Evidence-based Practice Attitudes Research Articles

“Hypertension is such a difficult disease to manage”: federally qualified health center staff- and leadership-perceived readiness to implement a technology-facilitated team-based hypertension model

BackgroundDespite decades of evidence demonstrating the efficacy of hypertension care delivery in reducing morbidity and mortality, a majority of hypertension cases remain uncontrolled. There is an urgent need to elucidate and address multilevel facilitators and barriers clinical staff face in delivering evidence-based hypertension care, patients face in accessing it, and clinical systems face in sustaining it. Through a rigorous pre-implementation evaluation, we aimed to identify facilitators and barriers bearing the potential to affect the planned implementation of a multilevel technology-facilitated hypertension management trial across six primary care sites in a large federally qualified health center (FQHC) in New York City.MethodsDuring a dedicated pre-implementation period (3–9 months/site, 2021–2022), a capacity assessment was conducted by trained practice facilitators, including (1) online anonymous surveys (n = 124; 70.5% of eligible), (2) hypertension training analytics (n = 69; 94.5% of assigned), and (3) audio-recorded semi-structured interviews (n = 67; 48.6% of eligible) with FQHC leadership and staff. Surveys measured staff sociodemographic characteristics, adaptive reserve, evidence-based practice attitudes, and implementation leadership scores via validated scales. Training analytics, derived from end-of-course quizzes, included mean score and number attempts needed to pass. Interviews assessed staff-reported facilitators and barriers to current hypertension care delivery and uptake; following audio transcription, trained qualitative researchers employed a deductive coding approach, informed by the Consolidated Framework for Implementation Research (CFIR).ResultsMost survey respondents reported moderate adaptive reserve (mean = 0.7, range = 0–1), evidence-based practice attitudes (mean = 2.7, range = 0–4), and implementation leadership (mean = 2.5, range = 0–4). Most staff passed training courses on first attempt and demonstrated high scores (means > 80%). Findings from interviews identified potential facilitators and barriers to implementation; specifically, staff reported that complex barriers to hypertension care, control, and clinical communication exist; there is a recognized need to improve hypertension care; in-clinic challenges with digital tool access imposes workflow delays; and despite high patient loads, staff are motivated to provide high-quality cares.ConclusionsThis study serves as one of the first to apply the CFIR to a rigorous pre-implementation evaluation within the understudied context of a FQHC and can serve as a model for similar trials seeking to identify and address contextual factors known to impact implementation success.Trial registrationClinicalTrials.gov NCT03713515, date of registration: October 19, 2018.

Provider attitudes toward evidence-based practice in autism: a mini-review

There are many established evidence-based practices (EBPs) for autistic youth which facilitate wellbeing and skill development across a range of domains. However, individuals on the autism spectrum are consistently underserved in mental health settings, limiting their access to these EBPs. Positive provider attitudes toward EBPs may increase their uptake or use. The current mini-review seeks to synthesize the literature regarding attitudes toward EBPs among providers working with autistic youth across a variety of settings (i.e., school, early intervention, and general mental health). Fifteen quantitative studies were included. The majority of studies (n = 13, 87%) utilized the Evidence Based Practice Attitudes Scale (EBPAS) or a variation of this scale. Attitudes toward EBPs were primarily used as a correlate or covariate, although some studies reported descriptive statistics of provider attitudes. When available, the reported results suggest that attitudes toward EBPs are moderately positive at baseline, although they vary between provider types. Two studies (13%) examined change in attitudes toward EBPs and suggested that they may be responsive to intervention. However, findings were mixed as to whether attitudes toward EBPs are predictive of EBP use/uptake. Implications and future directions are discussed.

Evidence-based practice - implementation level and attitude among physical, occupational, and speech and language therapists in Germany: status quo.

