Strategies to implement evidence-informed practice at organizations: A rapid systematic review

Strategies to implement evidence-informed practice at organizations: A rapid systematic review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Strategies to implement evidence-informed practice at organizations: A rapid systematic review Emily C Clark, Trish Burnett, Rebecca Blair, Robyn L Traynor, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3482543/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 01 Apr, 2024 Read the published version in BMC Health Services Research → Version 1 posted 4 You are reading this latest preprint version Abstract Background Achievement of evidence-informed decision making (EIDM) requires the integration of evidence into all practice decisions by identifying and synthesizing evidence, then developing and executing plans to implement and evaluate changes to practice. Evidence-informed practice (EIP) involves implementing a specific practice or program with proven effectiveness. This rapid systematic review examines strategies for the implementation of EIDM and EIPs across organizations, mapping facilitators and barriers to the COM-B (capability, opportunity, motivation, behaviour) model for behaviour change. Methods A systematic search was conducted in multiple databases and by reviewing publications of key authors. Articles that describe interventions to shift teams, departments, or organizations to EIDM or EIP were eligible for inclusion. For each article, quality was assessed, and details of the intervention, setting, outcomes, facilitators and barriers were extracted from each included article. A convergent integrated approach was undertaken to analyze both quantitative and qualitative findings. Results Fifty-nine articles are included. Studies were conducted in primary care, public health, social services, occupational health, and palliative care settings. Strategies to implement EIDM and EIP included the establishment of Knowledge Broker-type roles, building the EIDM capacity of staff, and research or academic partnerships. Facilitators and barriers align with the COM-B model for behaviour change. Facilitators for capability include the development of staff knowledge and skill, establishing specialized roles, and knowledge sharing across the organization, though staff turnover and subsequent knowledge loss was a barrier to capability. For opportunity, facilitators include the development of processes or mechanisms to support new practices, forums for learning and skill development, and protected time, and barriers include competing priorities. Facilitators identified for motivation include supportive organizational culture, expectations for new practices to occur, recognition and positive reinforcement, and strong leadership support. Barriers include negative attitudes toward new practices, and lack of understanding and support from management. Conclusion This review provides a comprehensive, in-depth analysis of facilitators and barriers for the implementation of EIDM and EIP in public health and related organizations, mapped to the COM-B model for behaviour change. The facilitators and barriers described in the included studies establish key factors for realizing greater implementation success in the future. Registration PROSPERO CRD42022318994 Evidence-informed decision making evidence-based practice knowledge translation knowledge mobilization implementation organizational change Figures Figure 1 Figure 2 Background There exist expectations from elected officials and their constituents that public health decisions and programs are informed by the best available evidence from research, local context, and political will ( 1 – 3 ). To achieve evidence-informed public health, it is important that the organization engages in and supports evidence-informed decision making (EIDM) and evidence-informed practice or programs (EIP) ( 4 – 7 ). EIDM, at an organizational level, involves the integration of evidence into all practice decisions by identifying and synthesizing evidence, then developing and executing plans to implement and evaluate changes to practice ( 2 , 8 , 9 ). EIP, on the other hand, refers to a specific practice or program with proven evidence of effectiveness that has been selected or mandated for implementation ( 9 – 11 ). Evidence-based practice (EBP) and evidence-based decision making (EBDM) are similar processes however, EBP and EBDM implies a greater focus on research evidence whereas EIDM and EIP focus on research evidence along with other factors such as context, resources, experience, and patient/community input to influence decision making and program implementation ( 2 , 3 , 12 , 13 ). When implemented, EIDM and EIP result in efficient use of scarce resources, encourage stakeholder involvement resulting in more effective programs and decisions, improve transparency and accountability