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Table 1 Intervention strategies to change health professional practicea

From: Systematic review of interventions to increase the delivery of preventive care by primary care nurses and allied health clinicians

Interventions Definition
Distribution of educational materials Published or printed recommendations for clinical care including clinical practice change guidelines, delivered personally or through mass mailings.
Educational meetings Health care providers who have participated in conferences, lectures, workshops, or traineeships.
Local consensus processes Inclusion of participating providers in discussion to ensure that they agreed that the chosen clinical problem was important and the approach to managing the problem was appropriate.
Educational outreach visits and academic detailing Use of a trained person who met with providers in their practice settings to give information with the intent of changing the provider’s practice. The information given may have included feedback on the performance of the provider(s).
Local opinion leaders Use of providers nominated by their colleagues as ‘educationally influential’.
Patient mediated interventions New clinical information (not previously available) collected directly from patients and given to the provider.
Audit and feedback Any summary of clinical performance of health care over a specified period of time. The summary may also have included recommendations for clinical action. The information may have been obtained from medical records, computerised databases, or observations from patients.
Reminders Patient or encounter specific information, provided verbally or on paper, or on a computer screen, which is designed or intended to prompt a health professional to recall information, including computer-aided decision support.
Marketing A survey of targeted providers to identify barriers to change and subsequent design of an intervention that addresses identified barriers.
Professional Individual behaviour (distributing educational materials) and organisational interventions (local consensus processes).
Financial Includes individual and organisational incentives and environmental restructuring (changing the available products).
Organisational Includes input (changing skill mix), processes (communication), and effects (satisfaction of providers). Influencing the organisation of services, including the process of care (delegation of tasks), the structure of care (the follow-up system), and the content of care (health charts, flow sheets).
Regulatory Includes legal (changes in patient liability) and social influence (peer review).
Patient resourcesb Distribution or addition of resources that may aid discussions of risk factors, or allow previously unavailable options for preventive care, including flipcharts, educational resources for patients, and referral opportunities (e.g. quitlines).
Ongoing supportb Email, telephone, or face-to-face communications which provided support and advice, responded to questions, or problems.
  1. aModified Cochrane Effective Practice and Organisation of Care group taxonomy of professional quality improvement strategies [82]
  2. bIntervention strategies not covered by EPOC criteria