Systematic review of determinants influencing knowledge implementation in occupational therapy

Abstract

IntroductionIn knowledge translation, implementation strategies are more effective in fostering practice change. When using these strategies, however, many determinants, such as individual or organisational factors, influence implementation. Currently, there is a lack of synthesis concerning how these determinants influence knowledge implementation (KI). The aim of this systematic review was to document how determinants influence KI outcomes with occupational therapists.MethodFollowing the PRISMA statement, we systematically reviewed the literature on KI in occupational therapy across 12 databases: MEDLINE, Embase, CINAHL, AMED, PsychINFO, Cochrane Library, FirstSearch, Web of Science, ProQuest Dissertations & Theses, ERIC, Education Source and Sociological Abstracts. Eligible studies reported KI strategies specifically with occupational therapists. Selected studies were appraised for quality with the Mixed Methods Appraisal Tool. Using the Consolidated Framework for Implementation Research (CFIR), we categorised reported mentions of CFIR (sub‐)constructs to identify the determinants studied most often, how they were documented and what influence they had on outcomes.ResultsTwenty‐two studies were analysed for this review. CFIR (sub‐)constructs were mentioned 81 times, and seven (sub‐)constructs received at least 5% of these mentions (4/81). These were as follows: (i) Adaptability of the practice; (ii) Learning climate; (iii) Leadership engagement; (iv) Available resources; (v) Knowledge and Beliefs about the Intervention; (vi) Individual Stage of Change; and vii) Executing the KI strategy. The Inner setting domain was the most documented and the domain with the most (sub‐)constructs with at least four mentions (3/7). Most studies used questionnaires as assessment tools, but these were mainly non‐standardised scales. The data were too heterogenous to perform a meta‐analysis.ConclusionSeven (sub‐)constructs mentioned most often would benefit from being assessed for salience by researchers intending to develop a KI strategy for occupational therapists. Future research aimed at improving our understanding of KI should also consider using standardised tools to measure the influence of determinants.

Screening for Scientific Skills in Spanish-Speaking Occupational Therapists (HACTO-Screen): Study Protocol of a Cross-Sectional Survey

“…Moreover, organizational factors such as system-level support, positive attitude and readiness of leaders and employers, available resources, and university support and partnerships were also identified as enablers of EBP. Using the criteria proposed by the Consolidated Framework for Implementation Research (CFIR) [14], a more recent systematic review based on 22 studies indicated several determinants that may influence how occupational therapists implement evidencebased knowledge in their practice [15]. In line with previously reported factors [6], it was suggested that adaptability of the practice, learning climate, leadership engagement, available resources, knowledge and beliefs about the intervention, individual stage of change, and executing the knowledge implementation strategy should be considered as relevant aspects when developing strategies for implementing EBP in occupational therapy [15].…”

A day in the life: a qualitative study of clinical decision-making and uptake of neurorehabilitation technology

“…We used deductive qualitative analysis to identify codes in the provided vignettes related to barriers to RT use and knowledge translation identified in literature [ 10 , 14 , 16 ]. We named these barriers using the CFIR framework, which explains 39 implementation constructs across 5 domains.…”

“…These constructs can be barriers or facilitators, making implementation more or less difficult, respectively [ 15 ]. The codebook (Table 1 ) contained 15 original CFIR constructs identified in prior research [ 10 , 14 , 16 ]. Two constructs were added to distinguish between the attributes, knowledge and beliefs of clinicians compared to patients.…”

Barriers and Facilitators for Implementation of a Patient Prioritization Tool in Rehabilitation Settings

“…We also incorporated in this gure (in parentheses) the two questionnaires that document inner setting and characteristics of the individuals. We included two standardized measures to document these two domains in depth, individual and organization characteristics, considering that these domains could have more important in uence on the implementation [38]. We therefore chose the Determinants of Implementation Behavior Questionnaire (DIBQ) [48] and the Organizational Readiness for Knowledge Translation (OR4KT) [49].…”

“…Successful implementation of a new practice or an innovation into clinical practice can be in uenced by a variety of determinants [37]. In rehabilitation settings, organizational factors were perceived to be an important determinant of implementation, but future studies are needed to improve our understanding of the implementation [38]. It is recommended to investigate key facilitators and barriers (F&B) of individuals and their environment when tailoring knowledge translation processes to achieve successful uptake with the knowledge users [39].…”