Article type
Year
Abstract
Introduction/Objective: 1) To conduct a systematic overview of the effectiveness of dissemination strategies to design a comprehensive framework of research dissemination and utilization, that is applicable to those in clinical program management and policy-making areas. To draw attention to the relevance of theories such as: the Diffusion of Innovations; Organizational Culture; and Decision-Making, to the field of research dissemination and utilization.
Methods: On-line searches of MEDLINE, CINAHL, ERIC, and HEALTHSTAR databases were conducted for the years 1980 to 1997. Relevance criteria determined whether the study a) evaluated dissemination strategies; b) was targeted at health professionals; and c) had a control or comparison group. The criteria to assess validity of the studies followed those set out by the Cochrane Collaboration for review articles. One rater reviewed all of the articles for relevance and validity, after a Kappa of 0.86 was obtained between two independent raters.
Results: This literature has demonstrated that organizational characteristics are more strongly associated with research use than either environmental or individual characteristics, and that these characteristics do not remain constant across health care settings and/or professionals. Academic detailing, audit and feedback, and opinion leaders are the most effective dissemination strategies in changing physician practice and prescribing behaviours. Dissemination interventions that involve one-to-one contact, such as those above, are more effective in changing practice, than the more impersonal or group focused strategies, such as continuing medical or nursing education and workshops.
Discussion: These findings demonstrate the complexity of research utilization, as well as indicate the need to tailor dissemination strategies to the specific needs of the target audience and organization. Future research efforts must begin to focus on the development of dissemination strategies that incorporate organizational and environmental factors, as well as measure the impact these factors have on changing clinical practice and policy decision-making.
Methods: On-line searches of MEDLINE, CINAHL, ERIC, and HEALTHSTAR databases were conducted for the years 1980 to 1997. Relevance criteria determined whether the study a) evaluated dissemination strategies; b) was targeted at health professionals; and c) had a control or comparison group. The criteria to assess validity of the studies followed those set out by the Cochrane Collaboration for review articles. One rater reviewed all of the articles for relevance and validity, after a Kappa of 0.86 was obtained between two independent raters.
Results: This literature has demonstrated that organizational characteristics are more strongly associated with research use than either environmental or individual characteristics, and that these characteristics do not remain constant across health care settings and/or professionals. Academic detailing, audit and feedback, and opinion leaders are the most effective dissemination strategies in changing physician practice and prescribing behaviours. Dissemination interventions that involve one-to-one contact, such as those above, are more effective in changing practice, than the more impersonal or group focused strategies, such as continuing medical or nursing education and workshops.
Discussion: These findings demonstrate the complexity of research utilization, as well as indicate the need to tailor dissemination strategies to the specific needs of the target audience and organization. Future research efforts must begin to focus on the development of dissemination strategies that incorporate organizational and environmental factors, as well as measure the impact these factors have on changing clinical practice and policy decision-making.