Efficacy of a knowledge translation approach in changing allied health practitioner use of evidence-based practices with children with cerebral palsy: a before and after longitudinal study

Abstract

Purpose To investigate the effect of a knowledge translation intervention on knowledge and frequency of routine evidence-based assessment behaviours of healthcare professionals working with children with cerebral palsy. Methods A before-and-after longitudinal study was conducted in five disability organisations. Four organisations (Commencing Knowledge Translation group) implemented a multifaceted intervention: knowledge brokers, targeted education, electronic-evidence library, and clinical outcomes database. These strategies were already in place at the fifth organisation (Comparison group). Outcomes evaluated at 0, 6, 12, and 24 months were health-professional knowledge and routine assessment behaviours (self-report and “completeness” of clinical assessment). Generalised estimating equations determined longitudinal changes. Results Four hundred and forty-seven professionals involved 861 children in the study. The Comparison group had higher knowledge and routine assessment behaviours at baseline. Professional knowledge in both groups remained stable (differences in change from baseline to 24 months: 0.3 units, 95%CI: −0.76 to 1.36). Assessment completeness of the Comparison group was stable (baseline mean 68 units, 95%CI: 65–71); the Commencing Knowledge Translation group improved from baseline mean 35 units (95%CI: 33–36), peaking at 12 months (mean 68 (95%CI: 65–71). Conclusions Multifaceted organisational support improved health-professional routine evidence-based assessment behaviours with children with cerebral palsy, despite no change in knowledge. Trial registration This trial was not a controlled health care intervention and was registered retrospectively: ACTRN12616001616460. The protocol of the trial was published in 2015 as follows: Imms et al. [6]. Implications for rehabilitation A multifaceted knowledge translation intervention increased allied health professionals’ assessment behaviours. Knowledge translation strategies can be chosen to target change in knowledge and/or change in behaviour. Knowledge translation interventions should be designed to address organisational barriers and enhance organisational supports. Interventions that target healthcare professionals’ behaviour directly can be effective even if their knowledge does not change.