Associations among unit leadership and unit climates for implementation in acute care: a cross-sectional study.

PubMed

Shuman, Clayton J; Liu, Xuefeng; Aebersold, Michelle L; Tschannen, Dana; Banaszak-Holl, Jane; Titler, Marita G

2018-04-25

Nurse managers have a pivotal role in fostering unit climates supportive of implementing evidence-based practices (EBPs) in care delivery. EBP leadership behaviors and competencies of nurse managers and their impact on practice climates are widely overlooked in implementation science. The purpose of this study was to examine the contributions of nurse manager EBP leadership behaviors and nurse manager EBP competencies in explaining unit climates for EBP implementation in adult medical-surgical units. A multi-site, multi-unit cross-sectional research design was used to recruit the sample of 24 nurse managers and 553 randomly selected staff nurses from 24 adult medical-surgical units from 7 acute care hospitals in the Northeast and Midwestern USA. Staff nurse perceptions of nurse manager EBP leadership behaviors and unit climates for EBP implementation were measured using the Implementation Leadership Scale and Implementation Climate Scale, respectively. EBP competencies of nurse managers were measured using the Nurse Manager EBP Competency Scale. Participants were emailed a link to an electronic questionnaire and asked to respond within 1 month. The contributions of nurse manager EBP leadership behaviors and competencies in explaining unit climates for EBP implementation were estimated using mixed-effects models controlling for nurse education and years of experience on current unit and accounting for the variability across hospitals and units. Significance level was set at α < .05. Two hundred sixty-four staff nurses and 22 nurse managers were included in the final sample, representing 22 units in 7 hospitals. Nurse manager EBP leadership behaviors (p < .001) and EBP competency (p = .008) explained 52.4% of marginal variance in unit climate for EBP implementation. Leadership behaviors uniquely explained 45.2% variance. The variance accounted for by the random intercepts for hospitals and units (p < .001) and years of nursing experience in current unit (p < .05) were significant but level of nursing education was not. Nurse managers are significantly related to unit climates for EBP implementation primarily through their leadership behaviors. Future implementation studies should consider the leadership of nurse managers in creating climates supportive of EBP implementation.

Physiotherapists’ behaviour, attitudes, awareness, knowledge and barriers in relation to evidence-based practice implementation in Saudi Arabia: a cross-sectional study

PubMed Central

Alshehri, Mansour A.; Alalawi, Ahmed; Alhasan, Hammad; Stokes, Emma

2017-01-01

ABSTRACT Aim: The implementation of evidence-based practice (EBP) is extremely important and plays a vital role in healthcare practice. There have been few studies concerning the level of healthcare provided to patients in Saudi Arabia, using EBP as an indicator. This study is aimed at investigating physiotherapists’ behaviour, attitudes, awareness and knowledge about EBP, along with barriers that curb the implementation of EBP. Methods: A sample of convenience was used and an online survey consisting of 14 closed-ended questions was given to both clinical and academic physiotherapists in Saudi Arabia from May to October 2016. Data regarding demographics, behaviour, attitudes, awareness, knowledge, previous formal training and barriers to implementation of EBP were recorded. The data were analysed using IBM SPSS version 19. Results: A total of 604 physiotherapists participated in the survey, out of which 385 respondents provided complete data. Nine participants were undergraduate physiotherapy students or not physiotherapists and their responses were excluded. The final number of participants included in data analysis was 376. The majority of the participants were men (60.4%) and most of them had completed their bachelor degree (66.2%). Although most physiotherapists reported a positive attitude towards the use of research in practice, there were many who were unfamiliar with the terms and implementation of EBP. The majority of physiotherapists had no formal EBP training (70.2%) in universities or any authorized training centres. According to the responses collected, the most important barrier to the implementation of EBP was insufficient teaching in previous education (43.1%), followed by lack of research knowledge and skills (36.4%). The study revealed that there was a significant association between physiotherapists’ attitude and their education level, while no significant associations were identified based on other demographic data. In addition, there were significant associations between physiotherapists’ awareness and knowledge and demographics such as education level, work setting, job title and previous training in EBP. Conclusion: There is a prominent gap in terms of understanding and applying the concept of EBP among physiotherapists in Saudi Arabia. Given that the majority of practicing physiotherapists reported no formal training in EBP, there is a need to integrate concepts related to EBP into the undergraduate and graduate curriculum. In addition, strategies must be developed and implemented to encourage practicing physiotherapists for gaining knowledge and proficiency in EBP. PMID:28399014

Implementation of evidence-based practice across medical, nursing, pharmacological and allied healthcare professionals: a questionnaire survey in nationwide hospital settings

PubMed Central

2013-01-01

Background Implementation of evidence-based practice (EBP) is regarded as core competence to improve healthcare quality. In the current study, we investigated the EBP of six groups of professionals: physicians, nurses, pharmacists, physical therapists, technicians, and other allied healthcare personnel. Methods A structured questionnaire survey of regional hospitals throughout Taiwan was conducted by post in 2011. Questionnaires were mailed to all healthcare workers of 11 randomly selected hospitals. Linear and logistic regression models were used to examine predictors for implementing EBP. Results In total, 6,160 returned questionnaires, including 645 from physicians, 4,206 from nurses, 430 from pharmacists, 179 from physical therapists, 537 from technicians, and 163 from other allied healthcare professionals, were valid for the analysis. Physicians and pharmacists were more aware of EBP than were the other professional groups (p < 0.001). Positive attitudes toward and beliefs in EBP were significantly lower among nurses than in the other groups (p < 0.001). Physicians had more sufficient knowledge and skills of EBP than did the other professionals (p < 0.001); in addition, they implemented EBP for clinical decision-making more often and perceived fewer personal barriers to EBP (p < 0.001). Multivariate logistic regression analyses showed that EBP implementation was associated with the following characteristics of participants: EBP training, having a faculty position, academic degree, one's profession, and perceptions (beliefs, attitudes, knowledge, skills and barriers). Conclusions This study depicts various levels of EBP implementation among medical, nursing, pharmacological, and allied healthcare personnel. There were significant differences in their implementation of EBP. We observed that certain factors were associated with EBP implementation, including personal backgrounds and perceptions toward EBP. The data suggest that strategies for enhancing EBP implementation should differ for various groups of professionals. PMID:24063756

Perceptions of Approved Clinical Instructors: Barriers in the Implementation of Evidence-Based Practice

PubMed Central

Hankemeier, Dorice A.; Van Lunen, Bonnie L.

2013-01-01

Context: As evidence-based practice (EBP) becomes prevalent in athletic training education, the barriers that Approved Clinical Instructors (ACIs) experience in implementing it with students need to be understood. Objective: To investigate barriers ACIs face when implementing EBP concepts in clinical practice and in teaching EBP to professional athletic training students and to investigate the educational emphases to improve the barriers. Design: Qualitative study. Setting: Telephone interviews. Patients or Other Participants: Sixteen ACIs (11 men, 5 women; experience as an athletic trainer = 10 ± 4.7 years, experience as an ACI = 6.81 ± 3.9 years) were interviewed. Data Collection and Analysis: We interviewed each participant by telephone. Interview data were analyzed and coded for common themes and subthemes regarding barriers and educational emphases. Themes were triangulated through multiple-analyst triangulation and interpretive verification. Results: Barriers to EBP incorporation and educational emphasis placed on EBP were the main themes reported. Resources, personnel, and student characteristics were subthemes identified as barriers. Resource barriers included time, equipment, access to current literature, and knowledge. Coworkers, clinicians, and coaches who were unwilling to accept evidence regarding advancements in treatment were identified as personnel barriers. Programmatic improvement and communication improvement were subthemes of the educational emphasis placed on EBP theme. The ACIs reported the need for better integration between the clinical setting and the classroom and expressed the need for EBP to be integrated throughout the athletic training education program. Conclusions: Integration of the classroom and clinical experience is important in advancing ACIs' use of EBP with their students. Collaborative efforts within the clinical and academic program could help address the barriers ACIs face when implementing EBP. This collaboration could positively affect the ability of ACIs to implement EBP within their clinical practices. PMID:23675798

Assessing the organizational context for EBP implementation: the development and validity testing of the Implementation Climate Scale (ICS).

PubMed

Ehrhart, Mark G; Aarons, Gregory A; Farahnak, Lauren R

2014-10-23

Although the importance of the organizational environment for implementing evidence-based practices (EBP) has been widely recognized, there are limited options for measuring implementation climate in public sector health settings. The goal of this research was to develop and test a measure of EBP implementation climate that would both capture a broad range of issues important for effective EBP implementation and be of practical use to researchers and managers seeking to understand and improve the implementation of EBPs. Participants were 630 clinicians working in 128 work groups in 32 US-based mental health agencies. Items to measure climate for EBP implementation were developed based on past literature on implementation climate and other strategic climates and in consultation with experts on the implementation of EBPs in mental health settings. The sample was randomly split at the work group level of analysis; half of the sample was used for exploratory factor analysis (EFA), and the other half was used for confirmatory factor analysis (CFA). The entire sample was utilized for additional analyses assessing the reliability, support for level of aggregation, and construct-based evidence of validity. The EFA resulted in a final factor structure of six dimensions for the Implementation Climate Scale (ICS): 1) focus on EBP, 2) educational support for EBP, 3) recognition for EBP, 4) rewards for EBP, 5) selection for EBP, and 6) selection for openness. This structure was supported in the other half of the sample using CFA. Additional analyses supported the reliability and construct-based evidence of validity for the ICS, as well as the aggregation of the measure to the work group level. The ICS is a very brief (18 item) and pragmatic measure of a strategic climate for EBP implementation. It captures six dimensions of the organizational context that indicate to employees the extent to which their organization prioritizes and values the successful implementation of EBPs. The ICS can be used by researchers to better understand the role of the organizational context on implementation outcomes and by organizations to evaluate their current climate as they consider how to improve the likelihood of implementation success.

Furthering Our Understanding of Therapist Knowledge and Attitudinal Measurement in Youth Community Mental Health.

PubMed

Okamura, Kelsie H; Hee, Puanani J; Jackson, David; Nakamura, Brad J

2018-02-19

Examining therapist evidence-based practice (EBP) knowledge seems an important step for supporting successful implementation. Advances in implementation science suggest a distinction between practice specific (i.e., knowing which practices are derived from the evidence base) and EBP process (i.e., integrating research evidence, clinical experience, client characteristics, and monitoring outcomes) knowledge. An examination of how these knowledge types are measured and relate to attitudes appears warranted. In our sample of 58 youth community therapists, both practice specific and EBP process knowledge accounted for EBP attitude scores, which varied by therapist demographic variables. Implications for measurement of therapist constructs and future research in identifying therapist predictors of EBP use and youth clinical improvement are discussed.

A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping

PubMed Central

2011-01-01

Background The goal of this study was to assess potential differences between administrators/policymakers and those involved in direct practice regarding factors believed to be barriers or facilitating factors to evidence-based practice (EBP) implementation in a large public mental health service system in the United States. Methods Participants included mental health system county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. As part of concept mapping procedures, brainstorming groups were conducted with each target group to identify specific factors believed to be barriers or facilitating factors to EBP implementation in a large public mental health system. Statements were sorted by similarity and rated by each participant in regard to their perceived importance and changeability. Multidimensional scaling, cluster analysis, descriptive statistics and t-tests were used to analyze the data. Results A total of 105 statements were distilled into 14 clusters using concept-mapping procedures. Perceptions of importance of factors affecting EBP implementation varied between the two groups, with those involved in direct practice assigning significantly higher ratings to the importance of Clinical Perceptions and the impact of EBP implementation on clinical practice. Consistent with previous studies, financial concerns (costs, funding) were rated among the most important and least likely to change by both groups. Conclusions EBP implementation is a complex process, and different stakeholders may hold different opinions regarding the relative importance of the impact of EBP implementation. Implementation efforts must include input from stakeholders at multiple levels to bring divergent and convergent perspectives to light. PMID:21899754

A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping.

PubMed

Green, Amy E; Aarons, Gregory A

2011-09-07

The goal of this study was to assess potential differences between administrators/policymakers and those involved in direct practice regarding factors believed to be barriers or facilitating factors to evidence-based practice (EBP) implementation in a large public mental health service system in the United States. Participants included mental health system county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. As part of concept mapping procedures, brainstorming groups were conducted with each target group to identify specific factors believed to be barriers or facilitating factors to EBP implementation in a large public mental health system. Statements were sorted by similarity and rated by each participant in regard to their perceived importance and changeability. Multidimensional scaling, cluster analysis, descriptive statistics and t-tests were used to analyze the data. A total of 105 statements were distilled into 14 clusters using concept-mapping procedures. Perceptions of importance of factors affecting EBP implementation varied between the two groups, with those involved in direct practice assigning significantly higher ratings to the importance of Clinical Perceptions and the impact of EBP implementation on clinical practice. Consistent with previous studies, financial concerns (costs, funding) were rated among the most important and least likely to change by both groups. EBP implementation is a complex process, and different stakeholders may hold different opinions regarding the relative importance of the impact of EBP implementation. Implementation efforts must include input from stakeholders at multiple levels to bring divergent and convergent perspectives to light.

Comparing Agency Leader and Therapist Perspectives on Evidence-Based Practices: Associations with Individual and Organizational Factors in a Mental Health System-Driven Implementation Effort.

PubMed

Stadnick, Nicole A; Lau, Anna S; Barnett, Miya; Regan, Jennifer; Aarons, Gregory A; Brookman-Frazee, Lauren

2018-05-01

Agency leaders and therapists are essential stakeholders in implementation of evidence-based practices (EBPs) within publicly-funded mental health services. Little is known about how these stakeholders differ in their perceptions of specific EBPs and which individual and organizational factors differentially influence these perceptions. Within the context of a system-driven implementation of multiple EBPs, survey data from 160 leaders and 720 therapists were examined to assess differences in perceptions of six EBPs. Findings indicated that leaders and therapists have unique perspectives and preferences regarding EBPs that are shaped by distinct sociodemographic and professional characteristics and aspects of organizational functioning.

Provider-agency fit in substance abuse treatment organizations: implications for learning climate, morale, and evidence-based practice implementation.

PubMed

Ramsey, Alex T; van den Berk-Clark, Carissa

2015-05-12

Substance abuse agencies have been slow to adopt and implement evidence-based practices (EBPs), due in part to poor provider morale and organizational climates that are not conducive to successful learning and integration of these practices. Person-organization fit theory suggests that alignment, or fit, between provider- and agency-level characteristics regarding the implementation of EBPs may influence provider morale and organizational learning climate and, thus, implementation success. The current study hypothesized that discrepancies, or lack of fit, between provider- and agency-level contextual factors would negatively predict provider morale and organizational learning climate, outcomes shown to be associated with successful EBP implementation. Direct service providers (n = 120) from four substance abuse treatment agencies responded to a survey involving provider morale, organizational learning climate, agency expectations for EBP use, agency resources for EBP use, and provider attitudes towards EBP use. Difference scores between combinations of provider- and agency-level factors were computed to model provider-agency fit. Quadratic regression analyses were conducted to more adequately and comprehensively model the level of the dependent variables across the entire "fit continuum". Discrepancies, or misfit, between agency expectations and provider attitudes and between agency resources and provider attitudes were associated with poorer provider morale and weaker organizational learning climate. For all hypotheses, the curvilinear model of provider-agency discrepancies significantly predicted provider morale and organizational learning climate, indicating that both directions of misfit (provider factors more favorable than agency factors, and vice-versa) were detrimental to morale and climate. However, outcomes were most negative when providers viewed EBPs favorably, but perceived that agency expectations and resources were less supportive of EBP use. The current research benefits from a strong theoretical framework, consistent findings, and significant practical implications for substance abuse treatment agencies. Comprehensive attempts to strengthen outcomes related to EBP implementation must consider both provider- and agency-level characteristics regarding EBP use. Organizational efforts to more closely align provider attitudes and agency priorities will likely constitute a key strategy in fostering the implementation of EBPs in substance abuse treatment organizations.

An Approach for Dynamic Optimization of Prevention Program Implementation in Stochastic Environments

NASA Astrophysics Data System (ADS)

Kang, Yuncheol; Prabhu, Vittal

The science of preventing youth problems has significantly advanced in developing evidence-based prevention program (EBP) by using randomized clinical trials. Effective EBP can reduce delinquency, aggression, violence, bullying and substance abuse among youth. Unfortunately the outcomes of EBP implemented in natural settings usually tend to be lower than in clinical trials, which has motivated the need to study EBP implementations. In this paper we propose to model EBP implementations in natural settings as stochastic dynamic processes. Specifically, we propose Markov Decision Process (MDP) for modeling and dynamic optimization of such EBP implementations. We illustrate these concepts using simple numerical examples and discuss potential challenges in using such approaches in practice.

Organizational fidelity to a medication management evidence-based practice in the treatment of schizophrenia.

PubMed

El-Mallakh, Peggy; Howard, Patricia B; Rayens, Mary Kay; Roque, Autumn P; Adkins, Sarah

2013-11-01

Organizational support is essential for successful implementation of evidence-based practice (EBP) in clinical settings. This 3-year study used a mixed qualitative and quantitative design to implement a medication management EBP in the treatment of schizophrenia in six community mental health clinics in a south-central state of the United States. Findings from organizational fidelity assessments indicate that support for EBP implementation was moderate. Organizational support was highest for prescriber access to relevant patient information at each medication visit, scheduling flexibility for patients' urgent problems, and availability of medication guidelines. Organizational support was lowest for medication availability and identification of treatment refractory patients. Findings suggest that leadership is essential to support successful implementation. Nurse educators can incorporate implementation research and leadership training into graduate nursing programs to facilitate successful EBP implementation in practice settings. Copyright 2013, SLACK Incorporated.

Evidence-based practice in physiotherapy: a systematic review of barriers, enablers and interventions.

PubMed

Scurlock-Evans, Laura; Upton, Penney; Upton, Dominic

2014-09-01

Despite clear benefits of the Evidence-Based Practice (EBP) approach to ensuring quality and consistency of care, its uptake within physiotherapy has been inconsistent. Synthesise the findings of research into EBP barriers, facilitators and interventions in physiotherapy and identify methods of enhancing adoption and implementation. Literature concerning physiotherapists' practice between 2000 and 2012 was systematically searched using: Academic Search Complete, Cumulative Index of Nursing and Allied Health Literature Plus, American Psychological Association databases, Medline, Journal Storage, and Science Direct. Reference lists were searched to identify additional studies. Thirty-two studies, focusing either on physiotherapists' EBP knowledge, attitudes or implementation, or EBP interventions in physiotherapy were included. One author undertook all data extraction and a second author reviewed to ensure consistency and rigour. Synthesis was organised around the themes of EBP barriers/enablers, attitudes, knowledge/skills, use and interventions. Many physiotherapists hold positive attitudes towards EBP. However, this does not necessarily translate into consistent, high-quality EBP. Many barriers to EBP implementation are apparent, including: lack of time and skills, and misperceptions of EBP. Only studies published in the English language, in peer-reviewed journals were included, thereby introducing possible publication bias. Furthermore, narrative synthesis may be subject to greater confirmation bias. There is no "one-size fits all" approach to enhancing EBP implementation; assessing organisational culture prior to designing interventions is crucial. Although some interventions appear promising, further research is required to explore the most effective methods of supporting physiotherapists' adoption of EBP. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Future Directions of Evidence-Based Practice in Athletic Training: Perceived Strategies to Enhance the Use of Evidence-Based Practice

PubMed Central

Welch, Cailee E.; Hankemeier, Dorice A.; Wyant, Aimee L.; Hays, Danica G.; Pitney, William A.; Van Lunen, Bonnie L.

2014-01-01

Context: The shift to a culture of evidence-based practice (EBP) in athletic training is a necessary step in both the optimization of patient care and the advancement of athletic trainers (ATs) as health care professionals. Whereas individuals have gained knowledge in this area, most ATs still are not practicing in an evidence-based manner. Exploring perceived strategies to enhance the use of EBP will help to determine the best approaches to assist ATs in applying EBP concepts to practice to improve patient care. Objective: To explore beneficial strategies and techniques ATs perceived would promote successful implementation of EBP within athletic training education and clinical practice. Design: Qualitative study. Setting: Individual telephone interviews. Patients or Other Participants: Twenty-five ATs (12 educators, 13 clinicians; athletic training experience = 16.00 ± 9.41 years) were interviewed. Data Collection and Analysis: One phone interview was conducted with each participant. After the interview was transcribed, the data were analyzed and coded into common themes and categories. Triangulation of the data occurred via the use of multiple researchers and member checking to confirm the accuracy of the data. Results: Participants identified several components they perceived as essential for enhancing the use of EBP within the athletic training profession. These components included the need for more EBP resources, more processed information, focused workshops, peer discussion and mentorship, and continual repetition and exposure. Participants also indicated that ATs need to accept their professional responsibilities to foster EBP in their daily practices. Conclusions: The proper shift to a culture of EBP in athletic training will take both time and a persistent commitment by ATs to create strategies that will enhance the implementation of EBP across the profession. Researchers should focus on continuing to identify effective educational interventions for ATs and to determine successful strategies to implement EBP into didactic curricula and clinical practice. Additional focus should be given to which strategies most effectively produce changes in clinical practice. PMID:24568230

Evidence-Based Practice Beliefs and Implementation in Doctor of Nursing Practice Students.

PubMed

Singleton, Joanne K

2017-10-01

Doctors of Nursing Practice focus on leadership in evidence-based practice (EBP). EBP is influenced by one's beliefs in and implementation of EBP. Little is known to date about the EBP beliefs and implementation of Doctor of Nursing Practice students and outcomes of Doctor of Nursing Practice education. Guided by the Advancing Research and Clinical practice through close Collaboration (ARCC) Model, the Evidence-Based Practice Beliefs (EBPB) and Implementation (EBPI) tools were used to assess the impact of EBP as a program pillar, curricular thread, and content area on EBPB and EBPI of Doctor of Nursing Practice-Family Nurse Practitioner students. Five cohorts who completed the same curriculum were studied. Fifty-four of the 89 students across the five cohorts began and completed the study. Paired t-test for group effects showed statistical significance from pre- to post-measure in students overall EBPB, t = 4.4 (52), p < .001, and EBPI, t = 8.4 (52), p < .001. A large effect size of .75 standard deviation (SD) gain above the mean for EBPB, and a very large effect size of 1 SD gain above the mean for EBPI were observed. Repeated measures ANOVA showed that all cohorts made gains across the curriculum. Effect sizes for EBPB ranged from .25 to 1 SD above the mean, and .75 to 1.5 for EBPI. DNP students who are educated to be EBP leaders must have a curriculum that supports them in the knowledge and skill-set needed to translate evidence into practice. The ARCC Model can guide faculty in EBP curriculum development. EBPB and EBPI are valid and reliable measures to assess for gains across a curriculum. Through educational outcomes, educators can assess desired student outcomes for EBP across a curriculum and can build an evidence base for ongoing curriculum development. © 2017 Sigma Theta Tau International.

Determining registered nurses' readiness for evidence-based practice.

PubMed

Thiel, Linda; Ghosh, Yashowanto

2008-01-01

As health care systems worldwide move toward instituting evidence-based practice (EBP), its implementation can be challenging. Conducting a baseline assessment to determine nurses' readiness for EBP presents opportunities to plan strategies before implementation. Although a growing body of research literature is focused on implementing EBP, little attention has been paid to assessing nurses' readiness for EBP. The purpose of this study was to assess registered nurses' readiness for EBP in a moderate-sized acute care hospital in the Midwestern United States before implementation of a hospital-wide nursing EBP initiative. A descriptive cross-sectional survey design was used; 121 registered nurses completed the survey. The participants (n= 121) completed the 64-item Nurses' Readiness for Evidence-Based Practice Survey that allowed measurement of information needs, knowledge and skills, culture, and attitudes. Data were analyzed using descriptive statistics and a post hoc analysis. The majority (72.5%) of respondents indicated that when they needed information, they consulted colleagues and peers rather than using journals and books; 24% of nurses surveyed used the health database, Cumulative Index to Nursing & Allied Health Literature (CINAHL). The respondents perceived their EBP knowledge level as moderate. Cultural EBP scores were moderate, with unit scores being higher than organizational scores. The nurses' attitudes toward EBP were positive. The post hoc analysis showed many significant correlations. Nurses have access to technological resources and perceive that they have the ability to engage in basic information gathering but not in higher level evidence gathering. The elements important to EBP such as a workplace culture and positive attitudes are present and can be built upon. A "site-specific" baseline assessment provides direction in planning EBP initiatives. The Nurses' Readiness for EBP Survey is a streamlined tool with established reliability and validity.

Using Survival Analysis to Understand Patterns of Sustainment within a System-Driven Implementation of Multiple Evidence-Based Practices for Children's Mental Health Services.

PubMed

Brookman-Frazee, Lauren; Zhan, Chanel; Stadnick, Nicole; Sommerfeld, David; Roesch, Scott; Aarons, Gregory A; Innes-Gomberg, Debbie; Bando, Lillian; Lau, Anna S

2018-01-01

Evidence-based practice (EBP) implementation requires substantial resources in workforce training; yet, failure to achieve long-term sustainment can result in poor return on investment. There is limited research on EBP sustainment in mental health services long after implementation. This study examined therapists' continued vs. discontinued practice delivery based on administrative claims for reimbursement for six EBPs [Cognitive Behavioral Interventions for Trauma in Schools (CBITS), Child-Parent Psychotherapy, Managing and Adapting Practices (MAP), Seeking Safety (SS), Trauma-Focused Cognitive Behavior Therapy (TF-CBT), and Positive Parenting Program] adopted in a system-driven implementation effort in public mental health services for children. Our goal was to identify agency and therapist factors associated with a sustained EBP delivery. Survival analysis (i.e., Kaplan-Meier survival functions, log-rank tests, and Cox regressions) was used to analyze 19 fiscal quarters (i.e., approximately 57 months) of claims data from the Prevention and Early Intervention Transformation within the Los Angeles County Department of Mental Health. These data comprised 2,322,389 claims made by 6,873 therapists across 88 agencies. Survival time was represented by the time elapsed from therapists' first to final claims for each practice and for any of the six EBPs. Results indicate that therapists continued to deliver at least one EBP for a mean survival time of 21.73 months (median = 18.70). When compared to a survival curve of the five other EBPs, CBITS, SS, and TP demonstrated a higher risk of delivery discontinuation, whereas MAP and TF-CBT demonstrated a lower risk of delivery discontinuation. A multivariate Cox regression model revealed that agency (centralization and service setting) and therapist (demographics, discipline, and case-mix characteristics) characteristics were significantly associated with risk of delivery discontinuation for any of the six EBPs. This study illustrates a novel application of survival analysis to administrative claims data in system-driven implementation of multiple EBPs. Findings reveal variability in the long-term continuation of therapist-level delivery of EBPs and highlight the importance of both agency and workforce characteristics in the sustained delivery of EBPs. Findings direct the field to potential targets of sustainment interventions (e.g., strategic assignment of therapists to EBP training and strategic selection of EBPs by agencies).

Evidence-based Practice Intentions and Long-term Behaviours of Physiotherapy Graduates Following an Intensive Education Programme.

PubMed

Perraton, L; Machotka, Z; Gibbs, C; Mahar, C; Kennedy, K; Grimmer, K

2017-07-01

Assisting physiotherapists to implement research evidence into clinical practice is essential to ensure the quality of practice and encourage lifelong learning and professional progression. However, many physiotherapists report barriers to implementing research, and there is little evidence regarding the sustainability of intended evidence-based practice (EBP) behaviours following EBP education programmes. This paper reports on intended and actual long-term EBP behaviours of physiotherapy students who completed an intensive EBP training programme embedded within a post-graduate coursework programme. An intensive 3-week course in quantitative health research methods and EBP was delivered annually from 2007 to 2014 as part of the programme to national and international students. Following the course, students were asked about their intention of using evidence to inform their future clinical practice. An online survey was used to evaluate EBP behaviours of graduates. Of a possible total of 202 students, contact details for 193 students were sourced, and 65 students responded to the survey (34% response rate). At course completion, 174 students (86%) indicated that they intended to use research to guide their clinical decisions at least once a week. At follow-up, most graduates reported frequently using research to inform their clinical practice; indicated by a mean score of 6.5 (±1.9) from a possible range of 0 (not at all) to 10 (all the time). On average, students reported spending 2.2 (±2.2) hours accessing and reading research evidence per week. The most common barriers to implementing evidence were lack of time, limited access to evidence sources and a perceived lack of generalizability of research findings to specific patient groups. Graduates of an intensive EBP training programme embedded within an existing post-graduate physiotherapy programme regularly implemented EBP in clinical practice. Barriers to evidence implementation were time, access to research and perceived lack of generalizability of research findings. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Advancing Evidence-Based Practice in Physical Therapy Settings: Multinational Perspectives on Implementation Strategies and Interventions.

PubMed

Bernhardsson, Susanne; Lynch, Elizabeth; Dizon, Janine Margarita; Fernandes, Jasmin; Gonzalez-Suarez, Consuelo; Lizarondo, Lucylynn; Luker, Julie; Wiles, Louise; Grimmer, Karen

2017-01-01

It is of critical importance that findings from the wealth of clinical physical therapist research are transferred into clinical practice without unnecessary delays. There is a lack of knowledge about strategies that can be used to effectively implement physical therapist research findings and evidence-based practice (EBP) into everyday clinical practice in different national settings and contexts. The purpose of this article is to contribute to knowledge about effective strategies for implementing EBP that have been studied in different national physical therapy settings. The specific aims of this article are to share experiences and provide a current multinational perspective on different approaches and strategies for implementing EBP and to highlight important considerations and implications for both research and practice. Six research studies from various settings in 3 countries are described and synthesized. Key characteristics of the studies and intervention components are tabulated and mapped to the Cochrane Effective Practice and Organisation of Care taxonomy. Commonalities and differences are presented. The implementation strategies described were: a theory-based guideline implementation tailored to identified barriers and facilitators; a multifaceted EBP training package; journal clubs; a multifaceted strategy comprising contextualized procedures, protocols, and standardized resources; barrier identification, education, audit, feedback, and reminders; and contextualized guidelines. Commonalities were the use of a multifaceted approach, educational measures, and clinical guidelines. Key outcomes across the studies were improved attitudes and increased awareness, knowledge, skills, and confidence in EBP; better access to clinical practice guidelines and other EBP resources; identification of barriers that could be targeted in future implementation activities; earlier referrals; and use of recommended outcome measures. The article can serve as a template for other physical therapist researchers in designing implementation studies, as well as to inform policies and practice for health care managers and decision makers who are looking for ways to implement research findings in their organizations. © 2017 American Physical Therapy Association.

Effectiveness of an Online Educational Module in Improving Evidence-Based Practice Skills of Practicing Registered Nurses.

PubMed

Moore, Lora

2017-10-01

Implementation of evidence-based practice (EBP) at the bedside has been difficult to achieve. Significant gaps between current research and actual practice have been identified and must be addressed in effort to increase utilization of EBP. The purpose of this study was to evaluate the efficacy of an online EBP educational intervention and to examine the relationship between educational preparation and years of nursing experience on nurses' practice, attitudes, and knowledge and skills of EBP. An experimental pretest-posttest design study with three randomized groups utilizing the EBPQ instrument was conducted. No significant differences were noted in EBPQ subscale scores of practice, attitude, or knowledge and skills from pre- to posttest. In addition, no statistical difference in EBPQ subscale scores regarding educational preparation or years of experience were noted. While nurses report positive attitudes toward EBP, their perceptions of practice and knowledge and skills score much lower. Educational interventions are needed for practicing nurses to overcome this knowledge deficit to successfully implement EBP. However, the use of online, independent, computer-based learning modules, while cost-efficient and offer several benefits when educating nurses, may not necessarily be the most effective method for teaching EBP knowledge and skills to practicing nurses. © 2017 Sigma Theta Tau International.

Interagency Collaborative Team Model for Capacity Building to Scale-Up Evidence-Based Practice

PubMed Central

Hurlburt, Michael; Aarons, Gregory A; Fettes, Danielle; Willging, Cathleen; Gunderson, Lara; Chaffin, Mark J

2015-01-01

Background System-wide scale up of evidence-based practice (EBP) is a complex process. Yet, few strategic approaches exist to support EBP implementation and sustainment across a service system. Building on the Exploration, Preparation, Implementation, and Sustainment (EPIS) implementation framework, we developed and are testing the Interagency Collaborative Team (ICT) process model to implement an evidence-based child neglect intervention (i.e., SafeCare®) within a large children’s service system. The ICT model emphasizes the role of local agency collaborations in creating structural supports for successful implementation. Methods We describe the ICT model and present preliminary qualitative results from use of the implementation model in one large scale EBP implementation. Qualitative interviews were conducted to assess challenges in building system, organization, and home visitor collaboration and capacity to implement the EBP. Data collection and analysis centered on EBP implementation issues, as well as the experiences of home visitors under the ICT model. Results Six notable issues relating to implementation process emerged from participant interviews, including: (a) initial commitment and collaboration among stakeholders, (b) leadership, (c) communication, (d) practice fit with local context, (e) ongoing negotiation and problem solving, and (f) early successes. These issues highlight strengths and areas for development in the ICT model. Conclusions Use of the ICT model led to sustained and widespread use of SafeCare in one large county. Although some aspects of the implementation model may benefit from enhancement, qualitative findings suggest that the ICT process generates strong structural supports for implementation and creates conditions in which tensions between EBP structure and local contextual variations can be resolved in ways that support the expansion and maintenance of an EBP while preserving potential for public health benefit. PMID:27512239

Interagency Collaborative Team Model for Capacity Building to Scale-Up Evidence-Based Practice.

PubMed

Hurlburt, Michael; Aarons, Gregory A; Fettes, Danielle; Willging, Cathleen; Gunderson, Lara; Chaffin, Mark J

2014-04-01

System-wide scale up of evidence-based practice (EBP) is a complex process. Yet, few strategic approaches exist to support EBP implementation and sustainment across a service system. Building on the Exploration, Preparation, Implementation, and Sustainment (EPIS) implementation framework, we developed and are testing the Interagency Collaborative Team (ICT) process model to implement an evidence-based child neglect intervention (i.e., SafeCare®) within a large children's service system. The ICT model emphasizes the role of local agency collaborations in creating structural supports for successful implementation. We describe the ICT model and present preliminary qualitative results from use of the implementation model in one large scale EBP implementation. Qualitative interviews were conducted to assess challenges in building system, organization, and home visitor collaboration and capacity to implement the EBP. Data collection and analysis centered on EBP implementation issues, as well as the experiences of home visitors under the ICT model. Six notable issues relating to implementation process emerged from participant interviews, including: (a) initial commitment and collaboration among stakeholders, (b) leadership, (c) communication, (d) practice fit with local context, (e) ongoing negotiation and problem solving, and (f) early successes. These issues highlight strengths and areas for development in the ICT model. Use of the ICT model led to sustained and widespread use of SafeCare in one large county. Although some aspects of the implementation model may benefit from enhancement, qualitative findings suggest that the ICT process generates strong structural supports for implementation and creates conditions in which tensions between EBP structure and local contextual variations can be resolved in ways that support the expansion and maintenance of an EBP while preserving potential for public health benefit.

Exploring multi-level system factors facilitating educator training and implementation of evidence-based practices (EBP): a study protocol.

PubMed

Stahmer, Aubyn C; Suhrheinrich, Jessica; Schetter, Patricia L; McGee Hassrick, Elizabeth

2018-01-08

This study examines how system-wide (i.e., region, district, and school) mechanisms such as leadership support, training requirements, structure, collaboration, and education affect the use of evidence-based practices (EBPs) in schools and how this affects the outcomes for students with autism spectrum disorder (ASD). Despite growing evidence for the positive effects of EBPs for ASD, these practices are not consistently or effectively used in schools. Although special education programs are mandated to use EBPs, there are very few evidence-based methods for selecting, implementing, and sustaining EBPs. Research focuses primarily on teacher training, without attention to contextual factors (e.g., implementation climate, attitudes toward EBPs, resource allocation, and social networks) that may impact outcomes. Using an implementation science framework, this project will prospectively examine relations between system-wide factors and teachers' use of EBPs and student education outcomes. Survey data will be collected from approximately 85 regional special education directors, 170 regional program specialists, 265 district special education directors, 265 behavior specialists, 925 school principals, 3538 special education teachers, and 2700 paraprofessionals. Administrative data for the students with ASD served by participating teachers will be examined. A total of 79 regional-, district-, and school-level personnel will also participate in social network interviews. Mixed methods, including surveys, administrative data, and observational checklists, will be used to gather in-depth information about system-wide malleable factors that relate to positive teacher implementation of EBPs and student outcomes. Multi-level modeling will be used to assess system-wide malleable factors related to EBP implementation which will be linked to the trainer, teacher, and student outcomes and examined based on moderators (e.g., district size, Special Education Local Plan Area structure, teachers' ASD experience). Finally, a dynamic social network approach will be used to map EBP-related connectivity across all levels of the system for selected regions. Dynamic network analysis will be used to gauge the degree to which and ways that EBP trainings, resources, and interventions are shared (or not shared) among school staff. Results are expected to inform the development of system-wide interventions to improve the school-based implementation of EBPs for students with ASD.

Perceived outcomes of web-based modules designed to enhance athletic trainers' knowledge of evidence-based practice.

PubMed

Welch, Cailee E; Van Lunen, Bonnie L; Hankemeier, Dorice A; Wyant, Aimee L; Mutchler, Jessica M; Pitney, William A; Hays, Danica G

2014-01-01

The release of evidence-based practice (EBP) Web-based learning modules to the membership of the National Athletic Trainers' Association has provided athletic trainers (ATs) the opportunity to enhance their knowledge of the various EBP concepts. Whereas increasing the knowledge of EBP among ATs is important, assessing whether this newfound knowledge is being translated into clinical practice and didactic education is crucial. To explore the effectiveness of an educational intervention regarding EBP on the didactic instruction patterns of athletic training educators and the clinical practice behaviors of clinicians. Qualitative study. Individual telephone interviews. A total of 25 ATs (12 educators, 13 clinicians; experience as an AT = 16.00 ± 9.41 years) were interviewed. We conducted 1 individual telephone interview with each participant. After transcription, the data were analyzed and coded into common themes and categories. Triangulation of the data occurred via the use of multiple researchers and member checking to confirm the accuracy of the data. Participants perceived the EBP Web-based modules to produce numerous outcomes regarding education and clinical practice. These outcomes included perceived knowledge gain among participants, an increase in the importance and scope of EBP, a positive effect on educators' didactic instruction patterns and on instilling value and practice of EBP among students, and an enhanced ability among clinicians to implement EBP within clinical practice. However, some clinicians reported the Web-based modules had no current effect on clinical practice. Although the EBP Web-based modules were successful at enhancing knowledge among ATs, translation of knowledge into the classroom and clinical practice remains limited. Researchers should aim to identify effective strategies to help ATs implement EBP concepts into didactic education and clinical practice.

Perceived Outcomes of Web-Based Modules Designed to Enhance Athletic Trainers' Knowledge of Evidence-Based Practice

PubMed Central

Welch, Cailee E.; Van Lunen, Bonnie L.; Hankemeier, Dorice A.; Wyant, Aimee L.; Mutchler, Jessica M.; Pitney, William A.; Hays, Danica G.

2014-01-01

Context: The release of evidence-based practice (EBP) Web-based learning modules to the membership of the National Athletic Trainers' Association has provided athletic trainers (ATs) the opportunity to enhance their knowledge of the various EBP concepts. Whereas increasing the knowledge of EBP among ATs is important, assessing whether this newfound knowledge is being translated into clinical practice and didactic education is crucial. Objective: To explore the effectiveness of an educational intervention regarding EBP on the didactic instruction patterns of athletic training educators and the clinical practice behaviors of clinicians. Design: Qualitative study. Setting: Individual telephone interviews. Patients or Other Participants: A total of 25 ATs (12 educators, 13 clinicians; experience as an AT = 16.00 ± 9.41 years) were interviewed. Data Collection and Analysis: We conducted 1 individual telephone interview with each participant. After transcription, the data were analyzed and coded into common themes and categories. Triangulation of the data occurred via the use of multiple researchers and member checking to confirm the accuracy of the data. Results: Participants perceived the EBP Web-based modules to produce numerous outcomes regarding education and clinical practice. These outcomes included perceived knowledge gain among participants, an increase in the importance and scope of EBP, a positive effect on educators' didactic instruction patterns and on instilling value and practice of EBP among students, and an enhanced ability among clinicians to implement EBP within clinical practice. However, some clinicians reported the Web-based modules had no current effect on clinical practice. Conclusions: Although the EBP Web-based modules were successful at enhancing knowledge among ATs, translation of knowledge into the classroom and clinical practice remains limited. Researchers should aim to identify effective strategies to help ATs implement EBP concepts into didactic education and clinical practice. PMID:24576306

Strengthening organizations to implement evidence-based clinical practices.

PubMed

VanDeusen Lukas, Carol; Engle, Ryann L; Holmes, Sally K; Parker, Victoria A; Petzel, Robert A; Nealon Seibert, Marjorie; Shwartz, Michael; Sullivan, Jennifer L

2010-01-01

Despite recognition that implementation of evidence-based clinical practices (EBPs) usually depends on the structure and processes of the larger health care organizational context, the dynamics of implementation are not well understood. This project's aim was to deepen that understanding by implementing and evaluating an organizational model hypothesized to strengthen the ability of health care organizations to facilitate EBPs. CONCEPTUAL MODEL: The model posits that implementation of EBPs will be enhanced through the presence of three interacting components: active leadership commitment to quality, robust clinical process redesign incorporating EBPs into routine operations, and use of management structures and processes to support and align redesign. In a mixed-methods longitudinal comparative case study design, seven medical centers in one network in the Department of Veterans Affairs participated in an intervention to implement the organizational model over 3 years. The network was selected randomly from three interested in using the model. The target EBP was hand-hygiene compliance. Measures included ratings of implementation fidelity, observed hand-hygiene compliance, and factors affecting model implementation drawn from interviews. Analyses support the hypothesis that greater fidelity to the organizational model was associated with higher compliance with hand-hygiene guidelines. High-fidelity sites showed larger effect sizes for improvement in hand-hygiene compliance than lower-fidelity sites. Adherence to the organizational model was in turn affected by factors in three categories: urgency to improve, organizational environment, and improvement climate. Implementation of EBPs, particularly those that cut across multiple processes of care, is a complex process with many possibilities for failure. The results provide the basis for a refined understanding of relationships among components of the organizational model and factors in the organizational context affecting them. This understanding suggests practical lessons for future implementation efforts and contributes to theoretical understanding of the dynamics of the implementation of EBPs.

Barriers to implementing evidence-based practices in addiction treatment programs: comparing staff reports on Motivational Interviewing, Adolescent Community Reinforcement Approach, Assertive Community Treatment, and Cognitive-behavioral Therapy.

PubMed

Amodeo, M; Lundgren, L; Cohen, A; Rose, D; Chassler, D; Beltrame, C; D'Ippolito, M

2011-11-01

This qualitative study explored barriers to implementing evidence-based practices (EBPs) in community-based addiction treatment organizations (CBOs) by comparing staff descriptions of barriers for four EBPs: Motivational Interviewing (MI), Adolescent Community Reinforcement Approach (A-CRA), Assertive Community Treatment (ACT), and Cognitive-behavioral Therapy (CBT). The CBOs received CSAT/SAMHSA funding from 2003 to 2008 to deliver services using EBPs. Phone interview responses from 172 CBO staff directly involved in EBP implementation were analyzed using content analysis, a method for making inferences and developing themes from the systematic review of participant narratives (Berelson, 1952). Staff described different types of barriers to implementing each EBP. For MI, the majority of barriers involved staff resistance or organizational setting. For A-CRA, the majority of barriers involved specific characteristics of the EBP or client resistance. For CBT, the majority of barriers were associated with client resistance, and for ACT, the majority of barriers were associated with resources. EBP designers, policy makers who support EBP dissemination and funders should include explicit strategies to address such barriers. Addiction programs proposing to use specific EBPs must consider whether their programs have the organizational capacity and community capacity to meet the demands of the EBP selected. Copyright © 2011 Elsevier Ltd. All rights reserved.

The impact of workplace factors on evidence-based speech-language pathology practice for children with autism spectrum disorders.

PubMed

Cheung, Gladys; Trembath, David; Arciuli, Joanne; Togher, Leanne

2013-08-01

Although researchers have examined barriers to implementing evidence-based practice (EBP) at the level of the individual, little is known about the effects workplaces have on speech-language pathologists' implementation of EBP. The aim of this study was to examine the impact of workplace factors on the use of EBP amongst speech-language pathologists who work with children with Autism Spectrum Disorder (ASD). This study sought to (a) explore views about EBP amongst speech-language pathologists who work with children with ASD, (b) identify workplace factors which, in the participants' opinions, acted as barriers or enablers to their provision of evidence-based speech-language pathology services, and (c) examine whether or not speech-language pathologists' responses to workplace factors differed based on the type of workplace or their years of experience. A total of 105 speech-language pathologists from across Australia completed an anonymous online questionnaire. The results indicate that, although the majority of speech-language pathologists agreed that EBP is necessary, they experienced barriers to their implementation of EBP including workplace culture and support, lack of time, cost of EBP, and the availability and accessibility of EBP resources. The barriers reported by speech-language pathologists were similar, regardless of their workplace (private practice vs organization) and years of experience.

Evidence-Based Practices: Providing Guidance for Early Childhood Practitioners

ERIC Educational Resources Information Center

Farley, Kristin S.; Brock, Matthew E.; Winterbottom, Christian

2018-01-01

Early childhood education represents a pivotal opportunity to improve the developmental trajectories of young children, and evidence-based practices (EBPs) are scientifically proven to improve these outcomes. Furthermore, federal law mandates that early childhood practitioners implement EBPs. However, because EBP has not been clearly defined in…

Walking the tightrope-perspectives on local politicians' role in implementing a national social care policy on evidence-based practice.

PubMed

Bäck, A; Ståhl, C; von Thiele Schwarz, U; Richter, A; Hasson, H

2016-01-01

Despite national policy recommending evidence-based practice (EBP), its application in social care has been limited. While local politicians can affect the process, little is known about their knowledge, attitudes and roles regarding EBP. The aim here is twofold: to explore the role of local politicians in the implementation of EBP in social care from both their own and a management perspective; and to examine factors politicians perceive as affecting their decisions and actions concerning the implementation of EBP policy. Local politicians (N = 13) and managers (N = 22) in social care were interviewed. Qualitative thematic analysis with both inductive and deductive codes was used. Politicians were rather uninformed regarding EBP and national policy. The factors limiting their actions were, beside the lack of awareness, lack of ability to question existing working methods, and a need for support in the steering of EBP. Thus, personal interest played a significant part in what role the politicians assumed. This resulted in some politicians taking a more active role in steering EBP while others were not involved. From the managers' perspective, a more active steering by politicians was desired. Setting budget and objectives, as well as active follow-up of work processes and outcomes, were identified as means to affect the implementation of EBP. However, the politicians seemed unaware of the facilitating effects of these actions. Local politicians had a possibility to facilitate the implementation of EBP, but their role was unclear. Personal interest played a big part in determining what role was taken. The results imply that social care politicians might need support in the development of their steering of EBP. Moving the responsibility for EBP facilitation upwards in the political structure could be an important step in developing EBP in social care.

Code of Ethics for Rehabilitation Educators and Counselors: A Call for Evidence-Based Practice

ERIC Educational Resources Information Center

Burker, Eileen J.; Kazukauskas, Kelly A.

2010-01-01

Given the emphasis on evidence-based practice (EBP) in the 2010 Code of Professional Ethics for Rehabilitation Counselors, it has become even more critical for rehabilitation educators and rehabilitation counselors to understand EBP, how to implement it in teaching and in practice, and how to access available EBP resources. This paper defines and…

Collaboration, negotiation, and coalescence for interagency-collaborative teams to scale-up evidence-based practice.

PubMed

Aarons, Gregory A; Fettes, Danielle L; Hurlburt, Michael S; Palinkas, Lawrence A; Gunderson, Lara; Willging, Cathleen E; Chaffin, Mark J

2014-01-01

Implementation and scale-up of evidence-based practices (EBPs) is often portrayed as involving multiple stakeholders collaborating harmoniously in the service of a shared vision. In practice, however, collaboration is a more complex process that may involve shared and competing interests and agendas, and negotiation. The present study examined the scale-up of an EBP across an entire service system using the Interagency Collaborative Team approach. Participants were key stakeholders in a large-scale county-wide implementation of an EBP to reduce child neglect, SafeCare. Semistructured interviews and/or focus groups were conducted with 54 individuals representing diverse constituents in the service system, followed by an iterative approach to coding and analysis of transcripts. The study was conceptualized using the Exploration, Preparation, Implementation, and Sustainment framework. Although community stakeholders eventually coalesced around implementation of SafeCare, several challenges affected the implementation process. These challenges included differing organizational cultures, strategies, and approaches to collaboration; competing priorities across levels of leadership; power struggles; and role ambiguity. Each of the factors identified influenced how stakeholders approached the EBP implementation process. System-wide scale-up of EBPs involves multiple stakeholders operating in a nexus of differing agendas, priorities, leadership styles, and negotiation strategies. The term collaboration may oversimplify the multifaceted nature of the scale-up process. Implementation efforts should openly acknowledge and consider this nexus when individual stakeholders and organizations enter into EBP implementation through collaborative processes.

Collaboration, Negotiation, and Coalescence for Interagency-Collaborative Teams to Scale-up Evidence-Based Practice

PubMed Central

Aarons, Gregory A.; Fettes, Danielle; Hurlburt, Michael; Palinkas, Lawrence; Gunderson, Lara; Willging, Cathleen; Chaffin, Mark

2014-01-01

Objective Implementation and scale-up of evidence-based practices (EBPs) is often portrayed as involving multiple stakeholders collaborating harmoniously in the service of a shared vision. In practice, however, collaboration is a more complex process that may involve shared and competing interests and agendas, and negotiation. The present study examined the scale-up of an EBP across an entire service system using the Interagency Collaborative Team (ICT) approach. Methods Participants were key stakeholders in a large-scale county-wide implementation of an EBP to reduce child neglect, SafeCare®. Semi-structured interviews and/or focus groups were conducted with 54 individuals representing diverse constituents in the service system, followed by an iterative approach to coding and analysis of transcripts. The study was conceptualized using the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Results Although community stakeholders eventually coalesced around implementation of SafeCare, several challenges affected the implementation process. These challenges included differing organizational cultures, strategies, and approaches to collaboration, competing priorities across levels of leadership, power struggles, and role ambiguity. Each of the factors identified influenced how stakeholders approached the EBP implementation process. Conclusions System wide scale-up of EBPs involves multiple stakeholders operating in a nexus of differing agendas, priorities, leadership styles, and negotiation strategies. The term collaboration may oversimplify the multifaceted nature of the scale-up process. Implementation efforts should openly acknowledge and consider this nexus when individual stakeholders and organizations enter into EBP implementation through collaborative processes. PMID:24611580

From a "perfect storm" to "smooth sailing": policymaker perspectives on implementation and sustainment of an evidence-based practice in two states.

PubMed

Willging, Cathleen E; Green, Amy E; Gunderson, Lara; Chaffin, Mark; Aarons, Gregory A

2015-02-01

Policymakers shape implementation and sustainment of evidence-based practices (EBPs), whether they are developing or responding to legislation and policies or negotiating public sector resource constraints. As part of a large mixed-method study, we conducted qualitative interviews with 24 policymakers involved in delivery of the same EBP in two U.S. states. We analyzed transcripts via open and focused coding techniques to identify the commonality, diversity, and complexity of implementation challenges; approaches to overcoming those challenges; and the importance of system-level contextual factors in ensuring successful implementation. Key findings centered on building support and leadership for EBPs; funding and contractual strategies; partnering with stakeholders; tackling challenges via proactive planning and problem solving; and the political, legal, and systemic pressures affecting EBP longevity. The policymaker perspectives offer guidance on nurturing system and organizational practice environments to achieve positive outcomes and for optimally addressing macro-level influences that bear upon the instantiation of EBPs in public sector child welfare systems. © The Author(s) 2014.

Aligning leadership across systems and organizations to develop a strategic climate for evidence-based practice implementation.

PubMed

Aarons, Gregory A; Ehrhart, Mark G; Farahnak, Lauren R; Sklar, Marisa

2014-01-01

There has been a growing impetus to bridge the gap between basic science discovery, development of evidence-based practices (EBPs), and the availability and delivery of EBPs in order to improve the public health impact of such practices. To capitalize on factors that support implementation and sustainment of EBPs, it is important to consider that health care is delivered within the outer context of public health systems and the inner context of health care organizations and work groups. Leaders play a key role in determining the nature of system and organizational contexts. This article addresses the role of leadership and actions that leaders can take at and across levels in developing a strategic climate for EBP implementation within the outer (i.e., system) and inner (i.e., organization, work group) contexts of health care. Within the framework of Edgar Schein's "climate embedding mechanisms," we describe strategies that leaders at the system, organization, and work group levels can consider and apply to develop strategic climates that support the implementation and sustainment of EBP in health care and allied health care settings.

From a “Perfect Storm” to “Smooth Sailing”: Policymaker Perspectives on Implementation and Sustainment of an Evidence-Based Practice in Two States

PubMed Central

Willging, Cathleen E.; Green, Amy E.; Gunderson, Lara; Chaffin, Mark; Aarons, Gregory A.

2015-01-01

Policymakers shape implementation and sustainment of evidence-based practices (EBPs), whether they are developing or responding to legislation and policies or negotiating public sector resource constraints. As part of a large mixed-method study, we conducted qualitative interviews with 24 policymakers involved in delivery of the same EBP in two U.S. states. We analyzed transcripts via open and focused coding techniques to identify the commonality, diversity, and complexity of implementation challenges; approaches to overcoming those challenges; and the importance of system-level contextual factors in ensuring successful implementation. Key findings centered on building support and leadership for EBPs; funding and contractual strategies; partnering with stakeholders; tackling challenges via proactive planning and problem solving; and the political, legal, and systemic pressures affecting EBP longevity. The policymaker perspectives offer guidance on nurturing system and organizational practice environments to achieve positive outcomes and for optimally addressing macro-level influences that bear upon the instantiation of EBPs in public sector child welfare systems. PMID:25125232

Effect of an educational intervention on attitudes toward and implementation of evidence-based practice.

PubMed

Varnell, Gayle; Haas, Barbara; Duke, Gloria; Hudson, Kathy

2008-01-01

Transitioning to an evidence-based practice (EBP) environment is a new and often overwhelming challenge for many organisations. The most effective strategies to implement EBP have yet to be determined. In this study an accelerated development EBP program, which was administered to nurses from five hospitals was evaluated. At each hospital, nurses were selected as an "EBP champion" whose role would be to help facilitate the transition within that organisation. The purpose of this study was to evaluate the effectiveness of an accelerated educational program on the attitudes toward and implementation of EBP among nurses employed in acute-care facilities. Forty-nine nurses from five acute-care facilities participated in an 8-week program to develop into EBP champions. Participants attended a 2-hour class each week conducted by four faculty members of a local university. Pre- and post-test mean scores of the EBP barriers (EBPB) and EBP implementation (EBPI) scales were compared using paired t tests to determine the effect of the accelerated development program. Respondents reported higher scores on both the beliefs and implementation scales at the end of the program. Paired t tests indicated a significant difference in means for both the EBPB (p < .01) and EBPI (p < .01). Nurses who attend an accelerated educational program have the potential to significantly improve beliefs and attitudes about EBP. Administrative support and collaboration between academia and service are essential for successful intervention.

Knowledge Translation in Audiology

PubMed Central

Kothari, Anita; Bagatto, Marlene P.; Seewald, Richard; Miller, Linda T.; Scollie, Susan D.

2011-01-01

The impetus for evidence-based practice (EBP) has grown out of widespread concern with the quality, effectiveness (including cost-effectiveness), and efficiency of medical care received by the public. Although initially focused on medicine, EBP principles have been adopted by many of the health care professions and are often represented in practice through the development and use of clinical practice guidelines (CPGs). Audiology has been working on incorporating EBP principles into its mandate for professional practice since the mid-1990s. Despite widespread efforts to implement EBP and guidelines into audiology practice, gaps still exist between the best evidence based on research and what is being done in clinical practice. A collaborative dynamic and iterative integrated knowledge translation (KT) framework rather than a researcher-driven hierarchical approach to EBP and the development of CPGs has been shown to reduce the knowledge-to-clinical action gaps. This article provides a brief overview of EBP and CPGs, including a discussion of the barriers to implementing CPGs into clinical practice. It then offers a discussion of how an integrated KT process combined with a community of practice (CoP) might facilitate the development and dissemination of evidence for clinical audiology practice. Finally, a project that uses the knowledge-to-action (KTA) framework for the development of outcome measures in pediatric audiology is introduced. PMID:22194314

Creating infrastructure supportive of evidence-based nursing practice: leadership strategies.

PubMed

Newhouse, Robin P

2007-01-01

Nursing leadership is the cornerstone of successful evidence-based practice (EBP) programs within health care organizations. The key to success is a strategic approach to building an EBP infrastructure, with allocation of appropriate human and material resources. This article indicates the organizational infrastructure that enables evidence-based nursing practice and strategies for leaders to enhance evidence-based practice using "the conceptual model for considering the determinants of diffusion, dissemination, and implementation of innovations in health service delivery and organization." Enabling EBP within organizations is important for promoting positive outcomes for nurses and patients. Fostering EBP is not a static or immediate outcome, but a long-term developmental process within organizations. Implementation requires multiple strategies to cultivate a culture of inquiry where nurses generate and answer important questions to guide practice. Organizations that can enable the culture and build infrastructure to help nurses develop EBP competencies will produce a professional environment that will result in both personal growth for their staff and improvements in quality that would not otherwise be possible.

Evidence-Based Practice in Special Education and Cultural Adaptations: Challenges and Implications for Research

ERIC Educational Resources Information Center

Wang, Mian; Lam, Yeana

2017-01-01

Many issues arise in the discussion of the evidence-based practice (EBP) movement and implementation science in special education and specific educational practices for students with severe disabilities. Yet cultural adaptations of EBPs, which have emerged as an area of research in other fields, are being left out as a focus of EBP discourse. The…

Implementation of Evidence-Based Practice in Relation to a Clinical Nursing Ladder System: A National Survey in Taiwan

PubMed Central

Weng, Yi-Hao; Chen, Chiehfeng; Kuo, Ken N; Yang, Chun-Yuh; Lo, Heng-Lien; Chen, Kee-Hsin; Chiu, Ya-Wen

2015-01-01

Background Although evidence-based practice (EBP) has been widely investigated, few studies have investigated its correlation with a clinical nursing ladder system. The current national study evaluates whether EBP implementation has been incorporated into the clinical ladder system. Methods A cross-sectional questionnaire survey was conducted nationwide of registered nurses among regional hospitals of Taiwan in January to April 2011. Subjects were categorized into beginning nurses (N1 and N2) and advanced nurses (N3 and N4) by the clinical ladder system. Multivariate logistic regression model was used to adjust for possible confounding demographic factors. Results Valid postal questionnaires were collected from 4,206 nurses, including 2,028 N1, 1,595 N2, 412 N3, and 171 N4 nurses. Advanced nurses were more aware of EBP than beginning nurses (p < 0.001; 90.7% vs. 78.0%). In addition, advanced nurses were more likely to hold positive beliefs about and attitudes toward EBP (p < 0.001) and possessed more sufficient knowledge of and skills in EBP (p < 0.001). Furthermore, they more often implemented EBP principles (p < 0.001) and accessed online evidence-based retrieval databases (p < 0.001). The most common motivation for using online databases was self-learning for advanced nurses and positional promotion for beginning nurses. Multivariate logistic regression analyses showed advanced nurses were more aware of EBP, had higher knowledge and skills of EBP, and more often implemented EBP than beginning nurses. Linking Evidence to Action The awareness of, beliefs in, attitudes toward, knowledge of, skills in, and behaviors of EBP among advanced nurses were better than those among beginning nurses. The data indicate that a clinical ladder system can serve as a useful means to enhance EBP implementation. PMID:25588625

Creating an evidence-based practice environment: one hospital's journey.

PubMed

Hockenberry, Marilyn; Walden, Marlene; Brown, Terri; Barrera, Patrick

2007-01-01

There is increasing effort in promoting evidence-based practice (EBP) that supports the best possible care to patients and families. This article describes essential concepts for developing an environment of EBP and its implementation at a large pediatric hospital. Essential components for creating an EBP environment include vision, engagement, integration, and evaluation. An institutional initiative to decrease procedure-related pain demonstrates how EBP is used to improve clinical care.

Evidence-based practice, research utilization, and knowledge translation in chiropractic: a scoping review.

PubMed

Bussières, André E; Al Zoubi, Fadi; Stuber, Kent; French, Simon D; Boruff, Jill; Corrigan, John; Thomas, Aliki

2016-07-13

Evidence-based practice (EBP) gaps are widespread across health disciplines. Understanding factors supporting the uptake of evidence can inform the design of strategies to narrow these EBP gaps. Although research utilization (RU) and the factors associated with EBP have been reported in several health disciplines, to date this area has not been reviewed comprehensively in the chiropractic profession. The purpose of this review was to report on the current state of knowledge on EBP, RU, and knowledge translation (KT) in chiropractic. A scoping review using the Arksey and O'Malley framework was used to systematically select and summarize existing literature. Searches were conducted using a combination of keywords and MeSH terms from the earliest date available in each database to May 2015. Quantitative and thematic analyses of the selected literature were conducted. Nearly 85 % (56/67) of the included studies were conducted in Canada, USA, UK or Australia. Thematic analysis for the three categories (EBP, RU, KT) revealed two themes related to EBP (attitudes and beliefs of chiropractors; implementation of EBP), three related to RU (guideline adherence; frequency and sources of information accessed; and perceived value of websites and search engines), and three related to KT (knowledge practice gaps; barriers and facilitators to knowledge use; and selection, tailoring, and implementation of interventions). EBP gaps were noted in the areas of assessment of activity limitation, determination of psychosocial factors influencing pain, general health indicators, establishing a prognosis, and exercise prescription. While most practitioners believed EBP and research to be important and a few studies suggested that traditional and online educational strategies could improve patient care, use of EBP and guideline adherence varied widely. Findings suggest that the majority of chiropractors hold favourable attitudes and beliefs toward EBP. However, much remains to be done for chiropractors to routinely apply evidence into clinical practice. Educational strategies aimed at practicing chiropractors can lead to more EBP and improved patient care. The chiropractic profession requires more robust dissemination and implementation research to improve guideline adherence and patient health outcomes.

Assessment of evidence-based practice among hospital pharmacists in Saudi Arabia: attitude, awareness, and practice.

PubMed

Al-Jazairi, Abdulrazaq S; Alharbi, Reem

2017-08-01

Background Many studies have previously looked at the perceptions, attitude, and use of Evidence-based Practice (EBP) among healthcare providers. However, limited data is available on the implementation of EBP among pharmacists in general, and Saudi Arabia in particular. Objective To evaluate the awareness, attitude, and practice of EBP among hospital practicing pharmacists in Saudi Arabia. Setting Secondary and tertiary care hospitals in Saudi Arabia with a bed capacity of ≥200 Methods This is a cross sectional, survey-based study where a validated selfadministrated questionnaire was utilized. Pharmacists working in secondary and tertiary care hospitals with a bed capacity of ≥200 were targeted. The descriptive data consisted of percentages for discrete and medians for continuous statistics. Results The survey was distributed to a total of 1136 pharmacists. Total number of respondents is 228 which represent a response rate of 20%. Most of them (75% median score = 8) have a positive attitude toward EBP. In addition to clinical expertise, only 48.6% of them were able to identify EBP resource as the second component of EBP concept, while only 1.7% of the respondents were able to identify patient preference as a third component. Lack of personal time, critical appraisal skills, and resources, (40%, 15.6% and 13.9% respectively) are considered as the major barriers to implementing EBP in pharmacy. Conclusion The majority of pharmacists in Saudi Arabia hold a positive attitude of EBP. Unfortunately, most of pharmacists do not consider patients' values as a component of EBP. The major barriers to practicing EBP are lack of personal time, critical appraisal skills, and resources availability.

Comprehensive Cancer Control Partners’ Use of and Attitudes About Evidence-Based Practices

PubMed Central

Rose, John M.; Townsend, Julie S.; Fonseka, Jamila; Richardson, Lisa C.; Chovnick, Gary

2015-01-01

Introduction National Comprehensive Cancer Control Program (NCCCP) awardees are encouraged to work with partners (eg, nonprofit organizations) to develop and implement plans to reduce the cancer burden in their jurisdictions using evidence-based practices (EBPs). However, the extent of EBP use among awardees and their partners is not well understood. Methods From March through July 2012, we conducted a web-based survey of program partners referred by NCCCP program directors who were involved in implementation of cancer control plans. Results Approximately 53% of referred partners (n = 83) completed surveys, 91.6% of whom represented organizations. Most partners reported involvement in helping to identify (80.5%), adapt (81.7%), implement (90.4%), and evaluate (81.9%) EBPs. The factors rated most frequently as very important when selecting EBPs were “consistent with our organization’s mission” (89.2%) and “cost-effective” (81.9%). Although most respondents said that their organizations understood the importance of using EBPs (84.3%) and had adequate access to cancer registry data (74.7%), few reported having sufficient financial resources to develop new EBPs (7.9%). The most frequently mentioned benefit of using EBPs was that they are proven to work. Resource limitations and difficulty adapting EBPs for specific populations and settings were challenges. Conclusions Our findings help indicate how NCCCP partners are involved in using EBPs and can guide ongoing efforts to encourage the use of EBPs for cancer control. The challenges of using EBPs that partners identified highlight the need to improve strategies to translate cancer prevention and control research into practice in real-world settings and for diverse populations. PMID:26182148

Outcomes From the First Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare Invitational Expert Forum.

PubMed

Melnyk, Bernadette Mazurek; Gallagher-Ford, Lynn; Zellefrow, Cindy; Tucker, Sharon; Van Dromme, Laurel; Thomas, Bindu Koshy

2018-02-01

Even though multiple positive outcomes are the result of evidence-based care, including improvements in healthcare quality, safety, and costs, it is not consistently delivered by clinicians in healthcare systems throughout the world. In an attempt to accelerate the implementation of evidence-based practice (EBP) across the United States, an invitational Interprofessional National EBP Forum to determine major priorities for the advancement of EBP was held during the launch of the newly established Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at The Ohio State University College of Nursing. Interprofessional leaders from national organizations and federal agencies across the United States were invited to participate in the Forum. A pre-Forum survey was disseminated to participants to assess their perceptions of the state of EBP and actions necessary to speed the translation of research into real-world clinical settings. Findings from a pre-Forum survey (n = 47) indicated ongoing low implementation of EBP in U.S. healthcare settings. These findings were shared with leaders from 45 organizations and agencies who attended the Forum. Breakout groups on practice, education, implementation science, and policy discussed the findings and responded to a set of standardized questions. High-priority action tactics were identified, including the need for: (a) enhanced reimbursement for EBP, (b) more interprofessional education and skills building in EBP, and (c) leaders to prioritize EBP and fuel it with resources. The delivery of and reimbursement for evidence-based care must become a high national priority. Academic faculty across all healthcare disciplines need to teach EBP, healthcare systems must invest in EBP resources, and payers must attach reimbursement to care that is evidence-based. An action collaborative of the participating organizations has been formed to accelerate EBP across the United States to achieve the quadruple aim in health care. © 2018 Sigma Theta Tau International.

Evidence-Based Practice: a survey regarding behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from São Paulo state

PubMed Central

Silva, Tatiane M.; Costa, Lucíola C. M.; Costa, Leonardo O. P.

2015-01-01

BACKGROUND: Evidence-Based Practice (EBP) has been widely used by health professionals. However, no study in Brazil has investigated the data regarding the knowledge and difficulties related to EBP from a representative sample of physical therapists. OBJECTIVE: To identify behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from the state of São Paulo regarding EBP. METHOD: A customized questionnaire about behavior, knowledge, skills, resources, opinions and perceived barriers regarding EBP was sent by email to a sample of 490 physical therapists registered by the Registration Board of São Paulo, Brazil. Physical therapists who did not respond to the questionnaire were contacted by telephone and/or letter. The data were analyzed descriptively. RESULTS: The final response rate was 64.4% (316/490). Because 60 physical therapists were no longer practicing, 256 answers were analyzed. The physical therapists reported that they routinely read scientific papers (89.5%) as a resource for professional development, followed by continuing education courses (88.3%) and books (86.3%). Approximately 35% of the respondents reported a clear understanding of the implementation of research findings in their practice; approximately 37% reported no difficulties in critically appraising scientific papers; and 67.2% strongly agreed that EBP is important for their practice. The most commonly reported barriers were related to difficulties in obtaining full-text papers (80.1%), using EBP may represent higher cost (80.1%) and the language of publication of the papers (70.3%). CONCLUSION: Physical therapists from São Paulo state believe that they have knowledge and skills to use EBP. Although they have favorable opinions regarding its implementation, they still encounter difficulties in implementing EBP successfully. PMID:26443977

Evidence-Based Practice: a survey regarding behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from São Paulo state.

PubMed

Silva, Tatiane M; Costa, Lucíola C M; Costa, Leonardo O P

2015-01-01

Evidence-Based Practice (EBP) has been widely used by health professionals. However, no study in Brazil has investigated the data regarding the knowledge and difficulties related to EBP from a representative sample of physical therapists. To identify behavior, knowledge, skills, resources, opinions and perceived barriers of Brazilian physical therapists from the state of São Paulo regarding EBP. A customized questionnaire about behavior, knowledge, skills, resources, opinions and perceived barriers regarding EBP was sent by email to a sample of 490 physical therapists registered by the Registration Board of São Paulo, Brazil. Physical therapists who did not respond to the questionnaire were contacted by telephone and/or letter. The data were analyzed descriptively. The final response rate was 64.4% (316/490). Because 60 physical therapists were no longer practicing, 256 answers were analyzed. The physical therapists reported that they routinely read scientific papers (89.5%) as a resource for professional development, followed by continuing education courses (88.3%) and books (86.3%). Approximately 35% of the respondents reported a clear understanding of the implementation of research findings in their practice; approximately 37% reported no difficulties in critically appraising scientific papers; and 67.2% strongly agreed that EBP is important for their practice. The most commonly reported barriers were related to difficulties in obtaining full-text papers (80.1%), using EBP may represent higher cost (80.1%) and the language of publication of the papers (70.3%). Physical therapists from São Paulo state believe that they have knowledge and skills to use EBP. Although they have favorable opinions regarding its implementation, they still encounter difficulties in implementing EBP successfully.

Exploring perceptions of a learning organization by RNs and relationship to EBP beliefs and implementation in the acute care setting.

PubMed

Estrada, Nicolette

2009-01-01

Health care professionals are expected to provide patient care based on best evidence. The context of the acute care setting presents a challenging environment for registered nurses (RNs) to utilize research and implement best evidence in practice. No organizational infrastructure has been identified that offers acute care RNs the support needed for evidence-based practice (EBP). The value of "learning organizations" has long been understood by corporate leaders. Potentially, the dimensions of a "learning organization" may offer a supportive EBP infrastructure for acute care RNs. (1) What is the relationship of the characteristics of the learning organization to registered nurses' beliefs regarding EBP? (2) Is there an impact of EBP beliefs on RNs' implementation of EBP? A descriptive, survey design study was conducted. Three established questionnaires were distributed to 1,750 RNs employed within six acute care hospitals. There were 594 questionnaires returned for a response rate of 34%. RNs rated their organizations in the mid-range on the dimensions of learning organization. Perceptions of the learning organization were found to be significant, although relatively small, predictors explaining 6% of knowledge beliefs, 11% of value beliefs, and 14% of resource beliefs. EBP beliefs explained 23% of EBP implementation reported by RNs. The study results indicate relationships between RNs' reported perception of a learning organization and EBP beliefs, and between EBP beliefs and implementation. However, findings were mixed. Overall, nurses rated their organizations the lowest in the dimensions of "promote inquiry and dialogue" and "empower people toward a collective vision." Leaders have an opportunity to offer a more supportive infrastructure through improving their organization in these two areas. RN beliefs explained 23% of EBP implementation in this study with a residual 77% yet to be identified. Acute care hospitals were perceived mid-range on learning organization dimensions by RNs, indicating an opportune area for leaders to strengthen their organizational infrastructure.

Social networks and implementation of evidence-based practices in public youth-serving systems: a mixed-methods study

PubMed Central

2011-01-01

Background The present study examines the structure and operation of social networks of information and advice and their role in making decisions as to whether to adopt new evidence-based practices (EBPs) among agency directors and other program professionals in 12 California counties participating in a large randomized controlled trial. Methods Interviews were conducted with 38 directors, assistant directors, and program managers of county probation, mental health, and child welfare departments. Grounded-theory analytic methods were used to identify themes related to EBP adoption and network influences. A web-based survey collected additional quantitative information on members of information and advice networks of study participants. A mixed-methods approach to data analysis was used to create a sociometric data set (n = 176) for examination of associations between advice seeking and network structure. Results Systems leaders develop and maintain networks of information and advice based on roles, responsibility, geography, and friendship ties. Networks expose leaders to information about EBPs and opportunities to adopt EBPs; they also influence decisions to adopt EBPs. Individuals in counties at the same stage of implementation accounted for 83% of all network ties. Networks in counties that decided not to implement a specific EBP had no extra-county ties. Implementation of EBPs at the two-year follow-up was associated with the size of county, urban versus rural counties, and in-degree centrality. Collaboration was viewed as critical to implementing EBPs, especially in small, rural counties where agencies have limited resources on their own. Conclusions Successful implementation of EBPs requires consideration and utilization of existing social networks of high-status systems leaders that often cut across service organizations and their geographic jurisdictions. Trial Registration NCT00880126 PMID:21958674

The current status of evidence-based practice in juvenile justice.

