Introduction: Survey data, when compared to CCPC (Cochrane Collaboration Pregnancy and Childbirth) Overview results, showed many gaps between research evidence and intrapartum nursing practice. A strategy had successfully altered selected physician practices but had never been tested with nurses. The objective of the project was to evaluate a marketing strategy to increase the impact of CCPC Overview results on intrapartum nursing practice. The primary outcome was the rate of epidural anaesthesia, which was expected to decrease if nurses spent more time providing support to labouring women. Secondary outcomes included rates of other useless/harmful obstetric interventions.

Methods: The design was an RCT; 20 hospitals were randomly allocated to either the experimental or control group. Nurses, chosen by their colleagues as educational influentials (Els), attempted to change practices in their settings over a one-year intervention period.

Results: The marketing strategy was largely unsuccessful, resulting in no improvements in the experimental group in either obstetrical outcomes or nurses' support for labouring women.

Discussion: Unlike the medical studies, which have involved relatively simple and single behaviour changes, in this trial nurses were asked to make multiple, complex changes. Also, nursing and medicine have very different cultural norms. We recommend that future trials involve all stakeholder groups: physicians, nurses, and clients.