Optimizing Implementation: Elucidating the Role of Behavior Change Techniques and Corresponding Strategies on Determinants and Implementation Performance: A Cross-Sectional Study

Abstract Method We performed a cross-sectional study among practitioners and management professionals working in youth (health)care organizations. Using questionnaires, we obtained data regarding the presence and perceived value of BCT-strategy combinations and the association between BCT-strategy combinations and determinants and ultimately, implementation performance. Chi-squared tests and multivariate regression analyses were performed to determine whether determinants and implementation performance were influenced by specific BCT-strategy combinations. Results Data from 104 practitioners and 34 management professionals were used for analyses. Most of the management professionals stated that the BCT-strategy combinations (could) positively affect(ed) their implementation performance. Results on practitioners’ level showed that half of the implementation hypotheses could be confirmed. Practitioners who reported an absence of BCT-strategy combinations were skeptical regarding their potential influence on determinants and implementation performance. Conclusion Several BCT-strategy combinations were found to improve or have the potential to improve the implementation performance of both practitioners and management professionals. When developing and evaluating implementation efforts, we recommend clearly describing the goal of the implementation effort and using frameworks that include a description of both the BCTs that will elicit behavior change, the strategy to achieve this, as well as the mechanisms that drive the observed changes in behavior or outcomes. Understanding the interconnected process between BCTs and strategies, and how they influence determinants, is important for designing targeted and evidence-based behavior change interventions. This understanding is key to optimizing resource allocation and ultimately contributing to the overall success of implementation efforts in youth care.