PubMed

McKee, Esther Chao; Rapp, Lisa

2014-01-01

The advent of evidence-based practice (EBP) has significantly changed the juvenile justice system while producing intense controversy. The intent of this article is to provide an update on the current status of EBP in the juvenile justice system. Specifically, this article will describe the evolution of juvenile justice philosophy as it has informed current juvenile justice policies and programs, discuss the scope of current juvenile justice research regarding EBP, identify barriers to implementing EBP, expound on the development of EBP in juvenile justice, discern the characteristics of evidence-based interventions in the juvenile justice system, and finally describe how to select and assess evidence-based practices and interventions.

Implementing evidence-based practice in community mental health agencies: a multiple stakeholder analysis.

PubMed

Aarons, Gregory A; Wells, Rebecca S; Zagursky, Karen; Fettes, Danielle L; Palinkas, Lawrence A

2009-11-01

We sought to identify factors believed to facilitate or hinder evidence-based practice (EBP) implementation in public mental health service systems as a step in developing theory to be tested in future studies. Focusing across levels of an entire large public sector mental health service system for youths, we engaged participants from 6 stakeholder groups: county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. Participants generated 105 unique statements identifying implementation barriers and facilitators. Participants rated each statement on importance and changeability (i.e., the degree to which each barrier or facilitator is considered changeable). Data analyses distilled statements into 14 factors or dimensions. Descriptive analyses suggest that perceptions of importance and changeability varied across stakeholder groups. Implementation of EBP is a complex process. Cross-system-level approaches are needed to bring divergent and convergent perspectives to light. Examples include agency and program directors facilitating EBP implementation by supporting staff, actively sharing information with policymakers and administrators about EBP effectiveness and fit with clients' needs and preferences, and helping clinicians to present and deliver EBPs and address consumer concerns.

Implementing evidence-based practice during an economic downturn.

PubMed

Beck, Mary S; Staffileno, Beth A

2012-01-01

Building a sustainable evidence-based practice (EBP) infrastructure during times of financial constraints poses challenges for nurse leaders. To be successful, plans need to be creative and adaptive, while mindful of limited resources. This commentary describes change management strategies used to implement an EBP infrastructure at a hospital after organizational restructuring occurred.

A Socio-Cultural Analysis of Practitioner Perspectives on Implementation of Evidence-Based Practice in Special Education

ERIC Educational Resources Information Center

Hudson, Roxanne F.; Davis, Carol A.; Blum, Grace; Greenway, Rosanne; Hackett, Jacob; Kidwell, James; Liberty, Lisa; McCollow, Megan; Patish, Yelena; Pierce, Jennifer; Schulze, Maggie; Smith, Maya M.; Peck, Charles A.

2016-01-01

Despite the central role "evidence-based practice" (EBP) plays in special education agendas for both research and policy, it is widely recognized that achieving "implementation" of EBPs remains an elusive goal. In an effort to better understand this problem, we interviewed special education practitioners in four school…

From the laboratory to the therapy room: National dissemination and implementation of evidence-based psychotherapies in the U.S. Department of Veterans Affairs Health Care System.

PubMed

Karlin, Bradley E; Cross, Gerald

2014-01-01

Despite their established efficacy and recommendation--often as first-line treatments--in clinical practice guidelines, evidence-based psychotherapies (EBPs) have largely failed to make their way into mainstream clinical settings. Numerous attempts over the years to promote the translation of EBPs from science to practice, typically relying on one-dimensional dissemination approaches, have yielded limited success. As part of the transformation of its mental health care system, the Veterans Health Administration (VHA) of the U.S. Department of Veterans Affairs (VA) is working to disseminate and implement a number of EBPs for various mental and behavioral health conditions throughout the VA health care system. This article examines VHA's multidimensional model and specific strategies, involving policy, provider, local systems, patient, and accountability levels, for promoting the national dissemination and implementation of EBPs in VHA. In addition, the article identifies key lessons learned and next steps for further promoting EBP delivery and sustainability in the VA health care system. Beyond promoting the availability of effective treatments for veterans returning from Iraq and Afghanistan and for veterans of previous combat eras, VHA's EBP dissemination and implementation model and key lessons learned may help to inform other private and public health care systems interested in disseminating and implementing EBPs. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Agency Leaders' Assessments of Feasibility and Desirability of Implementation of Evidence-Based Practices in Youth-Serving Organizations Using the Stages of Implementation Completion.

PubMed

Palinkas, Lawrence A; Campbell, Mark; Saldana, Lisa

2018-01-01

Background: This study examined influences on the decisions of administrators of youth-serving organizations to initiate and proceed with implementation of an evidence-based practice (EBP). Methods: Semi-structured interviews, developed using the Stages of Implementation Completion (SIC) as a framework, were conducted with 19 agency chief executive officers and program directors of 15 organizations serving children and adolescents. Results: Agency leaders' self-assessments of implementation feasibility and desirability prior to implementation (Pre-implementation) were influenced by intervention affordability, feasibility, requirements, validity, reliability, relevance, cost savings, positive outcomes, and adequacy of information; availability of funding, support from sources external to the agency, and adequacy of technical assistance; and staff availability and attitudes toward innovation in general and EBPs in particular, organizational capacity, fit between the EBP and agency mission and capacity, prior experience with implementation, experience with seeking evidence, and developing consensus. Assessments during the Implementation phase included intervention flexibility and requirements; availability of funding, adequacy of training and technical assistance, and getting sufficient and appropriate referrals; and staffing and implementing with fidelity. Assessments during the Sustainment phase included intervention costs and benefits; availability of funding, support from sources outside of the agency, and need for the EBP; and the fit between the EBP and the agency mission. Discussion: The results point to opportunities for using agency leader models to develop strategies to facilitate implementation of evidence-based and innovative practices for children and adolescents. The SIC provides a standardized framework for guiding agency leader self-assessments of implementation.

Agency Leaders' Assessments of Feasibility and Desirability of Implementation of Evidence-Based Practices in Youth-Serving Organizations Using the Stages of Implementation Completion

PubMed Central

Palinkas, Lawrence A.; Campbell, Mark; Saldana, Lisa

2018-01-01

Background: This study examined influences on the decisions of administrators of youth-serving organizations to initiate and proceed with implementation of an evidence-based practice (EBP). Methods: Semi-structured interviews, developed using the Stages of Implementation Completion (SIC) as a framework, were conducted with 19 agency chief executive officers and program directors of 15 organizations serving children and adolescents. Results: Agency leaders' self-assessments of implementation feasibility and desirability prior to implementation (Pre-implementation) were influenced by intervention affordability, feasibility, requirements, validity, reliability, relevance, cost savings, positive outcomes, and adequacy of information; availability of funding, support from sources external to the agency, and adequacy of technical assistance; and staff availability and attitudes toward innovation in general and EBPs in particular, organizational capacity, fit between the EBP and agency mission and capacity, prior experience with implementation, experience with seeking evidence, and developing consensus. Assessments during the Implementation phase included intervention flexibility and requirements; availability of funding, adequacy of training and technical assistance, and getting sufficient and appropriate referrals; and staffing and implementing with fidelity. Assessments during the Sustainment phase included intervention costs and benefits; availability of funding, support from sources outside of the agency, and need for the EBP; and the fit between the EBP and the agency mission. Discussion: The results point to opportunities for using agency leader models to develop strategies to facilitate implementation of evidence-based and innovative practices for children and adolescents. The SIC provides a standardized framework for guiding agency leader self-assessments of implementation. PMID:29896471

Provider Agency Practices as a Source of Social Work EBP.

PubMed

Blakely, Thomas J; Dziadosz, Gregory M

2016-01-01

Through this article the authors propose that agency service provider systems may be a source of evidence-based practices (EBP). One agency's design and implementation of a program entitled Community Treatment and Rehabilitation is presented as an example. The elements of this program conform to the creation of EBPs. It was formulated with consideration of clients' values and judgments through their participation at every step in the assessment and treatment process. Staff clinicians were trained in established EBP interventions, such as cognitive therapy, embedded in a system of ordered assessment, treatment, and outcome evaluation. A controlled research design was used to gather outcome data to inform clinicians' decisions about interventions that were then systematically applied with clients. The delivery system was organized for clinical supervisors to guide staff clinical practices so that all were operating on the same set of guidelines allowing for similar outcomes to occur with similar interventions. This method of developing EBPs makes them available for application immediately and successfully eliminates the delay between development and implementation that usually occurs with other sources of EBPs.

Overcoming Barriers to Implementation of Evidence-Based Practice Concepts in Athletic Training Education: Perceptions of Select Educators

PubMed Central

Manspeaker, Sarah; Van Lunen, Bonnie

2011-01-01

Context: The need to include evidence-based practice (EBP) concepts in entry-level athletic training education is evident as the profession transitions toward using evidence to inform clinical decision making. Objective: To evaluate athletic training educators' experience with implementation of EBP concepts in Commission on Accreditation of Athletic Training Education (CAATE)-accredited entry-level athletic training education programs in reference to educational barriers and strategies for overcoming these barriers. Design: Qualitative interviews of emergent design with grounded theory. Setting: Undergraduate CAATE-accredited athletic training education programs. Patients or Other Participants: Eleven educators (3 men, 8 women). The average number of years teaching was 14.73 ± 7.06. Data Collection and Analysis: Interviews were conducted to evaluate perceived barriers and strategies for overcoming these barriers to implementation of evidence-based concepts in the curriculum. Interviews were explored qualitatively through open and axial coding. Established themes and categories were triangulated and member checked to determine trustworthiness. Results: Educators identified 3 categories of need for EBP instruction: respect for the athletic training profession, use of EBP as part of the decision-making toolbox, and third-party reimbursement. Barriers to incorporating EBP concepts included time, role strain, knowledge, and the gap between clinical and educational practices. Suggested strategies for surmounting barriers included identifying a starting point for inclusion and approaching inclusion from a faculty perspective. Conclusions: Educators must transition toward instruction of EBP, regardless of barriers present in their academic programs, in order to maintain progress with other health professions' clinical practices and educational standards. Because today's students are tomorrow's clinicians, we need to include EBP concepts in entry-level education to promote critical thinking, inspire potential research interest, and further develop the available body of knowledge in our growing clinical practice. PMID:22488139

Overcoming barriers to implementation of evidence-based practice concepts in athletic training education: perceptions of select educators.

PubMed

Manspeaker, Sarah; Van Lunen, Bonnie

2011-01-01

The need to include evidence-based practice (EBP) concepts in entry-level athletic training education is evident as the profession transitions toward using evidence to inform clinical decision making. To evaluate athletic training educators' experience with implementation of EBP concepts in Commission on Accreditation of Athletic Training Education (CAATE)-accredited entry-level athletic training education programs in reference to educational barriers and strategies for overcoming these barriers. Qualitative interviews of emergent design with grounded theory. Undergraduate CAATE-accredited athletic training education programs. Eleven educators (3 men, 8 women). The average number of years teaching was 14.73 ± 7.06. Interviews were conducted to evaluate perceived barriers and strategies for overcoming these barriers to implementation of evidence-based concepts in the curriculum. Interviews were explored qualitatively through open and axial coding. Established themes and categories were triangulated and member checked to determine trustworthiness. Educators identified 3 categories of need for EBP instruction: respect for the athletic training profession, use of EBP as part of the decision-making toolbox, and third-party reimbursement. Barriers to incorporating EBP concepts included time, role strain, knowledge, and the gap between clinical and educational practices. Suggested strategies for surmounting barriers included identifying a starting point for inclusion and approaching inclusion from a faculty perspective. Educators must transition toward instruction of EBP, regardless of barriers present in their academic programs, in order to maintain progress with other health professions' clinical practices and educational standards. Because today's students are tomorrow's clinicians, we need to include EBP concepts in entry-level education to promote critical thinking, inspire potential research interest, and further develop the available body of knowledge in our growing clinical practice.

Building a Unit-Level Mentored Program to Sustain a Culture of Inquiry for Evidence-Based Practice.

PubMed

Breckenridge-Sproat, Sara T; Throop, Meryia D; Raju, Dheeraj; Murphy, Deborah A; Loan, Lori A; Patrician, Patricia A

2015-01-01

This study tested the effectiveness of a dynamic educational and mentoring program, facilitated by unit-level mentors, to introduce, promote, and sustain an evidence-based practice (EBP) culture among nurses in a military healthcare setting. The need to identify gaps in practice, apply principles of EBP, and advance scientific applications in the pursuit of quality nursing care is as important to military healthcare as it is in the civilian sector. The Advancing Research through Close Collaboration Model guided the intervention and study. Three instruments were used: the Organizational Readiness for System-wide Integration of Evidence-Based Practice, EBP Beliefs, and EBP Implementation scales. The study took place in 3 military hospitals simultaneously undergoing facility and staff integration. Data were collected from staff nurses in the inpatient nursing units before and after a facilitated education and mentoring intervention. Three hundred sixty nurses (38%) completed baseline, and 325 (31%) completed follow-up surveys. Scores improved on all 3 measures following implementation of the program; however, the differences were statistically significant only for the Organizational Readiness for System-wide Integration of Evidence-Based Practice scale (70.96 vs 77.63, t = -3.95, P < .01). In the paired individual pretest/posttest subsample (n = 56), scores improved significantly on all 3 instruments. Despite typically high turnover rates of military personnel and restructuring of 3 facilities during the study period, the readiness for, beliefs about, and implementation of EBP improved. This study suggests that a commitment to an EBP culture may diffuse among individuals in an organization, even while experiencing significant change. It also demonstrates that a unit-level mentored EBP program is sustainable despite changes in organizational structure and workforce composition.

The evidence-based practice profiles of academic and clinical staff involved in pre-registration nursing students' education: a cross sectional survey of US and UK staff.

PubMed

Upton, Penney; Scurlock-Evans, Laura; Williamson, Kathleen; Rouse, Joanne; Upton, Dominic

2015-01-01

Competency in evidence-based practice (EBP) is a requirement for graduate nurses. Despite a growing body of research exploring the EBP profiles of students, little research has explored the EBP profiles of nurse educators. To explore: the differences/similarities in the EBP profiles of US and UK clinical and academic faculty; the barriers nurse educators experience when teaching EBP; the impact of postgraduate education on EBP profile and; what nurse educators perceive "success" in implementing and teaching EBP to be. A cross-sectional online survey design was employed. Two Universities delivering undergraduate nursing education in the US and UK, in partnership with large hospital systems, small community hospitals, community settings, and independent sector health organisations. Eighty-one nurse educators working in academic and clinical contexts in the US and UK (US academic=12, US clinical=17, UK academic=9, UK clinical=43) were recruited opportunistically. Participants were emailed a weblink to an online survey, comprising demographic questions, the Evidence-Based Practice Questionnaire and open-ended questions about EBP barriers, facilitators and successes. Quantitative results indicated that academic faculty scored significantly higher on knowledge and skills of EBP, than clinical faculty, but revealed no other significant differences on EBP use or attitudes, or between US and UK professionals. Participants with postgraduate training scored significantly higher on EBP knowledge/skills, but not EBP attitudes or use. Qualitative findings identified key themes relating to EBP barriers and facilitators, including: Evidence-, organisational-, and teaching-related issues. Perceptions of successes in EBP were also described. Nurse educators working in the UK and US face similar EBP barriers to teaching and implementation, but view it positively and use it frequently. Clinical staff may require extra support to maintain their EBP knowledge and skills in comparison to staff working in academic contexts. Copyright © 2014 Elsevier Ltd. All rights reserved.

Implementing Evidence-Based Practice in Community Mental Health Agencies: A Multiple Stakeholder Analysis

PubMed Central

Wells, Rebecca S.; Zagursky, Karen; Fettes, Danielle L.; Palinkas, Lawrence A.

2009-01-01

Objectives. We sought to identify factors believed to facilitate or hinder evidence-based practice (EBP) implementation in public mental health service systems as a step in developing theory to be tested in future studies. Methods. Focusing across levels of an entire large public sector mental health service system for youths, we engaged participants from 6 stakeholder groups: county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. Results. Participants generated 105 unique statements identifying implementation barriers and facilitators. Participants rated each statement on importance and changeability (i.e., the degree to which each barrier or facilitator is considered changeable). Data analyses distilled statements into 14 factors or dimensions. Descriptive analyses suggest that perceptions of importance and changeability varied across stakeholder groups. Conclusions. Implementation of EBP is a complex process. Cross-system–level approaches are needed to bring divergent and convergent perspectives to light. Examples include agency and program directors facilitating EBP implementation by supporting staff, actively sharing information with policymakers and administrators about EBP effectiveness and fit with clients' needs and preferences, and helping clinicians to present and deliver EBPs and address consumer concerns. PMID:19762654

Aligning Leadership Across Systems and Organizations to Develop Strategic Climate to for Evidence-Based Practice Implementation

PubMed Central

Aarons, Gregory A.; Farahnak, Lauren R.; Ehrhart, Mark G.; Sklar, Marisa

2015-01-01

There has been a growing impetus to bridge the gap between basic science discovery, development of evidence-based practices (EBPs) and their availability and delivery in order to improve public health impact of such practices. In seeking to capitalize on factors that support implementation and sustainment of EBPs, it is important to consider that healthcare is delivered within the outer context of public health systems, and the inner context of healthcare organizations and workgroups. Leaders have a key role in determining the nature of system and organizational context. This article will addresses the role of leadership across levels in developing strategic climate for EBP implementation within the outer (i.e., system) and inner (i.e., organization, work group) contexts of healthcare. Within the framework of Edgar Schein’s “climate embedding mechanisms,” we describe strategies that leaders at the system, organization, and work group levels can consider and apply to develop a strategic climates that support the implementation and sustainment of EBP in healthcare and allied healthcare settings. PMID:24641560

Dissemination of Evidence-Based Practice to Directors of Nursing by an Outreach Campaign in Taiwan.

PubMed

Weng, Yi-Hao; Chen, Chiehfeng; Chen, Kee-Hsin; Kuo, Ken N; Yang, Chun-Yuh; Chiu, Ya-Wen

2016-04-01

Directors of nursing (DONs) have an important influence in the dissemination of evidence-based practice (EBP) in hospital settings. The current study examined how the knowledge, skills, and behaviors of DONs changed when EBP was implemented during a 5-year, nationwide promotional campaign providing EBP-related information resources and promotional activities in regional hospitals in Taiwan. Cross-sectional questionnaire surveys for a nationwide representative sample of DONs were conducted in 2007, 2009, and 2011 to examine views related to EBP, including changes in beliefs, attitudes, knowledge, skills, behaviors, and barriers. This study enrolled 267 DONs in 2007, 257 in 2009, and 287 in 2011. During the study period, DONs' EBP knowledge and skills increased, but their beliefs and attitudes did not significantly change. Furthermore, the use of Internet-based resources, including web portals, electronic textbooks, electronic journals, and evidence-based online databases, increased. Most barriers significantly declined after the intervention. DONs' knowledge, skills, and behaviors regarding EBP increased after the multifaceted intervention. The data suggest this outreach program is useful in disseminating EBP implementation to DONs. Copyright 2016, SLACK Incorporated.

The what, when, and why of implementation frameworks for evidence-based practices in child welfare and child mental health service systems.

PubMed

Hanson, Rochelle F; Self-Brown, Shannon; Rostad, Whitney L; Jackson, Matthew C

2016-03-01

It is widely recognized that children in the child welfare system are particularly vulnerable to the adverse health and mental effects associated with exposure to abuse and neglect, making it imperative to have broad-based availability of evidence-based practices (EBPs) that can prevent child maltreatment and reduce the negative mental health outcomes for youth who are victims. A variety of EBPs exist for reducing child maltreatment risk and addressing the associated negative mental health outcomes, but the reach of these practices is limited. An emerging literature documents factors that can enhance or inhibit the success of EBP implementation in community service agencies, including how the selection of a theory-driven conceptual framework, or model, might facilitate implementation planning by providing guidance for best practices during implementation phases. However, limited research is available to guide decision makers in the selection of implementation frameworks that can boost implementation success for EBPs that focus on preventing child welfare recidivism and serving the mental health needs of maltreated youth. The aims of this conceptual paper are to (1) provide an overview of existing implementation frameworks, beginning with a discussion of definitional issues and the selection criteria for frameworks included in the review; and (2) offer recommendations for practice and policy as applicable for professionals and systems serving victims of child maltreatment and their families. Copyright © 2015 Elsevier Ltd. All rights reserved.

Leadership, Organizational Climate, and Perceived Burden of Evidence-Based Practice in Mental Health Services.

PubMed

Brimhall, Kim C; Fenwick, Karissa; Farahnak, Lauren R; Hurlburt, Michael S; Roesch, Scott C; Aarons, Gregory A

2016-09-01

The use of evidence-based practices (EBPs) is associated with favorable client outcomes, yet perceived burden of using EBPs may affect the adoption and implementation of such practices. Multilevel path analysis was used to examine the associations of transformational leadership with organizational climate, and their associations with perceived burden of using EBPs. Results indicated significant relationships between transformational leadership and empowering and demoralizing climates, and between demoralizing climate and perceived burden of EBPs. We found significant indirect associations of leadership and perceived burden through organizational climate. Findings suggest that further research is needed to examine the extent to which improving leadership and organizational climate may reduce perceived burden and use of EBPs with the ultimate goal of enhancing quality of care.

Impact of organizational change on organizational culture: implications for introducing evidence-based practice.

PubMed

Austin, Michael J; Claassen, Jennette

2008-01-01

Evidence-based practice (EBP) seeks to integrate the expertise of individual practitioners with the best available evidence within the context of the values and expectations of clients. Prior to implementing EBP, it is important to understand the significance that organizational change and organizational culture play. This article seeks to explore the literature associated with both organizational change and organizational culture. The analysis of organizational culture and change draw upon findings from both the private, for-profit sector, and the public, non-profit field. It is divided into four sections: organizational change and innovation, organizational culture, managing organizational culture and change, and finally, applying the findings to the implementation of EBP. While the audience for this analysis is managers in public and nonprofit human service organizations who are considering implementing EBP into their work environment, it is not intended to provide a "how to" guide, but rather a framework for critical thinking.

Training and retaining staff to competently deliver an evidence-based practice: the role of staff attributes and perceptions of organizational functioning.

PubMed

Garner, Bryan R; Hunter, Brooke D; Godley, Susan H; Godley, Mark D

2012-03-01

Within the context of an initiative to implement evidence-based practices (EBPs) for adolescents with substance use disorders, this study examined the extent to which staff factors measured at an initial EBP training workshop were predictive of EBP competence and turnover status of staff (N = 121) measured 6, 9, and 12 months posttraining. By the final assessment point, 52.3% of staff transitioned to the employed/EBP-competent category, 26.6% transitioned to the not employed/not EBP-competent category, 4.6% transitioned to the not employed/EBP-competent category, and 16.5% had not transitioned out of the initial category. Multilevel multinomial regression analysis identified several measures that were significant predictors of staff transitions to the not employed/not EBP-competent category (e.g., program needs, job satisfaction, burnout) and transitions to the employed/EBP-competent category (e.g., months in position, pressures for change, influence). Findings have implications for the development and testing of strategies to train and retain staff to deliver EBPs in practice settings. Copyright © 2012 Elsevier Inc. All rights reserved.

Facilitating the implementation of evidence- based practice through contextual support and nursing leadership.

PubMed

Kueny, Angela; Shever, Leah L; Lehan Mackin, Melissa; Titler, Marita G

2015-01-01

Nurse managers (NMs) play an important role promoting evidence-based practice (EBP) on clinical units within hospitals. However, there is a dearth of research focused on NM perspectives about institutional contextual factors to support the goal of EBP on the clinical unit. The purpose of this article is to identify contextual factors described by NMs to drive change and facilitate EBP at the unit level, comparing and contrasting these perspectives across nursing units. This study employed a qualitative descriptive design using interviews with nine NMs who were participating in a large effectiveness study. To stratify the sample, NMs were selected from nursing units designated as high or low performing based on implementation of EBP interventions, scores on the Meyer and Goes research use scale, and fall rates. Descriptive content analysis was used to identify themes that reflect the complex nature of infrastructure described by NMs and contextual influences that supported or hindered their promotion of EBP on the clinical unit. NMs perceived workplace culture, structure, and resources as facilitators or barriers to empowering nurses under their supervision to use EBP and drive change. A workplace culture that provides clear communication of EBP goals or regulatory changes, direct contact with CEOs, and clear expectations supported NMs in their promotion of EBP on their units. High-performing unit NMs described a structure that included nursing-specific committees, allowing nurses to drive change and EBP from within the unit. NMs from high-performing units were more likely to articulate internal resources, such as quality-monitoring departments, as critical to the implementation of EBP on their units. This study contributes to a deeper understanding of institutional contextual factors that can be used to support NMs in their efforts to drive EBP changes at the unit level.

An organizational cybernetics framework for achieving balance in evidence-based practice and practice-based evidence.

PubMed

Fitch, Dale

2014-01-01

This article applies the systems science of organizational cybernetics to the implementation of evidence-based practice (EBP) in the provision of social work services in a residential treatment center setting. It does so by systemically balancing EBP with practice-based evidence (PBE) with a focus on the organizational and information system infrastructures necessary to ensure successful implementation. This application is illustrated by discussing a residential treatment program that implemented evidence-based programming and evaluated the results; however, the systemic principles articulated can be applied to any human services organizational setting.

Capability beliefs on, and use of evidence-based practice among four health professional and student groups in geriatric care: A cross sectional study

PubMed Central

2018-01-01

Implementation of evidence-based practice (EBP) is a complex task. This study, conducted in an acute geriatric setting, aims to compare self-reported capability beliefs on EBP between health professionals and students, and to compare the use of EBP between health professional groups. Occupational therapists, physicians, physiotherapists and registered nurses with three or more months’ employment, and all students from the occupational therapy, medical, physiotherapy and nursing programs, who had conducted workplace learning at the department, were invited. Data on capability beliefs and use of EBP were collected using the Evidence-based Practice Capabilities Beliefs Scale assessing six activities of EBP: formulate questions; search databases; search other sources; appraise research reports; participate in implementation in practice; and participate in evaluation. Descriptive and inferential statistics were used. Capability beliefs on EBP: The health professionals (n = 101; response rate 80%) reported high on search other sources but less on appraise research reports. The students (n = 124; response rate 73%) reported high on all EBP activities. The health professionals reported significantly higher on search other sources than the students. The students reported significantly higher on formulate questions and appraise research reports than the health professionals. No significant differences were identified between the health professional groups or between the student groups. Use of EBP: Health professionals reported wide-ranging use from several times each month to once every six months. The physicians reported significantly more frequent use than registered nurses and occupational therapists. Health professionals supervising students reported more frequent use of appraise research reports than the non-supervising group. There is a need for improving the use of EBP, particularly among registered nurses and occupational therapists. Supervision of students might enhance the motivation among staff to increase the use of EBP and students’ high EBP capability beliefs might inspire staff in this matter. PMID:29444179

Attitudes and barriers to evidence-based practice in optometry educators.

PubMed

Suttle, Catherine M; Challinor, Kirsten L; Thompson, Rachel E; Pesudovs, Konrad; Togher, Leanne; Chiavaroli, Neville; Lee, Adrian; Junghans, Barbara; Stapleton, Fiona; Watt, Kathleen; Jalbert, Isabelle

2015-04-01

Evidence-based practice (EBP) is an essential component of good quality, patient-centered health care. This requires practitioners to acquire EBP skills and knowledge during undergraduate and continuing education. Evidence-based practice education exists in a range of health care disciplines, including optometry. Evidence-based practice education, however, depends on relevant skills and knowledge in educators. Courses and workshops exist for the development of EBP teaching skills in some areas of health care but not in optometry. Here, we describe a pilot workshop designed to enhance the teaching of EBP and to investigate the perspectives of optometric educators on EBP including their attitudes and perceived barriers to EBP and its teaching. Twenty-seven optometric educators including 8 facilitators participated. Of these, 14 were academics (including the 8 facilitators) and 13 were practitioners. Evidence-based practice attitudes were assessed using the Evidence-Based Practice Attitude Scale-50 with appropriate modifications for optometry. Workshop design incorporated strategies to trigger discussion among participants. A nominal group technique was used to identify, prioritize, and reach consensus on barriers to EBP. Although some participants expressed reservations about EBP, a common understanding of the contemporary definition of EBP emerged in educators. Thirty-five barriers to EBP were identified; "time" was selected in the top five barriers by most participants and attracted the highest total score, well above any other barrier (negative attitude to EBP, volume of evidence, integration with clinical practice, and lack of lifelong learning mind-set). Attitudes toward EBP were generally positive and negatively correlated with age and time since graduation, respectively. A group of optometrists and academics new to implementing education in EBP displayed positive attitudes to EBP but considered that its application and teaching could be significantly hindered by a lack of time to access and appraise the large volume of available research evidence in the field of eye care.

Improving quality of care through routine, successful implementation of evidence-based practice at the bedside: an organizational case study protocol using the Pettigrew and Whipp model of strategic change

PubMed Central

2007-01-01

Background Evidence-based practice (EBP) is an expected approach to improving the quality of patient care and service delivery in health care systems internationally that is yet to be realized. Given the current evidence-practice gap, numerous authors describe barriers to achieving EBP. One recurrently identified barrier is the setting or context of practice, which is likewise cited as a potential part of the solution to the gap. The purpose of this study is to identify key contextual elements and related strategic processes in organizations that find and use evidence at multiple levels, in an ongoing, integrated fashion, in contrast to those that do not. Methods The core theoretical framework for this multi-method explanatory case study is Pettigrew and Whipp's Content, Context, and Process model of strategic change. This framework focuses data collection on three entities: the Why of strategic change, the What of strategic change, and the How of strategic change, in this case related to implementation and normalization of EBP. The data collection plan, designed to capture relevant organizational context and related outcomes, focuses on eight interrelated factors said to characterize a receptive context. Selective, purposive sampling will provide contrasting results between two cases (departments of nursing) and three embedded units in each. Data collection methods will include quantitative tools (e.g., regarding culture) and qualitative approaches including focus groups, interviews, and documents review (e.g., regarding integration and “success”) relevant to the EBP initiative. Discussion This study should provide information regarding contextual elements and related strategic processes key to successful implementation and sustainability of EBP, specifically in terms of a pervasive pattern in an acute care hospital-based health care setting. Additionally, this study will identify key contextual elements that differentiate successful implementation and sustainability of EBP efforts, both within varying levels of a hospital-based clinical setting and across similar hospital settings interested in EBP. PMID:17266756

Leadership, Organizational Climate, and Perceived Burden of Evidence-Based Practice in Mental Health Services

PubMed Central

Brimhall, Kim C.; Fenwick, Karissa; Farahnak, Lauren R.; Hurlburt, Michael S.; Roesch, Scott C.

2015-01-01

The use of evidence-based practices (EBPs) is associated with favorable client outcomes, yet perceived burden of using EBPs may affect the adoption and implementation of such practices. Multilevel path analysis was used to examine the associations of transformational leadership with organizational climate, and their associations with perceived burden of using EBPs. Results indicated significant relationships between transformational leadership and empowering and demoralizing climates, and between demoralizing climate and perceived burden of EBPs. We found significant indirect associations of leadership and perceived burden through organizational climate. Findings suggest that further research is needed to examine the extent to which improving leadership and organizational climate may reduce perceived burden and use of EBPs with the ultimate goal of enhancing quality of care. PMID:26152770

A Longitudinal Study of State Strategies and Policies to Accelerate Evidence-Based Practices in the Context of Systems Transformation.

PubMed

Rieckmann, Traci; Abraham, Amanda; Zwick, Janet; Rasplica, Caitlin; McCarty, Dennis

2015-08-01

To profile state agency efforts to promote implementation of three evidence-based practices (EBPs): screening and brief intervention (SBIRT), psychosocial interventions, and medication-assisted treatment (MAT). Primary data collected from representatives of 50 states and the District of Columbia's Single State Authorities from 2007 to 2009. The study used mixed methods, in-depth, semistructured interviews and quantitative surveys. Interviews assessed state and provider strategies to accelerate implementation of EBPs. Statewide implementation of psychosocial interventions and MAT increased significantly over 3 years. In the first two assessments, states that contracted directly with providers were more likely to link use of EBPs to reimbursement, and states with indirect contract, through counties and other entities, increased recommendations, and some requirements for provision of specific EBPs. The number of states using legislation as a policy lever to promote EBPs was unchanged. Health care reform and implementation of parity in coverage increases access to treatment for alcohol and drug use. Science-based substance abuse treatment will become even more crucial as payers seek consistent quality of care. This study provides baseline data on service delivery, contracting, and financing as state agencies and treatment providers prepare for implementation of the Affordable Care Act. © Health Research and Educational Trust.

Evidence-based practice: beliefs, attitudes, knowledge, and skills among Colombian physical therapists.

PubMed

Ramírez-Vélez, Robinson; Correa-Bautista, Jorge Enrique; Muñoz-Rodríguez, Diana Isabel; Ramírez, Lorena; González-Ruíz, Katherine; Domínguez-Sánchez, María Andrea; Durán-Palomino, Diana; Girabent-Farrés, Montserrat; Flórez-López, María Eugenia; Bagur-Calafat, M Caridad

2015-01-01

The main purpose of this study was to describe a group of Colombian physical therapists' beliefs and attitudes towards Evidence-Based Practice (EBP), their education, knowledge and skills for implementing EBP, the use of relevant literature in clinical practice, access to and availability of scientific information and perceived barriers to including EBP in practice. This was a cross-sectional study which involved 1,064 Colombian physical therapists. The study used a 50-item screening questionnaire EBP developed to estimate attitudes, beliefs, knowledge and skills regarding. This instrument has been adapted and was validated previously in Colombia by Flórez-López et al. The population mostly consisted of young females (77.2%) aged 22 to 29 years old (79.4%). Most respondents had an undergraduate degree (87.7%). The physical therapists stated that they had positive attitudes and beliefs regarding EBP, most of them answering that they agreed or strongly agreed that EBP is necessary (71.6%), the relevant literature is useful for practice (61.3%), EBP improves the quality of patient care (64.1%) and evidence helps in decision-making (44.5%). Forty-one percent of the respondents indicated that a lack of research skills was the most important barrier to the use of evidence in practice. The physical therapists reported that they had a positive attitude to EBP and were interested in learning about or improving the skills necessary to adopt EBP in their clinical practice.

Evidence-based practice: beliefs, attitudes, knowledge, and skills among Colombian physical therapists

PubMed Central

Correa-Bautista, Jorge Enrique; Muñoz-Rodríguez, Diana Isabel; Ramírez, Lorena; González-Ruíz, Katherine; Domínguez-Sánchez, María Andrea; Durán-Palomino, Diana; Girabent-Farrés, Montserrat; Flórez-López, María Eugenia; Bagur-Calafat, M Caridad

2015-01-01

Objective: The main purpose of this study was to describe a group of Colombian physical therapists' beliefs and attitudes towards Evidence-Based Practice (EBP), their education, knowledge and skills for implementing EBP, the use of relevant literature in clinical practice, access to and availability of scientific information and perceived barriers to including EBP in practice. Methods: This was a cross-sectional study which involved 1,064 Colombian physical therapists. The study used a 50-item screening questionnaire EBP developed to estimate attitudes, beliefs, knowledge and skills regarding. This instrument has been adapted and was validated previously in Colombia by Flórez-López et al. Results: The population mostly consisted of young females (77.2%) aged 22 to 29 years old (79.4%). Most respondents had an undergraduate degree (87.7%). The physical therapists stated that they had positive attitudes and beliefs regarding EBP, most of them answering that they agreed or strongly agreed that EBP is necessary (71.6%), the relevant literature is useful for practice (61.3%), EBP improves the quality of patient care (64.1%) and evidence helps in decision-making (44.5%). Forty-one percent of the respondents indicated that a lack of research skills was the most important barrier to the use of evidence in practice. Conclusion: The physical therapists reported that they had a positive attitude to EBP and were interested in learning about or improving the skills necessary to adopt EBP in their clinical practice. PMID:26019383

Evidence based practice in traditional & complementary medicine: An agenda for policy, practice, education and research.

PubMed

Leach, Matthew J; Canaway, Rachel; Hunter, Jennifer

2018-05-01

To develop a policy, practice, education and research agenda for evidence-based practice (EBP) in traditional and complementary medicine (T&CM). The study was a secondary analysis of qualitative data, using the method of roundtable discussion. The sample comprised seventeen experts in EBP and T&CM. The discussion was audio-recorded, and the transcript analysed using thematic analysis. Four central themes emerged from the data; understanding evidence and EBP, drivers of change, interpersonal interaction, and moving forward. Captured within these themes were fifteen sub-themes. These themes/sub-themes translated into three broad calls to action: (1) defining terminology, (2) defining the EBP approach, and (3) fostering social movement. These calls to action formed the framework of the agenda. This analysis presents a potential framework for an agenda to improve EBP implementation in T&CM. The fundamental elements of this action plan seek clarification, leadership and unification on the issue of EBP in T&CM. Copyright © 2018 Elsevier Ltd. All rights reserved.

Managerial attitudes and perceived barriers regarding evidence-based practice: An international survey

PubMed Central

Jepsen, Denise M.; Houghton, Edward; ten Have, Steven

2017-01-01

Evidence-based practice (EBP) in management is still in its infancy. Several studies suggest that managers in businesses and other organizations do not consult the scientific evidence when making decisions. To facilitate its uptake, we need to better understand practitioner attitudes and perceived barriers related to EBP. In medicine and nursing, an abundance of research exists on this subject, although such studies are rare in management. To address this gap, we surveyed 2,789 management practitioners in Belgium, the Netherlands, the United States, the United Kingdom and Australia. Our findings indicate that most managers we studied have positive attitudes towards EBP. However, lack of time and a limited understanding of scientific research are perceived as major barriers to the uptake and implementation of EBP in management. Studies in other professions where EBP is far more established also report similar barriers. We discuss the implications of our findings for practice, education and research, providing suggestions to enhance use of EBP in management practice. PMID:28972977

Costs to Community Mental Health Agencies to Sustain an Evidence-Based Practice.

PubMed

Roundfield, Katrina D; Lang, Jason M

2017-09-01

Dissemination of evidence-based practices (EBPs) has become a priority in children's mental health services. Although implementation approaches and initiatives are proliferating, little is known about sustainment of EBPs, but evidence suggests that most EBPs are not sustained for more than a few years. Cost is the most frequently cited barrier to sustainment, yet very little is known about these costs. This study provides a method for quantifying incremental costs of an EBP compared with usual care and preliminary data on the costs in staff time, lost revenue, and other expenses of sustaining an EBP (trauma-focused cognitive-behavioral therapy [TF-CBT]) in community mental health settings. Fourteen community mental health agencies (CMHAs) completed a measure developed for this study to collect administrative data on implementation costs to sustain TF-CBT. Survey items captured activities that were related specifically to TF-CBT and that would not otherwise be conducted for usual care, such as TF-CBT training. Staff time in hours was converted to monetary estimates. Costs varied widely across agencies. Preliminary results indicated that agencies spent on average $65,192 per year (2014 U.S.$) on incremental costs for TF-CBT sustainment (excluding costs of external trainers and other support); the average incremental cost per client was $1,896. The costs to sustain the EBP suggest that maintaining an EBP is a financial burden for CMHAs and that these costs can be a potential barrier to broader EBP uptake. Implications for public policy include providing reimbursement rates and financial incentives to offset potential implementation costs and promote sustainment of EBPs.

Leadership, Innovation Climate, and Attitudes toward Evidence-Based Practice during a Statewide Implementation

PubMed Central

Aarons, Gregory A.; Sommerfeld, David H.

2013-01-01

Objective Leadership is important in practice change, yet there are few studies addressing this issue in mental health and social services. This study examined the differential roles of transformational (i.e., charismatic) leadership and leader member exchange (i.e., the relationship between a supervisor and their direct service providers) on team innovation climate (i.e., openness to new innovations) and provider attitudes toward adopting evidence-based practice (EBP) during a statewide evidence-based practice implementation (EBPI) of an intervention to reduce child neglect. Methods Participants were 140 case-managers in 30 teams providing home-based services to families in a statewide child-welfare system. Teams were assigned by region to EBPI or services as usual (SAU) conditions. Multiple group path analysis was used to examine associations of transformational leadership and leader member exchange with innovation climate and attitudes toward adoption and use of EBP. Results Transformational leadership predicted higher innovation climate during implementation while leader member exchange predicted higher innovation climate during SAU. Innovation climate was, in turn, associated with more positive attitudes toward EBP for the EBPI group. Conclusions Strategies designed to enhance supervisor transformational leadership have the potential to facilitate implementation efforts by promoting a strong climate for EBPI and positive provider attitudes toward adoption and use of EBP. PMID:22449648

Facilitating interprofessional evidence-based practice in paediatric rehabilitation: development, implementation and evaluation of an online toolkit for health professionals.

PubMed

Glegg, Stephanie M N; Livingstone, Roslyn; Montgomery, Ivonne

2016-01-01

Lack of time, competencies, resources and supports are documented as barriers to evidence-based practice (EBP). This paper introduces a recently developed web-based toolkit designed to assist interprofessional clinicians in implementing EBP within a paediatric rehabilitation setting. EBP theory, models, frameworks and tools were applied or adapted in the development of the online resources, which formed the basis of a larger support strategy incorporating interactive workshops, knowledge broker facilitation and mentoring. The highly accessed toolkit contains flowcharts with embedded information sheets, resources and templates to streamline, quantify and document outcomes throughout the EBP process. Case examples relevance to occupational therapy and physical therapy highlight the utility and application of the toolkit in a clinical paediatric setting. Workshops were highly rated by learners for clinical relevance, presentation level and effectiveness. Eight evidence syntheses have been created and 79 interventions have been evaluated since the strategy's inception in January 2011. The toolkit resources streamlined and supported EBP processes, promoting consistency in quality and presentation of outputs. The online toolkit can be a useful tool to facilitate clinicians' use of EBP in order to meet the needs of the clients and families whom they support. Implications for Rehabilitation A comprehensive online EBP toolkit for interprofessional clinicians is available to streamline the EBP process and to support learning needs regardless of competency level. Multi-method facilitation support, including interactive education, e-learning, clinical librarian services and knowledge brokering, is a valued but cost-restrictive supplement to the implementation of online EBP resources. EBP resources are not one-size-fits-all; targeted appraisal tools, models and frameworks may be integrated to improve their utility for specific sectors, which may limit them for others.

Tools for evidence-based vascular nursing practice: Achieving information literacy for lifelong learning.

PubMed

Jameson, Jodi; Walsh, M Eileen

2017-12-01

Information literacy is essential in facilitating evidence-based practice (EBP) activities. In vascular nursing, the implementation of EBP is of utmost importance. Best practice grounded in research evidence can contribute to improved patient care outcomes for individuals with vascular disease. The following paper discusses information literacy competencies for nurses to develop in the context of EBP, with an emphasis on formulating a clinical question and searching for evidence. Relevant health science information resources are described, including their value and purpose in the 6S model of evidence. Also discussed are practical and supportive solutions with proven effectiveness in ensuring nurses' success with EBP. Copyright © 2017 Society for Vascular Nursing, Inc. Published by Elsevier Inc. All rights reserved.

Identifying Educational Practices Supported by Rigorous Evidence: A Guide to the Selection of Evidence-Based Practices

ERIC Educational Resources Information Center

Regional Resource Center Program, 2014

2014-01-01

One component of the recently required State Systemic Improvement Plan (SSIP) for State Departments of Education calls for the selection and implementation of evidence-based practices (EBPs). This report provides six steps to guide the process of selecting evidence based practices (EBP): (1) Begin with the End in Mind--Determine Targeted Outcomes;…

To Adapt or Not to Adapt: Navigating an Implementation Conundrum

ERIC Educational Resources Information Center

Leko, Melinda M.

2015-01-01

Maximizing the effectiveness of evidence-based practices (EBPs) requires an optimal balance of implementation fidelity and adaptation so EBPs fit local contexts and meet the individual learning needs of students with disabilities. The framework for classifying adaptations presented in this article can help educators make decisions about whether…

The role of relationships in connecting social work research and evidence-based practice.

PubMed

Jones, Johnny M; Sherr, Michael E

2014-01-01

Critics of evidence-based practice (EBP) often challenge the efficacy of applying social work research in practice. Such skepticism underscores the historic chasm that still exists between social work researchers and practitioners. If taught and implemented consistently, the EBP model can mend the connection between researchers and practitioners by merging their roles. Merging their roles, however, requires a renewed emphasis on relationships in the research process. This article explores the role of relationships in social work research. Using a researcher/practitioner continuum, we assess the types of interactions faculty have with stakeholders. We then offer strategies for cultivating relationships with stakeholders that lead to community-derived and implemented research that is critical to advancing the widespread use of EBP in social work.

Collaborating across services to advance evidence-based nursing practice.

PubMed

Kenny, Deborah J; Richard, Maggie L; Ceniceros, Xochitl; Blaize, Kelli

2010-01-01

Military medical treatment facilities offer a unique environment in which to develop a culture of evidence-based practice (EBP). Distinctive issues arise in the context of changed patient care demographics because of a war-injured population. These issues offer an opportunity to enhance the quality of care through the use and adaptation of research findings in this special nursing environment. In addition, the colocation of two military medical centers offers the prospect of collaborative efforts to create a regional culture for nursing EBP. The purposes of this study were to describe the processes of a collaborative project to train nurses in EBP and to share resources in developing and implementing evidence-based clinical nursing guidelines in two large military medical centers in the Northeastern United States and to discuss the collective efforts of nurse researchers, leadership, advanced practice nurses, and staff nurses in each hospital to facilitate the EBP process. A description of the organizational structure and the climate for EBP of each facility is provided followed by discussion of training efforts and the inculcation of an organizational culture for EBP. Contextual barriers and facilitators were encountered throughout the project. The two nurse researchers leading the projects were able to overcome the barriers and capitalize on opportunities to promote EBP. Three evidence-based clinical practice guidelines were developed at each facility and are currently in various stages of implementation. Despite the barriers, EBP continues to be at the forefront of military nursing practice in the U.S. National Capital Region. Clear communication and regular meetings were essential to the success of the collaborative project within and between the two military hospitals. Military-specific barriers to EBP included high team attrition and turnover because of the war mission and the usual high staff turnover at military hospitals. Military facilitators included a common mission of providing high-quality care for war-injured service members. Lessons learned from this project can be generalized to civilian facilities.

Evidence-Based Practices and Implementation Science in Special Education

ERIC Educational Resources Information Center

Cook, Bryan G.; Odom, Samuel L.

2013-01-01

Establishing a process for identifying evidence-based practices (EBPs) in special education has been a significant advance for the field because it has the potential for generating more effective educational programs and producing more positive outcomes for students with disabilities. However, the potential benefit of EBPs is bounded by the…

Athletic Training Educators' Knowledge, Comfort, and Perceived Importance of Evidence-Based Practice

ERIC Educational Resources Information Center

Welch, Cailee E.; Van Lunen, Bonnie L.; Walker, Stacy E.; Manspeaker, Sarah A.; Hankemeier, Dorice A.; Brown, Sara D.; Laursen, R. Mark; Onate, James A.

2011-01-01

Context: Before new strategies and effective techniques for implementation of evidence-based practice (EBP) into athletic training curricula can occur, it is crucial to recognize the current knowledge and understanding of EBP concepts among athletic training educators. Objective: To assess athletic training educators' current knowledge, comfort,…

Protocol: Adaptive Implementation of Effective Programs Trial (ADEPT): cluster randomized SMART trial comparing a standard versus enhanced implementation strategy to improve outcomes of a mood disorders program.

PubMed

Kilbourne, Amy M; Almirall, Daniel; Eisenberg, Daniel; Waxmonsky, Jeanette; Goodrich, David E; Fortney, John C; Kirchner, JoAnn E; Solberg, Leif I; Main, Deborah; Bauer, Mark S; Kyle, Julia; Murphy, Susan A; Nord, Kristina M; Thomas, Marshall R

2014-09-30

Despite the availability of psychosocial evidence-based practices (EBPs), treatment and outcomes for persons with mental disorders remain suboptimal. Replicating Effective Programs (REP), an effective implementation strategy, still resulted in less than half of sites using an EBP. The primary aim of this cluster randomized trial is to determine, among sites not initially responding to REP, the effect of adaptive implementation strategies that begin with an External Facilitator (EF) or with an External Facilitator plus an Internal Facilitator (IF) on improved EBP use and patient outcomes in 12 months. This study employs a sequential multiple assignment randomized trial (SMART) design to build an adaptive implementation strategy. The EBP to be implemented is life goals (LG) for patients with mood disorders across 80 community-based outpatient clinics (N = 1,600 patients) from different U.S. regions. Sites not initially responding to REP (defined as < 50% patients receiving ≥ 3 EBP sessions) will be randomized to receive additional support from an EF or both EF/IF. Additionally, sites randomized to EF and still not responsive will be randomized to continue with EF alone or to receive EF/IF. The EF provides technical expertise in adapting LG in routine practice, whereas the on-site IF has direct reporting relationships to site leadership to support LG use in routine practice. The primary outcome is mental health-related quality of life; secondary outcomes include receipt of LG sessions, mood symptoms, implementation costs, and organizational change. This study design will determine whether an off-site EF alone versus the addition of an on-site IF improves EBP uptake and patient outcomes among sites that do not respond initially to REP. It will also examine the value of delaying the provision of EF/IF for sites that continue to not respond despite EF. ClinicalTrials.gov identifier: NCT02151331.

Validating the Implementation Climate Scale (ICS) in Child Welfare Organizations

PubMed Central

Ehrhart, Mark G.; Torres, Elisa M.; Wright, Lisa A.; Martinez, Sandra Y.; Aarons, Gregory A.

2015-01-01

There is increasing emphasis on the use of evidence-based practices (EBPs) in child welfare settings and growing recognition of the importance of the organizational environment, and the organization’s climate in particular, for how employees perceive and support EBP implementation. Recently, Ehrhart, Aarons, and Farahnak (2014) reported on the development and validation of a measure of EBP implementation climate, the Implementation Climate Scale (ICS), in a sample of mental health clinicians. The ICS consists of 18 items and measures six critical dimensions of implementation climate: focus on EBP, educational support for EBP, recognition for EBP, rewards for EBP, selection or EBP, and selection for openness. The goal of the current study is to extend this work by providing evidence for the factor structure, reliability, and validity of the ICS in a sample of child welfare service providers. Survey data were collected from 215 child welfare providers across three states, 12 organizations, and 43 teams. Confirmatory factor analysis demonstrated good fit to the six-factor model and the alpha reliabilities for the overall measure and its subscales was acceptable. In addition, there was general support for the invariance of the factor structure across the child welfare and mental health sectors. In conclusion, this study provides evidence for the factor structure, reliability, and validity of the ICS measure for use in child welfare service organizations. PMID:26563643

Validating the Implementation Climate Scale (ICS) in child welfare organizations.

PubMed

Ehrhart, Mark G; Torres, Elisa M; Wright, Lisa A; Martinez, Sandra Y; Aarons, Gregory A

2016-03-01

There is increasing emphasis on the use of evidence-based practices (EBPs) in child welfare settings and growing recognition of the importance of the organizational environment, and the organization's climate in particular, for how employees perceive and support EBP implementation. Recently, Ehrhart, Aarons, and Farahnak (2014) reported on the development and validation of a measure of EBP implementation climate, the Implementation Climate Scale (ICS), in a sample of mental health clinicians. The ICS consists of 18 items and measures six critical dimensions of implementation climate: focus on EBP, educational support for EBP, recognition for EBP, rewards for EBP, selection or EBP, and selection for openness. The goal of the current study is to extend this work by providing evidence for the factor structure, reliability, and validity of the ICS in a sample of child welfare service providers. Survey data were collected from 215 child welfare providers across three states, 12 organizations, and 43 teams. Confirmatory factor analysis demonstrated good fit to the six-factor model and the alpha reliabilities for the overall measure and its subscales was acceptable. In addition, there was general support for the invariance of the factor structure across the child welfare and mental health sectors. In conclusion, this study provides evidence for the factor structure, reliability, and validity of the ICS measure for use in child welfare service organizations. Copyright © 2015 Elsevier Ltd. All rights reserved.

A framework of quality improvement interventions to implement evidence-based practices for pressure ulcer prevention.

PubMed

Padula, William V; Mishra, Manish K; Makic, Mary Beth F; Valuck, Robert J

2014-06-01

To enhance the learner's competence with knowledge about a framework of quality improvement (QI) interventions to implement evidence-based practices for pressure ulcer (PrU) prevention. This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Summarize the process of creating and initiating the best-practice framework of QI for PrU prevention.2. Identify the domains and QI interventions for the best-practice framework of QI for PrU prevention. Pressure ulcer (PrU) prevention is a priority issue in US hospitals. The National Pressure Ulcer Advisory Panel endorses an evidence-based practice (EBP) protocol to help prevent PrUs. Effective implementation of EBPs requires systematic change of existing care units. Quality improvement interventions offer a mechanism of change to existing structures in order to effectively implement EBPs for PrU prevention. The best-practice framework developed by Nelson et al is a useful model of quality improvement interventions that targets process improvement in 4 domains: leadership, staff, information and information technology, and performance and improvement. At 2 academic medical centers, the best-practice framework was shown to physicians, nurses, and health services researchers. Their insight was used to modify the best-practice framework as a reference tool for quality improvement interventions in PrU prevention. The revised framework includes 25 elements across 4 domains. Many of these elements support EBPs for PrU prevention, such as updates in PrU staging and risk assessment. The best-practice framework offers a reference point to initiating a bundle of quality improvement interventions in support of EBPs. Hospitals and clinicians tasked with quality improvement efforts can use this framework to problem-solve PrU prevention and other critical issues.

Integrating evidence-based practices for increasing cancer screenings in safety net health systems: a multiple case study using the Consolidated Framework for Implementation Research.

PubMed

Liang, Shuting; Kegler, Michelle C; Cotter, Megan; Emily, Phillips; Beasley, Derrick; Hermstad, April; Morton, Rentonia; Martinez, Jeremy; Riehman, Kara

2016-08-02

Implementing evidence-based practices (EBPs) to increase cancer screenings in safety net primary care systems has great potential for reducing cancer disparities. Yet there is a gap in understanding the factors and mechanisms that influence EBP implementation within these high-priority systems. Guided by the Consolidated Framework for Implementation Research (CFIR), our study aims to fill this gap with a multiple case study of health care safety net systems that were funded by an American Cancer Society (ACS) grants program to increase breast and colorectal cancer screening rates. The initiative funded 68 safety net systems to increase cancer screening through implementation of evidence-based provider and client-oriented strategies. Data are from a mixed-methods evaluation with nine purposively selected safety net systems. Fifty-two interviews were conducted with project leaders, implementers, and ACS staff. Funded safety net systems were categorized into high-, medium-, and low-performing cases based on the level of EBP implementation. Within- and cross-case analyses were performed to identify CFIR constructs that influenced level of EBP implementation. Of 39 CFIR constructs examined, six distinguished levels of implementation. Two constructs were from the intervention characteristics domain: adaptability and trialability. Three were from the inner setting domain: leadership engagement, tension for change, and access to information and knowledge. Engaging formally appointed internal implementation leaders, from the process domain, also distinguished level of implementation. No constructs from the outer setting or individual characteristics domain differentiated systems by level of implementation. Our study identified a number of influential CFIR constructs and illustrated how they impacted EBP implementation across a variety of safety net systems. Findings may inform future dissemination efforts of EBPs for increasing cancer screening in similar settings. Moreover, our analytic approach is similar to previous case studies using CFIR and hence could facilitate comparisons across studies.

The effect of a multifaceted evidence-based practice programme for nurses on knowledge, skills, attitudes, and perceived barriers: A cohort study.

PubMed

van der Goot, Wieke E; Keers, Joost C; Kuipers, Ruud; Nieweg, Roos M B; de Groot, Martijn

2018-04-01

The Dutch professional nursing standard of 2012 stipulates that Dutch nursing practices are to be evidence-based. Not all practicing nurses can satisfy these requirements, therefore, an educational programme about Evidence-Based Practice (EBP) was developed for a Dutch teaching hospital. The aim of this study was to measure the effects of a six month in-house EBP programme on knowledge, skills, attitudes, and perceived barriers of nurses (four European Credits equals two US Credit Hours). A multiple-cohort study was conducted with a pre-post-test design. In the period of 2011-2015, a total of 58 nurses (9 cohorts) followed the programme. Baseline and follow-up assessments consisted of three questionnaires each: the Dutch Modified Fresno, the two subscales of the McColl questionnaire, and the BARRIER scale to assess knowledge and skills, attitudes, and perceived barriers, respectively. Fifty nurses completed both assessments. The results demonstrated that actual knowledge and skills significantly increased by approximately 40%. Self-perceived knowledge increased significantly, while attitudes towards EBP remained (moderately) positive. Perceived barriers did not notably change except for the Research subscale which received many "no opinion" responses prior to the programme but fewer afterwards. Our multifaceted in-house EBP programme led to a significant improvement of approximately 40% in EBP knowledge and skills of participating nurses. Most nurses who followed the EBP programme are currently applying their knowledge and skills in practice. Managerial support and allocated time for EBP are important facilitators for its implementation. Furthermore, to maintain and expand nurses' EBP knowledge and skills and translate them into practice, follow-up interventions, such as journal clubs, may well be beneficial. Based on the positive results of our programme, we will implement it throughout the hospital with an emphasis on training more groups of nurses. Copyright © 2018 Elsevier Ltd. All rights reserved.

Clearing Hurdles: The Challenges of Implementation of Mental Health Evidence-Based Practices in Under-resourced Schools.

PubMed

Eiraldi, Ricardo; Wolk, Courtney Benjamin; Locke, Jill; Beidas, Rinad

Schools have become the main provider of services to children with mental health needs. Although there is substantial literature on barriers to implementation of evidence-based practices (EBPs) in under-resourced school districts, less has been written on how to overcome those barriers. Providing mental health services in the school setting presents a tremendous opportunity to increase access to quality mental health care for underserved youth. This review provides a brief overview of the barriers to successful implementation and sustainment of EBPs in under-resourced public schools and provides recommendations for overcoming them. The discussion is organized around an established conceptual framework adapted for the delivery of services in under-resourced schools that focuses on interdependent factors that exist at the individual-, team, school-, and macro-levels. This manuscript explores some recommendations and strategies for effectively addressing challenges related to implementation of EBPs. Research ideas are offered to bridge the research-to-practice gap that impacts many under-resourced public school districts.

Clearing Hurdles: The Challenges of Implementation of Mental Health Evidence-Based Practices in Under-resourced Schools

PubMed Central

Eiraldi, Ricardo; Wolk, Courtney Benjamin; Locke, Jill; Beidas, Rinad

2015-01-01

Schools have become the main provider of services to children with mental health needs. Although there is substantial literature on barriers to implementation of evidence-based practices (EBPs) in under-resourced school districts, less has been written on how to overcome those barriers. Providing mental health services in the school setting presents a tremendous opportunity to increase access to quality mental health care for underserved youth. This review provides a brief overview of the barriers to successful implementation and sustainment of EBPs in under-resourced public schools and provides recommendations for overcoming them. The discussion is organized around an established conceptual framework adapted for the delivery of services in under-resourced schools that focuses on interdependent factors that exist at the individual-, team, school-, and macro-levels. This manuscript explores some recommendations and strategies for effectively addressing challenges related to implementation of EBPs. Research ideas are offered to bridge the research-to-practice gap that impacts many under-resourced public school districts. PMID:26336512

Using a Critical Appraisal Assignment to Infuse Evidence-Based Practice into a Therapeutic Modality Course

ERIC Educational Resources Information Center

Zwart, Mary Beth; Olson, Bernadette

2014-01-01

Context: It is the responsibility of athletic training educators, through curriculum and clinical experiences, to engage students towards adopting evidence-based practice (EBP) into their practice. The initial task of implementing EBP into a curriculum or course can seem like a large task for educators and students. As a way to start scaffolding…

A Rasch Model Analysis of Evidence-Based Treatment Practices Used in the Criminal Justice System

PubMed Central

Henderson, Craig E.; Taxman, Faye S.; Young, Douglas W.

2008-01-01

This study used item response theory (IRT) to examine the extent to which criminal justice facilities and community-based agencies are using evidence-based substance abuse treatment practices (EBPs), which EBPs are most commonly used, and how EBPs cluster together. The study used data collected from wardens, justice administrators, and treatment directors as part of the National Criminal Justice Treatment Practices survey (NCJTP; Taxman et al., 2007a), and includes both adult criminal and juvenile justice samples. Results of Rasch modeling demonstrated that a reliable measure can be formed to gauge the extent to which juvenile and adult correctional facilities, and community treatment agencies serving offenders, have adopted various treatment practices supported by research. We also demonstrated the concurrent validity of the measure by showing that features of the facilities’ organizational contexts were associated with the extent to which facilities were using EBPs, and which EBPs they were using. Researchers, clinicians, and program administrators may find these results interesting not only because they show the program factors most strongly related to EBP use, but the results also suggest that certain treatment practices are generally clustered together, which may help stakeholders plan and prioritize the adoption of new EBPs in their facilities. The study has implications for future research focused on understanding the adoption and implementation of EBPs in correctional environments. PMID:18029116

How do nurse academics value and engage with evidence-based practice across Australia: Findings from a grounded theory study.

PubMed

Malik, Gulzar; McKenna, Lisa; Griffiths, Debra

2016-06-01

Integrating evidence-based practice (EBP) into undergraduate education and preparing future nurses to embrace EBP in clinical practice becomes paramount in today's complex and evolving healthcare environment. The role that EBP plays in the practical lives of nursing students will depend on the degree to which it is promoted by academics, how it is incorporated into courses and its application to clinical setting. Hence, nursing academics play a crucial role in influencing its integration into curricula. Drawn from a larger doctoral study, this paper presents findings discussing how nurse academics value and engage with EBP. Grounded theory was employed to explore processes used by nursing academics while incorporating EBP into teaching and learning practices. Twenty-three academics across Australian universities were interviewed. Nine were also observed while teaching undergraduate students. Data were collected from semi-structured interviews and non-participant observation. In keeping with the tenets of grounded theory, data collection and analysis continued until theoretical saturation was reached. In total, four categories emerged. This paper focuses on the category conceptualised as Valuing and Engaging with EBP. How nursing academics valued and engaged with EBP was closely associated with meanings they constructed around understanding it, attitudes and commitment to implementation while teaching and working clinically. Different opinions also existed in regard to what actually constituted EBP. However, they engaged with and valued EBP by keeping themselves up-to-date, being involved in research activities, using evidence in teaching, therefore leading by example. Participants identified a number of barriers influencing their engagement with EBP including heavy workloads, limited time, lack of commitment within their schools, lack of confidence with teaching EBP, and complexity of EBP application. Faculty clinical practice, committed academics, workload management and continuing education were highlighted as facilitators. A number of barriers prevented academics from fully engaging with EBP at academic or practice levels. Academic institutions and practice settings need to employ strategic planning to overcome such barriers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Impact of a Multifaceted and Clinically Integrated Training Program in Evidence-Based Practice on Knowledge, Skills, Beliefs and Behaviour among Clinical Instructors in Physiotherapy: A Non-Randomized Controlled Study.

PubMed

Olsen, Nina Rydland; Bradley, Peter; Espehaug, Birgitte; Nortvedt, Monica Wammen; Lygren, Hildegunn; Frisk, Bente; Bjordal, Jan Magnus

2015-01-01

Physiotherapists practicing at clinical placement sites assigned the role as clinical instructors (CIs), are responsible for supervising physiotherapy students. For CIs to role model evidence-based practice (EBP) they need EBP competence. The aim of this study was to assess the short and long term impact of a six-month multifaceted and clinically integrated training program in EBP on the knowledge, skills, beliefs and behaviour of CIs supervising physiotherapy students. We invited 37 CIs to participate in this non-randomized controlled study. Three self-administered questionnaires were used pre- and post-intervention, and at six-month follow-up: 1) The Adapted Fresno test (AFT), 2) the EBP Belief Scale and 3) the EBP Implementation Scale. The analysis approach was linear regression modeling using Generalized Estimating Equations. In total, 29 CIs agreed to participate in the study: 14 were invited to participate in the intervention group and 15 were invited to participate in the control group. One in the intervention group and five in the control group were lost to follow-up. At follow-up, the group difference was statistically significant for the AFT (mean difference = 37, 95% CI (15.9 -58.1), p < 0.001) and the EBP Beliefs scale (mean difference = 8.1, 95% CI (3.1 -13.2), p = 0.002), but not for the EBP Implementation scale (mean difference = 1.8. 95% CI (-4.5-8.1), p = 0.574). Comparing measurements over time, we found a statistically significant increase in mean scores related to all outcome measures for the intervention group only. A multifaceted and clinically integrated training program in EBP was successful in improving EBP knowledge, skills and beliefs among CIs. Future studies need to ensure long-term EBP behaviour change, in addition to assessing CIs' abilities to apply EBP knowledge and skills when supervising students.

Impact of a Multifaceted and Clinically Integrated Training Program in Evidence-Based Practice on Knowledge, Skills, Beliefs and Behaviour among Clinical Instructors in Physiotherapy: A Non-Randomized Controlled Study

PubMed Central

Olsen, Nina Rydland; Bradley, Peter; Espehaug, Birgitte; Nortvedt, Monica Wammen; Lygren, Hildegunn; Frisk, Bente; Bjordal, Jan Magnus

2015-01-01

Background and Purpose Physiotherapists practicing at clinical placement sites assigned the role as clinical instructors (CIs), are responsible for supervising physiotherapy students. For CIs to role model evidence-based practice (EBP) they need EBP competence. The aim of this study was to assess the short and long term impact of a six-month multifaceted and clinically integrated training program in EBP on the knowledge, skills, beliefs and behaviour of CIs supervising physiotherapy students. Methods We invited 37 CIs to participate in this non-randomized controlled study. Three self-administered questionnaires were used pre- and post-intervention, and at six-month follow-up: 1) The Adapted Fresno test (AFT), 2) the EBP Belief Scale and 3) the EBP Implementation Scale. The analysis approach was linear regression modeling using Generalized Estimating Equations. Results In total, 29 CIs agreed to participate in the study: 14 were invited to participate in the intervention group and 15 were invited to participate in the control group. One in the intervention group and five in the control group were lost to follow-up. At follow-up, the group difference was statistically significant for the AFT (mean difference = 37, 95% CI (15.9 -58.1), p<0.001) and the EBP Beliefs scale (mean difference = 8.1, 95% CI (3.1 -13.2), p = 0.002), but not for the EBP Implementation scale (mean difference = 1.8. 95% CI (-4.5-8.1), p = 0.574). Comparing measurements over time, we found a statistically significant increase in mean scores related to all outcome measures for the intervention group only. Conclusions A multifaceted and clinically integrated training program in EBP was successful in improving EBP knowledge, skills and beliefs among CIs. Future studies need to ensure long-term EBP behaviour change, in addition to assessing CIs’ abilities to apply EBP knowledge and skills when supervising students. PMID:25894559

Leadership, innovation climate, and attitudes toward evidence-based practice during a statewide implementation.

PubMed

Aarons, Gregory A; Sommerfeld, David H

2012-04-01

Leadership is important in practice change, yet there are few studies addressing this issue in mental health and social services. This study examined the differential roles of transformational (i.e., charismatic) leadership and leader-member exchange (i.e., the relationship between a supervisor and their direct service providers) on team innovation climate (i.e., openness to new innovations) and provider attitudes toward adopting evidence-based practice (EBP) during a statewide evidence-based practice implementation (EBPI) of an intervention to reduce child neglect. Participants were 140 case-managers in 30 teams providing home-based services to families in a statewide child-welfare system. Teams were assigned by region to EBPI or services as usual (SAU) conditions. Multiple group path analysis was used to examine associations of transformational leadership and leader-member exchange with innovation climate and attitudes toward adoption and use of EBP. Transformational leadership predicted higher innovation climate during implementation, whereas leader-member exchange predicted higher innovation climate during SAU. Innovation climate was, in turn, associated with more positive attitudes toward EBP for the EBPI group. Strategies designed to enhance supervisor transformational leadership have the potential to facilitate implementation efforts by promoting a strong climate for EBPI and positive provider attitudes toward adoption and use of EBP. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Lessons Learned From a System-wide Evidence-Based Practice Program Implementation

DTIC Science & Technology

2017-04-25

Practice Program Implementation presented at/published to 20 17 Triscrvice Nursing Research and Evidence-Based Practice Dissemination Course...34’ ~ ~ p : Nursing servrees staff of the 59 MDVI I c : lmplementmoo of an EBP program = Versus no program rmp[emenlation • Femim:l2~~s~ • rnamp...wid1 ~venous montif medin!f’ tD 21ow ample time for pogRe on peojects; • EmocGgc g~Sl’O<lts EBP medanioms tu nit pa;&e counc;is;, montif nursing

Stroke unit Nurse Managers' views of individual and organizational factors liable to influence evidence-based practice: A survey.

PubMed

Drury, Peta; McInnes, Elizabeth; Hardy, Jennifer; Dale, Simeon; Middleton, Sandy

2016-04-01

The uptake of evidence into practice may be impeded or facilitated by individual and organizational factors within the local context. This study investigated Nurse Managers of New South Wales, Australia, stroke units (n = 19) in their views on: leadership ability (measured by the Leadership Practices Inventory), organizational learning (measured by the Organizational Learning Survey), attitudes and beliefs towards evidence-based practice (EBP) and readiness for change. Overall Nurse Managers reported high-level leadership skills and a culture of learning. Nurse Managers' attitude towards EBP was positive, although nursing colleague's attitudes were perceived as less positive. Nurse Managers agreed that implementing evidence in practice places additional demands on staff; and almost half (n = 9, 47%) reported that resources were not available for evidence implementation. The findings indicate that key persons responsible for evidence implementation are not allocated sufficient time to coordinate and implement guidelines into practice. The findings suggest that barriers to evidence uptake, including insufficient resources and time constraints, identified by Nurse Managers in this study are not likely to be unique to stroke units. Furthermore, Nurse Managers may be unable to address these organizational barriers (i.e. lack of resources) and thus provide all the components necessary to implement EBP. © 2015 John Wiley & Sons Australia, Ltd.

The Influence of Social Capital on Nurse-Perceived Evidence-Based Practice Implementation in South Korea.

PubMed

Shin, Ji In; Lee, Eunjoo

2017-05-01

To examine the relationship between evidence-based practice (EBP) adoption and social capital in nurses and to determine how social capital affected EBP adoption in South Korea. A cross-sectional, correlational design was used. In total, 432 registered nurses from two university-affiliated teaching hospitals in South Korea completed the questionnaire, which included demographic items, the Developing Evidence-Based Practice Questionnaire, and the Social Capital Outcomes for Nurses scale. Data were analyzed using hierarchical regression to identify the predictors of EBP adoption. Nurses with higher social capital scores reported fewer perceived barriers to finding and reviewing evidence, and changing practice. Higher social capital scores were associated with higher levels of perceived facilitators of EBP adoption and skills appraisal in finding and reviewing evidence. Social capital was a significant predictor of EBP adoption. Nurses with greater opportunities to exchange and communicate their ideas freely are more likely to accept new evidence through diverse channels and trust-based relationships between nurses, which allows healthcare organizations to promote innovations such as EBP adoption. Therefore, social capital in nurses could serve as a driving force for EBP adoption and should provide a healthy foundation for changes in patient care practices. Nurses with higher social capital are tending to adopt EBP willingly. High trust enables nurses to facilitate and support change in practice. Therefore, to improve EBP adoption in patient care, it needs to be monitored that relationships between nurses are carefully structured and that they foster mutual interaction. © 2017 Sigma Theta Tau International.

Research and organizational issues for the implementation of family work in community psychiatric services.

PubMed

Jones, Adrian; Scannell, Tony

2002-04-01

The need for evidence-based practice (EBP) to guide and develop mental health services remains fundamental for modern services. Aim. To discuss issues that impact upon implementation of EBP and practice development using family work (FW) as an example. A selection of the FW literature was reviewed drawing on sources including the Cochrane Library, Cinahl and Medline. Keywords used were FW, community mental health team and research design. Centralized policy initiatives and guidelines that are themselves guided by evidence of randomized controlled trials predominantly risk alienating practitioners and clients/carers. Family work has some demonstrable clinical benefits although models differ and the active therapeutic agent remains unclear. Its adoption into routine care is also hindered by a productivity management outlook that seeks to maximize stretched resources and whose values are likely to be internalized by practitioners. The dichotomous position of previous research and practice development make implementation of EBP difficult and highlights the need for strategic planning that embraces both factors. The current drive to increase EBP requires a bi-directional process of influence that allows individual practitioners and clients/carers to become producers of evidence and not simply recipients. The authors support wider adoption of case study research designs to reflect the unpredictable nature of mental health care. Adoption of assertive community treatment models within community services is most likely to promote the excellence management model and accommodate EBP such as FW.

Addiction treatment staff perceptions of training as a facilitator or barrier to implementing evidence-based practices: a national qualitative research study.

PubMed

D'Ippolito, Melinda; Lundgren, Lena; Amodeo, Maryann; Beltrame, Clelia; Lim, Lynn; Chassler, Deborah

2015-01-01

This qualitative effort examines training-related facilitators and barriers to implementing evidence-based practices (EBPs) in 285 community-based addiction treatment organizations (CBOs) nationwide that were funded by the Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment (SAMHSA/CSAT) to implement EBPs. Using qualitative interviews, the authors explored staff (N = 514) descriptions of training as a facilitator or barrier to implementation. Training-related factors were described 663 times as facilitators (by 440 staff) and 233 times as barriers (by 170 staff). Responses were coded using content analysis. Specific characteristics of the training received, such as access to expert knowledge and quality, as well as ongoing training were described as central facilitating factors to EBP implementation. Key reasons training was perceived as a barrier included the amount of training; the training did not fit current staff and/or organizational needs; the training for some EBPs was perceived to be too demanding; and the difficulty accessing training. Since government funders of addiction treatments require that CBOs implement EBPs and they provide training resources, the quality, flexibility, and accessibility of the available training needs to be promoted throughout the addiction treatment network. Only 17% of CBOs reported that they used the SAMHSA-funded ATTC (Addiction Technology Transfer Center) training centers and 42% used SAMHSA technical assistance. Hence, federally funded resources for training were not always used.

