Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Feb 9:5:14.
doi: 10.1186/1748-5908-5-14.

A systematic review of the use of theory in the design of guideline dissemination and implementation strategies and interpretation of the results of rigorous evaluations

Philippa Davies  1 , Anne E Walker, Jeremy M Grimshaw
Affiliations

A systematic review of the use of theory in the design of guideline dissemination and implementation strategies and interpretation of the results of rigorous evaluations

Philippa Davies et al. Implement Sci. .

Abstract

Background: There is growing interest in the use of cognitive, behavioural, and organisational theories in implementation research. However, the extent of use of theory in implementation research is uncertain.

Methods: We conducted a systematic review of use of theory in 235 rigorous evaluations of guideline dissemination and implementation studies published between 1966 and 1998. Use of theory was classified according to type of use (explicitly theory based, some conceptual basis, and theoretical construct used) and stage of use (choice/design of intervention, process/mediators/moderators, and post hoc/explanation).

Results: Fifty-three of 235 studies (22.5%) were judged to have employed theories, including 14 studies that explicitly used theory. The majority of studies (n = 42) used only one theory; the maximum number of theories employed by any study was three. Twenty-five different theories were used. A small number of theories accounted for the majority of theory use including PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation), diffusion of innovations, information overload and social marketing (academic detailing).

Conclusions: There was poor justification of choice of intervention and use of theory in implementation research in the identified studies until at least 1998. Future research should explicitly identify the justification for the interventions. Greater use of explicit theory to understand barriers, design interventions, and explore mediating pathways and moderators is needed to advance the science of implementation research.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. The Improved linical Effectiveness through Behavioural Research Group (ICEBeRG) Designing theoretically-informed implementation interventions. Implement Sci. 2006;1:4. doi: 10.1186/1748-5908-1-4. - DOI - PMC - PubMed
    1. Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N. Changing the behavior of healthcare professionals: the use of theory in promoting the uptake of research findings. J Clin Epidemiol. 2005;58:107–112. doi: 10.1016/j.jclinepi.2004.09.002. - DOI - PubMed
    1. Grimshaw JM, Thomas RE, Maclennan G, Fraser C, Ramsay CR, Vale L. Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technol Assess. 2004;8:iii–72. - PubMed
    1. Bero L, Eccles M, Grilli R, Grimshaw J, Gruen RL, Mayhew A. Cochrane Effective Practice and Organisation of Care Group. About The Cochrane Collaboration (Cochrane Review Groups (CRGs)) 2007. Art. No.: EPOC.
    1. Anonymous. Building and applying a guideline-based performance measurement system: develop, apply, and evaluate medical review criteria and educational outreach based upon practice guidelines: final project report. 97-N002 - 97-N003, U-97. 1996. Rockville, MD, U.S. Dept. of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research; CCQE-AHCPR guideline criteria project.

LinkOut - more resources