Opinion leaders vs audit and feedback to implement practice guidelines. Delivery after previous cesarean section

Lomas, Jonathan; Enkin, Murray; Anderson, G. Brooke; Hannah, Walter J.; Vayda, Eugene; Singer, Joel

doi:10.1001/jama.265.17.2202

Cited by 317 publications

(253 citation statements)

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“…This is consistent with previous research that has found that local opinion leaders can influence change in the clinical practices of health professionals (Lomas 1991). It is suggested that such people may perform a "sanctioning function" for new procedures (Greer 1988), or impact on peer attitudes and beliefs (Mittman et al 1992).…”

Section: Cultural and Attitudinal Changessupporting

confidence: 91%

Evidence-based practice for young people who self harm: can it be sustained and does it improve outcomes?

Einfeld¹,

Beard²,

Tobin³

et al. 2002

Aust. Health Review

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Section: Cultural and Attitudinal Changessupporting

confidence: 91%

Evidence-based practice for young people who self harm: can it be sustained and does it improve outcomes?

Einfeld¹,

Beard²,

Tobin³

et al. 2002

Aust. Health Review

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“…Social actors in a community also tend to model the behavior of others located in central positions within a network (Galaskiewiecz 1985), such as those considered to have high status, reputation, or prestige (Podolny 1993;Haveman 1993;Kimberly 1984). These findings are similar to research on the diffusion of medical innovations that emphasize the impact of initial adoption by "opinion leaders" (Soumerai et al 1998;Lomas et al 1991;Coleman, Katz and Menzel 1966). Peripheral actors may be among the first to try a new, unproven innovation, but adoption by core members will increase rates of diffusion throughout a network (Pastor, Meindl, and Hunt 1998).…”

Section: Network and Linkagesmentioning

confidence: 69%

Interventions in Organizational and Community Context: A Framework for Building Evidence on Dissemination and Implementation in Health Services Research

Mendel

Meredith

Schoenbaum

et al. 2007

Adm Policy Ment Health

322

355

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The effective dissemination and implementation of evidence-based health interventions within community settings is an important cornerstone to expanding the availability of quality health and mental health services. Yet it has proven a challenging task for both research and community stakeholders. This paper presents the current framework developed by the UCLA/RAND NIMH Center to address this research-to-practice gap by: 1) providing a theoretically-grounded understanding of the multi-layered nature of community and healthcare contexts and the mechanisms by which new practices and programs diffuse within these settings; 2) distinguishing among key components of the diffusion process-including contextual factors, adoption, implementation, and sustainment of interventions-showing how evaluation of each is necessary to explain the course of dissemination and outcomes for individual and organizational stakeholders; 3) facilitating the identification of new strategies for adapting, disseminating, and implementing relatively complex, evidence-based healthcare and improvement interventions, particularly using a community-based, participatory approach; and 4) enhancing the ability to meaningfully generalize findings across varied interventions and settings to build an evidence base on successful dissemination and implementation strategies.

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“…Similarly, physician opinion leaders have been shown to be effective in speeding adoption of clinical guidelines. [12][13][14] Understanding how physician networks are structured will provide insights into how social networks influence physicians' beliefs and behaviors and may point toward improved strategies for disseminating medical information and guidelines.…”

Section: Introductionmentioning

confidence: 99%

Factors Affecting Influential Discussions Among Physicians: A Social Network Analysis of a Primary Care Practice

Keating

Ayanian

Cleary³

et al. 2007

J GEN INTERN MED

127

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BACKGROUND: Physicians often rely on colleagues for new information and advice about the care of their patients. OBJECTIVE: Evaluate the network of influential discussions among primary care physicians in a hospitalbased academic practice. DESIGN:Survey of physicians about influential discussions with their colleagues regarding women's health issues. We used social network analysis to describe the network of discussions and examined factors predictive of a physician's location in the network. SUBJECTS:All 38 primary care physicians in a hospital-based academic practice. MEASUREMENTS:Location of physician within the influential discussion network and relationship with other physicians in the network. RESULTS:Of 33 responding physicians (response rate= 87%), the 5 reporting expertise in women's health were more likely than others to be cited as sources of influential information (odds ratio [OR] 6.81, 95% Bayesian confidence interval [CI] 2.25-23.81). Physicians caring for more women were also more often cited (OR 1.03, 95% CI 1.01-1.05 for a 1 percentage-point increase in the proportion of women patients). Influential discussions were more frequent among physicians practicing in the same clinic within the practice than among those in different clinics (OR 5.03,) and with physicians having more weekly clinical sessions (OR 1.33, 95% CI 1.15 to 1.54 for each additional session). CONCLUSIONS:In the primary care practice studied, physicians obtained information from colleagues with greater expertise and experience as well as colleagues who were accessible based on location and schedule. It may be possible to organize practices to promote more rapid dissemination of high-quality evidence-based medicine.

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Opinion leaders vs audit and feedback to implement practice guidelines. Delivery after previous cesarean section

Cited by 317 publications

References 0 publications

Evidence-based practice for young people who self harm: can it be sustained and does it improve outcomes?

Evidence-based practice for young people who self harm: can it be sustained and does it improve outcomes?

Interventions in Organizational and Community Context: A Framework for Building Evidence on Dissemination and Implementation in Health Services Research

Factors Affecting Influential Discussions Among Physicians: A Social Network Analysis of a Primary Care Practice

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