The TRANSFER Approach for assessing the transferability of systematic review findings

These videos, originally part of the Cochrane Learning Live webinar series, introduce the TRANSFER Approach for assessing the transferability of systematic review findings. The TRANSFER Approach is a novel approach for supporting collaboration between review authors and stakeholders from the beginning of the review process to systematically and transparently consider factors that may influence the transferability of systematic review findings. The first part of the presentation covers how the TRANSFER Approach was developed. Next, a case study is presented to illustrate how the TRANSFER Approach works in practice, and the six stages involved. The session was intended for beginner or experienced review authors and/or decision makers who regularly commission systematic reviews.

Enhancing Evidence-Based Practice in Rural Social Work: Applying the Theory of Planned Behavior to Identify Key Determinants.

PURPOSE: This study explores the application and extent of utilization of Evidence-Based Practice (EBP) among rural social workers, identifying key factors such as attitudes, social pressures, and perceived barriers that influence its use. METHODS: Utilizing the Theory of Planned Behavior as a framework, this research involved a comprehensive survey targeting rural social workers. The survey assessed their attitudes toward EBP, the social pressures, and the barriers in implementing EBP. Data from 91 participants were analyzed using multiple regression to determine how these factors impact EBP utilization. RESULTS: The analysis indicated that while attitudes toward EBP did not significantly affect its use, perceived ease of use, social pressures, and practical barriers were significant predictors. Interestingly, the data showed that external factors like organizational support and resource availability played a larger role than personal attitudes in the adoption of EBP. The regression model successfully explained 39% of the variance in EBP usage among rural social workers. DISCUSSION: The findings underscore the importance of external over internal factors in the adoption of EBP within rural settings. The study suggests that improving access to EBP resources and enhancing organizational support could facilitate more effective use of EBP among rural social workers. CONCLUSION: Effective implementation of EBP in rural areas necessitates addressing both perceived and actual barriers. Developing strategies to enhance resource availability and organizational support is recommended to boost EBP adoption, ultimately aiming to improve service outcomes and client well-being.

Evidence-informed, experience-based co-design: a novel framework integrating research evidence and lived experience in priority-setting and co-design of health services.

OBJECTIVE: To describe a new co-design framework termed Evidence-informed, Experience-based Co-design (E2CD). BACKGROUND: Involving consumers and clinicians in planning, designing and implementing services results in the end-product being more likely to meet the needs of end-users and increases the likelihood of their uptake and sustainability. Different forms and definitions of co-design have been described in the literature and have had varying levels of success in health service redesign. However, many fall short of including people with lived experience in all aspects of the process, particularly in setting priorities for service (re)design. In addition, health services need to deliver evidence-based care as well as care that meets the needs of users, yet few ways of integrating research evidence into co-design processes are described. This paper describes a new framework to approach co-design which addresses these issues. We believe that it offers a roadmap to address some of healthcare's most wicked problems and potentially improve outcomes for some of the most vulnerable people in our society. We use improving services for people with high healthcare service utilisation as a working example of the Framework's application. CONCLUSION: Evidence-informed experience-based co-design has the potential to be used as a framework for co-design that integrates research evidence with lived experience and provides people with lived experience a central role in decision-making about prioritising and designing services to meet their needs.

Adaptation and validation of the evidence-based practice profile (EBP2) questionnaire in a Norwegian primary healthcare setting.

