Implementing evidence-based practice: evaluation of an opinion leader strategy to improve breast-feeding rates

Sisk, Jane E.; Greer, Ann; Wojtowycz, Martha A.; Pincus, Lani B; Aubry, Richard H.

doi:10.1016/j.ajog.2003.09.014

Cited by 21 publications

(32 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This strategy was ineffective with patients for improving breastfeeding rates. 27 Lomas et al 24 demonstrated the relative efficacy of the opinion leader strategy, but the impact on cesarean delivery rates was limited (significant odds ratio, but nonsignificant adjusted risk ratio for baseline imbalance, Table 2). Opinion leader seemed more effective in changing physicians' behaviors than patients' behaviors.…”

Section: Resultsmentioning

confidence: 99%

“…18,29,34 -36,39,50,52 The remaining studies were rated "fair." The main reasons for the fair quality rating for randomized controlled trials and controlled before-after studies were that protection against exclusion bias was not clear, 24,27,30,38 baseline measures were not reported or were unclear, 26,27,32,33,37 reliable primary outcome measures were unclear or not reported, 24,28,30,37,38 and protection against contamination was not clear. 28,37 Twelve interrupted time series studies were rated "fair" because no autoregressive integrated moving average models (ARIMA) or time series regression models were used for data analysis.…”

Section: Resultsmentioning

confidence: 99%

“…64 The key to success of the opinion leader strategy is the improvement of feedback and acceptance of the local intervention, 24,27 but his action is not systematically efficient alone. Sisk et al 27 showed that, although opinion leaders identified obstacles, they have not found a successful way to influence a mother's behavior. The opinion leader's action is efficient only if the actors contributing to behavior change recognize his or her influence.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Evidence-Based Strategies for Implementing Guidelines in Obstetrics

Chaillet

Dubé²,

Dugas³

et al. 2006

Obstetrics & Gynecology

209

194

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Evidence-Based Strategies for Implementing Guidelines in Obstetrics

Chaillet

Dubé²,

Dugas³

et al. 2006

Obstetrics & Gynecology

209

194

View full text Add to dashboard Cite

show abstract

“…Establishing respect as a change agent is also seen as crucial [32,48,49]. Beyond establishing respect, change agents must be role models of the evidence-informed healthcare values and practices they espouse [31,33,50,51]. …”

Section: Methodsmentioning

confidence: 99%

A realist review of interventions and strategies to promote evidence-informed healthcare: a focus on change agency

McCormack¹,

et al. 2013

View full text Add to dashboard Cite

BackgroundChange agency in its various forms is one intervention aimed at improving the effectiveness of the uptake of evidence. Facilitators, knowledge brokers and opinion leaders are examples of change agency strategies used to promote knowledge utilization. This review adopts a realist approach and addresses the following question: What change agency characteristics work, for whom do they work, in what circumstances and why?MethodsThe literature reviewed spanned the period 1997-2007. Change agency was operationalized as roles that are aimed at effecting successful change in individuals and organizations. A theoretical framework, developed through stakeholder consultation formed the basis for a search for relevant literature. Team members, working in sub groups, independently themed the data and developed chains of inference to form a series of hypotheses regarding change agency and the role of change agency in knowledge use.Results24, 478 electronic references were initially returned from search strategies. Preliminary screening of the article titles reduced the list of potentially relevant papers to 196. A review of full document versions of potentially relevant papers resulted in a final list of 52 papers. The findings add to the knowledge of change agency as they raise issues pertaining to how change agents’ function, how individual change agent characteristics effect evidence-informed health care, the influence of interaction between the change agent and the setting and the overall effect of change agency on knowledge utilization. Particular issues are raised such as how accessibility of the change agent, their cultural compatibility and their attitude mediate overall effectiveness. Findings also indicate the importance of promoting reflection on practice and role modeling. The findings of this study are limited by the complexity and diversity of the change agency literature, poor indexing of literature and a lack of theory-driven approaches.ConclusionThis is the first realist review of change agency. Though effectiveness evidence is weak, change agent roles are evolving, as is the literature, which requires more detailed description of interventions, outcomes measures, the context, intensity, and levels at which interventions are implemented in order to understand how change agent interventions effect evidence-informed health care.

show abstract

“…A third study combined sociometric and informant methods to study strategies for improving breast-feeding rates. 13 When EIPs were identified by 1 or more of the approaches just described, researchers were challenged by the task of summarizing and analyzing the physician pool to determine who met the criteria and would be classified as an EIP.…”

Section: Identification Methodsmentioning

confidence: 99%