Evidence-based practice (EBP) is an important component of clinical practice in public health. Its implementation involves interpreting scientific studies and then applying this knowledge to clinical decision-making. In Germany, the therapy professions are often trained in non-academic medical schools, and only a small number of therapists are university graduates. This study assessed the current status of EBP among physiotherapists, occupational therapists, and speech and language therapists and to determine whether academization influences the implementation of EBP in Germany. To assess the EBP implementation level and therapists' attitudes toward EBP, a cross-sectional study was conducted using the German version of the Evidence-Based Practice Inventory (EBPI), which consists of five dimensions: attitude; subjective norm; perceived behavioral control; decision-making; and intention and behavior. The structural validity and internal consistency of the EBPI survey were also tested. Of the 2,412 responses, only 557 were eligible. There were statistically significant differences between academically educated vs. non-academically educated therapists in four of the five EBPI dimensions. Furthermore, four of the five dimensions had sufficient unidimensionality and internal consistency. There are differences between academically educated and non-academically educated therapists regarding EBP knowledge, attitudes, and implementation. Academically educated therapists are more likely to use EBP than non-academically educated therapists. There are still barriers to clinical application that need to be addressed. http://links.lww.com/IJEBH/A195.

Chiropractic attitude and utilisation of evidence-based practice in South Africa: a secondary analysis

BackgroundEvidence-Based Practice (EBP) is a model utilised by the majority of healthcare professionals and is a clinical framework that assists with decision-making related to patient care, to improve outcomes and patient satisfaction. The study aimed to analyse the attitudes, skills, and utilization of evidence-based practice (EBP) among South African chiropractors, focusing on perceived skill levels, training, use and identifying facilitators and barriers to EBP application.MethodsA descriptive cross-sectional quantitative secondary analysis was conducted by inviting registered chiropractors in South Africa (n = 920) to participate in an anonymous online questionnaire using the Evidence-Based Practice Attitude and Utilisation Survey (EBASE).ResultsA total of 132 chiropractors completed the survey, yielding a response rate of 14.4%. Of the respondents, 59.9% were female, 52.3% were between 26 and 35 years old, and 63.3% had graduated from the University of Johannesburg. A third of respondents stated they have poor clinical research skills. Over half of the respondents (56.8%) indicated that EBP constituted a significant part of their education except for completing systematic reviews or meta-analyses. Published clinical evidence was ranked 6th as a source of information for clinical decisions. The obstacles indicated were time constraints and a lack of clinical research in complementary and alternative medicine. Access to the internet, databases and research tools were facilitators that were deemed to be “very useful” in promoting EBP.ConclusionThe majority of South African chiropractors are generally favourable towards EBP, and this practice therefore appears to be utilised and embraced, with the requisite skills.

Characterizing Provider Readiness for Meeting Engagement Challenges in Youth Psychotherapy

ABSTRACT Despite significant efforts to increase the delivery of evidence-based practice (EBP), little is known about provider readiness to address challenges with treatment engagement, and it is unclear whether provider characteristics, such as EBP training history and attitudes toward EBP, relate to such readiness. This study aimed to characterize provider knowledge of engagement strategies – one aspect of readiness – and to estimate the association between that knowledge and other provider characteristics. Data came from a multisite, cluster-randomized trial examining a coordinated system for integrating evidence-based engagement strategies into school-based mental health services. Providers (N = 93) received one of two levels of training in engagement strategies and completed pre- and post-training engagement knowledge tests. Pre-training knowledge was not significantly correlated with EBP training history (r = .11, p = .29) or attitudes toward EBP (r = .20, p = .06). Linear mixed model analysis revealed a significant interaction of training and time when accounting for provider site (B = 2.21, SE=.74, t(1,89) = 2.98, p < .005), such that at post-training, providers trained in a coordinated system for applying engagement strategies showed significantly increased knowledge compared with those who received training on a list of the same engagement strategies and their definitions (F(1,285.3) = 71, p < .001). Findings suggest that providers’ readiness to act on the evidence base may be focally limited to their specific training experiences. Additionally, training providers in a coordinated system for using engagement strategies may be a promising approach to enhancing provider knowledge and delivery of engagement strategies, thus promoting the public health impact of EBP for youth mental health.

