131 Barriers to and enablers of the use of the Otology Questionnaire Amsterdam in clinical practice 7 Patients were invited to participate in the study during the period from if they met the following inclusion criteria during the period from December 2022 to April 2023: (1) aged above 16 years, (2) visiting the ENT outpatient clinic with an ear or hearing complaint, (3) have been invited to complete the OQUA before their intake, pre- or post-operative consultation, (4) have an active digital account to access the OQUA in their own electronic patient record, (5) not familiar with a learning or cognitive disability, and (6) have a sufficient knowledge of the Dutch language. A maximum variation strategy was adopted in relation to age and ear- or hearing-related complaints to reflect heterogeneity within otology patient characteristics. There may be an overlap between the patients in the retrospective cohort (Table 1) and those who were invited for interview. Nevertheless, the patients of this qualitative post-implementation study are considered as a separate cohort, given the different time frame of the inclusions and the fact that patients who had not completed the OQUA or had completed it only once were also included. Figure 5: The Behaviour Change Wheel and the relationship with the Theoretical Domains Framework. Reprinted from “The Behaviour Change Wheel: A guide to designing interventions” (p.18 and p. 92) by Michie, S., Atkins, L., West, R., 2014, UK: Silverback Publishing.
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