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Use of theory to plan or evaluate guideline implementation among physicians: a scoping review

Overview of attention for article published in Implementation Science, February 2017
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (83rd percentile)
  • Above-average Attention Score compared to outputs of the same age and source (58th percentile)

Mentioned by

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19 tweeters

Citations

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58 Dimensions

Readers on

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171 Mendeley
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Title
Use of theory to plan or evaluate guideline implementation among physicians: a scoping review
Published in
Implementation Science, February 2017
DOI 10.1186/s13012-017-0557-0
Pubmed ID
Authors

Laurel Liang, Susanne Bernhardsson, Robin W. M. Vernooij, Melissa J. Armstrong, André Bussières, Melissa C. Brouwers, Anna R. Gagliardi

Abstract

Guidelines support health care decision-making and high quality care and outcomes. However, their implementation is sub-optimal. Theory-informed, tailored implementation is associated with guideline use. Few guideline implementation studies published up to 1998 employed theory. This study aimed to describe if and how theory is now used to plan or evaluate guideline implementation among physicians. A scoping review was conducted. MEDLINE, EMBASE, and The Cochrane Library were searched from 2006 to April 2016. English language studies that planned or evaluated guideline implementation targeted to physicians based on explicitly named theory were eligible. Screening and data extraction were done in duplicate. Study characteristics and details about theory use were analyzed. A total of 1244 published reports were identified, 891 were unique, and 716 were excluded based on title and abstract. Among 175 full-text articles, 89 planned or evaluated guideline implementation targeted to physicians; 42 (47.2%) were based on theory and included. The number of studies using theory increased yearly and represented a wide array of countries, guideline topics and types of physicians. The Theory of Planned Behavior (38.1%) and the Theoretical Domains Framework (23.8%) were used most frequently. Many studies rationalized choice of theory (83.3%), most often by stating that the theory described implementation or its determinants, but most failed to explicitly link barriers with theoretical constructs. The majority of studies used theory to inform surveys or interviews that identified barriers of guideline use as a preliminary step in implementation planning (76.2%). All studies that evaluated interventions reported positive impact on reported physician or patient outcomes. While the use of theory to design or evaluate interventions appears to be increasing over time, this review found that one half of guideline implementation studies were based on theory and many of those provided scant details about how theory was used. This limits interpretation and replication of those interventions, and seems to result in multifaceted interventions, which may not be feasible outside of scientific investigation. Further research is needed to better understand how to employ theory in guideline implementation planning or evaluation.

Twitter Demographics

The data shown below were collected from the profiles of 19 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 171 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
Germany 1 <1%
Unknown 169 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 25 15%
Researcher 24 14%
Student > Ph. D. Student 23 13%
Student > Doctoral Student 17 10%
Other 10 6%
Other 36 21%
Unknown 36 21%
Readers by discipline Count As %
Medicine and Dentistry 37 22%
Nursing and Health Professions 23 13%
Social Sciences 22 13%
Psychology 14 8%
Computer Science 5 3%
Other 25 15%
Unknown 45 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 12. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 August 2017.
All research outputs
#1,596,880
of 15,045,928 outputs
Outputs from Implementation Science
#481
of 1,454 outputs
Outputs of similar age
#42,901
of 259,841 outputs
Outputs of similar age from Implementation Science
#7
of 17 outputs
Altmetric has tracked 15,045,928 research outputs across all sources so far. Compared to these this one has done well and is in the 89th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,454 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 13.8. This one has gotten more attention than average, scoring higher than 66% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 259,841 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 83% of its contemporaries.
We're also able to compare this research output to 17 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 58% of its contemporaries.