Barriers to evidence
Closing the gap between research and practice: using
behavioural change theory to identify barriers to implementation
of evidence-based guidelines.
Despite growing amounts of evidence from high quality
research to guide practice, many patients continue to
receive treatments that are ineffective, harmful or
of unproven effectiveness. Better uptake of existing
evidence has the potential to significantly improve
health care quality and safety in Australia and internationally.
This study aims to identify the barriers related to
practitioners’ attitudes, beliefs and intentions
to implementing evidence and will test the utility of
behavioural theory to predict implementation behaviour.
This project will provide better information for targeting
implementation strategies to identified barriers and
will inform a model for research translation to help
close the ‘research-practice gap’.
This project aims to identify the barriers related to
general practitioners’ attitudes, beliefs and
intentions to implementing evidence and to test the
utility of behavioural theory in predicting implementation
behaviour. The ultimate aim of this project is to complete
the necessary preliminary research to inform the conduct
of a cluster randomized controlled
trial to test a theoretically underpinned intervention
to improve the uptake of evidence-based clinical practice
guidelines into general practice.
- to develop a questionnaire using behavioural change
theory for measuring attitudes, beliefs and intentions
of general practitioners towards implementation of
evidence-based clinical practice guidelines (EBCPG);
- to test the validity and reliability of the questionnaire;
- to identify the barriers related to general practitioners’
attitudes, beliefs and intentions to implementing
EBCPG in low back pain that are most likely to be
effective targets for change;
- to test the utility of the theory of planned behaviour
in predicting general practitioners’ behaviour
in implementing EBCPG.
Stage one consisted of conducting focus group interviews
with Victorian general practitioners, based on behavioural
theory, to elicit information about their intentions
and beliefs toward behaviours from an evidence-based
guideline. We conducted thematic analysis on the interview
data to generate items for inclusion in the questionnaire.
Stage two consisted of developing the questionnaire
instrument, based on behavioural theory, and testing
it for validity and reliability in a random sample of
Australian general practitioners. To date, the questionnaire
has been tested for face validity with international
experts in implementation research and local general
practitioners and we are currently collecting data using
the questionnaire in an Australian general practitioner
sample. Stages three and four of the project involve
identifying the barriers and testing the predictive
validity of the instrument.
This project is funded by a Strategic Grant from the
Faculty of Medicine, Nursing and Health Sciences, Monash
University (Jan-Dec 2006).
A/Prof Sally Green, Dr Denise O’Connor, A/Prof
Neil Spike, A/Prof Peter Schattner
Dr Simon French, Ms Jo McKenzie, Prof Jeremy Grimshaw,
Dr Jill Francis, Prof Susan Michie
firstname.lastname@example.org; phone: 03 9903 0366.