Using a taxonomy of behaviour change techniques to define key components of Stop Delirium! a complex intervention to prevent delirium in care homes

Objective: This paper aims to describe Behaviour Change Techniques (BCTs) used within a multi-component intervention to prevent delirium in older people living in care homes, called Stop Delirium! Methods: The Behaviour Change Technique Taxonomy version 1 (BCTTv1) was used to code and characterise the ‘key ingredients’ within Stop Delirium!. Four sources of information were examined to identify BCTs used: intervention manual and toolkit; the delirium resource box; and contemporaneous written logs recorded by staff delivering the intervention in two feasibility studies. Details of BCTs used in each part of the intervention and whom they were targeting were recorded, as well as the frequency of each identified BCT. Results: 31.2% of all BCTs described in the BCTTv1 were used in the Stop Delirium! intervention. The majority of BCTs focused on changing care home staff behaviour through enhanced education, training and empowerment. ‘Social support (practical)’ was the most frequently occurring BCT. Conclusion: The large number of different BCTs identified within the Stop Delirium! intervention reflects the complexities of multicomponent interventions. The prominence of social support and empowerment further emphasises the group and organisational effort required to improve delirium care. By explicitly identifying and describing the BCTs used in Stop Delirium!, can enhance standardisation and replicability, and promote intervention fidelity for future trial evaluation and implementation of a multicomponent intervention to prevent delirium in long-term care.