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Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews

Overview of attention for article published in Implementation Science, March 2016
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (95th percentile)
  • High Attention Score compared to outputs of the same age and source (99th percentile)

Citations

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191 Dimensions

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Title
Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews
Published in
Implementation Science, March 2016
DOI 10.1186/s13012-016-0396-4
Pubmed ID
Authors

Rosa Lau, Fiona Stevenson, Bie Nio Ong, Krysia Dziedzic, Shaun Treweek, Sandra Eldridge, Hazel Everitt, Anne Kennedy, Nadeem Qureshi, Anne Rogers, Richard Peacock, Elizabeth Murray

Abstract

This study is to identify, summarise and synthesise literature on the causes of the evidence to practice gap for complex interventions in primary care. This study is a systematic review of reviews. MEDLINE, EMBASE, CINAHL, Cochrane Library and PsychINFO were searched, from inception to December 2013. Eligible reviews addressed causes of the evidence to practice gap in primary care in developed countries. Data from included reviews were extracted and synthesised using guidelines for meta-synthesis. Seventy reviews fulfilled the inclusion criteria and encompassed a wide range of topics, e.g. guideline implementation, integration of new roles, technology implementation, public health and preventative medicine. None of the included papers used the term "cause" or stated an intention to investigate causes at all. A descriptive approach was often used, and the included papers expressed "causes" in terms of "barriers and facilitators" to implementation. We developed a four-level framework covering external context, organisation, professionals and intervention. External contextual factors included policies, incentivisation structures, dominant paradigms, stakeholders' buy-in, infrastructure and advances in technology. Organisation-related factors included culture, available resources, integration with existing processes, relationships, skill mix and staff involvement. At the level of individual professionals, professional role, underlying philosophy of care and competencies were important. Characteristics of the intervention that impacted on implementation included evidence of benefit, ease of use and adaptability to local circumstances. We postulate that the "fit" between the intervention and the context is critical in determining the success of implementation. This comprehensive review of reviews summarises current knowledge on the barriers and facilitators to implementation of diverse complex interventions in primary care. To maximise the uptake of complex interventions in primary care, health care professionals and commissioning organisations should consider the range of contextual factors, remaining aware of the dynamic nature of context. Future studies should place an emphasis on describing context and articulating the relationships between the factors identified here. PROSPERO CRD42014009410.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 323 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 2 <1%
United Kingdom 2 <1%
Switzerland 1 <1%
Germany 1 <1%
Belgium 1 <1%
Portugal 1 <1%
Unknown 315 98%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 52 16%
Student > Master 52 16%
Researcher 50 15%
Student > Doctoral Student 32 10%
Student > Bachelor 21 7%
Other 81 25%
Unknown 35 11%
Readers by discipline Count As %
Medicine and Dentistry 100 31%
Nursing and Health Professions 54 17%
Social Sciences 31 10%
Psychology 31 10%
Business, Management and Accounting 13 4%
Other 38 12%
Unknown 56 17%

Attention Score in Context

This research output has an Altmetric Attention Score of 56. 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 09 December 2020.
All research outputs
#430,578
of 16,575,021 outputs
Outputs from Implementation Science
#57
of 1,545 outputs
Outputs of similar age
#11,150
of 267,970 outputs
Outputs of similar age from Implementation Science
#1
of 13 outputs
Altmetric has tracked 16,575,021 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,545 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.0. This one has done particularly well, scoring higher than 96% 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 267,970 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 95% of its contemporaries.
We're also able to compare this research output to 13 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 99% of its contemporaries.