Behavior change interventions and policies influencing primary healthcare professionals’ practice—an overview of reviews

Chauhan, Bhupendrasinh F.; Jeyaraman, Maya; Mann, Amrinder Singh; Lys, Justin; Skidmore, Becky; Sibley, Kathryn M.; Abou-Setta, Ahmed; Zarychanksi, Ryan

doi:10.1186/s13012-016-0538-8

Implementation Science

Table 1 Key features of included reviews

From: Behavior change interventions and policies influencing primary healthcare professionals’ practice—an overview of reviews

Study	Type of review	Study design included	Number of included studies	Professionals evaluated	Intervention(s)	Type of disease(s)	Funding
Behavior change interventions
Education (increasing knowledge or understanding)
Chhina et al. [32] 2013	SR	Any study design	15	FPs	Academic detailing	NR	No
Mostofian et al. [29] 2015	Overview	Reviews	14	FPs	Any interventions	NR	No
Velden et al. [33] 2012	SR	Any study design	58	FPs, others	Any interventions	RTIs	Yes
Thepwongsa et al. [20] 2014	SR	RCTs, non-RCTs, ITS	11	FPs	CME	NR	Yes
Thomas et al. [34] 2006	SR	Any study design	13	FPs	CME	NR	Yes
Ginige et al. [21] 2007	SR	Any study design	4	FPs	CME, video, text	Chlamydia	No
Brody et al. [35] 2013	SR	Any study design	16	FPs, nurses, SWs, pharmacists	Dementia educational/dissemination intention	Dementia	Yes
Schichtel et al. [36] 2013	SR	RCTs, cluster RCTs	21	FPs, Nurses, PAs	Education	Cancer	Yes
Hardy et al. [37] 2011	SR	Any study design	0	FPs	Education	Mental illness	No
Miller et al. [38] 2010	SR	Any study design	16	FPs	Education	NR	No
Lineker et al. [39] 2010	SR	Any study design	7	FPs, nurses	Education	Arthritis	No
Alvarez et al. [40] 2006	SR	Any study design	18	FPs	Education	Pallative care	No
Howe et al. [41] 2006	SR	RCTs	18	FPs	Education	NR	No
Kamarudin et al. [42] 2013	SR	Any study design	47	FPs	Education	NR	No
Thepwongsa et al. [43] 2014	SR	Any study design	13	FPs	Education	T2DM	Yes
Perry et al. [44] 2011	SR	Any study design	5	FPs	Educational meetings, audit-feedback, reminders, mass media, local opinion leaders	Dementia	Yes
Vodicka et al. [45] 2013	SR	Any study design	17	FPs, nurses	Educational or behavior change interventions	RTIs, otitis media	Yes
Guldberg et al. [46] 2009	SR	RCTs	10	FPs	Feedback	T2DM	Yes
Cheraghi-Sohi et al. [47] 2008	SR	RCTs	9	FPs	Feedback or training or both	NR	No
Ring et al. [48] 2007	SR	RCTs	14	FPs	Interactive educational seminar, QI learning collaborative for general practice teams	Asthma	Yes
Rourke et al. [49] 2015	MA	Any study design	37	FPs	Lecture, audit-feedback, computer based learing, multicomponent intervention	Skin lesions	No
Reinders et al. [50] 2011	SR	RCTs	10	FPs	Patient feedback	NR	Yes
Gijbels et al. [51] 2010	SR	Any study design	61	Nurses, midwives	Education	NR	Yes
Zaher et al, [52] 2012	SR	Any study design	13	FPs	Practice-based small group learning programs	NR	No
Curti et al. [53] 2015	SR, MA	RCTs, cluster-RCTs, CBA	12	FPs	Educational materials, meetings, CME, audit-feedbacks, reminders	Occupational diseases	No
