Tailored interventions to address determinants of practice

Richard Baker, Janette Camosso-Stefinovic, Clare Gillies, Elizabeth J Shaw, Francine Cheater, Signe Flottorp, Noelle Robertson, Michel Wensing, Michelle Fiander, Martin P Eccles, Maciek Godycki-Cwirko, Jan van Lieshout, Cornelia Jaeger

Research output: Contribution to journalArticlepeer-review

317 Citations (Scopus)

Abstract

Plain language summary:
Tailored interventions to change professional practice are interventions planned following an investigation into the factors that explain current professional practice and any reasons for resisting new practice. These factors are referred to using various terms, including barriers, enablers, obstacles, and facilitators; in this review we use the term determinants of practice to include all such factors. The determinants may vary in different healthcare settings, groups of healthcare professionals, or clinical tasks. It is widely assumed that efforts to change professional practice have a lower likelihood of success unless these determinants are identified and taken into account.

In a previous review, we included 26 studies and we concluded that tailoring can change professional practice. However, more studies of tailoring have been published and therefore we have incorporated the new studies into an update of the review.

We have included 32 studies in the new review. The findings continue to indicate that tailored interventions can change professional practice, although they are not always effective and, when they are, the effect is small to moderate. There is insufficient evidence on the most effective approaches to tailoring, including how determinants should be identified, how decisions should be made on which determinants are most important to address, and how interventions should be selected to account for the important determinants. In addition, there is no evidence about the cost-effectiveness of tailored interventions compared to other interventions to change professional practice. Therefore, future research studies should seek to develop and evaluate more systematic approaches to tailoring.
Original languageEnglish
Article numberCD005470
JournalThe Cochrane Library
Issue number4
DOIs
Publication statusPublished - 2015

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