted by effective implementation strategies.
ISSUE ADDRESSED: The aim of this study was to assess potential barriers to the implementation of clinical guideline recommendations regarding maternal alcohol consumption by antenatal clinicians and managers. METHODS: Cross-sectional surveys of antenatal clinicians and managers employed in a New South Wales Local Health District were undertaken. Survey items were developed based on 11 domains of the Theoretical Domains Framework. Consistent with previous studies, a cut point of less than 4 was applied to mean values of survey items (range: 1-5) to identify domains representing barriers to the implementation. RESULTS: Thirty-three antenatal clinicians and eight managers completed the surveys. For clinicians, the domains with the lowest mean values included "environmental context and resources" (ie, complexity of appointments and availability of supporting systems) (mean: 3.13, SD: 0.93); "social influences" (ie, expectations of others that alcohol will be addressed) (mean: 3.33, SD: 0.68); "beliefs about capabilities" (ie, confidence in providing guideline recommendations) (mean: 3.51, SD: 0.67); and "behavioural regulation" (ie, planning and responding to feedback) (mean: 3.53, SD: 0.64). For managers, "emotion regulation" (ie, stress in managing change) (mean: 2.13, SD: 0.64) and "environmental context and resources" (ie, complexities of managing change) (mean: 3.13, SD: 0.83) were the lowest scoring domains. CONCLUSIONS: The antenatal service environment and availability of resources appear to be primary barriers to both clinicians and managers implementing guidelines for maternal alcohol consumption. SO WHAT?: In the development of interventions to support the delivery of clinical guideline recommendations addressing alcohol consumption during pregnancy, a broad range of potential barriers at both the clinician and manager levels need to be considered and targeted by effective implementation strategies.
Authors: Penny Reeves; Zoe Szewczyk; Melanie Kingsland; Emma Doherty; Elizabeth Elliott; Adrian Dunlop; Andrew Searles; John Wiggers Journal: Implement Sci Commun Date: 2020-10-15
Authors: Amy Finlay-Jones; Elizabeth Elliott; Astrid Chapman; Jane Halliday; Heather Jones; Natalie Kippin; Narelle Mullan; Hayley Passmore; Tracy Reibel; Neil Reynolds; Martyn Symons; Tracey W Tsang; Rochelle Watkins; Carol Bower Journal: Int J Popul Data Sci Date: 2022-03-02
Authors: J Dray; M Licata; E Doherty; B Tully; B Williams; S Curtin; D White; C Lecathelinais; S Ward; S Hasson; E J Elliott; J Wiggers; M Kingsland Journal: BMC Health Serv Res Date: 2022-03-26 Impact factor: 2.655
Authors: Emma Doherty; Melanie Kingsland; Elizabeth J Elliott; Belinda Tully; Luke Wolfenden; Adrian Dunlop; Ian Symonds; John Attia; Sarah Ward; Mandy Hunter; Carol Azzopardi; Chris Rissel; Karen Gillham; Tracey W Tsang; Penny Reeves; John Wiggers Journal: BMC Pregnancy Childbirth Date: 2022-04-21 Impact factor: 3.105
Authors: Tracey W Tsang; Melanie Kingsland; Emma Doherty; John Wiggers; John Attia; Luke Wolfenden; Adrian Dunlop; Belinda Tully; Ian Symonds; Chris Rissel; Christophe Lecathelinais; Elizabeth J Elliott Journal: Subst Abuse Treat Prev Policy Date: 2022-08-31