Effectiveness of an Evidence-Based Practice Nurse Mentor Training Program.

PubMed

Spiva, LeeAnna; Hart, Patricia L; Patrick, Sara; Waggoner, Jessica; Jackson, Charon; Threatt, Jamie L

2017-06-01

Multiple reasons are cited for why nurses do not incorporate evidence into clinical practice, including lack of knowledge and skills, training, time, and organizational support. To investigate the effectiveness of a mentor training program on mentors' perceptions of knowledge, attitude, skill, and confidence levels, and organizational readiness related to evidence-based practice (EBP) and research utilization; and to investigate the effectiveness of creating a formalized structure to enculturate EBP in order to prepare nurses to incorporate EBP into clinical practice on nurses' perceptions of knowledge, attitude, skill levels, barriers, nursing leadership, and organizational support related to EBP and research utilization. A two-group pretest-posttest quasi-experimental, interventional design was used. A convenience sample of 66 mentors and 367 nurses working at a five hospital integrated healthcare system located in the Southeastern United States participated. Nurse mentors' knowledge, attitude, skill level, and organizational readiness related to EBP, t = -8.64, p < .001, and confidence, t = -6.36, p < .001, improved after training. Nurses' knowledge, attitude, and skill level related to EBP, t = -19.12, p < .001, and barriers to research utilization, t = 20.86, p < .001, EBP work environment t = -20.18, p < .001, and EBP nurse leadership, t = -16.50, p < .001, improved after a formalized structure was implemented. EBP mentors are effective in educating and supporting nurses in evidence-based care. Leaders should use a multifaceted approach to build and sustain EBP, including developing a critical mass of EBP mentors to work with point of care staff. © 2017 Sigma Theta Tau International.

Changing Nephrology Nurses' Beliefs about the Value of Evidence-Based Practice and Their Ability to Implement in Clinical Practice.

PubMed

Hain, Debra; Haras, Mary S

2015-01-01

A rapidly evolving healthcare environment demands sound research evidence to inform clinical practice and improve patient outcomes. Over the past several decades, nurses have generated new knowledge by conducting research studies, but it takes time for this evidence to be implemented in practice. As nurses strive to be leaders and active participants in healthcare redesign, it is essential that they possess the requisite knowledge and skills to engage in evidence-based practice (EBP). Professional nursing organizations can make substantial contributions to the move healthcare quality forward by providing EBP workshops similar to those conducted by the American Nephrology Nurses'Association.

Developing the Autism Model of Implementation for Autism spectrum disorder community providers: study protocol

PubMed Central

2012-01-01

Background Currently, 1 out of 88 children are diagnosed with an autism spectrum disorder (ASD), and the estimated cost for treatment services is $126 billion annually. Typically, ASD community providers (ASD-CPs) provide services to children with any severity of ASD symptoms using a combination of various treatment paradigms, some with an evidence-base and some without. When evidence-based practices (EBPs) are successfully implemented by ASD-CPs, they can result in positive outcomes. Despite this promise, EBPs are often implemented unsuccessfully and other treatments used by ASD-CPs lack supportive evidence, especially for school-age children with ASD. While it is not well understood why ASD-CPs are not implementing EBPs, organizational and individual characteristics likely play a role. As a response to this need and to improve the lives of children with ASD and their families, this study aims to develop and test the feasibility and acceptability of the Autism Model of Implementation (AMI) to support the implementation of EBPs by ASD-CPs. Methods/design An academic-community collaboration developed to partner with ASD-CPs will facilitate the development of the AMI, a process specifically for use by ASD community-based agencies. Using a mixed methods approach, the project will assess agency and individual factors likely to facilitate or hinder implementing EBPs in this context; develop the AMI to address identified barriers and facilitators; and pilot test the AMI to examine its feasibility and acceptability using a specific EBP to treat anxiety disorders in school-age children with ASD. Discussion The AMI will represent a data-informed approach to facilitate implementation of EBPs by ASD-CPs by providing an implementation model specifically developed for this context. This study is designed to address the real-world implications of EBP implementation in ASD community-based agencies. In doing so, the AMI will help to provide children with ASD the best and most effective services in their own community. Moreover, the proposed study will positively impact the field of implementation science by providing an empirically supported and tested model of implementation to facilitate the identification, adoption, and use of EBPs. PMID:22963616

Using segmented regression analysis of interrupted time series data to assess colonoscopy quality outcomes of a web-enhanced implementation toolkit to support evidence-based practices for bowel preparation: a study protocol.

PubMed

Ramsey, Alex T; Maki, Julia; Prusaczyk, Beth; Yan, Yan; Wang, Jean; Lobb, Rebecca

2015-06-07

While there is convincing evidence on interventions to improve bowel preparation for patients, the evidence on how to implement these evidence-based practices (EBPs) in outpatient colonoscopy settings is less certain. The Strategies to Improve Colonoscopy (STIC) study compares the effect of two implementation strategies, physician education alone versus physician education plus an implementation toolkit for staff, on adoption of three EBPs (split-dosing of bowel preparation, low-literacy education, teach-back) to improve pre-procedure and intra-procedure quality measures. The implementation toolkit contains a staff education module, website containing tools to support staff in delivering EBPs, tailored patient education materials, and brief consultation with staff to determine how the EBPs can be integrated into the existing workflow. Given adaptations to the implementation plan and intentional flexibility in the delivery of the EBPs, we utilize a pragmatic study to balance external validity with demonstrating effectiveness of the implementation strategies. Participants will include all outpatient colonoscopy physicians, staff, and patients from a convenience sample of six endoscopy settings. Aim #1 will explore the relative effect of two strategies to implement patient-level EBPs on adoption and clinical quality outcomes. We will assess the change in level and trends of clinical quality outcomes (i.e., adequacy of bowel preparation, adenoma detection) using segmented regression analysis of interrupted time series data with two groups (intervention and delayed start). Aim #2 will examine the influence of organizational readiness to change on EBP implementation. We use a PRECIS diagram to reflect the extent to which each indicator of the study was pragmatic versus explanatory, revealing a largely pragmatic study. Implementation challenges have already motivated several adaptations to the original plan, reflecting the nature of implementation in real-world healthcare settings. The pragmatic study responds to the evolving needs of its healthcare partners and allows for flexibility in intervention delivery, thereby informing clinical decision-making in real-world settings. The current study will provide information about what works (intervention effectiveness), for whom it works (influence of Medicaid versus other insurance), in which contexts it works (setting characteristics that influence implementation), and how it works best (comparison of implementation strategies).

Sustainability of Evidence-Based Acute Pain Management Practices for Hospitalized Older Adults.

PubMed

Shuman, Clayton J; Xie, Xian-Jin; Herr, Keela A; Titler, Marita G

2017-11-01

Little is known regarding sustainability of evidence-based practices (EBPs) following implementation. This article reports sustainability of evidence-based acute pain management practices in hospitalized older adults following testing of a multifaceted Translating Research Into Practice (TRIP) implementation intervention. A cluster randomized trial with follow-up period was conducted in 12 Midwest U.S. hospitals (six experimental, six comparison). Use of evidence-based acute pain management practices and mean pain intensity were analyzed using generalized estimating equations across two time points (following implementation and 18 months later) to determine sustainability of TRIP intervention effects. Summative Index scores and six of seven practices were sustained. Experimental and comparison group differences for mean pain intensity over 72 hours following admission were sustained. Results revealed most evidence-based acute pain management practices were sustained for 18 months following implementation. Further work is needed to identify factors affecting sustainability of EBPs to guide development and testing of sustainability strategies.

Institutionalizing evidence-based practice: an organizational case study using a model of strategic change

PubMed Central

2009-01-01

Background There is a general expectation within healthcare that organizations should use evidence-based practice (EBP) as an approach to improving the quality of care. However, challenges exist regarding how to make EBP a reality, particularly at an organizational level and as a routine, sustained aspect of professional practice. Methods A mixed method explanatory case study was conducted to study context; i.e., in terms of the presence or absence of multiple, inter-related contextual elements and associated strategic approaches required for integrated, routine use of EBP ('institutionalization'). The Pettigrew et al. Content, Context, and Process model was used as the theoretical framework. Two sites in the US were purposively sampled to provide contrasting cases: i.e., a 'role model' site, widely recognized as demonstrating capacity to successfully implement and sustain EBP to a greater degree than others; and a 'beginner' site, self-perceived as early in the journey towards institutionalization. Results The two sites were clearly different in terms of their organizational context, level of EBP activity, and degree of institutionalization. For example, the role model site had a pervasive, integrated presence of EBP versus a sporadic, isolated presence in the beginner site. Within the inner context of the role model site, there was also a combination of the Pettigrew and colleagues' receptive elements that, together, appeared to enhance its ability to effectively implement EBP-related change at multiple levels. In contrast, the beginner site, which had been involved for a few years in EBP-related efforts, had primarily non-receptive conditions in several contextual elements and a fairly low overall level of EBP receptivity. The beginner site thus appeared, at the time of data collection, to lack an integrated context to either support or facilitate the institutionalization of EBP. Conclusion Our findings provide evidence of some of the key contextual elements that may require attention if institutionalization of EBP is to be realized. They also suggest the need for an integrated set of receptive contextual elements to achieve EBP institutionalization; and they further support the importance of specific interactions among these elements, including ways in which leadership affects other contextual elements positively or negatively. PMID:19948064

Prescribing Clinicians’ Perspectives on Evidence-Based Psychotherapy for Posttraumatic Stress Disorder

PubMed Central

Barnett, Erin R.; Bernardy, Nancy C.; Jenkyn, Aaron B.; Parker, Louise E.; Lund, Brian C.; Alexander, Bruce; Friedman, Matthew J.

2014-01-01

Evidence-based psychotherapies (EBP) for Posttraumatic Stress Disorder are not utilized to their full extent within the Department of Veterans Affairs (VA). VA provides care to many persons with PTSD and has been in the forefront of clinical practice guidelines and EBP training and dissemination. Yet VA continues to find EBP implementation difficult. Veterans with PTSD often initially present to prescribing clinicians, who then help make care decisions. It is therefore critical that these clinicians correctly screen and triage appropriate mental health care. The purpose of this study was to assess VA prescribing clinicians’ knowledge, perceptions, and referral behaviors related to EBPs for PTSD and to identify facilitators and barriers to implementing EBPs within VA. We conducted qualitative interviews with 26 VA prescribing clinicians. Limited access to EBPs was the most commonly noted barrier. The clinicians we interviewed also held specific beliefs and behaviors that may delay or deter EBPs. Strategies to improve utilization also emerged. Findings suggest the need for increased access to EBPs, training to optimize the role of prescribing clinicians in helping Veterans with PTSD make appropriate care decisions, and specific organizational changes to facilitate access and effective referral systems for EBPs. PMID:25431445

Dissemination and Implementation of Evidence-Based Practices: Training and Consultation as Implementation Strategies

PubMed Central

Edmunds, Julie M.; Beidas, Rinad S.; Kendall, Philip C.

2013-01-01

To provide effective treatment for individuals with mental health needs, there is a movement to deploy evidence-based practices (EBPs) developed in research settings into community settings. Training clinicians in EBPs is often used as the primary implementation strategy in these efforts, despite evidence suggesting that training alone does not change therapist behavior. A promising implementation strategy that can be combined with training is consultation, or ongoing support. This paper reviews the literature on consultation following initial training. A model of consultation is presented as well as preliminary findings regarding effective consultation techniques. Future directions are offered. PMID:24072959

Exploring Multi-Level System Factors Facilitating Educator Training and Implementation of Evidence-Based Practices (EBP): A Study Protocol

ERIC Educational Resources Information Center

Stahmer, Aubyn C.; Suhrheinrich, Jessica; Schetter, Patricia L.; Hassrick, Elizabeth McGee

2018-01-01

This study examines how system-wide (i.e., region, district, and school) mechanisms such as leadership support, training requirements, structure, collaboration, and education affect the use of evidence-based practices (EBPs) in schools and how this affects the outcomes for students with autism spectrum disorder (ASD). Despite growing evidence for…

Impact Challenges in Community Science-with-Practice: Lessons from PROSPER on Transformative Practitioner-Scientist Partnerships and Prevention Infrastructure Development

PubMed Central

Greenberg, Mark

2011-01-01

At present, evidence-based programs (EBPs) to reduce youth violence are failing to translate into widespread community practice, despite their potential for impact on this pervasive public health problem. In this paper we address two types of challenges in the achievement of such impact, drawing upon lessons from the implementation of a partnership model called PROSPER. First, we address five key challenges in the achievement of community-level impact through effective community planning and action: readiness and mobilization of community teams; maintaining EBP implementation quality; sustaining community teams and EBPs; demonstrating community-level impact; and continuous, proactive technical assistance. Second, we consider grand challenges in the large-scale translation of EBPs: (1) building, linking and expanding existing infrastructures to support effective EBP delivery systems, and (2) organizing networks of practitioner-scientist partnerships—networks designed to integrate diffusion of EBPs with research that examines effective strategies to do so. The PROSPER partnership model is an evidence-based delivery system for community-based prevention and has evolved through two decades of NIH-funded research, assisted by land grant universities' Cooperative Extension Systems. Findings and lessons of relevance to each of the challenges are summarized. In this context, we outline how practitioner-scientist partnerships can serve to transform EBP delivery systems, particularly in conjunction with supportive federal policy. PMID:21222151

Impact challenges in community science-with-practice: lessons from PROSPER on transformative practitioner-scientist partnerships and prevention infrastructure development.

PubMed

Spoth, Richard; Greenberg, Mark

2011-09-01

At present, evidence-based programs (EBPs) to reduce youth violence are failing to translate into widespread community practice, despite their potential for impact on this pervasive public health problem. In this paper we address two types of challenges in the achievement of such impact, drawing upon lessons from the implementation of a partnership model called PROSPER. First, we address five key challenges in the achievement of community-level impact through effective community planning and action: readiness and mobilization of community teams; maintaining EBP implementation quality; sustaining community teams and EBPs; demonstrating community-level impact; and continuous, proactive technical assistance. Second, we consider grand challenges in the large-scale translation of EBPs: (1) building, linking and expanding existing infrastructures to support effective EBP delivery systems, and (2) organizing networks of practitioner-scientist partnerships-networks designed to integrate diffusion of EBPs with research that examines effective strategies to do so. The PROSPER partnership model is an evidence-based delivery system for community-based prevention and has evolved through two decades of NIH-funded research, assisted by land grant universities' Cooperative Extension Systems. Findings and lessons of relevance to each of the challenges are summarized. In this context, we outline how practitioner-scientist partnerships can serve to transform EBP delivery systems, particularly in conjunction with supportive federal policy.

Mechanisms of change in the ARC organizational strategy: Increasing mental health clinicians’ EBP adoption through improved organizational culture and capacity

PubMed Central

Williams, Nathaniel J.; Glisson, Charles; Hemmelgarn, Anthony; Green, Philip

2016-01-01

Background The development of efficient and scalable implementation strategies in mental health is restricted by poor understanding of the change mechanisms that increase clinicians’ evidence-based practice (EBP) adoption. This study tests the cross-level change mechanisms that link an empirically-supported organizational strategy for supporting implementation (labeled ARC for Availability, Responsiveness, and Continuity) to mental health clinicians’ EBP adoption and use. Method Four hundred seventy five mental health clinicians in 14 children’s mental health agencies were randomly assigned to the ARC intervention or a control condition. Measures of organizational culture, clinicians’ intentions to adopt EBPs, and job-related EBP barriers were collected before, during, and upon completion of the three-year ARC intervention. EBP adoption and use were assessed at 12-month follow-up. Multilevel mediation analyses tested changes in organizational culture, clinicians’ intentions to adopt EBPs, and job-related EBP barriers as linking mechanisms explaining the effects of ARC on clinicians’ EBP adoption and use. Results ARC increased clinicians’ EBP adoption (OR = 3.19, p = .003) and use (81% vs. 56%, d = .79, p = .003) at 12-month follow-up. These effects were mediated by improvement in organizational proficiency culture leading to increased clinician intentions to adopt EBPs and by reduced job-related EBP barriers. A combined mediation analysis indicated the organizational culture-EBP intentions mechanism was the primary carrier of ARC’s effects on clinicians’ EBP adoption and use. Conclusions ARC increases clinicians’ EBP adoption and use by creating proficient organizational cultures that increase clinicians’ intentions to adopt EBPs. PMID:27236457

Mechanisms of Change in the ARC Organizational Strategy: Increasing Mental Health Clinicians' EBP Adoption Through Improved Organizational Culture and Capacity.

PubMed

Williams, Nathaniel J; Glisson, Charles; Hemmelgarn, Anthony; Green, Philip

2017-03-01

The development of efficient and scalable implementation strategies in mental health is restricted by poor understanding of the change mechanisms that increase clinicians' evidence-based practice (EBP) adoption. This study tests the cross-level change mechanisms that link an empirically-supported organizational strategy for supporting implementation (labeled ARC for Availability, Responsiveness, and Continuity) to mental health clinicians' EBP adoption and use. Four hundred seventy-five mental health clinicians in 14 children's mental health agencies were randomly assigned to the ARC intervention or a control condition. Measures of organizational culture, clinicians' intentions to adopt EBPs, and job-related EBP barriers were collected before, during, and upon completion of the three-year ARC intervention. EBP adoption and use were assessed at 12-month follow-up. Multilevel mediation analyses tested changes in organizational culture, clinicians' intentions to adopt EBPs, and job-related EBP barriers as linking mechanisms explaining the effects of ARC on clinicians' EBP adoption and use. ARC increased clinicians' EBP adoption (OR = 3.19, p = .003) and use (81 vs. 56 %, d = .79, p = .003) at 12-month follow-up. These effects were mediated by improvement in organizational proficiency culture leading to increased clinician intentions to adopt EBPs and by reduced job-related EBP barriers. A combined mediation analysis indicated the organizational culture-EBP intentions mechanism was the primary carrier of ARC's effects on clinicians' EBP adoption and use. ARC increases clinicians' EBP adoption and use by creating proficient organizational cultures that increase clinicians' intentions to adopt EBPs.

Sicily statement on evidence-based practice

PubMed Central

Dawes, Martin; Summerskill, William; Glasziou, Paul; Cartabellotta, Antonino; Martin, Janet; Hopayian, Kevork; Porzsolt, Franz; Burls, Amanda; Osborne, James

2005-01-01

Background A variety of definitions of evidence-based practice (EBP) exist. However, definitions are in themselves insufficient to explain the underlying processes of EBP and to differentiate between an evidence-based process and evidence-based outcome. There is a need for a clear statement of what Evidence-Based Practice (EBP) means, a description of the skills required to practise in an evidence-based manner and a curriculum that outlines the minimum requirements for training health professionals in EBP. This consensus statement is based on current literature and incorporating the experience of delegates attending the 2003 Conference of Evidence-Based Health Care Teachers and Developers ("Signposting the future of EBHC"). Discussion Evidence-Based Practice has evolved in both scope and definition. Evidence-Based Practice (EBP) requires that decisions about health care are based on the best available, current, valid and relevant evidence. These decisions should be made by those receiving care, informed by the tacit and explicit knowledge of those providing care, within the context of available resources. Health care professionals must be able to gain, assess, apply and integrate new knowledge and have the ability to adapt to changing circumstances throughout their professional life. Curricula to deliver these aptitudes need to be grounded in the five-step model of EBP, and informed by ongoing research. Core assessment tools for each of the steps should continue to be developed, validated, and made freely available. Summary All health care professionals need to understand the principles of EBP, recognise EBP in action, implement evidence-based policies, and have a critical attitude to their own practice and to evidence. Without these skills, professionals and organisations will find it difficult to provide 'best practice'. PMID:15634359

The effect of education with workplace supports on practitioners' evidence-based practice knowledge and implementation behaviours.

PubMed

Novak, Iona; McIntyre, Sarah

2010-12-01

Individual and workplace barriers affect uptake of evidence-based practice (EBP). This study evaluated the effects of a 1-day workshop with workplace supports on allied health professionals' EBP knowledge and behaviour. A prospective longitudinal pre-post design was used. A total of 88 allied health professionals participated. Knowledge was measured using the Adapted Fresno Test (AFT), behaviour was measured using frequency counts of presentations using EBP methodologies and critically appraised topics (CATs) were produced. Mean differences were analysed using paired t-tests. EBP knowledge significantly improved immediately after education on the AFT (from 36.67 to 46.84/156) a mean change of 10.17 points (95% confidence interval (CI): 7.19-13.50) (P <0.001). Behaviour also changed over 18 months. EBP content in presentations increased from 3 to 100% (t = 24.39, P <0.001, 95%CI: 0.86-1.03). CATs produced significantly increased by 0.26 per head (t =5.55, P <0.001, 95% CI: 0.17-0.35). Education with workplace supports (supervision, incentives, resource allocation and working groups) may lead to improvements in EBP knowledge and implementation. © 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.

Dissemination and implementation of evidence-based practices for child and adolescent mental health: a systematic review.

PubMed

Novins, Douglas K; Green, Amy E; Legha, Rupinder K; Aarons, Gregory A

2013-10-01

Although there has been a dramatic increase in the number of evidence-based practices (EBPs) to improve child and adolescent mental health, the poor uptake of these EBPs has led to investigations of factors related to their successful dissemination and implementation. The purpose of this systematic review was to identify key findings from empirical studies examining the dissemination and implementation of EBPs for child and adolescent mental health. Of 14,247 citations initially identified, 73 articles drawn from 44 studies met inclusion criteria. The articles were classified by implementation phase (exploration, preparation, implementation, and sustainment) and specific implementation factors examined. These factors were divided into outer (i.e., system level) and inner (i.e., organizational level) contexts. Few studies used true experimental designs; most were observational. Of the many inner context factors that were examined in these studies (e.g., provider characteristics, organizational resources, leadership), fidelity monitoring and supervision had the strongest empirical evidence. Albeit the focus of fewer studies, implementation interventions focused on improving organizational climate and culture were associated with better intervention sustainment as well as child and adolescent outcomes. Outer contextual factors such as training and use of specific technologies to support intervention use were also important in facilitating the implementation process. The further development and testing of dissemination and implementation strategies is needed to more efficiently move EBPs into usual care. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Effectiveness of the tailored EBP training program for Filipino physiotherapists: a randomised controlled trial.

PubMed

Dizon, Janine Margarita; Grimmer-Somers, Karen; Kumar, Saravana

2011-04-13

Evidence implementation continues to challenge health professionals most especially those from developing countries. Filipino physiotherapists represent a group of health professionals in a developing country who by tradition and historical practice, take direction from a doctor, on treatment options. Lack of autonomy in decision-making challenges their capacity to deliver evidence-based care. However, this scenario should not limit them from updating and up-skilling themselves on evidence- based practice (EBP). EBP training tailored to their needs and practice was developed to address this gap. This study will be conducted to assess the effectiveness of a tailored EBP-training program for Filipino physiotherapists, in improving knowledge, skills, attitudes and behaviour to EBP. Participation in this program aims to improve capacity to EBP and engage with referring doctors to determine the most effective treatments for their patients. A double blind randomised controlled trial, assessing the effectiveness of the EBP training intervention, compared with a waitlist control, will be conducted. An adequately powered sample of 54 physiotherapists from the Philippines will be recruited and randomly allocated to EBP intervention or waitlist control. The EBP program for Filipino physiotherapists is a one-day program on EBP principles and techniques, delivered using effective adult education strategies. It consists of lectures and practical workshops. A novel component in this program is the specially-developed recommendation form, which participants can use after completing their training, to assist them to negotiate with referring doctors regarding evidence-based treatment choices for their patients.Pre and post measures of EBP knowledge, skills and attitudes will be assessed in both groups using the Adapted Fresno Test and the Questions to EBP attitudes. Behaviour to EBP will be measured using activity diaries for a period of three months. Should the EBP-training program be found to be effective in improving EBP-uptake in Filipino physiotherapists, it will form the basis of a much needed national intervention which is contextually appropriate to Filipino physiotherapists. It will therefore form the genesis for a model for building EBP capacity of other health professionals in the Philippines as well as physiotherapists in developing countries. Current Controlled Trials: ISRCTN74485061.

Challenges and ideas from a research program on high-quality, evidence-based practice in school mental health.

PubMed

Weist, Mark D; Youngstrom, Eric A; Stephan, Sharon; Lever, Nancy; Fowler, Johnathan; Taylor, Leslie; McDaniel, Heather; Chappelle, Lori; Paggeot, Samantha; Hoagwood, Kimberly

2014-01-01

This article reviews the progression of a research program designed to develop, implement, and study the implementation of "achievable" evidence-based practices (EBPs) in schools. We review challenges encountered and ideas to overcome them to enhance this avenue of research. The article presents two federally funded randomized controlled trials involving comparison of a four-component targeted intervention (Quality Assessment and Improvement, Family Engagement and Empowerment, Modular Evidence-Based Practice, Implementation Support) versus a comparison intervention focused on personal wellness. In both studies, primary aims focused on changes in clinician attitudes and behavior, including the delivery of high-quality EBPs and secondary aims focused on student-level impacts. A number of challenges, many not reported in the literature, are reviewed, and ideas for overcoming them are presented. Given the reality that the majority of youth mental health services are delivered in schools and the potential of school mental health services to provide a continuum of mental health care from promotion to intervention, it is critical that the field consider and address the logistical and methodological challenges associated with implementing and studying EBP implementation by clinicians.

Associations among state and local organizational contexts: Use of evidence-based practices in the criminal justice system.

PubMed

Henderson, Craig E; Young, Douglas W; Farrell, Jill; Taxman, Faye S

2009-08-01

This study used hierarchical linear modeling (HLM) to examine the extent to which the organizational characteristics of state corrections agencies and local criminal justice facilities interacted in their associations with the extent to which local facilities are using evidence-based substance abuse treatment practices (EBPs). The study used data collected from two nationally representative surveys - one of state executives and the other of local prison wardens, justice administrators, and treatment directors - which were conducted as part of the National Criminal Justice Treatment Practices survey [NCJTP; Taxman, F.S., Young, D., Wiersema, B., Mitchell, S., Rhodes, A.G., 2007. The National Criminal Justice Treatment Practices Survey: Multi-level survey methods and procedures. J. Subst. Abuse Treat. 32, 225-238], and includes both adult criminal and juvenile justice samples. Results indicated that several state organizational characteristics were either associated with more EBP use or interacted with local organizational characteristics in associations with EBP use, including: (1) systems integration at the state level was associated with greater EBP use; (2) state staffing adequacy and stability accentuated the association between local training and resources for new programs and EBP use (i.e., in states with better staffing, the relationship between training/resources and EBP use in local facilities was stronger); and (3) state executives' attitudes regarding the missions and goals of corrections tended to diminish the extent to which corresponding local administrator attitudes were associated with EBP use. The study has implications for future research focused on EBP diffusion and implementation in correctional environments, particularly attempts to influence EBP use by working through state agencies.

Getting to uptake: do communities of practice support the implementation of evidence-based practice?

PubMed

Barwick, Melanie A; Peters, Julia; Boydell, Katherine

2009-02-01

Practitioners are increasingly encouraged to adopt evidence-based practices (EBP) leading to a need for new knowledge translation strategies to support implementation and practice change. This study examined the benefits of a community of practice in the context of Ontario's children's mental health sector where organizations are mandated to adopt a standardized outcome measure to monitor client response to treatment. Readiness for change, practice change, content knowledge, and satisfaction with and use of implementation supports were examined among practitioners newly trained on the measure who were randomly assigned to a community of practice (CoP) or a practice as usual (PaU) group. CoP practitioners attended 6 sessions over 12 months; PaU practitioners had access to usual implementation supports. Groups did not differ on readiness for change or reported practice change, although CoP participants demonstrated greater use of the tool in practice, better content knowledge and were more satisfied with implementation supports than PaU participants. CoPs present a promising model for translating EBP knowledge and promoting practice change in children's mental health that requires further study.

The evidence-based practice ideologies.

PubMed

Mantzoukas, Stefanos

2007-10-01

This paper puts forward the argument that there are various, competing, and antithetical evidence-based practice (EBP) definitions and acknowledges that the different EBP definitions are based on different epistemological perspectives. However, this is not enough to understand the way in which nurse professionals choose between the various EBP formations and consequently facilitate them in choosing the most appropriate for their needs. Therefore, the current article goes beyond and behind the various EBP epistemologies to identify how individuals choose an epistemology, which consequently will assist our understanding as to how an individual chooses a specific EBP formation. Individuals choose an epistemology on the mere belief that the specific epistemology offers the ideals or ideas of best explaining or interpreting daily reality. These ideals or ideas are termed by science, history, and politics as ideology. Similarly, individual practitioners choose or should choose between the different EBP formations based on their own personal ideology. Consequently, this article proceeds to analyse the various ideologies behind different EBP definitions as to conclude that there are two broad ideologies that inform the various EBP formations, namely the ideology of truth and the ideology of individual emancipation. These two ideologies are analysed and their connections to the various EBP formations are depicted. Eventually, the article concludes that the in-depth, critical, and intentional analysis by individual nurses of their own ideology will allow them to choose the EBP formation that is most appropriate and fitting for them, and their specific situation. Hence, the conscious analysis of individual ideology becomes the criterion for choosing between competing EBP formations and allows for best evidence to be implemented in practice. Therefore, the best way to teach EBP courses is by facilitating students to analyse their own ideology.

Implementing administrative evidence based practices: lessons from the field in six local health departments across the United States.

PubMed

Duggan, Kathleen; Aisaka, Kristelle; Tabak, Rachel G; Smith, Carson; Erwin, Paul; Brownson, Ross C

2015-06-06

Administrative evidence based practices (A-EBPs) are agency level structures and activities positively associated with performance measures (e.g., achieving core public health functions, carrying out evidence-based interventions). The objectives of this study were to examine the contextual conditions and explore differences in local health department (LHD) characteristics that influence the implementation of A-EBPs. Qualitative case studies were conducted based on data from 35 practitioners in six LHDs across the United States. The sample was chosen using an A-EBP score from our 2012 national survey and was linked to secondary data from the National Public Health Performance Standards Program. Three LHDs that scored high and three LHDs that scored low on both measures were selected as case study sites. The 37-question interview guide explored LHD use of an evidence based decision making process, including A-EBPs and evidence-based programs and policies. Each interview took 30-60 min. Standard qualitative methodology was used for data coding and analysis using NVivo software. As might be expected, high-capacity LHDs were more likely to have strong leadership, partnerships, financial flexibility, workforce development activities, and an organizational culture supportive of evidence based decision making and implementation of A-EBPs. They were also more likely to describe having strong or important relationships with universities and other educational resources, increasing their access to resources and allowing them to more easily share knowledge and expertise. Differences between high- and low-capacity LHDs in A-EBP domains highlight the importance of investments in these areas and the potential those investments have to contribute to overall efficiency and performance. Further research may identify avenues to enhance resources in these domains to create an organizational culture supportive of A-EBPs.

Evidence based practice in long term care settings.

PubMed

Specht, Janet K

2013-04-01

The purpose of this manuscript is to discuss the need for use of evidence based practice (EBP) in LTC, the current use of evidence in long term care facilities and what we know about adoption of the use of EBP in LTC. Literature review and reporting of findings from the M-TRAIN study that was a quasi-experimental design to test the effectiveness of an intervention to increase the use of EBPs for urinary incontinence and pain in 48 LTC facilities. Barriers to adopting EBPs include lack of available time, lack of access to current research literature, limited critical appraisal skills, excessive literature to review, non-receptive organizational culture, limited resources, and limited decision-making authority of staff to implement change. Strategies to promote adoption of EBP include the commitment of management; the culture of the home; leadership; staff knowledge, time, and reward; and facility size, complexity, the extent that members are involved outside the facility, NH chain membership, and high level of private pay residents. Findings from the M-TRAIN add, stability of nurse leader and congruency between the leaders perception of their leadership and the staff's perception of the leadership. There is clear evidence of the need and the benefits to residents of LTC and to the health care system yet adoption of EBP continues to be slow and sporadic. There is also evidence for the process of establishing best evidence and many resources to find the available EBPs. The urgent need now is finding ways to best get the EBPs implemented in LTC. There is growing evidence about best methods to do this but continued research is needed. Clearly, residents in LTC deserve the best care possible and EBPs represent an important vehicle by which to do this.

The effectiveness and feasibility of TREAT (Tailoring Research Evidence and Theory) journal clubs in allied health: a randomised controlled trial.

PubMed

Wenke, Rachel J; Thomas, Rae; Hughes, Ian; Mickan, Sharon

2018-05-09

Journal clubs (JC) may increase clinicians' evidence-based practice (EBP) skills and facilitate evidence uptake in clinical practice, however there is a lack of research into their effectiveness in allied health. We investigated the effectiveness of a structured JC that is Tailored According to Research Evidence And Theory (TREAT) in improving EBP skills and practice compared to a standard JC format for allied health professionals. Concurrently, we explored the feasibility of implementing TREAT JCs in a healthcare setting, by evaluating participating clinicians' perceptions and satisfaction. We conducted an explanatory mixed methods study involving a cluster randomised controlled trial with a nested focus group for the intervention participants. Nine JCs with 126 allied health participants were randomly allocated to receive either the TREAT or standard JC format for 1 h/month for 6 months. We conducted pre-post measures of EBP skills and attitudes using the EBP questionnaire and Assessing Competence in Evidence-Based Medicine tool and a tailored satisfaction and practice change questionnaire. Post-intervention, we also conducted a focus group with TREAT participants to explore their perceptions of the format. There were no significant differences between JC formats in EBP skills, knowledge or attitudes or influence on clinical practice, with participants maintaining intermediate level skills across time points. Participants reported significantly greater satisfaction with the organisation of the TREAT format. Participants in both groups reported positive changes to clinical practice. Perceived outcomes to the TREAT format and facilitating mechanisms were identified including the use of an academic facilitator, group appraisal approach and consistent appraisal tools which assisted skill development and engagement. It is feasible to implement an evidence-based JC for allied health clinicians. While clinicians were more satisfied with the TREAT format, it did not significantly improve their EBP skills, attitudes, knowledge and/or practice, when compared to the standard format. The use of an academic facilitator, group based critical appraisal, and the consistent use of appraisal tools were perceived as useful components of the JC format. A structured JC may maintain EBP skills in allied health clinicians and facilitate engagement, however additional training may be required to further enhance EBP skills. ACTRN12616000811404 Retrospectively registered 21 June 2016.

Implementing practice guidelines: lessons from public mental health settings.

PubMed

Parks, Joseph J

2007-01-01

There is evidence that state-of-the-art psychiatric treatments are not being translated into community settings, resulting in the de facto denial of up-to-date psychiatric care for many Americans with mental illness. Although multiple models of evidence-based care exist, little is known about how to disseminate information regarding these models to clinicians in real-world practice. Suggested solutions have included the use of published practice guidelines, such as the American Psychiatric Association Practice Guidelines and the Expert Consensus Guidelines, or algorithm-based programs, such as the Texas Medication Algorithm Project. Unfortunately, the real-world utility of practice guidelines tends to be limited, because their implementation depends entirely on practitioner self-motivation. Similarly, the use of algorithm-based programs may be limited by their pervasive high specificity, practitioner resistance, and various patient misperceptions. Another solution is the implementation of evidence-based practices (EBPs), such as the Substance Abuse and Mental Health Services Administration (SAMHSA) EBPs. However, states' use of the SAMHSA EBPs has been hampered by misalignment of the funding structure, lack of information regarding EBPs, high costs to train and supervise staff, staff turnover, and a lack of resources. As a result, federal and clinical/professional agencies have called for a change in the nation's mental health care delivery system, supplying persuasive arguments for the economic and clinical superiority of integrated care models. One such model, the Missouri Medical Risk Management (MRM) Program for Medicaid Recipients with Schizophrenia, currently assists patients identified as being at high risk for adverse medical and behavioral outcomes. Preliminary results from the Missouri MRM Program are described.

Individualized Clinical Coaching in the TLE TeachLivE Lab: Enhancing Fidelity of Implementation of System of Least Prompts among Novice Teachers of Students with Autism

ERIC Educational Resources Information Center

Vince Garland, Krista M.; Holden, Kara; Garland, Dennis Patrick

2016-01-01

One of the challenges facing educators who teach students with autism spectrum disorders is implementing evidence-based practices (EBPs) with fidelity. One EBP used to help such learners in acquiring targeted behavioral or academic skills is prompting. In this study, the authors examine the efficacy of individualized clinical coaching (ICC) of…

Social workers' perceptions of barriers to interpersonal therapy implementation for treating postpartum depression in a primary care setting in Israel.

PubMed

Bina, Rena; Barak, Adi; Posmontier, Barbara; Glasser, Saralee; Cinamon, Tali

2018-01-01

Research on evidence-based practice (EBP) implementation in social work often neglects to include evaluation of application barriers. This qualitative study examined social workers' perspectives of provider- and organisational-related barriers to implementing a brief eight-session interpersonal therapy (IPT) intervention, a time-limited EBP that addresses reducing depressive symptoms and improving interpersonal functioning. Implementation took place in a primary care setting in Israel and was aimed at treating women who have postpartum depression (PPD) symptoms. Using purposeful sampling, 25 primary care licensed social workers were interviewed between IPT training and implementation regarding their perceived barriers to implementing IPT in practice. Data analysis was facilitated using a phenomenological approach, which entails identifying the shared themes and shared experiences of research participants regarding barriers to implementing IPT. Three themes emerged from the analysis of interviews: Perceived lack of flexibility of IPT intervention in comparison with more familiar methods social workers previously applied, specifically regarding the number of sessions and therapeutic topics included in the IPT protocol; insecurity and hesitance to gain experience with a new method of intervention; and organisational barriers, including difficulties with referrals, the perception of HMOs as health facilities not suitable for therapy, and time constraints. Addressing perceived barriers of social workers toward implementing EBPs, such as IPT for postpartum depression, during the training phase is crucial for enabling appropriate implementation. Future training should include examining practitioners' attitudes toward implementation of EBPs, as part of standardised training protocols. © 2017 John Wiley & Sons Ltd.

Development, Implementation, and Use of a Process to Promote Knowledge Translation in Rehabilitation.

PubMed

Moore, Jennifer L; Carpenter, Julia; Doyle, Anne Marie; Doyle, Laura; Hansen, Piper; Hahn, Bridget; Hornby, T George; Roth, Heidi R; Spoeri, Susan; Tappan, Rachel; Van Der Laan, Krista

2018-01-01

To examine the use and effect of the Battery of Rehabilitation Assessments and Interventions on evidence-based practice (EBP) over 6 years. Successive independent samples study. Large rehabilitation system. Successive samples of allied health clinicians (N=372) in 2009 (n=136), 2012 (n=115), and 2015 (n=121). The Battery of Rehabilitation Assessments and Interventions includes 2 components: (1) a process to synthesize, adapt, and make recommendations about the application of evidence; and (2) a process to implement the recommended practices in 3 levels of care. To assess the effect of the project, surveys on EBP perspectives, use, and barriers were conducted before Battery of Rehabilitation Assessments and Interventions implementation and 3 and 6 years after implementation. Questions about effect of the project on clinical practice were included 3 and 6 years postimplementation. Survey data indicate the Battery of Rehabilitation Assessments and Interventions resulted in a significant increase in use of EBPs to make clinical decisions and justify care. As a result of the project, survey participants reported a substantial increase in use of outcome measures in 2012 (74%) and 2015 (91%) and evidence-based interventions in 2012 (62%) and 2015 (82%). In 2012, significant differences (P≤.01) in effect of the Battery of Rehabilitation Assessments and Interventions on practice were identified between therapists who were directly involved in the project and Interventions compared with uninvolved therapists. In 2015, no significant differences existed between involved and uninvolved therapists. After 6 years of sustained implementation efforts, the Battery of Rehabilitation Assessments and Interventions expedited the adoption of EBPs throughout a large system of care in rehabilitation. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Associations among state and local organizational contexts: Use of evidence-based practices in the criminal justice system

PubMed Central

Henderson, Craig E.; Young, Douglas W.; Farrell, Jill; Taxman, Faye S.

2016-01-01

This study used hierarchical linear modeling (HLM) to examine the extent to which the organizational characteristics of state corrections agencies and local criminal justice facilities interacted in their associations with the extent to which local facilities are using evidence-based substance abuse treatment practices (EBPs). The study used data collected from two nationally representative surveys – one of state executives and the other of local prison wardens, justice administrators, and treatment directors – which were conducted as part of the National Criminal Justice Treatment Practices survey [NCJTP; Taxman, F.S., Young, D., Wiersema, B., Mitchell, S., Rhodes, A.G., 2007. The National Criminal Justice Treatment Practices Survey: Multi-level survey methods and procedures. J. Subst. Abuse Treat. 32, 225–238], and includes both adult criminal and juvenile justice samples. Results indicated that several state organizational characteristics were either associated with more EBP use or interacted with local organizational characteristics in associations with EBP use, including: (1) systems integration at the state level was associated with greater EBP use; (2) state staffing adequacy and stability accentuated the association between local training and resources for new programs and EBP use (i.e., in states with better staffing, the relationship between training/resources and EBP use in local facilities was stronger); and (3) state executives’ attitudes regarding the missions and goals of corrections tended to diminish the extent to which corresponding local administrator attitudes were associated with EBP use. The study has implications for future research focused on EBP diffusion and implementation in correctional environments, particularly attempts to influence EBP use by working through state agencies. PMID:19174321

Evaluation of a tailored, multi-component intervention for implementation of evidence-based clinical practice guidelines in primary care physical therapy: a non-randomized controlled trial.

PubMed

Bernhardsson, Susanne; Larsson, Maria E H; Eggertsen, Robert; Olsén, Monika Fagevik; Johansson, Kajsa; Nilsen, Per; Nordeman, Lena; van Tulder, Maurits; Öberg, Birgitta

2014-03-04

Clinical practice guidelines are important for transmitting research findings into practice and facilitating the application of evidence-based practice (EBP). There is a paucity of knowledge about the impact of guideline implementation strategies in primary care physical therapy. The aim of this study was to evaluate the effect of a guideline implementation intervention in primary care physical therapy in western Sweden. An implementation strategy based on theory and current evidence was developed. A tailored, multi-component implementation intervention, addressing earlier identified determinants, was carried out in three areas comprising 28 physical therapy practices including 277 physical therapists (PTs) (intervention group). In two adjacent areas, 171 PTs at 32 practices received no intervention (control group). The core component of the intervention was an implementation seminar with group discussions. Among other components were a website and email reminders. Data were collected at baseline and follow-up with a web-based questionnaire. Primary outcomes were the self-reported awareness of, knowledge of, access to, and use of guidelines. Secondary outcomes were self-reported attitudes toward EBP and guidelines. Analyses were performed using Pearson's χ2 test and approximative z-test. 168 PTs (60.6%) in the intervention group and 88 PTs (51.5%) in the control group responded to the follow-up questionnaire. 186/277 PTs (67.1%) participated in the implementation seminars, of which 97 (52.2%) responded. The proportions of PTs reporting awareness of (absolute difference in change 20.6%, p = 0.023), knowledge where to find (20.4%, p = 0.007), access to (21.7%, p < 0.001), and frequent use of (9.5%, NS) guidelines increased more in the intervention group than in the control group. The proportion of PTs reporting frequent guideline use after participation in the implementation seminar was 15.2% (p = 0.043) higher than the proportion in the control group. A higher proportion considered EBP helpful in decision making (p = 0.018). There were no other significant differences in secondary outcomes. A tailored, theory- and evidence-informed, multi-component intervention for the implementation of clinical practice guidelines had a modest, positive effect on awareness of, knowledge of, access to, and use of guidelines, among PTs in primary care in western Sweden. In general, attitudes to EBP and guidelines were not affected.

Leadership and organizational change for implementation (LOCI): a randomized mixed method pilot study of a leadership and organization development intervention for evidence-based practice implementation.

PubMed

Aarons, Gregory A; Ehrhart, Mark G; Farahnak, Lauren R; Hurlburt, Michael S

2015-01-16

Leadership is important in the implementation of innovation in business, health, and allied health care settings. Yet there is a need for empirically validated organizational interventions for coordinated leadership and organizational development strategies to facilitate effective evidence-based practice (EBP) implementation. This paper describes the initial feasibility, acceptability, and perceived utility of the Leadership and Organizational Change for Implementation (LOCI) intervention. A transdisciplinary team of investigators and community stakeholders worked together to develop and test a leadership and organizational strategy to promote effective leadership for implementing EBPs. Participants were 12 mental health service team leaders and their staff (n = 100) from three different agencies that provide mental health services to children and families in California, USA. Supervisors were randomly assigned to the 6-month LOCI intervention or to a two-session leadership webinar control condition provided by a well-known leadership training organization. We utilized mixed methods with quantitative surveys and qualitative data collected via surveys and a focus group with LOCI trainees. Quantitative and qualitative analyses support the LOCI training and organizational strategy intervention in regard to feasibility, acceptability, and perceived utility, as well as impact on leader and supervisee-rated outcomes. The LOCI leadership and organizational change for implementation intervention is a feasible and acceptable strategy that has utility to improve staff-rated leadership for EBP implementation. Further studies are needed to conduct rigorous tests of the proximal and distal impacts of LOCI on leader behaviors, implementation leadership, organizational context, and implementation outcomes. The results of this study suggest that LOCI may be a viable strategy to support organizations in preparing for the implementation and sustainment of EBP.

Identifying and ranking implicit leadership strategies to promote evidence-based practice implementation in addiction health services.

PubMed

Guerrero, Erick G; Padwa, Howard; Fenwick, Karissa; Harris, Lesley M; Aarons, Gregory A

2016-05-14

Despite a solid research base supporting evidence-based practices (EBPs) for addiction treatment such as contingency management and medication-assisted treatment, these services are rarely implemented and delivered in community-based addiction treatment programs in the USA. As a result, many clients do not benefit from the most current and efficacious treatments, resulting in reduced quality of care and compromised treatment outcomes. Previous research indicates that addiction program leaders play a key role in supporting EBP adoption and use. The present study expanded on this previous work to identify strategies that addiction treatment program leaders report using to implement new practices. We relied on a staged and iterative mixed-methods approach to achieve the following four goals: (a) collect data using focus groups and semistructured interviews and conduct analyses to identify implicit managerial strategies for implementation, (b) use surveys to quantitatively rank strategy effectiveness, (c) determine how strategies fit with existing theories of organizational management and change, and (d) use a consensus group to corroborate and expand on the results of the previous three stages. Each goal corresponded to a methodological phase, which included data collection and analytic approaches to identify and evaluate leadership interventions that facilitate EBP implementation in community-based addiction treatment programs. Findings show that the top-ranked strategies involved the recruitment and selection of staff members receptive to change, offering support and requesting feedback during the implementation process, and offering in vivo and hands-on training. Most strategies corresponded to emergent implementation leadership approaches that also utilize principles of transformational and transactional leadership styles. Leadership behaviors represented orientations such as being proactive to respond to implementation needs, supportive to assist staff members during the uptake of new practices, knowledgeable to properly guide the implementation process, and perseverant to address ongoing barriers that are likely to stall implementation efforts. These findings emphasize how leadership approaches are leveraged to facilitate the implementation and delivery of EBPs in publicly funded addiction treatment programs. Findings have implications for the content and structure of leadership interventions needed in community-based addiction treatment programs and the development of leadership interventions in these and other service settings.

Graduate nursing students' evaluation of EBP courses: a cross-sectional study.

PubMed

Zelenikova, Renata; Beach, Michael; Ren, Dianxu; Wolff, Emily; Sherwood, Paula R

2015-01-01

There is a lack of appropriate tools for assessing the effectiveness of teaching evidence-based practice in nursing. The objective of the study was to develop the instrument evaluating the students' perception of the effectiveness of EBP courses and to verify its psychometric properties. A descriptive cross-sectional study design was used to verify psychometric properties of the questionnaire measuring the students' perception of the effectiveness of EBP courses. The psychometric properties were evaluated in a group of 129 graduate nursing students who completed EBP courses. The instrument for measuring the students' perception of the effectiveness of EBP courses was inspired by Kirkpatrick's evaluation model, which advocates evaluating interventions at four levels - reaction (satisfaction), learning, behavior change (transfer) and results (benefits). A web-based survey was used for data collection. Data was collected from the middle of January 2013 through the end of March 2013. A thirteen item instrument was developed for measuring the students' perception of the effectiveness of EBP courses. The internal consistency of the scale, based on standardized Cronbach's alpha, was .93. The results of factor analysis identified three factors of the instrument. The highest rated items on a scale of 1 (strongly disagree) to 7 (strongly agree) were 'implementation of EBP can improve clinical care' (mean 6.16), 'EBP instructors had a thorough knowledge of EBP' (6.13), 'EBP instructors were enthusiastic about teaching EBP' (5.65), and 'I can use my EBP knowledge and skills in my practice' (5.58). The results of testing of the psychometric properties of the questionnaire showed at least satisfactory validity and reliability. The majority of students perceived EBP courses as effective. The instrument may be used to assess the students' perception of the effectiveness of EBP courses. Copyright © 2014 Elsevier Ltd. All rights reserved.

Getting to Uptake: Do Communities of Practice Support the Implementation of Evidence-Based Practice?

PubMed Central

Barwick, Melanie A.; Peters, Julia; Boydell, Katherine

2009-01-01

Introduction Practitioners are increasingly encouraged to adopt evidence-based practices (EBP) leading to a need for new knowledge translation strategies to support implementation and practice change. This study examined the benefits of a community of practice in the context of Ontario’s children’s mental health sector where organizations are mandated to adopt a standardized outcome measure to monitor client response to treatment. Method Readiness for change, practice change, content knowledge, and satisfaction with and use of implementation supports were examined among practitioners newly trained on the measure who were randomly assigned to a community of practice (CoP) or a practice as usual (PaU) group. CoP practitioners attended 6 sessions over 12 months; PaU practitioners had access to usual implementation supports. Results Groups did not differ on readiness for change or reported practice change, although CoP participants demonstrated greater use of the tool in practice, better content knowledge and were more satisfied with implementation supports than PaU participants. Conclusion CoPs present a promising model for translating EBP knowledge and promoting practice change in children’s mental health that requires further study. PMID:19270845

Using a partnership between academic faculty and a physical therapist liaison to develop a framework for an evidence-based journal club: a discussion.

PubMed

Austin, Tricia M; Richter, Randy R; Frese, Tracy

2009-12-01

Evidence-based practice (EBP) in rehabilitation is increasingly recognized as important. Despite the importance of EBP, physical therapists' knowledge of EBP varies. Journal clubs have been used to educate clinicians about EBP. This discussion paper describes the partnership between academic faculty members and a physical therapist at a community hospital, and the process used to develop a framework to implement an evidence-based journal club. The partnership blended the expertise of academic faculty members and a physical therapist with knowledge of EBP who served as the liaison between members of the partnership team and the clinicians at the community hospital. The three-step framework developed enabled the clinicians to learn about critical appraisal, participate in guided practice of critical appraisal with the liaison, and lead critical appraisal of a paper with the assistance of the liaison as needed. This process could be easily replicated by other partnerships between academic faculty members and clinicians. Developing partnerships like the one described enables academicians to provide service to the profession, may enhance physical therapists' knowledge of the principles of EBP and may encourage EBP.

Agency responses to a system-driven implementation of multiple evidence-based practices in children's mental health services.

PubMed

Regan, Jennifer; Lau, Anna S; Barnett, Miya; Stadnick, Nicole; Hamilton, Alison; Pesanti, Keri; Bando, Lillian; Brookman-Frazee, Lauren

2017-09-19

Large mental health systems are increasingly using fiscal policies to encourage the implementation of multiple evidence-based practices (EBPs). Although many implementation strategies have been identified, little is known about the types and impacts of strategies that are used by organizations within implementation as usual. This study examined organizational-level responses to a fiscally-driven, rapid, and large scale EBP implementation in children's mental health within the Los Angeles County Department of Mental Health. Qualitative methods using the principles of grounded theory were used to characterize the responses of 83 community-based agencies to the implementation effort using documentation from site visits conducted 2 years post reform. Findings indicated that agencies perceived the rapid system-driven implementation to have both positive and negative organizational impacts. Identified challenges were primarily related to system implementation requirements rather than to characteristics of specific EBPs. Agencies employed a variety of implementation strategies in response to the system-driven implementation, with agency size associated with implementation strategies used. Moderate- and large-sized agencies were more likely than small agencies to have employed systematic strategies at multiple levels (i.e., organization, therapist, client) to support implementation. These findings are among the first to characterize organizational variability in response to system-driven implementation and suggest ways that implementation interventions might be tailored by organizational characteristics.

School-based pediatric physical therapists' perspectives on evidence-based practice.

PubMed

Schreiber, Joe; Stern, Perri; Marchetti, Gregory; Provident, Ingrid; Turocy, Paula Sammarone

2008-01-01

This study described the current knowledge, beliefs, attitudes, and practices of a group of school-based pediatric physical therapists regarding evidence-based practice (EBP). Five practitioners participated in this project. Each was interviewed individually and in a group and completed a quantitative survey. All of the participants had a positive attitude toward EBP and believed that it should be an important element of clinical practice. Knowledge and practice were more variable, with several individuals reporting a lack of confidence in this area and an inability to routinely implement EBP. These participants were more likely to rely on colleagues, interaction with their supervisor, and professional experience to aid in decision making than research evidence. Pediatric physical therapists face numerous challenges accessing, analyzing, and applying research evidence. It is critical for the profession to identify optimal ways to support practitioners in this aspect of clinical practice.

Librarians and occupational therapy faculty: a collaboration for teaching evidence-based practice.

PubMed

Vogel, Kimberly A

2012-01-01

Students in allied health educational programs learn evidence-based practice (EBP) skills, yet often do not consistently utilize these skills as practitioners. Barriers to implementing EBP include time pressures and lack of skill. This descriptive study explains how librarians can teach information literacy skills and strengthen knowledge of EBP in graduate occupational therapy (OT) students. The goal of the study was to evaluate students' perception of the effectiveness of learning activities about EBP, and librarians' perception of the value of teaching in an OT curriculum. Sixty-three students at the University of Texas Health Science Center at San Antonio read articles and learned didactic information from OT faculty and librarians about EBP. Students researched intervention questions and electronically sent searches to librarians for feedback. Students applied skills by researching an intervention of their choice. Evaluative data were collected from students in 2009 and 2010 and from librarians in 2009. Both groups rated the learning experiences highly. Students felt the learning experiences improved their effectiveness in carrying out EBP. Librarians valued the experience of teaching information literacy to OT students. These results support other studies showing librarians' effectiveness in developing EBP skills in students. Recommendations are given about using journal clubs and secondary literature to ensure the use of EBP at the workplace.

Exploring knowledge, attitudes, and barriers toward the use of evidence-based practice amongst academic health care practitioners in their teaching in a South African university: a pilot study.

PubMed

McInerney, Patricia; Suleman, Fatima

2010-06-01

If institutions of higher education are to produce health professionals whose practice is research based, then students need to be exposed to learning opportunities that include searching for information and critical appraisal. This requires teachers to incorporate the latest research in their teaching. One of the identified strategic goals of a South African university was to produce evidence-based health care practitioners. Evidence-based practice (EBP) requires that health care practitioners plan their actions based on clinically relevant studies and research as opposed to traditional actions that are steeped in opinion. To determine the extent to which academic health care practitioners use "evidence" in their teaching and what they perceived as barriers to the use of EBP. A quantitative design was chosen and a structured questionnaire was used. The areas that were measured included knowledge and attitudes, use of EBP and perceived barriers to the use of EBP. Twenty-three academic health care practitioners completed the questionnaire. Knowledge and attitudes: 80% strongly agreed on a four-point Likert scale, that there is a strong need to incorporate EBP into teaching, with only 48% strongly agreeing that EBP is another perspective of clinical effectiveness. Use of EBP: 73.9% stated that they used EBP in their teaching and 60.9% agreed that it imposes another demand on an already overloaded academic. More than half reported using journals, textbooks, the Internet, colleagues, and the Cochrane library to improve their teaching. Academic health care practitioners attempting to implement EBP have encountered a significant number of barriers in this South African institution. These barriers include lack of knowledge pertaining to EBP, lack of access to research findings, insufficient evidence, and insufficient time.

Pedagogical strategies to teach bachelor students evidence-based practice: A systematic review.

PubMed

Aglen, B

2016-01-01

The aim of this study is to review international scientific articles about pedagogical strategies to teach nursing students at bachelor degree evidence-based practice (EBP). A literature review including peer reviewed, original, empirical articles describing pedagogical interventions aimed at teaching bachelor's degree nursing students EBP in the period 2004-2014. Theories of discretion, knowledge transfer and cognitive maturity development are used as analytical perspectives. The main challenge teaching evidence based practice is that the students fail to see how research findings contribute to nursing practice. The pedagogical strategies described are student active learning methods to teach the students information literacy and research topics. Information literacy is mainly taught according to the stages of EBP. These stages focus on how to elaborate evidence from research findings for implementation into nursing practice. The articles reviewed mainly use qualitative, descriptive designs and formative evaluations of the pedagogical interventions. Although a considerable effort in teaching information literacy and research topics, nursing students still struggle to see the relevance evidence for nursing practice. Before being introduced to information literacy and research topics, students need insight into knowledge transfer and their own epistemic assumptions. Knowledge transfer related to clinical problems should be the learning situations prioritized when teaching EBP at bachelor level. Theoretical perspectives of cognitive maturity development, knowledge transfer and discretion in professional practice give alternative ways of designing pedagogical strategies for EBP. More research is needed to develop and test pedagogical strategies for EBP in light of these theories. Copyright © 2015. Published by Elsevier Ltd.

Evidence-based practice, step by step: critical appraisal of the evidence: part II: digging deeper--examining the "keeper" studies.

PubMed

Fineout-Overholt, Ellen; Melnyk, Bernadette Mazurek; Stillwell, Susan B; Williamson, Kathleen M

2010-09-01

This is the sixth article in a series from the Arizona State University College of Nursing and Health Innovation's Center for the Advancement of Evidence-Based Practice. Evidence-based practice (EBP) is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values. When delivered in a context of caring and in a supportive organizational culture, the highest quality of care and best patient outcomes can be achieved. The purpose of this series is to give nurses the knowledge and skills they need to implement EBP consistently, one step at a time. Articles will appear every two months to allow you time to incorporate information as you work toward implementing EBP at your institution. Also, we've scheduled "Chat with the Authors" calls every few months to provide a direct line to the experts to help you resolve questions. Details about how to participate in the next call will be published with November's Evidence-Based Practice, Step by Step.

Development and Testing of the Nurse Manager EBP Competency Scale.

PubMed

Shuman, Clayton J; Ploutz-Snyder, Robert J; Titler, Marita G

2018-02-01

The purpose of this study was to develop and evaluate the validity and reliability of an instrument to measure nurse manager competencies regarding evidence-based practice (EBP). The Nurse Manager EBP Competency Scale consists of 16 items for respondents to indicate their perceived level of competency on a 0 to 3 Likert-type scale. Content validity was demonstrated through expert panel review and pilot testing. Principal axis factoring and Cronbach's alpha evaluated construct validity and internal consistency reliability, respectively. Eighty-three nurse managers completed the scale. Exploratory factor analysis resulted in a 16-item scale with two subscales, EBP Knowledge ( n = 6 items, α = .90) and EBP Activity ( n = 10 items, α = .94). Cronbach's alpha for the entire scale was .95. The Nurse Manager EBP Competency Scale is a brief measure of nurse manager EBP competency with evidence of validity and reliability. The scale can enhance our understanding in future studies regarding how nurse manager EBP competency affects implementation.

Placing Evidence-Based Interventions at the Fingertips of School Social Workers.

PubMed

Castillo, Humberto López; Rivers, Tommi; Randall, Catherine; Gaughan, Ken; Ojanen, Tiina; Massey, Oliver Tom; Burton, Donna

2016-07-01

Through a university-community collaborative partnership, the perceived needs of evidence-based practices (EBPs) among school social workers (SSWs) in a large school district in central Florida was assessed. A survey (response rate = 83.6%) found that although 70% of SSWs claim to use EBPs in their everyday practice, 40% do not know where to find them, which may partially explain why 78% of respondents claim to spend 1 to 4 h every week looking for adequate EBPs. From this needs assessment, the translational model was used to address these perceived needs. A systematic review of the literature found 40 tier 2 EBPs, most of which (23%) target substance use, abuse, and dependence. After discussion with academic and community partners, the stakeholders designed, discussed, and implemented a searchable, online, password-protected, interface of these tier 2 EBPs, named Evidence-Based Intervention Toolkit (eBIT). Lessons learned, future directions, and implications of this "one-stop shop" for behavioral health are discussed.

Contemporary evidence-based practice in Canadian emergency medical services: a vision for integrating evidence into clinical and policy decision-making.

PubMed

Jensen, Jan L; Travers, Andrew H

2017-05-01

Nationally, emphasis on the importance of evidence-based practice (EBP) in emergency medicine and emergency medical services (EMS) has continuously increased. However, meaningful incorporation of effective and sustainable EBP into clinical and administrative decision-making remains a challenge. We propose a vision for EBP in EMS: Canadian EMS clinicians and leaders will understand and use the best available evidence for clinical and administrative decision-making, to improve patient health outcomes, the capability and quality of EMS systems of care, and safety of patients and EMS professionals. This vision can be implemented with the use of a structure, process, system, and outcome taxonomy to identify current barriers to true EBP, to recognize the opportunities that exist, and propose corresponding recommended strategies for local EMS agencies and at the national level. Framing local and national discussions with this approach will be useful for developing a cohesive and collaborative Canadian EBP strategy.

Placing Evidence-based Interventions at the Fingertips of School Social Workers

PubMed Central

Castillo, Humberto López; Rivers, Tommi; Randall, Catherine; Gaughan, Ken; Ojanen, Tiina; Massey, Oliver “Tom”; Burton, Donna

2015-01-01

Through a university-community collaborative partnership, the perceived needs of evidence-based practices (EBP) among school social workers (SSW) in a large school district in central Florida was assessed. A survey (response rate = 83.6%) found that although 70% of SSW claim to use EBP in their everyday practice, 40% do not know where to find them, which may partially explain why 78% of respondents claim to spend 1 to 4 hours every week looking for adequate EBP. From this needs assessment, the translational model was used to address these perceived needs. A systematic review of the literature found forty Tier 2 EBP, most of which (23%) target substance use, abuse, and dependence. After discussion with academic and community partners, the stakeholders designed, discussed, and implemented a searchable, online, password-protected, interface of these Tier 2 EBP, named eBIT (evidence-Based Intervention Toolkit). Lessons learned, future directions, and implications of this “one-stop shop” for behavioral health are discussed. PMID:26659382

Faculty perception of the effectiveness of EBP courses for graduate nursing students.

PubMed

Zeleníková, Renáta; Beach, Michael; Ren, Dianxu; Wolff, Emily; Sherwood, Paula

2014-12-01

Effective teaching is key in preparing students to become successful evidence-based healthcare professionals. The effectiveness of graduate evidence-based practice (EBP) pedagogy is not often a subject of research studies. The purpose of this study was to determine how faculty from the 50 top graduate nursing schools in the United States perceived the effectiveness of EBP courses for graduate nursing students. A descriptive cross-sectional design was used to explore faculty perception of the effectiveness of EBP courses. A web-based survey was used for data collection. A total of 45 questionnaires were subjected to statistical analysis. The mean perception of the effectiveness of EBP courses for the whole sample, on a scale from 1 to 7, was 5.58 (min. 4.29; max. 6.73), a higher score signifying higher perceived effectiveness. The highest rated item concerned a school's access to different databases. The strongest correlations were found between the total score and the scores for items describing students' opportunities to strengthen and apply their EBP skills (rs = .66). The internal consistency of the Perception of Effectiveness of EBP Courses scale, based on standardized Cronbach's alpha, was .84, which signifies strong internal consistency. Faculty perceived themselves as most competent at the following EBP skills: (a) "Asking questions regarding patients' care" (6.56), (b) "Considering patient preferences when implementing EBP" (6.40), and (c) "Critically appraising the relevant body of evidence to address clinical questions" (6.40). To strengthen the effectiveness of EBP courses, students should have more opportunities to implement their EBP knowledge and skills after completing EBP courses. Evaluation of faculty perceptions of the effectiveness of EBP courses can help to guide the development of nursing school curricula that better integrate EBP. Further evaluation of the psychometric properties of the instrument used to measure perception of the effectiveness of EBP courses is required along with objective measures of faculty knowledge and skills in teaching EBP. © 2014 Sigma Theta Tau International.

Use of Evidence-Based Practices and Resources Among Comprehensive Cancer Control Programs.

PubMed

Steele, C Brooke; Rose, John M; Chovnick, Gary; Townsend, Julie S; Stockmyer, Chrisandra K; Fonseka, Jamila; Richardson, Lisa C

2015-01-01

While efforts to promote use of evidence-based practices (EBPs) for cancer control have increased, questions remain whether this will result in widespread adoption of EBPs (eg, Guide to Community Preventive Services interventions) by comprehensive cancer control (CCC) programs. To examine use of EBPs among CCC programs to develop cancer control plans and select interventions. Conducted Web-based surveys of and telephone interviews with CCC program staff between March and July 2012. CCC programs funded by the Centers for Disease Control and Prevention's National Comprehensive Cancer Control Program (NCCCP). Sixty-one CCC program directors. 1) Use of and knowledge/attitudes about EBPs and related resources and 2) EBP-related technical assistance needs. Seventy-five percent of eligible program directors reported use of EBPs to a moderate or great extent to address program objectives. Benefits of using EBPS included their effectiveness has been proven, they are an efficient use of resources, and they lend credibility to an intervention. Challenges to using EBPs included resource limitations, lack of culturally appropriate interventions, and limited skills adapting EBPs for local use. Most respondents had heard of and used Web sites for The Guide to Community Preventive Services (95% and 91%, respectively) and Cancer Control P.L.A.N.E.T. (98% and 75%, respectively). Training needs included how to adapt an EBP and its materials for cultural appropriateness (state 78%, tribe 86%, territory 80%) and how to maintain the fidelity of an EBP (state 75%, tribe 86%, territory 60%). While awareness, knowledge, and use of EBPs and related resources are high, respondents identified numerous challenges and training needs. The findings from this study may be used to enhance technical assistance provided to NCCCP grantees related to selecting and implementing EBPs.

Use of Evidence-Based Practices and Resources Among Comprehensive Cancer Control Programs

PubMed Central

Steele, C. Brooke; Rose, John M.; Chovnick, Gary; Townsend, Julie S.; Stockmyer, Chrisandra K.; Fonseka, Jamila; Richardson, Lisa C.

2015-01-01

Context While efforts to promote use of evidence-based practices (EBPs) for cancer control have increased, questions remain whether this will result in widespread adoption of EBPs (eg, Guide to Community Preventive Services interventions) by comprehensive cancer control (CCC) programs. Objective To examine use of EBPs among CCC programs to develop cancer control plans and select interventions. Design Conducted Web-based surveys of and telephone interviews with CCC program staff between March and July 2012. Setting CCC programs funded by the Centers for Disease Control and Prevention’s National Comprehensive Cancer Control Program (NCCCP). Participants Sixty-one CCC program directors. Main Outcome Measures 1) Use of and knowledge/attitudes about EBPs and related resources and 2) EBP-related technical assistance needs. Results Seventy-five percent of eligible program directors reported use of EBPs to a moderate or great extent to address program objectives. Benefits of using EBPS included their effectiveness has been proven, they are an efficient use of resources, and they lend credibility to an intervention. Challenges to using EBPs included resource limitations, lack of culturally appropriate interventions, and limited skills adapting EBPs for local use. Most respondents had heard of and used Web sites for The Guide to Community Preventive Services (95% and 91%, respectively) and Cancer Control P.L.A.N.E.T. (98% and 75%, respectively). Training needs included how to adapt an EBP and its materials for cultural appropriateness (state 78%, tribe 86%, territory 80%) and how to maintain the fidelity of an EBP (state 75%, tribe 86%, territory 60%). Conclusions While awareness, knowledge, and use of EBPs and related resources are high, respondents identified numerous challenges and training needs. The findings from this study may be used to enhance technical assistance provided to NCCCP grantees related to selecting and implementing EBPs. PMID:24402431

Health professions faculty beliefs, confidence, use, and perceptions of organizational culture and readiness for EBP: A cross-sectional, descriptive survey.

PubMed

Milner, Kerry A; Bradley, Holly B; Lampley, Tammy

2018-05-01

Evidence-based practice (EBP) is an essential skill and ethical obligation for all practicing health professions clinicians because of its strong association with improved health outcomes. Emerging evidence suggests that faculty who prepare these clinicians lack proficiency to teach EBP. The purpose of this study was to describe; 1) health profession faculty beliefs about and confidence in their ability to teach and implement EBP, 2) use of EBP for education, 3) organizational culture and readiness for EBP; and to determine whether relationships exist among these variables. This study used a cross-sectional, descriptive survey design. College of Nursing (CON) and College of Health Professions (CHP) faculty from a university located in the Northeast, United States. Faculty were defined as anyone teaching a course for the CON or CHP during the fall of 2016. Faculty were invited to complete an electronic survey measuring EBP beliefs, EBP use, and EBP organizational culture and readiness. The survey was comprised of three tools developed specifically for health professions educators in 2010 by Fineout-Overholt & Melnyk. Sixty-nine faculty returned usable surveys (25.5% response rate). Mean EBP beliefs score was 89.49 (SD = 10.94) indicating respondents had a firm belief in and confidence in their ability to implement and teach EBP. Mean EBP use was 32.02 (SD = 20.59) indicating that respondents taught and implemented EBP between 1 and 3 times in the last 8-weeks. Mean EBP culture and readiness score was 90.20 (SD = 15.23) indicating essential movement toward a sustainable culture of college-wide integration of EBP. Mean scores for beliefs/confidence were higher for full-time clinical faculty compared to other groups [F (2, 55)  = 0.075, p = 0.928; ηp 2  = 0.003)]. Adjunct faculty reported higher EBP behaviors expected by health profession educators in the last 8-weeks compared to other groups [F (2, 55)  = 0.251, p = 0.779; ηp 2 . =0.009)]. Adjunct faculty had the highest mean scores on OCRSIEP-E followed by full-time clinical faculty. These group differences in OCRSIEP-E were statistically significant [F (2, 49)  = 7.92, p = 0.001; ηp 2  = 0.244)]. OCRSIEP-E was significantly different between full-time tenure/tenure track faculty (M = 78.0, SD = 12.58) and full-time clinical faculty (M = 91.37, SD = 14.79, p = 0.027) and between full-time tenure/tenure track faculty and adjunct faculty (M = 97.19, SD = 12.39, p = 0.001). Faculty adoption of EBP as a foundational pillar of teaching is essential. Research is needed to define the scope of the problem internationally. Organizations need to set standards for faculty teaching in the health professions to be EBP proficient. Programs preparing faculty to teach in nursing and other health professions must include educator EBP competencies. Copyright © 2018 Elsevier Ltd. All rights reserved.

Validation of the Implementation Leadership Scale (ILS) in Substance Use Disorder Treatment Organizations

PubMed Central

Ehrhart, Mark G.; Torres, Elisa M.; Finn, Natalie K.; Roesch, Scott C.

2016-01-01

There have been recent calls for pragmatic measures to assess factors that influence evidence-based practice (EBP) implementation processes and outcomes. The Implementation Leadership Scale (ILS) is a brief and efficient measure that can be used for research or organizational development purposes to assess leader behaviors and actions that actively support effective EBP implementation. The ILS was developed and validated in mental health settings. This study validates the ILS factor structure with providers in alcohol and other drug (AOD) use treatment agencies. Participants were 323 service providers working in 72 workgroups from three AOD use treatment agencies. Confirmatory factor analyses and reliability analyses were conducted to examine the psychometric properties of the ILS. Convergent and discriminant validity were also assessed. Confirmatory factor analyses demonstrated good fit to the hypothesized first and second order factor structure. Internal consistency reliability was excellent. Convergent and discriminant validity was supported. The ILS psychometric characteristics, reliability, and validity were supported in AOD use treatment agencies. The ILS is a brief and pragmatic measure that can be used for research and practice to assess leadership for EBP implementation in AOD use treatment agencies. PMID:27431044

Validation of the Implementation Leadership Scale (ILS) in Substance use Disorder Treatment Organizations.

PubMed

Aarons, Gregory A; Ehrhart, Mark G; Torres, Elisa M; Finn, Natalie K; Roesch, Scott C

2016-09-01

There have been recent calls for pragmatic measures to assess factors that influence evidence-based practice (EBP) implementation processes and outcomes. The Implementation Leadership Scale (ILS) is a brief and efficient measure that can be used for research or organizational development purposes to assess leader behaviors and actions that actively support effective EBP implementation. The ILS was developed and validated in mental health settings. This study validates the ILS factor structure with providers in alcohol and other drug (AOD) use treatment agencies. Participants were 323 service providers working in 72 workgroups from three AOD use treatment agencies. Confirmatory factor analyses and reliability analyses were conducted to examine the psychometric properties of the ILS. Convergent and discriminant validity were also assessed. Confirmatory factor analyses demonstrated good fit to the hypothesized first and second order factor structure. Internal consistency reliability was excellent. Convergent and discriminant validity was supported. The ILS psychometric characteristics, reliability, and validity were supported in AOD use treatment agencies. The ILS is a brief and pragmatic measure that can be used for research and practice to assess leadership for EBP implementation in AOD use treatment agencies. Copyright © 2016 Elsevier Inc. All rights reserved.

Sources of Knowledge and Barriers of Implementing Evidence-Based Practice Among Mental Health Nurses in Saudi Arabia.

PubMed

Hamaideh, Shaher H

2017-07-01

The purposes of this study were to identify the sources of knowledge for nursing practices and to identify the barriers of using "evidence-based practice" (EBP). Descriptive cross-sectional design was used to collect data from 164 Saudi mental health nurses by completing the Development of Evidence-Based Practice Questionnaire. The most frequently used sources of knowledge were relied on social interactions and the nurses' own experiences, while the least frequently used sources were external sources of knowledge and research evidences. Insufficient time to find research reports, difficulty in understanding research reports, and insufficient resources for evidences were the barriers of using EBP. The organizations should encourage using EBP by providing adequate time, resources, knowledge, and skills for mental health nurses through conducting workshops and mentoring. © 2016 Wiley Periodicals, Inc.

