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What strategies are available to address important barriers?

Brainstorming is a useful method for identifying potential implementation strategies to address important barriers and enablers.  This can be done in a structured or unstructured way. Typically, brainstorming generates ideas through face-to-face interaction as participants respond to each other’s suggestions to identify new ones, without criticism. Any evaluation of ideas is explicitly forbidden until after the generation process is completed. Participants can attend a session either in person or exchange ideas over the Internet.

Bringing together a group of people with different types of expertise and perspectives to generate as many potential solutions as possible increases the chance of finding valuable ideas. Subsequent discussion of proposed solutions and their merits can also help to focus attention on the ones that are most promising.

Theories can be used to inform the selection of interventions, but it also relies to a large extent on logic and judgement. Wensing and colleagues, for example, successfully matched implementation strategies to barriers related to changing professional practice, using a set of constructs derived from theories relevant to changing professional practice.6, 10, 11 Similarly, Michie and colleagues matched theoretically-derived behavioural determinants to behaviour change techniques.12 However, there is little research evidence supporting the use of specific interventions for specific barriers. Therefore, a ‘common sense’ use of theories can help to identify interventions to address different types of barriers, but this is mainly by providing frameworks and approaches to identifying interventions. Similarly, theory-based approaches can also be used when structuring and organising brainstorming sessions.

A checklist for identifying barriers and enablers to implementing a policy option and enablers and examples of potential interventions to address different types of barriers are provided in the ‘Additional resources’ section of this guide. An example showing how this checklist was applied by the REACH team in Uganda in their policy brief on task shifting is also provided in the ‘Additional resources’.



This page was last updated November 2011.