Developing and selecting interventions for translating knowledge to action

A wide range of methods exists for the identification of barriers to change10 and was discussed in more detail in an earlier paper in this series.1 Briefly, these methods can be divided into three broad categories. A first category comprises methods (i.e., interviews, questionnaires and group-based...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Canadian Medical Association journal (CMAJ) 2010-02, Vol.182 (2), p.E85-E88
Hauptverfasser: Wensing, Michel, Bosch, Marije, Grol, Richard
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:A wide range of methods exists for the identification of barriers to change10 and was discussed in more detail in an earlier paper in this series.1 Briefly, these methods can be divided into three broad categories. A first category comprises methods (i.e., interviews, questionnaires and group-based methods) to identify barriers to change as reported by professionals, patients and others. This type of method can be used simply or more scientifically, but its disadvantage is that the barriers reported may have little or no impact on knowledge translation in reality. An example is the study on barriers to changing treatment of heart failure (described above), which was based on semistructured questionnaires.6 This study found that family physicians perceived, on average, four barriers in prescribing ACE inhibitors or optimizing the dosage of these drugs. However, no significant relationships were found between the barriers they perceived and the prescribing of ACE inhibitors. A "common sense" use of theories would involve considering the chosen objectives and deciding which interventions are suggested by the theories to influence the determinants for change. This decision can be made in a group, so that the method used is close to the exploratory method. Suggestions about which interventions for knowledge translation could be linked to theory-based factors are provided in Appendix 1 (available at www.cmaj .ca/cgi/content/full/cmaj.081233/DC1). No firm research-based evidence exists to support either exploratory or theory-based approaches to creating an intervention for knowledge translation. We suggest combining explorative and theory-based methods to select interventions. Explorative methods may help in the consideration of issues that were not anticipated. The use of theory might help to broaden the scope of factors considered and thus reduce the chance of overlooking important issues. How comprehensive and systematic the analysis of determinants of change has to be is not clear. The added value of tailoring interventions for knowledge translation has not been proven. A systematic review on the effectiveness of tailored versus nontailored interventions did not show the added value of tailoring interventions to identified barriers.27 An explorative review that included some of the same studies28 found that many interventions for knowledge translation focused on a few cognitive factors specific to clinicians, such as gaps in knowledge, although a much wider r
ISSN:0820-3946
1488-2329
DOI:10.1503/cmaj.081233