Implementation Science for the Environment.

PubMed

Hering, Janet G

2018-05-15

The establishment of the field of implementation science was motivated by the understanding that medical and health research alone is insufficient to generate better health outcomes. With strong support from funding agencies for medical research, implementation science promotes the application of a structured framework or model in the implementation of research-based results, specifically evidence-based practices (EBPs). Furthermore, explicit consideration is given to the context of EBP implementation (i.e., socio-economic, political, cultural, and institutional factors that could affect the implementation process). Finally, implementation is monitored in a robust and rigorous way. Today, the field of implementation science supports conferences and professional societies as well as one dedicated journal and numerous others with related content. The goal of these various activities is to reduce the estimated, average "bench to bedside" time lag of 17 years for uptake of EBPs from health research into routine practice. Despite similar time lags and impediments to uptake in the environmental domain, a parallel field of implementation science for the environment has not (yet) emerged. Although some parallels in needs and opportunities can easily be drawn between the health and environmental domains, a detailed mapping exercise is needed to understand which aspects of implementation science could be applied in the environmental domain either directly or in a modified form. This would allow an accelerated development of implementation science for the environment.

The effectiveness and feasibility of an online educational program for improving evidence-based practice literacy: an exploratory randomized study of US chiropractors.

PubMed

Schneider, Michael; Evans, Roni; Haas, Mitchell; Leach, Matthew; Delagran, Louise; Hawk, Cheryl; Long, Cynthia; Cramer, Gregory D; Walters, Oakland; Vihstadt, Corrie; Terhorst, Lauren

2016-01-01

Online education programs are becoming a popular means to disseminate knowledge about evidence-based practice (EBP) among healthcare practitioners. This mode of delivery also offers a viable and potentially sustainable solution for teaching consistent EBP content to learners over time and across multiple geographical locations. We conducted a study with 3 main aims: 1) develop an online distance-learning program about the principles of evidence-based practice (EBP) for chiropractic providers; 2) test the effectiveness of the online program on the attitudes, skills, and use of EBP in a sample of chiropractors; and 3) determine the feasibility of expanding the program for broader-scale implementation. This study was conducted from January 2013 to September 2014. This was an exploratory randomized trial in which 293 chiropractors were allocated to either an online EBP education intervention or a waitlist control. The online EBP program consisted of 3 courses and 4 booster lessons, and was developed using educational resources created in previous EBP educational programs at 4 chiropractic institutions. Participants were surveyed using a validated EBP instrument (EBASE) with 3 rescaled (0 to 100) subscores: Attitudes, Skills, and Use of EBP. Multiple regression was used to compare groups, adjusting for personal and practice characteristics. Satisfaction and compliance with the program was evaluated to assess feasibility. The Training Group showed modest improvement compared to the Waitlist Group in attitudes (Δ =6.2, p < .001) and skills (Δ =10.0, p < .001) subscores, but not the use subscore (Δ = -2.3, p = .470). The majority of participants agreed that the educational program was 'relevant to their profession' (84 %) and 'was worthwhile' (82 %). Overall, engagement in the online program was less than optimal, with 48 % of the Training Group, and 42 % of the Waitlist Group completing all 3 of the program courses. Online EBP training leads to modest improvements in chiropractors' EBP attitudes and skill, but not their use of EBP. This online program can be delivered to a wide national audience, but requires modification to enable greater individualization and peer-to-peer interaction. Our results indicate that it is feasible to deliver an online EBP education on a broad scale, but that this mode of education alone is not sufficient for making large changes in chiropractors' use of EBP.

Therapist Perspectives on Training in a Package of Evidence-Based Practice Strategies for Children with Autism Spectrum Disorders Served in Community Mental Health Clinics

PubMed Central

Drahota, Amy; Stadnick, Nicole; Brookman-Frazee, Lauren

2012-01-01

Therapist perspectives regarding delivery of evidence-based practice (EBP) strategies are needed to understand the feasibility of implementation in routine service settings. This qualitative study examined the perspectives of 13 therapists receiving training and delivering a package of EBPs to children with autism spectrum disorders (ASD) in community mental health clinics. Therapists perceived the training and intervention delivery as effective at improving their clinical skills, the psychotherapy process, and child and family outcomes. Results expand parent pilot study findings, and add to the literature on training community providers and limited research on training providers to deliver EBPs to children with ASD. PMID:23086499

Predictors of the decision to adopt motivational interviewing in community health settings.

PubMed

Williams, Jessica Roberts; Blais, Marissa Puckett; Banks, Duren; Dusablon, Tracy; Williams, Weston O; Hennessy, Kevin D

2014-07-01

The purpose of this study is to concurrently examine the impact of individual and organizational characteristics on the decision to adopt the evidence-based practice (EBP) motivational interviewing (MI) among directors and staff (n = 311) in community health organizations (n = 92). Results from hierarchical linear modeling indicated that, at the individual level, attitudes toward EBPs and race each predicted directors' decisions to adopt, while gender predicted staff's decisionmaking. At the organizational level, organizational climate was inversely associated with both staff's and directors' decisions to adopt MI. Organizational barriers to implementing EBPs and use of reading materials and treatment manuals were related to directors' decision to adopt. Type of organization and staff attributes were associated with staff's decision to adopt. These findings underscore the need to tailor dissemination and implementation strategies to address differences between directors and staff in the adoption of EBPs.

From workshop to work practice: An exploration of context and facilitation in the development of evidence-based practice.

PubMed

Ellis, Isabelle; Howard, Peter; Larson, Ann; Robertson, Jeanette

2005-01-01

This article examines the process of translating evidence into practice using a facilitation model developed by the Western Australian Centre for Evidence Based Nursing and Midwifery. Using the conceptual framework Promoting Action on Research Implementation in Health Services (PARIHS), the aims of the study were (1) to explore the relative and combined importance of context and facilitation in the successful implementation of a new evidence-based clinical practice protocol and (2) to examine the establishment of more lasting change to individuals and organizations that resulted in greater incorporation of the principles of evidence-based practice (EBP). A pre-workshop, semi-structured telephone survey with 16 nurse managers in six rural hospitals; a summative evaluation immediately post-workshop with 54 participants; and follow-up, semi-structured interviews with 23 workshop participants. The contexts in each of the participating hospitals were very different; of the six hospitals, only one had not implemented the new protocol. Five had reviewed their practices and brought them in line with the protocol developed at the workshop. The rate of adoption varied considerably from 2 weeks to months. The participants reported being better informed about EBP in general and were positive about their ability to improve their practice and search more efficiently for best practice information. Underlying motivations for protocol development should be included in the PARIHS framework. IMPLICATIONS FOR EDUCATION: Good facilitation appears to be more influential than context in overcoming the barriers to the uptake of EBP.

Going above and beyond for implementation: the development and validity testing of the Implementation Citizenship Behavior Scale (ICBS).

PubMed

Ehrhart, Mark G; Aarons, Gregory A; Farahnak, Lauren R

2015-05-07

In line with recent research on the role of the inner context of organizations in implementation effectiveness, this study extends research on organizational citizenship behavior (OCB) to the domain of evidence-based practice (EBP) implementation. OCB encompasses those behaviors that go beyond what is required for a given job that contribute to greater organizational effectiveness. The goal of this study was to develop and test a measure of implementation citizenship behavior (ICB) or those behaviors that employees perform that go above and beyond what is required in order to support EBP implementation. The primary participants were 68 supervisors from ten mental health agencies throughout California. Items measuring ICB were developed based on past research on OCB and in consultation with experts on EBP implementation in mental health settings. Supervisors rated 357 of their subordinates on ICB and implementation success. In addition, 292 of the subordinates provided data on self-rated performance, attitudes towards EBPs, work experience, and full-time status. The supervisor sample was randomly split, with half used for exploratory factor analyses and the other half for confirmatory factor analyses. The entire sample of supervisors and subordinates was utilized for analyses assessing the reliability and construct validity of the measure. Exploratory factor analyses supported the proposed two-factor structure of the Implementation Citizenship Behavior Scale (ICBS): (1) Helping Others and (2) Keeping Informed. Confirmatory factor analyses with the other half of the sample supported the factor structure. Additional analyses supported the reliability and construct validity for the ICBS. The ICBS is a pragmatic brief measure (six items) that captures critical behaviors employees perform to go above and beyond the call of duty to support EBP implementation, including helping their fellow employees on implementation-related activities and keeping informed about issues related to EBP and implementation efforts. The ICBS can be used by researchers to better understand the outcomes of improved organizational support for implementation (i.e., implementation climate) and the proximal predictors of implementation effectiveness. The ICBS can also provide insight for organizations, practitioners, and managers by focusing on key employee behaviors that should increase the probability of implementation success.

Embedding Evidence-based Practice Education into a Post-graduate Physiotherapy Program: Eight Years of pre-Post Course Evaluations.

PubMed

Perraton, L; Machotka, Z; Grimmer, K; Gibbs, C; Mahar, C; Kennedy, K

2017-04-01

Little has been published about the effectiveness of training postgraduate physiotherapy coursework students in research methods and evidence-based practice (EBP) theory. Graduate qualities in most universities include lifelong learning. Inclusion of EBP in post-graduate coursework students' training is one way for students to develop the knowledge and skills needed to implement current best evidence in their clinical practice after graduation, thereby facilitating lifelong learning. This paper reports on change in confidence and anxiety in knowledge of statistical terminology and concepts related to research design and EBP in eight consecutive years of post-graduate physiotherapy students at one Australian university. Pre-survey/post-survey instruments were administered to students in an intensive 3-week post-graduate course, which taught health research methods, biostatistics and EBP. This course was embedded into a post-graduate physiotherapy programme from 2007 to 2014. The organization and delivery of the course was based on best pedagogical evidence for effectively teaching adult physiotherapists. The course was first delivered each year in the programme, and no other course was delivered concurrently. There were significant improvements in confidence, significantly decreased anxiety and improvements in knowledge of statistical terminology and concepts related to research design and EBP, at course completion. Age, gender and country of origin were not confounders on learning outcomes, although there was a (non-significant) trend that years of practice negatively impacted on learning outcomes (p = 0.09). There was a greater improvement in confidence in statistical terminology than in concepts related to research design and EBP. An intensive teaching programme in health research methods and biostatistics and EBP, based on best practice adult physiotherapy learning principles, is effective immediately post-course, in decreasing anxiety and increasing confidence in the terminology used in research methods and EBP. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Reported use of evidence in clinical practice: a survey of rehabilitation practices in Norway.

PubMed

Moore, Jennifer L; Friis, Svein; Graham, Ian D; Gundersen, Elisabeth Troøyen; Nordvik, Jan E

2018-05-25

The South Eastern Health Region in Norway serves approximately 2.8 million people, which is more than half of Norway's population. Physical medicine and rehabilitation services are provided by 9 public hospital trusts and 30 private rehabilitation facilities. The purposes of this study were to conduct a psychometric analysis of the EBP Implementation Scale (EBPIS) and describe rehabilitation clinicians' self-reported 1) use of evidence-based practices (EBPs), 2) use of EBPs across hospitals, and 3) determine factors associated with use of EBPs in the South Eastern Health Region in Norway. A cross-sectional study using an online survey was conducted with public hospitals and private rehabilitation centers. The survey, which was distributed throughout the region, included the EBPIS, 8 questions related to EBP in the health region, and demographics. Response frequencies were calculated and described. Internal consistency and factor structure of the EBPIS and its subscales were determined. Associations and differences in groups with similar demographics, EBPIS scores, and use of EBPs were identified. A total of 316 individuals completed the survey, including allied health clinicians, nurses, psychologists, social workers, and physicians. The EBPIS mean score was 30/72. A factor analysis identified that the EBPIS can be divided into 3 subscales: literature search and critical appraisal (α = .80), knowledge sharing (α = .83), and practice evaluation (α = .74). EBP activities reported were primarily related to literature searches, critical appraisal, and discussing evidence. Approximately 65 and 75% of respondents agreed that the same OMs and evidence based interventions were used within the local clinic respectively. Fewer agreed that the same OMs (13%) and evidence-based interventions (39%) are used regionally. The EBPIS and its subscales demonstrated excellent internal consistency. Practice variability exists in rehabilitation throughout Southeastern Norway. An increased emphasis on use of EBP throughout the region is needed.

Development of a competency framework for evidence-based practice in nursing.

PubMed

Leung, Kat; Trevena, Lyndal; Waters, Donna

2016-04-01

The measurement of competence in evidence-based practice (EBP) remains challenging to many educators and academics due to the lack of explicit competency criteria. Much uncertainty exists about what specific EBP competencies nurses should meet and how these should be measured. The objectives of this study are to develop a competency framework for measuring evidence-based knowledge and skills in nursing and to elicit the views of health educators/researchers about elements within the framework. A descriptive survey design with questionnaire. Between August and December 2013, forty-two health academics/educators, clinicians; and researchers from the medical and nursing schools at the University of Sydney and the Nurse Teacher's Society in Australia were invited to comment on proposed elements for measuring evidence-based knowledge and skills. The EBP competency framework was designed to measure nurses' knowledge and skills for using evidence in practice. Participants were invited to rate their agreement on the structure and relevance of the framework and to state their opinion about the measurement criteria for evidence-based nursing practice. Participant agreement on the structure and relevance of the framework was substantial, ICC: 0.80, 95% CI: 0.67-0.88, P<0.0001. Qualitative analysis of two open-ended survey questions revealed three common themes in participants' opinion of the competency elements: (1) a useful EBP framework; (2) varying expectations of EBP competence; and (3) challenges to EBP implementation. The findings of this study suggested that the EBP competency framework is of credible value for facilitating evidence-based practice education and research in nursing. However, there remains some uncertainty and disagreement about the levels of EBP competence required for nurses. These challenges further implicate the need for setting a reasonable competency benchmark with a broader group of stakeholders in nursing. Copyright © 2016 Elsevier Ltd. All rights reserved.

Building bridges in academic nursing and health care practice settings.

PubMed

Levin, Rona F; Vetter, Mary Jo; Chaya, Joan; Feldman, Harriet; Marren, Joan

2007-01-01

The purpose of this article is to describe the development and implementation of a shared position with a focus on evidence-based practice (EBP) between the Visiting Nurse Service of New York and the Lienhard School of Nursing, Pace University. A preexisting relationship between the two institutions in providing student experiences in a community setting paved the way for the evolution a new collaborative effort. The shared position was initially conceived by two of the authors as an outcome of research they were conducting in the home care setting, which tested a model of mentoring frontline nurses in the EBP process on health care professional and patient outcomes. An initial conception of the new role provided a working document for discussions between the two institutions and the creation of a workable contract. The implementation of several initiatives has already provided support for the position, and each partner has benefited from building this bridge between nursing education and service. Benefits include advancing knowledge of and implementing EBP in both settings and promoting collaborative, clinically related scholarship.

Evaluation of a tailored, multi-component intervention for implementation of evidence-based clinical practice guidelines in primary care physical therapy: a non-randomized controlled trial

PubMed Central

2014-01-01

Background Clinical practice guidelines are important for transmitting research findings into practice and facilitating the application of evidence-based practice (EBP). There is a paucity of knowledge about the impact of guideline implementation strategies in primary care physical therapy. The aim of this study was to evaluate the effect of a guideline implementation intervention in primary care physical therapy in western Sweden. Methods An implementation strategy based on theory and current evidence was developed. A tailored, multi-component implementation intervention, addressing earlier identified determinants, was carried out in three areas comprising 28 physical therapy practices including 277 physical therapists (PTs) (intervention group). In two adjacent areas, 171 PTs at 32 practices received no intervention (control group). The core component of the intervention was an implementation seminar with group discussions. Among other components were a website and email reminders. Data were collected at baseline and follow-up with a web-based questionnaire. Primary outcomes were the self-reported awareness of, knowledge of, access to, and use of guidelines. Secondary outcomes were self-reported attitudes toward EBP and guidelines. Analyses were performed using Pearson’s χ2 test and approximative z-test. Results 168 PTs (60.6%) in the intervention group and 88 PTs (51.5%) in the control group responded to the follow-up questionnaire. 186/277 PTs (67.1%) participated in the implementation seminars, of which 97 (52.2%) responded. The proportions of PTs reporting awareness of (absolute difference in change 20.6%, p = 0.023), knowledge where to find (20.4%, p = 0.007), access to (21.7%, p < 0.001), and frequent use of (9.5%, NS) guidelines increased more in the intervention group than in the control group. The proportion of PTs reporting frequent guideline use after participation in the implementation seminar was 15.2% (p = 0.043) higher than the proportion in the control group. A higher proportion considered EBP helpful in decision making (p = 0.018). There were no other significant differences in secondary outcomes. Conclusions A tailored, theory- and evidence-informed, multi-component intervention for the implementation of clinical practice guidelines had a modest, positive effect on awareness of, knowledge of, access to, and use of guidelines, among PTs in primary care in western Sweden. In general, attitudes to EBP and guidelines were not affected. PMID:24589291

Using planned adaptation to implement evidence-based programs with new populations.

PubMed

Lee, Shawna J; Altschul, Inna; Mowbray, Carol T

2008-06-01

The Interactive Systems Framework (ISF) for Dissemination and Implementation (Wandersman et al. 2008) elaborates the functions and structures that move evidence-based programs (EBPs) from research to practice. Inherent in that process is the tension between implementing programs with fidelity and the need to tailor programs to fit the target population. We propose Planned Adaptation as one approach to resolve this tension, with the goal of guiding practitioners in adapting EBPs so that they maintain core components of program theory while taking into account the needs of particular populations. Planned Adaptation is a form of capacity building within the Prevention Support System that provides a framework to guide practitioners in adapting programs while encouraging researchers to provide information relevant to adaptation as a critical aspect of dissemination research, with the goal of promoting wider dissemination and better implementation of EBPs. We illustrate Planned Adaptation using the JOBS Program (Caplan et al. 1989), which was developed for recently laid-off, working- and middle-class workers and subsequently implemented with welfare recipients.

Capability beliefs regarding evidence-based practice are associated with application of EBP and research use: validation of a new measure.

PubMed

Wallin, Lars; Boström, Anne-Marie; Gustavsson, J Petter

2012-08-01

Beliefs about capabilities, or self-efficacy, is a construct originating in social cognitive psychology. Capability beliefs have been found to be positively associated with intention and healthcare practice behaviour. A measure of an individual's beliefs about his/her capability to apply the components of evidence-based practice (EBP) has potential to be useful in implementation research. To evaluate the concurrent validity and internal structure of a new scale measuring nurses' capability beliefs regarding EBP. Data were taken from a prospective longitudinal study in Sweden (the Longitudinal Analyses of Nursing Education and Entry in Worklife [LANE]). A cohort of nursing students who graduated in the autumn of 2004 that was followed up 2 years after their graduation was used (n= 1,256). Concurrent validity was tested relating different levels of capability beliefs to extent of research use and application of EBP. An item-response approach was applied in the evaluation of internal structure of the proposed scale (six items). The psychometric analyses indicated that the six items could be summed to reflect a one-dimensional scale. Nurses with the highest level of capability beliefs reported that they used research findings in clinical practice more than twice as often as those with lower levels of capability beliefs. They also participated in the implementation of evidence seven times more often. There is a need for further studies of the construct and predictive validity of the scale. It should also be validated in other groups of health professionals. Learning including mastery experiences, role modelling, social persuasion, and manageable stress could be used in undergraduate education as well as practice development to increase beliefs about capabilities which might open the way to increased application of EBP in healthcare practice. This new measure is well grounded in social cognitive theory, functions as a one-dimensional scale and possesses promising properties of concurrent validity. ©2012 Sigma Theta Tau International.

An introduction to implementation science for the non-specialist.

PubMed

Bauer, Mark S; Damschroder, Laura; Hagedorn, Hildi; Smith, Jeffrey; Kilbourne, Amy M

2015-09-16

The movement of evidence-based practices (EBPs) into routine clinical usage is not spontaneous, but requires focused efforts. The field of implementation science has developed to facilitate the spread of EBPs, including both psychosocial and medical interventions for mental and physical health concerns. The authors aim to introduce implementation science principles to non-specialist investigators, administrators, and policymakers seeking to become familiar with this emerging field. This introduction is based on published literature and the authors' experience as researchers in the field, as well as extensive service as implementation science grant reviewers. Implementation science is "the scientific study of methods to promote the systematic uptake of research findings and other EBPs into routine practice, and, hence, to improve the quality and effectiveness of health services." Implementation science is distinct from, but shares characteristics with, both quality improvement and dissemination methods. Implementation studies can be either assess naturalistic variability or measure change in response to planned intervention. Implementation studies typically employ mixed quantitative-qualitative designs, identifying factors that impact uptake across multiple levels, including patient, provider, clinic, facility, organization, and often the broader community and policy environment. Accordingly, implementation science requires a solid grounding in theory and the involvement of trans-disciplinary research teams. The business case for implementation science is clear: As healthcare systems work under increasingly dynamic and resource-constrained conditions, evidence-based strategies are essential in order to ensure that research investments maximize healthcare value and improve public health. Implementation science plays a critical role in supporting these efforts.

Evidence-Based Practices in Special Education: Current Assumptions and Future Considerations

ERIC Educational Resources Information Center

Russo-Campisi, Jacqueline

2017-01-01

Background: The research on evidence-based practices (EBP) in special education has shifted over the last decade from identifying efficacious interventions to exploring issues that impede implementation in the classroom. Common barriers to implementation include absence of training and resources, limited collaboration between researchers and…

Initial Implementation Indicators From a Statewide Rollout of SafeCare Within a Child Welfare System

PubMed Central

Whitaker, Daniel J.; Ryan, Kerry A.; Wild, Robert C.; Self-Brown, Shannon; Lutzker, John R.; Shanley, Jenelle R.; Edwards, Anna M.; McFry, Erin A.; Moseley, Colby N.; Hodges, Amanda E.

2013-01-01

There is a strong movement toward implementation of evidence-based practices (EBP) in child welfare systems. The SafeCare parenting model is one of few parent-training models that addresses child neglect, the most common form of maltreatment. Here, the authors describe initial findings from a statewide effort to implement the EBP, SafeCare®, into a state child welfare system. A total of 50 agencies participated in training, with 295 individuals entering training to implement SafeCare. Analyses were conducted to describe the trainee sample, describe initial training and implementation indicators, and to examine correlates of initial training performance and implementation indicators. The quality of SafeCare uptake during training and implementation was high with trainees performing very well on training quizzes and role-plays, and demonstrating high fidelity when implementing SafeCare in the field (performing over 90% of expected behaviors). However, the quantity of implementation was generally low, with relatively few providers (only about 25%) implementing the model following workshop training. There were no significant predictors of training or implementation performance, once corrections for multiple comparisons were applied. The Discussion focuses on challenges to large-scale system-wide implementation of EBP. PMID:22146860

Implementation Measurement for Evidence-Based Violence Prevention Programs in Communities.

PubMed

Massetti, Greta M; Holland, Kristin M; Gorman-Smith, Deborah

2016-08-01

Increasing attention to the evaluation, dissemination, and implementation of evidence-based programs (EBPs) has led to significant advancements in the science of community-based violence prevention. One of the prevailing challenges in moving from science to community involves implementing EBPs and strategies with quality. The CDC-funded National Centers of Excellence in Youth Violence Prevention (YVPCs) partner with communities to implement a comprehensive community-based strategy to prevent violence and to evaluate that strategy for impact on community-wide rates of violence. As part of their implementation approach, YVPCs document implementation of and fidelity to the components of the comprehensive youth violence prevention strategy. We describe the strategies and methods used by the six YVPCs to assess implementation and to use implementation data to inform program improvement efforts. The information presented describes the approach and measurement strategies employed by each center and for each program implemented in the partner communities. YVPCs employ both established and innovative strategies for measurement and tracking of implementation across a broad range of programs, practices, and strategies. The work of the YVPCs highlights the need to use data to understand the relationship between implementation of EBPs and youth violence outcomes.

Effectiveness and Implementation of Evidence-Based Practices in Residential Care Settings

PubMed Central

James, Sigrid; Alemi, Qais; Zepeda, Veronica

2013-01-01

Purpose Prompted by calls to implement evidence-based practices (EBPs) into residential care settings (RCS), this review addresses three questions: (1) Which EBPs have been tested with children and youth within the context of RCS? (2) What is the evidence for their effectiveness within such settings? (3) What implementation issues arise when transporting EBPs into RCS? Methods Evidence-based psychosocial interventions and respective outcome studies, published from 1990–2012, were identified through a multi-phase search process, involving the review of four major clearinghouse websites and relevant electronic databases. To be included, effectiveness had to have been previously established through a comparison group design regardless of the setting, and interventions tested subsequently with youth in RCS. All outcome studies were evaluated for quality and bias using a structured appraisal tool. Results Ten interventions matching a priori criteria were identified: Adolescent Community Reinforcement Approach, Aggression Replacement Training, Dialectical Behavioral Therapy, Ecologically-Based Family Therapy, Eye Movement and Desensitization Therapy, Functional Family Therapy, Multimodal Substance Abuse Prevention, Residential Student Assistance Program, Solution-Focused Brief Therapy, and Trauma Intervention Program for Adjudicated and At-Risk Youth. Interventions were tested in 13 studies, which were conducted in different types of RCS, using a variety of study methods. Outcomes were generally positive, establishing the relative effectiveness of the interventions with youth in RCS across a range of psychosocial outcomes. However, concerns about methodological bias and confounding factors remain. Most studies addressed implementation issues, reporting on treatment adaptations, training and supervision, treatment fidelity and implementation barriers. Conclusion The review unearthed a small but important body of knowledge that demonstrates that EBPs can be implemented in RCS with encouraging results. PMID:23606781

Effectiveness and Implementation of Evidence-Based Practices in Residential Care Settings.

PubMed

James, Sigrid; Alemi, Qais; Zepeda, Veronica

2013-04-01

Prompted by calls to implement evidence-based practices (EBPs) into residential care settings (RCS), this review addresses three questions: (1) Which EBPs have been tested with children and youth within the context of RCS? (2) What is the evidence for their effectiveness within such settings? (3) What implementation issues arise when transporting EBPs into RCS? Evidence-based psychosocial interventions and respective outcome studies, published from 1990-2012, were identified through a multi-phase search process, involving the review of four major clearinghouse websites and relevant electronic databases. To be included, effectiveness had to have been previously established through a comparison group design regardless of the setting, and interventions tested subsequently with youth in RCS. All outcome studies were evaluated for quality and bias using a structured appraisal tool. Ten interventions matching a priori criteria were identified: Adolescent Community Reinforcement Approach, Aggression Replacement Training, Dialectical Behavioral Therapy, Ecologically-Based Family Therapy, Eye Movement and Desensitization Therapy, Functional Family Therapy, Multimodal Substance Abuse Prevention, Residential Student Assistance Program, Solution-Focused Brief Therapy, and Trauma Intervention Program for Adjudicated and At-Risk Youth. Interventions were tested in 13 studies, which were conducted in different types of RCS, using a variety of study methods. Outcomes were generally positive, establishing the relative effectiveness of the interventions with youth in RCS across a range of psychosocial outcomes. However, concerns about methodological bias and confounding factors remain. Most studies addressed implementation issues, reporting on treatment adaptations, training and supervision, treatment fidelity and implementation barriers. The review unearthed a small but important body of knowledge that demonstrates that EBPs can be implemented in RCS with encouraging results.

Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings.

PubMed

Bergström, Anna; Skeen, Sarah; Duc, Duong M; Blandon, Elmer Zelaya; Estabrooks, Carole; Gustavsson, Petter; Hoa, Dinh Thi Phuong; Källestål, Carina; Målqvist, Mats; Nga, Nguyen Thu; Persson, Lars-Åke; Pervin, Jesmin; Peterson, Stefan; Rahman, Anisur; Selling, Katarina; Squires, Janet E; Tomlinson, Mark; Waiswa, Peter; Wallin, Lars

2015-08-15

The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.

A mixed methods protocol for developing and testing implementation strategies for evidence-based obesity prevention in childcare: a cluster randomized hybrid type III trial.

PubMed

Swindle, Taren; Johnson, Susan L; Whiteside-Mansell, Leanne; Curran, Geoffrey M

2017-07-18

Despite the potential to reach at-risk children in childcare, there is a significant gap between current practices and evidence-based obesity prevention in this setting. There are few investigations of the impact of implementation strategies on the uptake of evidence-based practices (EBPs) for obesity prevention and nutrition promotion. This study protocol describes a three-phase approach to developing and testing implementation strategies to support uptake of EBPs for obesity prevention practices in childcare (i.e., key components of the WISE intervention). Informed by the i-PARIHS framework, we will use a stakeholder-driven evidence-based quality improvement (EBQI) process to apply information gathered in qualitative interviews on barriers and facilitators to practice to inform the design of implementation strategies. Then, a Hybrid Type III cluster randomized trial will compare a basic implementation strategy (i.e., intervention as usual) with an enhanced implementation strategy informed by stakeholders. All Head Start centers (N = 12) within one agency in an urban area in a southern state in the USA will be randomized to receive the basic or enhanced implementation with approximately 20 classrooms per group (40 educators, 400 children per group). The educators involved in the study, the data collectors, and the biostastician will be blinded to the study condition. The basic and enhanced implementation strategies will be compared on outcomes specified by the RE-AIM model (e.g., Reach to families, Effectiveness of impact on child diet and health indicators, Adoption commitment of agency, Implementation fidelity and acceptability, and Maintenance after 6 months). Principles of formative evaluation will be used throughout the hybrid trial. This study will test a stakeholder-driven approach to improve implementation, fidelity, and maintenance of EBPs for obesity prevention in childcare. Further, this study provides an example of a systematic process to develop and test a tailored, enhanced implementation strategy. ClinicalTrials.gov, NCT03075085.

Who Supports the Successful Implementation and Sustainability of Evidence-Based Practices? Defining and Understanding the Roles of Intermediary and Purveyor Organizations

ERIC Educational Resources Information Center

Franks, Robert P.; Bory, Christopher T.

2015-01-01

Research on implementation science has increased significantly over the past decade. In particular, psychologists have looked closely at the value and importance of bridging the gap between science and practice. As evidence-based practices (EBPs) become more prevalent, concrete mechanisms are needed to bring these scientifically supported…

Experiences of nursing students of Evidence-Based Practice Education according to Rogers' Diffusion of Innovation Model: A Directed Content Analysis.

PubMed

Pashaeypoor, Shahzad; Ashktorab, Tahereh; Rassouli, Maryam; Alavi Majd, Hamid

2017-10-01

Evidence based practice (EBP) education is essential in promoting of clinical care, but an effective educational strategy for teaching EBP in nursing faculties is not available. The aim of this study was to explore the experiences of nursing students of EBP Education according to Rogers' Diffusion of Innovation Model. This qualitative study was carried out using a directed content analysis method and purposeful sampling. Data were collected until saturation by fourteen semi-structured face-to-face individual interviews and two focus group discussions with nursing students from two nursing faculties in Tehran, Iran. Rogers' Model was used in this study. Data were classified into five themes and 11 categories according to the Rogers's Model. Themes and main categories were knowledge (educational enrichment, new strategy for education), persuasion (internalization of education, improvement of motivation), decision (acceptance, use in the future), implementation (objectivity, consolidation of learning) and confirmation (learning and teaching, achieving a goal, self-confidence). EBP Education, based on the teaching strategy of Rogers's Model, leads to an improved EBP learning. All the necessary steps for a better education of it are included in this educational approach which can be used to teach any new subject like EBP.

The Humble Leader: Association of Discrepancies in Leader and Follower Ratings of Implementation Leadership With Organizational Climate in Mental Health.

PubMed

Aarons, Gregory A; Ehrhart, Mark G; Torres, Elisa M; Finn, Natalie K; Beidas, Rinad S

2017-02-01

Discrepancies, or perceptual distance, between leaders' self-ratings and followers' ratings of the leader are common but usually go unrecognized. Research on discrepancies is limited, but there is evidence that discrepancies are associated with organizational context. This study examined the association of leader-follower discrepancies in Implementation Leadership Scale (ILS) ratings of mental health clinic leaders and the association of those discrepancies with organizational climate for involvement and performance feedback. Both involvement and performance feedback are important for evidence-based practice (EBP) implementation in mental health. A total of 593 individuals-supervisors (leaders, N=80) and clinical service providers (followers, N=513)-completed surveys that included ratings of implementation leadership and organizational climate. Polynomial regression and response surface analyses were conducted to examine the associations of discrepancies in leader-follower ILS ratings with organizational involvement climate and performance feedback climate, aspects of climate likely to support EBP implementation. Both involvement climate and performance feedback climate were highest where leaders rated themselves low on the ILS and their followers rated those leaders high on the ILS ("humble leaders"). Teams with "humble leaders" showed more positive organizational climate for involvement and for performance feedback, contextual factors important during EBP implementation and sustainment. Discrepancy in leader and follower ratings of implementation leadership should be a consideration in understanding and improving leadership and organizational climate for mental health services and for EBP implementation and sustainment in mental health and other allied health settings.

Are Evidence-based Practices Associated With Effective Prevention of Hospital-acquired Pressure Ulcers in US Academic Medical Centers?

PubMed

Padula, William V; Gibbons, Robert D; Valuck, Robert J; Makic, Mary B F; Mishra, Manish K; Pronovost, Peter J; Meltzer, David O

2016-05-01

In 2008, the Centers for Medicare and Medicaid Services (CMS) established nonpayment policies resulting from costliness of hospital-acquired pressure ulcers (HAPUs) to hospitals. This prompted hospitals to adopt quality improvement (QI) interventions that increase use of evidence-based practices (EBPs) for HAPU prevention. To evaluate the longitudinal impact of CMS policy and QI adoption on HAPU rates. We characterized longitudinal adoption of 25 QI interventions that support EBPs through hospital leadership, staff, information technology, and performance and improvement. Quarterly counts of HAPU incidence and inpatient characteristics were collected from 55 University HealthSystem Consortium hospitals between 2007 and 2012. Mixed-effects regression models tested the longitudinal association of CMS policy, HAPU coding, and QI on HAPU rates. The models assumed level-2 random intercepts and random effects for CMS policy and EBP implementation to account for between-hospital variability in HAPU incidence. Controlling for all 25 QI interventions, specific updates to EBPs for HAPU prevention had a significant, though modest reduction on HAPU rates (-1.86 cases/quarter; P=0.002) and the effect of CMS nonpayment policy on HAPU prevention was much greater (-11.32 cases/quarter; P<0.001). HAPU rates were significantly lower after changes in CMS reimbursement. Reductions are associated with hospital-wide implementation of EBPs for HAPU prevention. Given that administrative data were used, it remains unknown whether these improvements were due to changes in coding or improved quality of care.

Are Evidence-based Practices Associated with Effective Prevention of Hospital-acquired Pressure Ulcers in U.S. Academic Medical Centers?

PubMed Central

Padula, William V.; Gibbons, Robert D.; Valuck, Robert J.; Makic, Mary Beth F.; Mishra, Manish K.; Pronovost, Peter J.; Meltzer, David O.

2016-01-01

Background In 2008, the Centers for Medicare and Medicaid Services (CMS) established nonpayment policies resulting from costliness of hospital-acquired pressure ulcers (HAPUs) to hospitals. This prompted hospitals to adopt quality improvement (QI) interventions that increase use of evidence-based practices (EBPs) for HAPU prevention. Objective To evaluate the longitudinal impact of CMS policy and QI adoption on HAPU rates. Methods We characterized longitudinal adoption of 25 QI interventions that support EBPs through hospital leadership, staff, information technology, and performance and improvement. Quarterly counts of HAPU incidence and inpatient characteristics were collected from 55 UHC hospitals between 2007–2012. Mixed-effects regression models tested the longitudinal association of CMS policy, HAPU coding and QI on HAPU rates. The models assumed level-2 random-intercepts and random effects for CMS policy and EBP implementation to account for between-hospital variability in HAPU incidence. Results Controlling for all 25 QI interventions, specific updates to EBPs for HAPU prevention had a significant, though modest reduction on HAPU rates (−1.86 cases/quarter; p=0.002) and the effect of CMS nonpayment policy on HAPU prevention was much greater (−11.32 cases/quarter; p<0.001). Conclusions HAPU rates were significantly lower following changes in CMS reimbursement. Reductions are associated with hospital-wide implementation of EBPs for HAPU prevention. Given that administrative data were used, it remains unknown whether these improvements were due to changes in coding or improved quality of care. PMID:27078824

The impact of a unique knowledge translation programme implemented in a large multisite paediatric hospital.

PubMed

Christensen, Catie; Wessells, David; Byars, Michelle; Marrie, James; Coffman, Shaun; Gates, Erin; Selhorst, Mitch

2017-04-01

Physical therapists (PTs) display positive attitudes toward evidence-based practice (EBP), and implementing it can improve patient outcomes and reduce costs. However, barriers can lead to inconsistent use of EBP. The objectives of this manuscript are to (i) describe the initiation and revisions to a knowledge translation (KT) programme, (ii) assess staff participation in KT, and (iii) evaluate availability, internal use and external dissemination of evidence-based recommendations and research. The KT programme was implemented in a large paediatric hospital employing 66 PTs who provide services in the inpatient, outpatient developmental and sports and orthopaedics settings in 15 locations. The KT programme was initiated 9 years ago but underwent improvements over the past 3 years. Five key revisions included the subdivision of the EBP and Research Coordinator positions by area of practice, increasing the structure of the KT programme, implementing strategies to encourage use of local recommendations, obtaining leadership support to emphasize KT and providing staff education. With the revisions, staff participation in local recommendation development increased from 16.3-68.2%. Research involvement increased from 4.1-50%. The number of local recommendations increased from 1 to 9, and an overall compliance rate of 79% was achieved for the recommendations presented in an algorithm format. External dissemination increased from 1 to 44 for presentations and 0 to 7 for publications. Revisions to a KT programme improved PT engagement in KT activities, increased the availability of local recommendations, encouraged use of EBP and increased external dissemination of information. © 2016 John Wiley & Sons, Ltd.

Challenges and Ideas from a Research Program on High Quality, Evidence-Based Practice in School Mental Health

PubMed Central

Weist, Mark D.; Youngstrom, Eric A.; Stephan, Sharon; Lever, Nancy; Fowler, Johnathan; Taylor, Leslie; McDaniel, Heather; Chappelle, Lori; Paggeot, Samantha; Hoagwood, Kimberly

2013-01-01

Objective Reviews the progression of a research program designed to develop, implement and study the implementation of “achievable” evidence-based practices (EBPs) in schools. Reviews challenges encountered and ideas to overcome them to enhance this avenue of research. Method Presents two federally funded randomized controlled trials involving comparison of a four-component targeted intervention (Quality Assessment and Improvement, Family Engagement and Empowerment, Modular Evidence-Based Practice, Implementation Support) versus a comparison intervention focused on Personal Wellness. In both studies primary aims focused on changes in clinician attitudes and behavior, including the delivery of high quality, evidence-based practices and secondary aims focused on student level impacts. Results A number of challenges, many not reported in the literature are reviewed, and ideas for overcoming them are presented. Conclusions Given the reality that the majority of youth mental health services are delivered in schools and the potential of school mental health (SMH) services to provide a continuum of mental health care from promotion to intervention, it is critical that the field consider and address the logistical and methodological challenges associated with implementing and studying EBP implementation by clinicians. PMID:24063310

Clearing Hurdles: The Challenges of Implementation of Mental Health Evidence-Based Practices in Under-Resourced Schools

ERIC Educational Resources Information Center

Eiraldi, Ricardo; Wolk, Courtney Benjamin; Locke, Jill; Beidas, Rinad

2015-01-01

Schools have become the main provider of services to children with mental health needs. Although there is substantial literature on barriers to implementation of evidence-based practices (EBPs) in under-resourced school districts, less has been written on how to overcome those barriers. Providing mental health services in the school setting…

Faculty development initiatives to advance research literacy and evidence-based practice at CAM academic institutions.

PubMed

Long, Cynthia R; Ackerman, Deborah L; Hammerschlag, Richard; Delagran, Louise; Peterson, David H; Berlin, Michelle; Evans, Roni L

2014-07-01

To present the varied approaches of 9 complementary and alternative medicine (CAM) institutions (all grantees of the National Center for Complementary and Alternative Medicine) used to develop faculty expertise in research literacy and evidence-based practice (EBP) in order to integrate these concepts into CAM curricula. A survey to elicit information on the faculty development initiatives was administered via e-mail to the 9 program directors. All 9 completed the survey, and 8 grantees provided narrative summaries of faculty training outcomes. The grantees found the following strategies for implementing their programs most useful: assess needs, develop and adopt research literacy and EBP competencies, target early adopters and change leaders, employ best practices in teaching and education, provide meaningful incentives, capitalize on resources provided by grant partners, provide external training opportunities, and garner support from institutional leadership. Instructional approaches varied considerably across grantees. The most common were workshops, online resources, in-person short courses, and in-depth seminar series developed by the grantees. Many also sent faculty to intensive multiday extramural training programs. Program evaluation included measuring participation rates and satisfaction and the integration of research literacy and EBP learning objectives throughout the academic curricula. Most grantees measured longitudinal changes in beliefs, attitudes, opinions, and competencies with repeated faculty surveys. A common need across all 9 CAM grantee institutions was foundational training for faculty in research literacy and EBP. Therefore, each grantee institution developed and implemented a faculty development program. In developing the framework for their programs, grantees used strategies that were viewed critical for success, including making them multifaceted and unique to their specific institutional needs. These strategies, in conjunction with the grantees' instructional approaches, can be of practical use in other CAM and non-CAM academic environments considering the introduction of research literacy and EBP competencies into their curricula.

Evidence-based practice in chiropractic practice: A survey of chiropractors' knowledge, skills, use of research literature and barriers to the use of research evidence.

PubMed

Walker, B F; Stomski, N J; Hebert, J J; French, S D

2014-04-01

Scant research has been undertaken regarding chiropractors' skills and knowledge associated with evidence-based practice (EBP), and their perceived barriers to EBP. These issues appear to have been examined in only one small qualitative study and one small study of chiropractors holding orthopaedic diplomas. The lack of research in this area suggests that additional studies are warranted to develop a better understanding of factors that affect chiropractors' use of research evidence in clinical practice. We used a modified online questionnaire that captured information regarding EBP skills and knowledge, and barriers to EBP. Its adaption was informed by the use of a content validity panel. The questionnaire was disseminated through email by Australian chiropractic professional organisations and the Chiropractic Board of Australia. Logistic regression analyses were conducted to examine univariate associations between responses to items measuring knowledge and skills with items measuring: age; years since registration; reading research literature; and use of research literature in clinical decision-making. 584 respondents returned questionnaires. About half of the respondents stated they had learned the foundations of EBP (56.6%) during their undergraduate training. Slightly more than two thirds of the respondents were confident in their ability to critically review literature (69.5%) and find relevant research to answer clinical questions (72.6%). The most common factors involved with reading more research, and increased use of research literature in clinical decision-making, were confidence in critical appraisal skills and confidence in finding relevant research literature. Conclusion Educational interventions should be implemented to enhance Australian chiropractors' fundamental EBP skills. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evidence-Based Program Service Deserts: A Geographic Information Systems (GIS) Approach to Identifying Service Gaps for State-Level Implementation Planning.

PubMed

Walker, Sarah Cusworth; Hurvitz, Philip M; Leith, Jessica; Rodriguez, Felix I; Endler, Gregory C

2016-11-01

The long term effects of untreated mental health need for individuals, families and society has prompted a number of federal policy statements encouraging the use of evidence-based programs (EBP) in children's healthcare. However, among other challenges of evidence-based practice implementation, states often do not know where to make investments based on population need. In this paper we present the use of a Geographic Information System approach to undertake a mental health needs assessment for Washington State. Our study found that this technology can be beneficially applied to conducting needs assessment for EBP implementation, and we provide recommendations for future applications.

Assessing Culture and Climate of Federally Qualified Health Centers: A Plan for Implementing Behavioral Health Interventions.

PubMed

Kramer, Teresa L; Drummond, Karen L; Curran, Geoffrey M; Fortney, John C

2017-01-01

This study examines organizational factors relating to climate and culture that might facilitate or impede the implementation of evidence-based practices (EBP) targeting behavioral health in federally qualified health centers (FQHCs). Employees at six FQHCs participating in an evidence-based quality improvement (EBQI) initiative for mood disorders and alcohol abuse were interviewed (N=32) or surveyed using the Organizational Context Survey (OCS) assessing culture and climate (N=64). The FQHCs scored relatively well on proficiency, a previously established predictor of successful EBP implementation, but also logged high scores on scales assessing rigidity and resistance, which may hinder implementation. Qualitative data contextualized scores on FQHC culture and climate dimensions. Results suggest that the unique culture of FQHCs may influence implementation of evidence-based behavioral health interventions.

Clinical nurse specialist practice domains and evidence-based practice competencies: a matrix of influence.

PubMed

Kring, Daria L

2008-01-01

The purpose of this article is to describe master's-level evidence-based practice (EBP) competencies as determined by a national consensus panel and present an EBP matrix that illustrates the influence that the clinical nurse specialist (CNS) practice can have on driving EBP change. Evidence-based practice is a growing and necessary paradigm for nursing care. The ACE Star Model conceptualizes the knowledge transformation that must occur in an EBP environment as 5 distinct points: discovery, summary, translation, integration, and evaluation. Master's-level EBP competencies based on these 5 steps were established by a national consensus panel. The CNS's practice can be organized around 5 domains: expert practitioner, researcher, consultant, educator, and leader. The master's-level EBP competencies can be transposed on a crosswalk of the ACE Star Model and the 5 CNS practice domains to form a matrix representing the influence that CNSs can have over the EBP process. Each competency falls well within the practice domains of the CNS, making the CNS an ideal person to lead the EBP movement forward, providing tangible outcomes to further demonstrate the need for the CNS role.

Evidence-Based Special Education in the Context of Scarce Evidence-Based Practices

ERIC Educational Resources Information Center

TEACHING Exceptional Children, 2014

2014-01-01

Evidence-based practices (EBPs) are supported as generally effective for populations of learners by bodies of high-quality and experimental research and, when aligned with stakeholder values and practical needs, should be prioritized for implementation. However, evidence-based practices are not currently available for all learner types in all…

Enhancing assertive community treatment with cognitive behavioral social skills training for schizophrenia: study protocol for a randomized controlled trial.

PubMed

Granholm, Eric; Holden, Jason L; Sommerfeld, David; Rufener, Christine; Perivoliotis, Dimitri; Mueser, Kim; Aarons, Gregory A

2015-09-30

Schizophrenia leads to profound disability in everyday functioning (e.g., difficulty finding and maintaining employment, housing, and personal relationships). Medications can effectively reduce positive symptoms (e.g., hallucinations and delusions), but they do not meaningfully improve daily life functioning. Psychosocial evidence-based practices (EBPs) improve functioning, but these EBPs are not available to most people with schizophrenia. The field must close the research and service delivery gap by adapting EBPs for schizophrenia to facilitate widespread implementation in community settings. Our hybrid effectiveness and implementation study represents an initiative to bridge this divide. In this study we will test whether an existing EBP (i.e., Cognitive Behavioral Social Skills Training (CBSST)) modified to work in practice settings (i.e., Assertive Community Treatment (ACT) teams) commonly available to persons with schizophrenia results in better consumer outcomes. We will also identify key factors relevant to developing future CBSST implementation strategies. For the effectiveness study component, persons with schizophrenia will be recruited from existing publicly funded ACT teams operating in community settings. Participants will be randomized to one of the 2 treatments (ACT alone or ACT + Adapted CBSST) and followed longitudinally for 18 months with assessments every 18 weeks after baseline (5 in total). The primary outcome domain is psychosocial functioning (e.g., everyday living skills and activities related to employment, education, and housing) as measured by self-report, testing, and observation. Additional outcome domains of interest include mediators of change in functioning, symptoms, and quality of services. Primary analyses will be conducted using linear mixed-effects models for continuous data. The implementation study component consists of a structured, mixed qualitative-quantitative methodology (i.e., Concept Mapping) to characterize and assess the implementation experience from multiple stakeholder perspectives in order to inform future implementation initiatives. Adapting CBSST to fit into the ACT service delivery context found throughout the United States creates an opportunity to substantially increase the number of persons with schizophrenia who could have access to and benefit from EBPs. As part of the implementation learning process training materials and treatment workbooks have been revised to promote easier use of CBSST in the context of brief community-based ACT visits. ClinicalTrials.gov NCT02254733 . Date of registration: 25 April 2014.

The impact of inter-organizational alignment (IOA) on implementation outcomes: evaluating unique and shared organizational influences in education sector mental health.

PubMed

Lyon, Aaron R; Whitaker, Kelly; Locke, Jill; Cook, Clayton R; King, Kevin M; Duong, Mylien; Davis, Chayna; Weist, Mark D; Ehrhart, Mark G; Aarons, Gregory A

2018-02-07

Integrated healthcare delivered by work groups in nontraditional service settings is increasingly common, yet contemporary implementation frameworks typically assume a single organization-or organizational unit-within which system-level processes influence service quality and implementation success. Recent implementation frameworks predict that inter-organizational alignment (i.e., similarity in values, characteristics, activities related to implementation across organizations) may facilitate the implementation of evidence-based practices (EBP), but few studies have evaluated this premise. This study's aims examine the impact of overlapping organizational contexts by evaluating the implementation contexts of externally employed mental health clinicians working in schools-the most common integrated service delivery setting for children and adolescents. Aim 1 is to estimate the effects of unique intra-organizational implementation contexts and combined inter-organizational alignment on implementation outcomes. Aim 2 is to examine the underlying mechanisms through which inter-organizational alignment facilitates or hinders EBP implementation. This study will conduct sequential, exploratory mixed-methods research to evaluate the intra- and inter-organizational implementation contexts of schools and the external community-based organizations that most often employ school-based mental health clinicians, as they relate to mental health EBP implementation. Aim 1 will involve quantitative surveys with school-based, externally-employed mental health clinicians, their supervisors, and proximal school-employed staff (total n = 120 participants) to estimate the effects of each organization's general and implementation-specific organizational factors (e.g., climate, leadership) on implementation outcomes (fidelity, acceptability, appropriateness) and assess the moderating role of the degree of clinician embeddedness in the school setting. Aim 2 will explore the mechanisms through which inter-organizational alignment influences implementation outcomes by presenting the results of Aim 1 surveys to school-based clinicians (n = 30) and conducting semi-structured qualitative interviews. Qualitative data will be evaluated using an integrative inductive and deductive approach. The study aims are expected to identify intra- and inter-organizational constructs that are most instrumental to EBP implementation success in school-based integrated care settings and illuminate mechanisms that may account for the influence of inter-organizational alignment. In addition to improving school-based mental health, these findings will spur future implementation science that considers the relationships across organizations and optimize the capacity of implementation science to guide practice in increasingly complex systems of care.

Information systems: the key to evidence-based health practice.

PubMed Central

Rodrigues, R. J.

2000-01-01

Increasing prominence is being given to the use of best current evidence in clinical practice and health services and programme management decision-making. The role of information in evidence-based practice (EBP) is discussed, together with questions of how advanced information systems and technology (IS&T) can contribute to the establishment of a broader perspective for EBP. The author examines the development, validation and use of a variety of sources of evidence and knowledge that go beyond the well-established paradigm of research, clinical trials, and systematic literature review. Opportunities and challenges in the implementation and use of IS&T and knowledge management tools are examined for six application areas: reference databases, contextual data, clinical data repositories, administrative data repositories, decision support software, and Internet-based interactive health information and communication. Computerized and telecommunications applications that support EBP follow a hierarchy in which systems, tasks and complexity range from reference retrieval and the processing of relatively routine transactions, to complex "data mining" and rule-driven decision support systems. PMID:11143195

What Works for You? Using Teacher Feedback to Inform Adaptations of Pivotal Response Training for Classroom Use

PubMed Central

Stahmer, Aubyn C.; Suhrheinrich, Jessica; Reed, Sarah; Schreibman, Laura

2012-01-01

Several evidence-based practices (EBPs) have been identified as efficacious for the education of students with autism spectrum disorders (ASD). However, effectiveness research has rarely been conducted in schools and teachers express skepticism about the clinical utility of EBPs for the classroom. Innovative methods are needed to optimally adapt EBPs for community use. This study utilizes qualitative methods to identify perceived benefits and barriers of classroom implementation of a specific EBP for ASD, Pivotal Response Training (PRT). Teachers' perspectives on the components of PRT, use of PRT as a classroom intervention strategy, and barriers to the use of PRT were identified through guided discussion. Teachers found PRT valuable; however, they also found some components challenging. Specific teacher recommendations for adaptation and resource development are discussed. This process of obtaining qualitative feedback from frontline practitioners provides a generalizable model for researchers to collaborate with teachers to optimally promote EBPs for classroom use. PMID:23209896

Clinician Documentation on Receipt of Trauma-Focused Evidence-Based Psychotherapies in a VA PTSD Clinic.

PubMed

Lu, Mary W; Plagge, Jane M; Marsiglio, Mary C; Dobscha, Steven K

2016-01-01

The U.S. Department of Veterans Affairs (VA) is implementing two trauma-focused, evidence-based psychotherapies (TF-EBPs) for posttraumatic stress disorder (PTSD): cognitive processing therapy and prolonged exposure therapy (PE). Veterans with PTSD often do not receive these treatments, and little is known about the reasons veterans may not receive TF-EBPs. The aim of this qualitative study was to summarize clinician-reported reasons in medical records for nonreceipt of TF-EBPs. All veterans (N = 63) identified through PTSD screening who were newly engaged in mental health care and received individual evaluations in a PTSD specialty clinic in fiscal year 2008 were included in the sample. Content analysis of electronic medical records revealed multiple potential reasons for nonreceipt of TF-EBPs including referral to other PTSD treatments, other clinical priorities, poor engagement in care, practical barriers, negative beliefs, and receipt of care in other settings. Eight veterans (13%) initiated TF-EBPs. Further interventions to promote engagement in PTSD treatment are warranted.

What works for you? Using teacher feedback to inform adaptations of pivotal response training for classroom use.

PubMed

Stahmer, Aubyn C; Suhrheinrich, Jessica; Reed, Sarah; Schreibman, Laura

2012-01-01

Several evidence-based practices (EBPs) have been identified as efficacious for the education of students with autism spectrum disorders (ASD). However, effectiveness research has rarely been conducted in schools and teachers express skepticism about the clinical utility of EBPs for the classroom. Innovative methods are needed to optimally adapt EBPs for community use. This study utilizes qualitative methods to identify perceived benefits and barriers of classroom implementation of a specific EBP for ASD, Pivotal Response Training (PRT). Teachers' perspectives on the components of PRT, use of PRT as a classroom intervention strategy, and barriers to the use of PRT were identified through guided discussion. Teachers found PRT valuable; however, they also found some components challenging. Specific teacher recommendations for adaptation and resource development are discussed. This process of obtaining qualitative feedback from frontline practitioners provides a generalizable model for researchers to collaborate with teachers to optimally promote EBPs for classroom use.

Development and feasibility of a sibling intervention for youth in foster care.

PubMed

Kothari, Brianne H; McBeath, Bowen; Lamson-Siu, Emilie; Webb, Sara Jade; Sorenson, Paul; Bowen, Hannah; Waid, Jeff; Bank, Lew

2014-12-01

Due to their ubiquity and possible influence on youth mental health, academic, and other outcomes, sibling-focused intervention strategies may be important for the development and implementation of evidence-based practices (EBPs) in child welfare. However, there is no rigorous evidence as to either the best methods for, or feasibility of, incorporating the sibling link within existing clinical treatments for foster youth. This paper applies the literature on evidence-based practices (EBP) and implementation research in child welfare to sibling-focused intervention; and presents data concerning the development, delivery, cost, and feasibility of a novel sibling-focused intervention program, Supporting Siblings in Foster Care (SIBS-FC). Results suggest that despite the challenges and costs involved with delivering SIBS-FC, the program catered to the diverse needs of pre-adolescent and adolescent siblings living together and apart, was viewed positively by youth, and was implemented with a high degree of fidelity. These findings underscore the importance of attending to the early-stage development of psychosocial interventions in child welfare and highlight the role of interagency collaboration, program planning, staff training and supervision, and fidelity tracking for EBP development in child welfare. Implications for prevention research and sibling-focused intervention programming in child welfare are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Paraprofessional Implementation of Evidence-Based Practices for Special Education Students

ERIC Educational Resources Information Center

Bubb-McKinnie, Esther

2017-01-01

Paraprofessionals often constitute the primary support system for special education students and are core members of special education instructional teams. Therefore, the Individuals With Disabilities Education Act requires that paraprofessionals receive adequate training, including training in evidence-based practices (EBP). However,…

Testing use of payers to facilitate evidence-based practice adoption: protocol for a cluster-randomized trial

PubMed Central

2013-01-01

Background More effective methods are needed to implement evidence-based findings into practice. The Advancing Recovery Framework offers a multi-level approach to evidence-based practice implementation by aligning purchasing and regulatory policies at the payer level with organizational change strategies at the organizational level. Methods The Advancing Recovery Buprenorphine Implementation Study is a cluster-randomized controlled trial designed to increase use of the evidence-based practice buprenorphine medication to treat opiate addiction. Ohio Alcohol, Drug Addiction, and Mental Health Services Boards (ADAMHS), who are payers, and their addiction treatment organizations were recruited for a trial to assess the effects of payer and treatment organization changes (using the Advancing Recovery Framework) versus treatment organization changes alone on the use of buprenorphine. A matched-pair randomization, based on county characteristics, was applied, resulting in seven county ADAMHS boards and twenty-five treatment organizations in each arm. Opioid dependent patients are nested within cluster (treatment organization), and treatment organization clusters are nested within ADAMHS county board. The primary outcome is the percentage of individuals with an opioid dependence diagnosis who use buprenorphine during the 24-month intervention period and the 12-month sustainability period. The trial is currently in the baseline data collection stage. Discussion Although addiction treatment providers are under increasing pressure to implement evidence-based practices that have been proven to improve patient outcomes, adoption of these practices lags, compared to other areas of healthcare. Reasons frequently cited for the slow adoption of EBPs in addiction treatment include, regulatory issues, staff, or client resistance and lack of resources. Yet the way addiction treatment is funded, the payer’s role—has not received a lot of attention in research on EBP adoption. This research is unique because it investigates the role of payers in evidence-based practice implementation using a randomized controlled design instead of case examples. The testing of the Advancing Recovery Framework is designed to broaden the understanding of the impact payers have on evidence-based practice (EBP) adoption. Trial registration http://NCT01702142 (ClinicalTrials.gov registry, USA) PMID:23663749

Connecting Education to Quality: Engaging Medical Students in the Development of Evidence-Based Clinical Decision Support Tools.

PubMed

Crabtree, Elizabeth A; Brennan, Emily; Davis, Amanda; Squires, Jerry E

2017-01-01

Evidence-based practice (EBP) skills are crucial for delivering high-quality patient care. It is essential that medical students learn EBP concepts through a practical, in-depth research project. To date, literature on preparing students in this manner is limited. In academic year 2014-2015, the Medical University of South Carolina's (MUSC's) Center for Evidence-Based Practice (now known as the Value Institute) partnered with College of Medicine faculty to revitalize the undergraduate medical student EBP curriculum. Without adding to the number of the lecture hours, the curriculum was restructured to be more process driven, project based, and clinically relevant. The resulting yearlong EBP course partnered small teams of medical students with interprofessional clinical teams to engage the students in developing evidence-based clinical decision support tools. The content developed during the EBP projects is currently being used to develop evidence-based clinical practice guidelines and accompanying order sets. It is likely that this model will serve as a new framework for guideline development and will greatly expand the breadth of evidence-based content currently produced and available for clinicians at the MUSC. It would be feasible to offer a similar course within the MUSC to other disciplines and colleges, or at other institutions, if there were support from administration, interest on the part of clinicians and medical faculty, and individuals with the required expertise available to develop the curriculum and facilitate the course. It is worth considering how to improve the course and evaluating opportunities to implement it within other settings.

Field Supervisor Perspectives on Evidence-Based Practice: Familiarity, Feasibility, and Implementation

ERIC Educational Resources Information Center

Heffernan, Kristin; Dauenhauer, Jason

2017-01-01

The Council on Social Work Education has designated field education as social work's signature pedagogy, putting field supervisors in a key role of preparing students as competent social workers. This study examined field supervisors' Evidence Based Practice (EBP) behaviors using a modified version of the Evidence-Based Practice Process Assessment…

Promoting Best Practices regarding Exertional Heat Stroke: A Perspective from the Team Physician

ERIC Educational Resources Information Center

Mazerolle, Stephanie M.; Pagnotta, Kelly D.; McDowell, Lindsey; Casa, Douglas J.; Armstrong, Lawrence

2012-01-01

Context: Knowing the team physician's perspective regarding the use of evidence-based practice (EBP) for treatment of exertional heat stroke (EHS) may help increase the number of athletic trainers (ATs) implementing best practices and avoiding the use of improper assessment tools and treatment methods. Objective: To ascertain team physicians'…

Teaching Evidence-Based Practice (EBP) to Speech-Language Therapy Students: Are Students Competent and Confident EBP Users?

ERIC Educational Resources Information Center

Spek, B.; Wieringa-de Waard, M.; Lucas, C.; van Dijk, N.

2013-01-01

Background: The importance and value of the principles of evidence-based practice (EBP) in the decision-making process is recognized by speech-language therapists (SLTs) worldwide and as a result curricula for speech-language therapy students incorporated EBP principles. However, the willingness actually to use EBP principles in their future…

Organizational Implementation of Evidence-Based Substance Abuse Treatment in Racial and Ethnic Minority Communities

PubMed Central

He, Amy; Kim, Ahraemi; Aarons, Gregory A.

2013-01-01

We evaluated organizational factors associated with the implementation of contingency management treatment (CMT) and medication-assisted treatment (MAT) in substance abuse treatment (SAT) programs serving racial and ethnic minority communities. Analysis of cross-sectional data collected in 2010–2011 from a random sample of 148 publicly funded SAT programs showed that accepting private insurance was positively associated with CMT and MAT implementation, whereas larger programs were associated with greater implementation of MAT. Supervisorial openness to and expectations about implementing evidence-based practices (EBPs) and attributes for change were strongly associated with CMT, whereas the interactions between openness to EBPs and programs that accept private insurance and that are governed by parent organizations were positively associated with MAT. These external expectations and managerial attitudes supported the implementation of psychosocial and pharmacotherapy treatments in SAT. Implications for improving standards of care in minority communities are discussed. PMID:24046236

Teaching Evidence-Based Practice

ERIC Educational Resources Information Center

Mullen, Edward J.; Bellamy, Jennifer L.; Bledsoe, Sarah E.; Francois, Julia Jean

2007-01-01

A complete and mindfully developed blueprint for implementing evidence-based practice (EBP) in social work should include a full complement of coordinated goals and strategies for all stakeholders, including future social workers. To this end, schools of social work should teach students to be lifelong learners; teach students what is currently…

District Capacity and the Implementation of Positive Behavior Interventions and Supports: An Exploratory Study

ERIC Educational Resources Information Center

Blakely, Allison Wright

2017-01-01

The purpose of this study was to examine the relation between "district capacity" as measured by the District Capacity Assessment (DCA) and the "initial, depth, scale," and "sustained" implementation of an evidence-based practice (EBP), Positive Behavior Interventions and Supports (PBIS). This exploratory analysis…

Icelandic Physical Therapists' Attitudes Toward Adoption of New Knowledge and Evidence-Based Practice: Cross-Sectional Web-Based Survey.

PubMed

Arnadottir, Solveig A; Gudjonsdottir, Bjorg

2016-11-01

A positive attitude toward evidence-based practice (EBP) has been identified as an important factor in the effectiveness of the dissemination and implementation of EBP in real-world settings. The objectives of this study were: (1) to describe dimensions of Icelandic physical therapists' attitudes toward the adoption of new knowledge and EBP and (2) to explore the association between attitudes and selected personal and environmental factors. This study was a cross-sectional, Web-based survey of the total population of full members of the Icelandic Physiotherapy Association. The Evidence-Based Practice Attitude Scale (EBPAS) was used to survey attitudes toward EBP; the total EBPAS and its 4 subscales (requirements, appeal, openness, and divergence) were included. Linear regression was used to explore the association between the EBPAS and selected background variables. The response rate was 39.5% (N=211). The total EBPAS and all of its subscales reflected physical therapists' positive attitudes toward the adoption of new knowledge and EBP. Multivariable analysis revealed that being a woman was associated with more positive attitudes, as measured by the total EBPAS and the requirements, openness, and divergence subscales. Physical therapists with postprofessional education were more positive, as measured by the EBPAS openness subscale, and those working with at least 10 other physical therapists demonstrated more positive attitudes on the total EBPAS and the openness subscale. Because this was a cross-sectional survey, no causal inferences can be made, and there may have been unmeasured confounding factors. Potential nonresponse bias limits generalizability. The results expand understanding of the phenomenon of attitudes toward EBP. They reveal potentially modifiable dimensions of attitudes and the associated characteristics of physical therapists and their work environments. The findings encourage investigation of the effectiveness of strategies aimed at influencing various dimensions of attitudes toward EBP. © 2016 American Physical Therapy Association.

Validation of the Evidence-Based Practice Process Assessment Scale

ERIC Educational Resources Information Center

Rubin, Allen; Parrish, Danielle E.

2011-01-01

Objective: This report describes the reliability, validity, and sensitivity of a scale that assesses practitioners' perceived familiarity with, attitudes of, and implementation of the evidence-based practice (EBP) process. Method: Social work practitioners and second-year master of social works (MSW) students (N = 511) were surveyed in four sites…

Learning before leaping: integration of an adaptive study design process prior to initiation of BetterBirth, a large-scale randomized controlled trial in Uttar Pradesh, India.

PubMed

Hirschhorn, Lisa Ruth; Semrau, Katherine; Kodkany, Bhala; Churchill, Robyn; Kapoor, Atul; Spector, Jonathan; Ringer, Steve; Firestone, Rebecca; Kumar, Vishwajeet; Gawande, Atul

2015-08-14

Pragmatic and adaptive trial designs are increasingly used in quality improvement (QI) interventions to provide the strongest evidence for effective implementation and impact prior to broader scale-up. We previously showed that an on-site coaching intervention focused on the World Health Organization Safe Childbirth Checklist (SCC) improved performance of essential birth practices (EBPs) in one facility in Karnataka, India. We report on the process and outcomes of adapting the intervention prior to larger-scale implementation in a randomized controlled trial in Uttar Pradesh (UP), India. Initially, we trained a local team of physicians and nurses to coach birth attendants in SCC use at two public facilities for 4-6 weeks. Trained observers evaluated adherence to EBPs before and after coaching. Using mixed methods and a systematic adaptation process, we modified and strengthened the intervention. The modified intervention was implemented in three additional facilities. Pre/post-change in EBP prevalence aggregated across facilities was analyzed. In the first two facilities, limited improvement was seen in EBPs with the exception of post-partum oxytocin. Checklists were used <25 % of observations. We identified challenges in physicians coaching nurses, need to engage district and facility leadership to address system gaps, and inadequate strategy for motivating SCC uptake. Revisions included change to peer-to-peer coaching (nurse to nurse, physician to physician); strengthened coach training on behavior and system change; adapted strategy for effective leadership engagement; and an explicit motivation strategy to enhance professional pride and effectiveness. These modifications resulted in improvement in multiple EBPs from baseline including taking maternal blood pressure (0 to 16 %), post-partum oxytocin (36 to 97 %), early breastfeeding initiation (3 to 64 %), as well as checklist use (range 32 to 88 %), all p < 0.01. Further adaptations were implemented to increase the effectiveness prior to full trial launch. The adaptive study design of implementation, evaluation, and feedback drove iterative redesign and successfully developed a SCC-focused coaching intervention that improved EBPs in UP facilities. This work was critical to develop a replicable BetterBirth package tailored to the local context. The multi-center pragmatic trial is underway measuring impact of the BetterBirth program on EBP and maternal-neonatal morbidity and mortality. NCT02148952 .

Response to Commentary on Cheng, Broome, Feng, and Hu (2017) Leadership behaviours play a significant role in implementing evidence-based practice. Journal of Clinical Nursing, 2018;27:e1684-e1685.

PubMed

Cheng, Lei; Feng, Sheng; Hu, Yan; Broome, Marion E

2018-06-12

Thank you for the opportunity to respond to Hu and Gifford's comments(Hu & Gifford, 2018). We appreciated their acknowledgement of our findings about the factors influencing the successful implementation of evidence-based practice (EBP). The authors described leadership behaviors as having a significant role in implementing evidence-based practice. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Design, development, and evaluation of printed educational materials for evidence-based practice dissemination.

PubMed

Williams, Jessica R; Caceda-Castro, Lizbeth E; Dusablon, Tracy; Stipa, Melissa

2016-06-01

Printed educational materials (PEMs) are one of the most common dissemination strategies for communicating information about evidence-based practices (EBPs) to healthcare professionals and organizations; however, evidence is conflicting regarding the conditions and circumstances in which PEMs are effective in achieving desired outcomes. The effectiveness of PEMs is largely dependent on the manner in which they are developed. This article reports on the findings from a comprehensive review of the literature regarding best practices for creating PEMs for health professionals and illustrates how these practices were used to design, develop, and evaluate an informational packet to disseminate information about motivational interviewing. The informational packet was disseminated to 92 community health organizations not currently implementing motivational interviewing. Evaluation surveys were completed by 212 healthcare directors and providers to examine quality and perceived helpfulness of the packets, intention to use information from the packet, and sharing of the packet with others. Associations between these and individual and organizational characteristics were also assessed. Overall, the packet was perceived as appropriate and helpful in making a decision to implement motivational interviewing. For example, 84.9% of participants stated that the content was 'about right'. Three-quarters (75.9%) of participants reported plans to use the information in the packet and almost half (46.7%) reported talking about the packet with others in the organizations. Higher levels of baseline interest in motivational interviewing adoption were significantly related to packet use and wanting to utilize additional resources presented in the packet. Positive attitudes toward EBPs were also significantly related to the desire to obtain resources in the packet. Perceptions of the packet did not differ by type of community health organization (i.e., community health center, community behavioral health organization) or whether the individual was a director or provider. Results indicated that PEMs can be a useful tool to disseminate EBP information to healthcare professionals particularly if they have a prior interest in the EBP and have general attitudes supportive of EBPs. Recommendations for the improvement of future PEMs are discussed.

Integrating evidence-based practice into RN-to-BSN clinical nursing education.

PubMed

Oh, Eui Geum; Kim, Sunah; Kim, So Sun; Kim, Sue; Cho, Eun Yong; Yoo, Ji-Soo; Kim, Hee Soon; Lee, Ju Hee; You, Mi Ae; Lee, Hyejung

2010-07-01

This study examines the effects of integrating evidence-based practice (EBP) into clinical practicum on EBP efficacy and barriers to research utilization among Korean RN-to-BSN students. A one-group pretest-posttest design was used. Eighty-one students were recruited from a school of nursing in Korea. Evidence-based practice clinical practicum was composed of two consecutive programs during one semester. Lectures, individual mentoring on EBP practicum, small group, and wrap-up conferences were provided. Outcomes of EBP efficacy and barriers to research utilization were analyzed using paired t tests for 74 final participants. Evidence-based practice efficacy scores increased significantly (p < 0.05), and the barriers to research utilization scores decreased significantly after the EBP clinical practicum. The results highlight the effectiveness of EBP education among RN-to-BSN students. These results may help health educators develop effective educational strategies to integrate EBP concepts into a clinical practicum. Copyright 2010, SLACK Incorporated.

A survey of Australian chiropractors' attitudes and beliefs about evidence-based practice and their use of research literature and clinical practice guidelines.

PubMed

Walker, Bruce F; Stomski, Norman J; Hebert, Jeff J; French, Simon D

2013-12-17

Research into chiropractors' use of evidence in clinical practice appears limited to a single small qualitative study. The paucity of research in this area suggests that it is timely to undertake a more extensive study to build a more detailed understanding of the factors that influence chiropractors' adoption of evidence-based practice (EBP) principles. This study aimed to identify Australian chiropractors' attitudes and beliefs towards EBP in clinical practice, and also examine their use of research literature and clinical practice guidelines. We used an online questionnaire about attitudes, beliefs and behaviours towards the use of EBP in clinical practice that had been developed to survey physiotherapists and modified it to ensure that it was relevant to chiropractic practice. We endeavoured to survey all registered Australian chiropractors (n = 4378) via email invitation distributed by Australian chiropractic professional organisations and the Chiropractic Board of Australia. Logistic regression analyses were conducted to examine univariate associations between responses to items measuring attitudes and beliefs with items measuring: age; years since registration; attention to literature; and use of clinical practice guidelines. Questionnaires were returned by 584 respondents (response rate approximately 13%). The respondents' perceptions of EBP were generally positive: most agreed that the application of EBP is necessary (77.9%), literature and research findings are useful (80.2%), EBP helps them make decisions about patient care (66.5%), and expressed an interest in learning or improving EBP skills (74.9%). Almost half of the respondents (45.1%) read between two to five articles a month. Close to half of the respondents (44.7%) used literature in the process of clinical decision making two to five times each month. About half of the respondents (52.4%) agreed that they used clinical practice guidelines, and around half (54.4%) agreed that they were able to incorporate patient preferences with clinical practice guidelines. The most common factor associated with increased research uptake was the perception that EBP helps make decisions about patient care. Most Australian chiropractors hold positive attitudes towards EBP, thought EBP was useful, and were interested in improving EBP skills. However, despite the favourable inclination towards EBP, many Australian chiropractors did not use clinical practice guidelines. Our findings should be interpreted cautiously due to the low response rate.

Using a Theory-guided Learning Collaborative Model to Improve Implementation of EBPs in a State Children’s Mental Health System: A Pilot Study

PubMed Central

Nadeem, Erum; Weiss, Dara; Olin, S. Serene; Hoagwood, Kimberly E.; Horwitz, Sarah M.

