StrategEase tool
Now available in French! Check it out.
How the mapping works
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Barriers and facilitators operate at multiple levels: individual, organizational, community, and/or wider system levels.
Individual-level change is at the heart of most change efforts because people need to perform change, regardless of what level of the system change is occurring. This is why we focus primarily on individual change strategies in this tool.
The barriers and facilitators that individuals face can hinder or encourage behaviour change. These types of barriers can be mapped onto the Capability-Opportunity-Motivation-Behavior theory (COM-B) and the Theoretical Domains Framework (TDF). The COM-B tells us how change occurs. The TDF unpacks each component of the COM-B and tells us what specific types of barriers and facilitators can determine change.
Before using the StrategEase tool, you will need to collect barriers and facilitators and map them to the TDF. Based on your identified barriers and facilitators, list the relevant domains of the TDF.
✏️ If you would like to learn more about the process of collecting and mapping barriers and facilitators, join us for StrategEase: The HOW of Creating Sustainable Change.
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Change strategies (the HOW) are strategies that are meant to help people do the WHAT more easily. They do this by helping people overcome barriers and leverage facilitators to change.
The first step of selecting change strategies is to identify intervention functions (Types of HOWs). Types of HOWs describe the underlying function a change strategy would serve – you can think of this as the “purpose” of the change strategy (e.g., the function of professional development might be to “train” and the function of shadowing experts might be to “model”). They are not to be confused with change strategies themselves, but are broad categories in which change strategies can be grouped.
Based on the pertinent TDF domains you listed in the previous step, you can identify which functions (Types of HOWs) are relevant. These serve as the function/purpose of you change strategies and can be used to help you select change strategies.
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For each function (Types of HOWs), we have identified specific change strategies you can use that can serve this function and address the underlying barriers and facilitators. Going one step further – from a broad initiative to a more specific change strategy – is required so that your change strategies are more easily operationalizable.
All change strategies are not appropriate, applicable, and feasible in all situations. Therefore, as a team, you can review the possible change strategies and select the most appropriate, applicable, and feasible change strategies for your setting.
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Once you have selected your change strategies, it’s important to be thoughtful in how you enact the change strategy. For example, make sure that for each change strategy, you clearly outline the function(s) it serves and list all of the barriers and facilitators this change strategy is addressing.
There are additional frameworks that can help you think through the components of the change strategy.
Download the StrategEase tool worksheets
About this tool
The Center for Implementation supports people to plan for implementation and apply strategies that will lead them to effective change. Selecting change strategies is a fundamental HOW of implementation and is a vital component of an implementation plan.
StrategEase was formerly a paper-based process that has turned into a free, online interactive tool for busy professionals. It guides you through four steps that will simplify and speed up the time it takes to plan for implementation.
The goal of this tool is to guide you through the process of mapping your barriers and facilitators to a list of change strategies. It will help you select change strategies by linking them to theories and frameworks that can help you identify the underlying reasons for change and the types of strategies that can help address these reasons.
We explore the StrategEase process in greater detail in our online course, StrategEase: The HOW of Creating Sustainable Change.
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This tool has been developed and designed specifically to help you go through the process of selecting change strategies.
We wanted to make this tool freely accessible; therefore, it’s not mandatory that you take the course to use the tool. However, you must have already completed the following steps prior to using the tool:
Defining and clearly communicating the WHY
Defining the WHO
Describing the WHAT
Assessing barriers and facilitators
Mapping barriers and facilitators to the Theoretical Domains Framework (TDF)
Considerations
Given the tool’s limitations, it is important to note that this tool will not:
Help you map your barriers and facilitators to the Theoretical Domains Framework (TDF)
Replace the need of a barriers and facilitators assessment
Tell you which specific strategies to use
Looking for guidance?
To learn more about the process of clearly defining your WHY, WHO, and WHAT including how to assess and map barriers and facilitators, join us for StrategEase: The HOW of Creating Sustainable Change.
