Abstract
BackgroundHealth visitors play a pivotal position in providing parents with up-to-date evidence-based care on child health. The recent controversy over the safety of the MMR vaccine has drawn attention to the difficulties they face when new research which raises doubts about current guidelines and practices is published. In the aftermath of the MMR controversy, this paper investigates the sources health visitors use to find out about new research evidence on immunisation and examines barriers and facilitators to using evidence in practice. It also assesses health visitors' confidence in using research evidence.MethodsHealth visitors were recruited from the 2007 UK Community Practitioners' and Health Visitors' Association conference. All delegates were eligible to complete the questionnaire if in their current professional role they advise parents about childhood immunisation or administer vaccines to children. Of 228 who were eligible, 185 completed the survey (81.1%).ResultsThese health visitors used a wide range of resources to find out about new research evidence on childhood immunisation. Popular sources included information leaflets and publications, training days, nursing journals and networking with colleagues. A lack of time was cited as the main barrier to searching for new evidence. The most common reason given for not using research in practice was a perception of conflicting research evidence. Understanding the evidence was a key facilitator. Health visitors expressed less confidence about searching and explaining research on childhood immunisation than evidence on weaning and a baby's sleep position.ConclusionEven motivated health visitors feel they lack the time and, in some cases, the skills to locate and appraise research evidence. This research suggests that of the provision of already-appraised research would help to keep busy health professionals informed, up-to-date and confident in responding to public concerns, particularly when there is apparently conflicting evidence. Health visitors' relative lack of confidence about research on immunisation suggests there is still a job to be done in rebuilding confidence in evidence on childhood immunisation. Further research on what makes evidence more comprehensible, convincing and useable would contribute to understanding how to bridge the gulf between evidence and practice.
Highlights
Health visitors play a pivotal position in providing parents with up-to-date evidence-based care on child health
In the aftermath of the controversy, this paper aims to explore the sources of information health visitors use to find out about new research evidence on childhood immunisation and examine barriers and facilitators to using evidence in practice
A self administered questionnaire on the experience of using research evidence in practice was developed from a) a review of existing literature and b) informal qualitative telephone interviews (n = 20) with a range of community health professionals involved in childhood immunisation
Summary
Health visitors play a pivotal position in providing parents with up-to-date evidence-based care on child health. In the aftermath of the MMR controversy, this paper investigates the sources health visitors use to find out about new research evidence on immunisation and examines barriers and facilitators to using evidence in practice. Parents' satisfaction with health visitors with respect to immunisation visits is generally high [8], during the MMR debate some parents reported a lack of trust and confidence in information and advice offered by health professionals [9]. During this time MMR uptake declined [10] leading to an increase in confirmed cases of measles which is still apparent [11]
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