Goulart et al. [54] 2011	SR	Any study design	20	FPs	Education	Skin cancer	Yes
Omidvari et al. [55] 2013	SR	RCTs	3	FPs	Guidelines	NR	Yes
Benthem et al. [56] 2009	SR	RCTs, CBA or ITS	27	FPs	Education	Psychiatric disorders	No
Enablement (increasing means/reducing barriers to increase capability or opportunity)
Adaji et al. [57] 2008	SR	Any study design	29	FPs	Information technology	Diabetes	Yes
de Lusignan et al. [58] 2014	SR	Any study design	143	FPs	Access to electronic health records	NR	Yes
Pires et al. [59] 2014	SR	Any study design	18	FPs	Communication skills training for FPs	NR	No
Holstiege et al. [60] 2015	SR	RCTs; cluster RCTs	7	FPs	CDSSs	NR	No
Dixon et al. [61] 2013	SR	Any study design	10	FPs, others	Computer-based interventions	NR	Yes
Robertson et al. [62] 2010	SR	Any study design	21	Pharmacists	CDSSs	NR	Yes
Curtain et al. [63] 2014	SR	Any study design	8	Pharmacists	CDSSs	Allergic rhinitis, stroke	No
Souza et al. [64] 2011	SR	RCTs	41	FPs	CDSSs	Dyslipidaemia, cancer, mental illnesses	Yes
Fathima et al. [65] 2014	SR	RCTs	16	FPs, nurses, pharmacists, PAs	CDSSs	Asthma, COPD	No
Cleveringa et al. [66] 2013	SR	RCTs	20	FPs	CDSSs, feedback on performance	T2DM	Yes
Calabretto et al. [67] 2005	SR	RCTs	4	Pharmacists	Elecronic decision support system	NR	Yes
Boyle et al. [68] 2010	SR	Any study design	12	FPs	Electronic medical records	Tobacco dependence	Yes
Lainer et al. [69] 2013	SR	RCTs	10	FPs, pharmacists	Information technology	NR	Yes
Huang et al. [70] 2013	SR, MA	Any study design	13	FPs	Point of care testing	RTIs	No
Gialamas et al. [71] 2010	SR	RCTs, quasi-RCTs	6	FPs, others	Point of care testing	Diabetes, hyperlipedemia, coagulation disorders	Yes
Motulsky et al. [72] 2013	SR	Any study design	19	FPs, pharmacists	Second-generation electronic prescriptions	NR	No
Environmental restructuring (changing the physical or social context)
Damiani et al. [73] 2013	SR	Any study design	26	FPs	Group versus single handed practice, information and communication technology	NR	No
Riley et al. [74] 2010	SR	Any study design	12	Others	Group visits	Diabetes	No
Unverzagt et al. [75] 2014	SR	RCTs	84	FPs	Multiple interventions	Cardiovascular	Yes
Gilbody et al. [76] 2008	MA	RCTs	16	FPs	Screening and case-finding instruments	Depression	Yes
Legare et al. [77] 2010	SR	Any study design	39	FPs, nurses, pharmacists, SWs, midwives	Shared decision-making	NR	Yes
Smith et al. [78] 2007	SR, MA	RCTs, CBA, ITS	20	FPs	Shared-care interventions	Chronic diseases	No
Mitchell et al. [79] 2008	SR	Any study design	18	FPs	Multidisciplinary primary care team	Stroke	Yes
Page et al. [80] 2005	SR	RCTs, non-RCTs, CBA	6	FPs, Nurses	Any interventions in nurese-led care	Coronary heart disease	No
Kuethe et al. [81] 2013	SR	RCTs	5	FPs, nurses, PAs	Nurse-led care	Asthma	No
Carey et al. [82] 2007	SR	RCTs	22	Nurses	Nurse-led care	Diabetes	Yes
Desborough et al. [83] 2012	SR	Any study design	13	FPs, Nurses	Nurse-led care	NR	Yes
Urquhart et al. [84] 2009	SR	RCTs, CBA, ITS	9	Nurses	Nursing record system	NR	Yes
Martelly et al. [85] 2014	SR, MA	RCTs	24	FPs, Nurses	Nurse-led care	NR	No