BACKGROUND: Access to valid and reliable instruments is essential in the field of implementation science, where the measurement of factors associated with healthcare professionals' uptake of EBP is central. The Norwegian version of the Evidence-based practice profile questionnaire (EBP2-N) measures EBP constructs, such as EBP knowledge, confidence, attitudes, and behavior. Despite its potential utility, the EBP2-N requires further validation before being used in a cross-sectional survey targeting different healthcare professionals in Norwegian primary healthcare. This study assessed the content validity, construct validity, and internal consistency of the EBP2-N among Norwegian primary healthcare professionals. METHODS: To evaluate the content validity of the EBP2-N, we conducted qualitative individual interviews with eight healthcare professionals in primary healthcare from different disciplines. Qualitative data was analyzed using the "text summary" model, followed by panel group discussions, minor linguistic changes, and a pilot test of the revised version. To evaluate construct validity (structural validity) and internal consistency, we used data from a web-based cross-sectional survey among nurses, assistant nurses, physical therapists, occupational therapists, medical doctors, and other professionals (n = 313). Structural validity was tested using a confirmatory factor analysis (CFA) on the original five-factor structure, and Cronbach's alpha was calculated to assess internal consistency. RESULTS: The qualitative interviews with primary healthcare professionals indicated that the content of the EBP2-N was perceived to reflect the constructs intended to be measured by the instrument. However, interviews revealed concerns regarding the formulation of some items, leading to minor linguistic revisions. In addition, several participants expressed that some of the most specific research terms in the terminology domain felt less relevant to them in clinical practice. CFA results exposed partial alignment with the original five-factor model, with the following model fit indices: CFI = 0.749, RMSEA = 0.074, and SRMR = 0.075. Cronbach's alphas ranged between 0.82 and 0.95 for all domains except for the Sympathy domain (0.69), indicating good internal consistency in four out of five domains. CONCLUSION: The EBP2-N is a suitable instrument for measuring Norwegian primary healthcare professionals' EBP knowledge, attitudes, confidence, and behavior. Although EBP2-N seems to be an adequate instrument in its current form, we recommend that future research focuses on further assessing the factor structure, evaluating the relevance of the items, and the number of items needed. REGISTRATION: Retrospectively registered (prior to data analysis) in OSF Preregistration. Registration DOI: https://doi.org/10.17605/OSF.IO/428RP .

Implementation lead nurses to lead EBP quality improvement project using the PEACE framework.

Implementing evidence-based practice (EBP) in clinical practice is an ongoing challenge for nurses. EQUIP-Evidence-based QUality Improvement Project- is a multiphase project aimed at equipping nurses with the essential skills to implement EBP and advanced nursing practice. EQUIP embraces the assumption that implementation science models and partnership models can facilitate the implementation process of EBP, leading to successful and sustainable change. The current study is one of the EQUIP feasibility investigations in which the perspective of 12 implementation lead nurses (IL nurses) who attended a 1-day PEACE-based workshop was explored. Thematic analysis identified 2 overarching themes, 6 themes, and 18 subthemes. The first overarching theme showed that the PEACE-based workshop has successfully achieved its intended training implications, and the second overarching theme gave insight into factors that may influence the role of IL nurses. IL nurses reported general satisfaction and willingness to use the PEACE model at work; however, some IL nurses found Step 3 difficult to apply. The study's findings provide evidence of the perceived usefulness of adopting the PEACE model as an augmented approach in the EQUIP and the interest and enthusiasm of IL nurses in receiving more training on the implementation process of EBP.

The development of pre-registration occupational therapy student perceptions of research and evidence-based practice: A Q-methodology study.

BACKGROUND: Pedagogically sound curricula are needed for occupational therapy (OT) students to adopt evidence-based practice (EBP) principles and internalise EBP within their professional identities. Exploring students' perceptions of this knowledge area can contribute to effective curriculum design. AIMS/OBJECTIVES: To explore the evolution of pre-registration OT student perceptions of research and EBP over the course of their engagement with undergraduate teaching and learning. MATERIALS AND METHODS: The Q-sort approach synthesises different viewpoints regarding a sample of statements, using by-person factor analysis (respondents = variables; statements = sample). Final year pre-registration OT students completed the same Q-sort at three timepoints (pre-dissertation [n = 18]; post-dissertation submission [n = 12]; post-student research conference [n = 6]). Q-sort responses were intercorrelated and factor-analysed; extraction of factors with an eigenvalue of ¬>0.9 and varimax rotation identified majority viewpoints. RESULTS: Significant factors were revealed at each timepoint: 1a: 'Evidence-inseparable from OT practice', 1b: 'Research for research's sake-inseparable from the occupational therapy identity', 2: 'Who am I to question the gurus?', 3: 'I can do it with confidence…but so what?' CONCLUSIONS: Opportunities for completing 'authentic' student research projects, with 'ownership' of results, may enhance research and EBP confidence and professional identity. SIGNIFICANCE: Findings expand current knowledge regarding effective use of pre-registration educational opportunities to support future research and EBP.

