Introduction Behavior change techniques (BCTs) are considered as active components of implementation strate‑ gies, infuencing determinants and, ultimately, implementation performance. In our... Show moreIntroduction Behavior change techniques (BCTs) are considered as active components of implementation strate‑ gies, infuencing determinants and, ultimately, implementation performance. In our previous Delphi study, experts formulated ‘implementation hypotheses’, detailing how specifc combinations of BCTs and strategies (referred to as BCT-strategy combinations) might infuence determinants and guideline implementation within youth care. For example, educational meetings providing instructions on guideline use were hypothesized to enhance practition‑ ers’ knowledge and, consequently, guideline implementation. However, these hypotheses have not been verifed in practice yet. Method We conducted a cross-sectional study involving practitioners and management professionals from youth (health)care organizations. Using questionnaires, we obtained data on the presence of BCT-strategy combinations and their perceived infuence on determinants and implementation performance. Chi-squared tests and regres‑ sion analyses were employed to determine the infuence of specifc BCT-strategy combinations on determinants and implementation performance. Results Our analyses included data from 104 practitioners and 34 management professionals. Most of the manage‑ ment professionals indicated that the BCT-strategy combinations positively infuenced or had the potential to infu‑ ence their implementation performance. At the practitioner level, half of the combinations were perceived to have a positive infuence on determinants and implementation performance. Furthermore, practitioners who reported the absence of BCT-strategy combinations were more skeptical about their potential infuence on determinants and implementation performance. Conclusion Several BCT-strategy combinations were perceived to improve or potentially improve implementation performance of both practitioners and management professionals. In the development and evaluation of imple‑ mentation eforts, we advocate for clearly describing the implementation efort’s objective and using frameworks that detail the BCTs inducing behavior change, the strategy employed, and the processes driving the observed changes. Understanding these interconnected processes is important in designing targeted, evidence-based Show less
Family health history (FHH) is a valuable yet underused healthcare tool for assessing health risks for both prevalent disorders like diabetes, cancer, and cardiovascular diseases, and for rare,... Show moreFamily health history (FHH) is a valuable yet underused healthcare tool for assessing health risks for both prevalent disorders like diabetes, cancer, and cardiovascular diseases, and for rare, monogenic disorders. Full implementation of FHH collection and analysis in healthcare could improve both primary and secondary disease prevention for individuals and, through cascade testing, make at risk family members eligible for pre-symptomatic testing and preventative interventions. In addition to risk assessment in the clinic, FHH is increasingly important for interpreting clinical genetic testing results and for research connecting health risks to genomic variation. Despite this value, diverse implementation gaps in clinical settings undermine its potential clinical value and limit the quality of connected health and genomic data. The NHGRI Family Health History Group, an open-membership, US-based group with international members, believes that integrating FHH in healthcare and research is more important than ever, and that achievable implementation advances, including education, are urgently needed to boost the pace of translational utility in genomic medicine. An inventory of implementation gaps and proposed achievable strategies to address them, representing a consensus developed in meetings from 2019-2020, is presented here. The proposed measures are diverse, interdisciplinary, and are guided by experience and ongoing implementation and research efforts. Show less
Karkdijk, J.; Schee, J. van der; Admiraal, W.F. 2021
Relational thinking in geography is often complex, due to the interdisciplinary character of the subject and the many relationships between human and natural systems. We explored the strategies of... Show moreRelational thinking in geography is often complex, due to the interdisciplinary character of the subject and the many relationships between human and natural systems. We explored the strategies of twelve small groups of students in upper secondary education in the Netherlands as they attempted to understand a regional problem presented as a mystery. Four different relating strategies were found. The six low-performing groups on the mystery assignment employed different relating strategies from the six high-performing groups, who primarily used a webbing strategy. The findings suggest that a webbing strategy, focused on the establishment of multi-causal relationships, is more successful in tackling complex assignments in geography such as understanding regional problems. Show less
