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

Abstract

BackgroundEvidence-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.MethodsA 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.ResultsNearly 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.ConclusionFindings 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s12906-016-1175-0) contains supplementary material, which is available to authorized users.

Situating dissemination and implementation sciences within and across the translational research spectrum

“…These conceptualizations, while useful and accurate descriptions of present realities, likely limit understanding of the full applicability of the sciences and preclude key opportunities for synergy. For example, when translation is defined only as "the process of turning observations into interventions," [1] there is an assumption that "improvement in health" will be achieved by developing effective interventions alone, and that D&I barriers will be overcome naturallydespite a large body of evidence showing this is not the case [15][16][17][18][19][20]. Similarly, D&I sciences, in their effort to understand how best to scale up evidence-based practices, may fail to appreciate barriers to efficiently building strong, generalizable evidence and useful and usable interventions worth disseminating and implementing, as well as the role that the applicability and quality of evidence plays in the success of D&I efforts.…”

Nurse’s Perception of Barriers to Research Utilization in Hospitals; Comparative Descriptive Study

“…There is often a gap between theoretical knowledge and it is applied upon practical area [10]. Evidence-based practice and research utilization are concepts related to the identification, utilization and application of knowledge from research findings to clinical practice [11]. The focus should be upon manipulating factors at work place as well as learning environment that leads to less cost of health care and decrease patients suffering [12].…”

A collaborative process for a program redesign for education in evidence-based health care

“…1 Evidence-based practice (EBP) has been incorporated into health education worldwide because clinical research evidence is increasingly seen as a vital element of clinical decision making. [2][3][4] The ''driving force'' behind evidence-based medicine since the 1980s has been David Sackett 5 at McMaster University in Canada. In his words, evidence-based medicine integrates ''individual clinical expertise with the best available external clinical evidence from systematic research.''…”