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Part of our foundational equity work was to examine important research related to equity and implementation, and synthesize key guiding questions from research and practice that can help people reflect on equity at every step of StrategEase. These guiding questions are provided to users of this tool.
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We would like to acknowledge and thank the researchers who have developed the theories, frameworks, and approaches that have contributed to the development of this tool. Without their amazing efforts, this tool would not have been possible.
We would like give special thanks to the University College London Centre for Behaviour Change. Their work on the theoretical domains framework, the capability-opportunity-motivation-behavior, and intervention functions serves as the foundation for this tool.
The change strategies offered in this tool have been drawn from a combination of the Expert Recommendations for Implementing Change (ERIC) strategies, the EPOC taxonomy, behaviour change techniques, intervention mapping, and crowdsourcing activities with implementation practitioners.
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The Center for Implementation. (2022). StrategEase Tool [Web application]. https://thecenterforimplementation.com/strategease-tool
Want to learn more about how StrategEase can support your initiative?
Dive deeper into the StrategEase process in our online course, StrategEase: The HOW of Creating Sustainable Change.
We break down the components of the StrategEase Pathway to help you systematically understand barriers and facilitators to change, and how to select effective strategies that address them.
Open for enrollment year-round, 100% online, and self-paced.
List of change strategies and definitions*
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Audit and feedback: Collect and summarize performance data related to the ideal practice over a specified time period and give it to providers and administrators to monitor, evaluate, and modify behavior.
Capture and share local knowledge: Capture local knowledge from implementation sites on how individuals implemented the WHAT within their setting and then share knowledge with other sites (e.g., data, resources, lessons learned, etc.).
Community of Practice (CoP): Facilitate the formation of groups of providers or provider organizations, and foster a collaborative learning environment to improve implementation of the WHATs (e.g., a CoP where groups of people with a common interest deepen their knowledge and expertise in this area by interacting on an ongoing basis).
Educational materials: Create and distribute educational materials (e.g., guidelines, manuals, and toolkits) in person, by mail, and/or electronically to improve knowledge about the WHAT.
Educational sessions: Hold meetings involving the audience (e.g., providers, administrators, other organizational groups, and community, patient/consumer, and families) to improve knowledge about the WHAT.
Integrating the topic into staff meetings: Discuss the WHATs in staff meetings.
Knowledge broker: Use a knowledge broker (e.g., individual, groups, organizations) to provide a link between researchers, intermediaries, implementers, and end-users to develop relationships, provide ongoing support, and build capacity to support implementation of the WHATs.
Mass media: Use media to reach large numbers of people to spread the word about the THING or the WHAT.
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Competency-based training: Plan and conduct training in the WHATs in an ongoing manner for all individuals involved.
Educational materials: Create and distribute educational materials (e.g., guidelines, manuals, and toolkits) in person, by mail, and/or electronically to improve knowledge about the WHAT.
Educational outreach visit: Have a trained person (external to the setting/organization) meet with providers in their practice settings and educate them on how to perform the WHAT.
Educational sessions: Hold meetings involving the audience (e.g., providers, administrators, other organizational groups, and community, patient/consumer, and families) to improve knowledge about the WHAT.
Local opinion leaders: Inform providers identified by colleagues as opinion leaders or "educationally influential" about the WHATs and support them to influence colleagues to adopt the WHATs.
Mentorship: Adopt formal or informal mentorship models to support use of the WHAT.
Peer-to-peer learning: Partner individuals (e.g., in similar roles, occupations, etc.) for the purpose of shared training and building capacity.
Provide supervision: Provide individuals with ongoing supervision focused on the WHAT. Supervisors who will supervise individuals should also be trained in the WHAT.
Train-the-trainer: Train designated providers or organizations so that they can train others in the WHATs.
Work with educational institutions: Encourage educational institutions to train providers in the WHATs.
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Model change: Have experts/leaders/respected colleagues’ model or simulate the WHATs.
