Effectiveness of health consumer representative involvement in implementation of interventions to change health professional behaviour

Background

The adoption of research evidence to improve client outcomes may be enhanced using the principles of implementation science. This systematic review aimed to understand the effect of involving consumers to change health professional behaviours and practice. The barriers and enablers to consumer engagement will also be examined.

Methods

We searched Medline, CINAHL, Embase, The Cochrane Central Register of Controlled Trials (CENTRAL) and PDQ-Evidence from 2004 to February 2019. Implementation studies involving consumers in at least one phase (development, intervention, or facilitation) of an intervention that aimed to change health professional behaviour to align with evidence-based practice were included. Studies in the areas of paediatrics and primary care were excluded. Two review authors independently screened studies for inclusion, one author extracted data and conducted quality assessments with review of a second author. Knowledge translation interventions were categorised using the Effective Practice and Organisation of Care (EPOC) taxonomy. The primary outcome was measures of change in health professional behaviour.

Results

Sixteen articles met the inclusion criteria. Meta analysis of three studies found support for consumer involvement in changing health care professionals behaviour (Hedges' g = 0.41, 95% CI [.27, .57], p < .001). Most knowledge translation studies involved consumers during the development phase only (n = 12). Most studies (n = 9) included one type of knowledge translation intervention. Professional interventions (including education of health professionals, educational outreach, and audit and feedback) were described in 13 studies.

Conclusions

Consumer involvement rarely moves beyond the design phase of knowledge translation research in healthcare settings. Further research is needed of the barriers to and effect of increased consumer engagement across all stages of knowledge translation interventions.