2016-01-01

Learning collaboratives (LCs) are used widely to promote implementation of evidence-based practices (EBPs). However, there has been limited research on the effectiveness of LCs and models vary widely in their structure, focus and components. The goal of the present study was to develop and field test a theory-based LC model to augment a state-led, evidence-based training program for clinicians providing mental health services to children. Analysis of implementation outcomes contrasted LC sites to matched comparison sites that participated in the clinical training program alone. Results suggested that clinicians from sites participating in the LC were more highly engaged in the state-led clinical training program and were more likely to complete program requirements. PMID:27167744

State Adoption of Incentives to Promote Evidence-Based Practices in Behavioral Health Systems.

PubMed

Stewart, Rebecca E; Marcus, Steven C; Hadley, Trevor R; Hepburn, Brian M; Mandell, David S

2018-06-01

Despite the critical role behavioral health care payers can play in creating an incentive to use evidence-based practices (EBPs), little research has examined which incentives are used in public mental health systems, the largest providers of mental health care in the United States. The authors surveyed state mental health directors from 44 states about whether they used any of seven strategies to increase the use of EBPs. Participants also ranked attributes of each incentive on the basis of key characteristics of diffusion of innovation theory (perceived advantage, simplicity, compatibility, observability, and gradually implementable) and perceived effectiveness. Almost three-quarters of state directors endorsed using at least one financial incentive; most paid for training and technical assistance. Few used other incentives. Strategies perceived as simple and compatible were more readily adopted. Enhanced rates and paying for better outcomes were perceived as the most effective but were the least deployed, suggesting that simplicity and organizational compatibility may be the most decisive factors when choosing incentives. Payers are not using the incentives they perceive as most effective, and they are mostly using only one strategy for reasons of simplicity and compatibility. Future work should focus on barriers to measurement that likely hinder the adoption and implementation of paying for better outcomes and enhanced reimbursement rates, with the ultimate goal of measuring the effectiveness of incentives on EBP implementation efforts.

National Study of Nursing Research Characteristics at Magnet®-Designated Hospitals.

PubMed

Pintz, Christine; Zhou, Qiuping Pearl; McLaughlin, Maureen Kirkpatrick; Kelly, Katherine Patterson; Guzzetta, Cathie E

2018-05-01

To describe the research infrastructure, culture, and characteristics of building a nursing research program in Magnet®-designated hospitals. Magnet recognition requires hospitals to conduct research and implement evidence-based practice (EBP). Yet, the essential characteristics of productive nursing research programs are not well described. We surveyed 181 nursing research leaders at Magnet-designated hospitals to assess the characteristics in their hospitals associated with research infrastructure, research culture, and building a nursing research program. Magnet hospitals provide most of the needed research infrastructure and have a culture that support nursing research. Higher scores for the 3 categories were found when hospitals had a nursing research director, a research department, and more than 10 nurse-led research studies in the past 5 years. While some respondents indicated their nurse executives and leaders support the enculturation of EBP and research, there continue to be barriers to full implementation of these characteristics in practice.

An RCT of an Evidence-Based Practice Teaching Model with the Field Instructor

ERIC Educational Resources Information Center

Tennille, Julie Anne

2013-01-01

Problem: Equipping current and future social work practitioners with skills to deliver evidence-based practice (EBP) has remained an elusive prospect since synchronized efforts with field instructors have not been a consistent part of dissemination and implementation efforts. Recognizing the highly influential position of field instructors, this…

Development and Validation of the Evidence-Based Practice Process Assessment Scale: Preliminary Findings

ERIC Educational Resources Information Center

Rubin, Allen; Parrish, Danielle E.

2010-01-01

Objective: This report describes the development and preliminary findings regarding the reliability, validity, and sensitivity of a scale that has been developed to assess practitioners' perceived familiarity with, attitudes about, and implementation of the phases of the evidence-based practice (EBP) process. Method: After a panel of national…

Interdisciplinary Evidence-based Practice: Moving from Silos to Synergy

PubMed Central

Newhouse, Robin P.; Spring, Bonnie

2010-01-01

Despite the assumption that health care providers work synergistically in practice, professions have tended to be more exclusive than inclusive when it comes to educating students in a collaborative approach to interdisciplinary evidence-based practice (EBP). This article explores the state of academic and clinical training regarding interdisciplinary EBP, describes efforts to foster interdisciplinary EBP, and suggests strategies to accelerate the translation of EBP across disciplines. Moving from silos to synergy in interdisciplinary EBP will require a paradigm shift. Changes can be leveraged professionally and politically using national initiatives currently in place on improving quality and health care reform. PMID:21074648

Adoption of Evidence-Based Practices Among Substance Abuse Treatment Providers*

PubMed Central

Haug, Nancy A.; Shopshire, Michael; Tajima, Barbara; Gruber, Valerie; Guydish, Joseph

2009-01-01

This research was conducted at a Substance Abuse Forum designed to address local community needs by focusing on Evidence-Based Practices (EBPs) in addiction treatment. The purpose of the study was to assess substance abuse treatment professionals’ readiness to adopt EBPs, experience with EBPs, and attitudes toward EBPs, as well as agency support for EBPs. A total of 119 addiction treatment providers completed pre-test measures, and 82% completed a post-test. Eighty-three percent of participants reported using some EBPs in the past year, and 75% reported currently using EBPs. Participants who were currently licensed or certified in addictions had less negative attitudes toward EBPs than those without credentials. While respondents reported agency support for EBPs, most expressed interest in further training. This study underscores the movement toward EBPs in addiction treatment and the need for effective dissemination and training in this area. PMID:18724657

Exploring Nurse Manager Support of Evidence-Based Practice: Clinical Nurse Perceptions.

PubMed

Caramanica, Laura; Spiva, LeeAnna

2018-05-01

The study identifies what constitutes nurse manager (NM) support and other resources that enable clinical nurses (CNs) to engage in evidence-based practice (EBP). Clinical nurses report that NM support enables them to use EBP but what constitutes NM support is still unclear. Nurse managers, CNs, and EBP mentors received specialized education and use a team approach for EBP. Data were collected preintervention, mid-intervention, and postintervention from observations, interviews, journaling, and surveys. Results demonstrate how NMs can perform their role responsibilities and still engage CNs to develop a spirit of inquiry, seek answers to their clinical questions using EBP, and advance their clinical performance to improve patient outcomes. Four NM supportive behaviors emerged: cultivating a shared EBP vision, ensuring use of EBP, communicating the value of EBP, and providing resources for EBP. Through education and support, NMs describe supportive behaviors necessary for the successful conduction of EBP by CNs.

Evidence-based practice knowledge, attitudes, and practice of online graduate nursing students.

PubMed

Rojjanasrirat, Wilaiporn; Rice, Jan

2017-06-01

This study aimed to evaluate changes in evidence-based practice (EBP) knowledge, attitudes, and practice of nursing students before and after completing an online, graduate level, introductory research/EBP course. A prospective one-group pretest-posttest design. A private university in the Midwestern, USA. Sixty-three online nurse practitioner students in Master's program. A convenient sample of online graduate nursing students who enrolled in the research/EBP course was invited to participate in the study. Study outcomes were measured using the Evidence-Based Practice Questionnaire (EBPQ) before and after completing the course. Descriptive statistics and paired-Samples t-test was used to assess the mean differences between pre-and post-test scores. Overall, students' post-test EBP scores were significantly improved over pre-test scores, t(63)=-9.034, p<0.001). Statistically significant differences were found for practice of EBP mean scores t(63)=-12.78, p=0.001). No significant differences were found between pre and post-tests on knowledge and attitudes toward EBP scores. Most frequently cited barriers to EBP were lack of understanding of statistics, interpretation of findings, lack of time, and lack of library resources. Copyright © 2017 Elsevier Ltd. All rights reserved.

Self-reported attitudes, skills and use of evidence-based practice among Canadian doctors of chiropractic: a national survey

PubMed Central

Bussières, André E.; Terhorst, Lauren; Leach, Matthew; Stuber, Kent; Evans, Roni; Schneider, Michael J.

2015-01-01

Objectives: To identify Canadian chiropractors’ attitudes, skills and use of evidence based practice (EBP), as well as their level of awareness of previously published chiropractic clinical practice guidelines (CPGs). Methods: 7,200 members of the Canadian Chiropractic Association were invited by e-mail to complete an online version of the Evidence Based practice Attitude & utilisation SurvEy (EBASE); a valid and reliable measure of participant attitudes, skills and use of EBP. Results: Questionnaires were completed by 554 respondents. Most respondents (>75%) held positive attitudes toward EBP. Over half indicated a high level of self-reported skills in EBP, and over 90% expressed an interest in improving these skills. A majority of respondents (65%) reported over half of their practice was based on evidence from clinical research, and only half (52%) agreed that chiropractic CPGs significantly impacted on their practice. Conclusions: While most Canadian chiropractors held positive attitudes towards EBP, believed EBP was useful, and were interested in improving their skills in EBP, many did not use research evidence or CPGs to guide clinical decision making. Our findings should be interpreted cautiously due to the low response rate. PMID:26816412

Can Nursing Students Practice What Is Preached? Factors Impacting Graduating Nurses' Abilities and Achievement to Apply Evidence-Based Practices.

PubMed

Blackman, Ian R; Giles, Tracey M

2017-04-01

In order to meet national Australian nursing registration requisites, nurses need to meet competency requirements for evidence-based practices (EBPs). A hypothetical model was formulated to explore factors that influenced Australian nursing students' ability and achievement to understand and employ EBPs related to health care provision. A nonexperimental, descriptive survey method was used to identify self-reported EBP efficacy estimates of 375 completing undergraduate nursing students. Factors influencing participants' self-rated EBP abilities were validated by Rasch analysis and then modeled using the partial least squares analysis (PLS Path) program. Graduating nursing students' ability to understand and apply EBPs for clinical improvement can be directly and indirectly predicted by eight variables including their understanding in the analysis, critique and synthesis of clinically based nursing research, their ability to communicate research to others and whether they had actually witnessed other staff delivering EBP. Forty-one percent of the variance in the nursing students' self-rated EBP efficacy scores is able to be accounted for by this model. Previous exposure to EBP studies facilitates participants' confidence with EBP, particularly with concurrent clinical EBP experiences. © 2017 Sigma Theta Tau International.

Development and psychometric testing of a trans-professional evidence-based practice profile questionnaire.

PubMed

McEvoy, Maureen Patricia; Williams, Marie T; Olds, Timothy Stephen

2010-01-01

Previous survey tools operationalising knowledge, attitudes or beliefs about evidence-based practice (EBP) have shortcomings in content, psychometric properties and target audience. This study developed and psychometrically assessed a self-report trans-professional questionnaire to describe an EBP profile. Sixty-six items were collated from existing EBP questionnaires and administered to 526 academics and students from health and non-health backgrounds. Principal component factor analysis revealed the presence of five factors (Relevance, Terminology, Confidence, Practice and Sympathy). Following expert panel review and pilot testing, the 58-item final questionnaire was disseminated to 105 subjects on two occasions. Test-retest and internal reliability were quantified using intra-class correlation coefficients (ICCs) and Cronbach's alpha, convergent validity against a commonly used EBP questionnaire by Pearson's correlation coefficient and discriminative validity via analysis of variance (ANOVA) based on exposure to EBP training. The final questionnaire demonstrated acceptable internal consistency (Cronbach's alpha 0.96), test-retest reliability (ICCs range 0.77-0.94) and convergent validity (Practice 0.66, Confidence 0.80 and Sympathy 0.54). Three factors (Relevance, Terminology and Confidence) distinguished EBP exposure groups (ANOVA p < 0.001-0.004). The evidence-based practice profile (EBP(2)) questionnaire is a reliable instrument with the ability to discriminate for three factors, between respondents with differing EBP exposures.

A qualitative study examining methods of accessing and identifying research relevant to clinical practice among rehabilitation clinicians.

PubMed

Patel, Drasti; Koehmstedt, Christine; Jones, Rebecca; Coffey, Nathan T; Cai, Xinsheng; Garfinkel, Steven; Shaewitz, Dahlia M; Weinstein, Ali A

2017-01-01

Research examining the utilization of evidence-based practice (EBP) specifically among rehabilitation clinicians is limited. The objective of this study was to examine how various rehabilitative clinicians including physical therapists, occupational therapists, rehabilitation counselors, and physiatrists are gaining access to literature and whether they are able to implement the available research into practice. A total of 21 total clinicians were interviewed via telephone. Using NVivo, a qualitative analysis of the responses was performed. There were similarities found with respect to the information-seeking behaviors and translation of research across the different clinician types. Lack of time was reported to be a barrier for both access to literature and implementation of research across all clinician types. The majority of clinicians who reported having difficulty with utilizing the published literature indicated that the literature was not applicable to their practice, the research was not specific enough to be put into practice, or the research found was too outdated to be relevant. In addition, having a supportive work environment aided in the search and utilization of research through providing resources central to assisting clinicians in gaining access to health information. Our study identified several barriers that affect EBP for rehabilitation clinicians. The findings suggest the need for researchers to ensure that their work is applicable and specific to clinical practice for implementation to occur.

Enhancing Quality Interventions Promoting Healthy Sexuality (EQUIPS): A Novel Application of Translational Research Methods

PubMed Central

Acosta, Joie; Ebener, Patricia; Driver, Jennifer; Keith, Jamie; Peebles, Dana

2013-01-01

Abstract Translational research is expanding, in part, because Evidence‐Based Programs or Practices (EBPs) are not adopted in many medical domains. However, little translational research exists on EBPs that are prevention programs delivered in nonclinical, community‐based settings. These organizations often have low capacity, which undermines implementation quality and outcomes. Rigorous translational research is needed in these settings so within a single study, capacity, implementation quality, and outcomes are measured and links between them tested. This paper overviews the study Enhancing Quality Interventions Promoting Healthy Sexuality (EQUIPS), which tests how well a community‐based setting (Boys & Girls Clubs) conducts an EBP called Making Proud Choices that aims to prevent teen pregnancy and sexually transmitted infections, with and without an implementation support intervention called Getting To Outcomes. The study design is novel as it assesses: Getting To Outcomes’ impact on capacity, implementation quality, and outcomes simultaneously and in both study conditions; will assess sustainability by measuring capacity and fidelity a year after the Getting To Outcomes support ends; and will operate on a large scale similar to many national initiatives. Many studies have not incorporated all these elements and thus EQUIPS could serve as a model for translational research in many domains. PMID:23751031

Psychometric analysis of two new scales: the evidence-based practice nursing leadership and work environment scales.

PubMed

Pryse, Yvette; McDaniel, Anna; Schafer, John

2014-08-01

Those in nursing have been charged with practicing to the full extent of their education and training by the Institute of Medicine. Therefore, evidence-based practice (EBP) has never been more important to nursing than in the current healthcare environment. Frequently the burden of EBP is the responsibility of the bedside practitioner, but has been found to be a process that requires leadership and organizational support. A key underlying component of a strong EBP environment includes effective communications and collaboration among staff and nursing leadership. Developing measurement tools that examine the milieu and nursing leadership in which the staff nurse practices is an important component of understanding the factors that support or hinder EBP. The aim of this study is to report on the development and analysis of two new scales designed to explore leadership and organizational support for EBP. The EBP Nursing Leadership Scale (10 items) examines the staff nurses perception of support provided by the nurse manager for EBP, and the EBP Work Environment Scale (8 items) examines organizational support for EBP. Staff nurses who worked at least .5 FTE in direct patient care, from two inner city hospitals (n = 422) completed the scales. The scales were evaluated for internal consistency reliability with the Cronbach alpha technique, content validity using a panel of experts, and construct validity by The content validity index computed from expert rankings was .78 to 1.0 with an average of.96. Cronbach's alpha was .96 (n = 422) for the EBP Nursing Leadership Scale and .86 (n = 422) for the EBP Work Environment Scale. Factor analysis confirmed that each scale measured a unidimensional construct (p < .000). The EBP Nursing Leadership Scale and the EBP Work Environment Scale are psychometrically sound instruments to examine organizational influences on EBP. © 2014 Sigma Theta Tau International.

iPadagogy 101: Using Clinical ORthopedic Exam (C.O.R.E.) to Facilitate Evidence-Based Practice in the Orthopaedic Evaluation Classroom

ERIC Educational Resources Information Center

Hamson-Utley, J. Jordan; Stiller-Ostrowski, Jennifer L.

2013-01-01

Evidence-based practice (EBP) and educational technology have become fundamental skills within athletic training programs. The objective of this article is to share experiences implementing clinical orthopaedic evaluation applications ("apps") that can be integrated into classroom and clinical education to enhance students' proficiency…

Promoting Evidence-Based Practices: The Adoption of a Prevention Support System in Community Settings

ERIC Educational Resources Information Center

Hunter, Sarah B.; Paddock, Susan M.; Ebener, Patricia; Burkhart, A. K.; Chinman, Matthew

2009-01-01

Prevention support systems (PSSs) are designed to help communities implement evidence-based practices (EBPs). Little is known about the factors that influence their adoption. In this article, we examined adoption of a PSS for substance abuse prevention called Getting To Outcomes (GTO)[R] among staff in two community coalitions with varying levels…

Using Conjoint Behavioral Consultation to Implement Evidence-Based Practices for Students in Low-Income Urban Schools

ERIC Educational Resources Information Center

Garbacz, S. Andrew; Watkins, Natasha D.; Diaz, Yamalis; Barnabas, Ernesto R., Jr.; Schwartz, Billie; Eiraldi, Ricardo

2017-01-01

The purpose of this paper is to demonstrate how Conjoint Behavioral Consultation (CBC) can be used by school behavioral health programs within the Interactive Systems Framework (ISF) as a tool for developing and supporting intervention plans that integrate mental health evidence-based practices (EBPs). External behavioral health consultants…

Employing Policy and Purchasing Levers to Increase the Use of Evidence-Based Practices in Community-Based Substance Abuse Treatment Settings: Reports from Single State Authorities

ERIC Educational Resources Information Center

Rieckmann, Traci R.; Kovas, Anne E.; Cassidy, Elaine F.; McCarty, Dennis

2011-01-01

State public health authorities are critical to the successful implementation of science based addiction treatment practices by community-based providers. The literature to date, however, lacks examples of state level policy strategies that promote evidence-based practices (EBPs). This mixed-methods study documents changes in two critical…

Beliefs, Knowledge, Implementation, and Integration of Evidence-Based Practice Among Primary Health Care Providers: Protocol for a Scoping Review.

PubMed

Pereira, Filipa; Salvi, Mireille; Verloo, Henk

2017-08-01

The adoption of evidence-based practice (EBP) is promoted because it is widely recognized for improving the quality and safety of health care for patients, and reducing avoidable costs. Providers of primary care face numerous challenges to ensuring the effectiveness of their daily practices. Primary health care is defined as: the entry level into a health care services system, providing a first point of contact for all new needs and problems; patient-focused (not disease-oriented) care over time; care for all but the most uncommon or unusual conditions; and coordination or integration of care, regardless of where or by whom that care is delivered. Primary health care is the principal means by which to approach the main goal of any health care services system: optimization of health status. This review aims to scope publications examining beliefs, knowledge, implementation, and integration of EBPs among primary health care providers (HCPs). We will conduct a systematic scoping review of published articles in the following electronic databases, from their start dates until March 31, 2017: Medical Literature Analysis and Retrieval System Online (MEDLINE) via PubMed (from 1946), Embase (from 1947), Cumulative Index to Nursing and Allied Health Literature (CINAHL; from 1937), the Cochrane Central Register of Controlled Trials (CENTRAL; from 1992), PsycINFO (from 1806), Web of Science (from 1900), Joanna Briggs Institute (JBI) database (from 1998), Database of Abstracts of Reviews of Effects (DARE; from 1996), Trip medical database (from 1997), and relevant professional scientific journals (from their start dates). We will use the predefined search terms of, "evidence-based practice" and, "primary health care" combined with other terms, such as, "beliefs", "knowledge", "implementation", and "integration". We will also conduct a hand search of the bibliographies of all relevant articles and a search for unpublished studies using Google Scholar, ProQuest, Mednar, and WorldCat. We will consider publications in English, French, Spanish, and Portuguese. The electronic database searches were completed in April 2017. Retrieved articles are currently being screened, and the entire study is expected to be completed by November 2017. This systematic scoping review will provide a greater understanding of the beliefs, knowledge, implementation, and integration of EBPs among primary HCPs. The findings will inform clinical practice and help to draw a global picture of the EBP research topics that are relevant to primary care providers. ©Filipa Pereira, Mireille Salvi, Henk Verloo. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 01.08.2017.

Direct-to-Consumer Marketing: A Complementary Approach to Traditional Dissemination and implementation Efforts for Mental Health and Substance Abuse Interventions.

PubMed

Becker, Sara J

2015-03-01

The overall chasm between those who need treatment for mental health and substance abuse (M/SU) and those who receive effective treatment consists of two, interrelated gaps: the research-to-practice gap and the treatment gap. Prior efforts to disseminate evidence-based practice (EBP) for M/SU have predominantly targeted the research-to-practice gap, by focusing efforts toward treatment providers. This article introduces direct-to-consumer (DTC) marketing that targets patients and caregivers as a complementary approach to existing dissemination efforts. Specific issues discussed include: rationale for DTC marketing based on the concept of push versus pull marketing; overview of key stakeholders involved in DTC marketing; and description of the Marketing Mix planning framework. The applicability of these issues to the dissemination of EBP for M/SU is discussed.

Increasing Psychotherapists’ Adoption and Implementation of the Evidence-based Practice of Progress Monitoring

PubMed Central

Persons, Jacqueline B.; Koerner, Kelly; Eidelman, Polina; Thomas, Cannon; Liu, Howard

2015-01-01

Evidence-based practices (EBPs) reach consumers slowly because practitioners are slow to adopt and implement them. We hypothesized that giving psychotherapists a tool + training intervention that was designed to help the therapist integrate the EBP of progress monitoring into his or her usual way of working would be associated with adoption and sustained implementation of the particular progress monitoring tool we trained them to use (the Depression Anxiety Stress Scales on our Online Progress Tracking tool) and would generalize to all types of progress monitoring measures. To test these hypotheses, we developed an online progress monitoring tool and a course that trained psychotherapists to use it, and we assessed progress monitoring behavior in 26 psychotherapists before, during, immediately after, and 12 months after they received the tool and training. Immediately after receiving the tool + training intervention, participants showed statistically significant increases in use of the online tool and of all types of progress monitoring measures. Twelve months later, participants showed sustained use of any type of progress monitoring measure but not the online tool. PMID:26618237

Increasing psychotherapists' adoption and implementation of the evidence-based practice of progress monitoring.

PubMed

Persons, Jacqueline B; Koerner, Kelly; Eidelman, Polina; Thomas, Cannon; Liu, Howard

2016-01-01

Evidence-based practices (EBPs) reach consumers slowly because practitioners are slow to adopt and implement them. We hypothesized that giving psychotherapists a tool + training intervention that was designed to help the therapist integrate the EBP of progress monitoring into his or her usual way of working would be associated with adoption and sustained implementation of the particular progress monitoring tool we trained them to use (the Depression Anxiety Stress Scales on our Online Progress Tracking tool) and would generalize to all types of progress monitoring measures. To test these hypotheses, we developed an online progress monitoring tool and a course that trained psychotherapists to use it, and we assessed progress monitoring behavior in 26 psychotherapists before, during, immediately after, and 12 months after they received the tool and training. Immediately after receiving the tool + training intervention, participants showed statistically significant increases in use of the online tool and of all types of progress monitoring measures. Twelve months later, participants showed sustained use of any type of progress monitoring measure but not the online tool. Copyright © 2015 Elsevier Ltd. All rights reserved.

Undergraduate Health Students' Intention to Use Evidence-Based Practice After Graduation: A Systematic Review of Predictive Modeling Studies.

PubMed

Ramis, Mary-Anne; Chang, Anne; Nissen, Lisa

2018-04-01

Incorporating evidence-based practice (EBP) into clinical decision making and professional practice is a requirement for many health disciplines, yet research across health disciplines on factors that influence and predict student intention to use EBP following graduation has not been previously synthesized. To synthesize research on factors that influence development of EBP behaviors and subsequently predict undergraduate students' intention toward EBP uptake. A systematic review of prediction modeling studies was conducted according to a protocol previously published on the Prospero database: https://www.crd.york.ac.uk/PROSPERO/. The outcome variable was undergraduate students' future use or intention to use EBP. Evidence synthesis methods were guided by resources from the Cochrane Methods Prognosis Group Web site (https://prognosismethods.cochrane.org). Only three studies were found to meet inclusion criteria for the review. Factors relating to EBP capability, EBP attitudes, as well as clinical and academic support were identified as influential toward students' intention to use evidence in practice. Heterogeneity limited data pooling, consequently, results are presented in narrative and tabular form. Although using a developing method, this review presents a unique contribution to further discussions regarding students' intention to use EBP following graduation. Despite limitations, consideration of identified factors for undergraduate curriculum could support student's intention to use EBP in their respective clinical environments. © 2017 Sigma Theta Tau International.

Social and organizational factors affecting implementation of evidence-informed practice in a public health department in Ontario: a network modelling approach

PubMed Central

2014-01-01

Objective The objective of this study is to develop a statistical model to assess factors associated with information seeking in a Canadian public health department. Methods Managers and professional consultants of a public health department serving a large urban population named whom they turned to for help, whom they considered experts in evidence-informed practice, and whom they considered friends. Multilevel regression analysis and exponential random graph modeling were used to predict the formation of information seeking and expertise-recognition connections by personal characteristics of the seeker and source, and the structural attributes of the social networks. Results The respondents were more likely to recognize the members of the supervisory/administrative division as experts. The extent to which an individual implemented evidence-based practice (EBP) principles in daily practice was a significant predictor of both being an information source and being recognized as expert by peers. Friendship was a significant predictor of both information seeking and expertise-recognition connections. Conclusion The analysis showed a communication network segregated by organizational divisions. Managers were identified frequently as information sources, even though this is not a part of their formal role. Self-perceived implementation of EBP in practice was a significant predictor of being an information source or an expert, implying a positive atmosphere towards implementation of evidence-informed decision making in this public health organization. Results also implied that the perception of accessibility and trust were significant predictors of expertise recognition. PMID:24565228

Consumer preferences and values as an integral key to evidence-based practice.

PubMed

Melnyk, Bernadette Mazurek; Fineout-Overholt, Ellen

2006-01-01

Although evidence-based practice (EBP) integrates the best evidence from well-designed studies with a clinician's expertise and patient preferences and values, most of what is emphasized in books and reports on EBP is the 5-step EBP process. However, the consideration of patient values and preferences in making clinical decisions is essential to deliver the highest quality of care. This article briefly reviews the status of EBP in the United States, described the ARCC mentorship model, and highlights how to engage consumers in the EBP process.

The Implementation Leadership Scale (ILS): development of a brief measure of unit level implementation leadership.

PubMed

Aarons, Gregory A; Ehrhart, Mark G; Farahnak, Lauren R

2014-04-14

In healthcare and allied healthcare settings, leadership that supports effective implementation of evidenced-based practices (EBPs) is a critical concern. However, there are no empirically validated measures to assess implementation leadership. This paper describes the development, factor structure, and initial reliability and convergent and discriminant validity of a very brief measure of implementation leadership: the Implementation Leadership Scale (ILS). Participants were 459 mental health clinicians working in 93 different outpatient mental health programs in Southern California, USA. Initial item development was supported as part of a two United States National Institutes of Health (NIH) studies focused on developing implementation leadership training and implementation measure development. Clinician work group/team-level data were randomly assigned to be utilized for an exploratory factor analysis (n = 229; k = 46 teams) or for a confirmatory factor analysis (n = 230; k = 47 teams). The confirmatory factor analysis controlled for the multilevel, nested data structure. Reliability and validity analyses were then conducted with the full sample. The exploratory factor analysis resulted in a 12-item scale with four subscales representing proactive leadership, knowledgeable leadership, supportive leadership, and perseverant leadership. Confirmatory factor analysis supported an a priori higher order factor structure with subscales contributing to a single higher order implementation leadership factor. The scale demonstrated excellent internal consistency reliability as well as convergent and discriminant validity. The ILS is a brief and efficient measure of unit level leadership for EBP implementation. The availability of the ILS will allow researchers to assess strategic leadership for implementation in order to advance understanding of leadership as a predictor of organizational context for implementation. The ILS also holds promise as a tool for leader and organizational development to improve EBP implementation.

The implementation leadership scale (ILS): development of a brief measure of unit level implementation leadership

PubMed Central

2014-01-01

Background In healthcare and allied healthcare settings, leadership that supports effective implementation of evidenced-based practices (EBPs) is a critical concern. However, there are no empirically validated measures to assess implementation leadership. This paper describes the development, factor structure, and initial reliability and convergent and discriminant validity of a very brief measure of implementation leadership: the Implementation Leadership Scale (ILS). Methods Participants were 459 mental health clinicians working in 93 different outpatient mental health programs in Southern California, USA. Initial item development was supported as part of a two United States National Institutes of Health (NIH) studies focused on developing implementation leadership training and implementation measure development. Clinician work group/team-level data were randomly assigned to be utilized for an exploratory factor analysis (n = 229; k = 46 teams) or for a confirmatory factor analysis (n = 230; k = 47 teams). The confirmatory factor analysis controlled for the multilevel, nested data structure. Reliability and validity analyses were then conducted with the full sample. Results The exploratory factor analysis resulted in a 12-item scale with four subscales representing proactive leadership, knowledgeable leadership, supportive leadership, and perseverant leadership. Confirmatory factor analysis supported an a priori higher order factor structure with subscales contributing to a single higher order implementation leadership factor. The scale demonstrated excellent internal consistency reliability as well as convergent and discriminant validity. Conclusions The ILS is a brief and efficient measure of unit level leadership for EBP implementation. The availability of the ILS will allow researchers to assess strategic leadership for implementation in order to advance understanding of leadership as a predictor of organizational context for implementation. The ILS also holds promise as a tool for leader and organizational development to improve EBP implementation. PMID:24731295

Measuring Clinical Decision Support Influence on Evidence-Based Nursing Practice.

PubMed

Cortez, Susan; Dietrich, Mary S; Wells, Nancy

2016-07-01

To measure the effect of clinical decision support (CDS) on oncology nurse evidence-based practice (EBP).
. Longitudinal cluster-randomized design.
. Four distinctly separate oncology clinics associated with an academic medical center.
. The study sample was comprised of randomly selected data elements from the nursing documentation software. The data elements were patient-reported symptoms and the associated nurse interventions. The total sample observations were 600, derived from a baseline, posteducation, and postintervention sample of 200 each (100 in the intervention group and 100 in the control group for each sample).
. The cluster design was used to support randomization of the study intervention at the clinic level rather than the individual participant level to reduce possible diffusion of the study intervention. An elongated data collection cycle (11 weeks) controlled for temporary increases in nurse EBP related to the education or CDS intervention.
. The dependent variable was the nurse evidence-based documentation rate, calculated from the nurse-documented interventions. The independent variable was the CDS added to the nursing documentation software.
. The average EBP rate at baseline for the control and intervention groups was 27%. After education, the average EBP rate increased to 37%, and then decreased to 26% in the postintervention sample. Mixed-model linear statistical analysis revealed no significant interaction of group by sample. The CDS intervention did not result in an increase in nurse EBP.
. EBP education increased nurse EBP documentation rates significantly but only temporarily. Nurses may have used evidence in practice but may not have documented their interventions.
. More research is needed to understand the complex relationship between CDS, nursing practice, and nursing EBP intervention documentation. CDS may have a different effect on nurse EBP, physician EBP, and other medical professional EBP.

Health Sciences-Evidence Based Practice questionnaire (HS-EBP) for measuring transprofessional evidence-based practice: Creation, development and psychometric validation

PubMed Central

Fernández-Domínguez, Juan Carlos; de Pedro-Gómez, Joan Ernest; Morales-Asencio, José Miguel; Sastre-Fullana, Pedro; Sesé-Abad, Albert

2017-01-01

Introduction Most of the EBP measuring instruments available to date present limitations both in the operationalisation of the construct and also in the rigour of their psychometric development, as revealed in the literature review performed. The aim of this paper is to provide rigorous and adequate reliability and validity evidence of the scores of a new transdisciplinary psychometric tool, the Health Sciences Evidence-Based Practice (HS-EBP), for measuring the construct EBP in Health Sciences professionals. Methods A pilot study and a subsequent two-stage validation test sample were conducted to progressively refine the instrument until a reduced 60-item version with a five-factor latent structure. Reliability was analysed through both Cronbach’s alpha coefficient and intraclass correlations (ICC). Latent structure was contrasted using confirmatory factor analysis (CFA) following a model comparison aproach. Evidence of criterion validity of the scores obtained was achieved by considering attitudinal resistance to change, burnout, and quality of professional life as criterion variables; while convergent validity was assessed using the Spanish version of the Evidence-Based Practice Questionnaire (EBPQ-19). Results Adequate evidence of both reliability and ICC was obtained for the five dimensions of the questionnaire. According to the CFA model comparison, the best fit corresponded to the five-factor model (RMSEA = 0.049; CI 90% RMSEA = [0.047; 0.050]; CFI = 0.99). Adequate criterion and convergent validity evidence was also provided. Finally, the HS-EBP showed the capability to find differences between EBP training levels as an important evidence of decision validity. Conclusions Reliability and validity evidence obtained regarding the HS-EBP confirm the adequate operationalisation of the EBP construct as a process put into practice to respond to every clinical situation arising in the daily practice of professionals in health sciences (transprofessional). The tool could be useful for EBP individual assessment and for evaluating the impact of specific interventions to improve EBP. PMID:28486533

Health Sciences-Evidence Based Practice questionnaire (HS-EBP) for measuring transprofessional evidence-based practice: Creation, development and psychometric validation.

PubMed

Fernández-Domínguez, Juan Carlos; de Pedro-Gómez, Joan Ernest; Morales-Asencio, José Miguel; Bennasar-Veny, Miquel; Sastre-Fullana, Pedro; Sesé-Abad, Albert

2017-01-01

Most of the EBP measuring instruments available to date present limitations both in the operationalisation of the construct and also in the rigour of their psychometric development, as revealed in the literature review performed. The aim of this paper is to provide rigorous and adequate reliability and validity evidence of the scores of a new transdisciplinary psychometric tool, the Health Sciences Evidence-Based Practice (HS-EBP), for measuring the construct EBP in Health Sciences professionals. A pilot study and a subsequent two-stage validation test sample were conducted to progressively refine the instrument until a reduced 60-item version with a five-factor latent structure. Reliability was analysed through both Cronbach's alpha coefficient and intraclass correlations (ICC). Latent structure was contrasted using confirmatory factor analysis (CFA) following a model comparison aproach. Evidence of criterion validity of the scores obtained was achieved by considering attitudinal resistance to change, burnout, and quality of professional life as criterion variables; while convergent validity was assessed using the Spanish version of the Evidence-Based Practice Questionnaire (EBPQ-19). Adequate evidence of both reliability and ICC was obtained for the five dimensions of the questionnaire. According to the CFA model comparison, the best fit corresponded to the five-factor model (RMSEA = 0.049; CI 90% RMSEA = [0.047; 0.050]; CFI = 0.99). Adequate criterion and convergent validity evidence was also provided. Finally, the HS-EBP showed the capability to find differences between EBP training levels as an important evidence of decision validity. Reliability and validity evidence obtained regarding the HS-EBP confirm the adequate operationalisation of the EBP construct as a process put into practice to respond to every clinical situation arising in the daily practice of professionals in health sciences (transprofessional). The tool could be useful for EBP individual assessment and for evaluating the impact of specific interventions to improve EBP.

Endeavoring to Contextualize Curricula Within an EBP Framework: A Grounded Theory Study.

PubMed

Malik, Gulzar; McKenna, Lisa; Griffiths, Debra

2018-01-01

Adopting evidence-based practice (EBP) principles in undergraduate education can facilitate nursing students' appreciation of EBP. Using grounded theory method, this study aimed to explore processes used by nurse academics while integrating EBP concepts in undergraduate nursing curricula across Australian universities. Twenty-three nurse academics were interviewed and nine were observed during teaching of undergraduate students. In addition, 20 unit/subject guides were analyzed using grounded theory approach of data analysis. The theory " On a path to success: Endeavoring to contextualize curricula within an EBP framework" reflects academics' endeavors toward linking EBP concepts to practice, aiming to contextualize curricula in a manner that engages students within an EBP framework. However, academics' journeys were influenced by several contextual factors which require strategies to accomplish their endeavors. In conclusion, initiatives to minimize barriers, faculty development, and provision of resources across educational and clinical settings are fundamental to achieving undergraduate curricula underpinned by EBP concepts.

A unique collaborative nursing evidence-based practice initiative using the Iowa model: a clinical nurse specialist, a health science librarian, and a staff nurse's success story.

PubMed

Krom, Zachary R; Batten, Janene; Bautista, Cynthia

2010-01-01

The purpose of this article was to share how the collaboration of a clinical nurse specialist (CNS), a health science librarian, and a staff nurse can heighten staff nurses' awareness of the evidence-based practice (EBP) process. The staff nurse is expected to incorporate EBP into daily patient care. This expectation is fueled by the guidelines established by professional, accrediting, and regulatory bodies. Barriers to incorporating EBP into practice have been well documented in the literature. A CNS, a health science librarian, and a staff nurse collaborated to develop an EBP educational program for staff nurses. The staff nurse provides the real-time practice issues, the CNS gives extensive knowledge of translating research into practice, and the health science librarian is an expert at retrieving the information from the literature. The resulting collaboration at this academic medical center has increased staff nurse exposure to and knowledge about EBP principles and techniques. The collaborative relationship among the CNS, health science librarian, and staff nurse effectively addresses a variety of barriers to EBP. This successful collaborative approach can be utilized by other medical centers seeking to educate staff nurses about the EBP process.

Social Workers' Orientations toward the Evidence-Based Practice Process: A Comparison with Psychologists and Licensed Marriage and Family Therapists

ERIC Educational Resources Information Center

Parrish, Danielle E.; Rubin, Allen

2012-01-01

This article describes the results from a large, cross-sectional survey of social workers, psychologists, and licensed marriage and family therapists (LMFTs) in Texas (N = 865) regarding their orientation toward and implementation of evidence-based practice (EBP). All social workers were recruited by e-mail using the state NASW Listserv (analysis…

Participatory System Dynamics Modeling: Increasing Stakeholder Engagement and Precision to Improve Implementation Planning in Systems.

PubMed

Zimmerman, Lindsey; Lounsbury, David W; Rosen, Craig S; Kimerling, Rachel; Trafton, Jodie A; Lindley, Steven E

2016-11-01

Implementation planning typically incorporates stakeholder input. Quality improvement efforts provide data-based feedback regarding progress. Participatory system dynamics modeling (PSD) triangulates stakeholder expertise, data and simulation of implementation plans prior to attempting change. Frontline staff in one VA outpatient mental health system used PSD to examine policy and procedural "mechanisms" they believe underlie local capacity to implement evidence-based psychotherapies (EBPs) for PTSD and depression. We piloted the PSD process, simulating implementation plans to improve EBP reach. Findings indicate PSD is a feasible, useful strategy for building stakeholder consensus, and may save time and effort as compared to trial-and-error EBP implementation planning.

Evidence-based speech-language pathology practices in schools: findings from a national survey.

PubMed

Hoffman, Lavae M; Ireland, Marie; Hall-Mills, Shannon; Flynn, Perry

2013-07-01

This study documented evidence-based practice (EBP) patterns as reported by speech-language pathologists (SLPs) employed in public schools during 2010-2011. Using an online survey, practioners reported their EBP training experiences, resources available in their workplaces, and the frequency with which they engage in specific EBP activities, as well as their resource needs and future training format preferences. A total of 2,762 SLPs in 28 states participated in the online survey, 85% of whom reported holding the Certificate of Clinical Competence in Speech-Language Pathology credential. Results revealed that one quarter of survey respondents had no formal training in EBP, 11% of SLPs worked in school districts with official EBP procedural guidelines, and 91% had no scheduled time to support EBP activities. The majority of SLPs posed and researched 0 to 2 EBP questions per year and read 0 to 4 American Speech-Language-Hearing Association (ASHA) journal articles per year on either assessment or intervention topics. Use of ASHA online resources and engagement in EBP activities were documented to be low. However, results also revealed that school-based SLPs have high interest in additional training and resources to support scientifically based practices. Suggestions for enhancing EBP support in public schools and augmenting knowledge transfer are provided.

Pre-Practicum Training in Professional Psychology to Close the Research-Practice Gap: Changing Attitudes Towards Evidence-Based Practice

PubMed Central

Bearman, Sarah Kate; Wadkins, Melanie; Bailin, Abby; Doctoroff, Greta

2014-01-01

Despite the rapid proliferation of mental health interventions with proven benefit for youth, empirically supported interventions (ESIs) are underutilized in most service settings. Treatment outcome studies in these community-based settings suggest that the majority of youth do not show improvement, underscoring the importance of addressing the gap between research and practice. Clinician attitudes toward evidence-based practice (EBP) may limit the use of ESIs, and efforts to address these attitudes with post-graduate training pose significant challenges. Pre-practicum training in EBP may address these challenges by familiarizing students with the framework of EBP as well as with the current youth treatment evidence base and the theories and strategies of well-supported interventions. We describe a required EBP course within a professional psychology doctoral program. Forty-two students in two class cohorts completed a measure of attitudes toward EBP prior to the first class and after the final class lecture. Students were predominantly Caucasian women with bachelor's degrees. As expected, over the course of the class, student attitudes became significantly more favorable toward EBP. Students who had previously received a master's degree had more favorable attitudes prior to the class, and students with a prior bachelor's degree showed the greatest change in attitude. The results support the use of pre-practicum training in EBP to improve attitudes toward EBP, which may lead to use of effective practices with clients following training. PMID:25745525

Pre-Practicum Training in Professional Psychology to Close the Research-Practice Gap: Changing Attitudes Towards Evidence-Based Practice.

PubMed

Bearman, Sarah Kate; Wadkins, Melanie; Bailin, Abby; Doctoroff, Greta

2015-02-01

Despite the rapid proliferation of mental health interventions with proven benefit for youth, empirically supported interventions (ESIs) are underutilized in most service settings. Treatment outcome studies in these community-based settings suggest that the majority of youth do not show improvement, underscoring the importance of addressing the gap between research and practice. Clinician attitudes toward evidence-based practice (EBP) may limit the use of ESIs, and efforts to address these attitudes with post-graduate training pose significant challenges. Pre-practicum training in EBP may address these challenges by familiarizing students with the framework of EBP as well as with the current youth treatment evidence base and the theories and strategies of well-supported interventions. We describe a required EBP course within a professional psychology doctoral program. Forty-two students in two class cohorts completed a measure of attitudes toward EBP prior to the first class and after the final class lecture. Students were predominantly Caucasian women with bachelor's degrees. As expected, over the course of the class, student attitudes became significantly more favorable toward EBP. Students who had previously received a master's degree had more favorable attitudes prior to the class, and students with a prior bachelor's degree showed the greatest change in attitude. The results support the use of pre-practicum training in EBP to improve attitudes toward EBP, which may lead to use of effective practices with clients following training.

Advancing Counselor Education in Evidence-Based Practice

ERIC Educational Resources Information Center

Morrow, Michael T.; Lee, Hsin-Hua; Bartoli, Eleonora; Gillem, Angela R.

2017-01-01

Evidence-based practice (EBP) is a core priority in counselor education. This paper details one United States' counselor education program's self-assessment of its EBP curriculum. Faculty members collaborated to identify challenges and generate solutions to strengthen the EBP emphasis within the program. This paper is intended as a resource for…

Teaching evidence based practice in physical therapy in a developing country: a national survey of Philippine schools

PubMed Central

2013-01-01

Background Early education on the foundations of evidence based practice (EBP) is advocated as a potent intervention toward enhancing EBP uptake among physical therapists. Little is known about the extent to which EBP is integrated in educational curricula in developing countries where the benefits of EBP are more acutely needed. This study sought to describe EBP education in Philippine physical therapy schools, including the challenges encountered by educators in teaching EBP. Methods A national survey of higher education institutions offering an undergraduate degree program in physical therapy was conducted from August 2011 through January 2012. A 35-item questionnaire was developed to gather data on whether or not EBP was taught, specific EBP content covered and courses in which content was covered, teaching and evaluation methods, and challenges in teaching EBP. Data were analyzed descriptively. Results The study had a response rate of 55.7% (34/61). Majority of the participating educational institutions (82%, 28/34) reported teaching EBP by incorporating EBP content in the professional courses. Among those that did not teach EBP, inadequate educator competence was the leading barrier. Courses commonly used to teach EBP were those on research (78.6%, 22/28), therapy planning (71.4%, 20/28), treatment skills (57.1-64.3%, 16-18/28), and undergraduate thesis (60.7%, 17/28). Various EBP contents were covered, with statistical concepts more frequently taught compared with critical EBP content. Lectures and journal reports were the usual teaching methods (96.4%, 27/28 and 89.3%, 25/28, respectively) while written examinations, completion of an undergraduate thesis, and oral reports (82.1%, 23/28, 78.6%, 22/28, and 78.6%, 22/28, respectively) were often used in evaluation. Students’ inadequate knowledge of statistics and lack of curricular structure for EBP were identified as leading challenges to teaching (75%, 21/28 and 50%, 14/28, respectively). Conclusions Many physical therapy faculties across the Philippines are incorporating EBP content in teaching. However, there is arbitrary and fragmented coverage of EBP content and inadequate emphasis on clinically oriented teaching-learning and assessment methods. These findings suggest the need to design appropriate entry-level educational programs on EBP. Effective ‘educating the educators’ strategies are urgently needed and can have far-reaching positive repercussions on EBP uptake in physical therapist practice. PMID:24267512

Teaching evidence based practice in physical therapy in a developing country: a national survey of Philippine schools.

PubMed

Gorgon, Edward James R; Basco, Mark David S; Manuel, Almira T

2013-11-22

Early education on the foundations of evidence based practice (EBP) is advocated as a potent intervention toward enhancing EBP uptake among physical therapists. Little is known about the extent to which EBP is integrated in educational curricula in developing countries where the benefits of EBP are more acutely needed. This study sought to describe EBP education in Philippine physical therapy schools, including the challenges encountered by educators in teaching EBP. A national survey of higher education institutions offering an undergraduate degree program in physical therapy was conducted from August 2011 through January 2012. A 35-item questionnaire was developed to gather data on whether or not EBP was taught, specific EBP content covered and courses in which content was covered, teaching and evaluation methods, and challenges in teaching EBP. Data were analyzed descriptively. The study had a response rate of 55.7% (34/61). Majority of the participating educational institutions (82%, 28/34) reported teaching EBP by incorporating EBP content in the professional courses. Among those that did not teach EBP, inadequate educator competence was the leading barrier. Courses commonly used to teach EBP were those on research (78.6%, 22/28), therapy planning (71.4%, 20/28), treatment skills (57.1-64.3%, 16-18/28), and undergraduate thesis (60.7%, 17/28). Various EBP contents were covered, with statistical concepts more frequently taught compared with critical EBP content. Lectures and journal reports were the usual teaching methods (96.4%, 27/28 and 89.3%, 25/28, respectively) while written examinations, completion of an undergraduate thesis, and oral reports (82.1%, 23/28, 78.6%, 22/28, and 78.6%, 22/28, respectively) were often used in evaluation. Students' inadequate knowledge of statistics and lack of curricular structure for EBP were identified as leading challenges to teaching (75%, 21/28 and 50%, 14/28, respectively). Many physical therapy faculties across the Philippines are incorporating EBP content in teaching. However, there is arbitrary and fragmented coverage of EBP content and inadequate emphasis on clinically oriented teaching-learning and assessment methods. These findings suggest the need to design appropriate entry-level educational programs on EBP. Effective 'educating the educators' strategies are urgently needed and can have far-reaching positive repercussions on EBP uptake in physical therapist practice.

The interplay of contextual elements in implementation: an ethnographic case study.

PubMed

McCullough, Megan B; Chou, Ann F; Solomon, Jeffrey L; Petrakis, Beth Ann; Kim, Bo; Park, Angela M; Benedict, Ashley J; Hamilton, Alison B; Rose, Adam J

2015-02-14

Contextual elements have significant impact on uptake of health care innovations. While existing conceptual frameworks in implementation science suggest contextual elements interact with each other, little research has described how this might look in practice. To bridge this gap, this study identifies the interconnected patterns among contextual elements that influence uptake of an anticoagulation clinic improvement initiative. We completed 51 semi-structured interviews and ethnographic observations across five case study sites involved in an evidence-based practice (EBP) quality improvement initiative. We analyzed data in NVivo 10 using an a priori approach based on the Promoting Action on Research Implementation in Health Services (PARIHS) model and an emergent thematic analysis. Key contextual elements, such as leadership, teamwork, and communication, interacted with each other in contributing to site-level uptake of the EBP, often yielding results that could not be predicted by looking at just one of these elements alone. Sites with context conducive to change in these areas predictably had high uptake, while sites with uniformly weak contextual elements had low uptake. Most sites presented a mixed picture, with contextual elements being strongly supportive of change in some areas and weak or moderate in others. In some cases, we found that sites with strong context in at least one area only needed to have adequate context in other areas to yield high uptake. At other sites, weak context in just one area had the potential to contribute to low uptake, despite countervailing strengths. Even a site with positive views of EBPs could not succeed when context was weak. Interrelationships among different contextual elements can act as barriers to uptake at some sites and as facilitators at others. Accounting for interconnections among elements enables PARIHS to more fully describe the determinants of successful implementation as they operate in real-world settings.

Direct-to-Consumer Marketing: A Complementary Approach to Traditional Dissemination and implementation Efforts for Mental Health and Substance Abuse Interventions

PubMed Central

Becker, Sara J.

2014-01-01

The overall chasm between those who need treatment for mental health and substance abuse (M/SU) and those who receive effective treatment consists of two, interrelated gaps: the research-to-practice gap and the treatment gap. Prior efforts to disseminate evidence-based practice (EBP) for M/SU have predominantly targeted the research-to-practice gap, by focusing efforts toward treatment providers. This article introduces direct-to-consumer (DTC) marketing that targets patients and caregivers as a complementary approach to existing dissemination efforts. Specific issues discussed include: rationale for DTC marketing based on the concept of push versus pull marketing; overview of key stakeholders involved in DTC marketing; and description of the Marketing Mix planning framework. The applicability of these issues to the dissemination of EBP for M/SU is discussed. PMID:25937710

Evidence-based practice in speech-language pathology curricula: a scoping study.

PubMed

Togher, Leanne; Yiannoukas, Corina; Lincoln, Michelle; Power, Emma; Munro, Natalie; Mccabe, Patricia; Ghosh, Pratiti; Worrall, Linda; Ward, Elizabeth; Ferguson, Alison; Harrison, Elisabeth; Douglas, Jacinta

2011-12-01

This scoping study investigated how evidence-based practice (EBP) principles are taught in Australian speech-language pathology (SLP) teaching and learning contexts. It explored how Australian SLP university programs: (1) facilitate student learning about the principles of EBP in academic and clinical settings, and (2) self-evaluate their curricula in relation to EBP. The research involved two surveys. Survey 1 respondents were 131 academic staff, program coordinators, and on-campus and off-campus clinical educators. This survey gathered information about EBP teaching and learning in SLP programs as well as future EBP curriculum plans. Survey 2 investigated how clinical educators incorporated EBP into the way they taught clinical decision-making to students. Surveys responses from 85 clinical educators were analysed using descriptive and non-parametric statistics and thematic grouping of open-ended qualitative responses. Both surveys revealed strengths and gaps in integrating EBP into Australian SLP curricula. Perceived strengths were that respondents were positive about EBP, most had EBP training and access to EBP resources. The perceived gaps included the academic staff's perceptions of students' understanding and application of EBP, respondents' understanding of research methodologies, communication and collaboration between academic staff and clinical educators, and a lack of explicit discussion by clinical educators and students of EBP in relation to clients.

Transportability of an Evidence-Based Early Childhood Intervention in a Low-Income African Country: Results of a Cluster Randomized Controlled Study.

PubMed

Huang, Keng-Yen; Nakigudde, Janet; Rhule, Dana; Gumikiriza-Onoria, Joy Louise; Abura, Gloria; Kolawole, Bukky; Ndyanabangi, Sheila; Kim, Sharon; Seidman, Edward; Ogedegbe, Gbenga; Brotman, Laurie Miller

2017-11-01

Children in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions (EBIs) are not available in SSA. This study investigated the implementation quality and effectiveness of one component of an EBI from a developed country (USA) in a SSA country (Uganda). The EBI component, Professional Development, was provided by trained Ugandan mental health professionals to Ugandan primary school teachers. It included large-group experiential training and small-group coaching to introduce and support a range of evidence-based practices (EBPs) to create nurturing and predictable classroom experiences. The study was guided by the Consolidated Framework for Implementation Research, the Teacher Training Implementation Model, and the RE-AIM evaluation framework. Effectiveness outcomes were studied using a cluster randomized design, in which 10 schools were randomized to intervention and wait-list control conditions. A total of 79 early childhood teachers participated. Teacher knowledge and the use of EBPs were assessed at baseline and immediately post-intervention (4-5 months later). A sample of 154 parents was randomly selected to report on child behavior at baseline and post-intervention. Linear mixed effect modeling was applied to examine effectiveness outcomes. Findings support the feasibility of training Ugandan mental health professionals to provide Professional Development for Ugandan teachers. Professional Development was delivered with high levels of fidelity and resulted in improved teacher EBP knowledge and the use of EBPs in the classroom, and child social competence.

Evidence-based practice in physical therapy in Austria: current state and factors associated with EBP engagement.

PubMed

Diermayr, Gudrun; Schachner, Herbert; Eidenberger, Margit; Lohkamp, Monika; Salbach, Nancy M

2015-12-01

Research examining the use of evidence-based practice (EBP) in physical therapy in many countries has revealed positive attitudes, varying degrees of EBP use and barriers at practitioner, patient and organizational levels. In contrast to these countries, Austria does not have an academic or research tradition in physical therapy. Engagement in EBP in countries such as Austria is unknown. The objectives of the study were to describe the current state of EBP engagement and identify factors associated with EBP engagement among Austrian physical therapists (PTs). A cross-sectional online survey was conducted. Existing questionnaires and the theory of planned behaviour guided questionnaire development. Face and content validity and ease of use of the questionnaire were evaluated in pilot tests. Item-level response frequencies and percentages were determined. Simple and multiple regressions were used to identify factors associated with EBP engagement. The final sample size was 588 (response rate: 17.5%). Ten percent of participants fully agreed that they regularly use guidelines and standardized assessment tools in clinical practice. While 49.9% reported not using electronic databases for literature searching, 41.9% reported reading research articles 2-5 times per month. Most frequently cited barriers to EBP engagement were lack of scientific skills, lack of time and insufficient organizational support. Research awareness, attitude, behavioural control, involvement in research and degree level were final correlates of EBP engagement. Austrian PTs show a low level of engagement in EBP. Initiatives to advance EBP in Austria and other countries with no academic or research tradition should primarily target practitioner-level factors. © 2015 John Wiley & Sons, Ltd.

Effectiveness of an evidence-based practice (EBP) course on the EBP competence of undergraduate nursing students: A quasi-experimental study.

PubMed

Ruzafa-Martínez, María; López-Iborra, Lidón; Armero Barranco, David; Ramos-Morcillo, Antonio Jesús

2016-03-01

International nursing institutions and experts recommend evidence-based practice (EBP) as a core component of the curriculum for nurses. However, the impact of EBP training on the competence of undergraduate nursing students remains unclear. To evaluate the effectiveness of an EBP course on the EBP competence undergraduate nursing students'. Quasi-experimental study carried out in non-randomized intervention and control groups. The study was conducted in a Spanish public university in 2010. Out of 420 second- and third-year nursing students, 75 were enrolled in the EBP course, forming the intervention group, and 73 were not enrolled in this course were recruited as controls. The educational intervention was a 15-week course designed to teach EBP competence. The EBP Competence Questionnaire (EBP-COQ) was administered before and after the intervention. Repeated-measure ANOVA was used to compare intervention and control group scores before and at two months after the 15-week intervention period. At 2months after the EBP course, mean EBP-COQ scores of the intervention group were significantly improved versus baseline in attitude (4.28 vs. 3.33), knowledge (3.92 vs. 2.82) and skills (4.01 vs. 2.75) dimensions, whereas little change was observed in control group scores over the same time period. Repeated-measures ANOVA revealed a significant effect of Time ×Group interaction on global competence and all three EBP-COQ dimensions. Undergraduate nursing students experience positive changes in EBP competence, knowledge, skills, and attitude as the result of a 15-week educational intervention on EBP. This EBP course may provide nursing school educators and policymakers with a useful model for integrating EBP teaching within the nursing curriculum. Copyright © 2015 Elsevier Ltd. All rights reserved.

Elizabeth Usher Memorial Lecture: How do we change our profession? Using the lens of behavioural economics to improve evidence-based practice in speech-language pathology.

PubMed

McCabe, Patricia J

2018-06-01

Evidence-based practice (EBP) is a well-accepted theoretical framework around which speech-language pathologists strive to build their clinical decisions. The profession's conceptualisation of EBP has been evolving over the last 20 years with the practice of EBP now needing to balance research evidence, clinical data and informed patient choices. However, although EBP is not a new concept, as a profession, we seem to be no closer to closing the gap between research evidence and practice than we were at the start of the movement toward EBP in the late 1990s. This paper examines why speech-language pathologists find it difficult to change our own practice when we are experts in changing the behaviour of others. Using the lens of behavioural economics to examine the heuristics and cognitive processes which facilitate and inhibit change, the paper explores research showing how inconsistency of belief and action, or cognitive dissonance, is inevitable unless we act reflectively instead of automatically. The paper argues that heuristics that prevent us changing our practice toward EBP include the sunk cost fallacy, loss aversion, social desirability bias, choice overload and inertia. These automatic cognitive processes work to inhibit change and may partially account for the slow translation of research into practice. Fortunately, understanding and using other heuristics such as the framing effect, reciprocity, social proof, consistency and commitment may help us to understand our own behaviour as speech-language pathologists and help the profession, and those we work with, move towards EBP.

Advancing the Scientific Foundation for Evidence-Based Practice in Clinical Child and Adolescent Psychology.

PubMed

Roberts, Michael C; Blossom, Jennifer B; Evans, Spencer C; Amaro, Christina M; Kanine, Rebecca M

2017-01-01

Evidence-based practice (EBP) has become a central focus in clinical child and adolescent psychology. As originally defined, EBP in psychology is the integration of the best available research evidence, patient characteristics, and clinical expertise. Although evidence-based perspectives have garnered widespread acceptance in recent years, there has also been some confusion and disagreement about the 3-part definition of EBP, particularly the role of research. In this article, we first provide a brief review of the development of EBP in clinical child and adolescent psychology. Next, we outline the following 4 points to help clarify the understanding of EBP: (a) knowledge should not be confused with epistemic processes, (b) research on clinician and client factors is needed for EBP, (c) research on assessment is needed for EBP, and (d) the 3-part conceptualization of EBP can serve as a useful framework to guide research. Based on these principles, we put forth a slightly revised conceptualization of EBP, in which the role of research is expanded and more clearly operationalized. Finally, based on our review of the literature, we offer illustrative examples of specific directions for future research to advance the evidence base for EBP in clinical child and adolescent psychology.

Evidence-based practice exposure and physiotherapy students' behaviour during clinical placements: a survey.

PubMed

Olsen, Nina Rydland; Lygren, Hildegunn; Espehaug, Birgitte; Nortvedt, Monica Wammen; Bradley, Peter; Bjordal, Jan Magnus

2014-12-01

Physiotherapists are expected to practice in an evidence-based way. Evidence-based practice (EBP) should be an integral part of the curriculum to ensure use of the five EBP steps: asking clinical questions, searching for and appraising research evidence, integrating the evidence into clinical practice and evaluating this process. The aim of this study was to compare self-reported EBP behaviour, abilities and barriers during clinical placements reported by five cohorts of final year physiotherapy students' with different EBP exposure across the 3-year bachelor programme. A cross-sectional study was conducted among five cohorts (2006-2010) with third year physiotherapy students at a University College in Norway. In total, 246 students were eligible for this study. To collect data, we used a questionnaire with 42 items related to EBP behaviour, ability and barriers. Associations were investigated using the Spearman's rho (r). In total, 180 out of 246 third year physiotherapy students, who had recently completed a clinical placement, filled out the questionnaire (73 %). The association between the level of EBP exposure and students' self-reported EBP behaviour, abilities and barriers was low for most items in the questionnaire. Statistically significant correlations were found for eight items, related to information need, question formulation, use of checklists, searching and perceived ability to search for and critically appraise research evidence. The strongest correlation was found between the level of EBP exposure and ability to critically appraise research evidence (r = 0.41, p < 0.001). An association between the level of EBP exposure and physiotherapy students' EBP behaviour was found for elements such as asking and searching, ability to search for and critically appraise research evidence, and experience of critical appraisal as a barrier. Further research need to explore strategies for EBP exposure throughout the curriculum, regarding content, timing, amount and type of training. Copyright © 2014 John Wiley & Sons, Ltd.

Korean Nursing Students' Acquisition of Evidence-Based Practice and Critical Thinking Skills.

PubMed

Kim, Sang Suk; Kim, Eun Joo; Lim, Ji Young; Kim, Geun Myun; Baek, Hee Chong

2018-01-01

Evidence-based practice (EBP) is essential for enhancing nurses' quality of care. We identified Korean nursing students' practices, attitudes, and knowledge concerning EBP, as well as their critical thinking disposition (CTD). The EBP Questionnaire (EBPQ) was administered to a convenience sample of 266 nursing students recruited from four nursing schools in Seoul and its metropolitan area. Average EBPQ and CTD total scores were 4.69 ± 0.64 and 3.56 ± 0.32, respectively. Students who were ages ⩾23 years, male, and satisfied with their major demonstrated higher EBPQ and CTD scores. EBPQ scores were significantly correlated with CTD scores (r = .459, p < .01), and CTD was an explanatory factor of EBP (adjusted R 2 = 0.200). It is necessary to develop comprehensive teaching strategies to help nursing students improve their CTD and information utilization skills, as well as integrate EBP in undergraduate programs to enhance nurses' EBP abilities. [J Nurs Educ. 2018;57(1):21-27.]. Copyright 2018, SLACK Incorporated.

Research utilization among children's mental health providers.

PubMed

Barwick, Melanie A; Boydell, Katherine M; Stasiulis, Elaine; Ferguson, H Bruce; Blase, Karen; Fixsen, Dean

2008-04-09

Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP) relies, in part, on the research utilization practices of mental health care providers. This study reports on a survey of research utilization practices among 80 children's mental health (CMH) service provider organizations in Ontario, Canada. A web-based survey was distributed to 80 CMH service provider organizations, to which 51 executive directors and 483 children's mental health practitioners responded. Research utilization was assessed using questions with Likert-type responses based on the Canadian Health Services Research Foundation's Four-A's approach: access, assess, adapt, apply. There was general agreement among executive directors and practitioners regarding the capacity of their organizations to use - access, assess, adapt, and apply - research evidence. Overall, both groups rated their organizations as using research information 'somewhat well.' The low response rate to the practitioner survey should be noted. These findings provide a useful benchmark from which changes in reported research utilization in the Ontario CMH sector can be tracked over time, as a function of EBP training and implementation initiatives, for instance. The need to improve access to research evidence should be addressed because it relates to the eventual implementation and uptake of evidence-based practices. Communities of practice are recommended as a strategy that would enable practitioners to build capacity in their adaptation and application of research evidence.

Review for librarians of evidence-based practice in nursing and the allied health professions in the United States

PubMed Central

Kronenfeld, Michael; Stephenson, Priscilla L.; Nail-Chiwetalu, Barbara; Tweed, Elizabeth M.; Sauers, Eric L.; McLeod, Tamara C. Valovich; Guo, Ruiling; Trahan, Henry; Alpi, Kristine M.; Hill, Beth; Sherwill-Navarro, Pamela; Allen, Margaret (Peg); Stephenson, Priscilla L.; Hartman, Linda M.; Burnham, Judy; Fell, Dennis; Kronenfeld, Michael; Pavlick, Raymond; MacNaughton, Ellen W.; Nail-Chiwetalu, Barbara

2007-01-01

Objective: This paper provides an overview of the state of evidence-based practice (EBP) in nursing and selected allied health professions and a synopsis of current trends in incorporating EBP into clinical education and practice in these fields. This overview is intended to better equip librarians with a general understanding of the fields and relevant information resources. Included Professions: Professions are athletic training, audiology, health education and promotion, nursing, occupational therapy, physical therapy, physician assisting, respiratory care, and speech-language pathology. Approach: Each section provides a description of a profession, highlighting changes that increase the importance of clinicians' access to and use of the profession's knowledgebase, and a review of each profession's efforts to support EBP. The paper concludes with a discussion of the librarian's role in providing EBP support to the profession. Conclusions: EBP is in varying stages of growth among these fields. The evolution of EBP is evidenced by developments in preservice training, growth of the literature and resources, and increased research funding. Obstacles to EBP include competing job tasks, the need for additional training, and prevalent attitudes and behaviors toward research among practitioners. Librarians' skills in searching, organizing, and evaluating information can contribute to furthering the development of EBP in a given profession. PMID:17971887

An Opportunity to Bridge the Gap Between Clinical Research and Clinical Practice: Implications for Clinical Training

PubMed Central

Hershenberg, Rachel; Drabick, Deborah A. G.; Vivian, Dina

2013-01-01

Clinical researchers and clinical practitioners share a goal of increasing the integration of research and clinical practice, which is reflected in an evidence-based practice (EBP) approach to psychology. The EBP framework involves the integration of research findings with clinical expertise and client characteristics, values, and preferences, and consequently provides an important foundation for conducting clinically relevant research, as well as empirically based and clinically sensitive practice. Given the critical role that early training can play in the integration of science and practice and in promoting the future of the field, the present article addresses predoctoral training programs as a context for adopting an EBP approach to clinical work. We address training in the three components of EBP and provide suggestions for curriculum development and practicum training that we hope will contribute to bridging the gap between research and practice. PMID:22642520

Autonomy and Accountability: Teacher Perspectives on Evidence-Based Practice and Decision-Making for Students with Intellectual and Developmental Disabilities

ERIC Educational Resources Information Center

Greenway, Rosanne; McCollow, Meaghan; Hudson, Roxanne F.; Peck, Charles; Davis, Carol A.

2013-01-01

The purpose of this study was to examine teacher perspectives about evidence-based practices (EBP) and decision-making for students with intellectual and developmental disabilities. Given the current EBP movement, our study sought to understand practitioner definitions and perspectives on EBP and decision-making. Interview data from nine special…

Toward a Transdisciplinary Model of Evidence-Based Practice

PubMed Central

Satterfield, Jason M; Spring, Bonnie; Brownson, Ross C; Mullen, Edward J; Newhouse, Robin P; Walker, Barbara B; Whitlock, Evelyn P

2009-01-01

Context This article describes the historical context and current developments in evidence-based practice (EBP) for medicine, nursing, psychology, social work, and public health, as well as the evolution of the seminal “three circles” model of evidence-based medicine, highlighting changes in EBP content, processes, and philosophies across disciplines. Methods The core issues and challenges in EBP are identified by comparing and contrasting EBP models across various health disciplines. Then a unified, transdisciplinary EBP model is presented, drawing on the strengths and compensating for the weaknesses of each discipline. Findings Common challenges across disciplines include (1) how “evidence” should be defined and comparatively weighted; (2) how and when the patient's and/or other contextual factors should enter the clinical decision-making process; (3) the definition and role of the “expert”; and (4) what other variables should be considered when selecting an evidence-based practice, such as age, social class, community resources, and local expertise. Conclusions A unified, transdisciplinary EBP model would address historical shortcomings by redefining the contents of each model circle, clarifying the practitioner's expertise and competencies, emphasizing shared decision making, and adding both environmental and organizational contexts. Implications for academia, practice, and policy also are discussed. PMID:19523122

Teaching EBP Using Game-Based Learning: Improving the Student Experience.

PubMed

Davidson, Sandra J; Candy, Laurie

2016-08-01

Evidence-based practice (EBP) is considered a key entry to practice competency for nurses. However, many baccalaureate nursing programs continue to teach "traditional" nursing research courses that fail to address many of the critical knowledge, skills, and attitudes that foster EBP. Traditional classroom teaching strategies do little to promote the development of competencies critical for engaging in EBP in clinical contexts. The purpose of this work was to develop, implement, and evaluate an innovative teaching strategy aimed at improving student learning, engagement and satisfaction in an online EBP course. The goals of this paper are to: (1) describe the process of course development, (2) describe the innovative teaching strategy, and (3) discuss the outcomes of the pilot course offered using game-based learning. A midterm course-specific survey and standard institutional end of course evaluations were used to evaluate student satisfaction. Game platform analytics and thematic analysis of narrative comments in the midterm and end of course surveys were used to evaluate students' level of engagement. Student learning was evaluated using the end of course letter grade. Students indicated a high satisfaction with the course. Student engagement was also maintained throughout the course. The majority of students (87%, 26/30) continued to complete learning quests in the game after achieving the minimum amount of points to earn an A. Seven students completed every learning quest available in the game platform. Of the 30 students enrolled in the course, 17 students earned a final course grade of A+ and 13 earned an A. Provide students with timely, individualized feedback to enable mastery learning. Create student choice and customization of learning. Integrate the use of badges (game mechanics) to increase engagement and motivation. Level learning activities to build on each other and create flow. © 2016 Sigma Theta Tau International.

Organizational Culture and Climate and Mental Health Provider Attitudes Toward Evidence-Based Practice

PubMed Central

Aarons, Gregory A.; Sawitzky, Angelina C.

2006-01-01

Mental health provider attitudes toward adopting evidence-based practice (EBP) are associated with organizational context and provider individual differences. Organizational culture and climate are contextual factors that can affect staff acceptance of innovation. This study examined the association of organizational culture and climate with attitudes toward adopting EBP. Participants were 301 public sector mental health service providers from 49 programs providing mental health services for youths and families. Correlation analyses and multilevel hierarchical regressions, controlling for effects of provider characteristics, showed that constructive culture was associated with more positive attitudes toward adoption of EBP and poor organizational climates with perceived divergence of usual practice and EBP. Behavioral health organizations may benefit from consideration of how culture and climate affect staff attitudes toward change in practice. PMID:17183411

Organizational Culture and Climate and Mental Health Provider Attitudes Toward Evidence-Based Practice.

PubMed

Aarons, Gregory A; Sawitzky, Angelina C

2006-02-01

Mental health provider attitudes toward adopting evidence-based practice (EBP) are associated with organizational context and provider individual differences. Organizational culture and climate are contextual factors that can affect staff acceptance of innovation. This study examined the association of organizational culture and climate with attitudes toward adopting EBP. Participants were 301 public sector mental health service providers from 49 programs providing mental health services for youths and families. Correlation analyses and multilevel hierarchical regressions, controlling for effects of provider characteristics, showed that constructive culture was associated with more positive attitudes toward adoption of EBP and poor organizational climates with perceived divergence of usual practice and EBP. Behavioral health organizations may benefit from consideration of how culture and climate affect staff attitudes toward change in practice.

Testing the leadership and organizational change for implementation (LOCI) intervention in substance abuse treatment: a cluster randomized trial study protocol.

PubMed

Aarons, Gregory A; Ehrhart, Mark G; Moullin, Joanna C; Torres, Elisa M; Green, Amy E

2017-03-03

Evidence-based practice (EBP) implementation represents a strategic change in organizations that requires effective leadership and alignment of leadership and organizational support across organizational levels. As such, there is a need for combining leadership development with organizational strategies to support organizational climate conducive to EBP implementation. The leadership and organizational change for implementation (LOCI) intervention includes leadership training for workgroup leaders, ongoing implementation leadership coaching, 360° assessment, and strategic planning with top and middle management regarding how they can support workgroup leaders in developing a positive EBP implementation climate. This test of the LOCI intervention will take place in conjunction with the implementation of motivational interviewing (MI) in 60 substance use disorder treatment programs in California, USA. Participants will include agency executives, 60 program leaders, and approximately 360 treatment staff. LOCI will be tested using a multiple cohort, cluster randomized trial that randomizes workgroups (i.e., programs) within agency to either LOCI or a webinar leadership training control condition in three consecutive cohorts. The LOCI intervention is 12 months, and the webinar control intervention takes place in months 1, 5, and 8, for each cohort. Web-based surveys of staff and supervisors will be used to collect data on leadership, implementation climate, provider attitudes, and citizenship. Audio recordings of counseling sessions will be coded for MI fidelity. The unit of analysis will be the workgroup, randomized by site within agency and with care taken that co-located workgroups are assigned to the same condition to avoid contamination. Hierarchical linear modeling (HLM) will be used to analyze the data to account for the nested data structure. LOCI has been developed to be a feasible and effective approach for organizations to create a positive climate and fertile context for EBP implementation. The approach seeks to cultivate and sustain both effective general and implementation leadership as well as organizational strategies and support that will remain after the study has ended. Development of a positive implementation climate for MI should result in more positive service provider attitudes and behaviors related to the use of MI and, ultimately, higher fidelity in the use of MI. This study is registered with Clinicaltrials.gov ( NCT03042832 ), 2 February 2017, retrospectively registered.

Baseline evidence-based practice use, knowledge, and attitudes of allied health professionals: a survey to inform staff training and organisational change.

PubMed

Wilkinson, Shelley A; Hinchliffe, Fiona; Hough, Judith; Chang, Anne

2012-01-01

Evidence-based practice (EBP) is fundamental to improving patient outcomes. Universal adoption of EBP into the allied health clinical setting has not yet occurred. The primary aim of this project was to capture baseline measurements of the level of EBP self-efficacy, outcome expectancy, knowledge and use at our health service prior to training and organisational changes to support EBP. All allied health staff (n=252) employed across the campus were invited to participate in an online survey consisting of a battery of validated and reliable survey tools. Professional background, knowledge and previous training in EBP and research processes were collected. One hundred eighty-two allied health staff completed the survey (response rate 72%). One-way ANOVAs were used to compare levels of self-efficacy, outcome expectancy, knowledge and use, according to allied health discipline and experience with EBP and research processes. Mean scores for EBP attitudes (self-efficacy and outcome expectancy) and knowledge were higher than for use. Professional group differences were noted in the post-hoc analysis of the significant EBP constructs. Regression analyses indicated that EBP course attendance as well as training in research design and analysis impacted positively on EBP construct scores. Despite positive attitudes about, a belief in and knowledge of EBP, self-reports of EBP processes do not indicate systematic application in the allied health workplace. The results of this research will inform a targeted intervention to foster ongoing training in EBP and research activity for allied health staff.