How Attitudes Toward Evidence-Based Practice Impacts Burnout: A Sequential Mediation Model.

PURPOSE: With the rapid development of China's social work sector, the increasing job pressures, and risks of professional burnout among social workers have become more prevalent. This study examined the relationship between Chinese social workers' attitudes toward evidence-based practice (EBP) and burnout, exploring the mediating mechanisms of evidence-based knowledge (EBK) and service quality perception (SQP). MATERIALS AND METHODS: We applied PROCESS 4.2 macro in SPSS to analyze the data from 5,931 social workers, testing the sequential mediation effects of EBK and SQP between their attitudes toward EBP and burnout. RESULTS: The findings revealed: (1) Attitudes toward EBP had significant indirect positive effects on burnout; (2) EBK partially mediated the relationship between EBP attitude and burnout; (3) SQP partially mediated the relationship between attitudes toward EBP and burnout; (4) Attitudes toward EBP had a sequential mediated effect on burnout through EBK and SQP. DISCUSSION: The findings emphasize the need to implement targeted interventions and training programs to foster positive attitudes toward EBP, promote continuous professional development, and provide access to EBP resources. Moreover, nurturing EBK and SQP could help alleviate burnout by improving social workers' ability to address client issues and enhance their sense of confidence and accomplishment. CONCLUSION: This study fills a research gap by providing empirical evidence on the negative correlation between Chinese social workers' attitudes toward EBP and burnout, while demonstrating the mediating roles of EBK and SQP.

Evaluating the impact of the global evidence, local adaptation (GELA) project for enhancing evidence-informed guideline recommendations for newborn and young child health in three African countries: a mixed-methods protocol.

BACKGROUND: Poverty-related diseases (PRD) remain amongst the leading causes of death in children under-5 years in sub-Saharan Africa (SSA). Clinical practice guidelines (CPGs) based on the best available evidence are key to strengthening health systems and helping to enhance equitable health access for children under five. However, the CPG development process is complex and resource-intensive, with substantial scope for improving the process in SSA, which is the goal of the Global Evidence, Local Adaptation (GELA) project. The impact of research on PRD will be maximized through enhancing researchers and decision makers' capacity to use global research to develop locally relevant CPGs in the field of newborn and child health. The project will be implemented in three SSA countries, Malawi, South Africa and Nigeria, over a 3-year period. This research protocol is for the monitoring and evaluation work package of the project. The aim of this work package is to monitor the various GELA project activities and evaluate the influence these may have on evidence-informed decision-making and guideline adaptation capacities and processes. The specific project activities we will monitor include (1) our ongoing engagement with local stakeholders, (2) their capacity needs and development, (3) their understanding and use of evidence from reviews of qualitative research and, (4) their overall views and experiences of the project. METHODS: We will use a longitudinal, mixed-methods study design, informed by an overarching project Theory of Change. A series of interconnected qualitative and quantitative data collections methods will be used, including knowledge translation tracking sheets and case studies, capacity assessment online surveys, user testing and in-depth interviews, and non-participant observations of project activities. Participants will comprise of project staff, members of the CPG panels and steering committees in Malawi, South Africa and Nigeria, as well as other local stakeholders in these three African countries. DISCUSSION: Ongoing monitoring and evaluation will help ensure the relationship between researchers and stakeholders is supported from the project start. This can facilitate achievement of common goals and enable researchers in South Africa, Malawi and Nigeria to make adjustments to project activities to maximize stakeholder engagement and research utilization. Ethical approval has been provided by South African Medical Research Council Human Research Ethics Committee (EC015-7/2022); The College of Medicine Research and Ethics Committee, Malawi (P.07/22/3687); National Health Research Ethics Committee of Nigeria (01/01/2007).

