HS865 Unit 5 Theoretical Domains Framework Section Example

Fourteen Domains That Each Do a Job: A Unit 5 Theoretical Framework Section for a Study of Why Radiographers Keep Shielding

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Purdue University Global

HS865: Doctoral Project II: Research

Unit 5 Theoretical Framework Section

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[Date]

The study and its instruments are composite; the frameworks and validation studies cited are real.

Why the Study Needs a Framework

The literature review found that radiographers who still shield usually know the guidance has changed, and that the reasons they give are social and environmental. No included study used a theory of behavior to examine those reasons systematically. A framework is needed to decide what the survey will measure, what the interviews will ask and how the transcripts will be coded, so that the study covers the full range of possible determinants rather than the ones the researcher happens to expect.

The Theoretical Domains Framework

The Theoretical Domains Framework was developed by synthesizing constructs from many theories of behavior change into domains, so that implementation researchers could examine influences on clinical behavior comprehensively. Its validated version has 14 domains (Cane et al., 2012). Some concern what a person knows and can do, such as knowledge and skills. Some concern beliefs, about capabilities, consequences and one's professional role and identity, along with optimism. Some concern motivation and control, including intentions, goals, reinforcement, emotion and behavioral regulation. And some concern the setting: the physical environment and resources available, the people around the clinician and the attention and decision processes involved in acting quickly. A practical guide sets out how to use the framework to design interview and survey studies of implementation problems and how to analyze the results by domain (Atkins et al., 2017). The domains also map onto the components of the COM-B model, capability, opportunity and motivation, which link determinants to types of intervention (Michie et al., 2011).

Why This Framework Rather Than the Alternatives

Theory of planned behavior. Here behavior follows from intention, and intention from a person's attitude toward the act, perceived social pressure and confidence in being able to act (Ajzen, 1991). It is well tested and parsimonious, and its subjective norm construct would capture some of the social pressure the review found. But it centers on deliberate intention. Shielding in a busy room is likely to be habitual, cued by the environment and performed without deliberation, and the theory has no construct for habit, memory or the physical room. It would miss the determinants the review suggests matter most.

Diffusion of innovations. Rogers's account (Rogers, 2003) traces the uptake of new practices across a community according to their perceived advantages, compatibility and complexity, and through adopter categories. It is useful for adoption but less suited to stopping a practice, which is the problem here. Removing a shield is not adopting an innovation; it is abandoning a visible routine, and diffusion theory has little to say about the loss involved.

The Theoretical Domains Framework covers both deliberate and automatic influences, includes the physical and social environment explicitly and has been used in many studies of clinical practice, including efforts to reduce unnecessary care.

A framework earns its place by deciding what gets measured, asked and coded; one that sits in its own section and appears nowhere else is decoration.

Where Each Domain Appears in the Design

Survey. Each domain becomes a block of two to four items adapted from a published domain-based questionnaire and worded for shielding during pediatric pelvis and abdomen radiography, for example "I know the current professional recommendation about gonadal shielding" for knowledge and "Parents expect me to use a shield on their child" for social influences.

Interview guide. Each domain becomes a prompt, for example "Tell me about the last time you decided not to use a shield" for memory, attention and decision processes, and "Where are the shields kept in your room?" for environmental context.

Coding. Each domain becomes a parent code in a directed content analysis, with definitions taken from the framework and a residual code for anything that does not fit.

Analysis. Survey domain scores will be compared between the routine shielders and everyone else. Interview data will explain how the domains that differ operate in practice. The domains also give the two strands a shared structure for integration, since each domain appears in both.

How the Framework Shapes Sampling and Integration

The framework also shapes who is interviewed. Interview participants will be chosen to include radiographers whose survey responses show high and low scores on the domains expected to matter, so that the interviews can explore how those determinants work rather than simply repeating what the survey found. Integration will then compare, domain by domain, what the survey shows about differences between groups with what the interviews show about how those differences play out in the room. Where the two strands agree, the finding is strengthened; where they disagree, the disagreement becomes a result in its own right. Using one framework for both strands is what makes this comparison possible, since a survey built on one theory and interviews built on another would produce findings that cannot be laid side by side.

A further use is practical. Because the domains map to intervention types through the COM-B model, a finding that, for example, social influences and environmental context distinguish shielders points toward interventions such as scripts for talking with parents and removing shields from default positions in the room, rather than another round of education. The framework therefore links the study's findings to the decisions an imaging manager could make.

Domains Expected to Matter

Based on the review, five domains are expected to differ most between radiographers who shield and those who stopped: the expectations of patients and colleagues, the layout and supplies of the room, the quick decisions made mid-examination, what radiographers believe will happen if they skip the shield and how they see their professional role. Knowledge is expected to differ little. These expectations are stated in advance so that the analysis can show whether they were wrong.

Limits of the Framework

The framework identifies determinants but does not specify how they interact. It can produce long instruments, and fourteen domains measured by short scales will have modest reliability. Domain boundaries can blur in coding, particularly between social influences and environmental context, which the codebook will need to address. Finally, the framework was developed largely from studies of starting new practices, and its fit for stopping an old one has been tested less often, a limit the study will report.

References

Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179-211. https://doi.org/10.1016/0749-5978(91)90020-T

Atkins, L., Francis, J., Islam, R., O'Connor, D., Patey, A., Ivers, N., Foy, R., Duncan, E. M., Colquhoun, H., Grimshaw, J. M., Lawton, R., & Michie, S. (2017). A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems. Implementation Science, 12, 77. https://doi.org/10.1186/s13012-017-0605-9

Cane, J., O'Connor, D., & Michie, S. (2012). Validation of the theoretical domains framework for use in behaviour change and implementation research. Implementation Science, 7, 37. https://doi.org/10.1186/1748-5908-7-37

Michie, S., van Stralen, M. M., & West, R. (2011). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science, 6, 42. https://doi.org/10.1186/1748-5908-6-42

Rogers, E. M. (2003). Diffusion of innovations (5th ed.). Free Press.