Optimizing nursing care by integrating theory-driven evidence-based practice.

PubMed

Pipe, Teri Britt

2007-01-01

An emerging challenge for nursing leadership is how to convey the importance of both evidence-based practice (EBP) and theory-driven care in ensuring patient safety and optimizing outcomes. This article describes a specific example of a leadership strategy based on Rosswurm and Larrabee's model for change to EBP, which was effective in aligning the processes of EBP and theory-driven care.

[Evidence-based prevention: a new model for public health].

PubMed

Vitale, Francesco; Cusimano, Rosanna; Bruno, Giuseppe; Firenze, Alberto; De Crescenzo, Loredana; Romano, Nino

2005-01-01

The concept of evidence-based prevention (EBP), was developed during the last decade as the counterpart, in Public Health, of Evidence-Based Medicine (EBM) in Clinical Medicine. The growing debate on EBP reflects the increasing recognition that successful evaluation of public health interventions will necessarily entail the use of research designs other than controlled trials as well as the use of various other types of evidence, often in combination. Evidence-based prevention, therefore, aims to implement those prevention strategies that have been found to be useful and effective through a formal evaluation based on scientific methodology. A the same it aims to progressively discard all preventive practices for which usefulness and effectiveness have not been proved.

Oncology nurses and the experience of participation in an evidence-based practice project.

PubMed

Fridman, Mary; Frederickson, Keville

2014-07-01

To illuminate the experiences of oncology nurses who participated in an evidence-based practice (EBP) project in an institution with an EBP organizational structure. A descriptive phenomenologic approach and in-depth interviews with each participant. An oncology-focused academic medical center with an established organizational infrastructure for EBP. 12 RNs working in an oncology setting who participated in an EBP project. Descriptive, qualitative phenomenologic approach through use of interviews and analysis of interview text. Four essential themes (i.e., support, challenges, evolution, and empowerment) and 11 subthemes emerged that reflected nurses' professional and personal growth, as well as the creation of a culture of EBP in the workplace. The participants described the EBP project as a positive, empowering personal and professional evolutionary experience with supports and challenges that resulted in improvements in patient care. To the authors' knowledge, the current study is the first qualitative study to demonstrate improved nursing outcomes (e.g., professional growth, improved nursing performance) and nurses' perception of improved patient outcomes (e.g., ongoing healthcare collaboration, evidence-based changes in practice).

Information behaviour of French-speaking speech-language therapists in Belgium: results of a questionnaire survey.

PubMed

Durieux, Nancy; Pasleau, Françoise; Piazza, Aurelie; Donneau, Anne-Françoise; Vandenput, Sandrina; Maillart, Christelle

2016-03-01

Speech-language therapists (SLTs) are encouraged to implement evidence-based practice (EBP). Nevertheless, EBP use by practitioners can be questioned. The objective of this study was to explore Belgian French-speaking SLTs' information behaviour and their awareness of EBP. The collected data allow one to determine how far they have embraced this approach. The two Belgian French-speaking SLT professional associations promoted an online questionnaire survey by email. Additionally, clinical supervisors of students were asked to participate. In March 2012, 2068 emails were sent. The participation rate was at least 20% (n = 415). The reported information needs mainly concerned treatment or diagnosis. Most of the time, to attempt to fulfil their information needs, SLTs relied on their own resources (personal experience and libraries) and on colleagues in the workplace. When they searched on the Internet, they preferred to use a general search engine rather than a specialised bibliographic database. Barriers to obtaining scientific information are highlighted. Only 12% of the respondents had already heard about EBP. This study provides the first overview of the information behaviour of SLTs working in the French community of Belgium. Several recommendations are suggested for SLTs and librarians. © 2015 Health Libraries Group.

A Concept Mapping Approach to Guide and Understand Dissemination and Implementation

PubMed Central

Green, Amy E.; Fettes, Danielle L.; Aarons, Gregory A.

2013-01-01

Many efforts to implement evidence-based programs do not reach their full potential or fail due to the variety of challenges inherent in dissemination and implementation. This article describes the use of concept mapping—a mixed method strategy—to study implementation of behavioral health innovations and evidence-based practice (EBP). The application of concept mapping to implementation research represents a practical and concise way to identify and quantify factors affecting implementation, develop conceptual models of implementation, target areas to address as part of implementation readiness and active implementation, and foster communication among stakeholders. Concept mapping is described and a case example is provided to illustrate its use in an implementation study. Implications for the use of concept mapping methods in both research and applied settings towards the dissemination and implementation of behavioral health services are discussed. PMID:22892987

A concept mapping approach to guide and understand dissemination and implementation.

PubMed

Green, Amy E; Fettes, Danielle L; Aarons, Gregory A

2012-10-01

Many efforts to implement evidence-based programs do not reach their full potential or fail due to the variety of challenges inherent in dissemination and implementation. This article describes the use of concept mapping-a mixed method strategy-to study implementation of behavioral health innovations and evidence-based practice (EBP). The application of concept mapping to implementation research represents a practical and concise way to identify and quantify factors affecting implementation, develop conceptual models of implementation, target areas to address as part of implementation readiness and active implementation, and foster communication among stakeholders. Concept mapping is described and a case example is provided to illustrate its use in an implementation study. Implications for the use of concept mapping methods in both research and applied settings towards the dissemination and implementation of behavioral health services are discussed.

Improving and sustaining delivery of CPT for PTSD in mental health systems: a cluster randomized trial.

PubMed

Wiltsey Stirman, Shannon; Finley, Erin P; Shields, Norman; Cook, Joan; Haine-Schlagel, Rachel; Burgess, James F; Dimeff, Linda; Koerner, Kelly; Suvak, Michael; Gutner, Cassidy A; Gagnon, David; Masina, Tasoula; Beristianos, Matthew; Mallard, Kera; Ramirez, Vanessa; Monson, Candice

2017-03-06

Large-scale implementation of evidence-based psychotherapies (EBPs) such as cognitive processing therapy (CPT) for posttraumatic stress disorder can have a tremendous impact on mental and physical health, healthcare utilization, and quality of life. While many mental health systems (MHS) have invested heavily in programs to implement EBPs, few eligible patients receive EBPs in routine care settings, and clinicians do not appear to deliver the full treatment protocol to many of their patients. Emerging evidence suggests that when CPT and other EBPs are delivered at low levels of fidelity, clinical outcomes are negatively impacted. Thus, identifying strategies to improve and sustain the delivery of CPT and other EBPs is critical. Existing literature has suggested two competing strategies to promote sustainability. One emphasizes fidelity to the treatment protocol through ongoing consultation and fidelity monitoring. The other focuses on improving the fit and effectiveness of these treatments through appropriate adaptations to the treatment or the clinical setting through a process of data-driven, continuous quality improvement. Neither has been evaluated in terms of impact on sustained implementation. To compare these approaches on the key sustainability outcomes and provide initial guidance on sustainability strategies, we propose a cluster randomized trial with mental health clinics (n = 32) in three diverse MHSs that have implemented CPT. Cohorts of clinicians and clinical managers will participate in 1 year of a fidelity oriented learning collaborative or 1 year of a continuous quality improvement-oriented learning collaborative. Patient-level PTSD symptom change, CPT fidelity and adaptation, penetration, and clinics' capacity to deliver EBP will be examined. Survey and interview data will also be collected to investigate multilevel influences on the success of the two learning collaborative strategies. This research will be conducted by a team of investigators with expertise in CPT implementation, mixed method research strategies, quality improvement, and implementation science, with input from stakeholders in each participating MHS. It will have broad implications for supporting ongoing delivery of EBPs in mental health and healthcare systems and settings. The resulting products have the potential to significantly improve efforts to ensure ongoing high quality implementation and consumer access to EBPs. NCT02449421 . Registered 02/09/2015.

Social Workers’ Orientation Toward the Evidence-Based Practice Process

PubMed Central

Kolmer, Deirdre M. Beneken genaamd; Schalk, René

2014-01-01

Objectives: This study assesses social workers’ orientation toward the evidence-based practice (EBP) process and explores which specific variables (e.g. age) are associated. Methods: Data were collected from 341 Dutch social workers through an online survey which included a Dutch translation of the EBP Process Assessment Scale (EBPPAS), along with 13 background/demographic questions. Results: The overall level of orientation toward the EBP process is relatively low. Although respondents are slightly familiar with it and have slightly positive attitudes about it, their intentions to engage in it and their actual engagement are relatively low. Respondents who followed a course on the EBP process as a student are more oriented toward it than those who did not. Social workers under 29 are more familiar with the EBP process than those over 29. Conclusions: We recommend educators to take a more active role in teaching the EBP process to students and social workers. PMID:27630517

Social Workers' Orientation Toward the Evidence-Based Practice Process: A Dutch Survey.

PubMed

van der Zwet, Renske J M; Kolmer, Deirdre M Beneken Genaamd; Schalk, René

2016-10-01

This study assesses social workers' orientation toward the evidence-based practice (EBP) process and explores which specific variables (e.g. age) are associated. Data were collected from 341 Dutch social workers through an online survey which included a Dutch translation of the EBP Process Assessment Scale (EBPPAS), along with 13 background/demographic questions. The overall level of orientation toward the EBP process is relatively low. Although respondents are slightly familiar with it and have slightly positive attitudes about it, their intentions to engage in it and their actual engagement are relatively low. Respondents who followed a course on the EBP process as a student are more oriented toward it than those who did not. Social workers under 29 are more familiar with the EBP process than those over 29. We recommend educators to take a more active role in teaching the EBP process to students and social workers.

Achieving successful evidence-based practice implementation in juvenile justice: The importance of diagnostic and evaluative capacity.

PubMed

Walker, Sarah Cusworth; Bumbarger, Brian K; Phillippi, Stephen W

2015-10-01

Evidence-based programs (EBPs) are an increasingly visible aspect of the treatment landscape in juvenile justice. Research demonstrates that such programs yield positive returns on investment and are replacing more expensive, less effective options. However, programs are unlikely to produce expected benefits when they are not well-matched to community needs, not sustained and do not reach sufficient reach and scale. We argue that achieving these benchmarks for successful implementation will require states and county governments to invest in data-driven decision infrastructure in order to respond in a rigorous and flexible way to shifting political and funding climates. We conceptualize this infrastructure as diagnostic capacity and evaluative capacity: Diagnostic capacity is defined as the process of selecting appropriate programing and evaluative capacity is defined as the ability to monitor and evaluate progress. Policy analyses of Washington State, Pennsylvania and Louisiana's program implementation successes are used to illustrate the benefits of diagnostic and evaluate capacity as a critical element of EBP implementation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cross-Validation of the Implementation Leadership Scale (ILS) in Child Welfare Service Organizations.

PubMed

Finn, Natalie K; Torres, Elisa M; Ehrhart, Mark G; Roesch, Scott C; Aarons, Gregory A

2016-08-01

The Implementation Leadership Scale (ILS) is a brief, pragmatic, and efficient measure that can be used for research or organizational development to assess leader behaviors and actions that actively support effective implementation of evidence-based practices (EBPs). The ILS was originally validated with mental health clinicians. This study validates the ILS factor structure with providers in community-based organizations (CBOs) providing child welfare services. Participants were 214 service providers working in 12 CBOs that provide child welfare services. All participants completed the ILS, reporting on their immediate supervisor. Confirmatory factor analyses were conducted to examine the factor structure of the ILS. Internal consistency reliability and measurement invariance were also examined. Confirmatory factor analyses showed acceptable fit to the hypothesized first- and second-order factor structure. Internal consistency reliability was strong and there was partial measurement invariance for the first-order factor structure when comparing child welfare and mental health samples. The results support the use of the ILS to assess leadership for implementation of EBPs in child welfare organizations. © The Author(s) 2016.

New Territory for School Library Research: Let the Data Speak

ERIC Educational Resources Information Center

Subramaniam, Mega

2015-01-01

A seminal dialogue on evidence based practice (EBP) at the International Association of School Librarianship in 2001 encouraged a worldwide paradigm shift in school librarianship from rhetorical and advocacy defenses to evidential documentation. Ross Todd described EBP as evidence for practice, evidence in practice, and evidence of practice (Todd…

Using Intervention Mapping for Program Design and Production of iCHAMPSS: An Online Decision Support System to Increase Adoption, Implementation, and Maintenance of Evidence-Based Sexual Health Programs

PubMed Central

Peskin, Melissa F.; Hernandez, Belinda F.; Gabay, Efrat K.; Cuccaro, Paula; Li, Dennis H.; Ratliff, Eric; Reed-Hirsch, Kelly; Rivera, Yanneth; Johnson-Baker, Kimberly; Emery, Susan Tortolero; Shegog, Ross

2017-01-01

In Texas and across the United States, unintended pregnancy, HIV, and sexually transmitted infections (STIs) among adolescents remain serious public health issues. Sexual risk-taking behaviors, including early sexual initiation, contribute to these public health problems. Over 35 sexual health evidence-based programs (EBPs) have been shown to reduce sexual risk behaviors and/or prevent teen pregnancies or STIs. Because more than half of these EBPs are designed for schools, they could reach and impact a considerable number of adolescents if implemented in these settings. Most schools across the U.S. and in Texas, however, do not implement these programs. U.S. school districts face many barriers to the successful dissemination (i.e., adoption, implementation, and maintenance) of sexual health EBPs, including lack of knowledge about EBPs and where to find them, perceived lack of support from school administrators and parents, lack of guidance regarding the adoption process, competing priorities, and lack of specialized training on sexual health. Therefore, this paper describes how we used intervention mapping (Steps 3 and 4, in particular), a systematic design framework that uses theory, empirical evidence, and input from the community to develop CHoosing And Maintaining Effective Programs for Sex Education in Schools (iCHAMPSS), an online decision support system to help school districts adopt, implement, and maintain sexual health EBPs. Guided by this systematic intervention design approach, iCHAMPSS has the potential to increase dissemination of sexual health EBPs in school settings. PMID:28848729

Using Intervention Mapping for Program Design and Production of iCHAMPSS: An Online Decision Support System to Increase Adoption, Implementation, and Maintenance of Evidence-Based Sexual Health Programs.

PubMed

Peskin, Melissa F; Hernandez, Belinda F; Gabay, Efrat K; Cuccaro, Paula; Li, Dennis H; Ratliff, Eric; Reed-Hirsch, Kelly; Rivera, Yanneth; Johnson-Baker, Kimberly; Emery, Susan Tortolero; Shegog, Ross

2017-01-01

In Texas and across the United States, unintended pregnancy, HIV, and sexually transmitted infections (STIs) among adolescents remain serious public health issues. Sexual risk-taking behaviors, including early sexual initiation, contribute to these public health problems. Over 35 sexual health evidence-based programs (EBPs) have been shown to reduce sexual risk behaviors and/or prevent teen pregnancies or STIs. Because more than half of these EBPs are designed for schools, they could reach and impact a considerable number of adolescents if implemented in these settings. Most schools across the U.S. and in Texas, however, do not implement these programs. U.S. school districts face many barriers to the successful dissemination (i.e., adoption, implementation, and maintenance) of sexual health EBPs, including lack of knowledge about EBPs and where to find them, perceived lack of support from school administrators and parents, lack of guidance regarding the adoption process, competing priorities, and lack of specialized training on sexual health. Therefore, this paper describes how we used intervention mapping (Steps 3 and 4, in particular), a systematic design framework that uses theory, empirical evidence, and input from the community to develop CH oosing A nd M aintaining Effective P rograms for S ex Education in S chools ( iCHAMPSS ), an online decision support system to help school districts adopt, implement, and maintain sexual health EBPs. Guided by this systematic intervention design approach, iCHAMPSS has the potential to increase dissemination of sexual health EBPs in school settings.

Evidence-based practice instruction by faculty members and librarians in North American optometry and ophthalmology programs.

PubMed

MacDonald, Katherine A; Hrynchak, Patricia K; Spafford, Marlee M

2014-07-01

North American optometry and ophthalmology faculty members and vision science librarians were surveyed online (14% response rate) about teaching evidence-based practice (EBP). Similar to studies of other health care programs, all five EBP steps (Ask, Acquire, Appraise, Apply, Assess) were taught to varying degrees. Optometry and ophthalmology EBP educators may want to place further emphasis on (1) the Apply and Assess steps, (2) faculty- and student-generated questions and self-assessment in clinical settings, (3) online teaching strategies, (4) programmatic integration of EBP learning objectives, and (5) collaboration between faculty members and librarians.

iCHAMPSS: Usability and Psychosocial Impact for Increasing Implementation of Sexual Health Education.

PubMed

Hernandez, Belinda F; Peskin, Melissa F; Shegog, Ross; Gabay, Efrat K; Cuccaro, Paula M; Addy, Robert C; Ratliff, Eric; Emery, Susan T; Markham, Christine M

2017-05-01

Diffusion of sexual health evidence-based programs (EBPs) in schools is a complex and challenging process. iCHAMPSS ( CHoosing And Maintaining effective Programs for Sex education in Schools) is an innovative theory- and Web-based decision support system that may help facilitate this process. The purpose of this study was to pilot-test iCHAMPSS for usability and short-term psychosocial impact. School district stakeholders from across Texas were recruited ( N = 16) and given access to iCHAMPSS for 3 weeks in fall 2014. Pre- and posttests were administered to measure usability parameters and short-term psychosocial outcomes. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test. Most participants reported that iCHAMPSS was easy to use, credible, helpful, and of sufficient motivational appeal. iCHAMPSS significantly increased participants' self-efficacy to obtain approval from their board of trustees to implement a sexual health EBP. Positive, though nonsignificant, trends included increased knowledge to locate EBPs, skills to prioritize sexual health education at the district level, and ability to choose an EBP that best meets district needs. iCHAMPSS is an innovative decision support system that could accelerate uptake of EBPs by facilitating diffusion and advance the field of dissemination and implementation science for the promotion of sexual health EBPs.

Evidence-based treatment practices for drug-involved adults in the criminal justice system.

PubMed

Friedmann, Peter D; Taxman, Faye S; Henderson, Craig E

2007-04-01

The aim of this study was to estimate the extent and organizational correlates of evidence-based practices (EBPs) in correctional facilities and community-based substance abuse treatment programs that manage drug-involved adult offenders. Correctional administrators and treatment program directors affiliated with a national sample of 384 criminal justice and community-based programs providing substance abuse treatment to adult offenders in the United States were surveyed in 2004. Correctional administrators reported the availability of up to 13 specified EBPs, and treatment directors up to 15. The sum total of EBPs indicates their extent. Linear models regress the extent of EBPs on variables measuring structure and leadership, culture and climate, administrator attitudes, and network connectedness of the organization. Most programs offer fewer than 60% of the specified EBPs to drug-involved offenders. In multiple regression models, offender treatment programs that provided more EBPs were community based, accredited, and network connected, with a performance-oriented, nonpunitive culture, more training resources, and leadership with a background in human services, a high regard for the value of substance abuse treatment, and an understanding of EBPs. The use of EBPs among facility- and community-based programs that serve drug-involved adult offenders has room for improvement. Initiatives to disseminate EBPs might target these institutional and environmental domains, but further research is needed to determine whether such organization interventions can promote the uptake of EBPs.

EVIDENCE-BASED TREATMENT PRACTICES FOR DRUG-INVOLVED ADULTS IN THE CRIMINAL JUSTICE SYSTEM

PubMed Central

Friedmann, Peter D.; Taxman, Faye S.; Henderson, Craig E.

2007-01-01

OBJECTIVE To estimate the extent and organizational correlates of evidence-based practices (EBPs) in correctional facilities and community-based substance abuse treatment programs that manage drug-involved adult offenders. METHODS Correctional administrators and treatment program directors affiliated with a national sample of 384 criminal justice and community-based programs providing substance abuse treatment to adult offenders in the United States were surveyed in 2004. Correctional administrators reported the availability of up to 13 specified EBPs and treatment directors up to 15. The sum total of EBPs indicates their extent. Linear models regress the extent of EBPs on variables measuring structure and leadership, culture and climate, administrator attitudes and network connectedness of the organization. RESULTS Most programs offer fewer than 60% of the specified EBPs to drug-involved offenders. In multiple regression models, offender treatment programs that provided more EBPs were community-based, accredited, and network-connected; with a performance-oriented, non-punitive culture, more training resources; and leadership with a background in human services, a high regard for the value of substance abuse treatment and an understanding of EBPs. CONCLUSIONS The use of EBPs among facility- and community-based programs that serve drug-involved adult offenders has room for improvement. Initiatives to disseminate EBPs might target these institutional and environmental domains, but further research is needed to determine whether such organization interventions can promote the uptake of EBPs. PMID:17383551

Clinician adoption patterns and patient outcome results in use of evidence-based nursing plans of care.

PubMed

Kim, Tae Youn; Lang, Norma M; Berg, Karen; Weaver, Charlotte; Murphy, Judy; Ela, Sue

2007-10-11

Delivery of safe, effective and appropriate health care is an imperative facing health care organizations globally. While many initiatives have been launched in a number of countries to address this need from a medical perspective, a similar focus for generating evidence-based nursing knowledge has been missing. This paper reports on a collaborative evidence-based practice (EBP) research initiative that adds nursing knowledge into computerized care protocols. Here, a brief overview of the study's aims, purpose and methodology is presented as well as results of data analysis and lessons learned. The research team examined nurses' adoption patterns of EBP recommendations with respect to activity tolerance using four-month patient data collected from a pilot hospital. Study findings indicate a need for more focus on the system design and implementation process with the next rollout phase to promote evidence-based nursing practice.

Clinician Adoption Patterns and Patient Outcome Results in Use of Evidence-Based Nursing Plans of Care

PubMed Central

Kim, Tae Youn; Lang, Norma M.; Berg, Karen; Weaver, Charlotte; Murphy, Judy; Ela, Sue

2007-01-01

Delivery of safe, effective and appropriate health care is an imperative facing health care organizations globally. While many initiatives have been launched in a number of countries to address this need from a medical perspective, a similar focus for generating evidence-based nursing knowledge has been missing [1]. This paper reports on a collaborative evidence-based practice (EBP) research initiative that adds nursing knowledge into computerized care protocols. Here, a brief overview of the study’s aims, purpose and methodology is presented as well as results of data analysis and lessons learned. The research team examined nurses’ adoption patterns of EBP recommendations with respect to activity tolerance using four-month patient data collected from a pilot hospital. Study findings indicate a need for more focus on the system design and implementation process with the next rollout phase to promote evidence-based nursing practice. PMID:18693871

Leadership in evidence-based practice: a systematic review.

PubMed

Reichenpfader, Ursula; Carlfjord, Siw; Nilsen, Per

2015-01-01

This study aims to systematically review published empirical research on leadership as a determinant for the implementation of evidence-based practice (EBP) and to investigate leadership conceptualization and operationalization in this field. A systematic review with narrative synthesis was conducted. Relevant electronic bibliographic databases and reference lists of pertinent review articles were searched. To be included, a study had to involve empirical research and refer to both leadership and EBP in health care. Study quality was assessed with a structured instrument based on study design. A total of 17 studies were included. Leadership was mostly viewed as a modifier for implementation success, acting through leadership support. Yet, there was definitional imprecision as well as conceptual inconsistency, and studies seemed to inadequately address situational and contextual factors. Although referring to an organizational factor, the concept was mostly analysed at the individual or group level. The concept of leadership in implementation science seems to be not fully developed. It is unclear whether attempts to tap the concept of leadership in available instruments truly capture and measure the full range of the diverse leadership elements at various levels. Research in implementation science would benefit from a better integration of research findings from other disciplinary fields. Once a more mature concept has been established, researchers in implementation science could proceed to further elaborate operationalization and measurement. Although the relevance of leadership in implementation science has been acknowledged, the conceptual base of leadership in this field has received only limited attention.

Reassessment of Allied Health Professionals' Level of Self-Efficacy in, Outcome Expectancy in, and Use of Evidence-Based Practice.

PubMed

Wilkinson, Shelley A; Hills, Andrew P; Street, Steven J; Hinchliffe, Fiona

2016-01-01

Evidence-based practice (EBP) is fundamental to improving patient outcomes. Factors affecting EBP capabilities are linked with institutional culture and barriers, personal self-belief, and individual ability. To effect change in capabilities, interventions must target barriers and be informed by behaviour change theory. This study measured the effect of training and organisational change on EBP measures amongst allied health professionals. All allied health staff (n=196) employed across the Mater Health Services (Brisbane, Queensland) were invited to complete a survey assessing EBP self-efficacy, outcome expectancy and use, as well as EBP training undertaken. Data were compared with those of surveys from 2010 and 2011. Response rate was 70.9% (n=139/196); 32 staff completed all surveys. Significant improvements were observed in staff undertaking training (EBP, p=0.008; research design and analysis, p=0.003) since the first survey. The significant increase in EBP self-efficacy that occurred from T1 to T2 remained at T3 (p=0.008). Fewer between-department differences were observed over time. This study identified sustained EBP self-efficacy improvements in this cohort and found that between-department differences have virtually disappeared. Ongoing interventions are required to sustain and improve staff's belief in their ability to deliver EBP.

The Teaching of Evidence-Based Practice in Social Work Higher Education--Living by the Charlie Parker Dictum: A Response to Papers by Shlonsky and Stern, and Soydan

ERIC Educational Resources Information Center

Springer, David W.

2007-01-01

This article, as a response to two papers, identifies five critical issues and themes related to the teaching of evidence-based practice (EBP) in social work higher education. These five themes are: defining EBP; modeling the complexity of EBP in teaching; examining social work curriculum; coordinating social work professional organizations; and…

De-adoption of an evidence-based trauma intervention in schools: A retrospective report from an urban school district

PubMed Central

Nadeem, Erum; Ringle, Vanesa

2017-01-01

The de-adoption of evidence-based practices (EBPs) is a largely understudied topic. The present study examined factors related to the de-adoption of an EBP for students exposed to traumatic events in a large urban school district. Qualitative interviews conducted with school clinicians and district administrators two years after the district embarked on a large-scale roll-out of the EBP distinguished between factors that impacted partial de-adoption after one year (phase 1) and complete de-adoption by the district after two years (phase 2). Phase 1 factors included organizational consistency, workforce stability, prior success, positive student outcomes, school- and district- level supports, innovation-setting fit, and innovation-related issues. Phase 2 factors included district-level leadership changes, financial and workforce instability, and shifting priorities. Study results suggest that sustainment-enhancing strategies should be included in the early stages of program implementation to most effectively adapt to school- and system- level changes. PMID:28775793

Powerful Outcomes: Delivering What Works

ERIC Educational Resources Information Center

Brendtro, Larry K.; Mitchell, Martin M.

2014-01-01

Professionals in education, treatment, social services, and juvenile justice are bombarded by messages promoting virtually every method as an "evidence-based practice" (EBP). After years of debating EBP, research is turning toward "practice-based evidence" (PBE). The focus shifts from arguing about what practice works best to…

Facilitating Lewin's change model with collaborative evaluation in promoting evidence based practices of health professionals.

PubMed

Manchester, Julianne; Gray-Miceli, Deanna L; Metcalf, Judith A; Paolini, Charlotte A; Napier, Anne H; Coogle, Constance L; Owens, Myra G

2014-12-01

Evidence based practices (EBPs) in clinical settings interact with and adapt to host organizational characteristics. The contextual factors themselves, surrounding health professions' practices, also adapt as practices become sustained. The authors assert the need for better planning models toward these contextual factors, the influence of which undergird a well-documented science to practice gap in literature on EBPs. The mechanism for EBP planners to anticipate contextual effects as programs Unfreeze their host settings, create Movement, and become Refrozen (Lewin, 1951) is present in Lewin's 3-step change model. Planning for contextual change appears equally important as planning for the actual practice outcomes among providers and patients. Two case studies from a Geriatric Education Center network will illustrate the synthesis of Lewin's three steps with collaborative evaluation principles. The use of the model may become an important tool for continuing education evaluators or organizations beginning a journey toward EBP demonstration projects in clinical settings. Copyright © 2014 Elsevier Ltd. All rights reserved.

Teaching evidence-based practice (EBP) to speech-language therapy students: are students competent and confident EBP users?

PubMed

Spek, B; Wieringa-de Waard, M; Lucas, C; van Dijk, N

2013-01-01

The importance and value of the principles of evidence-based practice (EBP) in the decision-making process is recognized by speech-language therapists (SLTs) worldwide and as a result curricula for speech-language therapy students incorporated EBP principles. However, the willingness actually to use EBP principles in their future profession not only depends on EBP knowledge and skills, but also on self-efficacy and task value students perceive towards EBP. To investigate the relation between EBP knowledge and skills, and EBP self-efficacy and task value in different year groups of Dutch SLT students. Students from three year groups filled in a tool that measured EBP knowledge and skills: the Dutch Modified Fresno (DMF). EBP self-efficacy and task value were assessed by using a 20-item questionnaire. Both tools were validated for this population. Mean scores for the three year groups were calculated and tested for group differences using a one-way analysis of variance (ANOVA) with a post-hoc Games-Howell procedure. With a multiple linear regression technique it was assessed whether EBP self-efficacy and task value predict learning achievement scores on the DMF. Other possible predictors included in the model were: level of prior education, standard of English, having had mathematics in prior education and the SLT study year. A total of 149 students filled in both measurement tools. Mean scores on EBP knowledge and skills were significantly different for the three year groups, with students who were further along their studies scoring higher on the DMF. Mean scores on the EBP self-efficacy and task value questionnaire were the same for the three year groups: all students valued EBP positive but self-efficacy was low in all groups. Of the possible predictors, only the year in which students study and EBP self-efficacy were significant predictors for learning achievements in EBP. Despite a significant increase in EBP knowledge and skills over the years as assessed by the DMF, the integrated EBP curriculum did not raise levels of EBP self-efficacy and task value. This lack of feeling competent might have an impact on students' willingness actually to use EBP. In curricula, therefore, there should be a focus on how to raise EBP self-efficacy in SLT students. This goes even beyond the educational department because a professional culture in which professionals are competent and confident EBP users would have a positive effect on EBP self-efficacy in students. © 2013 Royal College of Speech and Language Therapists.

The Humble Leader: Association of Discrepancies in Leader and Follower Ratings of Implementation Leadership with Organizational Climate in Mental Health

PubMed Central

Aarons, Gregory A.; Ehrhart, Mark G.; Torres, Elisa M.; Finn, Natalie K.; Beidas, Rinad

2017-01-01

Objectives Discrepancies between leaders' self-ratings and follower ratings of the leader are common but usually go unrecognized. Research on discrepancies is limited but there is evidence that discrepancies are associated with organizational context. This study examined the association of leader-follower discrepancies in Implementation Leadership Scale (ILS) ratings of mental health clinic leaders, and the association of those discrepancies with organizational climate for involvement and performance feedback. Both involvement and performance feedback may be important for evidence-based practice implementation in mental health. Methods A total of 593 supervisors (i.e., leaders, n=80) and clinical service providers (i.e., followers, n=513) completed surveys including ratings of implementation leadership and organizational climate. Polynomial regression and response surface analyses were conducted to examine the associations of discrepancies in leader-follower ILS ratings with organizational involvement climate and performance feedback climate, aspects of climate likely to support EBP implementation. Results Both involvement climate and performance feedback climate were highest where leaders rated themselves low on the ILS and their followers rated those leaders high on the ILS (i.e., “humble leaders”). Conclusions Teams with “humble leaders” showed more positive organizational climate for involvement and for performance feedback, contextual factors important during EBP implementation and sustainment. Discrepancy in leader and follower ratings of implementation leadership should be a consideration in understanding and improving leadership and organizational climate for mental health services and for evidence-based practice implementation and sustainment in mental health and other allied health settings. PMID:27691380

Linking research to practice: the rise of evidence-based health sciences librarianship.

PubMed

Marshall, Joanne Gard

2014-01-01

The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work. FOUR SOURCES OF EVIDENCE ARE USED TO EXAMINE THE RISE OF EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement. These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired by evidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice. Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services.

State Knowledge Utilization Spotlight: Maryland. Transforming State Systems to Improve Outcomes for Children with Disabilities

ERIC Educational Resources Information Center

Pentimonti, Jill; Pfannenstiel, Kathleen; Walker, Melodee

2017-01-01

The selection of evidence-based practices (EBPs) in mathematics is a critical step toward improving mathematics outcomes for students with disabilities. This state spotlight presents how the Maryland State Department of Education uses the TAP-IT (Team, Analyze, Plan, Implement, and Track) process coupled with systems coaching to support the…

Randomized Trial of the Availability, Responsiveness, and Continuity (ARC) Organizational Intervention With Community-Based Mental Health Programs and Clinicians Serving Youth

ERIC Educational Resources Information Center

Glisson, Charles; Hemmelgarn, Anthony; Green, Philip; Dukes, Denzel; Atkinson, Shannon; Williams, Nathaniel J.

2012-01-01

Objective: Evidence-based Practice (EBP) implementation is likely to be most efficient and effective in organizations with positive social contexts (i.e., organizational culture, climate, and work attitudes of clinicians). The study objective was to test whether an organizational intervention labeled Availability, Responsiveness and Continuity…

Risk and Strategic Decision-Making in Developing Evidence-Based Practice Guidelines

ERIC Educational Resources Information Center

Wilczynski, Susan M.

2012-01-01

Evidence-based practice (EBP) represents an important approach to educating and treating individuals diagnosed with disabilities or disorders. Understanding research findings is the cornerstone of EBP. The methodology of systematic reviews, which involves carefully analyzing research findings, can result a practice guideline that recommends…

Emotion-based preventive intervention: Effectively promoting emotion knowledge and adaptive behavior among at-risk preschoolers.

PubMed

Finlon, Kristy J; Izard, Carroll E; Seidenfeld, Adina; Johnson, Stacy R; Cavadel, Elizabeth Woodburn; Ewing, E Stephanie Krauthamer; Morgan, Judith K

2015-11-01

Effectiveness studies of preschool social-emotional programs are needed in low-income, diverse populations to help promote the well-being of at-risk children. Following an initial program efficacy study 2 years prior, 248 culturally diverse Head Start preschool children participated in the current effectiveness trial and received either the Emotion-Based Prevention Program (EBP) or the I Can Problem Solve (ICPS) intervention. Pre- and postdata collection included direct child assessment, teacher report, parent interview, and independent observations. Teachers implementing the EBP intervention demonstrated good and consistent fidelity to the program. Overall, children in EBP classrooms gained more emotion knowledge and displayed greater decreases in negative emotion expressions and internalizing behaviors across the implementation period as compared to children in ICPS classrooms. In addition, cumulative risk, parental depressive symptoms, and classroom climate significantly moderated treatment effects. For children experiencing more stress or less support, EBP produced more successful outcomes than did ICPS. These results provide evidence of EBP sustainability and program effectiveness, as did previous findings that demonstrated EBP improvements in emotion knowledge, regulation skills, and behavior problems replicated under unsupervised program conditions.

Development of a theory-based intervention to increase prescription of inspiratory muscle training by health professionals in the management of people with chronic obstructive pulmonary disease.

PubMed

Simms, Alanna M; Li, Linda C; Reid, W Darlene

2011-01-01

The purpose of this paper is twofold: (1) to provide an overview of the literature on barriers to evidence-based practice (EBP) and the effectiveness of implementation interventions in health care; and (2) to outline the development of an implementation intervention for improving the prescription of inspiratory muscle training (IMT) by physical therapists and other health professionals for people with chronic obstructive pulmonary disease (COPD). Individuals, organizations, and the research itself present barriers to EBP in physical therapy. Despite the evidence supporting the use of IMT, this treatment continues to be under-used in managing COPD. Current health services research shows that traditional information-based approaches to implementation, such as didactic lectures, do not adequately address the challenges health professionals face when trying to make changes in practice. We propose the development of a theory-based intervention to improve health professionals' use of IMT in the management of COPD. It is postulated that a behavioural intervention, based on the theory of planned behaviour (TPB), may be more effective than an information-based strategy in increasing the prescription of IMT by health professionals. TPB may be used to understand the antecedents of health professionals' behaviour and to guide the development of implementation interventions. Further research is needed to evaluate the effectiveness of this proposed intervention in the management of people with COPD.

Evidence-based practice instruction by faculty members and librarians in North American optometry and ophthalmology programs

PubMed Central

Hrynchak, Patricia K.; Spafford, Marlee M.

2014-01-01

North American optometry and ophthalmology faculty members and vision science librarians were surveyed online (14% response rate) about teaching evidence-based practice (EBP). Similar to studies of other health care programs, all five EBP steps (Ask, Acquire, Appraise, Apply, Assess) were taught to varying degrees. Optometry and ophthalmology EBP educators may want to place further emphasis on (1) the Apply and Assess steps, (2) faculty- and student-generated questions and self-assessment in clinical settings, (3) online teaching strategies, (4) programmatic integration of EBP learning objectives, and (5) collaboration between faculty members and librarians. PMID:25031564

Using family paradigms to improve evidence-based practice.

PubMed

Hidecker, Mary Jo Cooley; Jones, Rebecca S; Imig, David R; Villarruel, Francisco A

2009-08-01

Evidence-based practice (EBP) describes clinical decision making using research, clinical experience, and client values. For family-centered practices, the client's family is integral to this process. This article proposes that using family paradigms, a family science framework, may help elicit and understand client/family values within family-centered EBP. This article describes the family paradigms framework: 4 classic paradigms of "closed," "random," "open," and "synchronous." Its applicability to family-centered EBP is proposed using augmentative and alternative communication examples. A family-centered approach to EBP requires families to be an integral part of clinical decision making, but some families may need assistance in enumerating their views and values. Family paradigms (which consider how a family uses its resources of time, space, energy, and material in the pursuit of its goals of control, affect, meaning, and content) may be a way to elicit family values and preferences relevant to clinical decisions. Family and client values can be incorporated throughout the EBP steps. Considering family paradigms may increase awareness and understanding of how families' views of their goals and resources affect clinical decisions. Further research is needed into both the processes and effectiveness of using family paradigms to conduct family-centered EBP.

To embed or not to embed? A longitudinal study exploring the impact of curriculum design on the evidence-based practice profiles of UK pre-registration nursing students.

PubMed

Scurlock-Evans, Laura; Upton, Penney; Rouse, Joanne; Upton, Dominic

2017-11-01

The use of Evidence-Based Practice (EBP) is increasingly emphasized within healthcare. However, little research has focused on nurses' pre-registration training; particularly regarding the impact of curriculum-design on learning EBP. This study compared the impact of embedding EBP throughout the curriculum, with modular-based teaching, on pre-registration nursing students' EBP profiles. A longitudinal panel study. A convenience sample of fifty-six pre-registration nursing students (55.4% studying an embedded EBP-curriculum and 44.6% studying a modular EBP-curriculum), were recruited from a UK University between 2011 and 2014. Participants completed the Student Evidence-Based Practice Questionnaire (S-EBPQ) in the first, second and third year of their course. This questionnaire measures four EBP domains: frequency of use, attitude, knowledge and skills in retrieving and reviewing evidence, and knowledge and skills in applying and sharing evidence. Two-way mixed between-within Analyses of Variance revealed significant improvements across all domains, except attitude (which remained broadly positive across all years), for both curriculum-groups. No significant differences in this improvement were identified between the two curricula overall. However, the direction and rate of change of scores on the retrieving and applying subscales (but not frequency of use) for the two groups differed across time; specifically those on the embedded curriculum showed a dip in scores on these subscales in year 2. This appeared to be related to associated features of the course such as the timing of placements and delivery of theory. Taking a modular or embedded approach to EBP may have little impact on students' final EBP profiles. However, careful consideration should be given to the timing of related course features which may play a key role in students' perceptions of their knowledge and skills in its application. Further research should explore how curriculum-design might build on students' initial positive attitudes towards EBP and its use in their practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

Essential elements for community engagement in evidence-based youth violence prevention.

PubMed

Miao, Tai-An; Umemoto, Karen; Gonda, Deanna; Hishinuma, Earl S

2011-09-01

In the field of youth violence prevention, there has been increasing emphasis on "evidence based" programs and principles shown through scientific research as reaching their intended outcomes. Community mobilization and engagement play a critical role in many evidence-based programs and strategies, as it takes a concerted effort among a wide range of people within a community to alter behavior and maintain behavioral change. How do concerned individuals and groups within a community engage others within and outside of that community to effectively plan, develop and implement appropriate EB programs as well as evaluate the outcomes and impacts of locally developed programs yet to be proven? The authors discuss five elements essential for community engagement in evidence-based youth violence prevention based on their work in a university-community partnership through the Asian/Pacific Islander Youth Violence Prevention Center (API Center), a National Academic Center for Excellence on Youth Violence Prevention Center supported by the Centers for Disease Control and Prevention. They include: (a) aligning EBPs with a community's shared vision and values; (b) establishing an inclusive environment for the planning, implementation and evaluation of EBPs; (c) nurturing collaboration for increased effectiveness and efficacy of EBPs; (d) building adequate leadership and community capacity to develop and sustain EBPs; and (e) building a learning community for evaluation and self-reflection. The authors propose placing greater emphasis on "evaluative thinking" and organizational capacity for evaluation as we pursue evidence-based practices for youth violence prevention. This is especially important for ethnic groups for which an evidence base is not well established.

Implementation of a multi-professional standardized care plan in electronic health records for the care of stroke patients.

PubMed

Pöder, Ulrika; Fogelberg-Dahm, Marie; Wadensten, Barbro

2011-09-01

To compare staff opinions about standardized care plans and self-reported habits with regard to documentation, and their perceived knowledge about the evidence-based guidelines in stroke care before and after implementation of an evidence-based-standardized care plan (EB-SCP) and quality standard for stroke care. The aim was also to describe staff opinions about, and their use of, the implemented EB-SCP. To facilitate evidence-based practice (EBP), a multi-professional EB-SCP and quality standard for stroke care was implemented in the electronic health record (EHR). Quantitative, descriptive and comparative, based on questionnaires completed before and after implementation. Perceived knowledge about evidence-based guidelines in stroke care increased after implementation of the EB-SCP. The majority agreed that the EB-SCP is useful and facilitates their work. There was no change between before and after implementation with regard to opinions about standardized care plans, self-reported documentation habits or time spent on documentation. An evidence-based SCP seems to be useful in patient care and improves perceived knowledge about evidence-based guidelines in stroke care. For nursing managers, introduction of evidence-based SCP in the EHR may improve the prerequisites for promoting high-quality EBP in multi-professional care. 2011 Blackwell Publishing Ltd.

Creating a halo traction wheelchair resource manual: using the EBP approach.

PubMed

Difazio, Rachel

2003-04-01

This article describes a clinically based project that used evidence-based practice (EBP). It follows the EBP process of: (1) identifying a clinical problem and stating a clinical question that focuses the process; (2) doing a literature search for best research evidence; (3) using query techniques, such as phone calls and e-mails, to determine best clinical practice among similar institutions; and (4) drawing a practice conclusion-to accept the status quo, to instigate change of practice, or to do more research. This project was an interdisciplinary effort orchestrated by the surgical programs nurses at Boston Children's Hospital. Copyright 2003, Elsevier Inc. All rights reserved.

Evidence-Based Practice Guidelines and School Nursing

ERIC Educational Resources Information Center

Adams, Susan; McCarthy, Ann Marie

2007-01-01

The use of evidence-based practice (EBP) has become the standard of health care practice. Nurses are expected to use best evidence on a wide range of topics, yet most nurses have limited time, resources, and/or skills to access and evaluate the quality of research and evidence needed to practice evidence-based nursing. EBP guidelines allow nurses…

Evaluation Criteria for Nursing Student Application of Evidence-Based Practice: A Delphi Study.

PubMed

Bostwick, Lina; Linden, Lois

2016-06-01

Core clinical evaluation criteria do not exist for measuring prelicensure baccalaureate nursing students' application of evidence-based practice (EBP) during direct care assignments. The study objective was to achieve consensus among EBP nursing experts to create clinical criteria for faculty to use in evaluating students' application of EBP principles. A three-round Delphi method was used. Experts were invited to participate in Web-based surveys. Data were analyzed using qualitative coding and categorizing. Quantitative analyses were descriptive calculations for rating and ranking. Expert consensus occurred in the Delphi rounds. The study provides a set of 10 core clinical evaluation criteria for faculty evaluating students' progression toward competency in their application of EBP. A baccalaureate program curriculum requiring the use of Bostwick's EBP Core Clinical Evaluation Criteria will provide a clear definition for understanding basic core EBP competence as expected for the assessment of student learning. [J Nurs Educ. 2016;55(5):336-341.]. Copyright 2016, SLACK Incorporated.

Child welfare caseworkers as service brokers for youth in foster care: findings from project focus.

PubMed

Dorsey, Shannon; Kerns, Suzanne E U; Trupin, Eric W; Conover, Kate L; Berliner, Lucy

2012-02-01

Youth in the foster care system have substantially higher rates of mental health needs compared to the general population, yet they rarely receive targeted, evidence-based practices (EBPs). Increasingly emerging in the literature on mental health services is the importance of "brokers" or "gateway providers" of services. For youth in foster care, child welfare caseworkers often play this role. This study examines caseworker-level outcomes of Project Focus, a caseworker training and consultation model designed to improve emotional and behavioral outcomes for youth in foster care through increased linkages with EBPs. Project Focus was tested through a small, randomized trial involving four child welfare offices. Caseworkers in the Project Focus intervention group demonstrated an increased awareness of EBPs and a trend toward increased ability to identify appropriate EBP referrals for particular mental health problems but did not have significantly different rates of actual referral to EBPs. Dose of consultation was associated with general awareness of EBPs. Implications for practice and outcomes for youth are discussed.

Increasing the practice of questioning among pediatric nurses: "The Growing Culture of Clinical Inquiry" project.

PubMed

Laibhen-Parkes, Natasha

2014-01-01

This paper describes an innovative methodology implemented in an acute care pediatric setting to build nurses' confidence and competence in questioning practice. The Growing Culture of Clinical Inquiry (GCCI) project was composed of several evidence-based strategies to attain and maintain a spirit of clinical inquiry. These strategies included PowerPoint presentations, evidence-based practice (EBP) unit champions, patient-intervention-comparison-outcome (PICO) boxes, Clinical Inquiry Posters, summaries of evidence (SOE), layman's SOE, medical librarian in-services, and journal clubs. After 1 year of implementation, the GCCI project was evaluated and found to be a promising methodology for fostering a culture of inquiry among pediatric nurses. © 2014.

Changes in physiotherapy students' knowledge and perceptions of EBP from first year to graduation: a mixed methods study.

PubMed

McEvoy, Maureen P; Lewis, Lucy K; Luker, Julie

2018-05-11

Dedicated Evidence-Based Practice (EBP) courses are often included in health professional education programs. It is important to understand the effectiveness of this training. This study investigated EBP outcomes in entry-level physiotherapy students from baseline to completion of all EBP training (graduation). Mixed methods with an explanatory sequential design. Physiotherapy students completed two psychometrically-tested health professional EBP instruments at baseline and graduation. The Evidence-Based Practice Profile questionnaire collected self-reported data (Terminology, Confidence, Practice, Relevance, Sympathy), and the Knowledge of Research Evidence Competencies instrument collected objective data (Actual Knowledge). Focus groups with students were conducted at graduation to gain a deeper understanding of the factors impacting changes in students' EBP knowledge, attitudes, behaviour and competency. Descriptive statistics, paired t-tests, 95% CI and effect sizes (ES) were used to examine changes in outcome scores from baseline to graduation. Transcribed focus group data were analysed following a qualitative descriptive approach with thematic analysis. A second stage of merged data analysis for mixed methods studies was undertaken using side-by-side comparisons to explore quantitatively assessed EBP measures with participants' personal perceptions. Data were analysed from 56 participants who completed both instruments at baseline and graduation, and from 21 focus group participants. Large ES were reported across most outcomes: Relevance (ES 2.29, p ≤ 0.001), Practice (1.8, p ≤ 0.001), Confidence (1.67, p ≤ 0.001), Terminology (3.13, p ≤ 0.001) and Actual Knowledge (4.3, p ≤ 0.001). A medium ES was found for Sympathy (0.49, p = 0.008). Qualitative and quantitative findings mostly aligned but for statistical terminology, participants' self-reported understanding was disparate with focus group reported experiences. Qualitative findings highlighted the importance of providing relevant context and positive role models for students during EBP training. Following EBP training across an entry-level physiotherapy program, there were qualitative and significant quantitative changes in participants' knowledge and perceptions of EBP. The qualitative and quantitative findings were mainly well-aligned with the exception of the Terminology domain, where the qualitative findings did not support the strength of the effect reported quantitatively. The findings of this study have implications for the timing and content of EBP curricula in entry-level health professional programs.

From Caterpillars to Butterflies: Engaging Nurse Leaders in Evidence-Based Practice Reform.

PubMed

Sanares-Carreon, Dolora

2016-01-01

Evidence-based practice (EBP) occurs when the integration of best evidence is brought to the bedside to ground patient care decisions. Barriers to EBP have lingered for years and held unabated. The experiences of an academic medical center offer fresh perspectives in devolving the accountability for EBP where care is provided and received by patients. More specifically, the initiative is a focused engagement of nurse leaders in administrative positions for energizing bedside nurses to reform the enculturation of EBP. The goal is not to control but to explore approaches of handling the barriers with a complexity mindset amidst uncertainties. Nurses' collective engagement is envisioned to spark or refine creative ideas that will steer and account for EBP outcomes. The flight of the butterfly is used as a metaphor; hence, the title for the Monarch Moments Initiative.

Web-Based Evidence Based Practice Educational Intervention to Improve EBP Competence among BSN-Prepared Pediatric Bedside Nurses: A Mixed Methods Pilot Study

ERIC Educational Resources Information Center

Laibhen-Parkes, Natasha

2014-01-01

For pediatric nurses, their competence in EBP is critical for providing high-quality care and maximizing patient outcomes. The purpose of this pilot study was to assess and refine a Web-based EBP educational intervention focused on improving EBP beliefs and competence in BSN-prepared pediatric bedside nurses, and to examine the feasibility,…

Linking research to practice: the rise of evidence-based health sciences librarianship*

PubMed Central

Marshall, Joanne Gard

2014-01-01

Purpose: The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work. Methods: Four sources of evidence are used to examine the rise of EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement. Results: These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired by evidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice. Implications: Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services. PMID:24415915

Teaching evidence-based practice principles to prepare health professions students for an interprofessional learning experience.

PubMed

Aronoff, Nell; Stellrecht, Elizabeth; Lyons, Amy G; Zafron, Michelle L; Glogowski, Maryruth; Grabowski, Jeremiah; Ohtake, Patricia J

2017-10-01

The research assessed online learning modules designed to teach health professions students evidence-based practice (EBP) principles in an interprofessional context across two institutions. Students from nine health professions at two institutions were recruited to participate in this pilot project consisting of two online learning modules designed to prepare students for an in-person case-based interprofessional activity. Librarians and an instructional designer created two EBP modules. Students' competence in EBP was assessed before and after the modules as well as after the in-person activity. Students evaluated the online learning modules and their impact on the students' learning after the in-person session. A total of 39 students from 8 health professions programs participated in the project. Average quiz scores for online EBP module 1 and module 2 were 83% and 76%, respectively. Following completion of the learning modules, adapted Fresno test of competence in EBP scores increased ( p =0.001), indicating that the modules improved EBP skill competence. Student evaluations of the learning modules were positive. Students indicated that they acquired new information skills that contributed to their ability to develop a patient care plan and that they would use these information skills in their future clinical practice. Online EBP learning modules were effective in developing EBP knowledge and skills for health professions students. Using the same modules ensured that students from different health professions at different stages of their professional programs had consistent knowledge and enabled each student to fully engage in an interprofessional evidence-based activity. Student feedback indicated the modules were valued and beneficial.

Implementing Evidence-Based Programs: Lessons Learned from the Field

ERIC Educational Resources Information Center

Powers, Jane; Maley, Mary; Purington, Amanda; Schantz, Karen; Dotterweich, Jutta

2015-01-01

Evidence-based programs (EBPs) are used in many health promotion efforts to ensure that the intended positive behavioral and health outcomes will be achieved. However, because EBPs are developed and tested in research settings, the contextual elements of real world implementation play an important role in their successful delivery in communities.…

Measuring Use of Evidence-Based Psychotherapy for PTSD in VA Residential Treatment Settings with Clinician Survey and Electronic Medical Record Templates.

PubMed

Shiner, Brian; Leonard Westgate, Christine; Simiola, Vanessa; Thompson, Richard; Schnurr, Paula P; Cook, Joan M

2018-03-14

Available studies on implementation of evidence-based psychotherapy (EBP) for patients attending Department of Veterans Affairs (VA) residential post-traumatic stress disorder (PTSD) programs rely on therapist self-report of EBP delivery. Patient-level data on receipt of EBP are needed both to corroborate therapist self-report and to understand patient factors that predict receipt of EBPs for PTSD. We identified 159 therapists from 38 VA residential PTSD programs who responded to a survey about EBP implementation during the 2015 fiscal year (FY15). Therapists self-reported their use of two EBPs, including prolonged exposure delivered in an individual format (PE-I) and cognitive processing therapy delivered in individual and group formats (CPT-I and CPT-G). Using electronic medical record (EMR) templates mandated for EBP documentation in FY15, we measured contemporaneous patient-level receipt of EBPs for PTSD. We assessed the degree of correlation between therapist self-reported EBP delivery and patient receipt of EBT as measured by EMR templates using polychoric correlation coefficients. We determined patient and therapist factors that predicted the receipt of EBPs with multivariable logistic regression, using random effects and robust standard error estimation, and controlling for site. The Veterans IRB of Northern New England provided a waiver of informed consent; as this was a retrospective review, no patients or therapists were contacted, and all data were stored, transmitted, and analyzed on secure VA servers. The VA Connecticut Health Care System Human Research Protection Program approved secondary use of therapist survey data for this project. When EMR template use became mandated in FY15, the proportion of patients in residential PTSD programs who received at least one EBP session that was recorded with an EMR template increased dramatically from 8.8% to 33.9%. There was adequate correlation and between survey-based and EMR-based measures of EBP receipt, with polychoric correlation values of 0.77 for PE-I, 0.69 for CPT-I, and 0.82 for CPT-G. Multiple patient factors were positive (e.g., female gender) and negative (e.g., depressive disorders) predictors of receipt of EBPs, even after controlling for site. Among therapist factors, only EBP consultant or trainer status was a positive predictor of EBP provision and only therapist race was a negative predictor of EBT provision after controlling for site. Following a FY15 mandate, EMR templates documenting EBP delivery were widely used by therapists working in VA residential PTSD programs. EBP receipt measured using EMR templates was consistent with therapist self-report of EBT delivery. There were several patient-level predictors of EBP receipt and therapist-level predictors of EBP delivery. However, therapists most likely to deliver EBPs were clustered at a limited number of sites.

Evidence-based practice: the importance of education and leadership.

PubMed

Johansson, Birgitta; Fogelberg-Dahm, Marie; Wadensten, Barbro

2010-01-01

To describe evidence-based practice among head nurses and to explore whether number of years of duty is associated with such activities. Further to evaluate the effects of education on evidence-based practice and perceived support from immediate superiors. Registered nurses in Sweden are required by law to perform care based on research findings and best experiences. In order to achieve this, evidence-based practice (EBP) is of key importance. All 168 head nurses at two hospitals were asked to participate. Ninety-nine (59%) completed the survey. Data were collected using a study-specific web-based questionnaire. The majority reported a positive attitude towards EBP, but also a lack of time for EBP activities. A greater number of years as a head nurse was positively correlated with research utilization. Education in research methods and perceived support from immediate superiors were statistically and significantly associated with increased EBP activities. The present study highlights the value of education in research methods and the importance of supportive leadership. Education is an important factor in the employment of head nurses. We recommend interventions to create increased support for EBP among management, the goal being to deliver high-quality care and increase patient satisfaction.

When craft and science collide: Improving therapeutic practices through evidence-based innovations.

PubMed

Justice, Laura M

2010-04-01

Evidence-based practice (EBP) is a model of clinical decision-making that is increasingly being advocated for use in the field of speech-language pathology. With the increased emphasis on scientific evidence as a form of knowledge important to EBP, clinicians may wonder whether their craft-based knowledge (i.e., knowledge derived from theory and practice), remains a legitimate form of knowledge for use in clinician decisions. This article describes forms of knowledge that may be used to address clinical questions, to include both craft and science. Additionally, the steps used when engaging in EBP are described so that clinicians understand when and how craft comes into play. The major premise addressed within this article is that craft is a legitimate form of knowledge and that engagement in EBP requires one to employ craft-based knowledge.

Creating Synergy in Practice: Promoting Complementarity between Evidence-Based and Postmodern Approaches

ERIC Educational Resources Information Center

Jacobs, Stephanie; Kissil, Karni; Scott, Dalesa; Davey, Maureen

2010-01-01

Postmodern and evidence-based practice (EBP) are compared and contrasted with the primary aim of adapting evidence-based practice with a more flexible epistemological lens. We begin by reviewing the epistemological underpinnings of postmodern and EBP within the field of marriage and family therapy (MFT). We next discuss how these contrasting…

Measuring Nurses' Value, Implementation, and Knowledge of Evidence-Based Practice: Further Psychometric Testing of the Quick-EBP-VIK Survey.

PubMed

Connor, Linda; Paul, Fiona; McCabe, Margaret; Ziniel, Sonja

2017-02-01

The Quick-EBP-VIK is a new instrument for measuring nurses' value, implementation, and knowledge of EBP. Psychometric testing was conducted in two parts. Part 1 describes the tool development and validity testing which resulted in the development of a 25-item survey after receiving ≥0.80 Item-Level Content Validity Index for both clarity and relevance. Part 2 describes psychometric testing was necessary to assess additional types of validity and reliability. The purpose of this paper is to further describe the psychometric testing of the Quick-EBP-VIK survey instrument. This descriptive study was designed to assess test-retest reliability, internal consistency and construct validity via a web-based survey. The survey instrument was e-mailed to all nurses at the study hospital. Nurses who responded to the first survey (Wave 1) received another e-mail invitation to complete the survey instrument again (Wave 2) for the purpose of assessing the test-retest reliability of the instrument. A total of 1,177 deliverable e-mails were sent to all nursing staff at one free standing pediatric hospital with Magnet ® designation in the northeast. A total of 382 nurses returned completed surveys, indicating a 32.5% response rate for Wave 1. A total of 131 nurses responded to Wave 2 indicating a response rate of 34.3%. The intraclass correlation coefficients for the items included in the final instrument ranged from 0.43 to 0.80 and were deemed sufficient. These represent a sufficient intraclass correlation coefficient. The Cronbach's Alpha values for each of the three domains are all higher than 0.7 indicating that the items of each of the measurement dimension are internally consistent. However, the composite reliability of the third domain was slightly lower than 0.7 when using Raykov's Rho. The Quick-EBP-VIK instrument has gone through rigorous comprehensive testing and has demonstrated good psychometric properties. © 2016 Sigma Theta Tau International.

Evidence-Based Youth Psychotherapy in the Mental Health Ecosystem

ERIC Educational Resources Information Center

Weisz, John R.; Ugueto, Ana M.; Cheron, Daniel M.; Herren, Jenny

2013-01-01

Five decades of randomized trials research have produced dozens of evidence-based psychotherapies (EBPs) for youths. The EBPs produce respectable effects in traditional efficacy trials, but the effects shrink markedly when EBPs are tested in practice contexts with clinically referred youths and compared to usual clinical care. We considered why…

Leadership for evidence-based practice: strategic and functional behaviors for institutionalizing EBP.

PubMed

Stetler, Cheryl B; Ritchie, Judith A; Rycroft-Malone, Jo; Charns, Martin P

2014-08-01

Making evidence-based practice (EBP) a reality throughout an organization is a challenging goal in healthcare services. Leadership has been recognized as a critical element in that process. However, little is known about the exact role and function of various levels of leadership in the successful institutionalization of EBP within an organization. To uncover what leaders at different levels and in different roles actually do, and what actions they take to develop, enhance, and sustain EBP as the norm. Qualitative data from a case study regarding institutionalization of EBP in two contrasting cases (Role Model and Beginner hospitals) were systematically analyzed. Data were obtained from multiple interviews of leaders, both formal and informal, and from staff nurse focus groups. A deductive coding schema, based on concepts of functional leadership, was developed for this in-depth analysis. Participants' descriptions reflected a hierarchical array of strategic, functional, and cross-cutting behaviors. Within these macrolevel "themes," 10 behavioral midlevel themes were identified; for example, Intervening and Role modeling. Each theme is distinctive, yet various themes and their subthemes were interrelated and synergistic. These behaviors and their interrelationships were conceptualized in the framework "Leadership Behaviors Supportive of EBP Institutionalization" (L-EBP). Leaders at multiple levels in the Role Model case, both formal and informal, engaged in most of these behaviors. Supportive leadership behaviors required for organizational institutionalization of EBP reflect a complex set of interactive, multifaceted EBP-focused actions carried out by leaders from the chief nursing officer to staff nurses. A related framework such as L-EBP may provide concrete guidance needed to underpin the often-noted but abstract finding that leaders should "support" EBP. © 2014 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International.

Leadership for Evidence-Based Practice: Strategic and Functional Behaviors for Institutionalizing EBP

PubMed Central

Stetler, Cheryl B; Ritchie, Judith A; Rycroft-Malone, Jo; Charns, Martin P

2014-01-01

Background Making evidence-based practice (EBP) a reality throughout an organization is a challenging goal in healthcare services. Leadership has been recognized as a critical element in that process. However, little is known about the exact role and function of various levels of leadership in the successful institutionalization of EBP within an organization. Aims To uncover what leaders at different levels and in different roles actually do, and what actions they take to develop, enhance, and sustain EBP as the norm. Methods Qualitative data from a case study regarding institutionalization of EBP in two contrasting cases (Role Model and Beginner hospitals) were systematically analyzed. Data were obtained from multiple interviews of leaders, both formal and informal, and from staff nurse focus groups. A deductive coding schema, based on concepts of functional leadership, was developed for this in-depth analysis. Results Participants’ descriptions reflected a hierarchical array of strategic, functional, and cross-cutting behaviors. Within these macrolevel “themes,” 10 behavioral midlevel themes were identified; for example, Intervening and Role modeling. Each theme is distinctive, yet various themes and their subthemes were interrelated and synergistic. These behaviors and their interrelationships were conceptualized in the framework “Leadership Behaviors Supportive of EBP Institutionalization” (L-EBP). Leaders at multiple levels in the Role Model case, both formal and informal, engaged in most of these behaviors. Linking Evidence to Action Supportive leadership behaviors required for organizational institutionalization of EBP reflect a complex set of interactive, multifaceted EBP-focused actions carried out by leaders from the chief nursing officer to staff nurses. A related framework such as L-EBP may provide concrete guidance needed to underpin the often-noted but abstract finding that leaders should “support” EBP. PMID:24986669

The propensity to adopt evidence-based practice among physical therapists

PubMed Central

Bridges, Patricia H; Bierema, Laura L; Valentine, Thomas

2007-01-01

Background Many authors, as well as the American Physical Therapy Association, advocate that physical therapists adopt practice patterns based on research evidence, known as evidence-based practice (EBP). At the same time, physical therapists should be capable of integrating EBP within the day-to-day practice of physical therapy. The purpose of this study was to determine the extent to which personal characteristics and the characteristics of the social system in the workplace influence the propensity of physical therapists to adopt EBP. Methods The study used a 69 item mailed self-completion questionnaire. The questionnaire had four major sections. The first three sections were each drawn from a different theoretical framework and from different authors' work. The instrument was developed to capture the propensity of physical therapists to adopt EBP, characteristics of the social system in the workplace of physical therapists, personal characteristics of physical therapists, and selected demographic variables of physical therapists. The eligible population consisted of 3,897 physical therapists licensed by the state of Georgia in the United States of America. A random sample of 1320 potential participants was drawn. Results 939 questionnaires were returned for a response rate of 73%. 831 of the participants' questionnaires were useable and became the basis for the study. There was a moderate association between desire for learning (r = .36, r2 = .13), highest degree held (r = .29, r2 = .08), practicality (r = .27, r2 = .07) and nonconformity (r = .24, r2 = .06) and the propensity to adopt EBP. A negative correlation was found between age, years licensed and percentage of time in direct patient care. The findings demonstrated that the best three variables for predicting the propensity to adopt EBP in physical therapy were: desire for learning, highest degree held, and practicality. Conclusion The study confirms there is no single factor to facilitate research evidence into day-to-day practice. Multiple practice change strategies will be needed to facilitate change in practice. PMID:17615076

Translation of oral care practice guidelines into clinical practice by intensive care unit nurses.

PubMed

Ganz, Freda DeKeyser; Ofra, Raanan; Khalaila, Rabia; Levy, Hadassa; Arad, Dana; Kolpak, Orly; Ben Nun, Maureen; Drori, Yardena; Benbenishty, Julie

2013-12-01

The purpose of this study was to determine whether there was a change in the oral care practices of intensive care unit (ICU) nurses for ventilated patients after a national effort to increase evidence-based oral care practices. Descriptive comparison of ICU nurses in 2004-2005 and 2012. Two convenience national surveys of ICU nurses were collected in 2004-2005 (n = 218) and 2012 (n = 233). After the results of the initial survey were reported, a national effort to increase awareness of evidence-based oral care practices was conducted that included in-service presentations; publication of an evidence-based protocol in a national nursing journal; publication of the survey findings in an international nursing journal; and reports to the local press. A repeat survey was conducted 7 to 8 years later. The same survey instrument was used for both periods of data collection. This questionnaire included questions about demographic and personal characteristics and a checklist of oral care practices. Nurses rated their perceived priority level concerning oral care on a scale from 0 to 100. An evidence-based practice (EBP)[O4] score was computed representing the sum of 14 items related to equipment, solutions, assessments, and techniques associated with the evidence. The EBP score, priority score, and oral care practices were compared between the two samples. A regression model was built based on those variables that were associated with the EBP score in 2012. There was a statistically significant increase in the use of EBPs as shown by the EBP score and in the perceived priority level of oral care. Increased EBPs were found in the areas of teeth brushing and oral assessment. Decreases were found in the use of non-evidence-based practices, such as the use of gauze pads, tongue depressors, lemon water, and sodium bicarbonate. No differences were found in the use of chlorhexidine, toothpaste, or the nursing documentation of oral care practices. A multiple regression model was found to be significant with the time of participation (2004-2005 vs. 2012) and priority level of oral care significantly contributing to the regression model. The national effort was partially successful in improving evidence-based oral care practices; however, increased awareness to EBP also might have come from other sources. Other strategies related to knowledge translation need to be attempted and researched in this clinical setting such as the use of opinion leaders, audits and feedback, small group consensus, provider reminder systems, incentives, clinical information systems, and computer decision support systems. This national effort to improve EBP did reap some rewards; however, other knowledge translation strategies should be used to further improve clinical practice. © 2013 Sigma Theta Tau International.

Mediating role of critical thinking disposition in the relationship between perceived barriers to research use and evidence-based practice.

PubMed

Kim, Sun-Ae; Song, Youngshin; Sim, Hee-Sook; Ahn, Eun-Kyong; Kim, Jung-Hee

2015-01-01

Despite the importance of critical thinking in clinical and educational settings, little is known about its role in evidence-based practice (EBP). This study examined whether critical thinking disposition (CTD) mediates the relationship between perceived barriers to research use and EBP in clinical nurses (N=409). A path diagram using structural equation modeling was used to estimate the direct and indirect effects of perceived barriers to research use on EBP, controlling for CTD as a mediator. CTD partially mediated the relationship between perceived barriers to research use and EBP. Furthermore, the hypothesized mediation model demonstrated an appropriate fit to the data. Individual and organizational efforts are needed to help nurses further improve their critical thinking skills. CTD is important as research barriers to engage effectively in EBP. Without the skills to evaluate evidence carefully, research utilization may be compromised.

Integrating evidence-based practice and information literacy skills in teaching physical and occupational therapy students.

PubMed

Boruff, Jill T; Thomas, Aliki

2011-12-01

To ensure that physical and occupational therapy graduates develop evidence-based practice (EBP) competencies, their academic training must promote EBP skills, such as posing a clinical question and retrieving relevant literature, and the information literacy skills needed to practice these EBP skills. This article describes the collaborative process and outcome of integrating EBP and information literacy early in a professional physical therapy and occupational therapy programme. The liaison librarian and a faculty member designed an instructional activity that included a lecture, workshop and assignment that integrated EBP skills and information literacy skills in the first year of the programme. The assignment was designed to assess students' ability to conduct a search independently. The lecture and workshop were successful in their objectives, as 101 of the 104 students received at least 8 out of 10 points on the search assignment. The teaching activities developed for the students in this course appear to have achieved the goal of teaching students the EBP research cycle so that they might begin to emulate it. The collaboration between the faculty member and the librarian was integral to the success of this endeavour. Future work will include the evaluation of students' long-term retention of information literacy objectives. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

Reducing the Shared Burden of Chronic Conditions among Persons Aging with Disability and Older Adults in the United States through Bridging Aging and Disability

PubMed Central

Campbell, Margaret L.; Putnam, Michelle

2017-01-01

Persons aging with long-term disabilities such as spinal cord injury or multiple sclerosis and older adults share similar chronic conditions in mid and later life in the United States. The rising general interest and more prevalent federal requirements for use of evidence-based practices (EBP) in health promotion and chronic condition interventions highlight the gap between demand and the availability of EBPs for persons aging with disability in particular. Addressing this gap will require focused efforts that will benefit substantially by bridging the fields of aging and disability/rehabilitation to develop new EBPs, translate existing EBPs across populations, and borrow best practices across fields where there are few current EBPs. Understanding distinctions between disability-related secondary conditions and age-related chronic conditions is a first step in identifying shared conditions that are important to address for both mid-life and older adults with disabilities. This review articulates these distinctions, describes shared conditions, and discusses the current lack of EBPs for both populations. It also provides recommendations for bridging activities in the United States by researchers, professionals, and consumer advocates. We argue that these can more efficiently move research and practice than if activities were undertaken separately in each field (aging and disability/rehabilitation). PMID:28895898

Using a pedagogical approach to integrate evidence-based teaching in an undergraduate women's health course.

PubMed

Dawley, Katy; Bloch, Joan Rosen; Suplee, Patricia Dunphy; McKeever, Amy; Scherzer, Gerri

2011-06-01

Evidence-based practice (EBP) is promoted as a foundation for nursing practice. However, the 2005 U.S. survey of nurses revealed that they do not have requisite skills for EBP. PURPOSE AND GOALS: To evaluate a pedagogical approach aimed at (1) fostering undergraduate nursing students EBP competencies, and (2) identifying gaps in the literature to direct future women's health research. A secondary analysis of data abstracted from required EBP clinical journals for an undergraduate women's health course in which students (n = 198) were asked to find evidence to answer their clinical questions. Content analysis was used to identify main themes of the topics of inquiry. Students identified 1,808 clinical questions and 30.3% (n = 547) of these could not be answered or supported by evidence in the literature. This assignment was an important teaching and assessment tool for EBP. Questions reflected critical thinking and quest for in-depth knowledge to support nursing practice. Some students lacked skills in searching databases and a significant number of knowledge gaps were identified that can direct women's health research. Copyright ©2010 Sigma Theta Tau International.

Using pedagogical approaches to influence evidence-based practice integration - processes and recommendations: findings from a grounded theory study.

PubMed

Malik, Gulzar; McKenna, Lisa; Griffiths, Debra

2017-04-01

The study aimed to explore the processes undertaken by nurse academics when integrating evidence-based practice (EBP) into their teaching and learning practices. This article focuses on pedagogical approaches employed by academics to influence evidence-based practice integration into undergraduate programs across Australian universities. Nursing academics are challenged to incorporate a variety of teaching and learning strategies to teach evidence-based practice and determine their effectiveness. However, literature suggests that there are limited studies available focusing on pedagogical approaches in evidence-based practice education. A constructivist grounded theory methodology, informed by Charmaz was used for this study. Data were collected during 2014 from 23 nurse academics across Australian universities through semi-structured interviews. Additionally, nine were observed during teaching of undergraduate students. Twenty subject outlines were also analysed following Charmaz's approach of data analysis. 'Influencing EBP integration' describes the pedagogical approaches employed by academics to incorporate EBP knowledge and skills into undergraduate curricula. With the use of various teaching and learning strategies, academics attempted to contextualize EBP by engaging students with activities aiming to link evidence to practice and with the EBP process. Although, some strategies appeared to be engaging, others were traditional and seemed to be disengaging for students due to the challenges experienced by participants that impeded the use of the most effective teaching methods. Study findings offer valuable insights into the teaching practices and identify some key challenges that require the adoption of appropriate strategies to ensure future nurses are well prepared in the paradigm of evidence-based practice. © 2016 John Wiley & Sons Ltd.

Assessing Awareness and Use of Evidence-Based Programs for Cancer Control in Puerto Rico

PubMed Central

Calo, William A.; Fernández, María E.; Rivera, Mirza; Díaz, Elba C.; Correa-Fernández, Virmarie; Pattatucci, Angela; Wetter, David W.

2012-01-01

The Community Cancer Control Outreach Program (CCCOP) is a community-academic partnership aimed at developing and implementing a cancer control outreach, research, and training program in Puerto Rico. The CCCOP surveyed 56 partners to assess their awareness, training needs, and use of resources related to evidence-based programs (EBPs). Despite relatively high levels (70%) of confidence in adopting EBPs, there were low levels of awareness (37%) and use (25%) of existing EBPs resources. Respondents’ who had used EBPs resources were more likely to have positive beliefs about EBPs than nonusers (p<0.05). Training needs were high among respondents and no significant differences were found between those who had and had not used existing EBPs resources. These findings can guide the development of training tools and technical assistance to increase the use of EBPs for Latino audiences. PMID:22528632

[Evidence-based practice in nursing curricula: the experience of nursing degree course of Reggio Emilia. A pilot study].

