The use of theory in process evaluations conducted alongside randomized trials of implementation interventions: A systematic review.

Interventions to implement changes into health care practice (i.e., implementation interventions) are critical to improving care but their effects are poorly understood.

How do hospitals respond to feedback about blood transfusion practice? A multiple case study investigation.

National clinical audits play key roles in improving care and driving system-wide change. However, effects of audit and feedback depend upon both reach (e.g.

Knowing too much: Knowledge of energy content prevents liking change through flavour-nutrient associations.

Associations between flavours and the consequences of ingestion can lead to changes in flavour liking depending on nutrient content, an example of flavour-nutrient learning (FNL). Expectations about the consequences of ingestion can be modified by information at the point of ingestion, such as nutritional labelling. What is unknown is the extent to which these label-based expectations modify FNL.

The evaluation of enhanced feedback interventions to reduce unnecessary blood transfusions (AFFINITIE): protocol for two linked cluster randomised factorial controlled trials.

Background: Blood for transfusion is a frequently used clinical intervention, and is also a costly and limited resource with risks. Many transfusions are given to stable and non-bleeding patients despite no clear evidence of benefit from clinical studies. Audit and feedback (A&F) is widely used to improve the quality of healthcare, including appropriate use of blood.

Combined use of the Consolidated Framework for Implementation Research (CFIR) and the Theoretical Domains Framework (TDF): a systematic review.

Background: Over 60 implementation frameworks exist. Using multiple frameworks may help researchers to address multiple study purposes, levels, and degrees of theoretical heritage and operationalizability; however, using multiple frameworks may result in unnecessary complexity and redundancy if doing so does not address study needs. The Consolidated Framework for Implementation Research (CFIR) and the Theoretical Domains Framework (TDF) are both well-operationalized, multi-level implementation determinant frameworks derived from theory.

A multidimensional approach to assessing intervention fidelity in a process evaluation of audit and feedback interventions to reduce unnecessary blood transfusions: a study protocol.

Background: In England, NHS Blood and Transplant conducts national audits of transfusion and provides feedback to hospitals to promote evidence-based practice. Audits demonstrate 20% of transfusions fall outside guidelines. The AFFINITIE programme (Development & Evaluation of Audit and Feedback INterventions to Increase evidence-based Transfusion practIcE) involves two linked, 2×2 factorial, cluster-randomised trials, each evaluating two theoretically-enhanced audit and feedback interventions to reduce unnecessary blood transfusions in UK hospitals.

Application of theory to enhance audit and feedback interventions to increase the uptake of evidence-based transfusion practice: an intervention development protocol.

Background: Audits of blood transfusion demonstrate around 20% transfusions are outside national recommendations and guidelines. Audit and feedback is a widely used quality improvement intervention but effects on clinical practice are variable, suggesting potential for enhancement. Behavioural theory, theoretical frameworks of behaviour change and behaviour change techniques provide systematic processes to enhance intervention.

Acquired hedonic and sensory characteristics of odours: influence of sweet liker and propylthiouracil taster status.

Repeated pairings of novel food-related odours with sweet tastes can result in enduring changes in sweetness of the odour alone, but have less consistent effects on odour liking. Variation in ability to taste propylthiouracil (PROP) might account for this, since PROP supertasters (ST) have been reported both to experience stronger sweetness intensity and to be more likely to dislike sweetness than do PROP nontasters (NT). Alternatively, individual differences in liking for sweetness may transfer to sweet-paired odours independently of PROP sensitivity.

Effects of energy density and portion size on development of acquired flavour liking and learned satiety.

The concept of learned satiety (LS) suggests that associations between the sensory quality and post-ingestive effects of foods may lead to acquired control of meal-size. Although a recent study appeared to support LS since participants learned to eat more of a flavoured cereal with lower energy density (ED) after repeated experience, suggesting that they adjusted voluntary intake to ensure adequate energy was consumed, the large serving portion used in training may have lead to over-satiation. To investigate this further, groups of 12 men were assigned to one of four conditions based on the trained serving portion (150 or 300 g) and presence or absence of cues to differentiate high and low ED versions.

Acquired liking for sweet-paired odours is related to the disinhibition but not restraint factor from the Three Factor Eating Questionnaire.

Previous research suggests that women scoring high on dietary restraint may be insensitive to flavour-flavour learning, but no study has yet explored this using the olfactory conditioning paradigm. Accordingly, 56 women who were sweet likers were classified as either high or low on both the Three Factor Eating Questionnaire restraint and disinhibition scales. They evaluated two odours before and after disguised pairings of one odour with 10% sucrose and the other with 0.

Acquired flavor acceptance and intake facilitated by monosodium glutamate in humans.

Monosodium glutamate (MSG) is known to enhance liking for the flavor of savory foods, but whether associations between flavors and effects of MSG lead to changes in subsequent liking and intake for the flavor alone is unclear. To test this, 32 volunteers evaluated and consumed a novel savory soup with no added MSG before and after four training sessions where the same soup was consumed either unchanged (Control) or with added MSG. The addition of MSG during training increased both pleasantness and savory character of the soup and resulted in a larger increase in rated pleasantness of the soup in the MSG-trained relative to control condition when the soup was re-evaluated Post-training without MSG.

Differential hedonic, sensory and behavioral changes associated with flavor-nutrient and flavor-flavor learning.

Flavor-flavor and flavor-nutrient associations can modify liking for a flavor CS, while flavor-flavor associations can also modify the sensory experience of the trained flavor. Less is known about how these associations modify behavioral responses to the trained CS. To test this, 60 participants classified as sweet likers were divided into five training conditions with a novel flavor CS.