Provide supervision: Provide individuals with ongoing supervision focused on the WHAT. Supervisors who will supervise individuals should also be trained in the WHAT.
Shadow other experts: Provide ways for designated WHOS to directly observe other experienced people perform the WHAT.
Simulate change: Use technology or interactions with other to practice doing the WHAT is a simulated environment (e.g., role play or practicing with an app).
Visit other sites: Visit sites that have been successful in implementing the WHATs.
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Champions: Identify individuals who show interest and prepare them to dedicate themselves to supporting, marketing, and overcoming indifference or resistance related to implementing the doing the WHATs.
Engage leaders: Engage and train designated change leaders (e.g., within an organization or recruit from outside to fill roles such as executive sponsor or day-to-day manager) to support implementing the change.
Facilitation: Provide practice facilitation through a process of problem solving, enabling, and supporting individuals and organizations to adopt the WHATs.
Identify early adopters: Identify individuals at local sites that can inspire others. They can be people tasked with implementing the WHATs and those that are already applying it.
Implementation coaching: Seek guidance from experts in implementation to support and provide training for the implementation initiative.
Leaders supporting the change: Leaders express their support for the WHATs or the overall vision of where the work is going.
Local consensus process: Engage local providers and other relevant partners in discussions about whether the chosen problem is important and whether the selected THING to address it is appropriate (e.g., adapting a guideline for a local health system).
Mass media: Use media to reach large numbers of people to spread the word about the THING or the WHAT.
Opinion leaders: Identify individuals who have a lot of influence and are usually the people who others automatically turn to for advice.
Public demand: Attempt to influence “market” (public demand) to increase the need for the THING.
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Accreditation: Strive to alter accreditation standards so that they require or encourage people to do that WHAT. Work to alter membership organization requirements so that those who want to affiliate with the organization are encouraged or required to do the WHAT.
Allocations of funds: Allocate or re-allocate resources to meet needs (including funds, human resources, physical space…).
Audit and feedback: Collect and summarize performance data related to the ideal practice over a specified time period and give it to providers and administrators to monitor, evaluate, and modify behavior.
Change payment schemes or structures: Set system priorities to encourage implementation of the THING or WHATs by establishing government/funder/service payer funding formulas, proposal requests, and how providers are paid for providing the THING or supporting the use of WHATs.
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Action planning: Detailed plan of how to perform the behavior.
Allocation of funds: Allocate or re-allocate resources to meet needs (including funds, human resources, physical space…).
Build a coalition/network: Identify and build a coalition or network of individuals and/or organizations who share the same goals, vision, or desire to implement the THING (e.g., a coalition may be best suited for policy change; a network may be considered to understand and address problems, create solutions, and disseminate best practices).
Champions: Identify individuals who show interest and prepare them to dedicate themselves to supporting, marketing, and overcoming indifference or resistance related to implementing the doing the WHATs.
Change payment schemes or structures: Set system priorities to encourage implementation of the THING or WHATs by establishing government/funder/service payer funding formulas, proposal requests, and how providers are paid for providing the THING or supporting the use of WHATs.
Community of Practice (CoP): Facilitate the formation of groups of providers or provider organizations, and foster a collaborative learning environment to improve implementation of the WHATs (e.g., a CoP where groups of people with a common interest deepen their knowledge and expertise in this area by interacting on an ongoing basis).
Data sharing: Acquire, manage, report, and use data to influence providers to adopt the WHAT.
Engage leaders: Engage and train designated change leaders (e.g., within an organization or recruit from outside to fill roles such as executive sponsor or day-to-day manager) to support implementing the change.
Goal setting: Identify or agree on a defined goal (e.g., a planned behavior change).
Implementation coaching: Seek guidance from experts in implementation to support and provide training for the implementation initiative.
Involve executive boards: Connecting with and engaging executive boards in the initiative and potentially taking actions to support the initiative.
