Objectives/Purpose
With advances in the use of implementation science in healthcare and growing recognition of the importance of specifying behaviour in implementation planning, there is a need for practical tools that enable detailed and consistent behavioural specification. In response, we developed and refined a semi-structured interview guide (AACTT-InG) that systematically elicits the five domains of the AACTT framework (Action, Actor, Context, Target and Time) to support comprehensive behavioural specification for implementation planning in dynamic healthcare systems.
Sample and Setting
Twelve multidisciplinary healthcare professionals from clinical, research, and allied health settings participated. The sample included individuals with and without prior experience in implementation science or familiarity with the AACTT framework.
Procedures
Using Kallio et al.’s five-step method for developing qualitative interview guides, we conducted a literature review, drafted a prototype guide, and piloted it through think-aloud interviews. Interview transcripts were deductively analysed using adapted evaluative criteria informed by Sekhon et al., focusing on question clarity, relevance, and redundancy.
Results
Of 215 studies citing AACTT, only three applied it in qualitative interviews, highlighting a gap in operationalisation. Think-aloud testing revealed issues with question clarity and redundancy, particularly within the ‘context’ and ‘target’ domains. These were resolved through simplification, reordering, and refining prompts. The final AACTT-InG supported detailed mapping of current, ideal, and alternative behaviours. Participants noted that the guide encouraged reflection on task-sharing, roles, and care settings—enhancing its utility for real-world implementation planning.
Conclusion and Clinical Implications
AACTT-InG is a novel, theory-informed tool that supports detailed behavioural specification in healthcare. It enhances implementation planning by mapping current practice, care gaps, and alternative models. This promotes adaptable, efficient care delivery and sustainable intervention design. The guide enables researchers to move beyond static descriptions to context-responsive care models, aligning implementation science with real-world system needs supporting better healthcare delivery.