Building core domains for the evaluation of PBS: A consensus-based approach

Background: The PBS framework brings together values, theory and procedures that principally facilitate high quality lifestyles and constructive changes for people with disabilities, other stakeholders and organisations. Most commonly, however, PBS research has focused on a small range of potential outcomes, with a primary emphasis on reducing behaviour that challenges (CB). Agreeing a more comprehensive set of outcome domains that fit with the UK context is important for ensuring the implementation and development of PBS. Method and materials: This study used a three phase, consensus-building approach to identify a set of core outcome domains for PBS. Phase One comprised a four-round Delphi exercise to identify an initial pool of domains and overall structure. Subsequent phases involved stakeholder voting exercises to identify core domains and a stakeholder representative group to shape final wording. Results: A total of 23 core domains were identified that covered a broad scope of outcomes for people with disabilities, family and paid caregivers, and systems change at an organisational level. Conclusions: The identified domains provide a useful structure to support the evaluation and implementation of PBS in the UK with potential benefits for people with disabilities, families, professionals and commissioners. The core domains will also allow for development of focused research programmes to build a more detailed evidence base for best practice.