Developing and evaluating an evidence-based practice research competency enhancement program for clinical nurses in Korea: a pilot study

BackgroundEvidence-based practice (EBP) is crucial for delivering high-quality healthcare and effective self-care. Enhancing clinical nurses’ research competencies through structured mentorship is key to the widespread application of EBP. This study evaluated a newly developed Research Competency Enhancement Program (RCEP), aimed at bolstering EBP among experienced nurses.MethodsConducted in a tertiary university hospital in Korea, this single-group study employed a pretest-post-test design and a mixed-methods approach. The RCEP involved 11 experienced clinical nurses in an 8-week intervention, featuring mentor-led workshops, interactive sessions, and resource-driven activities. Data were collected using the Evidence-Based Practice Beliefs Scale (EBPB), the Evidence-Based Practice Attitude Scale (EBPA), and the Research Practice Ability (RPA) tool, alongside qualitative feedback. These measures assessed the program’s feasibility, acceptability, and preliminary effectiveness.ResultsThe quantitative analysis indicated significant improvements in research competency post-intervention. Mean scores on the EBPB and RPA scales increased (Z = -2.53, p = .011; Z = -2.66, p = .008). Participants described the RCEP as inspirational and challenging, creating an environment conducive to research. Facilitators included mentor support and innovative learning tools, while barriers were internet connectivity and scheduling conflicts. Suggestions for improvement included more hands-on sessions, small team collaborations, and integration with academic institutions.ConclusionThe RCEP, facilitated by EBP mentors, significantly improved the research competencies and attitudes of clinical nurses towards EBP. The study underscores the importance of continual RCEP refinement, integrating structured, interactive, and collaborative elements to further empower nurses in evidence-based practice. The program shows promise in enhancing research competencies and fostering a commitment to EBP in clinical settings.

Determinants of Evidence Implementation by Nurses: #Evidencer Model for the Use of Evidence-Based Practice (#EvidencerMUSEBP)—A Structural Equation Model

Existing studies have identified specific factors influencing some dimensions of evidence-based practice (EBP) competence and use. However, the way these factors interact still needs to be clarified. The purpose of the study was to test a model based on the Determinant Frameworks that explain the relationships and the direct pathways between the characteristics of the nurses, the context, and the implementation strategies and the dimensions of EBP competence, attitude, knowledge, skills, and use of EBP. A cross-sectional study was carried out in Spain during January and February 2020, involving 2,370 nurses employed in public health centers across all autonomous communities within the National Health System. An online survey was administered to gather data, addressing various topics related to the nurses’ characteristics, the context in which they worked, the implementation strategy, and their competence in evidence-based practice (EBP). As depicted in the conceptual framework, a structural equation model was constructed to test the hypothesized relationships among key study variables. The model obtained showed a good fit (χ2/df = 3.20, p&lt;0.001; RMSEA = 0.030 [90% CI 0.025, 0.036]; CFI = 0.989; GFI = 0.990; TLI = 0.983). The context, more specifically, the dimensions of nurse participation in the center’s affairs, nursing foundations for quality of care, nurse manager ability leadership and support of nurses, and implementation strategy have a direct and positive effect on EBP use. Training in EBP, reading scientific articles, and having a doctorate are associated with higher competence and knowledge in EBP. The final fit shows the #Evidencer model for the use of EBP (#EvidencerMUSEBP) with two main components: the contextual and strategic factors that influence the implementation of EBP and the characteristics of the professionals, such as their training and reading of articles, which have an impact on EBP competence. This model could guide healthcare organizations in proposing comprehensive interventions to improve EBP use and the competency of nurses.

Evidence-based practice attitudes and nutrition support guideline knowledge between holders and nonholders of the Certified Nutrition Support Clinician credential.

