Factors of the Innovation, Organization, Environment, and Individual That Predict the Influence Five Systematic Reviews Had on Public Health Decisions

Abstract

Objective: To determine the extent to which systematic reviews of public health interventions influenced public health decisions and which factors were associated with influencing these decisions.Methods: This cross-sectional follow-up survey evaluated the use of five systematic reviews in public health decision making. Independent variables included characteristics of the innovation, organization, environment, and individual. Primary data were collected using a telephone survey and a self-administered organizational demographics questionnaire. Public health decision makers in all 41 public health units in Ontario were invited to participate in the study. Multiple linear regression analyses on the five program decisions were conducted.Results: The systematic reviews were perceived as having the greatest amount of influence on decisions related to program justification and program planning, and the least influence on program evaluation decisions. The greater the perception that one's organization valued the use of research evidence for decision making and that ongoing training in the critical appraisal of research literature was provided, the greater the perception of the influence the systematic review had on public health decisions.Conclusions: Organizational characteristics are important predictors of the use of systematic reviews in public health decision making. Future dissemination strategies need to promote the value of using systematic reviews for program decision making as well as promote ongoing training in critical appraisal among intended users in Ontario.

Building Capacity for Evidence-Based Public Health: Reconciling the Pulls of Practice and the Push of Research

“…In a national survey of public health practitioners in the United States, absence of incentives within the organization was the largest barrier to evidence-based decision making (104), including the inevitable disincentive of time required for locating and studying evidence sources, which delays launching programs or services. Other studies have found a strong correlation between the perception of institutional priority and expectation of documentation for evidence-based practices and actual use of research to inform program adoption and implementation (24, 50). Therefore, it is important to recognize that uptake of EBIs is not likely to succeed in an environment that is not explicitly supportive of innovation or is protective of the status quo (163).…”

“…Several studies have reported practitioners’ personal and institutional barriers to utilizing EBIs. Lack of time, inadequate funding, inability to analyze and interpret evidence, and absence of cultural and managerial support are among the most commonly cited barriers (50, 52, 55, 104, 115, 133). In a national survey of public health practitioners in the United States, absence of incentives within the organization was the largest barrier to evidence-based decision making (104), including the inevitable disincentive of time required for locating and studying evidence sources, which delays launching programs or services.…”

“…Studies have focused on public health practitioners’ personal (e.g., lack of skills) and organizational challenges (e.g., lack of incentives or resources) in utilizing EBIs. There is a strong correlation between the perception of organizational leadership or priority for evidence-based practices and use of research to inform program adoption and implementation among practitioners (24, 50, 102). …”

Supporting Policy In health with Research: an Intervention Trial (SPIRIT)—protocol for a stepped wedge trial

“…It extends previous studies which often evaluated only one strategy,10–12 did not use objective outcome measures10 11 13 and were unable to include a detailed process evaluation 10–14. In addition, SPIRIT is the only trial designed to bring about organisational change in policy and programme agencies and that has the capacity to assess the long-term impact of the programme (up to 18 months after its completion).…”

Evaluating computerised health information systems: Opportunities were missed

“…Given that innovation implementation is a complex, longitudinal process entailing phases that evolve over time and comprise many layers of social interactions,4 this positivist research strategy seems misguided. Organisational learning and progressive user empowerment need to be accounted for in any information system evaluative framework in which both the user and the innovation are fluid and evolving.…”