Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Implementation of evidence-informed practice through central network actors; a case study of three public health units in Canada

Authors: Reza Yousefi Nooraie, Alexandra Marin, Robert Hanneman, Lynne Lohfeld, Maureen Dobbins

Published in: BMC Health Services Research | Issue 1/2017

Login to get access

Abstract

Background

Workforce development is an important aspect of evidence-informed decision making (EIDM) interventions. The social position of individuals in formal and informal social networks, and the relevance of formal roles in relation to EIDM are important factors identifying key EIDM players in public health organizations. We assessed the role of central actors in information sharing networks in promoting the adoption of EIDM by the staff of three public health units in Canada, over a two-year period during which an organization-wide intervention was implemented.

Methods

A multi-faceted and tailored intervention to train select staff applying research evidence in practice was implemented in three public health units in Canada from 2011 to 2013. Staff (n = 572) were asked to identify those in the health unit whom they turned to get help using research in practice, whom they considered as experts in EIDM, and friends. We developed multi-level linear regression models to predict the change in EIDM behavior scores predicted by being connected to peers who were central in networks and were engaged in the intervention.

Results

Only the group of highly engaged central actors who were connected to each other, and the staff who were not engaged in the intervention but were connected to highly engaged central actors significantly improved their EIDM behavior scores. Among the latter group, the staff who were also friends with their information sources showed a larger improvement in EIDM behavior.