PubMed

Finotto, Stefano; Chiesi, Ivens; Mecugni, Daniela; Casali, Patrizia; Doro, Lucia Maria Grazia; Lusetti, Simona

2010-01-01

Given the lack of evidence in literature concerning the presence of Evidence-Based Practice (EBP) in nursing curricula, but considering its importance in order to educate future nurses to use critical thinking and to base their practice on scientific evidence, tutors and nursing teachers of the Nursing Degree Course of Reggio Emilia (Università degli Studi di Modena e Reggio Emilia), have decided to introduce a three-year laboratory of EBP. The purposes of this project are: to describe the three-year EBP laboratory of Nursing Degree, its objectives, its structure, its integration with practical training and nursing subjects and its students evaluation strategies; to get students verify the perception of the usefulness of the three-year EBP laboratory regarding the elaboration of the graduation thesis, the search for appropriatem answers for patients met during clinical trainings and the usefulness of the EBP process in view of the development of their professional career. The design of research of this pilot study is correlation-descriptive. It has been selected a sample of convenience consisting of 56 nurses graduated in the autumn session of the academic year 2007-2008. For data collection we have used an electronic questionnaire (Microsoft Word with closed fields) structured for the purpose. The laboratory has been effective in learning to use the database to search for evidences and to use the database to search for evidences related to nursing problems met in training placements. Finally, graduated nurses consider the EBP process an essential element of professional nursing luggage. Although the sample is restricted the results indicates the good educational choice made by our Nursing Degree Course of integrating the EBP Laboratory in the curriculum.

EBP partners: doctoral students and practicing clinicians bridging the theory-practice gap.

PubMed

Peck, Sydney; Lester, Jennifer; Hinshaw, Ginger; Stiles, Anne; Dingman, Sharon K

2009-01-01

The theory-practice gap is one component of the barriers to implementing evidence-based practice. Texas Woman's University College of Nursing and Presbyterian Hospital of Denton joined forces to bridge this gap, allowing doctoral students to provide educational offerings to practicing nurses. Through a Graduate Assistance in Areas of National Need grant, doctoral students completed supervised teaching practicums at the hospital, assisting the hospital to implement evidence-based practice with the ultimate goal of applying for Magnet status. The hospital benefited from the addition of research expertise and mentoring for the staff members. The students benefited from the opportunities to teach and to share knowledge with these clinical experts. This program has been successful in meeting the needs of both parties. Recommendations are given for other institutions interested in establishing similar relationships.

Evidence-Based Practice and Research: A Challenge to the Development of Adapted Physical Activity

ERIC Educational Resources Information Center

Hutzler, Yeshayahu Shayke

2011-01-01

Evidence-based practice (EBP) is a growing movement in the health and educational disciplines that recommends emphasis on research outcomes during decision making in practice. EBP is made possible through evidence based research (EBR), which attempts to synthesize the volume and scientific rigor of intervention effectiveness. With the purpose of…

Evaluating the Properties of the Evidence-Based Practice Attitude Scale (EBPAS) in Health Care

ERIC Educational Resources Information Center

Melas, Christos D.; Zampetakis, Leonidas A.; Dimopoulou, Anastasia; Moustakis, Vassilis

2012-01-01

The Evidence-Based Practice Attitude Scale (EBPAS; Aarons, 2004) is a relatively new construct for the study of attitudes toward the adoption of innovation and evidence-based practices (EBPs) in mental health service settings. Despite widespread interest in measuring the attitudes of health care providers in conjunction with the adoption of EBPs,…

Evidence-Based Practice in Mental Health Care to Ethnic Minority Communities: Has Its Practice Fallen Short of Its Evidence?

ERIC Educational Resources Information Center

Aisenberg, Eugene

2008-01-01

Evidence-based practice (EBP) has contributed substantially to the advancement of knowledge in the treatment and prevention of adult mental health disorders. A fundamental assumption, based on documented evidence of effectiveness with certain populations, is that EBP is equally effective and applicable to all populations. However, small sample…

Attitudes Toward Adoption of Evidence-Based Practice Among Physical Therapists and Social Workers: A Lesson for Interprofessional Continuing Education.

PubMed

Gudjonsdottir, Bjorg; Arnadottir, Hervor A; Gudmundsson, Halldor S; Juliusdottir, Sigrun; Arnadottir, Solveig A

2017-01-01

Professionals who embrace evidence-based practice (EBP) continually search for research evidence, appraise, and apply it, while interacting with each client in his/her situation. This dynamic learning process takes a substantial commitment from professionals and requires a positive attitude toward EBP. The main objective of this research was to explore the following: 1) distinct dimensions of attitudes toward adoption of EBP among physical therapists and social workers and 2) the relationship between these dimensions of attitudes and selected background characteristics of the compared professions. Cross-sectional web-based surveys were conducted in 2012 and 2013 on a population-based sample from the Icelandic Physical Therapy Association and the Icelandic Association of Social Workers. The participants were 214 physical therapists (76.3% women) and 163 social workers (92.2% women). The Evidence-Based Practice Attitude Scale (EBPAS) and its four subscales were used to survey dimensions of attitudes toward EBP. Scores on the total EBPAS range from zero to five, with a higher score indicating a more positive attitude toward EBPs. Linear regression was used to explore the relationship between the EBPAS scales and selected background variables. The overall response rate was 39%. Both professions generally held positive attitudes toward adoption of EBP, with an average EBPAS total score of 3.06 (SD = 0.46). The professionals' background characteristics were independently related to at least one dimension of attitudes toward EBP. More positive attitudes were associated with being a physical therapist, a woman, in a younger age group, having a graduate degree, working with individual clients, and having at least five same-profession coworkers. The results may be useful to design continuing education focusing on EBP. Such inventions should be targeted to professional attitudes, background, and other contextual factors.

Teaching evidence-based practice principles to prepare health professions students for an interprofessional learning experience

PubMed Central

Aronoff, Nell; Stellrecht, Elizabeth; Lyons, Amy G.; Zafron, Michelle L.; Glogowski, Maryruth; Grabowski, Jeremiah; Ohtake, Patricia J.

2017-01-01

Objective: The research assessed online learning modules designed to teach health professions students evidence-based practice (EBP) principles in an interprofessional context across two institutions. Methods: Students from nine health professions at two institutions were recruited to participate in this pilot project consisting of two online learning modules designed to prepare students for an in-person case-based interprofessional activity. Librarians and an instructional designer created two EBP modules. Students’ competence in EBP was assessed before and after the modules as well as after the in-person activity. Students evaluated the online learning modules and their impact on the students’ learning after the in-person session. Results: A total of 39 students from 8 health professions programs participated in the project. Average quiz scores for online EBP module 1 and module 2 were 83% and 76%, respectively. Following completion of the learning modules, adapted Fresno test of competence in EBP scores increased (p=0.001), indicating that the modules improved EBP skill competence. Student evaluations of the learning modules were positive. Students indicated that they acquired new information skills that contributed to their ability to develop a patient care plan and that they would use these information skills in their future clinical practice. Conclusions: Online EBP learning modules were effective in developing EBP knowledge and skills for health professions students. Using the same modules ensured that students from different health professions at different stages of their professional programs had consistent knowledge and enabled each student to fully engage in an interprofessional evidence-based activity. Student feedback indicated the modules were valued and beneficial. PMID:28983201

Integrating community-based health promotion programs and primary care: a mixed methods analysis of feasibility.

PubMed

Leppin, Aaron L; Schaepe, Karen; Egginton, Jason; Dick, Sara; Branda, Megan; Christiansen, Lori; Burow, Nicole M; Gaw, Charlene; Montori, Victor M

2018-01-31

Implementation of evidence-based programs (EBPs) for disease self-management and prevention is a policy priority. It is challenging to implement EBPs offered in community settings and to integrate them with healthcare. We sought to understand, categorize, and richly describe key challenges and opportunities related to integrating EBPs into routine primary care practice in the United States. As part of a parent, participatory action research project, we conducted a mixed methods evaluation guided by the PRECEDE implementation planning model in an 11-county region of Southeast Minnesota. Our community-partnered research team interviewed and surveyed 15 and 190 primary care clinicians and 15 and 88 non-clinician stakeholders, respectively. We coded interviews according to pre-defined PRECEDE factors and by participant type and searched for emerging themes. We then categorized survey items-before looking at participant responses-according to their ability to generate further evidence supporting the PRECEDE factors and emerging themes. We statistically summarized data within and across responder groups. When consistent, we merged these with qualitative insight. The themes we found, "Two Systems, Two Worlds," "Not My Job," and "Seeing is Believing," highlighted the disparate nature of prescribed activities that different stakeholders do to contribute to health. For instance, primary care clinicians felt pressured to focus on activities of diagnosis and treatment and did not imagine ways in which EBPs could contribute to either. Quantitative analyses supported aspects of all three themes, highlighting clinicians' limited trust in community-placed activities, and the need for tailored education and system and policy-level changes to support their integration with primary care. Primary care and community-based programs exist in disconnected worlds. Without urgent and intentional efforts to bridge well-care and sick-care, interventions that support people's efforts to be and stay well in their communities will remain outside of-if not at odds with-healthcare.

Critical thinking: knowledge and skills for evidence-based practice.

PubMed

Finn, Patrick

2011-01-01

I respond to Kamhi's (2011) conclusion in his article "Balancing Certainty and Uncertainty in Clinical Practice" that rational or critical thinking is an essential complement to evidence-based practice (EBP). I expand on Kamhi's conclusion and briefly describe what clinicians might need to know to think critically within an EBP profession. Specifically, I suggest how critical thinking is relevant to EBP, broadly summarize the relevant skills, indicate the importance of thinking dispositions, and outline the various ways our thinking can go wrong. I finish the commentary by suggesting that critical thinking skills should be considered a required outcome of our professional training programs.

Evaluating a Teaching Module on Ethically Responsible Evidence-Based Practice Decision Making in an Advanced Micro Practice Course

ERIC Educational Resources Information Center

Wong, Rose

2017-01-01

This article adds to the growing body of literature on the use of evidence-based practice (EBP) in social work. Specifically, it examines a 9-hour EBP educational model designed to prepare MSW students for appropriate decision-making strategies in working with multicultural client populations. The model places emphasis on identification and…

Right at Your Fingertips: Important Web-Based Resources for Understanding Evidence-Based Practices

ERIC Educational Resources Information Center

Purper, Cammy J.

2016-01-01

The era of educational accountability has drawn attention to a need for the use of evidence-based practices (EBPs) in today's classrooms. The existence of a research-to-practice gap is well established in the field of early childhood education (ECE), and significant barriers to the use of EBPs by practitioners have been documented through…

A Comparison of Evidence-Based Practice and the ACRL Information Literacy Standards: Implications for Information Literacy Practice

ERIC Educational Resources Information Center

Adams, Nancy E.

2014-01-01

Evidence-based practice (EBP), like information literacy, is concerned with an individual's knowledge, skills, and attitudes relating to using information. EBP is now a professional competency in fields as diverse as social work, nursing and allied health fields, and public policy. A comparison of the Association of College and Research Libraries'…

A Question of Evidence

ERIC Educational Resources Information Center

Todd, Ross J.

2008-01-01

Broadly defined, evidence-based practice (EBP) is fundamentally about professional practice being informed and guided by best available evidence of what works. The EBP movement had its origins in the early 1990s in the United Kingdom in medicine and health care services. Sackett et al. defined evidence-based medicine as the "conscientious,…

Evidence-Based Practice for Outpatient Clinical Teams

ERIC Educational Resources Information Center

Hamilton, John D.

2006-01-01

This column focuses on evidence-based practice (EBP) within multidisciplinary outpatient settings, but first provides some definitions. Besides EBP (Burns and Hoagwood, 2005; Guyatt and Rennie, 2002), there are also evidence-based medicine (EBM; March et al., 2005), evidence-based service (EBS; Chorpita et al., 2002), and evidence-based treatment…

Need to Address Evidence-Based Practice in Educational Administration

ERIC Educational Resources Information Center

Kowalski, Theodore

2009-01-01

Purpose: This article presents a case for addressing evidence-based practice (EBP) in educational administration. Content is arranged around four objectives: (a) summarizing the status of educational administration as a profession, (b) defining evidence and the model, (c) explaining EBP's social and professional merit, and (d) identifying barriers…

[To know to change: the nurses of the Oncology Institute of Southern Switzerland (IOSI) and their relationship with the Evidence Based Practise (EBP) and Nursing Research].

PubMed

Valcarenghi, Dario; Pedrazzani, Carla; Bianchi, Monica

2013-01-01

To promote the development of a culture and a professional practice based on "evidence of effectiveness", the IOSI Nursing Officer instituted a specific Unit which decided to establish its own lines of action based on the results of an internal investigation conducted among nurses employed within IOSI, with reference to the model of action research. In July 2010, a semi-structured questionnaire self compiled was sent to all nurses to find out their opinions and experiences on EBP and nursing research, to recognize their proposals, and willingness to be part of an internal network. 63 out of 98 questionnaire were filled in. Several nurses have knowledge and experience in these fields, but change their professional behavior especially under pressure from the external environment, rather than by autonomous choice. They consider EBP substantially useful, but difficult to implement especially without their direct involvement. Two third of the sample have felt the need of EBP during their professional activity and there is a general willingness to develop nursing research (56%) and/or play an active role of "referent" on these issues within own Unit (35%). The survey showed that at IOSI there is a favorable substrate for EBP and nursing research (for basic knowledge and availability). The data collected have served to define internal lines of action in a narrow relationship with the clinical areas, according to the model of action research. It is a process that requires vision, coordinated efforts, perseverance and time.

Assessing Evidence-Based Practice Knowledge, Attitudes, Access and Confidence Among Dental Hygiene Educators.

PubMed

Stanley, Jennifer L; Hanson, Carrie L; Van Ness, Christopher J; Holt, Lorie

2015-10-01

To assess U.S. dental hygiene educators' evidence-based practice (EBP) knowledge, attitude, access and confidence and determine whether a correlation exists between assessment scores and level of education, length teaching and teaching setting (didactic, clinical or both). A cross-sectional survey was conducted with a sample of dental hygiene faculty from all 334 U.S. dental hygiene schools. ANOVA and Pearson correlation coefficient statistical analysis were utilized to investigate relationships between demographic variables and application of evidence-based principles of patient care. This study involved a non-probability sample (n=124), since the total faculty among all U.S. dental hygiene schools was not determined. Analysis demonstrated a positive correlation between EBP knowledge, access and confidence scores indicating that as knowledge scores increased, so did confidence and access scores (r=0.313, p<0.01 and r=0.189, p<0.05, respectively). Study findings also revealed that faculty who held advanced educational degrees scored significantly higher in EBP knowledge (F3,120=2.81, p<0.04) and confidence (F3,120=7.26, p<0.00). This study suggests the level of EBP knowledge, attitude, access and confidence increases with additional education. Therefore, more EBP training may be necessary for faculty who do not possess advanced education. Results of the study indicate that further incorporation of EBP into dental hygiene curricula may occur as dental hygiene educators' knowledge of EBP increases, which in turn could enhance students' acquisition of EBP skills and their application of EBP principles toward patient care. Copyright © 2015 The American Dental Hygienists’ Association.

Teaching evidence-based practice: developing a curriculum model to foster evidence-based practice in undergraduate student nurses.

PubMed

Finotto, Stefano; Carpanoni, Marika; Turroni, Elena Casadei; Camellini, Riccarda; Mecugni, Daniela

2013-09-01

For the nature of the Evidence-Based Practice (EBP) and its relevance to nursing, the skills that it requires should be a component in the basic Nursing degree courses. For this reason, the EBP process should be introduced early on in nursing education to develop students' independence and ability to self-learning. the aim of this study is to describe the perception that newly graduated nurses have relative to the benefits of the skills learned during the laboratory's three-year EBP in consideration of the construction of the thesis, the research of evidence and usefulness of the EBP process for the development of their professional career. A descriptive study with a sample of 300 newly graduated nurses from the Degree Course in Nursing of the University of Modena and Reggio Emilia, venue of Reggio Emilia. The data collection instrument was an anonymous questionnaire. It was possible to answer through a 10 Likert scale. The sample considers effective the research of evidence carried out (mean 6, SD 2), related to the problems of patients (mean 7, SD 2); the sample considered the skills acquired during the laboratory's three-year EBP to be useful for career development (mean 7, SD 2). the decision to include the laboratory's three-year EBP in the curriculum of the Nursing degree promotes the development of skills relating to the use of the EBP process, competence that in the literature is indicated as one of the core competencies that all health professionals should develop and maintain throughout their professional career. Copyright © 2013 Elsevier Ltd. All rights reserved.

Promoting Best Practices for Managing Acute Low Back Pain in an Occupational Environment.

PubMed

Slaughter, Amanda Lynn; Frith, Karen; O'Keefe, Louise; Alexander, Susan; Stoll, Regina

2015-09-01

Providers treating low back pain must be confident and knowledgeable in evidence-based practice (EBP) to provide the best outcomes. An online education course was created in an effort to increase knowledge and confidence in EBP and clinical practice guidelines specific to low back pain in an occupational setting. There were 80 participants who completed the pre-test and post-test. The results showed a statistically significant improvement in knowledge and confidence scores after completion of the course. An online education course was shown to be a cost-effective, accessible tool to increase knowledge and confidence of EBP for different health care providers. © 2015 The Author(s).

A Practical Protocol for Situating Evidence-Based Mental Health Programs and Practices within School-Wide Positive Behavioral Interventions and Supports

ERIC Educational Resources Information Center

Runge, Timothy J.; Knoster, Timothy P.; Moerer, Deanna; Breinich, Todd; Palmiero, James

2017-01-01

Schools have limited experience and little guidance to identify and install evidence-based and promising programs and practices/interventions (EBPs) within advanced tiers of School-Wide Positive Behavioral Intervention and Supports (SWPBIS). One form of guidance is the Hexagon Tool which can be used to ensure a match between the EBP and student…

An Investigation of Counselor Educators' Attitudes towards Evidence-Based Practices and Perceived Barriers to the Incorporation of Evidence-Based Practices in Counselor Education Curricula

ERIC Educational Resources Information Center

Patel, Samir H.

2010-01-01

The overall purpose of this study was to investigate counselor educators' attitudes towards evidence-based practices (EBPs) and perceived barriers to the inclusion of EBPs in counselor education curricula. Additionally, this study aimed to assess whether counselor educators' level of agreement towards the presence of motivational interviewing (MI)…

Augmentative and Alternative Communication and Language: Evidence-Based Practice and Language Activity Monitoring

ERIC Educational Resources Information Center

Hill, Katya

2004-01-01

The goal of augmentative and alternative communication (AAC) is the most effective communication possible. Speech-language pathologists are obligated to collect data, measure communication, and apply the principles of evidence-based practice (EBP). This article presents a model for EBP that represents how collecting and evaluating performance data…

Evidence-Based Practice Empowers Practitioners: A Response to Epstein

ERIC Educational Resources Information Center

Rubin, Allen

2015-01-01

Epstein makes a strong argument for the value of clinical data mining (CDM), although he minimizes some of the potential limitations in that methodology, such as attrition. Epstein's portrayal of evidence-based practice (EBP) as practitioner-bashing and treasuring intervention manuals overlooks the emphasis in the EBP process on the need for…

Adopting and Teaching Evidence-Based Practice in Master's-Level Social Work Programs

ERIC Educational Resources Information Center

Drake, Brett; Hovmand, Peter; Jonson-Reid, Melissa; Zayas, Luis H.

2007-01-01

This article makes specific suggestions for teaching evidence-based practice (EBP) in the master's-in-social-work (MSW) curriculum. The authors use the model of EBP as it was originally conceived: a process for posing empirically answerable questions, finding and evaluating the best available evidence, and applying that evidence in conjunction…

An Effective Model for Continuing Education Training in Evidence-Based Practice

ERIC Educational Resources Information Center

Parrish, Danielle E.; Rubin, Allen

2011-01-01

This study utilized a replicated one-group pretest-posttest design with 3 month follow-up to evaluate the impact of a one-day continuing education training on the evidence-based practice (EBP) process with community practitioners (N = 69). Outcome measures assessed the level of workshop participants' familiarity with the EBP process, their…

Evidence-Based Speech-Language Pathology Practices in Schools: Findings from a National Survey

ERIC Educational Resources Information Center

Hoffman, LaVae M.; Ireland, Marie; Hall-Mills, Shannon; Flynn, Perry

2013-01-01

Purpose: This study documented evidence-based practice (EBP) patterns as reported by speech-language pathologists (SLPs) employed in public schools during 2010-2011. Method: Using an online survey, practioners reported their EBP training experiences, resources available in their workplaces, and the frequency with which they engage in specific EBP…

Athletic Trainers' Current Knowledge and Envisioned Use of Foundational Evidence-Based Practice Concepts

ERIC Educational Resources Information Center

Manspeaker, Sarah A.; Hankemeier, Dorice A.

2017-01-01

Context: The Board of Certification (BOC) requires 10 continuing education units (CEUs) in evidence-based practice (EBP) each reporting period. It is unknown whether participation in programming in the Foundations category for CEUs results in improved knowledge of and confidence in EBP. Objective: To examine a continuing professional education…

Knowledge and Use of Intervention Practices by Community-Based Early Intervention Service Providers

ERIC Educational Resources Information Center

Paynter, Jessica M.; Keen, Deb

2015-01-01

This study investigated staff attitudes, knowledge and use of evidence-based practices (EBP) and links to organisational culture in a community-based autism early intervention service. An EBP questionnaire was completed by 99 metropolitan and regionally-based professional and paraprofessional staff. Participants reported greater knowledge and use…

Social Workers' Orientation toward the Evidence-Based Practice Process: A Dutch Survey

ERIC Educational Resources Information Center

van der Zwet, Renske J. M.; Kolmer, Deirdre M. Beneken genaamd; Schalk, René

2016-01-01

Objectives: This study assesses social workers' orientation toward the evidence-based practice (EBP) process and explores which specific variables (e.g. age) are associated. Methods: Data were collected from 341 Dutch social workers through an online survey which included a Dutch translation of the EBP Process Assessment Scale (EBPPAS), along with…

Use of a Journal Club for Professional Development: Outcomes in a School-Based Occupational Therapy Practice

ERIC Educational Resources Information Center

Szucs, Kimberly A.; Benson, Jeryl D.; Corturillo, Amanda

2016-01-01

This article investigates the outcomes of a journal club on the evidence-based practice (EBP) skills of school-based practitioners. Participants' knowledge, attitudes, and perceptions of EBP were collected using pre- and postsurveys following 6 monthly journal club sessions. Participants identified time, availability of articles, and decreased…

An Evidence-Based Practice Model across the Academic and Clinical Settings

ERIC Educational Resources Information Center

Wolter, Julie A.; Corbin-Lewis, Kim; Self, Trisha; Elsweiler, Anne

2011-01-01

This tutorial is designed to provide academic communication sciences and disorders (CSD) programs, at both the undergraduate and graduate levels, with a comprehensive instructional model on evidence-based practice (EBP). The model was designed to help students view EBP as an ongoing process needed in all clinical decision making. The three facets…

Implementation science in low-resource settings: using the interactive systems framework to improve hand hygiene in a tertiary hospital in Ghana.

PubMed

Kallam, Brianne; Pettitt-Schieber, Christie; Owen, Medge; Agyare Asante, Rebecca; Darko, Elizabeth; Ramaswamy, Rohit

2018-05-19

Low-resource clinical settings often face obstacles that challenge the implementation of recommended evidence-based practices (EBPs). Implementation science approaches are useful in identifying barriers and developing strategies to address them. Ridge Regional Hospital (RRH), a tertiary referral hospital in Accra, Ghana experienced a spike in rates of neonatal sepsis and launched a quality improvement (QI) initiative that identified poor adherence to hand hygiene in the neonatal intensive care unit as a potential source of infections. A multi-modal change package of World Health Organization-recommended solutions was created to address this issue. To ensure that the outputs of the QI effort were adopted within the organization, leaders at RRH and Kybele, Inc. used an implementation science framework called the 'Interactive Systems Framework for Dissemination and Implementation' (ISF) to create a package of locally acceptable implementation strategies. The ISF has never been used before to guide implementation in low-resource settings. Hand hygiene compliance rose from 67% to 92% overall, including a 36% increase during the night shifts-a group of healthcare workers with typically very low levels of compliance. The drastic improvement in adherence to hand hygiene suggests the potential value of the joint use of QI and implementation science to promote the creation and application of contextually appropriate EBPs in low-resource settings. Our results also suggest that using an implementation framework such as the ISF could rapidly increase the uptake of other evidence-based interventions in low-resource settings.

Balancing health care evidence and art to meet clinical needs: policymakers' perspectives.

PubMed

Parker, Louise E; Ritchie, Mona J; Kirchner, Joann E; Owen, Richard R

2009-12-01

Rationale, aims and objectives Although many believe that evidence-based practice (EBP) has great potential, critics have identified limitations including a focus on randomized clinical trial (RCT) evidence to the exclusion of other evidence types and a disregard for the art of medicine. Others have argued, however, that proper application of EBP involves reasoned consideration of a wide variety of information; thus, the dichotomy between medical science and art may be false. We explore the views of executive-level policymakers from the Veterans Health Administration, a leader in the EBP movement, regarding what constitutes evidence and the relative importance of evidence versus practical needs when determining clinical policy. Method We conducted 26 semi-structured qualitative interviews and performed a content analysis. Results Although informants generally believed in the value of EBP and the role of RCTs within it, they also valued other types of evidence. Further, they had concerns that were sometimes antithetical with strict adherence to an evidence-based approach. These included practical concerns, fit with organizational values and with local circumstances, resources, political pressures and patient needs. They were especially concerned about how to address medical conditions that affect many individuals or high-risk populations that have no evidence-based treatment. Conclusion When possible, health care practice should be evidence-based. When this is not possible, health care providers must turn to the art of medicine by using consensus-based best practices. Further, it is important for policymakers and researchers to work in concert to develop EBPs that are practical and meet needs.

A Review of Studies on the System-Wide Implementation of Evidence-Based Psychotherapies for Posttraumatic Stress Disorder in the Veterans Health Administration.

PubMed

Rosen, C S; Matthieu, M M; Wiltsey Stirman, S; Cook, J M; Landes, S; Bernardy, N C; Chard, K M; Crowley, J; Eftekhari, A; Finley, E P; Hamblen, J L; Harik, J M; Kehle-Forbes, S M; Meis, L A; Osei-Bonsu, P E; Rodriguez, A L; Ruggiero, K J; Ruzek, J I; Smith, B N; Trent, L; Watts, B V

2016-11-01

Since 2006, the Veterans Health Administration (VHA) has instituted policy changes and training programs to support system-wide implementation of two evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD). To assess lessons learned from this unprecedented effort, we used PubMed and the PILOTS databases and networking with researchers to identify 32 reports on contextual influences on implementation or sustainment of EBPs for PTSD in VHA settings. Findings were initially organized using the exploration, planning, implementation, and sustainment framework (EPIS; Aarons et al. in Adm Policy Ment Health Health Serv Res 38:4-23, 2011). Results that could not be adequately captured within the EPIS framework, such as implementation outcomes and adopter beliefs about the innovation, were coded using constructs from the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework (Glasgow et al. in Am J Public Health 89:1322-1327, 1999) and Consolidated Framework for Implementation Research (CFIR; Damschroder et al. in Implement Sci 4(1):50, 2009). We highlight key areas of progress in implementation, identify continuing challenges and research questions, and discuss implications for future efforts to promote EBPs in large health care systems.

Effectiveness of evidence-based medicine training for undergraduate students at a Chinese Military Medical University: a self-controlled trial.

PubMed

Ma, Xiangyu; Xu, Bin; Liu, Qingyun; Zhang, Yao; Xiong, Hongyan; Li, Yafei

2014-07-04

To evaluate the effect of the integration of evidence-based medicine (EBM) into medical curriculum by measuring undergraduate medical students' EBM knowledge, attitudes, personal application, and anticipated future use. A self-controlled trial was conducted with 251 undergraduate students at a Chinese Military Medical University, using a validated questionnaire regarding the students' evidence-based practice (EBP) about knowledge (EBP-K), attitude (EBP-A), personal application (EBP-P), and future anticipated use (EBP-F). The educational intervention was a 20-hour EBM course formally included in the university's medical curriculum, combining lectures with small group discussion and student-teacher exchange sessions. Data were analyzed using paired t-tests to test the significance of the difference between a before and after comparison. The difference between the pre- and post-training scores were statistically significant for EBP-K, EBP-A, EBP-P, and EBP-F. The scores for EBP-P showed the most pronounced percentage change after EBM training (48.97 ± 8.6%), followed by EBP-A (20.83 ± 2.1%), EBP-K (19.21 ± 3.2%), and EBP-F (17.82 ± 5.7%). Stratified analyses by gender, and program subtypes did not result in any significant changes to the results. The integration of EBM into the medical curriculum improved undergraduate medical students' EBM knowledge, attitudes, personal application, and anticipated future use. A well-designed EBM training course and objective outcome measurements are necessary to ensure the optimum learning opportunity for students.

Evidence-Based Practice Point-of-Care Resources: A Quantitative Evaluation of Quality, Rigor, and Content.

PubMed

Campbell, Jared M; Umapathysivam, Kandiah; Xue, Yifan; Lockwood, Craig

2015-12-01

Clinicians and other healthcare professionals need access to summaries of evidence-based information in order to provide effective care to their patients at the point-of-care. Evidence-based practice (EBP) point-of-care resources have been developed and are available online to meet this need. This study aimed to develop a comprehensive list of available EBP point-of-care resources and evaluate their processes and policies for the development of content, in order to provide a critical analysis based upon rigor, transparency and measures of editorial quality to inform healthcare providers and promote quality improvement amongst publishers of EBP resources. A comprehensive and systematic search (Pubmed, CINAHL, and Cochrane Central) was undertaken to identify available EBP point-of-care resources, defined as "web-based medical compendia specifically designed to deliver predigested, rapidly accessible, comprehensive, periodically updated, and evidence-based information (and possibly also guidance) to clinicians." A pair of investigators independently extracted information on general characteristics, content presentation, editorial quality, evidence-based methodology, and breadth and volume. Twenty-seven summary resources were identified, of which 22 met the predefined inclusion criteria for EBP point-of-care resources, and 20 could be accessed for description and assessment. Overall, the upper quartile of EBP point-of-care providers was assessed to be UpToDate, Nursing Reference Centre, Mosby's Nursing Consult, BMJ Best Practice, and JBI COnNECT+. The choice of which EBP point-of-care resources are suitable for an organization is a decision that depends heavily on the unique requirements of that organization and the resources it has available. However, the results presented in this study should enable healthcare providers to make that assessment in a clear, evidence-based manner, and provide a comprehensive list of the available options. © 2015 Sigma Theta Tau International.

Effective strategies for scaling up evidence-based practices in primary care: a systematic review.

PubMed

Ben Charif, Ali; Zomahoun, Hervé Tchala Vignon; LeBlanc, Annie; Langlois, Léa; Wolfenden, Luke; Yoong, Sze Lin; Williams, Christopher M; Lépine, Roxanne; Légaré, France

2017-11-22

While an extensive array of existing evidence-based practices (EBPs) have the potential to improve patient outcomes, little is known about how to implement EBPs on a larger scale. Therefore, we sought to identify effective strategies for scaling up EBPs in primary care. We conducted a systematic review with the following inclusion criteria: (i) study design: randomized and non-randomized controlled trials, before-and-after (with/without control), and interrupted time series; (ii) participants: primary care-related units (e.g., clinical sites, patients); (iii) intervention: any strategy used to scale up an EBP; (iv) comparator: no restrictions; and (v) outcomes: no restrictions. We searched MEDLINE, Embase, PsycINFO, Web of Science, CINAHL, and the Cochrane Library from database inception to August 2016 and consulted clinical trial registries and gray literature. Two reviewers independently selected eligible studies, then extracted and analyzed data following the Cochrane methodology. We extracted components of scaling-up strategies and classified them into five categories: infrastructure, policy/regulation, financial, human resources-related, and patient involvement. We extracted scaling-up process outcomes, such as coverage, and provider/patient outcomes. We validated data extraction with study authors. We included 14 studies. They were published since 2003 and primarily conducted in low-/middle-income countries (n = 11). Most were funded by governmental organizations (n = 8). The clinical area most represented was infectious diseases (HIV, tuberculosis, and malaria, n = 8), followed by newborn/child care (n = 4), depression (n = 1), and preventing seniors' falls (n = 1). Study designs were mostly before-and-after (without control, n = 8). The most frequently targeted unit of scaling up was the clinical site (n = 11). The component of a scaling-up strategy most frequently mentioned was human resource-related (n = 12). All studies reported patient/provider outcomes. Three studies reported scaling-up coverage, but no study quantitatively reported achieving a coverage of 80% in combination with a favorable impact. We found few studies assessing strategies for scaling up EBPs in primary care settings. It is uncertain whether any strategies were effective as most studies focused more on patient/provider outcomes and less on scaling-up process outcomes. Minimal consensus on the metrics of scaling up are needed for assessing the scaling up of EBPs in primary care. This review is registered as PROSPERO CRD42016041461 .

Teaching Evidence-Based Practice in Service-Learning: A Model for Education and Service

ERIC Educational Resources Information Center

Terry, John D.; Smith, Bradley H.; McQuillin, Samuel D.

2014-01-01

Evidence-based practice (EBP) is strongly emphasized in many professions and should be taught as part of pre-professional training or to promote the development of enlightened citizens who utilize professional services. Service-learning (SL) classes provide an excellent opportunity to provide meaningful training in how EBP relates to education,…

Comparison of Evidence-Based Practice between Physicians and Nurses: A National Survey of Regional Hospitals in Taiwan

ERIC Educational Resources Information Center

Chiu, Ya-Wen; Weng, Yi-Hao; Lo, Heng-Lien; Hsu, Chih-Cheng; Shih, Ya-Hui; Kuo, Ken N.

2010-01-01

Introduction: Although evidence-based practice (EBP) has been widely investigated, few studies compare physicians and nurses on performance. Methods: A structured questionnaire survey was used to investigate EBP among physicians and nurses in 61 regional hospitals of Taiwan. Valid postal questionnaires were collected from 605 physicians and 551…

The Technology of Evidence-Based Practice: Tools for Navigating the Health Sciences Literature

ERIC Educational Resources Information Center

Townsend, Whitney

2011-01-01

Medical and health sciences libraries have incorporated the elements of evidence-based practice (EBP) into their reference services, instruction, and online resource development for years. While EBP focuses on the use of medical and health sciences literature in the clinical environment (i.e., making decisions about how to treat a particular…

Marketing evidence-based practice: what a CROC™!

PubMed

Boyington, Alice R; Ferrall, Sheila M; Sylvanus, Terry

2010-10-01

Nurses should be engaged in evidence-based practice (EBP) to ensure that nursing care is efficient and effective. This article describes one cancer center's use of the Marketing Mix framework to educate staff nurses with the CROC™: Clinging Rigidly to Outdated Care campaign. As a result of the campaign, five EBP projects have been initiated in the cancer center.

Evidence-based practice.

PubMed Central

McKibbon, K A

1998-01-01

Evidence-based practice (EBP) is spreading in popularity in many health care disciplines. One of its main features is the reliance on the partnership among hard scientific evidence, clinical expertise, and individual patient needs and choices. Librarians play an important role in the spread of EBP because of the importance of identifying and retrieving appropriate literature from various sources for use in making health care decisions. This article gives an overview of how to search for therapy, diagnosis, etiology, and prognosis both for original studies and secondary publications such as systematic reviews, meta-analyses, and clinical practice guidelines. Understanding how this research is done, how it is indexed, and how to retrieve the clinical evidence are an important set of skills that librarians can provide for clinicians interested in EBP. PMID:9681176

Contemporary occupational therapy practice: the challenges of being evidence based and philosophically congruent.

PubMed

Gustafsson, Louise; Molineux, Matthew; Bennett, Sally

2014-04-01

Several authors have written of the need to embrace occupation and use it to energise our practice, research and education for the benefit of the profession, individual occupational therapists and ultimately, and most significantly, our clients. However, Wilcock (1999) best summarises the issues and the work that must be done, calling for the profession to adopt a consistent professional philosophy. This approach is entirely congruent with the paradigm approach proposed by Kielhofner (2009). Reinforcing the ideas of Doris Sym, Wilcock (p. 192) states that ‘the first essential for each individual in any profession is the acceptance of a philosophy that is the profession’s keystone.’ Wilcock is clear that such a philosophy should not be adopted and enacted in a rigid way, but it should be dynamic so as to enable the profession to respond to research and theories, and changes in the world. In essence, a professional philosophy should guide research, education and practice and be a touchstone when considering potential changes to practice. It is our suggestion that occupational therapists, individually and collectively, need to use our occupational philosophy, currently best operationalised by the Contemporary Paradigm, to inform EBP. In conclusion, we again find ourselves at a cross road for the profession with the occupational philosophy of the Contemporary Paradigm at times challenged by the adoption of research evidence into practice. We would encourage all occupational therapists to engage in EBP but do so ever mindful of its complexity. We would suggest that evidence-based decision making is viewed through the lens of the occupational therapy philosophy, with occupational therapists critically questioning whether or not the ‘procedure’ for which there is evidence is consistent with the Contemporary Paradigm. This is a complex matter, with many remaining issues to be explored. We would encourage all occupational therapists to interrogate the ways in which they implement EBP and consider the extent to which the profession’s philosophy guides practice decisions.

Long term care staff beliefs about evidence based practices for the management of dementia and agitation.

PubMed

Ayalon, Liat; Arean, Patricia; Bornfeld, Heather; Beard, Renee

2009-02-01

Despite a growing literature on effective interventions for Alzheimer's disease (AD) and agitation, the management of these conditions in long term care (LTC) often is inadequate. The goals of the present study were: (a) to evaluate existing beliefs about evidence based practices (EBP) for the management of Alzheimer's disease and agitation among LTC staff; and (b) to evaluate the contribution of demographic and attitudinal variables to LTC staff beliefs about these EBP. A cross sectional study of 371 LTC staff members completed an EBP questionnaire, a short demographic questionnaire, and an attitudinal questionnaire about AD and agitation. Paraprofessional caregivers, those of lower educational level, and ethnic minorities were more likely to be in disagreement with the EBP views examined in this study. Those in disagreement with the EBP views also reported a preference towards not working with residents with AD and agitation and a sense of helplessness associated with such work. Disagreement with EBP views was associated with both normalization and stigmatization of AD and agitation. Paraprofessional caregivers, ethnic minorities, and people of lower educational level are most at need for educational activities about AD and neuropsychiatric symptoms. Educational efforts geared towards changing the belief system of LTC staff should target not only EBP but also information about AD and agitation as conditions that are deviant from the normal aging process, yet non-stigmatizing. It is expected that following EBP will empower staff and improve staff motivation to work with residents with AD and agitation. (c) 2008 John Wiley & Sons, Ltd.

Effectiveness of evidence-based medicine training for undergraduate students at a Chinese Military Medical University: a self-controlled trial

PubMed Central

2014-01-01

Background To evaluate the effect of the integration of evidence-based medicine (EBM) into medical curriculum by measuring undergraduate medical students’ EBM knowledge, attitudes, personal application, and anticipated future use. Methods A self-controlled trial was conducted with 251 undergraduate students at a Chinese Military Medical University, using a validated questionnaire regarding the students’ evidence-based practice (EBP) about knowledge (EBP-K), attitude (EBP-A), personal application (EBP-P), and future anticipated use (EBP-F). The educational intervention was a 20-hour EBM course formally included in the university’s medical curriculum, combining lectures with small group discussion and student-teacher exchange sessions. Data were analyzed using paired t-tests to test the significance of the difference between a before and after comparison. Results The difference between the pre- and post-training scores were statistically significant for EBP-K, EBP-A, EBP-P, and EBP-F. The scores for EBP-P showed the most pronounced percentage change after EBM training (48.97 ± 8.6%), followed by EBP-A (20.83 ± 2.1%), EBP-K (19.21 ± 3.2%), and EBP-F (17.82 ± 5.7%). Stratified analyses by gender, and program subtypes did not result in any significant changes to the results. Conclusions The integration of EBM into the medical curriculum improved undergraduate medical students’ EBM knowledge, attitudes, personal application, and anticipated future use. A well-designed EBM training course and objective outcome measurements are necessary to ensure the optimum learning opportunity for students. PMID:24996537

Staff views on supporting evidence based practice for children with ASD.

PubMed

Trembath, David; Sulek, Rhylee; Paynter, Jessica; Simpson, Kate; Keen, Deb

2017-11-22

A variety of empirically supported interventions are available for children with autism spectrum disorder (ASD), but previous research suggests that their selection and use within an evidence-based practice (EBP) framework in clinical settings is challenging. To date, research has primarily focused on identifying individual, organisational, and contextual barriers to EBP rather than identifying collaborative solutions to these barriers through consultation with staff. The aim of our study was to explore staff views on supporting EBP in their work with children with ASD. We conducted five focus groups involving 29 professional (e.g., speech pathologists, teachers), paraprofessional (e.g., childcare workers), and managerial staff to explore their views. Audio recordings were transcribed verbatim and analysed using thematic analysis. Two central themes, comprising six categories, emerged to account for the participants' views. Initiative and Effort accounted for the range of creative strategies staff had developed to support their engagement in EBP. They also expressed the need for A Better Way involving organisational-wide support such as this engagement, including peer-to-peer mentoring. The findings suggest that an organisational-wide model to support engagement in EBP, with peer-to-peer mentoring at its foundation, may provide a desirable, ecologically valid, and acceptable model. Implications for Rehabilitation Clinicians and educators recognise the importance of evidence-based practice. Efforts to support evidence-based practice have focused mostly on access to research evidence. Clinicians and educators in this study were developing their own strategies based on intuition. They identified a need for organisation-wide approaches to supporting evidence-based practice. Peer-to-peer mentoring appears to be an acceptable and viable strategy.

Aligning Theory and Design: The Development of an Online Learning Intervention to Teach Evidence-based Practice for Maximal Reach.

PubMed

Delagran, Louise; Vihstadt, Corrie; Evans, Roni

2015-09-01

Online educational interventions to teach evidence-based practice (EBP) are a promising mechanism for overcoming some of the barriers to incorporating research into practice. However, attention must be paid to aligning strategies with adult learning theories to achieve optimal outcomes. We describe the development of a series of short self-study modules, each covering a small set of learning objectives. Our approach, informed by design-based research (DBR), involved 6 phases: analysis, design, design evaluation, redesign, development/implementation, and evaluation. Participants were faculty and students in 3 health programs at a complementary and integrative educational institution. We chose a reusable learning object approach that allowed us to apply 4 main learning theories: events of instruction, cognitive load, dual processing, and ARCS (attention, relevance, confidence, satisfaction). A formative design evaluation suggested that the identified theories and instructional approaches were likely to facilitate learning and motivation. Summative evaluation was based on a student survey (N=116) that addressed how these theories supported learning. Results suggest that, overall, the selected theories helped students learn. The DBR approach allowed us to evaluate the specific intervention and theories for general applicability. This process also helped us define and document the intervention at a level of detail that covers almost all the proposed Guideline for Reporting Evidence-based practice Educational intervention and Teaching (GREET) items. This thorough description will facilitate the interpretation of future research and implementation of the intervention. Our approach can also serve as a model for others considering online EBP intervention development.

Aligning Theory and Design: The Development of an Online Learning Intervention to Teach Evidence-based Practice for Maximal Reach

PubMed Central

Vihstadt, Corrie; Evans, Roni

2015-01-01

Background: Online educational interventions to teach evidence-based practice (EBP) are a promising mechanism for overcoming some of the barriers to incorporating research into practice. However, attention must be paid to aligning strategies with adult learning theories to achieve optimal outcomes. Methods: We describe the development of a series of short self-study modules, each covering a small set of learning objectives. Our approach, informed by design-based research (DBR), involved 6 phases: analysis, design, design evaluation, redesign, development/implementation, and evaluation. Participants were faculty and students in 3 health programs at a complementary and integrative educational institution. Results: We chose a reusable learning object approach that allowed us to apply 4 main learning theories: events of instruction, cognitive load, dual processing, and ARCS (attention, relevance, confidence, satisfaction). A formative design evaluation suggested that the identified theories and instructional approaches were likely to facilitate learning and motivation. Summative evaluation was based on a student survey (N=116) that addressed how these theories supported learning. Results suggest that, overall, the selected theories helped students learn. Conclusion: The DBR approach allowed us to evaluate the specific intervention and theories for general applicability. This process also helped us define and document the intervention at a level of detail that covers almost all the proposed Guideline for Reporting Evidence-based practice Educational intervention and Teaching (GREET) items. This thorough description will facilitate the interpretation of future research and implementation of the intervention. Our approach can also serve as a model for others considering online EBP intervention development. PMID:26421233

Inpatient Pressure Ulcer Prevalence in an Acute Care Hospital Using Evidence-Based Practice.

PubMed

Beal, M Elizabeth; Smith, Kimberly

2016-04-01

A national goal was set in 2004 for decreasing hospital-acquired pressure ulcers (HAPUs). A mean to achieve that goal was initiated in 2005 with long-term care facilities. Acute care facilities, with encouragement from the Centers for Medicare and Medicaid Services, took action. Pressure ulcer prevention efforts at MaineGeneral Medical Center (MGMC), a 192-bed acute care hospital in Augusta, Maine, sought to reduce HAPU prevalence from a mean of 7.8% in 2005. A retrospective study over a 10-year period, from 2005 through 2014, tracked HAPUs and evidence-based practice (EBP) initiatives to decrease the annual mean prevalence rate. The annual mean HAPU prevalence rate of 7.8% in 2005 decreased to 1.4% in 2011, then maintaining this level through 2014 at MGMC. Evidence-based practices for pressure ulcer prevention were implemented using data collection tools from the National Database of Nursing Quality Indicators; guidelines from the National Pressure Ulcer Advisory Panel; and procedural guidance tools from the 5 Million Lives Campaign and the Agency for Healthcare Research and Quality. Accurate data collection methods and evidence-based guidelines are vital to improving care; yet planning with annual review, fostering an EBP culture, by-in of stakeholders, and education, are the means to long-term consistent implementation of pressure ulcer prevention measures. Keys to decreasing and maintaining the rate were based on effective scientific evidence for prevention of pressure ulcers: assessment tools, education, planning guidance, documentation, and evidence-based practice guidelines. © 2016 Sigma Theta Tau International.

Counselor Attitudes toward and Use of Evidence-based Practices in Private Substance Use Disorder Treatment Centers: A Comparison of Social Workers and Non–Social Workers

PubMed Central

Bride, Brian E.; Kintzle, Sara; Abraham, Amanda J.; Roman, Paul M.

2012-01-01

The purpose of this study was to examine factors that may be associated with variation in social workers' perceptions of effectiveness, perceptions of acceptability, and use of psychosocial evidence-based practices (EBPs) for the treatment of substance use disorders (SUD) in comparison to other SUD counselors who are non–social workers. A national sample of 1,140 counselors in private SUD treatment settings completed a mailed survey. Overall, counselors perceive both motivational interviewing (MI) and contingency management (CM) to be effective and acceptable interventions, with MI perceived to be both more effective and more acceptable than CM. The results of this study also shed light on the factors associated with perceptions of effectiveness and acceptability of MI and CM. The results of this study underscore the importance of exposure to EBPs in the development of positive attitudes toward and use of EBPs. In particular, professional networks are an important route to introduce social workers to EBPs, as is professional training on specific EBPs. Efforts to increase the uptake of evidence-based SUD interventions should not be limited to dissemination of information regarding effectiveness; rather, efforts should also be expended to expose social workers to EBPs. PMID:23193729

Results of an assessment of information needs among speech-language pathologists and audiologists in Idaho.

PubMed

Guo, Ruiling; Bain, Barbara A; Willer, Janene

2008-04-01

The research assesses the information needs of speech-language pathologists (SLPs) and audiologists in Idaho and identifies specific needs for training in evidence-based practice (EBP) principles and searching EBP resources. A survey was developed to assess knowledge and skills in accessing information. Questionnaires were distributed to 217 members of the Idaho Speech-Language-Hearing Association, who were given multiple options to return the assessment survey (web, email, mail). Data were analyzed descriptively and statistically. The total response rate was 38.7% (84/217). Of the respondents, 87.0% (73/84) indicated insufficient knowledge and skills to search PubMed. Further, 47.6% (40/84) indicated limited knowledge of EBP. Of professionals responding, 52.4% (44/84) reported interest in learning more about EBP and 47.6% (40/84) reported interest in learning to search PubMed. SLPs and audiologists who graduated within the last 10 years were more likely to respond online, while those graduating prior to that time preferred to respond via hard copy. DISCUSSIONS/CONCLUSION: More effort should be made to ensure that SLPs and audiologists develop skills in locating information to support their practice. Results from this information needs assessment were used to design a training and outreach program on EBP and EBP database searching for SLPs and audiologists in Idaho.

Counselor attitudes toward and use of evidence-based practices in private substance use disorder treatment centers: a comparison of social workers and non-social workers.

PubMed

Bride, Brian E; Kintzle, Sara; Abraham, Amanda J; Roman, Paul M

2012-08-01

The purpose of this study was to examine factors that may be associated with variation in social workers' perceptions of effectiveness, perceptions of acceptability, and use of psychosocial evidence-based practices (EBPs) for the treatment of substance use disorders (SUD) in comparison to other SUD counselors who are nonsocial workers. A national sample of 1,140 counselors in private SUD treatment settings completed a mailed survey. Overall, counselors perceive both motivational interviewing (MI) and contingency management (CM) to be effective and acceptable interventions, with MI perceived to be both more effective and more acceptable than CM. The results of this study also shed light on the factors associated with perceptions of effectiveness and acceptability of MI and CM. The results of this study underscore the importance of exposure to EBPs in the development of positive attitudes toward and use of EBPs. In particular, professional networks are an important route to introduce social workers to EBPs, as is professional training on specific EBPs. Efforts to increase the uptake of evidence-based SUD interventions should not be limited to dissemination of information regarding effectiveness; rather, efforts should also be expended to expose social workers to EBPs.

Who Supports the Successful Implementation and Sustainability of Evidence-Based Practices? Defining and Understanding the Roles of Intermediary and Purveyor Organizations.

PubMed

Franks, Robert P; Bory, Christopher T

2015-01-01

Research on implementation science has increased significantly over the past decade. In particular, psychologists have looked closely at the value and importance of bridging the gap between science and practice. As evidence-based practices (EBPs) become more prevalent, concrete mechanisms are needed to bring these scientifically supported treatments and interventions to community-based settings. Intermediary and purveyor organizations (IPOs) have emerged in recent years that specialize in bringing research to practice. Using a framework developed by Franks (), this descriptive study surveyed respondents that self-identified as IPOs and focused on identifying shared definitions, functions, and activities. Results indicated that seven descriptive roles previously identified were supported by this survey and many common shared activities, goals, and functions across these organizations were observed. Further, these organizations appear to be influenced by the growing field of implementation science. Limitations and implications of this study are discussed. © 2015 Wiley Periodicals, Inc.

Influencing Social Workers to Use Research Evidence in Practice: Lessons from Medicine and the Allied Health Professions

ERIC Educational Resources Information Center

Gira, Emmanuelle C.; Kessler, Michelle L.; Poertner, John

2004-01-01

This study sought to identify lessons for social workers from the health care research on influencing practitioners to use evidence-based practices (EBP). Research reviews of strategies to influence providers to use EBP are summarized. Among the findings are that printed educational materials, the use of local opinion leaders, and continuous…

Three Cs of Translating Evidence-Based Programs for Youth and Families to Practice Settings

ERIC Educational Resources Information Center

Freire, Kimberley E.; Perkinson, Leah; Morrel-Samuels, Susan; Zimmerman, Marc A.

2015-01-01

Despite the growing number of evidence-based programs (EBPs) for youth and families, few are well-integrated in service systems or widely adopted by communities. One set of challenges to widespread adoption of EBPs relates to the transfer of programs from research and development to practice settings. This is often because program developers have…

Current Status of Evidence-Based Practice for Students with Intellectual Disability and Autism Spectrum Disorders

ERIC Educational Resources Information Center

West, Elizabeth A.; McCollow, Meaghan; Umbarger, Gardner; Kidwell, James; Cote, Debra L.

2013-01-01

The purpose of this paper is to provide a current look at the status of evidence-based practice (EBP) for students with intellectual disability and autism spectrum disorders. Specifically, this paper will (1) provide an introduction to the history and evolution of the use of levels of evidence, (2) discuss the importance of EBPs, (3) identify…

Practice to research: integrating evidence-based practices with culture and context.

PubMed

Weisner, Thomas S; Hay, M Cameron

2015-04-01

There are ways to integrate culturally competent services (CCS) and evidence-based practices (EBP) which can improve the experiences of patients and their families and communities when faced with health problems, as well as the effectiveness and positive experiences of practitioners. CCS and EBP evidence should be jointly deployed for helping patients and clinicians. Partnership research models are useful for achieving the integration of CCS and EBP, since they involve close observation of and participation by clinicians and practitioners in the research process, and often use integrated qualitative and quantitative mixed methods. We illustrate this with 3 examples of work that can help integrate CCS and EBP: ongoing collection of information from patients, clinicians and staff, or "evidence farming"; close study and continuous improvement of activities and accommodations; and use of evidence of tacit, implicit cultural scripts and norms, such as being "productive," as well as explicit scripts. From a research practice point of view, collaborative partnerships will likely produce research with culture and context bracketed in, and will contribute stronger research models, methods, and units of analysis. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

"They just know": the epistemological politics of "evidence-based" non-formal education.

PubMed

Archibald, Thomas

2015-02-01

Community education and outreach programs should be evidence-based. This dictum seems at once warranted, welcome, and slightly platitudinous. However, the "evidence-based" movement's more narrow definition of evidence--privileging randomized controlled trials as the "gold standard"--has fomented much debate. Such debate, though insightful, often lacks grounding in actual practice. To address that lack, the purpose of the study presented in this paper was to examine what actually happens, in practice, when people support the implementation of evidence-based programs (EBPs) or engage in related efforts to make non-formal education more "evidence-based." Focusing on three cases--two adolescent sexual health projects (one in the United States and one in Kenya) and one more general youth development organization--I used qualitative methods to address the questions: (1) How is evidence-based program and evidence-based practice work actually practiced? (2) What perspectives and assumptions about what non-formal education is are manifested through that work? and (3) What conflicts and tensions emerge through that work related to those perspectives and assumptions? Informed by theoretical perspectives on the intersection of science, expertise, and democracy, I conclude that the current dominant approach to making non-formal education more evidence-based by way of EBPs is seriously flawed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evaluation of organizational support for use of online information resources in nursing care.

PubMed

Kahouei, Mehdi; Ahmadi, Zahra; Kazemzadeh, Farzaneh

2014-12-01

While there is general agreement concerning the barriers to use online information resources in nursing decisions, there have not been any studies that demonstrate how healthcare organizations have overcome these obstacles in developing countries. The purpose of this present study was to evaluate organizational support of healthcare organizations after introducing information technology for the use of online information resources in nursing care. This study was performed on nurses and nursing students in hospitals affiliated to the Semnan University of Medical Sciences, Iran. The findings showed that the use of online information resources was not adequately supported by healthcare social networks and the role of leadership has received minimal attention. There appears to be little confidence in the usefulness of evidence-based practice (EBP) in nursing care in Iranian society. The development of organizational norms for EBP behavior within an organization is important, and in order to monitor the development of these behaviors, the cultural competence in the healthcare institutions should be assessed and measured. However, it is far more difficult to develop a robust design, which encompasses the implementation of EBP across an entire organization. Such studies are highly complex and would need to be adapted as the organization changed, in addition, they would be likely to take considerable time to complete. Nevertheless, such studies are essential if a full understanding of organizational approaches to promoting EBP in developing countries is to occur. © 2014 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

Combining training in knowledge translation with quality improvement reduced 30-day heart failure readmissions in a community hospital: a case study.

PubMed

Wyer, Peter; Stojanovic, Zorica; Shaffer, Jonathan A; Placencia, Mitzy; Klink, Kathleen; Fosina, Michael J; Lin, Susan X; Barron, Beth; Graham, Ian D

2016-04-01

Training programmes in evidence-based practice (EBP) frequently fail to translate their content into practice change and care improvement. We linked multidisciplinary training in EBP to an initiative to decrease 30-day readmissions among patients admitted to a community teaching hospital for heart failure (HF). Hospital staff reflecting all services and disciplines relevant to care of patients with HF attended a 3-day innovative capacity building conference in evidence-based health care over a 3-year period beginning in 2009. The team, facilitated by a conference faculty member, applied a knowledge-to-action model taught at the conference. We reviewed published research, profiled our population and practice experience, developed a three-phase protocol and implemented it in late 2010. We tracked readmission rates, adverse clinical outcomes and programme cost. The protocol emphasized patient education, medication reconciliation and transition to community-based care. Senior administration approved a full-time nurse HF coordinator. Thirty-day HF readmissions decreased from 23.1% to 16.4% (adjusted OR = 0.64, 95% CI = 0.42-0.97) during the year following implementation. Corresponding rates in another hospital serving the same population but not part of the programme were 22.3% and 20.2% (adjusted OR = 0.87, 95% CI = 0.71-1.08). Adherence to mandated HF quality measures improved. Following a start-up cost of $15 000 US, programme expenses balanced potential savings from decreased HF readmissions. Training of a multidisciplinary hospital team in use of a knowledge translation model, combined with ongoing facilitation, led to implementation of a budget neutral programme that decreased HF readmissions. © 2015 John Wiley & Sons, Ltd.

Readiness for evidence-based practice: information literacy needs of nurses in the United States.

PubMed

Tanner, Annelle; Pierce, Susan; Pravikoff, Diane

2004-01-01

In this paper U.S. nurses' readiness to provide Evidence-Based Practice (EBP) as measured by their information literacy knowledge and skills is described. The Institute of Medicine directed health care providers to use EBP as a means to improve patient safety, efficiency and effectiveness of health care services. Information literacy has been identified as a nursing informatics competency for the basic nurse. As such, information literacy is an essential component in the application of EBP. The importance of developing information literacy skills is enhancement of the nurse's ability to use current best available research literature in the conduct of EBP with subsequent improvement in nursing sensitive patient outcomes. This study describes the level of nurses' information literacy knowledge and gaps in their skills for identifying, accessing, retrieving, evaluating and utilizing research evidence to provide best care for patients. The value of this study is to increase awareness among nurse administrators, educators, and clinicians of the need for information literacy education to enable evidence-based nursing practice and to guide development of supportive curricula and professional continuing education.

[Evidence-based practice competence in undergraduate Nursing Degree students].

PubMed

Ruzafa-Martínez, María; Molina-Salas, Yolanda; Ramos-Morcillo, Antonio Jesús

2016-01-01

Evidence-based practice (EBP) learning has become a key issue for nurses. An EPB subject was included in the 4(th) year in the new syllabus of the Nursing Degree at University of Murcia (UM). To know the competence level in EBP of undergraduate nursing students at UM and compare the results between all four years. Observational descriptive study with a cross-sectional approach. undergraduate nursing students from all four years at Nursing Degree at the Faculty of Social and Healthcare Science at UM in the year 2013-14. EBP evaluation of competence of the nursing students consisted of attitude, skills and knowledge on EBP. A validated questionnaire, the EBP-COQ, was used. The scale range is 1 point «lowest level» to 5 points «higher level».The SPSS 21.0 program has been used to carry out descriptive and bivariate analyses. 144 students were included, 76.4% was female, and the median age was 23 years, 84.7% attended more than 75% class hours. The mean differences in the questionnaire between first and fourth years were 0.58 points in attitude, 0.60 in skills, 1.6 in knowledge and 0.83 in global competence in EBP. Significant differences in mean scores between the fourth and the remaining years in the global competence in EBP were observed, as well as in the three dimensions (p <0.05). The undergraduate-nursing students studied here have acquired an appropriate competence level in EBP, with a gradual increase by year. The biggest increase was in the fourth year students. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Evidence-Based Practice Knowledge, Attitude, Access and Confidence: A comparison of dental hygiene and dental students.

PubMed

Santiago, Victoria; Cardenas, Melissa; Charles, Anne Laure; Hernandez, Estefany; Oyoyo, Udochukwu; Kwon, So Ran

2018-04-01

Purpose: The purpose of this study was to evaluate whether current educational strategies at a dental institution in the United States made a difference in dental hygiene (DNHY) and dental students' (D3) learning outcomes in the four domains of evidence-based practice (EBP), knowledge, attitude, accessing evidence, and confidence (KACE), following a 12-week research design course. Methods: All participants DNHY (n=19) and D3 (n=96) enrolled in the research design course at Loma Linda University completed a paper KACE survey distributed on the first day of class. Students completed the KACE survey once more at the end of the 12-week course. Pre- and post-survey results were compared both within and between the DNHY and D3 student groups to identify the learning outcomes in the four domains of EBP; knowledge, attitude, accessing evidence, and confidence in EBP. Descriptive statistics were conducted to profile all variables in the study; the level of significance was set at α=0.05. Results: All DNHY students (n=19) completed the pre and post KACE surveys; of the D3 (n=96) students enrolled in the course 82% (n=79) competed the post-survey. Comparison of the survey results showed that both DNHY and D3 students demonstrated statistically significant increases in their level of knowledge and attitude (p < 0.05) towards EBP. In the attitude domain, DNHY students indicated more positive attitudes towards EBP (p < 0.001) than their D3 student cohorts. Neither group demonstrated significant changes in confidence in applying EBP (p > 0.05). Conclusion: DNHY and D3 students increased their knowledge and developed more positive attitudes towards EBP following a 12-week research design course. Study results identify improvement areas for EBP knowledge acquisition including determining levels of evidence, analysis of study results, and evaluating the appropriateness of research study designs through the use of validated EBP survey instrument. Copyright © 2018 The American Dental Hygienists’ Association.

Evidence-based practice among primary care physicians in Kuwait.

PubMed

Ahmad, Abeer S H; Al-Mutar, Nouf B E; Al-Hulabi, Fahad A S; Al-Rashidee, Eman S L; Doi, Suhail A R; Thalib, Lukman

2009-12-01

The level of evidence-based practice (EBP) and awareness has not been previously assessed among primary care physicians in Kuwait. The objectives of this study were to quantify the level of EBP and awareness in Kuwait and identify the factors related to EBP. We used a cross sectional study that enrolled 332 primary care physicians in 57 primary care centres randomly chosen in Kuwait. A self-administered questionnaire was used to collect the data with a response rate of about 93%. Although half of the physicians self reported that they use EBP most of the time, further analysis revealed that only about 24% of this group had a reasonable understanding of EBP. Most of the clinical practice in the Kuwaiti primary care system seems to be based on the clinician's own judgment or what they learned in the medical school and traditional text books, rather than evidence-based sources. None of the physicians had an Internet connection at their work place and a vast majority of them had no access to international journals nor were confident about critical appraisal of published evidence. Overall level of awareness of evidence-based medicine (EBM) among primary care physicians in Kuwait was considerably low. Training in the areas of EBM as well as making sure the Kuwaiti primary care centres have access to evidence-based sources are critically important if primary care in Kuwait were to become evidence based.

A model for rigorously applying the Exploration, Preparation, Implementation, Sustainment (EPIS) framework in the design and measurement of a large scale collaborative multi-site study.

PubMed

Becan, Jennifer E; Bartkowski, John P; Knight, Danica K; Wiley, Tisha R A; DiClemente, Ralph; Ducharme, Lori; Welsh, Wayne N; Bowser, Diana; McCollister, Kathryn; Hiller, Matthew; Spaulding, Anne C; Flynn, Patrick M; Swartzendruber, Andrea; Dickson, Megan F; Fisher, Jacqueline Horan; Aarons, Gregory A

2018-04-13

This paper describes the means by which a United States National Institute on Drug Abuse (NIDA)-funded cooperative, Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS), utilized an established implementation science framework in conducting a multi-site, multi-research center implementation intervention initiative. The initiative aimed to bolster the ability of juvenile justice agencies to address unmet client needs related to substance use while enhancing inter-organizational relationships between juvenile justice and local behavioral health partners. The EPIS (Exploration, Preparation, Implementation, Sustainment) framework was selected and utilized as the guiding model from inception through project completion; including the mapping of implementation strategies to EPIS stages, articulation of research questions, and selection, content, and timing of measurement protocols. Among other key developments, the project led to a reconceptualization of its governing implementation science framework into cyclical form as the EPIS Wheel. The EPIS Wheel is more consistent with rapid-cycle testing principles and permits researchers to track both progressive and recursive movement through EPIS. Moreover, because this randomized controlled trial was predicated on a bundled strategy method, JJ-TRIALS was designed to rigorously test progress through the EPIS stages as promoted by facilitation of data-driven decision making principles. The project extended EPIS by (1) elucidating the role and nature of recursive activity in promoting change (yielding the circular EPIS Wheel), (2) by expanding the applicability of the EPIS framework beyond a single evidence-based practice (EBP) to address varying process improvement efforts (representing varying EBPs), and (3) by disentangling outcome measures of progression through EPIS stages from the a priori established study timeline. The utilization of EPIS in JJ-TRIALS provides a model for practical and applied use of implementation frameworks in real-world settings that span outer service system and inner organizational contexts in improving care for vulnerable populations. NCT02672150 . Retrospectively registered on 22 January 2016.

Does journal club membership improve research evidence uptake in different allied health disciplines: a pre-post study.

PubMed

Lizarondo, Lucylynn M; Grimmer-Somers, Karen; Kumar, Saravana; Crockett, Alan

2012-10-29

Although allied health is considered to be one 'unit' of healthcare providers, it comprises a range of disciplines which have different training and ways of thinking, and different tasks and methods of patient care. Very few empirical studies on evidence-based practice (EBP) have directly compared allied health professionals. The objective of this study was to examine the impact of a structured model of journal club (JC), known as iCAHE (International Centre for Allied Health Evidence) JC, on the EBP knowledge, skills and behaviour of the different allied health disciplines. A pilot, pre-post study design using maximum variation sampling was undertaken. Recruitment was conducted in groups and practitioners such as physiotherapists, occupational therapists, speech pathologists, social workers, psychologists, nutritionists/dieticians and podiatrists were invited to participate. All participating groups received the iCAHE JC for six months. Quantitative data using the Adapted Fresno Test (McCluskey & Bishop) and Evidence-based Practice Questionnaire (Upton & Upton) were collected prior to the implementation of the JC, with follow-up measurements six months later. Mean percentage change and confidence intervals were calculated to compare baseline and post JC scores for all outcome measures. The results of this study demonstrate variability in EBP outcomes across disciplines after receiving the iCAHE JC. Only physiotherapists showed statistically significant improvements in all outcomes; speech pathologists and occupational therapists demonstrated a statistically significant increase in knowledge but not for attitude and evidence uptake; social workers and dieticians/nutritionists showed statistically significant positive changes in their knowledge, and evidence uptake but not for attitude. There is evidence to suggest that a JC such as the iCAHE model is an effective method for improving the EBP knowledge and skills of allied health practitioners. It may be used as a single intervention to facilitate evidence uptake in some allied health disciplines but may need to be integrated with other strategies to influence practice behaviour in other practitioners. An in-depth analysis of other factors (e.g. individual, contextual, organisational), or the relative contribution of these variables is required to better understand the determinants of evidence uptake in allied health.

Does journal club membership improve research evidence uptake in different allied health disciplines: a pre-post study

PubMed Central

2012-01-01

Background Although allied health is considered to be one 'unit' of healthcare providers, it comprises a range of disciplines which have different training and ways of thinking, and different tasks and methods of patient care. Very few empirical studies on evidence-based practice (EBP) have directly compared allied health professionals. The objective of this study was to examine the impact of a structured model of journal club (JC), known as iCAHE (International Centre for Allied Health Evidence) JC, on the EBP knowledge, skills and behaviour of the different allied health disciplines. Methods A pilot, pre-post study design using maximum variation sampling was undertaken. Recruitment was conducted in groups and practitioners such as physiotherapists, occupational therapists, speech pathologists, social workers, psychologists, nutritionists/dieticians and podiatrists were invited to participate. All participating groups received the iCAHE JC for six months. Quantitative data using the Adapted Fresno Test (McCluskey & Bishop) and Evidence-based Practice Questionnaire (Upton & Upton) were collected prior to the implementation of the JC, with follow-up measurements six months later. Mean percentage change and confidence intervals were calculated to compare baseline and post JC scores for all outcome measures. Results The results of this study demonstrate variability in EBP outcomes across disciplines after receiving the iCAHE JC. Only physiotherapists showed statistically significant improvements in all outcomes; speech pathologists and occupational therapists demonstrated a statistically significant increase in knowledge but not for attitude and evidence uptake; social workers and dieticians/nutritionists showed statistically significant positive changes in their knowledge, and evidence uptake but not for attitude. Conclusions There is evidence to suggest that a JC such as the iCAHE model is an effective method for improving the EBP knowledge and skills of allied health practitioners. It may be used as a single intervention to facilitate evidence uptake in some allied health disciplines but may need to be integrated with other strategies to influence practice behaviour in other practitioners. An in-depth analysis of other factors (e.g. individual, contextual, organisational), or the relative contribution of these variables is required to better understand the determinants of evidence uptake in allied health. PMID:23106851

Results of an assessment of information needs among speech-language pathologists and audiologists in Idaho*

PubMed Central

Guo, Ruiling; Bain, Barbara A.; Willer, Janene

2008-01-01

Objectives: The research assesses the information needs of speech-language pathologists (SLPs) and audiologists in Idaho and identifies specific needs for training in evidence-based practice (EBP) principles and searching EBP resources. Methods: A survey was developed to assess knowledge and skills in accessing information. Questionnaires were distributed to 217 members of the Idaho Speech-Language-Hearing Association, who were given multiple options to return the assessment survey (web, email, mail). Data were analyzed descriptively and statistically. Results: The total response rate was 38.7% (84/217). Of the respondents, 87.0% (73/84) indicated insufficient knowledge and skills to search PubMed. Further, 47.6% (40/84) indicated limited knowledge of EBP. Of professionals responding, 52.4% (44/84) reported interest in learning more about EBP and 47.6% (40/84) reported interest in learning to search PubMed. SLPs and audiologists who graduated within the last 10 years were more likely to respond online, while those graduating prior to that time preferred to respond via hard copy. Discussions/Conclusion: More effort should be made to ensure that SLPs and audiologists develop skills in locating information to support their practice. Results from this information needs assessment were used to design a training and outreach program on EBP and EBP database searching for SLPs and audiologists in Idaho. PMID:18379669

Facilitating change from a distance - a story of success? A discussion on leaders' styles in facilitating change in four nursing homes in Norway.

PubMed

Øye, Christine; Mekki, Tone Elin; Jacobsen, Frode Fadnes; Førland, Oddvar

2016-09-01

To examine the influence of leadership when facilitating change in nursing homes. The study is a part of an education intervention for care staff to prevent the use of restraint in nursing home residents with dementia in 24 nursing homes (NHs) in Norway. Leadership is known to be a fundamental factor for success of evidence-based practice (EBP) implementation in health services. However, the type of leadership that strengthens the processes of change remains to be clarified. A multi-site comparative ethnography was performed in four nursing homes to investigate how contextual factors influenced the implementation. The analysis was informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework, and in particular the sub-element of leadership. Different leadership styles to facilitate change were identified. Paradoxically, a strong collective and collaborative leadership style was found to hamper change in one particular home, whereas a remote leadership style combined with almost no cooperation with staff proved successful in another setting. The study indicates that leadership cannot be understood on a low-high continuum as suggested by the PARIHS framework, but rather as a factor characterised by diversity. Our study indicates, as a minimum, that a leader's presence is necessary to facilitate the internal processes in order more successfully to implement EBP. © 2016 John Wiley & Sons Ltd.

Modeling the fate of a photoproduct of ketoprofen in urban rivers receiving wastewater treatment plant effluent.

PubMed

Hanamoto, Seiya; Hasegawa, Eisuke; Nakada, Norihide; Yamashita, Naoyuki; Tanaka, Hiroaki

2016-12-15

Photoproducts of pharmaceuticals have been studied in order not to overlook their potential risks to aquatic organisms. However, no studies have verified an equation for predicting the fate of photoproducts in aquatic environment (Poiger equation) by field measurements, leaving uncertainties in its practical utility. Therefore, we conducted this study to test the applicability of the Poiger equation to 3-ethylbenzophenone (EBP), a photoproduct of ketoprofen (KTP). Photolysis experiments determined the fraction of KTP transformed into EBP as 0.744±0.074 and the quantum yield of EBP degradation as 0.000418±0.000090. Field studies in urban rivers and wastewater treatment plants (WWTPs) revealed that EBP was produced by sunlight, mainly in the rivers, but also appreciably in outdoor primary and secondary clarifiers in the WWTPs. We developed a model in the secondary clarifiers, disinfection tanks, and rivers by incorporating the Poiger equation, which was effective at predicting the concentrations of EBP in the river waters and wastewaters. Thus, our first trial of verification by field measurements enhanced the practical utility of the Poiger equation, though further study including several photoproducts should be conducted. Copyright © 2016 Elsevier B.V. All rights reserved.

Building Capacity for Evidence-Based Practice: Understanding How Licensed Practical Nurses (LPNs) Source Knowledge.