Laurant et al. [86] 2005	SR	RCTs, CBA, ITS	16	FPs, Nurses	Nurse-led care	NR	Yes
Courtenay et al. [87] 2008	SR	Any study design	21	Nurses	Nurse-led care	Pain	Yes
Dennis et al. [88] 2009	SR	Any study design	46	FPs, nurses, pharmacists	Task shifting	Chronic diseases	Yes
Health, [89] 2013	SR	RCTs, SRs	6	FPs, nurses	Task shifting	Chronic diseases	Yes
Proia et al. [90] 2014	SR	Any study design	80	FPs, nurses, pharmacists	Team based care	Blood pressure	No
Schadewaldt et al. [91] 2011	SR	RCTs	7	Nurses	Multiple interventions	Coronary artery disease	No
Incentivization (creating expectation of reward)
Scott et al, [92] 2011	SR	RCTs, CBA, ITS	7	FPs	Financial incentives	NR	Yes
McDonald et al. [93] 2008	SR	Any study design	23	FPs	Funding initiatives or incentives	NR	Yes
Langdown et al. [94] 2014	SR	Any study design	11	FPs	P4P	Asthma, coronary heart disease, diabetes	No
Eijkenaar et al. [30] 2013	Overview	SRs	22	FPs	P4P	NR	No
Houle et al. [95] 2012	SR	Any study design	30	FPs	P4P	Chronic diseases	No
Gillam et al. [96] 2012	SR	Any study design	94	FPs	P4P	Chronic diseases	No
Vahidi et al. [97] 2013	SR	Any study design	11	FPs	Payment mechanisms to FPs	NR	Yes
Modeling (providing an example for people to aspire to or imitate)
Flodgren et al. [98] 2011	SR	RCTs	18	FPs	Local opinion leaders	NR	Yes
Harkness et al. [99] 2009	SR, MA	RCTs, CBA, ITS	42	FPs, others	Mental health workers involvement	Mental health	Yes
Multiple interventions
Zou et al. [115] 2012	SR	Any study design	8	FPs	Any interventions	STDs	Yes
Dwamena et al. [116] 2012	SR	RCTs, CBA, CCTs, ITS	43	FPs, nurses	Any interventions	General medical problems	Yes
Castelino et al. [117] 2009	SR	RCTs	12	Pharmacists	Interventions for prescribing	NR	No
Mansell et al. [118] 2011	SR	Any study design	22	FPs	Multiple interventions	Cancer	Yes
Guy et al. [119] 2011	SR	Any study design	16	FPs	Multiple interventions	Chlamydia screening	Yes
Laliberte et al. [120] 2011	SR, MA	Any study design	13	FPs, pharmacists	Multiple interventions	Osteoporosis	No
Jacobson et al. [121] 2011	SR	Any study design	15	FPs, nurses	Multiple interventions	Childhood obesity	No
Dennis et al. [122] 2008	SR	Any study design	164	FPs, nurses	Any interventions	NR	Yes
Grindrod et al. [31] 2006	Overview	SRs	34	Pharmacists	Any interventions	NR	No
Arnold et al. [123] 2005	SR	RCTs, quasi-RCT, CBA, ITS	39	FPs	Any interventions	NR	Yes
Moe-Byrne et al. [125] 2014 [124]	SR	SRs, studies	23	FPs	Any interventions	NR	Yes
McMillan et al. [125] 2013	SR	RCTs	30	FPs, nurses, others	Any interventions	NR	Yes
Loganathan et al. [126] 2011	SR	Any study design	16	FPs, nurses, Others	Any interventions	NR	Yes
Kaur et al. [127] 2009	SR	Any study design	24	FPs, pharmacists, others	Any interventions	NR	No
Okelo et al. [128] 2013	SR	Any study design	73	FPs, nurses, Pharmacists, others	Any interventions	Asthma	Yes
Huijg et al. [129] 2014	SR	Any study design	59	FPs, nurses, others	Any interventions	NR	Yes
Fahey et al. [130] 2005	SR	RCTs	72	FPs, nurses, pharmacists	Educational and organizational strategies	Hypertension	No