of organizations, improve health outcomes and reduce harm ( 3 , 12 , 13 ). Therefore, it is important that EIDM and EIP are integrated into public health organizations. Integration of EIDM and EIP into practice is challenging due to the need for multifaceted interventions ( 14 ). Systematic reviews have been completed on the barriers and facilitators to EIDM. Mathieson et al and Li et al examined the barriers and facilitators to evidence-based practice (EBP) implementation in community nursing and Paci et al examined barriers in physiotherapy ( 6 , 7 , 15 ). Li et al found that EBP implementation is associated with an organizational culture for EBP, where staff at all levels value and contribute to EBP ( 6 ). Similarly, Mathieson et al and Paci et al found that that organizational context plays an important role in EBP implementation along with organizational support and resources for EBP ( 7 , 15 ). Strategies to implement EBP may also build capacity for staff to find, interpret and synthesize evidence to develop practice and program recommendations ( 4 , 5 , 16 , 17 ). Saunders et al completed an overview of systematic reviews on health care professionals’ EBP competencies ( 14 ). The authors found that implementation of EBP across studies was low ( 14 ). Participants reported insufficient EBP knowledge and skills to implement EBP in daily practice even though participants also reported positive EBP beliefs and attitudes ( 14 ). Sadeghi-Bazargani et al and Barzkar et al also explored the implementation of EBP and found similar results, listing inadequate skills and lack of knowledge amongst the most common barriers to EBP ( 18 , 19 ). Moraes et al explored the implementation of an EIP in Intensive Care Units and de Wit et al examined how to best implement EIPs in the emergency department ( 20 , 21 ). Both reviews found that effective strategies for the successful implementation of an EIP include staff training, transparency, and inclusion of staff in the planning and implementation process ( 20 , 21 ). Change initiatives for the implementation of an EIP must also address challenges such as resistance from staff or lack of staff expertise, as well as tailor strategies to specific organizational climates and structures (20–24). At least two streams of research have emerged in this field: one focused on understanding the processes and mechanisms for achieving organization-wide EIDM, ( 4 , 5 ) and the other exploring strategies to implement specific EIPs into practice ( 25 ). These two streams of research, however, appear to converge in organizational change. For example, whether one is aspiring to achieve EIDM or to implement an EIP, significant organizational change is usually necessary, resulting in substantial impact on the entire organization, as well as for individuals working there. However, there is minimal synthesized evidence of EIDM and EIP implementation at the organizational level. This review seeks to address this research gap by identifying, appraising, and summarizing research evidence from studies seeking to understand the EIDM process at an organizational level, as well as studies exploring how to best implement EIPs across health organizations. The COM-B model for behaviour change was used as a guide for contextualizing the findings across studies. This model is designed to guide organizational change initiatives and distill complex systems that influence behaviour into simpler, visual representations. Specifically, this model looks at capability (C), opportunity (O) and motivation (M) as three key influencers of behaviour (B). The capability section of the COM-B model reflects whether the intended audience possess the knowledge and skill for a new behaviour. Opportunity reflects whether there is opportunity for new behaviour to occur. Motivation reflects whether there is sufficient motivation for a new behaviour to occur. All three components interact to create behaviour and behaviours can, in turn, alter capability, motivation and opportunity ( 26 ). The COM-B model has been used often to map findings related to organizational and behavioural change in both EIP implementation ( 27 – 30 )and in mapping findings from systematic reviews examining the barriers and facilitators of various health interventions including nicotine replacement, chlamydia testing and lifestyle management of polycystic ovary syndrome ( 31 – 33 ). Overall, EIDM and EIP are expected to be used in public health to achieve optimal health of populations. However, the capacity of public health organizations to realize EIDM and to implement EIP varies considerably from organization to organization ( 5 , 34 – 37 ). This rapid review aims to examine the implementation of EIDM at the organizational level, as well as the implementation of EIP across organizations, to inform change efforts at Canadian public health organizations. The findings of this review can be