Promoting professional behaviour change in healthcare: what interventions work, and why? A theory-led overview of systematic reviews

摘要: Objectives Translating research evidence into routine clinical practice is notoriously difficult. Behavioural interventions are often used to change practice, although their success variable and the characteristics of more successful unclear. We aimed establish behaviour in healthcare. Design carried out a systematic overview reviews on effectiveness with theory-led analysis using constructs normalisation process theory (NPT). MEDLINE, CINAHL, PsychINFO Cochrane Library were searched electronically from inception July 2015. Setting Primary secondary care. Participants any patients healthcare professionals who met inclusion criteria having examined professional improving and/or patient outcomes. Interventions Professional as defined by Effective Practice Organisation Care Review Group. outcome measures Success each intervention changing or outcomes, mechanisms action. Reviews coded included, how they had been which NPT its component covered. Results Searches identified 4724 articles, 67 criteria. fell three main categories: persuasive; educational informational; action monitoring. focusing education (eg, Audit Feedback, Reminders, Educational Outreach) acted Collective Action Reflexive Monitoring, them tended report positive Conclusions This suggests that contribute normative restructuring modifying peer group norms expectations outreach) relational restructuring, reinforcing modified emphasising an external reference Feedback), offer best chances success. Combining such most likely behaviour.