A guide to using the Theoretical Domains Framework of behavior change to investigate implementation problems

In an article published in Implementation Science this month based on a meeting of researchers from Canada, the UK, and Australia, Lou Atkins and her colleagues offer practical guidance for applying the Theoretical Domains Framework (TDF) of behavior change to achieve implementation outcomes. The TDF, which synthesizes 128 theoretical constructs from 33 theories into 12 key domains (e.g., knowledge, skills, motivation and goals), has been used extensively in implementation research to identify determinants of behaviors among health-care professionals. The TDF has also been used to systematically design behavior change interventions. However, until recently, formal guidance on how to apply the TDF did not exist. In the article, Atkins and her colleagues offer step-by-step instructions for each stage of conducting TDF-based implementation research (e.g., selecting and specifying the target behavior, selecting the study design, developing study materials), drawing on examples from published studies. The guide is publicly available and downloadable online.