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首页> 外文期刊>Implementation Science >A KT intervention including the evidence alert system to improve clinician’s evidence-based practice behavior—a cluster randomized controlled trial
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A KT intervention including the evidence alert system to improve clinician’s evidence-based practice behavior—a cluster randomized controlled trial

机译：一项包括证据警报系统的KT干预措施，旨在改善临床医生基于证据的实践行为-一项集群随机对照试验

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Background It 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. Methods This 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. Results The 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?
机译：背景技术难以促进专职医疗专业人员（AHP）之间的研究利用。现在建议采用量身定制的多方面知识翻译（KT）策略，但实施起来会占用大量资源。雇主需要有效的KT解决方案，但鲜为人知。使用在线KT工具进行的多方面KT策略的影响和可行性，其与AHP的有效性以及对循证实践（EBP）决策行为的影响。该研究的目的是衡量包括定制KT工具在内的多方面KT干预措施的有效性，以改变EBP行为，AHP的知识和态度。方法这是一项在澳大利亚社区为基础的脑瘫服务机构中进行的评估者盲目的，整群随机对照试验。将来自四个地区的135名AHP（物理治疗师，职业治疗师，言语病理学家，心理学家和社会工作者）随机分组（n == 4）到KT干预组（n == 73 AHP）或对照组（n ？=？62 AHP），由计算机生成的随机数，由独立人员隐藏在不透明的信封中。 KT干预包括为期三天的技能培训讲习班和多方面的工作场所支持以纠正障碍（有偿的EBP时间，指导，系统更改以及使用在线研究综合工具的机会）。使用目标达成量表（个人水平）测量主要结局（自我和同伴评估的EBP行为）。次要结果（知识和态度）使用考试和循证实践态度量表进行衡量。结果干预组的主要结局得分相对于对照组有所改善，但是，考虑到聚类，结果并不重要：自我评估的EBP行为[影响大小4.97（95％CI -10.47，20.41）（p？ =？0.52）];同行评等的EBP行为[影响大小5.86（95％CI -17.77，29.50）（p？=？0.62）]。检测到EBP知识有统计学上的显着改善[效应量2.97（95％CI 1.97，3.97（p？<？0.0001））。EBP态度的变化无统计学意义。结论调整聚类后，EBP行为的改善在统计学上无统计学意义。效果，但是同级评级的类似改善表明行为上有意义。集群之间观察到的行为差异很大，表明障碍评估和随后的KT干预可能需要针对组织内的亚组。试验注册已在澳大利亚新西兰临床试验注册中心注册（ ACTRN12611000529943）。

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