applied more broadly and will support public health organizations beyond Canada implement change efforts to practice in an evidence-informed way. Methods Study design The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO; Registration CRD42022318994). The review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting systematic reviews and meta-analyses ( 38 ). Given the nature of the research question, a mixed methods systematic review approach was taken, with guidance from the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis ( 39 ). Information sources and search strategy The search was conducted on March 18, 2022. The following databases were searched from 2012 onward: Medline, Embase, Emcare, Global Health Database, PsycINFO, Web of Science. Each database was searched using combinations and variations of the terms “implement*”, “knowledge broker*”, “transform*”, “organizational culture”, “change management”, “evidence-based”, “knowledge translation”, and “knowledge mobilization”. Additionally, publications by key contributors to the field were reviewed. The full search strategy is included in Appendix 1 . Studies were screened using DistillerSR software. Titles and abstracts of retrieved studies were screened by a single reviewer. Full texts of included studies were screened by a second reviewer and reviewed by a third. Screening was not completed in duplicate, consistent with a rapid review protocol ( 40 ). Eligibility criteria English-language, published primary studies with experimental or observational designs were eligible for inclusion. Review papers, such as literature and systematic reviews, were excluded. Grey literature was not included. Population Studies conducted with public sector health-related service-delivery organizations were eligible for inclusion. This included public health departments and authorities, health care settings and social services. Studies focused on departments or teams within an organization, or on entire organizations, were also eligible for inclusion. Studies conducted in private sectors or academic institutions were excluded. Intervention Interventions designed and implemented to shift teams, departments, or organizations to EIDM or EIP were eligible for inclusion. For studies focused on implementation of EIPs, interventions implemented by external organizations were excluded because the overall objective of this review was to inform internal strategies for EIDM or EIPs. Outcomes Outcomes measured either quantitatively or qualitatively were considered. These included behaviour change, confidence and skills, patient-level data such as quality indicators, evidence of EIDM embedded in organizational and decision-making processes, changes in organizational culture, and changes to budget allocation. Studies that reported primarily on implementation fidelity were excluded, since these would not inform the drivers for organizational change. Setting Studies conducted in the 38 member countries of the Organization for Economic Co-operation and Development (OECD) were included in this review to best align with the Canadian context and to inform organizational change efforts in public health within Canada ( 41 ). Quality Assessment The methodological rigour of included studies was evaluated using the JBI suite of critical appraisal tools ( 42 ). Ratings of low, moderate, or high quality were assigned based on the critical appraisal results. Quality assessment was completed by one reviewer and verified by a second. Conflicts were resolved through discussion or by consulting a third reviewer. Data extraction Data extraction was completed by a single reviewer and reviewed by a second. Data on the study design, setting, sector (e.g., public health, primary care, etc.), participants, intervention (e.g., description of learning initiatives, implementation strategies, etc.), outcome measures, and findings were extracted. Data analysis Studies were grouped according to whether they reported on implementation of EIDM or an EIP. Quantitative and qualitative data were synthesized simultaneously, using a convergent integrated approach ( 39 ). Quantitative data underwent narrative synthesis, where findings that caused benefit were compared with those that caused harm or no effect ( 43 ). Vote counting based on the direction of effect was used to determine whether most studies found a positive or negative effect {McKenzie, 2021 #613}. Findings were reviewed for trends in reported facilitators and barriers. Emerging themes in facilitators and barriers were mapped to the COM-B model for behaviour change ( 44 ). Due to the heterogeneity in study outcomes, the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) ( 45 ) approach was not used for this review. Overall certainty of evidence was determined based on the risk of bias of included study designs and study quality. Results Database searching retrieved 7067 records. After