McKinstry et al. [131] 2006	SR	RCTs, quasi-RCTs, CBA, ITS	10	FPs	Informative, educational, multiple interventions	NR	No
Akbari et al. [132] 2008	SR	Any study design	17	FPs	Multiple interventions	NR	Yes
Gunten et al. [133] 2007	SR	Any study design	43	FPs, nurses, pharmacists	Pharmacists’ interventions	NR	No
Beach et al. [134] 2006	SR	RCTs	27	FPs	Provider and organization interventions	NR	No
Smit et al. [135] 2007	SR	RCTs	12	FPs, nurses, psychologists, others	Psychological and supportive interventions	Depression	No
Newhouse et al. [136] 2011	SR	Any study design	69	FPs, nurses, others	Advanced practice nurse care	NR	No
Lau et al. [137] 2012	SR, MA	Any study design	77	FPs, nurses	QI	Vaccination	Yes
Saxena et al. [138] 2007	SR	Any study design	9	FPs, nurses, others	Case management	Diabetes	No
Majka et al. [139] 2014	SR, MA	Any study design	15	FPs, nurses, dieticians, others	Care coordination and/or team approach methods; multiple simultaneous strategies	Patients with long term enteral tube feeding	No
Archer et al. [140] 2012	SR, MA	RCTs	79	FPs, nurses, pharmacists, psychologists	Colloborative care	Anxiety, depression	Yes
Thota et al. [141] 2012	SR, MA	RCTs	69	FPs	Collaborative care models	Depressive disorders	No
Christensen et al. [142] 2008	SR	RCTs, controlled trials	55	FPs, nurses, pharmacists, psychologists	Community models of care	NR	Yes
Phillips et al. [143] 2010	SR	Any study design	19	FPs	Different models using various interventions	NR	Yes
De Belvis et al. [144] 2009	SR	RCTs	13	FPs, nurses, PAs	Evidence based medicine tools	Diabetes	Yes
Sandall et al. [145] 2013	SR, MA	RCTs, cluster RCTs	13	FPs, midwives	Mid-wife led continuity model	NR	Yes
Baishnab et al. [146] 2012	SR	RCTs	3	FPs, Nurses	Organized asthma care	Asthma	Yes
Jackson et al. [147] 2013	SR	Any study design	19	FPs	PCMH	NR	Yes
Van Cleave et al. [148] 2012	SR	Any study design	23	FPs	QI initiatives, electronic records	NR	Yes
Shojania et al. [149] 2006	SR	RCTs, quasi-RCTs, CBA studies	58	FPs	QI strategies	T2DM	Yes
Tory et al. [150] 2015	SR	Any study design	7	FPs, pharmacists	QI measures	Osteoporosis	No
Gallagher et al. [151] 2010	SR	Any study design	9	Nurses, pharmacists	QI strategies	Hypertension, chronic kidney disease	Yes
Ranji et al. [152] 2008	SR	RCTs, CBA, ITS	43	FPs	QI strategies	NR	Yes
Gask et al. [153] 2011	SR	RCTs, CBA	13	FPs	Reattribution model	Medically unexplained symptoms	No
Rolfe et al. [154] 2014	SR	RCTs, quasi-RCTs, CBA	10	FPs	Interventions (informative, educational, behavioral, organizational)	NR	No
Persuasion (using communication to induce positive or negative feelings or stimulate action)
Jenkins et al. [100] 2015	SR	Any study design	7	FPs	Audit-feedback, reminders, clinical decision support on imaging	Lower back pain	No
Holt et al. [101] 2012	SR, MA	CCTs	42	FPs	Reminders	NR	No
Siddiqui et al. [102] 2011	SR	RCTs	5	FPs	Reminders	Colorectal cancer screening	No
Lu et al. [103] 2008	SR	RCTs	164	FPs, pharmacists	Any interventions	Asthma, depression, Helicobacter pylori infection	Yes