Clinical practice frequently changes, and professionals should stay abreast of evidence-based practice (EBP) guidelines. Negative attitudes towards EBP are a barrier to guideline adoption. This study explored EBP attitudes and knowledge of a complex nutrition support clinical case scenario of individuals holding or not holding the Certified Nutrition Support Clinician (CNSC) credential. This cross-sectional study used an online survey sent to American Society for Parenteral and Enteral Nutrition (ASPEN) members with and without the CNSC credential and all CNSC credential holders from the National Board of Nutrition Support Certification email list. The survey included the Evidence-Based Practice Attitude Scale Score (EBPAS-15) and eight knowledge questions using a nutrition support case scenario. An independent samples t test compared knowledge and EBPAS-15 total scores and subscores between CNSC holders and nonholders. Pearson correlation determined the correlation between knowledge and EBPAS-15 scores. The response rate was 7.8% (N = 706). CNSC holders (n = 536) had significantly higher mean knowledge scores (4.7 ± 1.6 out of 8) than nonholders (n = 159, 4.1 ± 1.7) (P < 0.001). Total EBPAS-15 scores were not significantly different between CNSC holders (n = 542, 2.9 ± 0.4 out of 4) and nonholders (n = 164, 2.8 ± 0.7) (P = 0.434), and knowledge scores and total EBPAS-15 scores (P = 0.639) or subscores were not significantly correlated. Regardless of holding the CNSC credential, EBPAS-15 scores indicated respondents had positive EBP attitudes. CNSC holders had significantly higher knowledge scores of recent nutrition support EBP guidelines compared with non-CNSC credential holders. Positive EBP attitudes are a precursor to clinical decision-making, but future research should determine the use of guidelines in clinical practice.

Mental Health Provider Reach and Engagement in a Countywide Training Initiative.

Many training initiatives are underway to increase implementation of evidence-based practice (EBPs) in mental healthcare. However, little is known about what types of trainings and supports yield the highest reach and engagement. Supported by a tax-funded, countywide initiative to improve access to quality care for youths, the current mixed methods study evaluates mental health (MH) provider reach, or registering for the training initiative, and engagement, or participation in training activities, for several EBP training and implementation supports. MH providers were offered free 1) formal EBP workshops, 2) a biweekly learning community, 3) individual case consultation, and 4) confidential online clinical feedback system. To register, interested providers (N = 698) completed a web-based assessment measuring clinical practice information, organizational implementation climate, and EBP knowledge, attitudes, and practices. Thirteen providers, selected via purposeful sampling stratified by level of participation, completed semi-structured qualitative interviews. While the training initiative achieved high reach (66% of county agencies had a provider register), far fewer providers engaged substantially in training. Quantitative results indicated that providers whose professional discipline was not psychology, had higher baseline EBP knowledge, more extensive use of common evidence-based strategies, and less extensive use of other therapy strategies, engaged in more training. Rapid qualitative analysis of interviews expanded upon these findings and illuminated provider, organizational, system, practical, and training activity-specific barriers and facilitators to engagement. Findings suggest the importance of identifying strategies for improving provider engagement in training activities beyond workshops. Implications for future research and training initiatives are discussed.

A Psychometric Study of the Student Evidence-Based Practice Scale S-EBPQ-Arabic Version for Use among Undergraduate Nursing Students.

Previous studies have demonstrated the significance of evidence-based practice in improving patient care and outcomes. Therefore, integrating evidence-based practice into the health professions' education curriculum has become a pedagogical priority. However, there is a lack of reliable and valid scales to measure students' evidence-based practice usage, attitudes, knowledge, and skills in Arab countries. This study aims to examine the adapted Student Evidence-Based Practice Scale Questionnaire (S-EBPQ) validity at logical statistical level and reliability for use among students in Arabic context. This cross-sectional study included 233 undergraduate nursing students from a university in Saudi Arabia, who were recruited after translating and pilot testing the S-EBPQ. Three distinctive types of validity including conceptual, content, and face validity were assessed to determine the quality of the questionnaire items logically. Exploratory factor analyses were performed to examine the tool's structural validity. Additionally, internal consistency was assessed to evaluate reliability. Findings. All items were considered relevant to Arab culture, and no changes were made to any items. The content validity indices for all items were above 0.80 as this was considered an acceptable value. The exploratory factor analysis identified the same four factors (practice, attitude, retrieving and reviewing evidence, and sharing and applying evidence-based practice). All KMO values for the individual items ≥0.876 were also well above the acceptable 0.6 limit. The four-factor structure explained a total variance of 64%, with factor load score λ ≥ 0.455. The total and subscale S-EBPQ scores showed evidence of reliability, with Cronbach's alpha ≥0.8. This study demonstrated the reliability and validity of the Arabic S-EBPQ version. The study has the potential to advance Arab countries' understanding of evidence-based practice. S-EBPQ is a validated tool that can be used to assess nursing students' knowledge of EBP practices. Since educators need to continually evaluate instructional and curricular design in order to meet contemporary nursing needs, this scale can enhance the educational process and enhance students' competencies.

