Abstract:
BACKGROUND:In the previous version of this review, the effectiveness of interventions tailored to barriers to change was found to be uncertain. OBJECTIVES:To assess the effectiveness of interventions tailored to address identified barriers to change on professional practice or patient outcomes. SEARCH STRATEGY:For this update, in addition to the EPOC Register and pending files, we searched the following databases without language restrictions, from inception until August 2007: MEDLINE, EMBASE, CINAHL, BNI and HMIC. We searched the National Research Register to November 2007. We undertook further searches to October 2009 to identify potentially eligible published or ongoing trials. SELECTION CRITERIA:Randomised controlled trials (RCTs) of interventions tailored to address prospectively identified barriers to change that reported objectively measured professional practice or healthcare outcomes in which at least one group received an intervention designed to address prospectively identified barriers to change. DATA COLLECTION AND ANALYSIS:Two reviewers independently assessed quality and extracted data. We undertook quantitative and qualitative analyses. The quantitative analyses had two elements.1. We carried out a meta-regression to compare interventions tailored to address identified barriers to change with either no interventions or an intervention(s) not tailored to the barriers.2. We carried out heterogeneity analyses to investigate sources of differences in the effectiveness of interventions. These included the effects of: risk of bias, concealment of allocation, rigour of barrier analysis, use of theory, complexity of interventions, and the reported presence of administrative constraints. MAIN RESULTS:We included 26 studies comparing an intervention tailored to address identified barriers to change to no intervention or an intervention(s) not tailored to the barriers. The effect sizes of these studies varied both across and within studies.Twelve studies provided enough data to be included in the quantitative analysis. A meta-regression model was fitted adjusting for baseline odds by fitting it as a covariate, to obtain the pooled odds ratio of 1.54 (95% CI, 1.16 to 2.01) from Bayesian analysis and 1.52 (95% CI, 1.27 to 1.82, P < 0.001) from classical analysis. The heterogeneity analyses found that no study attributes investigated were significantly associated with effectiveness of the interventions. AUTHORS' CONCLUSIONS:Interventions tailored to prospectively identified barriers are more likely to improve professional practice than no intervention or dissemination of guidelines. However, the methods used to identify barriers and tailor interventions to address them need further development. Research is required to determine the effectiveness of tailored interventions in comparison with other interventions.
journal_name
Cochrane Database Syst Revjournal_title
The Cochrane database of systematic reviewsauthors
Baker R,Camosso-Stefinovic J,Gillies C,Shaw EJ,Cheater F,Flottorp S,Robertson Ndoi
10.1002/14651858.CD005470.pub2subject
Has Abstractpub_date
2010-03-17 00:00:00pages
CD005470issue
3issn
1469-493Xpub_type
杂志文章,meta分析,评审abstract:BACKGROUND:Metal pins are used to apply skeletal traction or external fixation devices in the management of orthopaedic fractures. These pins protrude through the skin (described as 'percutaneous') and the way in which they are treated after insertion may affect the incidence of pin site infection. This review set out ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD004551.pub2
更新日期:2008-10-08 00:00:00
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD007398.pub2
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abstract:BACKGROUND:In general, in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) implies a single fresh and one or more frozen-thawed embryo transfers. Alternatively, the 'freeze-all' strategy implies transfer of frozen-thawed embryos only, with no fresh embryo transfers. In practice, both strategies can ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD011184.pub2
更新日期:2017-03-28 00:00:00
abstract:BACKGROUND:Skin-to-skin care (SSC), otherwise known as Kangaroo Care (KC) due to its similarity with marsupial behaviour of ventral maternal-infant contact, is one non-pharmacological intervention for pain control in infants. OBJECTIVES:The primary objectives were to determine the effect of SSC alone on pain from medi...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD008435.pub2
更新日期:2014-01-23 00:00:00
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doi:10.1002/14651858.CD001560
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pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD003591.pub2
更新日期:2005-04-18 00:00:00
abstract:BACKGROUND:Hypoxaemia during labour can alter the shape of the fetal electrocardiogram (ECG) waveform, notably the relation of the PR to RR intervals, and elevation or depression of the ST segment. Technical systems have therefore been developed to monitor the fetal ECG during labour as an adjunct to continuous electro...
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doi:10.1002/14651858.CD000116.pub4
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doi:10.1002/14651858.CD008639.pub2
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD000184.pub4
更新日期:2015-02-09 00:00:00
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doi:10.1002/14651858.CD011460.pub2
更新日期:2015-09-25 00:00:00
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pub_type: 杂志文章,评审
doi:10.1002/14651858.CD001730
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Treatment of cancer is increasingly effective but associated with short and long term side effects. Oral side effects, including oral mucositis (mouth ulceration), remain a major source of illness despite the use of a variety of agents to treat them. OBJECTIVES:To assess the effectiveness of interventions f...
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pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD001973.pub4
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD002991.pub2
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doi:10.1002/14651858.CD001452
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doi:10.1002/14651858.CD007654.pub2
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journal_title:The Cochrane database of systematic reviews
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更新日期:2005-10-19 00:00:00
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更新日期:2018-07-24 00:00:00
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更新日期:2004-01-01 00:00:00
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更新日期:2009-10-07 00:00:00