Training (imparting skills)
Moore et al. [104] 2013	SR, MA	RCTs, CBA	15	FPs, nurses, others	Communication skills training	Cancer	Yes
Eggenberger et al. [105] 2013	SR	RCTs, CCTs, CBA	12	FPs, nurses, SWs, psychologists, others	Communication skills training, education	Dementia	Yes
Horvat et al. [106] 2014	SR	RCTs, cluster RCTs, CCTs	5	FPs, nurses, PAs, psychologists, others	Cultural competence training	NR	No
Lie et al. [107] 2011	SR	Any study design	7	FPs, nurses, PAs	Cultural competency training	Blood pressure, diabetes	Yes
Henderson et al. [108] 2011	SR	RCTs, controlled studies	24	FPs	Cultural competency training	Chronic diseases	Yes
Soderlund et al. [109] 2011	SR	Any study design	10	FPs, nurses, PAs, SWs, psychologists, others	Motivational interviewing training	NR	Yes
Rashid et al. [110] 2010	SR	Any study design	8	Nurses	Nurse training	NR	No
Mesquita et al. [111] 2010	SR	Any study design	15	Pharmacists	Simulated patient methods	NR	Yes
Xu et al. [112] 2012	SR	Any study design	30	Pharmacists	Simulated-patient methods	Headache, abdominal pain	No
Sikorski et al. [113] 2012	SR, MA	RCTs	11	FPs	Training	Depression	Yes
Paskins et al. [114] 2014	SR	Any study design	28	FPs	Video stimulated recall	NR	Yes
Policy
Service provision (delivering a service)
OHTA [160] 2012	Report	SRs, MA, RCTs	7	FPs	Specialized community-based care	T2DM	Yes
Wilson et al. [156] 2006	SR	SRs, RCTs, CCTs, CBA	4	FPs	Any interventions altering consultation time	NR	Yes
McNaughton et al. [157] 2009	SR	RCTs	9	FPs	Brief non-pharmacological interventions	Depression	No
Wilson et al. [158] 2006	SR	RCTs, CCTs	7	FPs	Consultation time	NR	Yes
Bhanbhro et al. [159] 2011	SR	Any study design	17	FPs, nurses, pharmacists	Non-medical prescribing	NR	No
Communications (using print, electronic, telephonic or broadcast media)
Jiwa et al. [161] 2014	SR	Any study design	18	FPs, others	Communications	NA	Yes
Cant et al. [162] 2011	SR	Any study design	20	FPs, dieticians	Dietitians’ correspondence practices	NR	No
Sawmynaden et al. [163] 2012	SR, MA	RCTs, quasi-RCTs, CBA, ITS	6	FPs	Email communication	NR	Yes
Guidelines (creating documents that recommend or mandate practice)
Ramsaroop et al. [164] 2007	SR	Any study design	18	FPs	Advance Directive	NR	Yes
Clarke et al. [165] 2010	SR	Any study design	24	FPs	Guidelines	NR	Yes

BP blood pressure; CBA controlled before-after sudy; CCTs controlled clinical trails; CME continuing medical education; COPD chronic obstructive pulmonary disease; FP family physician; ITS interrupted time series study; MA meta-analysis; NA not applicable; OR odds ratio; PAs physician assistants; P4P pay-for-performance; PCMH patient-centered medical home; PCPs primary care providers; RCTs randomized clinical trails; RD risk difference; RTIs respiratory tract infections ; SMD standardized mean difference; STD sexually transmitted disease; SR systematic review; SWs social workers; T2DM type 2 diabetes mellitus; WMD weighted mean difference

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