Objective To evaluate whether a multifaceted behavioural change programme increases physical activities in patients with Parkinson's disease.
Over 20 systematic reviews [ 25- 27] and reviews of them[ 28, 29] suggest that behaviour change interventions should be multifaceted, assess barriers to change, be responsive to local circumstances, have a focused and active educational outreach component, including skills development, and be resonant with clinicians' values[ 30, 31].
This result provides support that food safety training interventions with more than one session or lesson and media campaigns and messaging interventions that provide materials through more than one medium or exposure type (i.e. multifaceted interventions) can enhance consumer safe-food handling behaviour change.
Behaviour change may require more complex and multifaceted interventions that include practice organisation strategies to initiate, support and maintain change.
Similarly to the other CME courses, the PSP modules follow the established adult education principles that are most likely to lead to behaviour change in GPs' practices, by offering multifaceted, multi-professional and interactive learning opportunities.
Conversely, a cluster RCT in a sample of UK general practitioners showed that an active, tailored, multifaceted educational intervention, including the identification and targeting of specific barriers to behaviour change via outreach visits, failed to demonstrate a statistically significant change in prescribing or referral behaviour [ 82].
Therefore, appropriate performance measures would need to be identified because when multifaceted interventions were grounded in an accurate assessment of barriers to change, successful behaviour change was more likely to result [ 36].
Synthesis of existing evidence will inform future studies, but the heterogeneity in target populations recruited, behaviour change techniques and intervention strategies employed, and measurement conducted, may require a multifaceted review method.
In the field of obstetrics, for example, one study concluded that a multifaceted strategy based on audit and feedback that is facilitated by local opinion leaders may be the most effective behaviour change than any single KT intervention [ 35].