Evaluating the implementation of a community health worker-delivered intervention integrating asthma care in West Philadelphia public schools

Objective Schools are an important setting because students spend much of their time in school and engage in physical activity during the school day that could exacerbate asthma symptoms. Our objective is to understand the barriers and facilitators to implementing an experimental community health worker-delivered care coordination program for students with asthma within the context of the West Philadelphia Controls Asthma study. Methods Surveys (n = 256) and semi-structured interviews (n = 41) were completed with principals, teachers, nurses, and community health workers from 21 public and charter schools in West Philadelphia between January 2019 and September 2021. Survey participants completed the Evidence Based Practice Attitudes Scale, the Implementation Leadership Scale, and Organizational Climate Index. Semi-structured qualitative interview guides were developed, informed by the Consolidated Framework for Implementation Research. Results Participant responses indicate that they perceived benefits for schools and students related to the community health worker-based care coordination program. Several barriers and facilitators to implementing the program were noted, including challenges associated with incorporating the program into school nurse workflow, environmental triggers in the school environment, and challenges communicating with family members. An important facilitator that was identified was having supportive school administrators and staff who were engaged and saw the benefits of the program. Conclusions This work can inform implementation planning for other locales interested in implementing community-based pediatric asthma control programs delivered by community health workers in schools.

Attitudes Toward and Usage of Evidence-Based Mental Health Practices for Autistic Youth in Bangladesh and Germany: A Cross-Cultural Comparison.

The implementation of evidence-based practices (EBPs) for autistic youth is a critical concern worldwide. Research examining factors facilitating the implementation of EBPs found that providers' attitudes are an important factor. In this study, we evaluated cross-cultural differences in attitudes toward and use of EBPs. We tested socio-demographic factors as predictors of attitudes, and attitudes as predictors of EBPs use among mental health professionals working with autistic youth in Bangladesh and Germany. We used purposeful sampling. Two-hundred-ninety-two professionals who worked in a clinical setting responded to the survey and fulfilled the inclusion criteria (101 in Bangladesh, 191 in Germany). Participants were asked to respond to nine subscales of the Evidence-Based Practice Attitude Scale-36 (EBPAS-36), to indicate which of nine types of treatments they used, and to provide sociodemographic data. Measurement invariance across countries could be established for four subscales of the EBPAS-36. Comparative analyses of attitudes showed that professionals in both countries were open to using EBPs, but German practitioners were more likely to use EBPs when they appealed to them. By contrast, Bangladeshi professionals claimed to be more likely to adopt an EBP when required and to be more willing to learn EBPs to enhance job security. The relationship between caseload and attitudes varied between countries. A broader variety of EBPs was used in Germany. The findings highlight the importance of considering country-specific factors when implementing EBPs. Directions for conducting comparative studies on mental health professionals' attitudes towards EBP including methodological considerations are discussed.