Challenges in institutionalizing evidence-informed priority setting for health service packages: a qualitative document and interview analysis from Iran.

BACKGROUND: Setting and implementing evidence-informed health service packages (HSPs) is crucial for improving health and demonstrating the effective use of evidence in real-world settings. Despite extensive training for large groups on evidence generation and utilization and establishing structures such as evidence-generation entities in many countries, the institutionalization of setting and implementing evidence-informed HSPs remains unachieved. This study aims to review the actions taken to set the HSP in Iran and to identify the challenges of institutionalizing the evidence-informed priority-setting process. METHODS: Relevant documents were obtained through website search, Google queries, expert consultations and library manual search. Subsequently, we conducted nine qualitative semi-structured interviews with stakeholders. The participants were purposively sampled to represent diverse backgrounds relevant to health policymaking and financing. These interviews were meticulously audio-recorded, transcribed and reviewed. We employed the framework analysis approach, guided by the Kuchenmüller et al. framework, to interpret data. RESULTS: Efforts to incorporate evidence-informed process in setting HSP in Iran began in the 1970s in the pilot project of primary health care. These initiatives continued through the Health Transformation Plan in 2015 and targeted disease-specific efforts in 2019 in recent years. However, full institutionalization remains a challenge. The principal challenges encompass legal gaps, methodological diversity, fragile partnerships, leadership changeovers, inadequate financial backing of HSP and the dearth of an accountability culture. These factors impede the seamless integration and enduring sustainability of evidence-informed practices, hindering collaborative decision-making and optimal resource allocation. CONCLUSIONS: Technical aspects of using evidence for policymaking alone will not ensure sustainability unless it achieves the necessary requirements for institutionalization. While addressing all challenges is crucial, the primary focus should be on required transparency and accountability, public participation with an intersectionality lens and making this process resilience to shocks. It is imperative to establish a robust legal framework and a strong and sustainable political commitment to embrace and drive change, ensuring sustainable progress.

Clinician Knowledge of and Attitudes Toward Guided Self-Help.

The current study evaluated knowledge of and attitudes toward guided self-help (GSH) among clinicians who use evidence-based practices to treat one or more of the following: panic disorder, major depressive disorder, bulimia nervosa, binge-eating disorder, and generalized anxiety disorder. A total of 153 of 256 individuals recruited online and at professional conferences were eligible. This study assessed prior experience with and knowledge of GSH, as well as hypothetical use with a mock patient. Less than 20% of clinicians had ever used GSH, and fewer had used it as a stand-alone treatment. Given a mock patient reporting moderate symptoms, clinicians indicated a 53.62% likelihood that they would use GSH. Exploratory analyses indicated that hypothetical use was predicted by prior use of GSH as well as the Openness subscale of the Evidence-Based Practice Attitude Scale. Study findings suggest that clinicians using evidence-based practices do not uniformly know of or endorse the use of GSH. Lack of training in GSH was one of the most frequently endorsed barriers to implementing GSH in clinical practice (n = 99, 64%). These findings have implications for the use of therapy formats that scale evidence-based treatments in the United States.

Identifying the essential elements to inform the development of a research agenda for Paramedicine in Ireland: a Delphi Study.

BACKGROUND: Paramedicine is a dynamic profession which has evolved from a "treat and transport" service into a complex network of health professionals working in a diverse range of clinical roles. Research is challenging in the paramedicine context, and internationally, research capacity and culture has developed slowly. International examples of research agendas and strategies in paramedicine exist, however, research priorities have not previously been identified in Ireland. METHODS: This study was a three round electronic modified Delphi design which aimed to establish the key aspects of the research priorities via end-user consensus. Participants included interested stakeholders involved in prehospital care or research in Ireland. The first round questionnaire consisted of open-ended questions with results coded and developed into themes for the closed-ended questions used in the second and third round questionnaires. A consensus level of 70% was set a priori for second and third rounds. RESULTS: Research Priorities that reached consensus included Staff Wellbeing, Education and Professionalism and Acute Medical Conditions. Respondents indicated that these three areas should be a priority in the next 2 years. Education, Staffing and Leadership were imperative Key Resources that required change. Education was a Key Processes change deemed imperative to allow the future research to occur. Outcomes that should be included in the future research strategy were Patient Outcomes, Practitioner Development, Practitioner Wellbeing, Alternate Pathways, Evidence-based Practice and Staff Satisfaction. CONCLUSION: The results of this study are similar to previously published international studies, with some key differences. There was a greater emphasis on Education and Practitioner Wellbeing with the latter possibly attributed to the timing of the research in relation to the COVID-19 pandemic. The disseminated findings of this study should inform sustainable funding models to aid the development of paramedicine research in Ireland.

