Skip to main content

TDF (Theoretical Domain Framework): how inclusive are TDF domains and constructs compared to other tools for assessing barriers to change?

Background

Theoretical Domain Framework (TDF) provides an integrative conceptual model for assessing barriers to change. The TDF questionnaire has been applied by healthcare researchers in several countries for assessing barriers to performance improvement implying its possible usefulness in behavior modification.

Aim

The purpose of this study is to review published literature on barriers to change using specific tools created without adhering to TDF theoretical framework and to investigate whether these tools incorporate domains and constructs of the TDF questionnaire.

Materials and methods

We conducted a systematic literature review. We searched for papers in MEDLINE OVIDSP, PubMed, CINAHL, PsycINFO (that includes full text from PsycARTICLES), EBSCO Databases: Academic Search Complete and Google Scholar from beginning until April 2014. Selection criteria We included all papers that investigated barriers to change in health-related behavior or changing practice in health-related workplaces regardless of study design. Only papers published in English were included. We included in our review manuscripts that included the questionnaires either as attachment or in the content of the article. Duplicate studies were eliminated from the review by comparing authors’ names, type and location of study.

Data abstraction Study review and data abstraction were conducted by two reviewers working independently. Disagreements were resolved by discussion and referring unresolved issues to a third person.

Results

Of 552 papers initially identified, 50 papers were selected for final review. The average number of items in the questionnaires assessing barriers was 19.2. In total the 50 questionnaires included 961 items, out of which 96.8% (930 out of 961) were covered by TDF. The “Environmental Context and Resources”, “Beliefs about consequences” and “Social Influence” were the domains of TDF that most frequently studied in the selected papers: 30.2%, 12.4% and 10.3%, respectively.

Conclusions

This study confirms the validity of TDF framework to assess barriers to change: only 2.2% of 961 items identified were not covered by the TDF questionnaire. However, unclear boundaries between domains and the difficulty in identifying the appropriate construct were two issues identified that may be worth considering to improve the framework.

Author information

Authors and Affiliations

Authors

Rights and permissions

Open Access  This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.

The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/.

The Creative Commons Public Domain Dedication waiver (https://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Sarmast, H., Mosavianpour, M., Collet, JP. et al. TDF (Theoretical Domain Framework): how inclusive are TDF domains and constructs compared to other tools for assessing barriers to change?. BMC Health Serv Res 14 (Suppl 2), P81 (2014). https://doi.org/10.1186/1472-6963-14-S2-P81

Download citation

  • Published:

  • DOI: https://doi.org/10.1186/1472-6963-14-S2-P81

Keywords

  • Social Influence
  • Environmental Context
  • Systematic Literature Review
  • Specific Tool
  • Unresolved Issue