Cluster Randomized Trial of an Active, Multifaceted Educational Intervention Based on the WHO Reproductive Health Library to Improve Obstetric Practices

Background: Evidence-based practice (EBP) can provide appropriate care for women and their babies; however implementation of EBP requires health professionals to have access to knowledge, the ability to interpret health care information and then strategies to apply care. The aim of this survey was to assess current knowledge of evidence-based practice, information seeking practices, perceptions and potential enablers and barriers to clinical practice change among maternal and infant health practitioners in South East Asia.

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“…These difficulties are greater for health workers outside research settings involved mainly in routine care [13]. …”

Section: Discussionmentioning

confidence: 99%

Survey of knowledge and perception on the access to evidence-based practice and clinical practice change among maternal and infant health practitioners in South East Asia

Martis

Crowther

2008

BMC Pregnancy Childbirth

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“…Our results are particularly relevant to the planning of implementation research studies, where estimated ICCs for both process and outcome variables are often required. Moreover, our results are relevant to settings in developing nations, where there is currently a pressing need for implementation research to identify effective strategies for bringing policies and practices in line with the latest research evidence 23,24 …”

Section: Introductionmentioning

confidence: 95%

Intracluster correlation coefficients from the 2005 WHO Global Survey on Maternal and Perinatal Health: implications for implementation research

Taljaard

Donner

Villar

et al. 2008

Paediatric Perinatal Epid

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Cluster-based studies involving aggregate units such as hospitals or medical practices are increasingly being used in healthcare evaluation. An important characteristic of such studies is the presence of intracluster correlation, typically quantified by the intracluster correlation coefficient (ICC). Sample size calculations for cluster-based studies need to account for the ICC, or risk underestimating the sample size required to yield the desired levels of power and significance. In this article, we present values for ICCs that were obtained from data on 97,095 pregnancies and 98,072 births taking place in a representative sample of 120 hospitals in eight Latin American countries. We present ICCs for 86 variables measured on mothers and newborns from pregnancy to the time of hospital discharge, including 'process variables' representing actual medical care received for each mother and newborn. Process variables are of primary interest in the field of implementation research. We found that overall, ICCs ranged from a minimum of 0.0003 to a maximum of 0.563 (median 0.067). For maternal and newborn outcome variables, the median ICCs were 0.011 (interquartile range 0.007-0.037) and 0.054 (interquartile range 0.013-0.075) respectively; however, for process variables, the median was 0.161 (interquartile range 0.072-0.328). Thus, we confirm previous findings that process variables tend to have higher ICCs than outcome variables. We demonstrate that ICCs generally tend to increase with higher prevalences (close to 0.5). These results can help researchers calculate the required sample size for future research studies in maternal and perinatal health.

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“…But to achieve this, just making practitioners aware of the new evidence is not enough. 5,6 Qualitative research and reviews have suggested the following steps. First, clinicians need to become aware of, and knowledgeable about, the new evidence.…”

Section: How Does One Achieve Wide Implementation Of New Level-i/a Evmentioning

confidence: 99%

“…12 months or more) are the keys to successfully changing physician behaviour. 5 Active participation in an ongoing review, modification of their work under careful supervision, and guidance by respected local leaders seems to be one of the most effective combinations to change physician behavior. 8 Selection and training of opinion leaders in each hospital or office, prospective identification of barriers to implementation, consideration of patient opinion, interactive workshops, audit based on evaluation methods, one-on-one face-to-face academic sessions, reminders, quality improvement, intensive targeted feedback, printed educational materials, as well as combinations of these (multifaceted strategies) have all been shown to help in implementing changes in practice in obstetrics.…”

Section: How Does One Achieve Wide Implementation Of New Level-i/a Evmentioning

confidence: 99%

Best management of threatened preterm labour – how to implement the evidence into practice

Berghella¹

2010

BJOG

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Cluster Randomized Trial of an Active, Multifaceted Educational Intervention Based on the WHO Reproductive Health Library to Improve Obstetric Practices

Cited by 4 publications

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Survey of knowledge and perception on the access to evidence-based practice and clinical practice change among maternal and infant health practitioners in South East Asia

Survey of knowledge and perception on the access to evidence-based practice and clinical practice change among maternal and infant health practitioners in South East Asia

Intracluster correlation coefficients from the 2005 WHO Global Survey on Maternal and Perinatal Health: implications for implementation research

Best management of threatened preterm labour – how to implement the evidence into practice

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