Key steps to making and using a Table of changes

  1. Collect feedback from target intervention users using one / a combination of the methods described on the Optimising Interventions page – if you don’t have much time, having discussions with PPI and other stakeholders is really important.
  2. Make notes during discussions and/or audio- or video- record interviews where possible.
  3. Use these notes and/or interview transcripts to draw out key positive and negative comments about specific elements / features/ sections of your intervention materials – record these in the first two columns of the table. Negative comments are very important for identifying things that may need changing - but recording positive comments allows the team to discuss whether or not to change items that some people like even if others do not.
  4. Discuss with members of your team (including PPI and stakeholders) the ways any identified problems might be solved – record these in the third column.
  5. The team can use the coding framework provided to help decide how important any proposed changes are and why they are important (recorded in the fourth column). It’s fine to use more than one code. Your team can adapt or replace this set of codes and/or the criteria for deciding how important a change is to reflect what you consider most important for your intervention.

Coding Framework

Code
Stands For
Means

IMP

Important for behaviour change

Important change. For example, it may be important because it is likely to impact engagement or behaviour change, or for practical, ethical or safety reasons.

EAS

Easy and uncontroversial

An easy and feasible change that doesn’t involve any major design changes. For example, a participant was unsure of a technical term, so you add a definition. 

REP

Repeatedly

This was said repeatedly, by more than one participant.

EXP

Experience  

This is supported by experience. Please specify what kind of experience, for example:

  1. PPIs agree this would be an appropriate change.
  2. Experts (e.g. clinicians on your development team) agree that this would be an appropriate change.
  3. Literature: This is supported by evidence in the literature.

NCON

Does not contradict

This does not contradict experience (e.g. evidence), or the Logic Model, or the Guiding Principles

NC

Not changed 

It was decided not to make this change. Please explain why (e.g. it would not be feasible). 

  1. Discuss with your team which of the agreed changes are essential and do-able within your resources, using the MoSCoW framework (Must do; Should do; Could do; Would Like to do, and record the final agreed changes in columns 5 and 6.
  2. Additional columns can be included depending on what your team needs to document or keep track of, e.g. the date/version number of changes made. We sometimes find it useful to use Excel for our Table of Changes, as this enables you to filter or sort by certain columns when reviewing changes. Here is an online template in Excel, which you can copy into a new file and adapt for your work.
    Strength and Balance Concerns pages
    Negative Comments Positive Comments Possible Change Reason for change Agreed change MoScoW
    “I very seldom make plans to go and visit the doctor. And I certainly wouldn’t regarding this, I think.” (P1)

    “There’s lots of things I’ve seen recently, that have ‘check with your doctor first.’ On the one hand, the television is showing us a surgery waiting room full of people. And you’ve just popped up and said, ‘Will it be all right if I do some exercise?’” (Laughs.)” (P2)

    Would be surprised if a patient came to me and asked for this type of advice –better for them to check with those who knew them best first (GP Coinvestigator)
    Suggest individuals discuss with family member/friend first if they are unsure.
    EAS, REP, EXP – participants mindful of high demand on GP and don’t feel this is necessary/ feel able to make decision themselves.

    Resonates with views of GP coinvestigator

    Suggest individuals discuss with family member/friend first if unsure. If still concerned after this then ask advice of GP M
    Ideas about breaking up sedentary time
    Negative Comments Positive Comments Possible Change Reason for change Agreed change MoScoW
    Unsure how realistic/’sensible’ some of the suggestions about breaking up sitting time are – will people really do these? (PPI feedback)

    “I mean these are…, leaving your phone in the hall, you’ve always got your mobile on you, haven’t you?” (P5)

    “Leave your bedtime book on the kitchen table. I don't get that one” (P6)
    Remove and/or replace these suggestions IMP, EXP, REP – if suggestions not deemed acceptable/feasible by multiple participants and PPI contributors, risk that this would impair uptake of the recommended behaviour Replace suggestions with ideas about introducing small movements into otherwise sedentary activities M

    Provides an explanation of the table of changes categories.

    Bradbury, K., Morton, K., Band, R., van Woezik, A., Grist, R., McManus, R., ... Yardley, L. (2018). Using the Person-Based Approach to optimise a digital intervention for the management of hypertension. PLoS ONE, 13(5), 1-18. [e0196868]. https://doi.org/10.1371/journal.pone.0196868Cite.

    Click here to find more papers that relate to the using the table of changes.