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      The effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare: a systematic review

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          Abstract

          Background

          It is widely acknowledged that health policy and management decisions rarely reflect research evidence. Therefore, it is important to determine how to improve evidence-informed decision-making. The primary aim of this systematic review was to evaluate the effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare. The secondary aim of the review was to describe factors perceived to be associated with effective strategies and the inter-relationship between these factors.

          Methods

          An electronic search was developed to identify studies published between January 01, 2000, and February 02, 2016. This was supplemented by checking the reference list of included articles, systematic reviews, and hand-searching publication lists from prominent authors. Two reviewers independently screened studies for inclusion, assessed methodological quality, and extracted data.

          Results

          After duplicate removal, the search strategy identified 3830 titles. Following title and abstract screening, 96 full-text articles were reviewed, of which 19 studies (21 articles) met all inclusion criteria. Three studies were included in the narrative synthesis, finding policy briefs including expert opinion might affect intended actions, and intentions persisting to actions for public health policy in developing nations. Workshops, ongoing technical assistance, and distribution of instructional digital materials may improve knowledge and skills around evidence-informed decision-making in US public health departments. Tailored, targeted messages were more effective in increasing public health policies and programs in Canadian public health departments compared to messages and a knowledge broker. Sixteen studies (18 articles) were included in the thematic synthesis, leading to a conceptualisation of inter-relating factors perceived to be associated with effective research implementation strategies. A unidirectional, hierarchal flow was described from (1) establishing an imperative for practice change, (2) building trust between implementation stakeholders and (3) developing a shared vision, to (4) actioning change mechanisms. This was underpinned by the (5) employment of effective communication strategies and (6) provision of resources to support change.

          Conclusions

          Evidence is developing to support the use of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare. The design of future implementation strategies should be based on the inter-relating factors perceived to be associated with effective strategies.

          Trial registration

          This systematic review was registered with Prospero (record number: 42016032947).

          Electronic supplementary material

          The online version of this article (10.1186/s13012-017-0662-0) contains supplementary material, which is available to authorized users.

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          Most cited references43

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          Factors influencing healthcare service quality.

          The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context.
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            The case for knowledge translation: shortening the journey from evidence to effect.

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              A cross-sectional study of the number and frequency of terms used to refer to knowledge translation in a body of health literature in 2006: a Tower of Babel?

              Background The study of implementing research findings into practice is rapidly growing and has acquired many competing names (e.g., dissemination, uptake, utilization, translation) and contributing disciplines. The use of multiple terms across disciplines pose barriers to communication and progress for applying research findings. We sought to establish an inventory of terms describing this field and how often authors use them in a collection of health literature published in 2006. Methods We refer to this field as knowledge translation (KT). Terms describing aspects of KT and their definitions were collected from literature, the internet, reports, textbooks, and contact with experts. We compiled a database of KT and other articles by reading 12 healthcare journals representing multiple disciplines. All articles published in these journals in 2006 were categorized as being KT or not. The KT articles (all KT) were further categorized, if possible, for whether they described KT projects or implementations (KT application articles), or presented the theoretical basis, models, tools, methods, or techniques of KT (KT theory articles). Accuracy was checked using duplicate reading. Custom designed software determined how often KT terms were used in the titles and abstracts of articles categorized as being KT. Results A total of 2,603 articles were assessed, and 581 were identified as KT articles. Of these, 201 described KT applications, and 153 included KT theory. Of the 100 KT terms collected, 46 were used by the authors in the titles or abstracts of articles categorized as being KT. For all 581 KT articles, eight terms or term variations used by authors were highly discriminating for separating KT and non-KT articles (p < 0.001): implementation, adoption, quality improvement, dissemination, complex intervention (with multiple endings), implementation (within three words of) research, and complex intervention. More KT terms were associated with KT application articles (n = 13) and KT theory articles (n = 18). Conclusions We collected 100 terms describing KT research. Authors used 46 of them in titles and abstracts of KT articles. Of these, approximately half discriminated between KT and non-KT articles. Thus, the need for consolidation and consistent use of fewer terms related to KT research is evident.
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                Author and article information

                Contributors
                Mitchell.sarkies@monash.edu
                Kelly-ann.bowles@monash.edu
                drlizzieskinner@gmail.com
                romi.haas@monash.edu
                haylee.lane@monash.edu
                terrence.haines@monash.edu
                Journal
                Implement Sci
                Implement Sci
                Implementation Science : IS
                BioMed Central (London )
                1748-5908
                14 November 2017
                14 November 2017
                2017
                : 12
                : 132
                Affiliations
                [1 ]ISNI 0000 0004 1936 7857, GRID grid.1002.3, Kingston Centre, , Monash University and Monash Health Allied Health Research Unit, ; 400 Warrigal Road, Heatherton, VIC 3202 Australia
                [2 ]ISNI 0000 0004 1936 7857, GRID grid.1002.3, Monash University Department of Community Emergency Health and Paramedic Practice, ; Building H McMahons Road, Frankston, VIC 3199 Australia
                Article
                662
                10.1186/s13012-017-0662-0
                5686806
                29137659
                91f655e0-764c-45e0-adc8-65e1b984754d
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 20 February 2017
                : 1 November 2017
                Categories
                Systematic Review
                Custom metadata
                © The Author(s) 2017

                Medicine
                implementation,translation,health,policy,management
                Medicine
                implementation, translation, health, policy, management

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