The dilemma of the split between theory and reality as experienced by primary healthcare professionals: a mixed methods study of evidence-based practice in a primary care context

BackgroundPrimary care depends upon a good information flow across professional and structural boundaries to provide the best care for patients. Previous research has mainly focused on Evidence-Based Practice (EBP) within specific professions. Mapping of pan-professional experiences of and attitudes to EBP in publicly funded clinical practice is necessary to deepen the understanding of EBP and its implementation. Thus, this study aimed to investigate healthcare professionals’ experiences of and attitudes towards working in accordance with EBP in primary care.MethodsThe study used a convergent mixed methods design divided into two strands: a quantitative enquiry tool (Evidence-Based Practice Attitude Scale, EBPAS) and a set of qualitative interviews analysed by means of qualitative content analysis. Both strands included all primary care employees with patient interaction in the studied county (n = 625), including doctors, nurses, physiotherapists, psychologists and assistant nurses. Out of the original 625 healthcare professionals, 191 finished the first strand and 8 volunteered for the second strand (2 nurses, 2 physiotherapists, 1 psychiatrist and 3 doctors).ResultsThe EBPAS value of 2.8 (max 4) indicated a generally positive attitude towards EBP amongst the population, which was also evident in the interviews. However, there were additional experiences of not having the ability or resources to engage in EBP. This was illustrated by the theme that emerged from the qualitative content analysis: “The dilemma of the split between theory and reality”. Due to the organisational and managerial focus on efficiency rather than quality of care, there were few or no incentives for promoting individual educational or research development.ConclusionsAlthough the general attitude towards EBP is positive, experiences of practising it differ. There is a need to increase knowledge of EBP concepts, requirements and implementation in the clinical setting. The absence of opportunities to do research and collegial debate about new ways of finding and implementing research-based evidence results might influence the quality of care.

A 10-month impact evaluation of a journal club among diagnostic radiographers in a single NHS Trust: A service evaluation study

IntroductionJournal clubs (JC) have emerged as a popular tool within medical and health professions to deliver outcomes such as promotion of evidence-based practice (EBP), improvement of critical appraisal skills, as well as stimulation of research interest among participating professionals. However, the delivery of these outcomes within the diagnostic radiography profession has not been evidenced and this is the aim of this service evaluation. MethodsThis evaluation adopted a pre- and post-evaluation survey design to explore the impact of a novel JC introduced among diagnostic radiographers in a UK NHS Trust. Impact was assessed based on four pre-determined outcomes such as Knowledge of EBP, Attitude to EBP, Critical Appraisal Skill and Research interest. Open ended questions in the post evaluation survey were also used to obtain participants feedback on JC activities attended. ResultsEvaluation of the four pre-determined outcomes indicated that JC activities participated by diagnostic radiographers resulted in positive changes across all evaluated categories. Attitude to EBP was the only outcome to show a statistically significant positive change across all participants, highlighting that the JC affected EBP attitudes positively for those that attended. Furthermore, thematic analysis of open-ended questions indicated that the collaboration experienced among JC members during critical appraisal of articles was a motivation for continued participation while factors such as high clinical workload and absence of management in meetings were identified as mitigating barriers. ConclusionParticipation in the JC showed positive improvements in all pre-determined categories. The collaborative nature of JC was motivating for staff, however barriers such as management absence in meetings, and high clinical workload did cause some challenges. Research is recommended to look at the longer-term impact of JC activities amongst diagnostic radiographers.

Teacher attitudes towards evidence-based practices for social, emotional and mental health difficulties in school and association with teacher academic research engagement

ABSTRACT The study examined the association between teacher engagement with academic research to inform practice for pupils with Social Emotional Mental Health Difficulties (SEMHD) and teacher attitudes towards the adoption of evidence-based practices (EBP) for pupils with SEMHD in a sample (n = 79) of undergraduate and postgraduate primary school trainee teachers in England, UK. A questionnaire was used to assess teachers’ academic research engagement operationalised as positive attitudes towards academic research, use of academic research, and knowledge about research. The Evidence-based Practice Attitude Scale (EBPAS) was used to examine attitudes towards EBP. The findings showed that while appreciation of academic research in the sample was high, the use of academic research to inform practice and knowledge about research was low. A positive attitude towards academic research, less scepticism towards the value of academic research to inform school practice, and high research knowledge was associated with a more positive attitude towards EBP. More scepticism towards academic research to inform school practice for SEMHD and weaker understanding of research methods was linked to more scepticism about the relevance of EBP for school practice. The findings have implications for pre-service and in-service teacher training on SEMHD and the implementation of EBP for SEMHD in schools.