PubMed

Phillips, Leah; Neumeier, Melanie

2018-03-23

In Canada, all nurses are required to engage in evidence-based practice (EBP) as an entry-to-practice competency; however, there is little research that examines Licensed Practical Nurses' (LPNs') information seeking behaviors or preferred sources of knowledge to conduct EBP. Due to the differences in education and roles of LPNs and Registered Nurses (RNs), it is both necessary and important to gain an understanding of how LPNs utilize evidence in their unique nursing practice. The purpose of this study was to investigate how LPNs source knowledge for their nursing practice. A descriptive, cross-sectional survey of LPNs from Alberta, Canada asked participants to rank sources of knowledge that inform their practice. Responses were correlated with age and years of practice. Analysis of variance was used to determine if there were significant mean differences between average scores and place of employment. LPN participants used similar sources of knowledge as RNs. The top source of knowledge for both RNs and LPNs was the information they learn about each individual client and the least utilized sources of knowledge were articles published in nursing, medical, and research journals, tradition, and popular media. This finding is consistent with previous studies on RNs that found nurses do not often access current research evidence to inform their practice. Since relatively few LPNs access nursing and research journals, it is important to tailor EBP education information to the workplace context. Future avenues of research might explore the potential of using in-services and webinars to disseminate information and skills training on EBP to the LPNs, as this was a popular source of practice knowledge. © 2018 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.

Decision-making processes for the uptake and implementation of family-based therapy by eating disorder treatment teams: a qualitative study.

PubMed

Kimber, Melissa; Couturier, Jennifer; Jack, Susan; Niccols, Alison; Van Blyderveen, Sherry; McVey, Gail

2014-01-01

To explore the decision-making processes involved in the uptake and implementation of evidence-based treatments (EBTs), namely, family-based treatment (FBT), among therapists and their administrators within publically funded eating disorder treatment programs in Ontario, Canada. Fundamental qualitative description guided sampling, data collection, and analytic decisions. Forty therapists and 11 administrators belonging to a network of clinicians treating eating disorders completed an in-depth interview regarding the decision-making processes involved in EBT uptake and implementation within their organizations. Content analysis and the constant comparative technique were used to analyze interview transcripts, with 20% of the data independently double-coded by a second coder. Therapists and their administrators identified the importance of an inclusive change culture in evidence-based practice (EBP) decision-making. Each group indicated reluctance to make EBP decisions in isolation from the other. Additionally, participants identified seven stages of decision-making involved in EBT adoption, beginning with exposure to the EBT model and ending with evaluating the impact of the EBT on patient outcomes. Support for a stage-based decision-making process was in participants' indication that the stages were needed to demonstrate that they considered the costs and benefits of making a practice change. Participants indicated that EBTs endorsed by the Provincial Network for Eating Disorders or the Academy for Eating Disorders would more likely be adopted. Future work should focus on integrating the important decision-making processes identified in this study with known implementation models to increase the use of low-cost and effective treatments, such as FBT, within eating disorder treatment programs. Copyright © 2013 Wiley Periodicals, Inc.

Three Collaborative Models for Scaling Up Evidence-Based Practices

PubMed Central

Roberts, Rosemarie; Jones, Helen; Marsenich, Lynne; Sosna, Todd; Price, Joseph M.

2015-01-01

The current paper describes three models of research-practice collaboration to scale-up evidence-based practices (EBP): (1) the Rolling Cohort model in England, (2) the Cascading Dissemination model in San Diego County, and (3) the Community Development Team model in 53 California and Ohio counties. Multidimensional Treatment Foster Care (MTFC) and KEEP are the focal evidence-based practices that are designed to improve outcomes for children and families in the child welfare, juvenile justice, and mental health systems. The three scale-up models each originated from collaboration between community partners and researchers with the shared goal of wide-spread implementation and sustainability of MTFC/KEEP. The three models were implemented in a variety of contexts; Rolling Cohort was implemented nationally, Cascading Dissemination was implemented within one county, and Community Development Team was targeted at the state level. The current paper presents an overview of the development of each model, the policy frameworks in which they are embedded, system challenges encountered during scale-up, and lessons learned. Common elements of successful scale-up efforts, barriers to success, factors relating to enduring practice relationships, and future research directions are discussed. PMID:21484449

Assessing and Treating Pain in Hospices: Current State of Evidence-Based Practices

PubMed Central

Herr, Keela; Titler, Marita; Fine, Perry; Sanders, Sara; Cavanaugh, Joe; Swegle, John; Forcucci, Chris; Tang, Xiongwen

2010-01-01

The aim of this article is to report on current provider evidence-based assessment and treatment practices for older adults with cancer in community-based hospice settings. Using the Cancer Pain Practices Index (CPPI), a tool developed by the researchers to measure evidence-based pain management practices, patients received an average of 32% of the those key evidence-based practices (EBPs) that were applicable to their situation. When examining individual practices, the majority of patients had their pain assessed at admission using a valid pain scale (69.7%) and had primary components of a comprehensive assessment completed at admission (52.7%); most patients with admission reports of pain had an order for pain medication (83.5%). However, data revealed a number of practice gaps including: additional components of a comprehensive assessment completed within 48 hours of admission (0%); review of the Pain Treatment Plan at each reassessment (35.7%); reassessment of moderate or greater pain (5.3%); consecutive pain reports of 5 or greater followed by pain medication increases (15.8%); monitoring of analgesic- induced side effects (19.3%); initiation of a bowel regimen for patients with an opioid order (32.3%); and documentation of both non-pharmacological therapies (22.5%) and written pain management plans (0.6%). Findings highlight positive EBPs and areas for improving the translation of EBPs into practice. Data suggest that cancer pain is not being documented as consistently assessed, reassessed or treated in a manner consistent with current EBP recommendations for older adults with cancer in community-based hospices. PMID:20471542

Illicit Drugs, Policing and the Evidence-Based Policy Paradigm

ERIC Educational Resources Information Center

Ritter, Alison; Lancaster, Kari

2013-01-01

The mantra of evidence-based policy (EBP) suggests that endeavours to implement evidence-based policing will produce better outcomes. However there is dissonance between the rhetoric of EBP and the actuality of policing policy. This disjuncture is critically analysed using the case study of illicit drugs policing. The dissonance may be ameliorated…

The Impact of an Integrated Electronic Health Record Adoption on Nursing Care Quality.

PubMed

Walker-Czyz, AnneMarie

2016-01-01

The purpose of this study was to measure the impact of an integrated electronic health record (EHR) innovation adoption on the quality of nursing care delivered, including hospital-acquired falls, hospital-acquired pressure ulcers, ventilator-associated pneumonia (VAP), central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), and costs measured in nursing hours. The impact on quality, cost, and nurse satisfaction measured in turnover rates before, during, and after implementation of EHR tools was also investigated. Little is known about the adoption patterns of computerized documentation by nursing and the effects on the practice environment. A quantitative, retrospective analysis using interrupted time series model of a large data set was conducted in a 431-bed urban hospital, with 10 medical surgical units and 2 critical care units. The research was constructed using the Diffusion of Innovations (DOI) theory. Incorporating electronic, evidenced-based practice (EBP) tools into bedside nurse's workflow promotes decision making at the point of care that may improve quality with no negative impact on direct cost. The data revealed that total falls, CAUTI, and CLABSI rates were positively impacted after the implementation of an integrated EHR. Hospital-acquired pressure ulcer and VAP rates were negatively impacted at the implementation period followed by a significant positive rate reduction that surpassed the preimplementation period. Cost indicators, measured in hours per patient day and overtime, were negatively impacted during the implementation period followed by a return to baseline. Nurse turnover had a significant increase from the preimplementation to postimplementation period and failed to return to baseline. This study confirms that nurses have the ability to positively impact the quality of patient care through successful innovation adoption related to the use of EBP computerized documentation tools at the bedside. This study further clarified the practice environment of nurses during DOI.

Evolving with Evidence: Leveraging New Tools for EBP

ERIC Educational Resources Information Center

Valenza, Joyce Kasman

2015-01-01

Focusing on evidence-based practice (EBP) aligns with the school librarian's leadership role acknowledged by the American Association of School Librarians (AASL) in "Empowering Learners: Guidelines for School Library Programs" (2009) and in AASL's newly adopted mission statement. "The American Association of School Librarians…

Nurses' perceptions of evidence-based practice: a quantitative study at a teaching hospital in Iran.

PubMed

Shafiei, Ebrahim; Baratimarnani, Ahmad; Goharinezhad, Salime; Kalhor, Rohollah; Azmal, Mohammad

2014-01-01

Evidence-based practice (EBP) provides nurses a method to use critically appraised and scientifically proven evidence for delivering quality health care and the best decision that leads to quality outcomes. The purpose of this study was to measure the practice, attitude and knowledge/skill of evidence-based practice of nurses in a teaching hospital in Iran. This cross-sectional study was conducted in 2011.The study sample was composed of 195 nurses who were working at the Fatemeh Zahra Hospital affiliated to Bushehr University of Medical Sciences (BPUMS). The survey instrument was a questionnaire based on Upton and Upton study. This tool measures Nurses' perceptions in the three sub-scales of practice, attitude and knowledge/skill of evidence-based practice. Descriptive statistical analysis was used to analyze the data. Pearson correlation coefficients were used to examine the relationship between subscales. The overall mean score of the evidence-based practice in this study was 4.48±1.26 from 7, and the three subscales of practice, attitude and knowledge/skill in evidence-based practice were, 4.58±1.24, 4.57±1.35 and 4.39±1.20, respectively. There was a strong relationship between knowledge and performance subscale (r=0.73,p<0.01). Findings of the study indicate that more training and education are required for evidence-based nursing. Successful implementation of evidence-based nursing depends on organizational plans and empowerment programs in hospitals. Hence, hospital managers should formulate a comprehensive strategy for improving EBP.

Information Literacy: Instrument Development to Measure Competencies and Knowledge Among Nursing Educators, Nursing Administrators, and Nursing Clinicians: A Pilot Study

PubMed Central

Pierce, Susan; Pravikoff, Diane; Tanner, Annelle

2003-01-01

This poster describes a pilot study conducted to establish validity and reliability of an instrument that will be used in a nationwide needs assessment, implemented to identify gaps in Information Literacy skills, competencies, and knowledge among key nursing groups nationally. Data and information gathered using the tool will guide the profession in developing appropriate education and continuing education programs to close identified gaps and enhance nurses’ readiness for Evidence-Based Practice (EBP). PMID:14728475

Use of research in undergraduate nursing students' theses: A mixed methods study.

PubMed

Nordsteien, Anita; Horntvedt, May-Elin T; Syse, Jonn

2017-09-01

Health care personnel are expected to be familiar with evidence-based practice (EBP). Asking clinical questions, conducting systematic literature searches and conducting critical appraisal of research findings have been some of the barriers to EBP. To improve undergraduate nurses' research skills, a collaborative library-faculty teaching intervention was established in 2012. The aim of this study was to evaluate how the collaborative library-faculty teaching intervention affected the nursing students' research skills when writing their final theses. Both quantitative and qualitative data collection and analysis were used. The study focused on a final year undergraduate nurse training programme in Norway. 194 theses submitted between 2013 and 2015 were collected and assessed. The students were exposed to the intervention for respectively one, two and three years during this period. Descriptive statistics were used to compare each year's output over the three-year period and to examine the frequency of the use of various databases, types of information and EBP-tools. Qualitative data was used to capture the students' reasoning behind their selection processes in their research. The research skills with regard to EBP have clearly improved over the three years. There was an increase in employing most EBP-tools and the justifications were connected to important EBP principles. The grades in the upper half of the grading scale increased from 66.7 to 82.1% over the period 2013 to 2015, and a correlation was found between grades and critical appraisal skills. The collaborative library-faculty teaching intervention employed has been successful in the promotion of nursing student research skills as far as the EBP principles are concerned. Writing a thesis in the undergraduate nursing programme is important to develop and practice these research skills. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using Instructional Design, Analyze, Design, Develop, Implement, and Evaluate, to Develop e-Learning Modules to Disseminate Supported Employment for Community Behavioral Health Treatment Programs in New York State.

PubMed

Patel, Sapana R; Margolies, Paul J; Covell, Nancy H; Lipscomb, Cristine; Dixon, Lisa B

2018-01-01

Implementation science lacks a systematic approach to the development of learning strategies for online training in evidence-based practices (EBPs) that takes the context of real-world practice into account. The field of instructional design offers ecologically valid and systematic processes to develop learning strategies for workforce development and performance support. This report describes the application of an instructional design framework-Analyze, Design, Develop, Implement, and Evaluate (ADDIE) model-in the development and evaluation of e-learning modules as one strategy among a multifaceted approach to the implementation of individual placement and support (IPS), a model of supported employment for community behavioral health treatment programs, in New York State. We applied quantitative and qualitative methods to develop and evaluate three IPS e-learning modules. Throughout the ADDIE process, we conducted formative and summative evaluations and identified determinants of implementation using the Consolidated Framework for Implementation Research (CFIR). Formative evaluations consisted of qualitative feedback received from recipients and providers during early pilot work. The summative evaluation consisted of levels 1 and 2 (reaction to the training, self-reported knowledge, and practice change) quantitative and qualitative data and was guided by the Kirkpatrick model for training evaluation. Formative evaluation with key stakeholders identified a range of learning needs that informed the development of a pilot training program in IPS. Feedback on this pilot training program informed the design document of three e-learning modules on IPS: Introduction to IPS, IPS Job development, and Using the IPS Employment Resource Book . Each module was developed iteratively and provided an assessment of learning needs that informed successive modules. All modules were disseminated and evaluated through a learning management system. Summative evaluation revealed that learners rated the modules positively, and self-report of knowledge acquisition was high (mean range: 4.4-4.6 out of 5). About half of learners indicated that they would change their practice after watching the modules (range: 48-51%). All learners who completed the level 1 evaluation demonstrated 80% or better mastery of knowledge on the level 2 evaluation embedded in each module. The CFIR was used to identify implementation barriers and facilitators among the evaluation data which facilitated planning for subsequent implementation support activities in the IPS initiative. Instructional design approaches such as ADDIE may offer implementation scientists and practitioners a flexible and systematic approach for the development of e-learning modules as a single component or one strategy in a multifaceted approach for training in EBPs.

Evidence-Based Practice Knowledge, Perceptions, and Behavior: A Multi-Institutional, Cross-Sectional Study of a Population of U.S. Dental Students.

PubMed

Straub-Morarend, Cheryl L; Wankiiri-Hale, Christine R; Blanchette, Derek R; Lanning, Sharon K; Bekhuis, Tanja; Smith, Becky M; Brodie, Abby J; Oliveira, Deise Cruz; Handysides, Robert A; Dawson, Deborah V; Spallek, Heiko

2016-04-01

The aim of this study was to help inform faculty and curriculum leaders in academic dental institutions about the knowledge, skills, perceptions, and behavior of an institutionally diverse population of dental students with respect to evidence-based practice (EBP). A survey utilizing the validated Knowledge, Attitudes, Access, and Confidence Evaluation instrument developed by Hendricson et al. was conducted in 2012 with fourth-year dental students at seven geographically dispersed U.S. dental schools. The survey addressed elements of EBP knowledge, attitudes toward EBP, behavior in accessing evidence, and perceptions of competence in statistical analysis. A total of 138 students from the seven schools participated. A slight majority of these students correctly responded to the knowledge of critical appraisal questions. While the students demonstrated positive attitudes about EBP, they did not report high levels of confidence in their critical appraisal skills. The findings also showed that the students accessed various sources of evidence with differing frequencies. The most frequently accessed resources were colleagues, the Internet (excluding Cochrane Database of Systematic Reviews), and textbooks. The results of this study help to identify areas for improvement in EBP education in order to advance dental students' preparation to become evidence-based practitioners.

Evidence-Based Practice Knowledge, Perceptions, and Behavior: A Multi-Institutional, Cross-Sectional Study of a Population of U.S. Dental Students

PubMed Central

Straub-Morarend, Cheryl L.; Wankiiri-Hale, Christine R.; Blanchette, Derek R.; Lanning, Sharon K.; Bekhuis, Tanja; Smith, Becky M.; Brodie, Abby J.; Oliveira, Deise Cruz; Handy-sides, Robert A.; Dawson, Deborah V.; Spallek, Heiko

2016-01-01

The aim of this study was to help inform faculty and curriculum leaders in academic dental institutions about the knowledge, skills, perceptions, and behavior of an institutionally diverse population of dental students with respect to evidence-based practice (EBP). A survey utilizing the validated Knowledge, Attitudes, Access, and Confidence Evaluation instrument developed by Hendricson et al. was conducted in 2012 with fourth-year dental students at seven geographically dispersed U.S. dental schools. The survey addressed elements of EBP knowledge, attitudes toward EBP, behavior in accessing evidence, and perceptions of competence in statistical analysis. A total of 138 students from the seven schools participated. A slight majority of these students correctly responded to the knowledge of critical appraisal questions. While the students demonstrated positive attitudes about EBP, they did not report high levels of confidence in their critical appraisal skills. The findings also showed that the students accessed various sources of evidence with differing frequencies. The most frequently accessed resources were colleagues, the Internet (excluding Cochrane Database of Systematic Reviews), and textbooks. The results of this study help to identify areas for improvement in EBP education in order to advance dental students’ preparation to become evidence-based practitioners. PMID:27037451

Use of Evidence-Based Practice Among Athletic Training Educators, Clinicians, and Students, Part 1: Perceived Importance, Knowledge, and Confidence

PubMed Central

Hankemeier, Dorice A.; Walter, Jessica M.; McCarty, Cailee W.; Newton, Eric J.; Walker, Stacy E.; Pribesh, Shana L.; Jamali, Beth E.; Manspeaker, Sarah A.; Van Lunen, Bonnie L.

2013-01-01

Context: Although evidence-based practice (EBP) has become more prevalent, athletic trainers' perceptions of importance and knowledge of these concepts and their confidence in EBP are largely unknown. Objective: To assess perceived importance and knowledge of and confidence in EBP concepts in athletic trainers in various roles and with different degree levels. Design: Cross-sectional study. Setting: Online survey instrument. Patients or Other Participants: The survey was sent to 6702 athletic training educators, clinicians, and postprofessional students. A total of 1209 completed the survey, for a response rate of 18.04%. Main Outcome Measure(s): Demographic information and perceived importance and knowledge of and confidence in the steps of EBP were obtained. One-way analysis of variance, a Kruskal-Wallis test, and an independent-samples t test were used to determine differences in scores among the demographic variables. Results: Athletic trainers demonstrated low knowledge scores (64.2% ± 1.29%) and mild to moderate confidence (2.71 ± 0.55 out of 4.0). They valued EBP as moderately to extremely important (3.49 ± 0.41 out of 4.0). Perceived importance scores differed among roles (clinicians unaffiliated with an education program scored lower than postprofessional educators, P = .001) and highest educational degree attained (athletic trainers with terminal degrees scored higher than those with bachelor's or master's degrees, P < .001). Postprofessional athletic training students demonstrated the highest total EBP knowledge scores (4.65 ± 0.91), whereas clinicians demonstrated the lowest scores (3.62 ± 1.35). Individuals with terminal degrees had higher (P < .001) total knowledge scores (4.31 ± 1.24) than those with bachelor's (3.78 ± 1.2) or master's degrees (3.76 ± 1.35). Postprofessional educators demonstrated greater confidence in knowledge scores (3.36 ± 0.40 out of 4.0) than did those in all other athletic training roles (P < .001). Conclusions: Overall knowledge of the basic EBP steps remained low across the various athletic trainers' roles. The higher level of importance indicated that athletic trainers valued EBP, but this value was not reflected in the knowledge of EBP concepts. Individuals with a terminal degree possessed higher knowledge scores than those with other educational preparations; however, EBP knowledge needs to increase across all demographics of the profession. PMID:23675799

The Influence of Team Functioning and Workload on Sustainability of Trauma-Focused Evidence-Based Psychotherapies.

PubMed

Mohr, David C; Rosen, Craig S; Schnurr, Paula P; Orazem, Robert J; Noorbaloochi, Siamak; Clothier, Barbara A; Eftekhari, Afsoon; Bernardy, Nancy C; Chard, Kathleen M; Crowley, Jill J; Cook, Joan M; Kehle-Forbes, Shannon M; Ruzek, Josef I; Sayer, Nina A

2018-05-25

It has been over a decade since the U.S. Department of Veterans Affairs (VA) began formal dissemination and implementation of two trauma-focused evidence-based psychotherapies (TF-EBPs). The objective of this study was to examine the sustainability of the TF-EBPs and determine whether team functioning and workload were associated with TF-EBP sustainability. This observational study used VA administrative data for 6,251 patients with posttraumatic stress disorder (PTSD) and surveys from 78 providers from 10 purposefully selected PTSD clinical teams located in nine VA medical centers. The outcome was sustainability of TF-EBPs, which was based on British National Health System Sustainability Index scores (possible scores range from 0 to 100.90). Primary predictors included team functioning, workload, and TB-EBP reach to patients with PTSD. Multiple linear regression models were used to examine the influence of team functioning and workload on TF-EBP sustainability after adjustment for covariates that were significantly associated with sustainability. Sustainability Index scores ranged from 53.15 to 100.90 across the 10 teams. Regression models showed that after adjustment for patient and facility characteristics, team functioning was positively associated (B=9.16, p<.001) and workload was negatively associated (B=-.28, p<.05) with TF-EBP sustainability. There was considerable variation across teams in TF-EBP sustainability. The contribution of team functioning and workload to the sustainability of evidence-based mental health care warrants further study.

The Threshold and Inclusive Approaches to Determining "Best Available Evidence": An Empirical Analysis

ERIC Educational Resources Information Center

Stockard, Jean; Wood, Timothy W.

2017-01-01

Most evaluators have embraced the goal of evidence-based practice (EBP). Yet, many have criticized EBP review systems that prioritize randomized control trials and use various criteria to limit the studies examined. They suggest this could produce policy recommendations based on small, unrepresentative segments of the literature and recommend a…

Achieving Adherence to Evidence-Based Practices: Are Health IT and Hospital-Physician Integration Complementary or Substitutive Strategies?

PubMed

Everson, Jordan; Lee, Shoou-Yih Daniel; Adler-Milstein, Julia

2016-12-01

In response to evolving policies and conditions, hospitals have increased health information technology (HIT) adoption and strived to improve hospital-physician integration. While evidence suggests that both HIT and integration confer independent benefits, when combined, they may provide complementary means to achieve high performance or overlap to offset each other's contribution. We explore this relationship in the context of hospital adherence to evidence-based practices (EBPs). Using the American Hospital Association's Annual and IT Supplement surveys, and Centers for Medicare and Medicaid Services's Hospital Compare, we estimate the independent relationships and interactions between HIT and hospital-physician integration with respect to EBP adherence. HIT adoption and tight (but not loose) integration are independently associated with greater adherence to EBPs. The interaction between HIT adoption and tight integration is negative, consistent with an offsetting association between HIT adoption and integration in their relationship to EBP adherence. This finding reveals the need to be aware of potential substitutive effects from simultaneous pursuit of multiple approaches to performance improvement. © The Author(s) 2016.

Evidence-Based Practice: Separating Science From Pseudoscience

PubMed Central

Lee, Catherine M; Hunsley, John

2015-01-01

Evidence-based practice (EBP) requires that clinicians be guided by the best available evidence. In this article, we address the impact of science and pseudoscience on psychotherapy in psychiatric practice. We describe the key principles of evidence-based intervention. We describe pseudoscience and provide illustrative examples of popular intervention practices that have not been abandoned, despite evidence that they are not efficacious and may be harmful. We distinguish efficacy from effectiveness, and describe modular approaches to treatment. Reasons for the persistence of practices that are not evidence based are examined at both the individual and the professional system level. Finally, we offer suggestions for the promotion of EBP through clinical practice guidelines, modelling of scientific decision making, and training in core skills. PMID:26720821

Evidence-Based Practice: Separating Science From Pseudoscience.

PubMed

Lee, Catherine M; Hunsley, John

2015-12-01

Evidence-based practice (EBP) requires that clinicians be guided by the best available evidence. In this article, we address the impact of science and pseudoscience on psychotherapy in psychiatric practice. We describe the key principles of evidence-based intervention. We describe pseudoscience and provide illustrative examples of popular intervention practices that have not been abandoned, despite evidence that they are not efficacious and may be harmful. We distinguish efficacy from effectiveness, and describe modular approaches to treatment. Reasons for the persistence of practices that are not evidence based are examined at both the individual and the professional system level. Finally, we offer suggestions for the promotion of EBP through clinical practice guidelines, modelling of scientific decision making, and training in core skills.

Assisting undergraduate nursing students to learn evidence-based practice through self-directed learning and workshop strategies during clinical practicum.

PubMed

Zhang, Qi; Zeng, Tieying; Chen, Ying; Li, Xiaopan

2012-07-01

To equip undergraduate nursing students with basic knowledge and skills and foster positive attitudes toward evidence-based practice (EBP), a pilot learning program during their clinical practicum was developed in a teaching hospital in China. This article describes the specific learning process through which self-directed learning and workshop strategies were used, and a pre- and post-intervention survey were conducted to evaluate the effectiveness of the learning strategies. The findings show a significant improvement in their perceptions of EBP knowledge, attitudes and beliefs, and behavior levels. Beginning competencies in EBP were achieved. Participants reported great satisfaction and have found this program helpful in promoting their analytical and problem-solving abilities, independent learning ability, and cooperative and communication abilities as well. Copyright © 2011 Elsevier Ltd. All rights reserved.

Critical Appraisal Tools and Reporting Guidelines for Evidence-Based Practice.

PubMed

Buccheri, Robin K; Sharifi, Claire

2017-12-01

Nurses engaged in evidence-based practice (EBP) have two important sets of tools: Critical appraisal tools and reporting guidelines. Critical appraisal tools facilitate the appraisal process and guide a consumer of evidence through an objective, analytical, evaluation process. Reporting guidelines, checklists of items that should be included in a publication or report, ensure that the project or guidelines are reported on with clarity, completeness, and transparency. The primary purpose of this paper is to help nurses understand the difference between critical appraisal tools and reporting guidelines. A secondary purpose is to help nurses locate the appropriate tool for the appraisal or reporting of evidence. A systematic search was conducted to find commonly used critical appraisal tools and reporting guidelines for EBP in nursing. This article serves as a resource to help nurse navigate the often-overwhelming terrain of critical appraisal tools and reporting guidelines, and will help both novice and experienced consumers of evidence more easily select the appropriate tool(s) to use for critical appraisal and reporting of evidence. Having the skills to select the appropriate tool or guideline is an essential part of meeting EBP competencies for both practicing registered nurses and advanced practice nurses (Melnyk & Gallagher-Ford, 2015; Melnyk, Gallagher-Ford, & Fineout-Overholt, 2017). Nine commonly used critical appraisal tools and eight reporting guidelines were found and are described in this manuscript. Specific steps for selecting an appropriate tool as well as examples of each tool's use in a publication are provided. Practicing registered nurses and advance practice nurses must be able to critically appraise and disseminate evidence in order to meet EBP competencies. This article is a resource for understanding the difference between critical appraisal tools and reporting guidelines, and identifying and accessing appropriate tools or guidelines. © 2017 Sigma Theta Tau International.

Meta-Analysis of Single-Case Design Research: Introduction to the Special Issue

ERIC Educational Resources Information Center

Burns, Matthew K.

2012-01-01

Single-case design (SCD) research focuses on finding powerful effects, but the influence of this methodology on the evidence-based practice (EBP) movement is questionable. Meta-analytic procedures may help facilitate the role of SCD research in the EBP movement, but meta-analyses of SCDs are controversial. The current article provides an…

Comparing the Effects of Working Memory-Based Interventions for Children with Language Impairment. EBP Briefs. Volume 9, Issue 1

ERIC Educational Resources Information Center

Farquharson, Kelly; Franzluebbers, Chelsea E.

2014-01-01

Clinical Question: Do working memory-based interventions improve language, reading, and/or working memory skills in school-aged children with language impairment? Method: Literature review of evidence-based practice (EBP) intervention comparisons. Sources: Google Scholar, ASHA journals database, Academic OneFile, Academic Search Complete, and…

Using the Knowledge to Action Process Model to Incite Clinical Change

ERIC Educational Resources Information Center

Petzold, Anita; Korner-Bitensky, Nicol; Menon, Anita

2010-01-01

Introduction: Knowledge translation (KT) has only recently emerged in the field of rehabilitation with attention on creating effective KT interventions to increase clinicians' knowledge and use of evidence-based practice (EBP). The uptake of EBP is a complex process that can be facilitated by the use of the Knowledge to Action Process model. This…

Manualization, Feasibility, and Effectiveness of the School-Based Social Competence Intervention for Adolescents (SCI-A)

ERIC Educational Resources Information Center

Stichter, Janine P.; Herzog, Melissa J.; Owens, Sarah A.; Malugen, Emily

2016-01-01

Despite the movement toward identification of evidence-based practices (EBPs), there is a discrepancy in the availability of school-based EBPs targeting the unique needs of students with high functioning forms of autism and related social needs. Based on calls for systematic intervention development and evaluation processes, the current study…

Education of speech and language therapists/logopedists in selected Central and Southeastern European countries: challenges and new horizons.

PubMed

Georgieva, Dobrinka; Woźniak, Tomasz; Topbaş, Seyhun; Vitaskova, Katerina; Vukovic, Mile; Zemva, Nada; Duranovic, Mirela

2014-01-01

To provide an overview of student training in speech and language therapy/logopedics (SLT) in selected Central and Southeastern European countries (Poland, Slovenia, Bulgaria, Czech Republic, Serbia, Bosnia and Herzegovina and Turkey). Data were collected using a special questionnaire developed by Söderpalm and supplemented by Georgieva. Results from 23 SLT programs in the seven countries were collected and organized. In all these countries, SLT has roots in special education or health and is centralized in the university environment. The training programs have positive accreditation provided by the national agencies of accreditation and evaluation. Results were examined specifically for evidence of the new paradigm of evidence-based practice (EBP) according to the revised International Association of Logopedics and Phoniatrics (IALP) guidelines and the application of research-based teaching in SLT. The professional bodies that govern clinical practice in public health and/or educational fields are in the process of EBP implementation. Most speech and language therapists/logopedists in the selected countries work in an educational setting, clinical organization and/or hospital as well as in social day care centers. Except in Turkey, private practices are not regulated by the law. In the seven countries examined in this survey, SLT is progressing as a professional discipline but must be supported by government funding of SLT education and services to relevant populations. © 2015 S. Karger AG, Basel.

Training Substance Use Disorder Counselors in Cognitive Behavioral Therapy for Depression: Development and Initial Exploration of an Online Training Program.

PubMed

Curran, Geoffrey M; Woo, Stephanie M; Hepner, Kimberly A; Lai, Wen Pin; Kramer, Teresa L; Drummond, Karen L; Weingardt, Ken

2015-11-01

Evidence based psychotherapies (EBPs) remain underutilized. Models for EBP training and implementation that are cost-effective, minimally disruptive, and sufficiently flexible are needed. Internet-based technology is a promising platform, but questions remain about how this technology can address the barriers to implementation. We developed and examined the implementation of an online training for the Building Recovery by Improving Goals, Habits, and Thoughts (BRIGHT) intervention-a manualized, sixteen-session group depression treatment for individuals with substance use disorders (SUDs). We explored the feasibility of replacing in-person BRIGHT training with a self-paced, online training. A highly partnered and iterative process was followed to translate the written BRIGHT manual and associated didactic training materials into a media rich, interactive, and detailed (12-16 h) online training. Subsequently, 8 volunteer counselors across 7 Veterans' Affairs SUD programs completed the training. Semi-structured interviews focused on the counselors' experiences and their plans for implementing BRIGHT groups. A template approach, using a mixture of deductive and inductive coding, was used for data analyses. The most important barrier to completing training was a lack of protected time. Most counselors were not afforded protected time and reported a sometimes frustrating and fragmented training experience. Many used personal time at work and at home to complete the work. Facilitators to completing the training included positive reactions/attitudes towards the training modules, supervisor support, counselor dedication, and strong beliefs supporting providing services for depression. Many counselors were also concerned about the feasibility of fitting 16 group sessions (2h each) into their program's clinical schedule, but many had devised potential solutions or "work-arounds" to accommodate or approximate the recommended treatment course (e.g., using lunch times, reducing some content/exercises). This work contributes to the literature on implementation of complex EBPs and addresses the strengths and limitations of web-based technologies in supporting the implementation of EBPs. Published by Elsevier Inc.

Science-based practice and the speech-language pathologist.

PubMed

Lof, Gregory L

2011-06-01

Evidence-based practice (EBP) is a well established concept in the field of speech-language pathology. However, evidence from research may not be the primary information that practitioners use to guide their treatment selection from the many potential options. There are various alternative therapy procedures that are strongly promoted, so clinicians must become skilled at identifying pseudoscience from science in order to determine if a treatment is legitimate or actually quackery. In order to advance the use of EBP, clinicians can gather practice-based evidence (PBE) by using the scientific method. By adhering to the principles of science, speech-language pathologists can incorporate science-based practice (SBP) into all aspects of their clinical work.

Using a Theory-Guided Learning Collaborative Model to Improve Implementation of EBPs in a State Children's Mental Health System: A Pilot Study.

PubMed

Nadeem, Erum; Weiss, Dara; Olin, S Serene; Hoagwood, Kimberly E; Horwitz, Sarah M

2016-11-01

Learning collaboratives (LCs) are used widely to promote implementation of evidence-based practices. However, there has been limited research on the effectiveness of LCs and models vary widely in their structure, focus and components. The goal of the present study was to develop and field test a theory-based LC model to augment a state-led, evidence-based training program for clinicians providing mental health services to children. Analysis of implementation outcomes contrasted LC sites to matched comparison sites that participated in the clinical training program alone. Results suggested that clinicians from sites participating in the LC were more highly engaged in the state-led clinical training program and were more likely to complete program requirements.

Evaluating the Impact of EBP Education: Development of a Modified Fresno Test for Acute Care Nursing.

PubMed

Halm, Margo A

2018-05-14

Proficiency in evidence-based practice (EBP) is essential for relevant research findings to be integrated into clinical care when congruent with patient preferences. Few valid and reliable tools are available to evaluate the effectiveness of educational programs in advancing EBP attitudes, knowledge, skills, or behaviors, and ongoing competency. The Fresno test is one objective method to evaluate EBP knowledge and skills; however, the original and modified versions were validated with family physicians, physical therapists, and speech and language therapists. To adapt the Modified Fresno-Acute Care Nursing test and develop a psychometrically sound tool for use in academic and practice settings. In Phase 1, modified Fresno (Tilson, 2010) items were adapted for acute care nursing. In Phase 2, content validity was established with an expert panel. Content validity indices (I-CVI) ranged from .75 to 1.0. Scale CVI was .95%. A cross-sectional convenience sample of acute care nurses (n = 90) in novice, master, and expert cohorts completed the Modified Fresno-Acute Care Nursing test administered electronically via SurveyMonkey. Total scores were significantly different between training levels (p < .0001). Novice nurses scored significantly lower than master or expert nurses, but differences were not found between the latter cohorts. Total score reliability was acceptable: (interrater [ICC (2, 1)]) = .88. Cronbach's alpha was 0.70. Psychometric properties of most modified items were satisfactory; however, six require further revision and testing to meet acceptable standards. The Modified Fresno-Acute Care Nursing test is a 14-item test for objectively assessing EBP knowledge and skills of acute care nurses. While preliminary psychometric properties for this new EBP knowledge measure for acute care nursing are promising, further validation of some of the items and scoring rubric is needed. © 2018 Sigma Theta Tau International.

An assessment of the information-seeking abilities and needs of practicing speech-language pathologists

PubMed Central

Nail-Chiwetalu, Barbara; Bernstein Ratner, Nan

2007-01-01

Objectives: This study assessed the information-seeking practices and needs of speech-language pathologists (SLPs). Improved understanding of these needs can inform librarians and educators to better prepare students in principles and methods of evidence-based practice (EBP) and, through continuing education (CE), promote the integration of EBP into clinical practice of SLPs. Methods: A 16-question survey was mailed to 1,000 certified speech-language pathologists in the United States. Results: Two hundred and eight usable surveys were returned for a response rate of 21%. For clinical questions, SLPs most often consulted with a colleague, participated in CE activities, and searched the open Internet. Few respondents relied on scholarly journal articles for assistance with clinical cases. The most prominent barriers to finding appropriate information were time and knowledge of where and how to find relevant information. Few reported having information literacy instruction by a librarian. Discussion: If EBP is to become a viable practice in clinical decision making, there appears to be a tremendous need for information literacy instruction in the university curriculum, as well as through CE activities for currently practicing SLPs. Given respondents' reported lack of time and limited access to full-text journals containing evidence relevant to clinical practice, the field of speech-language pathology will need to generate readily accessible clinical summaries of research evidence through meta-analyses, systematic reviews, and clinical practice guidelines. PMID:17443251

Comparison of consumer derived evidence with an omaha system evidence-based practice guideline for community dwelling older adults.

PubMed

Pruinelli, Lisiane; Fu, Helen; Monsen, Karen A; Westra, Bonnie L

2014-01-01

Consumer involvement in healthcare is critical to support continuity of care for consumers to manage their health while transitioning from one care setting to another. Validation of evidence-based practice (EBP) guideline by consumers is essential to achieving consumer health goals over time that is consistent with their needs and preferences. The purpose of this study was to compare an Omaha System EBP guideline for community dwelling older adults with consumer-derived evidence of their ongoing needs, resources, and strategies after home care discharge. All identified problems were relevant for all patients except for Neglect and Substance use. Ten additional problems were identified from the interviews, five of which affected at least 10% of the participants. Consumer derived evidence both validated and expanded EBP guidelines; thus further emphasizing the importance of consumer involvement in the delivery of home healthcare.

Supporting influenza vaccination intent among nurses: effects of leadership and attitudes toward adoption of evidence-based practice.

PubMed

Paparone, Pamela

2015-03-01

The leadership styles of healthcare organizations and the attitudes of nurses toward the adoption of evidence-based practice (EBP) were examined to provide a predictor of influenza vaccination intent (VI) and improve the current inadequate vaccination rate among nurses. Influenza is a costly and potentially serious disease. The United States has set a benchmark of a 90% influenza vaccination rate among healthcare personnel by 2020. A sample of 354 registered nurses completed a survey assessing demographic data, the leadership styles of their organization, their attitudes toward EBP, and their VI. A significant positive correlation was found between transformational leadership and VI, but not between transactional leadership and VI. Attitudes toward EBP correlated weakly, but insignificantly, with VI. Transformational leadership can predict and positively influence vaccination rates among nurses, thus decreasing vaccine preventable illness and improving patient outcomes.

Testing the implementation and sustainment facilitation (ISF) strategy as an effective adjunct to the Addiction Technology Transfer Center (ATTC) strategy: study protocol for a cluster randomized trial.

PubMed

Garner, Bryan R; Zehner, Mark; Roosa, Mathew R; Martino, Steve; Gotham, Heather J; Ball, Elizabeth L; Stilen, Patricia; Speck, Kathryn; Vandersloot, Denna; Rieckmann, Traci R; Chaple, Michael; Martin, Erika G; Kaiser, David; Ford, James H

2017-11-17

Improving the extent to which evidence-based practices (EBPs)-treatments that have been empirically shown to be efficacious or effective-are integrated within routine practice is a well-documented challenge across numerous areas of health. In 2014, the National Institute on Drug Abuse funded a type 2 effectiveness-implementation hybrid trial titled the substance abuse treatment to HIV Care (SAT2HIV) Project. Aim 1 of the SAT2HIV Project tests the effectiveness of a motivational interviewing-based brief intervention (MIBI) for substance use as an adjunct to usual care within AIDS service organizations (ASOs) as part of its MIBI Experiment. Aim 2 of the SAT2HIV Project tests the effectiveness of implementation and sustainment facilitation (ISF) as an adjunct to the Addiction Technology Transfer Center (ATTC) model for training staff in motivational interviewing as part of its ISF Experiment. The current paper describes the study protocol for the ISF Experiment. Using a cluster randomized design, case management and leadership staff from 39 ASOs across the United States were randomized to receive either the ATTC strategy (control condition) or the ATTC + ISF strategy (experimental condition). The ATTC strategy is staff-focused and includes 10 discrete strategies (e.g., provide centralized technical assistance, conduct educational meetings, provide ongoing consultation). The ISF strategy is organization-focused and includes seven discrete strategies (e.g., use an implementation advisor, organize implementation team meetings, conduct cyclical small tests of change). Building upon the exploration-preparation-implementation-sustainment (EPIS) framework, the effectiveness of the ISF strategy is examined via three staff-level measures: (1) time-to-proficiency (i.e., preparation phase outcome), (2) implementation effectiveness (i.e., implementation phase outcome), and (3) level of sustainment (i.e., sustainment phase outcome). Although not without limitations, the ISF experiment has several strengths: a highly rigorous design (randomized, hypothesis-driven), high-need setting (ASOs), large sample size (39 ASOs), large geographic representation (23 states and the District of Columbia), and testing along multiple phases of the EPIS continuum (preparation, implementation, and sustainment). Thus, study findings will significantly improve generalizable knowledge regarding the best preparation, implementation, and sustainment strategies for advancing EBPs along the EPIS continuum. Moreover, increasing ASO's capacity to address substance use may improve the HIV Care Continuum. Trial registration ClinicalTrials.gov: NCT03120598.

YouTube as a source of quitting smoking information.

PubMed

Backinger, Cathy L; Pilsner, Alison M; Augustson, Erik M; Frydl, Andrea; Phillips, Todd; Rowden, Jessica

2011-03-01

To conduct analyses to determine the extent to which YouTube videos posted specific to smoking cessation were actually about quitting smoking and if so, whether or not they portrayed evidence-based practices (EBPs). In August 2008, researchers identified YouTube videos by search strategies, 'relevance' and 'view count' using the following three search terms: 'stop smoking', 'quit smoking' and 'smoking cessation (n=296 for full sample and n=191 for unique videos). Overall, almost 60% of videos contained a message about quitting smoking. Differences were found across search terms for videos about quitting smoking, with 'stop smoking' yielding the highest percentage (80.8%) of videos about quitting smoking. Almost half of the videos (48.9%) contained EBPs for cessation strategies; however, a significant portion contained either non--EBPs (28.4%) or both EBPs and non-EBPs (22.7%). The number of views per an individual video across the six categories ranged from a low of 8 in the 'relevance' strategy and 'smoking cessation' search term to a high of 1,247,540 in the 'view count' strategy and 'stop smoking' search term. Of the top three most viewed videos by strategy and search term, 66.7% included a specific mention of quitting smoking and, of these, the majority included EBPs. Results highlight the need to develop and upload videos containing EBPs both to increase the overall proportion of EBP videos in all categories, particularly in 'quit smoking' and 'stop smoking.' Research is needed to study whether YouTube videos influence knowledge, attitudes and behaviours regarding quitting smoking.

An Integrative Review of Engaging Clinical Nurses in Nursing Research.

PubMed

Scala, Elizabeth; Price, Carrie; Day, Jennifer

2016-07-01

To review the literature for best practices for engaging clinical nurses in nursing research. Review of the research and nonresearch papers published between 2005 and 2015 that answered the evidence-based practice (EBP) question: what are the best practices for engaging clinical nursing staff in nursing research? PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Joanna Briggs Institute, and Cochrane were searched using a combination of controlled vocabulary and key words. Nineteen papers that answered the EBP question were selected for review. It can be difficult to involve clinical nurses in research. There are multiple factors to consider when nursing leadership looks to engage clinical nurses in nursing research. Nurse leaders can take many approaches to engage clinical nurses in research. Each organization must perform its own assessment to identify areas of opportunity. Nursing leadership can take these areas of opportunity to structure a multifaceted approach to support clinical staff in the conduct and dissemination of nursing research. The evidence from this review offers EBP recommendations as well as reports on the gaps in the literature related to best practices for engaging clinical nurses in nursing research. © 2016 Sigma Theta Tau International.

Beyond evidence-based nursing: tools for practice.

PubMed

Jutel, Annemarie

2008-05-01

This commentary shares my views of evidence-based nursing as a framework for practice, pointing out its limitations and identifying a wider base of appraisal tools required for making good clinical decisions. As the principles of evidence-based nursing take an increasingly greater hold on nursing education, policy and management, it is important to consider the range of other decision-making tools which are subordinated by this approach. This article summarizes nursing's simultaneous reliance on and critique of evidence-based practice (EBP) in a context of inadequate critical reasoning. It then provides an exemplar of the limitations of evidence-based practice and offers an alternative view of important precepts of decision-making. I identify means by which nurses can develop skills to engage in informed and robust critique of practices and their underpinning rationale. Nurses need to be able to locate and assess useful and reliable information for decision-making. This skill is based on a range of tools which include, but also go beyond EBP including: information literacy, humanities, social sciences, public health, statistics, marketing, ethics and much more. This essay prompts nursing managers to reflect upon whether a flurried enthusiasm to adopt EBP neglects other important decision-making skills which provide an even stronger foundation for robust nursing decisions.

An information technology infrastructure to enable evidence-based nursing practice.

PubMed

Pochciol, Joan M; Warren, Joan I

2009-01-01

The movement toward evidence-based practice (EBP) poses new organizational challenges to provide the necessary infrastructure to promote effective nursing interventions based on the best available evidence. The purpose of this article is to describe a collaborative effort between nursing and library services to provide readily accessible information at the bedside to support nurses using the best available evidence. In collaboration with nursing, the Health Services Librarian created an information resource titled "Research-based Nursing Practice: Finding the Evidence," which enables nursing staff to access the resources at the bedside without having to perform lengthy searches. Every known resource that will educate nurses in defining EBP to providing them with the links to Web sites, published articles, and all the information resources is included in the tool. Much has been written about building the organizational infrastructure to promote EBP and finding the filtered, synthesized research evidence, but to our knowledge, little has been published on building the information technology infrastructure, which will give nurses real-time access at the point-of-care to the research evidence. The research-based nursing practice system is helping bridge the gap between evidence-based resources and practice by compiling the literature in one place and making it easily and readily accessible.

Creating an EBP framework on a journey to becoming an EBP agency: pioneers in the field of children's mental health.

PubMed

Archer-Kuhn, Beth; Bouchard, Terrance Thomas; Greco, Adelle

2014-01-01

Agencies servicing children, youth, and families have been particularly pressured to demonstrate service effectiveness and accountability by government funders. The human service fields have not fully embraced research evidence into the organizational culture creating a challenge of introducing research evidence into agencies. Gaps in knowledge have been identified when agencies attempt to travel down the path of introducing evidence-based practice into organizational culture. The paradigm shift of introducing research into practice was the journey taken by one mid-sized agency in southwestern Ontario, Canada. A framework for assessing evidence-based practice programs in services was created as part of their journey.

The Diffusion of Evidence-Based Practice: Reviewing the Evidence-Based Practice Networks in the United States and German-Speaking Countries.

PubMed

Ghanem, Christian; Lawson, Thomas R; Pankofer, Sabine; Maragkos, Markos; Kollar, Ingo

2017-01-01

Evidence-based practice (EBP) has had a major influence on U.S. social work while it has rarely been adapted in German-speaking countries. This study investigates how knowledge about EBP is diffused within and across geographical contexts. Network analysis methods reveals different diffusion patterns and provide reasons for these differences. For example, the U.S. discourse is self-contained and based on a more homogeneous knowledge base, while the German discourse is more heterogeneous and focuses on a notion of reflexive professionalism. The different conceptual influences within the U.S. and German discourses are discussed in light of future directions of disciplinary social work.

Translating knowledge into best practice care bundles: a pragmatic strategy for EBP implementation via moving postprocedural pain management nursing guidelines into clinical practice.

PubMed

Saunders, Hannele

2015-07-01

To describe quantitative and qualitative best evidence as sources for practical interventions usable in daily care delivery in order to integrate best evidence into clinical decision-making at local practice settings. To illustrate the development, implementation and evaluation of a pain management nursing care bundle based on a clinical practice guideline via a real-world clinical exemplar. Successful implementation of evidence-based practice requires consistent integration of best evidence into daily clinical decision-making. Best evidence comprises high-quality knowledge summarised in systematic reviews and translated into guidelines. However, consistent integration of guidelines into care delivery remains challenging, partly due to guidelines not being in a usable form for daily practice or relevant for the local context. A position paper with a clinical exemplar of a nurse-led, evidence-based quality improvement project to design, implement and evaluate a pain management care bundle translated from a national nursing guideline. A pragmatic approach to integrating guidelines into daily practice is presented. Best evidence from a national nursing guideline was translated into a pain management care bundle and integrated into daily practice in 15 medical-surgical (med-surg) units of nine hospitals of a large university hospital system in Finland. Translation of best evidence from guidelines into usable form as care bundles adapted to the local setting may increase implementation and uptake of guidelines and improve quality and consistency of care delivery. A pragmatic approach to translating a nursing guideline into a pain management care bundle to incorporate best evidence into daily practice may help achieve more consistent and equitable integration of guidelines into care delivery, and better quality of pain management and patient outcomes. © 2015 John Wiley & Sons Ltd.

Research evidence utilization in policy development by child welfare administrators.

PubMed

Jack, Susan; Dobbins, Maureen; Tonmyr, Lil; Dudding, Peter; Brooks, Sandy; Kennedy, Betty

2010-01-01

An exploratory qualitative study was conducted to explore how child welfare administrators use research evidence in decision-making. Content analysis revealed that a cultural shift toward evidence-based practice (EBP) is occurring in Canadian child welfare organizations and multiple types of evidence inform policy decisions. Barriers to using evidence include individual, organizational, and environmental factors. Facilitating factors include the development of internal champions and organizational cultures that value EBP. Integrating research into practice and policy decisions requires a multifaceted approach of creating organizational cultures that support research utilization and supporting senior bureaucrats to use research evidence in policy development.

Single-Case Design Research: Building the Evidence-Base in the Field of Education of Deaf and Hard of Hearing Students

ERIC Educational Resources Information Center

Cannon, Joanna E.; Guardino, Caroline; Antia, Shirin D.; Luckner, John L.

2015-01-01

The field of education of deaf and hard of hearing (DHH) students has a paucity of evidence-based practices (EBPs) to guide instruction. The authors discussed how the research methodology of single-case design (SCD) can be used to build EBPs through direct and systematic replication of studies. An overview of SCD research methods is presented,…

An Adaptation of the Original Fresno Test to Measure Evidence-Based Practice Competence in Pediatric Bedside Nurses.

PubMed

Laibhen-Parkes, Natasha; Kimble, Laura P; Melnyk, Bernadette Mazurek; Sudia, Tanya; Codone, Susan

2018-06-01

Instruments used to assess evidence-based practice (EBP) competence in nurses have been subjective, unreliable, or invalid. The Fresno test was identified as the only instrument to measure all the steps of EBP with supportive reliability and validity data. However, the items and psychometric properties of the original Fresno test are only relevant to measure EBP with medical residents. Therefore, the purpose of this paper is to describe the development of the adapted Fresno test for pediatric nurses, and provide preliminary validity and reliability data for its use with Bachelor of Science in Nursing-prepared pediatric bedside nurses. General adaptations were made to the original instrument's case studies, item content, wording, and format to meet the needs of a pediatric nursing sample. The scoring rubric was also modified to complement changes made to the instrument. Content and face validity, and intrarater reliability of the adapted Fresno test were assessed during a mixed-methods pilot study conducted from October to December 2013 with 29 Bachelor of Science in Nursing-prepared pediatric nurses. Validity data provided evidence for good content and face validity. Intrarater reliability estimates were high. The adapted Fresno test presented here appears to be a valid and reliable assessment of EBP competence in Bachelor of Science in Nursing-prepared pediatric nurses. However, further testing of this instrument is warranted using a larger sample of pediatric nurses in diverse settings. This instrument can be a starting point for evaluating the impact of EBP competence on patient outcomes. © 2018 Sigma Theta Tau International.

Approaches to teach evidence-based practice among health professionals: an overview of the existing evidence.

PubMed

Patelarou, Athina E; Kyriakoulis, Konstantinos G; Stamou, Aliki A; Laliotis, Aggelos; Sifaki-Pistolla, Dimitra; Matalliotakis, Michail; Prokopakis, Emmanuel; Patelarou, Evridiki

2017-01-01

Health care professionals' adoption of evidence-based practice (EBP) remains limited, although most health care professionals are familiar with EBP and believe in its value. This systematic review aimed to bring together the best methods used to teach EBP to health professionals. The authors conducted a systematic search for the period 2005-2015 (an update of the search took place in October 2016) using PubMed interface (Medline). MeSH terms as well as free-text keywords were used. Studies were analyzed and evaluated by title and abstract. Those studies which fulfilled the inclusion criteria were assessed by full text. References of articles were also taken into consideration for identifying relevant studies not found through algorithm search. Twenty articles were found to be relevant. The majority of the studies were conducted among nurses (n=7) and physicians (n=6), and only a few among professionals from mixed disciplines (n=5). Two studies were conducted among chiropractors (n=1) and faculty members from a naturopathic and classical Chinese medicine institution (n=1). Researchers used a variety of different approaches, which varied with respect to duration and organization. We divided interventions into two categories. Single interventions included either a workshop, or a journal club, or a conference, or a lecture, or online learning tools, whereas multiple interventions included a combination of these approaches. An increase in EBP competencies and attitudes was reported in nine studies. Teaching methods for optimizing EBP among health professionals could become a robust standardized procedure of the medical educational curricula and lifelong learning of health care professionals.

Psychiatric mental health evidence-based practice.

PubMed

Rice, Michael J

2008-05-01

This article is the first in a new column focusing on evidence-based practice (EBP) in psychiatric mental health nursing. The EBP movement was strongly influenced by a British epidemiologist, Dr. Cochrane, who advocated care based on randomized clinical controlled trials in the late 1900s. Although the majority of the EBP movement is directed toward developing clinical guidelines, the critical element focuses on the therapeutic relationship and clinical judgment associated with providing care. This column will address a clinical problem, define PICO questions, report knowledge base searches, and present existing evidence. Recommendations will be offered for potential interventions and suggestions for evaluating clinical outcomes. Nurses can no longer view clinical studies as academic exercises discarded on graduation and not applied to the clinical setting. Conscientiously applying what is known about treatments and interventions of ethical, if not legal, value is consistent with the professional definition of care. J Am Psychiatr Nurses Assoc, 2008; 14(2), 107-111. DOI: 10.1177/1078390308315798.

Research-Practice Integration in Real Practice Settings: Issues and Suggestions

ERIC Educational Resources Information Center

Cheung, Monit; Ma, Anny K.; Thyer, Bruce A.; Webb, Ann E.

2015-01-01

At the National Bridging the Research and Practice Gap Symposium to discuss evidence-based practice (EBP) in social work, 150 participants attended five breakout groups to address real practice setting applications. These participants from social work academia and practice communities addressed issues and looked for solutions to promote…

Educational strategies for teaching evidence-based practice to undergraduate health students: systematic review

PubMed Central

2016-01-01

Purpose The aim of this systematic review was to find best teaching strategies for teaching evidence-based practice (EBP) to undergraduate health students that have been adopted over the last years in healthcare institutions worldwide. Methods The authors carried out a systematic, comprehensive bibliographic search using Medline database for the years 2005 to March 2015 (updated in March 2016). Search terms used were chosen from the USNLM Institutes of Health list of MeSH (Medical Subject Headings) and free text key terms were used as well. Selected articles were measured based on the inclusion criteria of this study and initially compared in terms of titles or abstracts. Finally, articles relevant to the subject of this review were retrieved in full text. Critical appraisal was done to determine the effects of strategy of teaching evidence-based medicine (EBM). Results Twenty articles were included in the review. The majority of the studies sampled medical students (n=13) and only few conducted among nursing (n=2), pharmacy (n=2), physiotherapy/therapy (n=1), dentistry (n=1), or mixed disciplines (n=1) students. Studies evaluated a variety of educational interventions of varying duration, frequency and format (lectures, tutorials, workshops, conferences, journal clubs, and online sessions), or combination of these to teach EBP. We categorized interventions into single interventions covering a workshop, conference, lecture, journal club, or e-learning and multifaceted interventions where a combination of strategies had been assessed. Seven studies reported an overall increase to all EBP domains indicating a higher EBP competence and two studies focused on the searching databases skill. Conclusion Followings were deduced from above analysis: multifaceted approach may be best suited when teaching EBM to health students; the use of technology to promote EBP through mobile devices, simulation, and the web is on the rise; and the duration of the interventions varying form some hours to even months was not related to the students’ EBP competence. PMID:27649902

Educational strategies for teaching evidence-based practice to undergraduate health students: systematic review.

PubMed

Kyriakoulis, Konstantinos; Patelarou, Athina; Laliotis, Aggelos; Wan, Andrew C; Matalliotakis, Michail; Tsiou, Chrysoula; Patelarou, Evridiki

2016-01-01

The aim of this systematic review was to find best teaching strategies for teaching evidence-based practice (EBP) to undergraduate health students that have been adopted over the last years in healthcare institutions worldwide. The authors carried out a systematic, comprehensive bibliographic search using Medline database for the years 2005 to March 2015 (updated in March 2016). Search terms used were chosen from the USNLM Institutes of Health list of MeSH (Medical Subject Headings) and free text key terms were used as well. Selected articles were measured based on the inclusion criteria of this study and initially compared in terms of titles or abstracts. Finally, articles relevant to the subject of this review were retrieved in full text. Critical appraisal was done to determine the effects of strategy of teaching evidence-based medicine (EBM). Twenty articles were included in the review. The majority of the studies sampled medical students (n=13) and only few conducted among nursing (n=2), pharmacy (n=2), physiotherapy/therapy (n=1), dentistry (n=1), or mixed disciplines (n=1) students. Studies evaluated a variety of educational interventions of varying duration, frequency and format (lectures, tutorials, workshops, conferences, journal clubs, and online sessions), or combination of these to teach EBP. We categorized interventions into single interventions covering a workshop, conference, lecture, journal club, or e-learning and multifaceted interventions where a combination of strategies had been assessed. Seven studies reported an overall increase to all EBP domains indicating a higher EBP competence and two studies focused on the searching databases skill. Followings were deduced from above analysis: multifaceted approach may be best suited when teaching EBM to health students; the use of technology to promote EBP through mobile devices, simulation, and the web is on the rise; and the duration of the interventions varying form some hours to even months was not related to the students' EBP competence.

Evaluating Evidence-Based Intervention to Prevent Fall and Pressure Ulcers

DTIC Science & Technology

2011-12-20

Group 1 and 2 attended EBP ED. Out of this group , 205 completed a pretest and 213 completed a posttest for CPG knowledge uptake. In group 1, ninety...various times and locations while supporting the staffing needs of the nursing care unit. This adjustment extended the timeline by one month. Group ...structured EBP education focusing on translation of research into practice for all nurses involved in this initiative to include clinicians, managers, and

Teaching Evidence-Based Practice across Curricula-An Overview of a Professional Development Course for Occupational Therapy Educators.

PubMed

Daly, Marta M; DeAngelis, Tina M

2017-01-01

A professional development course for occupational therapy educators about teaching evidence-based practice (EBP) was developed and piloted. The course was developed to promote increased awareness of resources and methods for teaching EBP that are applicable across entry-level curricula. Participants included full-time faculty (n = 7) from one entry-level occupational therapy program in the New York City area. The results of the pilot informed refinement of the course in preparation for delivery to a wider audience of educators. This paper provides a description of the course, results of the pilot, and implications for future delivery of the course.

Where Words Fail, Music Speaks: A Mixed Method Study of an Evidence-Based Music Protocol.

PubMed

Daniels, Ruby A; Torres, David; Reeser, Cathy

2016-01-01

Despite numerous studies documenting the benefits of music, hospice social workers are often unfamiliar with evidence-based music practices that may improve end of life care. This mixed method study tested an intervention to teach hospice social workers and chaplains (N = 10) an evidence-based music protocol. Participants used the evidence-based practice (EBP) for 30 days, recording 226 journal entries that described observations of 84 patients and their families. There was a significant increase in EBP knowledge (35%). Prompting behavioral and emotional responses, music was described frequently as a catalyst that facilitated deeper dialogue between patients, families, social workers, and chaplains.

Evidence-Based and Values-Based Practices for People with Severe Disabilities

ERIC Educational Resources Information Center

Singer, George H. S.; Agran, Martin; Spooner, Fred

2017-01-01

This article discusses the relationship between evidence-based practices (EBPs) and values in research and practice pertaining to people with severe disabilities. The importance of basing educational and habilitation practices on substantial scientific evidence for practical, moral, and legal reasons is acknowledged given the prevalence of…

Evidence-based policy versus morality policy: the case of syringe access programs.

PubMed

de Saxe Zerden, Lisa; O'Quinn, Erin; Davis, Corey

2015-01-01

Evidence-based practice (EBP) combines proven interventions with clinical experience, ethics, and client preferences to inform treatment and services. Although EBP is integrated into most aspects of social work and public health, at times EBP is at odds with social policy. In this article the authors explore the paradox of evidence-based policy using syringe access programs (SAP) as a case example, and review methods of bridging the gap between the emphasis on EBP and lack of evidence informing SAP policy. Analysis includes the overuse of morality policy and examines historical and current theories why this paradox exists. Action steps are highlighted for creating effective policy and opportunities for public health change. Strategies on reframing the problem and shifting target population focus to garner support for evidence-based policy change are included. This interdisciplinary understanding of the way in which these factors converge is a critical first step in moving beyond morality-based policy toward evidence-based policy.

Comparing and improving chronic illness primary care in Sweden and the USA.

PubMed

Øvretveit, John; Ramsay, Patricia; Shortell, Stephen M; Brommels, Mats

2016-06-13

Purpose - The purpose of this paper is to identify opportunities for improving primary care services for people with chronic illnesses by comparing how Sweden and US services use evidence-based practices (EBPs), including digital health technologies (DHTs). Design/methodology/approach - A national primary healthcare center (PHCC) heads surveys in 2012-2013 carried out in both countries in 2006. Findings - There are large variations between the two countries. The largest, regarding effective DHT use in primary care centers, were that few Swedish primary healthcare compared to US heads reported having reminders or prompts at the point of care (38 percent Sweden vs 84 percent USA), despite Sweden's established electronic medical records (EMR). Swedish heads also reported 30 percent fewer centers receiving laboratory results (67 percent Sweden vs 97 percent USA). Regarding following other EBPs, 70 percent of Swedish center heads reported their physicians had easy access to diabetic patient lists compared to 14 percent in the USA. Most Swedish PHCC heads (96 percent) said they offered same day appointment compared to 36 percent in equivalent US practices. Practical implications - There are opportunities for improvement based on significant differences in effective practices between the countries, which demonstrates to primary care leaders that their peers elsewhere potentially provide better care for people with chronic illnesses. Some improvements are under primary care center control and can be made quickly. There is evidence that people with chronic illnesses in these two countries are suffering unnecessarily owing to primary care staff failing to provide proven EBP, which would better meet patient needs. Public finance has been invested in DHT, which are not being used to their full potential. Originality/value - The study shows the gaps between current and potential proven effective EBPs for services to patients with chronic conditions. Findings suggest possible explanations for differences and practical improvements by comparing the two countries. Many enhancements are low cost and the proportionate reduction in suffering and costs they bring is high.

A Delphi survey to determine how educational interventions for evidence-based practice should be reported: Stage 2 of the development of a reporting guideline

PubMed Central

2014-01-01

Background Undertaking a Delphi exercise is recommended during the second stage in the development process for a reporting guideline. To continue the development for the Guideline for Reporting Evidence-based practice Educational interventions and Teaching (GREET) a Delphi survey was undertaken to determine the consensus opinion of researchers, journal editors and educators in evidence-based practice (EBP) regarding the information items that should be reported when describing an educational intervention for EBP. Methods A four round online Delphi survey was conducted from October 2012 to March 2013. The Delphi panel comprised international researchers, educators and journal editors in EBP. Commencing with an open-ended question, participants were invited to volunteer information considered important when reporting educational interventions for EBP. Over three subsequent rounds participants were invited to rate the importance of each of the Delphi items using an 11 point Likert rating scale (low 0 to 4, moderate 5 to 6, high 7 to 8 and very high >8). Consensus agreement was set a priori as at least 80 per cent participant agreement. Consensus agreement was initially calculated within the four categories of importance (low to very high), prior to these four categories being merged into two (<7 and ≥7). Descriptive statistics for each item were computed including the mean Likert scores, standard deviation (SD), range and median participant scores. Mean absolute deviation from the median (MAD-M) was also calculated as a measure of participant disagreement. Results Thirty-six experts agreed to participate and 27 (79%) participants completed all four rounds. A total of 76 information items were generated across the four survey rounds. Thirty-nine items (51%) were specific to describing the intervention (as opposed to other elements of study design) and consensus agreement was achieved for two of these items (5%). When the four rating categories were merged into two (<7 and ≥7), 18 intervention items achieved consensus agreement. Conclusion This Delphi survey has identified 39 items for describing an educational intervention for EBP. These Delphi intervention items will provide the groundwork for the subsequent consensus discussion to determine the final inclusion of items in the GREET, the first reporting guideline for educational interventions in EBP. PMID:25081371

Validation of an instrument to assess evidence-based practice knowledge, attitudes, access, and confidence in the dental environment.

PubMed

Hendricson, William D; Rugh, John D; Hatch, John P; Stark, Debra L; Deahl, Thomas; Wallmann, Elizabeth R

2011-02-01

This article reports the validation of an assessment instrument designed to measure the outcomes of training in evidence-based practice (EBP) in the context of dentistry. Four EBP dimensions are measured by this instrument: 1) understanding of EBP concepts, 2) attitudes about EBP, 3) evidence-accessing methods, and 4) confidence in critical appraisal. The instrument-the Knowledge, Attitudes, Access, and Confidence Evaluation (KACE)-has four scales, with a total of thirty-five items: EBP knowledge (ten items), EBP attitudes (ten), accessing evidence (nine), and confidence (six). Four elements of validity were assessed: consistency of items within the KACE scales (extent to which items within a scale measure the same dimension), discrimination (capacity to detect differences between individuals with different training or experience), responsiveness (capacity to detect the effects of education on trainees), and test-retest reliability. Internal consistency of scales was assessed by analyzing responses of second-year dental students, dental residents, and dental faculty members using Cronbach coefficient alpha, a statistical measure of reliability. Discriminative validity was assessed by comparing KACE scores for the three groups. Responsiveness was assessed by comparing pre- and post-training responses for dental students and residents. To measure test-retest reliability, the full KACE was completed twice by a class of freshman dental students seventeen days apart, and the knowledge scale was completed twice by sixteen faculty members fourteen days apart. Item-to-scale consistency ranged from 0.21 to 0.78 for knowledge, 0.57 to 0.83 for attitude, 0.70 to 0.84 for accessing evidence, and 0.87 to 0.94 for confidence. For discrimination, ANOVA and post hoc testing by the Tukey-Kramer method revealed significant score differences among students, residents, and faculty members consistent with education and experience levels. For responsiveness to training, dental students and residents demonstrated statistically significant changes, in desired directions, from pre- to post-test. For the student test-retest, Pearson correlations for KACE scales were as follows: knowledge 0.66, attitudes 0.66, accessing evidence 0.74, and confidence 0.76. For the knowledge scale test-retest by faculty members, the Pearson correlation was 0.79. The construct validity of the KACE is equivalent to that of instruments that assess similar EBP dimensions in medicine. Item consistency for the knowledge scale was more variable than for other KACE scales, a finding also reported for medically oriented EBP instruments. We conclude that the KACE has good discriminative validity, responsiveness to training effects, and test-retest reliability.

Using Principles of Evidence-Based Practice to Improve Prescriptive Recommendations

ERIC Educational Resources Information Center

Schraw, Gregory; Patall, Erika A.

2013-01-01

We draw on the evidence-based practice (EBP) literature to consider the relationship between empirical results reported in primary research journals and prescriptive recommendations for practice based on those results. We argue that the relationship between individual empirical findings and practice should be mediated by two additional steps in…

Preparing Current and Future Practitioners to Integrate Research in Real Practice Settings

ERIC Educational Resources Information Center

Thyer, Bruce A.

2015-01-01

Past efforts aimed at promoting a better integration between research and practice are reviewed. These include the empirical clinical practice movement (ECP), originating within social work; the empirically supported treatment (EST) initiative of clinical psychology; and the evidence-based practice (EBP) model developed within medicine. The…

Evaluation of a Shared Decision-Making Intervention on the Utilization of Evidence-Based Psychotherapy in a VA Outpatient PTSD Clinic.

PubMed

Hessinger, Jonathan D; London, Melissa J; Baer, Sheila M

2017-03-13

The Veterans Health Administration (VHA) has continued to emphasize the availability, access, and utilization of high quality mental health care particularly in the treatment of posttraumatic stress disorder (PTSD). While dissemination and availability of evidence-based psychotherapies (EBPs) have only increased, treatment engagement and utilization have continued to be oft-noted challenges. Administrators, researchers, and individual clinicians have continued to develop and explore novel systemic and individualized interventions to address these issues. Pilot studies utilizing shared decision-making models to aid in veteran treatment selection have demonstrated the impact this approach may have on selection of and engagement in EBPs for PTSD. Based on these promising studies, a Department of Veterans Affairs (VA) outpatient PTSD clinic began to implement a shared-decision making intervention as part of a clinic redesign. In seeking to evaluate the impact of this intervention, archival clinical data from 1,056 veterans were reviewed by the authors for rates of treatment selection, EBP initiation, session attendance, and EBP completion. Time elapsed from consult until EBP initiation was also computed by the authors. These variables were then compared on the basis of whether the veteran received the shared-decision making intervention. Veterans who received the intervention were more likely to select and thus initiate an EBP for PTSD sooner than veterans who did not receive this intervention. Veterans, whether receiving the intervention or not, did not differ in therapy session attendance and completion. Implications of these findings and directions for future study are further discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Validation of the Implementation Leadership Scale (ILS) with Supervisors' Self-Ratings.

PubMed

Torres, Elisa M; Ehrhart, Mark G; Beidas, Rinad S; Farahnak, Lauren R; Finn, Natalie K; Aarons, Gregory A

2018-01-01

Although often discussed, there is a lack of empirical research on the role of leadership in the management and delivery of health services. The implementation leadership scale (ILS) assesses the degree to which leaders are knowledgeable, proactive, perseverant, and supportive during evidence-based practice (EBP) implementation. The purpose of this study was to examine the psychometric properties of the ILS for leaders' self-ratings using a sample of mental health clinic supervisors (N = 119). Supervisors (i.e., leaders) completed surveys including self-ratings of their implementation leadership. Confirmatory factor analysis, reliability, and validity of the ILS were evaluated. The ILS factor structure was supported in the sample of supervisors. Results demonstrated internal consistency reliability and validity. Cronbach alpha's ranged from 0.92 to 0.96 for the ILS subscales and 0.95 for the ILS overall scale. The factor structure replication and reliability of the ILS in a sample of supervisors demonstrates its applicability with employees across organizational levels.

Communities of Practice: A Knowledge Translation Tool for Rehabilitation Professionals

ERIC Educational Resources Information Center

Bezyak, Jill L.; Ditchman, Nicole; Burke, Jana; Chan, Fong

2013-01-01

Increased attention to evidence-based practice (EBP) among rehabilitation professionals closely corresponds to recent interest in knowledge translation, which connects quality research to rehabilitation practice aimed at improving the lives of people with disabilities. Despite the importance of knowledge translation for rehabilitation…

Survey of knowledge and perception on the access to evidence-based practice and clinical practice change among maternal and infant health practitioners in South East Asia.

PubMed

Martis, Ruth; Ho, Jacqueline J; Crowther, Caroline A

2008-08-05

Evidence-based practice (EBP) can provide appropriate care for women and their babies; however implementation of EBP requires health professionals to have access to knowledge, the ability to interpret health care information and then strategies to apply care. The aim of this survey was to assess current knowledge of evidence-based practice, information seeking practices, perceptions and potential enablers and barriers to clinical practice change among maternal and infant health practitioners in South East Asia. Questionnaires about IT access for health information and evidence-based practice were administered during August to December 2005 to health care professionals working at the nine hospitals participating in the South East Asia Optimising Reproductive and Child Health in Developing countries (SEA-ORCHID) project in Indonesia, Malaysia, Thailand and The Philippines. The survey was completed by 660 staff from six health professional groups. Overall, easy IT access for health care information was available to 46% of participants. However, over a fifth reported no IT access was available and over half of nurses and midwives never used IT health information. Evidence-based practice had been heard of by 58% but the majority did not understand the concept. The most frequent sites accessed were Google and PubMed. The Cochrane Library had been heard of by 47% of whom 51% had access although the majority did not use it or used it less than monthly. Only 27% had heard of the WHO Reproductive Health Library and 35% had been involved in a clinical practice change and were able to identify enablers and barriers to change. Only a third of participants had been actively involved in practice change with wide variation between the countries. Willingness to participate in professional development workshops on evidence-based practice was high. This survey has identified the need to improve IT access to health care information and health professionals' knowledge of evidence-based health care to assist in employing evidence base practice effectively.

Survey of knowledge and perception on the access to evidence-based practice and clinical practice change among maternal and infant health practitioners in South East Asia

PubMed Central

Martis, Ruth; Ho, Jacqueline J; Crowther, Caroline A

2008-01-01

Background Evidence-based practice (EBP) can provide appropriate care for women and their babies; however implementation of EBP requires health professionals to have access to knowledge, the ability to interpret health care information and then strategies to apply care. The aim of this survey was to assess current knowledge of evidence-based practice, information seeking practices, perceptions and potential enablers and barriers to clinical practice change among maternal and infant health practitioners in South East Asia. Methods Questionnaires about IT access for health information and evidence-based practice were administered during August to December 2005 to health care professionals working at the nine hospitals participating in the South East Asia Optimising Reproductive and Child Health in Developing countries (SEA-ORCHID) project in Indonesia, Malaysia, Thailand and The Philippines. Results The survey was completed by 660 staff from six health professional groups. Overall, easy IT access for health care information was available to 46% of participants. However, over a fifth reported no IT access was available and over half of nurses and midwives never used IT health information. Evidence-based practice had been heard of by 58% but the majority did not understand the concept. The most frequent sites accessed were Google and PubMed. The Cochrane Library had been heard of by 47% of whom 51% had access although the majority did not use it or used it less than monthly. Only 27% had heard of the WHO Reproductive Health Library and 35% had been involved in a clinical practice change and were able to identify enablers and barriers to change. Only a third of participants had been actively involved in practice change with wide variation between the countries. Willingness to participate in professional development workshops on evidence-based practice was high. Conclusion This survey has identified the need to improve IT access to health care information and health professionals' knowledge of evidence-based health care to assist in employing evidence base practice effectively. PMID:18680603