Using the Theoretical Domains Framework and Behavior Change Wheel Framework within the world of nutrition support

Abstract

Attempts at behavior change have been shown to be more effective when interventions are based on evidence linked to an implementation framework. The Theoretical Domains Framework (TDF) and Behavior Change Wheel (BCW) provide a systematic way to map effective implementation strategies to address barriers and enablers to behavior change. This paper aims to outline the steps involved in designing and evaluating an intervention using the TDF and BCW, including (1) identifying barriers and enablers (TDF); (2) mapping barriers and enablers to the Capabilities, Opportunities, Motivation hub; and (3) identifying key interventions and specific strategies that are known to bring about behavior change. Real world gaps in the implementation of malnutrition screening and implementation of a preoperative prehabilitation clinic are used as examples to highlight the functionality of the framework. Given the TDF and BCW have been designed specifically to change clinician behavior, it is an ideal framework for addressing evidence-practice gaps in nutrition support.