Abstract
BackgroundIt is difficult to foster research utilization among allied health professionals (AHPs). Tailored, multifaceted knowledge translation (KT) strategies are now recommended but are resource intensive to implement. Employers need effective KT solutions but little is known about; the impact and viability of multifaceted KT strategies using an online KT tool, their effectiveness with AHPs and their effect on evidence-based practice (EBP) decision-making behavior. The study aim was to measure the effectiveness of a multifaceted KT intervention including a customized KT tool, to change EBP behavior, knowledge, and attitudes of AHPs.MethodsThis is an evaluator-blinded, cluster randomized controlled trial conducted in an Australian community-based cerebral palsy service. 135 AHPs (physiotherapists, occupational therapists, speech pathologists, psychologists and social workers) from four regions were cluster randomized (n = 4), to either the KT intervention group (n = 73 AHPs) or the control group (n = 62 AHPs), using computer-generated random numbers, concealed in opaque envelopes, by an independent officer. The KT intervention included three-day skills training workshop and multifaceted workplace supports to redress barriers (paid EBP time, mentoring, system changes and access to an online research synthesis tool). Primary outcome (self- and peer-rated EBP behavior) was measured using the Goal Attainment Scale (individual level). Secondary outcomes (knowledge and attitudes) were measured using exams and the Evidence Based Practice Attitude Scale.ResultsThe intervention group’s primary outcome scores improved relative to the control group, however when clustering was taken into account, the findings were non-significant: self-rated EBP behavior [effect size 4.97 (95% CI -10.47, 20.41) (p = 0.52)]; peer-rated EBP behavior [effect size 5.86 (95% CI -17.77, 29.50) (p = 0.62)]. Statistically significant improvements in EBP knowledge were detected [effect size 2.97 (95% CI 1.97, 3.97 (p < 0.0001)]. Change in EBP attitudes was not statistically significant.ConclusionsImprovement in EBP behavior was not statistically significant after adjusting for cluster effect, however similar improvements from peer-ratings suggest behaviorally meaningful gains. The large variability in behavior observed between clusters suggests barrier assessments and subsequent KT interventions may need to target subgroups within an organization.Trial registrationRegistered on the Australian New Zealand Clinical Trials Registry (ACTRN12611000529943).
Highlights
Cerebral palsy (CP) is the most common physical disability in childhood [1]
The large variability in behavior observed between clusters suggests barrier assessments and subsequent knowledge translation (KT) interventions may need to target subgroups within an organization
Participant attributes were mostly comparable between groups, the exception being prior evidence-based practice (EBP) education attendance (88% compared to 66% for controls) (Table 3)
Summary
Cerebral palsy (CP) is the most common physical disability in childhood [1]. Of people with CP, three in four are in pain; one in two have an intellectual disability; one in three cannot walk; one in three have a hip displacement; one in four cannot talk; one in four have epilepsy; one in four have a behavior disorder; one in four have bladder control problems; one in five have a sleep disorder; one in five dribble; one in ten are blind; one in fifteen are tube fed; and one in twenty-five are deaf [2]. Allied health professionals (AHPs) who treat people with CP are faced with complex clinical decision making. AHPs provide the majority of health services to these people and need to have up-to-date knowledge and skills in providing evidence-based interventions. AHPs endorse providing evidence-based care [4,5], but goodwill alone does not guarantee the latest research is translated and applied within practice [6,7]. Employers need effective KT solutions but little is known about; the impact and viability of multifaceted KT strategies using an online KT tool, their effectiveness with AHPs and their effect on evidence-based practice (EBP) decision-making behavior. The study aim was to measure the effectiveness of a multifaceted KT intervention including a customized KT tool, to change EBP behavior, knowledge, and attitudes of AHPs
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