Title:
Closing the gap between research and practice: using behavioural change theory to identify barriers to implementation of evidence-based guidelines.
Background:
Despite growing amounts of evidence from high quality research to guide practice, many patients continue to receive treatments that are ineffective, harmful or of unproven effectiveness. Better uptake of existing evidence has the potential to significantly improve health care quality and safety in Australia and internationally. This study aims to identify the barriers related to practitioners’ attitudes, beliefs and intentions to implementing evidence and will test the utility of behavioural theory to predict implementation behaviour. This project will provide better information for targeting implementation strategies to identified barriers and will inform a model for research translation to help close the ‘research-practice gap’.
Aims:
This project aims to identify the barriers related to general practitioners’ attitudes, beliefs and intentions to implementing evidence and to test the utility of behavioural theory in predicting implementation behaviour. The ultimate aim of this project is to complete the necessary preliminary research to inform the conduct of a cluster randomized controlled trial to test a theoretically underpinned intervention to improve the uptake of evidence-based clinical practice guidelines into general practice.
Objectives:
- to develop a questionnaire using behavioural change theory for measuring attitudes, beliefs and intentions of general practitioners towards implementation of evidence-based clinical practice guidelines (EBCPG);
- to test the validity and reliability of the questionnaire;
- to identify the barriers related to general practitioners’ attitudes, beliefs and intentions to implementing EBCPG in low back pain that are most likely to be effective targets for change;
- to test the utility of the theory of planned behaviour in predicting general practitioners’ behaviour in implementing EBCPG.
Stage one consisted of conducting focus group interviews with Victorian general practitioners, based on behavioural theory, to elicit information about their intentions and beliefs toward behaviours from an evidence-based guideline. We conducted thematic analysis on the interview data to generate items for inclusion in the questionnaire. Stage two consisted of developing the questionnaire instrument, based on behavioural theory, and testing it for validity and reliability in a random sample of Australian general practitioners. To date, the questionnaire has been tested for face validity with international experts in implementation research and local general practitioners and we are currently collecting data using the questionnaire in an Australian general practitioner sample. Stages three and four of the project involve identifying the barriers and testing the predictive validity of the instrument.
Funding:
This project is funded by a Strategic Grant from the Faculty of Medicine, Nursing and Health Sciences, Monash University (Jan-Dec 2006).
Investigators:
A/Prof Sally Green, Dr Denise O’Connor, A/Prof Neil Spike, A/Prof Peter Schattner
Associate Investigators:
Dr Simon French, Ms Jo McKenzie, Prof Jeremy Grimshaw, Dr Jill Francis, Prof Susan Michie
Research Assistant:
Sharon King
Contact:
denise.oconnor@monash.edu; phone: 03 9903 0366.