JBI Ferramentas de avaliação crítica

As ferramentas de avaliação crítica do JBI auxiliam na avaliação da confiabilidade, relevância e resultados de artigos publicados.

JBI Manual for Evidence Synthesis

Este manual orienta os autores que desejam realizar revisões sistemáticas e de escopo seguindo as metodologias JBI. Cada capítulo é dedicado à síntese de diferentes tipos de evidências para abordar diferentes tipos de questões clínicas e políticas.

Teamwork and implementation of innovations in healthcare and human service settings: a systematic review.

BACKGROUND: Implementation of new practices in team-based settings requires teams to work together to respond to new demands and changing expectations. However, team constructs and team-based implementation approaches have received little attention in the implementation science literature. This systematic review summarizes empirical research examining associations between teamwork and implementation outcomes when evidence-based practices and other innovations are implemented in healthcare and human service settings. METHODS: We searched MEDLINE, CINAHL, APA PsycINFO and ERIC for peer-reviewed empirical articles published from January 2000 to March 2022. Additional articles were identified by searches of reference lists and a cited reference search for included articles (completed in February 2023). We selected studies using quantitative, qualitative, or mixed methods to examine associations between team constructs and implementation outcomes in healthcare and human service settings. We used the Mixed Methods Appraisal Tool to assess methodological quality/risk of bias and conducted a narrative synthesis of included studies. GRADE and GRADE-CERQual were used to assess the strength of the body of evidence. RESULTS: Searches identified 10,489 results. After review, 58 articles representing 55 studies were included. Relevant studies increased over time; 71% of articles were published after 2016. We were unable to generate estimates of effects for any quantitative associations because of very limited overlap in the reported associations between team variables and implementation outcomes. Qualitative findings with high confidence were: 1) Staffing shortages and turnover hinder implementation; 2) Adaptive team functioning (i.e., positive affective states, effective behavior processes, shared cognitive states) facilitates implementation and is associated with better implementation outcomes; Problems in team functioning (i.e., negative affective states, problematic behavioral processes, lack of shared cognitive states) act as barriers to implementation and are associated with poor implementation outcomes; and 3) Open, ongoing, and effective communication within teams facilitates implementation of new practices; poor communication is a barrier. CONCLUSIONS: Teamwork matters for implementation. However, both team constructs and implementation outcomes were often poorly specified, and there was little overlap of team constructs and implementation outcomes studied in quantitative studies. Greater specificity and rigor are needed to understand how teamwork influences implementation processes and outcomes. We provide recommendations for improving the conceptualization, description, assessment, analysis, and interpretation of research on teams implementing innovations. TRIAL REGISTRATION: This systematic review was registered in PROSPERO, the international prospective register of systematic reviews. REGISTRATION NUMBER: CRD42020220168.

Research strategies for trainee and qualified advanced clinical practitioners that enhance evidence-based practice.

Advanced clinical practitioners (ACPs) are integral to modern healthcare, providing high-quality, evidence-based care to patients. While ACPs show some development in clinical practice, leadership, and education, challenges persist in the research pillar. Trainee and qualified ACPs often have difficulties initiating their research journey and may feel uncertain about where to start. Existing studies have explored and emphasised the importance of ACPs developing and maintaining their research skills, yet there remains a gap in understanding how they can effectively demonstrate their research capabilities. Therefore, this article aims to help trainees and qualified ACPs on how to evidence their research pillar capabilities.