BACKGROUND Designing implementation interventions to change the behaviour of healthcare providers and other professionals in the health system requires detailed specification of the behaviour(s) targeted for change to ensure alignment between intervention components and measured outcomes. Detailed behaviour specification can help to clarify evidence-practice gaps, clarify who needs to do what differently, identify modifiable barriers and enablers, design interventions to address these and ultimately provides an indicator of what to measure to evaluate an intervention's effect on behaviour change. An existing behaviour specification framework proposes four domains (Target, Action, Context, Time; TACT), but insufficiently clarifies who is performing the behaviour (i.e. the Actor). Specifying the Actor is especially important in healthcare settings characterised by multiple behaviours performed by multiple different people. We propose and describe an extension and re-ordering of TACT to enhance its utility to implementation intervention designers, practitioners and trialists: the Action, Actor, Context, Target, Time (AACTT) framework. We aim to demonstrate its application across key steps of implementation research and to provide tools for its use in practice to clarify the behaviours of stakeholders across multiple levels of the healthcare system. METHODS AND RESULTS We used French et al.'s four-step implementation process model to describe the potential applications of the AACTT framework for (a) clarifying who needs to do what differently, (b) identifying barriers and enablers, (c) selecting fit-for-purpose intervention strategies and components and (d) evaluating implementation interventions. CONCLUSIONS Describing and detailing behaviour using the AACTT framework may help to enhance measurement of theoretical constructs, inform development of topic guides and questionnaires, enhance the design of implementation interventions and clarify outcome measurement for evaluating implementation interventions.

中文翻译：

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动作，演员，背景，目标，时间（AACTT）：用于指定行为的框架。

背景技术设计实施干预以改变卫生保健提供者和其他专业人员在卫生系统中的行为，需要详细说明改变的目标行为，以确保干预成分与测量结果之间的一致性。详细的行为规范可以帮助澄清证据与实践之间的差距，阐明谁需要采取不同的措施，确定可修改的障碍和促成因素，设计干预措施以解决这些问题，并最终提供衡量指标以评估干预措施对行为变化的影响。现有的行为规范框架提出了四个域（目标，动作，上下文，时间； TACT），但不足以阐明谁在执行行为（即，参与者）。指定Actor在以多个不同人执行的多种行为为特征的医疗保健环境中尤其重要。我们提出并描述了TACT的扩展和重新排序，以增强其对实施干预设计人员，从业人员和试验人员的效用：行动，演员，背景，目标，时间（AACTT）框架。我们旨在证明其在实施研究的关键步骤中的应用，并提供其在实践中使用的工具，以阐明医疗保健系统各个级别上利益相关者的行为。方法和结果我们使用了French等人的四步实施过程模型来描述AACTT框架的潜在应用，以便（a）阐明谁需要做不同的事情，（b）识别障碍和促成因素，（c）选择适合目的的干预策略和组成部分，以及（d）评估实施干预措施。结论使用AACTT框架描述和详细描述行为可能有助于增强理论构造的度量，为主题指南和问卷的开发提供信息，增强实施干预措施的设计并阐明评估实施干预措施的结果度量。