Efficacy of a Knowledge Translation Approach in Changing Allied Health Practitioner Use of Evidence-Based Practice with Children with Cerebral Palsy: A Before and After Longitudinal Study

Imms, C., Kerr, C., Bowe, S. J., Karlsson, P., Novak, I., Shields, N., Reddihough, D., & Best Service Best Time Author Group. (2020). Efficacy of a knowledge translation approach in changing allied health practitioner use of evidence-based practices with children with cerebral palsy: A before and after longitudinal study. Disability and Rehabilitation, 1-14.

Early intervention programs provide on-going evidence-based assessment and intervention to support children who born with developmental delays and disabilities, and their families. During the time of this research an early intervention assessment program was being implemented in Australia for children with cerebral palsy. The program involved on-going and comprehensive assessment and monitoring of musculoskeletal functioning, pain, sleep, and communication of children with cerebral palsy. The introduction of a new early intervention requires change in clinician and organizational behaviours which can be difficult to accomplish without the use of behaviour changing strategies. Knowledge translation (KT) approaches can be used to support the implementation of the early intervention and facilitate behaviour change. KT approaches incorporate activities that support the movement of research into practice.

The present study reported outcomes related to the KT strategies that were adopted to increase the use of evidence-based assessment behaviours by clinicians. Four KT strategies were implemented into 4 hospitals (commencing group) and outcomes were compared to a 5th hospital (comparison group) where the KT strategies and early intervention had already been implemented for 2 years. The strategies included: the introduction of knowledge brokers to identify barriers to implementation, targeted education to increase clinician knowledge, an online library to provide easy access to scholarly evidence, and an online database for clinicians to record assessment results. Researchers were interested in (1) whether these tailored KT strategies increased the number of children receiving routine assessments, (2) if clinicians’ knowledge of evidence-based interventions would increase, and (3) how the outcomes from the commencing group were related to the comparison group. Data were collected from knowledge quizzes and the online database of assessments. Results revealed that there was not a significant increase in the number of assessments completed over time for the commencing group. However, more assessments were completed as a result of the intervention, which narrowed the gap between the commencing group and the comparison group. Knowledge scores did not change over time for either group, however, the clinicians reported an increase in the frequency that they communicated evidence-based expectations.

These results underscore the challenge of changing clinical practice. Nevertheless, even without knowledge change, the use of KT strategies increased evidenced-based assessment behaviours among clinicians in a hospital setting. This research demonstrates the complexity of a KT intervention and suggests the need for a multicomponent KT intervention in supporting clinician and organizational behaviour change.

Blogger: Meghan Vollebregt is a student in the combined SLP MClSc/PhD program working under the supervision of Dr. Lisa Archibald.