Background: The current state of evidence regarding measures that assess evidence-informed decision-making (EIDM) competence attributes (i.e., knowledge, skills, attitudes/beliefs, behaviours) among nurses is unknown. This systematic review provides a narrative synthesis of the psychometric properties and general characteristics of EIDM competence attribute measures in nursing. Methods: The search strategy included online databases, hand searches, grey literature, and content experts. To align with the Cochrane Handbook of Systematic Reviews, psychometric outcome data (i.e., acceptability, reliability, validity) were extracted in duplicate, while all remaining data (i.e., study and measure characteristics) were extracted by one team member and checked by a second member for accuracy. Acceptability data was defined as measure completion time and overall rate of missing data. The Standards for Educational and Psychological Testing was used as the guiding framework to define reliability, and validity evidence, identified as a unified concept comprised of four validity sources: content, response process, internal structure and relationships to other variables. A narrative synthesis of measure and study characteristics, and psychometric outcomes is presented across measures and settings. Results: A total of 5883 citations were screened with 103 studies and 35 unique measures included in the review. Measures were used or tested in acute care (n = 31 measures), public health (n = 4 measures), home health (n = 4 measures), and long-term care (n = 1 measure). Half of the measures assessed a single competence attribute (n = 19; 54.3%). Three measures (9%) assessed four competence attributes of knowledge, skills, attitudes/beliefs and behaviours. Regarding acceptability, overall missing data ranged from 1.6-25.6% across 11 measures and completion times ranged from 5 to 25 min (n = 4 measures). Internal consistency reliability was commonly reported (21 measures), with Cronbach's alphas ranging from 0.45-0.98. Two measures reported four sources of validity evidence, and over half (n = 19; 54%) reported one source of validity evidence.
BackgroundThere are growing professional expectations for nurses to engage in and develop competence in evidence-informed decision-making (EIDM) due to opportunities for improved client and community outcomes and provision of the highest quality of care. However, EIDM is underdeveloped, with low implementation rates among nurses. The use of indicators to assess EIDM performance has potential to encourage nurses’ engagement in EIDM through competence recognition and support assessment of strengths and competency gaps for individual nurses and organizations. Currently, the state of evidence regarding measures that assess EIDM competence attributes (i.e., knowledge, skills, beliefs/values, behaviors) among nurses is unknown. This systematic review aims to address this gap through a narrative synthesis of the characteristics and psychometric properties of EIDM competence measures.MethodsThe search strategy, developed in consultation with a Health Sciences Librarian, consists of online databases, contacting experts, hand searching reference lists, key journals, websites, conference proceedings, and grey literature. Studies will be included if the following criteria are met: (1) sample includes practicing nurses and data for nurses are reported separately; (2) conducted in any healthcare setting; (3) quantitative or mixed-methods design; (4) reports use or testing of a measure assessing EIDM competence attributes (i.e., knowledge, skills, attitudes/values, and/or behaviors); and (5) published in English. Screening will be conducted independently by two reviewers using a two-stage process: (1) title and abstract level; and (2) full-text level. Data extraction of study characteristics (e.g., sample, setting) will be conducted by a single reviewer and checked for accuracy by a second reviewer. Psychometric properties of acceptability, reliability, and validity evidence for each measure will be independently extracted by two reviewers. Data on measures will be synthesized narratively according to acceptability, number of validity evidence sources established, and reliability of scores. Data pertaining to population and healthcare setting will also be reported for each measure.DiscussionThis systematic review will provide a current understanding about the state of evidence with respect to EIDM competence measures in nursing to assist in determining potentially relevant and robust measures for use in different nursing practice settings.Systematic review registrationProtocol registered in PROSPERO Registration #: CRD42018088754Electronic supplementary materialThe online version of this article (10.1186/s13643-018-0849-8) contains supplementary material, which is available to authorized users.
Objective This study examined the associations between public health engagement (PHE) in school-based substance use prevention programs and student substance use. For the purposes of this study, PHE refers to any form of collaboration between the local government public health agency and the school to promote the physical and mental health of students. Methods Data for this study were collected from the Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking and Sedentary behaviour (COMPASS) study during the 2018/2019 data collection year. Multilevel logistic regression was used to analyze the associations between PHE and student substance use. Results Data from 84 schools and 42,149 students were included; 70% of schools had PHE in substance use prevention programs. PHE in substance use prevention appears to have had no significant impact on student substance use in our models. When PHE was divided into five methods of engagement, it was found that when public health solved problems jointly with schools, the odds of a student using alcohol or cannabis significantly increased. When schools were split into low- and high-use schools for each substance measured, some methods of PHE significantly decreased the odds of cannabis and cigarette use in high-use schools and significantly increased the odds of alcohol and cannabis use in low-use schools. Conclusion This study highlights the need to develop better partnerships and collaborations between public health and schools, and the importance of ensuring that school-based substance use prevention programs are evidence-based and tailored to the specific needs of schools and students.
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