Evidence map›Paper›PMID 33973346›Full record

ArticleWorldviews on evidence-based nursing2021

Mapping Clinical Barriers and Evidence-Based Implementation Strategies in Low-to-Middle Income Countries (LMICs).

Ashley Whitehorn, Liang Fu, Kylie Porritt, Lucylynn Lizarondo, Matthew Stephenson, Tania Marin, Aye Aye Gyi, Kim Dell, Alex Mignone, Craig Lockwood

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In one paragraph

Article in Worldviews on evidence-based nursing, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ashley WhitehornJBI, The University of Adelaide, Adelaide, SA, Australia.ORCID https://orcid.org/0000-0002-1255-5279
Liang FuJBI, The University of Adelaide, Adelaide, SA, Australia.ORCID https://orcid.org/0000-0003-2776-1419
Kylie PorrittJBI, The University of Adelaide, Adelaide, SA, Australia.ORCID https://orcid.org/0000-0002-5975-4179
Lucylynn LizarondoJBI, The University of Adelaide, Adelaide, SA, Australia.ORCID https://orcid.org/0000-0003-4902-7610
Matthew StephensonJBI, The University of Adelaide, Adelaide, SA, Australia.ORCID https://orcid.org/0000-0003-4863-4232
Tania MarinJBI, The University of Adelaide, Adelaide, SA, Australia.ORCID https://orcid.org/0000-0001-7627-572X
Aye Aye GyiJBI, The University of Adelaide, Adelaide, SA, Australia.
Kim DellJBI, The University of Adelaide, Adelaide, SA, Australia.
Alex MignoneJBI, The University of Adelaide, Adelaide, SA, Australia.
Craig LockwoodJBI, The University of Adelaide, Adelaide, SA, Australia.ORCID https://orcid.org/0000-0003-3722-676X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLow-to-middle income countries (LMICs) experience a high burden of disease from both non-communicable and communicable diseases. Addressing these public health concerns requires effective implementation strategies and localization of translation of knowledge into practice.

aimTo identify and categorize barriers and strategies to evidence implementation in LMICs from published evidence implementation studies.

methodsA descriptive analysis of key characteristics of evidence implementation projects completed as part of a 6-month, multi-phase, intensive evidence-based clinical fellowship program, conducted in LMICs and published in the JBI Database of Systematic Reviews and Implementation Reports was undertaken. Barriers were identified and categorized to the Donabedian dimensions of care (structure, process, and outcome), and strategies were mapped to the Cochrane effective practice and organization of care taxonomy.

resultsA total of 60 implementation projects reporting 58 evidence-based clinical audit topics from LMICs were published between 2010 and 2018. The projects included diverse populations and were predominantly conducted in tertiary care settings. A total of 279 barriers to implementation were identified. The most frequently identified groupings of barriers were process-related and associated predominantly with staff knowledge. A total of 565 strategies were used across all projects, with every project incorporating more than one strategy to address barriers to implementation of evidence-based practice; most strategies were categorized as educational meetings for healthcare workers. LINKING EVIDENCE TO ACTION: Context-specific strategies are required for successful evidence implementation in LMICs, and a number of common barriers can be addressed using locally available, low-cost resources. Education for healthcare workers in LMICs is an effective awareness-raising, workplace culture, and practice-transforming strategy for evidence implementation.

Indexed as

Developing CountriesEvidence-Based PracticeHumansQuality ImprovementWorkplacebarriersevidence-based practiceimplementationknowledge translationLMIClow-to-middle income countriesstrategies

Identifiers

PMID33973346
PMCPMC8251858

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.