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Tailored interventions to address determinants of practice

Overview of attention for article published in Cochrane database of systematic reviews, April 2015
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (87th percentile)
  • Above-average Attention Score compared to outputs of the same age and source (55th percentile)

Mentioned by

blogs
1 blog
policy
1 policy source
twitter
2 tweeters

Citations

dimensions_citation
237 Dimensions

Readers on

mendeley
406 Mendeley
citeulike
1 CiteULike
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Title
Tailored interventions to address determinants of practice
Published in
Cochrane database of systematic reviews, April 2015
DOI 10.1002/14651858.cd005470.pub3
Pubmed ID
Authors

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 Jäger

Abstract

Tailored intervention strategies are frequently recommended among approaches to the implementation of improvement in health professional performance. Attempts to change the behaviour of health professionals may be impeded by a variety of different barriers, obstacles, or factors (which we collectively refer to as determinants of practice). Change may be more likely if implementation strategies are specifically chosen to address these determinants. To determine whether tailored intervention strategies are effective in improving professional practice and healthcare outcomes. We compared interventions tailored to address the identified determinants of practice with either no intervention or interventions not tailored to the determinants. We conducted searches of The Cochrane Library, MEDLINE, EMBASE, PubMed, CINAHL, and the British Nursing Index to May 2014. We conducted a final search in December 2014 (in MEDLINE only) for more recently published trials. We conducted searches of the metaRegister of Controlled Trials (mRCT) in March 2013. We also handsearched two journals. Cluster-randomised controlled trials (RCTs) of interventions tailored to address prospectively identified determinants of practice, which reported objectively measured professional practice or healthcare outcomes, and where at least one group received an intervention designed to address prospectively identified determinants of practice. Two review authors independently assessed quality and extracted data. We undertook qualitative and quantitative analyses, the quantitative analysis including two elements: we carried out 1) meta-regression analyses to compare interventions tailored to address identified determinants with either no interventions or an intervention(s) not tailored to the determinants, and 2) heterogeneity analyses to investigate sources of differences in the effectiveness of interventions. These included the effects of: risk of bias, use of a theory when developing the intervention, whether adjustment was made for local factors, and number of domains addressed with the determinants identified. We added nine studies to this review to bring the total number of included studies to 32 comparing an intervention tailored to address identified determinants of practice to no intervention or an intervention(s) not tailored to the determinants. The outcome was implementation of recommended practice, e.g. clinical practice guideline recommendations. Fifteen studies provided enough data to be included in the quantitative analysis. The pooled odds ratio was 1.56 (95% confidence interval (CI) 1.27 to 1.93, P value < 0.001). The 17 studies not included in the meta-analysis had findings showing variable effectiveness consistent with the findings of the meta-regression. Despite the increase in the number of new studies identified, our overall finding is similar to that of the previous review. Tailored implementation can be effective, but the effect is variable and tends to be small to moderate. The number of studies remains small and more research is needed, including trials comparing tailored interventions to no or other interventions, but also studies to develop and investigate the components of tailoring (identification of the most important determinants, selecting interventions to address the determinants). Currently available studies have used different methods to identify determinants of practice and different approaches to selecting interventions to address the determinants. It is not yet clear how best to tailor interventions and therefore not clear what the effect of an optimally tailored intervention would be.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 406 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 3 <1%
Canada 1 <1%
Colombia 1 <1%
South Africa 1 <1%
Denmark 1 <1%
Spain 1 <1%
United States 1 <1%
Unknown 397 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 75 18%
Researcher 59 15%
Student > Ph. D. Student 53 13%
Student > Postgraduate 32 8%
Student > Bachelor 31 8%
Other 99 24%
Unknown 57 14%
Readers by discipline Count As %
Medicine and Dentistry 138 34%
Nursing and Health Professions 67 17%
Social Sciences 29 7%
Psychology 29 7%
Pharmacology, Toxicology and Pharmaceutical Science 12 3%
Other 42 10%
Unknown 89 22%

Attention Score in Context

This research output has an Altmetric Attention Score of 12. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 September 2020.
All research outputs
#1,700,224
of 15,906,905 outputs
Outputs from Cochrane database of systematic reviews
#4,248
of 11,323 outputs
Outputs of similar age
#30,467
of 237,832 outputs
Outputs of similar age from Cochrane database of systematic reviews
#112
of 251 outputs
Altmetric has tracked 15,906,905 research outputs across all sources so far. Compared to these this one has done well and is in the 89th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 11,323 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 23.6. This one has gotten more attention than average, scoring higher than 62% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 237,832 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 87% of its contemporaries.
We're also able to compare this research output to 251 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 55% of its contemporaries.