Published September 22, 2022 | Version v1
Proposal Open

Tailored strategies to address determinants of practice

Creators

  • 1. School of Public Health, University College Cork
  • 2. School of Medicine, School of Psychology. National University of Ireland, Galway
  • 3. Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, 98101, USA
  • 4. Center for Mental Health Services Research, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, Missouri, USA;Division of Infectious Diseases, John T. Milliken Department of Medicine, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA; Center for Dissemination and Implementation, Institute for Public Health, Washington University in St. Louis, St. Louis, Missouri, USA
  • 5. Dept. of General Practice and Health Services Research, University Hospital Heidelberg
  • 6. Norwegian Institute of Public Health
  • 7. School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, the University of Newcastle, Callaghan, NSW, Australia

Description

Background

There are often gaps between what is recommended in guidelines and what health professionals do and service users receive. Implementation strategies, as distinct from EBIs, are “methods or techniques used to enhance the adoption, implementation, and sustainment of a clinical program or practice”. Although descriptions and applications of the process of tailoring implementation strategies vary, tailoring has generally been described as a prospective process for selecting and modifying strategies to address contextual determinants of implementation in an effort to increase implementation success. This review updates a Cochrane review of the effects of tailored strategies originally completed in 2005 and subsequently updated in 2010 and 2015. The 2015 review identified 32 studies and reported a small to moderate effect compared to no strategy or a non-tailored strategy Since the publication of the last revision of this review, several new studies of tailored strategies have been published. Consequently, there may be additional evidence on the effectiveness of tailoring or on how it can be undertaken most effectively. Since tailoring implementation strategies is increasingly advised as an approach for selecting and modifying strategies, we feel it important to undertake an update of this review.

 

Objectives

We will address the same two questions considered in the previous versions of the review:

  • Are tailored strategies effective in improving professional practice?
  • Are tailored strategies effective in improving healthcare outcomes?

 

Search methods

We will search RCTs and cluster RCTs on CENTRAL, CINAHL, Embase, MEDLINE, BNI, and grey literature sources, along with three trial registers.

 

Selection criteria

We will include studies evaluating strategies “to improve professional practice that are planned, taking account of prospectively identified determinants of practice”.  The strategy must target healthcare teams or individuals.  The identification of determinants must have been undertaken before the design and delivery of the strategy. Outcomes must include measures of professional practice, patient healthcare outcomes or measures of adverse effects.

 

Data collection and analysis

At least two authors will perform title and abstract screening and full texts, extract data, and assess risk of bias. We will assess effects on professional practice, patient healthcare outcomes or measures of adverse effects. We will assess heterogeneity, sensitivity, and undertake meta-analysis where appropriate.

 

Main results

Publication is anticipated Q4 2023.

Notes

Funded by a Health Research Board Research Leader award held by Sheena McHugh (HRB-RL-2020-004)

Files

Tailored strategies_review update_protocol_clean_v220922.pdf

Files (391.4 kB)