Conclusions

If engaged, central network actors use their formal and informal connections to promote EIDM. Central actors themselves are more likely to adopt EIDM if they communicate with each other. These social communications should be reinforced and supported through the implementation of training interventions as a means to promoting EIDM.
Appendix
Available only for authorised users
Literature
1.
Brownson R, Reis R, Allen P, Duggan K, Fields R, Stamatakis K, Erwin P. Understanding administrative evidence-based practices: findings from a survey of local health department leaders. Am J Prev Med. 2014;46:49–57.CrossRefPubMedPubMedCentral
2.
Brownson R, Allen P, Duggan K, Stamatakis K, Erwin P. Fostering more-effective public health by identifying administrative evidence-based practices: a review of the literature. Am J Prev Med. 2012;43:309–19.CrossRefPubMedPubMedCentral
3.
Orton L, Lloyd-Williams F, Taylor-Robinson D, O’Flaherty M, Capewell S. The use of research evidence in public health decision making processes: systematic review. PLoS One. 2011;6:e21704.CrossRefPubMedPubMedCentral
4.
Maxwell M, Adily A, Ward J. Promoting evidence-based practice in population health at the local level: a case study in workforce capacity development. Aust Heal Rev. 2007;31:422–9.CrossRef
5.
Légaré F, Ratté S, Gravel K, Graham ID. Barriers and facilitators to implementing shared decision-making in clinical practice: update of a systematic review of health professionals’ perceptions. Patient Educ Couns. 2008;73:526–35.CrossRefPubMed
6.
Oxman A, Thomson M, Davis D, Hayes J. No magic bullets: a systematic review of 102 trials of interventions to improve professional practice. CMAJ. 1995;153:1423–31.PubMedPubMedCentral
7.
Dobbins M, Davies B, Danseco E, Edwards N, Virani T. Changing nursing practice: evaluating the usefulness of a best-practice guideline implementation toolkit. Nurs Leadersh (Tor Ont). 2005;18:34–45.CrossRef
8.
Baker R, Camosso-Stefanovic J, Gilliss C, Shaw E, Cheater F, Flottorp S, Robertson N. Tailored interventions to overcome identified barriers to change: Effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2010;3:CD005470.
9.
10.
Mehra A, Dixon AL, Robertson B. The social network ties of group leaders: implications for group performance and leader reputation. Organ Sci. 2006;17:64–79.CrossRef
11.
Ibarra H, Andrews S. Power, social influence, and sense making: effects of network centrality and proximity on employee perceptions. Adm Sci Q. 1993;38:277–303.CrossRef
12.
Valente T, Pumpuang P. Identifying opinion leaders to promote behavior change. Heal Educ Behav. 2007;34:881–96.CrossRef
13.
Majumdar S, Tsuyuki R, McAlister F. Impact of opinion leader? endorsed evidence summaries on the quality of prescribing for patients with cardiovascular disease: a randomized controlled trial. Am Hear J. 2007;153:22. e1222.e8.CrossRef
14.
Rogers E. Diffusion of innovations. 4th ed. New York: The Free Press; 2003.
15.
Kelly J, Amirkhanian Y, Kabakchieva E, Vassileva S, McAuliffe T, DiFranceisco W. Prevention of HIV and sexually transmitted diseases in high risk social networks of young Roma (Gypsy) men in Bulgaria: randomised controlled trial. BMJ. 2006;333:1098–101.CrossRefPubMedPubMedCentral
16.
Valente T, Gallaher P, Mouttapa M. Using social networks to understand and prevent substance use: a transdisciplinary perspective. Subst Use Misuse. 2004;39:1685–712.CrossRefPubMed
17.
Flodgren G, Parmelli E, Doumit G, Gattellari M, O’Brien M, Grimshaw J, Eccles M. Local opinion leaders: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2011;8:CD000125.
18.
Grimshaw JM, Eccles MP, Greener J, Maclennan G, Ibbotson T, Kahan JP, Sullivan F. Is the involvement of opinion leaders in the implementation of research findings a feasible strategy? Implement Sci. 2006;1:3.CrossRefPubMedPubMedCentral
19.
Iyengar R, Van den Bulte C, Valente TW. Opinion leadership and social contagion in new product diffusion. Mark Sci. 2011;30:195–212.CrossRef
20.
French J, Raven B. The bases of social power. In: Cartwright D, editor. Studies in social power. Ann Arbor: Institute for Social Research; 1959. p. 150–67.
21.
Erickson B. The relational basis of attitudes. In Social structures: A network approach. Edited by Wellman B, Berkowitz S. New York: Cambridge University Press; 1988:99–121.
22.
Graham I, Logan J, Harrison M, Straus S, Tetroe J, Craswell W, Robinson N. Lost in knowledge translation: time for a map? J Contin Educ Health Prof. 2006;26:13–24.CrossRefPubMed
23.
Marsden PV, Friedkin NE. Network studies of social influence. Sociol Methods Res. 1993;22:127–51.CrossRef
24.
Bandura A. Social learning theory. Englewood Cliffs: Prentice-Hall; 1977.
25.
Yost J, Dobbins M, Traynor R, DeCorby K, Workentine S, Greco L. Tools to support evidence-informed public health decision making. BMC Public Health. 2014;14:728.CrossRefPubMedPubMedCentral
26.
Dobbins M, Traynor R, Greco L. Building capacity for evidence-informed decision making in Canadian public health. Implement Sci. 2015;10 Suppl 1:A21.CrossRefPubMedCentral
27.
Ciliska D, Thomas H, Buffett C. An introduction to evidence-based public health and a compendium of critical appraisal tools for public health practice (revised). Ontario: Hamilton; 2012.
28.
Mazurek Melnyk B, Fineout-Overholt E, Mays M. The evidence-based practice beliefs and implementation scales: psychometric properties of two new instruments. Worldviews Evidence-Based Nurs. 2008;5:208–16.CrossRef
29.
Dillman D. Mail and internet surveys: the tailored design method. 2nd ed. New York: Wiley; 2007.
30.
StataCorp. Stata statistical software: release 12. 2011.
31.
McAllister D. Affect-and cognition-based trust as foundations for interpersonal cooperation in organizations. Acad Manag J. 1995;38:24–59.CrossRef
32.
Gibbons DE. Friendship and advice networks in the context of changing professional values. Adm Sci Q. 2004;49:238–62.
33.
Lewis J, Weigert A. Trust as a social reality. Soc Forces. 1985;63:967–85.CrossRef
34.
Mayer R, Davis J, Schoorman F. An integrative model of organizational trust. Acad Manag Rev. 1995;20:709–34.
35.
Wasserman S, Faust K. Social network analysis: methods and applications. Cambridge: Cambridge University Press; 1994.CrossRef
36.
Valente T, Davis R. Accelerating the diffusion of innovations using opinion leaders. Ann Am Acad. 1999;566:55–67.CrossRef
37.
Childers T. Assessment of the psychometric properties of an opinion leadership scale. J Mark Res. 1986;23:184–8.CrossRef
38.
Van Eck P, Jager W, Leeflang P. Opinion leaders’ role in innovation diffusion: a simulation study. J Prod Innov Manag. 2011;28:187–203.CrossRef
39.
Gibson D. Concurrency and commitment: network scheduling and its consequences for diffusion. J Math Sociol. 2005;29:295–323.CrossRef
40.
Myers JH, Robertson TS. Dimensions of opinion leadership. J Mark Res. 1972;9:41–6.CrossRef
41.
Yousefi Nooraie R, Lohfeld L, Marin A, Hanneman R, & Dobbins M. Informing the implementation of evidence-informed decision making interventions using a social network analysis perspective; a mixed-methods study. BMC Health Services Research, 2017;17(1):122.
42.
Yousefi-Nooraie R, Dobbins M, Marin A, Hanneman R, Lohfeld L. The evolution of social networks through the implementation of evidence-informed decision-making interventions: a longitudinal analysis of three public health units in Canada. Implement Sci. 2015;10:166.CrossRefPubMedPubMedCentral
43.
Wenger E, McDermott R, Snyder W. Cultivating communities of practice. Boston: Harvard Business School Press; 2002.
44.
Estabrooks C, Thompson D, Lovely J, Hofmeyer A. A guide to knowledge translation theory. J Contin Educ Health Prof. 2006;26:25–36.CrossRefPubMed
45.
Friedkin N, Johnsen E. Social influence networks and opinion change. Adv Gr Process. 1999;16:1–29.
46.
47.
Snijders TAB, Van de Bunt GG, Steglich CEG, van der Bunt G. Introduction to stochastic actor-based models for network dynamics. Soc Networks. 2010;32:44–60.CrossRef
48.
Steglich C, Snijders TAB, Pearson M. Dynamic networks and behavior: separating selection from influence. Sociol Methodol. 2010;40:329–93.CrossRef
Metadata
Title
Implementation of evidence-informed practice through central network actors; a case study of three public health units in Canada
Authors
Reza Yousefi Nooraie
Alexandra Marin
Robert Hanneman
Lynne Lohfeld
Maureen Dobbins
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2147-x

Other articles of this Issue 1/2017

BMC Health Services Research 1/2017 Go to the issue

Research article

Cost of physician-led home visit care (Zaitaku care) compared with hospital care at the end of life in Japan

Research article

Health facility and skilled birth deliveries among poor women with Jamkesmas health insurance in Indonesia: a mixed-methods study

Research article

Validation of an instrument to assess the delivery of patient-centred care to people with intellectual disabilities as perceived by professionals

Research article

Variability in market uptake of psychotropic medications in Europe reflects cultural diversity

Research article

Burnout among workers in emergency Departments in Palestinian hospitals: prevalence and associated factors

Research article

Resource Use and Disease Course in dementia - Nursing Home (REDIC-NH), a longitudinal cohort study; design and patient characteristics at admission to Norwegian nursing homes