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Table 1 Theoretical rationale for elements of IPAF and corresponding guide

From: Interactive and Participatory Audit and Feedback (IPAF): theory-based development and multi-site implementation outcomes with specialty clinic staff

Elements addressed in delivery of IPAF

Applications of Concepts from Theory*

Theory

I. Introduction

 A

Show respect for staff, creating positive interpersonal environment.

Building relatedness, interacting in a humanistic manner

SDT

 B

Share that facilitator will use a written guide for consistency.

Knowing what to expect can give staff realistic expectations and reduce uncertainty

SRT

II. Clarifying purpose of meeting

 A

Clarify overall purpose of meeting with IPAF.

Being transparent can give staff clarity of expectations for their behaviors.

SRT

 B

Specify purpose is not to judge staff’s job performance.

Reduce anxiety, improve attention;

Non-judgement interaction can support staff participation.

SRT,

SDT

 C

Share topics for meeting;

To gain feedback from staff about their experience implementing target behaviors and to provide staff feedback on target behaviors.

Treating staff as colleague facilitates relatedness and perceived competence and can support corresponding staff behavior.

 

 D

Review altruistic purpose (e.g., screening & referral for CVD risk), the intervention goals

Sharing rationale can assist staff to endorse long-term goal of study to which they can align their specific goals and behaviors.

SRT

 E

Facilitator invites discussion of contextual factors that influence target behaviors and

Invites exchange of information.

Staff likely to believe leaders understand their situation, supporting motivation for behavior.

SDT

III. Offering choice

 A

Offer meaningful choices re: what to discuss first: staff feedback to facilitator or facilitator’s feedback to staff.

Maintaining relatedness, respect and autonomy can support staff participation.

SDT

IV. Obtaining feedback from staff

 A

Request feedback from staff on facilitators to engaging in target behaviors.

Focus on staff capability and desirable behavior can facilitate relatedness and perceived competence; Focus staff’s attention on their recent behaviors in comparison to intended outcomes; Elicits participation.

SRT

SDT

 B

Request feedback from staff on barriers to engaging in target behaviors. (barriers identification)

As above. Avoids undermining staff perceived competence. Recognition of contextual influences on behaviors can improve staff motivation for target behaviors.

SRT

SDT

V. Sharing feedback on performance data with staff

 A

Focus staff’s attention on their recent behaviors.

Can stimulate comparison of current behavior vs. reference point; Can result in discrepancy or congruence, which can stimulate motivation to improve or maintain behavior.

SRT

 B

Offer choices for staff setting their short-term behavioral goals. (goal setting)

Facilitating participation. Supporting autonomy. Directing attention to short-term goals and intervention outcomes can be motivating.

SRT

SDT

VII. Planning action steps

 A

Offering choice of action plans, setting up situation for building perceived competence to improve target behaviors and intervention goals. (action planning)

Facilitating participation. Supporting autonomy, perceived competence, and motivation for adoption of target behaviors.

SDT

SRT

  1. *Concept descriptions and assumptions are clarified on first mention. For brevity, subsequent mentions state only the concept. Abbreviations: SRT Self-Regulation Theory, SDT Self-Determination Theory