Education This word cloud represents the roles and growing responsibilities of the school nurse.
The overarching topic involves providing health-related evidence effectively to patients and clinicians. Specifically, we were asked to examine various strategies for communicating and disseminating evidence to these target audiences. As discussed more fully later, communication and dissemination lies on a continuum that ends with effective adoption and implementation.
Finally, we were charged with exploring ways to explain uncertainty in evidence about preventive health and health care services. Some of our findings are pertinent only to one Key Question KQ ; other findings can inform and provide context for two or all three KQs.
In this final section of the report, we first discuss each Key Question individually in terms of principal findings, limitations and applicability, and future research. In the last part of this chapter, we discuss some issues that cut across all three KQs, noting where important synergies and differences arise, and end with implications.
Communication Strategies Key Findings and Strength of Evidence We found seven unique randomized trials RCTs examining the effects of alternate communication strategies; these approaches entail tailoring messages to individuals, targeting messages to audience segments, using narratives to convey messages, and using framing to convey messages to various end-users.
Overall, the strength of the evidence on communication strategies was poor. Specifically, the trial testing various approaches to framing against using narratives i.
Two trials comparing framing and targeting both showed that loss framed messages used in combination with targeting more broadly i. Findings in Relationship to What Is Already Known Investigators used different strategies to convey evidence frequently presented as risk and benefit information to promote informed choices among study participants.
The literature suggests that how information is presented can influence health related decisions. We are unable to determine at this time which, if any, of the four strategies are better than any other, or whether or not a particular combination of strategies is better than a single strategy.
It may be most prudent to consider using multiple strategies since they are not mutually exclusive. Nonetheless, our review revealed some intriguing insights about the potential comparative strengths of the four strategies that add to the existing literature. The preponderance of the literature on framing focuses on gain and loss framed messages.
It supports that loss-framed messages are more effective than gain frame messages because detection behaviors are perceived as risky in the short term because of their ability to detect disease.
However, all three studies used framing in conjunction with another strategy targeting and narratives. The included KQ 1 trials chiefly involved targeting and tailoring strategies.
Investigators hypothesized that tailored interventions would be more effective in promoting screening relative to targeted interventions because they are more personalized.
We are aware of at least one study that did not meet our criteria for evidence that quantified the contribution of individual tailoring over groups targeting.
Another trial expected the combination of tailoring and targeting would be more effective than targeting alone, but this was not the case.
The communication strategies we examined are rooted in theory. Framing and targeting may influence beliefs about illness severity and likelihood, which are thought to motivate health behavior change.
Two studies examined mediating variables directly. One study found that mediating variables were not influenced by the framing and targeting interaction.
Instead, they focused on the message framing gain versus loss. Nonetheless, the results suggest that the loss framed and narrative approach was more persuasive in promoting self-reported likelihood of screening in an immediate posttest. A recent review of the literature found that numeric information appears to improve understanding of risks and benefits relative to non-numeric presentation; presenting both numeric and non-numeric information when possible may be best practice.
The strategies are not necessarily substitutes for each other, but are complementary. Using more than one strategy at a time could be synergistic.
Thus, one should consider whether looking at comparative effectiveness of two strategies is the most appropriate analytic approach.
Mode of Communication Most studies delivered the interventions via postal mail or in person. One trial augmented a targeted and tailored intervention by using lay health workers to communicate the information in the intervention to the target audience.
In such an approach, communication and dissemination strategies were arguably comingled. Using individuals to help to communicate the messages also did not appear to make any difference in the main outcomes of this trial, even though interpersonal communication is generally viewed as the best approach for communication but also the most expensive.
Advances in technology have made it easier to tailor interventions based on information provided by an individual. Data for tailoring the interventions in the trials were derived from medical record data and from baseline surveys of study participants.Mar 29, · Dissemination Strategies.
Dissemination is the targeted distribution of information and intervention materials to a specific public health or clinical practice audience.
The intent is to spread knowledge and the associated evidence-based interventions. 4,5 Dissemination occurs through a variety of channels, social contexts, and settings. Evidence dissemination has several very broad . Disseminating Evidence -Based Practice Projects: Abstracts, Posters, and Presentations Patricia McCartney PhD RNC FAAN Director of Nursing Research.
Evidence-based practice is defined as “a problem-solving approach to practice that involves the conscientious use of current best evidence in making decisions about patient care.” 1 Evidence-based practice involves a systematic search for the most relevant evidence, as well as critical appraisal of this evidence to answer a clinical.
Dissemination is the purposive distribution of information and intervention materials to a specific public health or clinical practice audience. The intent is to spread information and the associated evidence-based interventions.
Research on dissemination addresses how information about health. approaches for disseminating evidence from those who develop it to those who are expected to use it.
Third, it examines the comparative effectiveness of various ways of communicating uncertainty associated with health-related evidence to different target audiences, including evidence.
Objectives. We explored the effect of disseminating evidence-based guidelines that promote physical activity on US health department organizational practices in the United States. Methods. We implemented a quasi-experimental design to examine changes in the dissemination of suggested guidelines to.