Cultural Adaptation and Psychometric Properties of the Persian Version of the Evidence-Based Practice Attitudes Scale in Audiologists

Background and Aim: Evidence-based practice improves the quality of clinical performance. Attitude affects the implementation of research findings into practice. The Evidence-Based Practice Attitude Scale (EBPAS-36) evaluates the attitude of therapists toward evidence-based practice. The present study aimed to provide a validated Persian translation of the EBPAS-36 for audiologists.&#x0D; Methods: The original EBPAS-36 was translated by using the international quality of life assessment protocol. The validity of translated version was surveyed by an expert panel and the Persian version with 35 questions was yielded. A demographic questionnaire and EBPAS P-35 were given to 182 audiologists to evaluate the psychometric properties. The reliability was evaluated by completing the EBPAS P-35 after 2 weeks by 30 of the participants and Cronbach’s alpha and Intra-Class Correlation (ICC) were calculated. Confirmatory Factor Analyses (CFA) were also conducted.&#x0D; Results: The content validity ratio was above 0.33 for all except item 10 which was removed from the Persian version. The mean(SD) total score was 2.38(0.46). A significant relationship was observed between the total score and all subscales (p&lt;0.05). The original factor structure showed an acceptable model fit (CMIN/DF=1.39, GFI=0.84, CFI=0.94, IFI=0.94, RMSEA=0.04) confirming the 12-factor structure of the EBPAS-36. The internal consistency was very good for the total score (α=0.88) and adequate to very good for the subscales (0.65–0.84), indicating high reliability. The ICC showed good agreement in the score of test-retest (total ICC=0.65).&#x0D; Conclusion: This study confirms good psychometric properties and validity of the EBPAS P-35 in a sample of audiologists.&#x0D; Keywords: Evidence-based practice; research-based intervention; clinical implementation; attitude; audiologist

Investigating Physiotherapists’ Knowledge, Attitude, and Practice of Evidence-Based Practice in Indonesia

Introduction: In order to deliver quality care to patients and clients, physiotherapists should implement Evidence Based Practice (EBP) in the area of clinical services. There has been little research into the adoption of EBP among physiotherapists in Indonesia.&#x0D; Aims: This study aims to investigate the attitudes, knowledge, and practice of physiotherapists in Indonesia regarding EBP.&#x0D; Methods: A descriptive, cross-sectional research approach was used to assess physiotherapists' attitudes, knowledge, and practice in Indonesia. An online self-administered questionnaire-based survey containing validated Indonesian versions of the Evidence Based Practice Questionnaire (EBPQ) and sociodemographic variables was distributed to physiotherapists via social media.&#x0D; Results: The questionnaire was completed by 156 physiotherapists, with 73 (46.8 %) men and 83 (53.35 %) women participating. The total EBP Questionnaire (EBPQ) average score was 127.67, with a mean of 5.31 out of 7 (SD = 0.96). The attitude (5.23, S D= 0.95) had the highest EBP score, followed by knowledge (5.25, SD=1.01) and practice (5.23, SD=1.30). Education level (p = 0.001), professional category (p = 0.002), and clinical instructor (p = 0.024) were the characteristics related with increased EBP performance.&#x0D; Conclusion: In summary, physiotherapists in Indonesia have positive attitudes, knowledge, and practices towards EBP. Higher education levels, working as a clinician and educator, and teaching clinical students may all help to enhance EBP implementation.