Leaders supporting the change: Leaders express their support for the WHATs or the overall vision of where the work is going.
Opinion leaders: Identify individuals who have a lot of influence and are usually the people who others automatically turn to for advice.
Patients/public as active participants: Prepare patients/consumers/public to be active in the change (e.g., to ask questions about the WHAT, and evidence behind the THING).
Problem solving: Analyze or prompt people to analyze barriers and facilitators to achieving a change or goal.
Restructure the environment: Physically change the environment to support the change.
Self-monitoring of behavior: Establish a method for the person to monitor and record their behaviour(s) (e.g., tracking what you eat).
Social support: Advise on, arrange or provide social support (e.g., encouragement, problem solving, and/or emotional support).
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Change sites that provide services: Change the setting where the WHAT is provided (e.g., specialized vs. non specialized facility).
Change the physical environment: Change the physical environment to support the use of the WHAT (e.g., change layout of a room, add required equipment).
Prompts/cues: Develop systems to help individuals recall information and/or prompt them to use the WHAT.
Record systems: Change records systems to allow better capturing of information and assessment of implementation or innovation outcomes related to the WHATs (e.g., electronic patient records).
Reminders: Develop reminder systems to help providers recall information and/or prompt the performance of the WHAT.
Revise professional roles: Shift and revise roles among professionals and redesign job characteristics to promote uptake of the WHATs.
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Change payment schemes or structures: Set system priorities to encourage implementation of the THING or WHATs by establishing government/funder/service payer funding formulas, proposal requests, and how providers are paid for providing the THING or supporting the use of WHATs.
Change policies: Change a policy (e.g., at an organizational level) to facilitate the adoption of the WHATs.
Develop disincentives: Work to disincentivize the adoption and implementation of the WHAT.
Mandate change: Have leadership declare the priority of the THING or the WHAT and their commitment to seeing it implemented.
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Knowledge: An awareness of the existence of something
Skills: An ability or proficiency acquired through practice
Memory, Attention, & Decision Processes: The ability to retain information, focus selectively on aspects of the environment and choose between two or more alternatives
Behavior Regulation (e.g., habits): Anything aimed at managing or changing objectively observed or measured actions
Beliefs about Capabilities (e.g., confidence): Acceptance of the truth, reality, or validity about an ability, talent, or facility that a person can put to constructive use.
Social/Professional Role/Identity: A coherent set of behaviours and displayed personal qualities of an individual in a social or work setting
Beliefs about Consequences: Acceptance of the truth, reality, or validity about outcomes of a behaviour in a given situation
Emotions: A complex reaction pattern, involving experiential, behavioural, and physiological elements, by which the individual attempts to deal with a personally significant matter or event
Goals (e.g., I want to): Mental representations of outcomes or end states that an individual wants to achieve
Intentions (e.g., I plan to): A conscious decision to perform a behaviour or a resolve to act in a certain way.
Reinforcing Behavior: Increasing the probability of a response by arranging a dependent relationship, or contingency, between the response and a given stimulus.
Optimism/Pessimism: The confidence that things will happen for the best or that desired goals will be attained or the tendency to see the worst aspect of things or believe that the worst will happen
Environmental Context/Resources: Any circumstance of a person's situation or environment that discourages or encourages the development of skills and abilities, independence, social competence, and adaptive behaviour.
Social Influences (e.g., influenced by others): Those interpersonal processes that can cause individuals to change their thoughts, feelings, or behaviours.
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Educating: Increasing knowledge or understanding.
Training: Imparting skills.
Modeling: Providing an example for people to aspire to imitate.
Persuading: Using communication to induce positive or negative feelings or simulate action.
Incentivizing: Creating expectation of reward.
Enabling: Increasing means/reducing barriers to increase capability or opportunity.
Environmental Restructuring: Changing the physical or social context.
Restricting: Using rules to reduce the opportunity to engage in target behaviors (or to increase target behaviors by reducing opportunities to engage in competing behaviors).