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Table 6 Summary of feedback from think-aloud interviews and resulting changes

From: Development of an intervention to support the implementation of evidence-based strategies for optimising antibiotic prescribing in general practice

Website section

Example suggestions from think-aloud interviews with health professionals

How they were addressed

Home page

• The website was perceived as unattractive without pictures.

• Unclear why these three AMS strategies are promoted.

• Unclear logo. More ‘branding’ would seem helpful.

➢ Added pictures for each AMS strategy.

➢ Clarified reasons for promoting the three strategies.

➢ Unchanged as participants held different views and was not considered a priority.

Section on communication strategies

• Example phrases and mock conversations liked.

• Perceived difficulty with using leaflets with patients where English isn’t their first language; unclear how they could access leaflets in other languages from the website.

• Some disliked the mnemonic CHESTSSS, seen as hard to remember.

• Too many webpages to go through to access the leaflets.

➢ Added more example phrases.

➢ Highlighted availability of leaflets in other languages and provided a link to them.

➢ CHESTSSS retained as covering all key elements.

➢ Moved all information on leaflets to one webpage.

Section on POC-CRPT

• References to NICE guideline should be highlighted.

• Would like more information on using and interpreting results for different conditions.

• Add information about manufacturer’s training and quality control tests.

• Questioned if the website/project was funded by CRP test producers.

• Would like a template or Standard Operating Procedures (SOP) for using POC-CRPT in practices.

➢ NICE guidelines and trial evidence highlighted.

➢ No evidence for different conditions (other than respiratory infections) so no change.

➢ Added details on training and quality control.

➢ Clarified sources of funding.

➢ No template/SOP provided; suggested questions to agree on practice approach in meeting slides.

Section on DP

• Concerned about ‘red flags’ and need for reconsultation or urgent care.

• Highlight the information on typical duration of common infections.

• Some confusion about the different names for DP used.

➢ Added information on red flags (e.g. sepsis).

➢ Added a specific table on typical duration of infections.

➢ ‘Back-up/delayed’ retained as different people prefer/use different names.

Section on Implementation Support and Champions

• More focus on addressing concerns and suggested actions for champions, rather than reasons for promoting AMS.

• Practice meeting slides need to be shorter (for 5–10-min meetings).

• Unclear who the resources for antibiotic champion webpage/link is for.

• Information seemed targeted at those who already are champions and not encouraging people to become one.

➢ Shortened the text on reasons and benefits, and expanded actions for champions.

➢ Shortened slides and divided into multiple sets.

➢ Called the webpage ‘implementation support’.

➢ Edited text to clarify the information is for everyone promoting prudent prescribing.