Evidence-based maintenance care among chiropractors in Norway: a cross-sectional survey in the Nordic maintenance care program

BackgroundChiropractors use a treatment strategy called maintenance care with the intent of secondary and tertiary prevention. The Nordic Maintenance Care Program provides evidence of when and for whom maintenance care should be offered. Dissemination has occurred through articles, workshops, social media, conference in Europe and internationally. However, little is known about chiropractors’ awareness and use of this evidence. This study explores chiropractors’ attitudes, skills, and use of evidence on maintenance care, as well as study their association with general evidence-based practice and demographic characteristics. Moreover, barriers and facilitators of evidence access are also examined.MethodsQuestions pertaining our research aim were included in the anonymous and digital Evidence-Based practice Attitude and utilization SurvEy, which was distributed to all members (n = 770) of the Norwegian chiropractic association in the fall of 2021.ResultsThe response rate was 41% (n = 312). Regarding attitudes towards evidence-based maintenance care, 26% agreed they needed tools to recommend this care to patients. Approximately half (57%) believed they had skills to identify suitable patients, and 45% had used published information in the past month. Strong alignment was observed between Norwegian chiropractors’ attitudes, skills, and utilization of evidence-based maintenance care and general evidence-based practice. Maintenance care skills were significantly associated with age (those between 40 and 59 years being less likely to report having high skills), clinical setting (those working with conventional health care providers being less likely to report having high skills) and country of education (those educated in the US and Australia being more likely to report having high skills). Moreover, maintenance care use was significantly associated with country of education (those educated in Australia were less likely to have used published information regarding patient selection for maintenance care). Access to resources was a barrier, whereas knowledge of patient suitability facilitated evidence-based maintenance care.ConclusionsNorwegian chiropractors had neutral attitudes towards maintenance care, but generally reported moderate skills. Most had not used evidence about maintenance care in the previous month. Access to useful resources about the evidence regarding maintenance care was a barrier, and knowledge of who responds to maintenance care was a facilitator.

Development and validation of a questionnaire to assess evidence-based practice and evidence-informed practice knowledge, attitudes, understanding and behavior

Good-quality questionnaires are needed to assess the effectiveness of educational programs on undergraduate healthcare students’ knowledge, attitudes, understanding and behavior regarding evidence-based practice and evidence-informed practice. However, there is currently no available questionnaires designed to evaluate the outcomes of evidence-based practice and evidence-informed practice education. Based on the methods proposed by Streiner et al., this study developed and validated a questionnaire for assessing evidence-informed practice and evidence-based practice knowledge, attitudes, understanding, self-perceived application and use, and behavior among undergraduate preregistration students in the nursing and allied health disciplines. Seventy-three questionnaire items were developed and administered to varied groups of people, including students and academics. Principal component analysis was conducted to reduce dimensions and establish construct validity and internal consistency of the developed questionnaire. Following pilot-testing and expert review, the final validated questionnaire consists of 53 items (8 demographic items, 25 evidence-based practice items, and 20 evidence-informed practice items). The evidence-based practice and evidence-informed practice questionnaire is a valid and reliable tool to measure the outcomes of evidence-based practice and evidence-informed practice education.

Evidence implementation in naturopathy: A cross-sectional study of Australian naturopaths

Background and PurposeEvidence implementation refers to the application of appropriate enabling strategies to improve clinician engagement with the best available evidence. To date, little attention has been paid to evidence implementation in disciplines such as naturopathy. This study addresses this knowledge gap by examining the determinants of evidence implementation in Australian naturopathic practice. Materials and methodsThis cross-sectional study was open to all Australian naturopaths who had internet access and were fluent in the English language. Participants were invited to complete the 84-item Evidence-Based practice Attitude and utilization Survey (EBASE) online between March and July 2020. ResultsThe survey was completed in full by 174 naturopaths (87.4% female; 31.6% aged 40–59 years). While participant attitudes were predominantly favourable of evidence implementation, engagement in evidence implementation activities was reported at a low to moderate level. Factors impacting participant engagement in such activities included a lack of clinical evidence in naturopathy, lack of time, and a moderate to moderately-high level of self-reported skill in evidence implementation. Enablers of evidence implementation were access to the internet, free online databases, full-text journal articles, and online education materials. ConclusionThis study has provided valuable insights into the level of, and factors impacting evidence implementation among Australian naturopaths. Attitude did not pose a major barrier to evidence implementation; rather, the barriers were largely structural and cognitive. This suggests that the obstacles to evidence implementation in naturopathy are most likely surmountable with the right means and concerted effort.