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 identifying factors that influence behaviour tailoring interventions to change professional practice.
  • Generates lots of ideas since many different methods have been used.
  • Some of the literature on guideline topics (urinary tract infections in women and sore throat) gives specific and useful information about impediments to best practice for these conditions.
/
  • The methods used are often poorly described.
  • The efficiency of the different methods is not examined.
  • The published literature gives poor guidance on which methods to use and how to do it in order to develop effective interventions.

Guideline development
Survey and comments on draft guidelines /
  • Convenient to combine people’s engagement in guideline development with the development of implementation strategies.
/
  • Many respondents not familiar with these concepts and likely do not use much time reflecting on them.
  • We did not receive many comments on perceived barriers or suggested solutions.

Brainstorming /
  • Inspiring way to create lots of ideas.
  • Neither resource- nor time-consuming to conduct.
/
  • Risk of chaotic and confused process.
  • Difficult to tell which ideas that are most important.

Focus groups /
  • Rich source of information from various perspectives.
  • A good way to get information from patients.
  • Quite easy and quick to run.
/
  • Resources needed to organise and analyse properly.
  • It is difficult to gather busy practitioners.

Pilot study /
  • Convenient to collect information about barriers to change and ways to improve interventions while conducting the pilot study.
/
  • Technical and practical problems got more attention than identification of barriers to change.

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

Workshops with small group discussions with GPs and GP assistants /
  • The practitioners were able to identify many barriers and suggest solutions based on their own experience 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.
/
  • The concepts were not familiar and it was necessary to spend time explaining them.

Interviews during the project /
  • Follow-up by phone during the project gives lots of opportunities for informal interviews.
  • Information received throughout the project is useful for modifying interventions.
/
  • Great variation in attitudes between practitioners both within and across practices.
  • Information collected may not be representative.
  • Structure and resources needed to analyse and use information wisely. It is difficult to rebuild an airplane while you are flying.