removing duplicates, 4174 records were screened by title and abstract, resulting in 1370 reports for full text review. Of those 1370 records, 55 articles were included. Scanning the publication lists of key authors retrieved 187 records, of which eight were retrieved for full text review and four were included, for a total of 59 articles included in this review. See Fig. 1 for a PRISMA flow chart illustrating the article search and selection process. Of the 59 articles in this review, 38 studies explore the implementation of EIDM at the organizational level, while 21 studies report on the implementation of selected EIPs across organizations. Study Characteristics The overall characteristics of included studies are summarized in Table 1 . Of 59 included studies, most were conducted in primary care settings (n = 26) and public health settings (n = 20), with some in social services (n = 10), child and youth mental health (n = 1), occupational health (n = 1), and palliative care (n = 1). In public health, studies of organization-wide implementation of EIDM (n = 16) were more common than studies of EIP implementation (n = 4). Most studies were conducted in the USA (n = 30), followed by Canada (n = 16), Australia (n = 8), and Europe (n = 5). Table 1 Included studies of organization-wide implementation of EIDM and implementation of EIPs Reference Study design, comparison Setting, timeline Sector Participants Intervention Outcomes (Measurement tool) Findings Quality Rating (Tool) Studies of organization-wide implementation of EIDM Allen, 2018 (71) Case report, no comparator State health department, Georgia, USA, 2013–2016 Public health Program staff across organization Program staff received training for EIDM that included lectures, and small group problem-solving and discussion. Qualitative: EIDM facilitators and barriers (interviews) Facilitators for EIDM: -Leadership support -Consistent internal messaging on EIDM -Close partnerships with evaluation teams -Requirement for evidence in proposals Barriers to EIDM: -Competing priorities -Limited budget for staff -Political conflicts in state and local agendas High (Case report) Allen, 2018 (70) Qualitative State health departments, USA, 2016 Public health Leaders and program managers State health departments to an intervention group that received EIDM training and support (See Brownson, 2017). Qualitative: EIDM facilitators and barriers (structured interviews) Facilitators for EIDM: -Leadership support -Developing structures and culture incorporating evidence based public health -Ongoing training -Building and maintaining partnerships with external partners Barriers to EIDM: -Funding/budget cuts -Lack of time -Lack of political will/support -Staff turnover Moderate (Qualitative) Augustino, 2020 (46) Case report, no comparator Military treatment facilities, USA, 2018 Primary care Nursing staff at 4 facilities An evidence-based practice facilitator role supported organization-wide EIDM teams through training, mentoring, and encouraging EIDM. Findings were described in a narrative case report. Facilitators for EIDM: -Incorporating the evidence-based practice facilitator into existing practice -Involving evidence-based practice facilitator in nursing meetings and committees -Aligning the evidence-based practice facilitator’s work with organizational priorities Barriers to EIDM: -Staff turnover -Lack of standardized evaluation of EIDM use High (Case report) Awan, 2015 (74) Case report, no comparator Centre for Addiction and Mental Health, Toronto, Ontario, Canada, 2013–2014 Primary care Service providers, researchers at organization An integrated care pathway, which relies on EIDM, was implemented for patients with concurrent major depressive disorder and alcohol dependence. Development of the integrated care pathway included evidence reviews, knowledge translation, process reengineering and change management. Quantitative: -patient symptom assessment and medication titration (Penn Alcohol Craving Scale, Quick Inventory for Depressive Symptoms scores and Beck Depression Inventory) Qualitative: -Facilitators and barriers (focus groups) Evaluation of patient care found: -Lower program dropout (78–46% p < 0.05) -Reduction in depressive symptom severity (p-value not reported) -Reduction in heavy drinking days (42–23%, p < 0.04) Facilitators for EIDM: -Inclusion and frontline clinicians -Use of tools/templates (e.g., process maps, medication algorithms) -Team meetings Barriers to EIDM: -Lack of knowledge and skill for EIDM -Communication with referring providers Moderate (Case report) Bennett, 2016 (73) Case report, no comparator Large urban hospital, Australia, 18 months; dates not specified Primary care Occupational therapists in hospital An EIDM capacity building program was implemented. The program included: -Educational outreach across organization -Teams working on clinical case studies -Allocating time for EIDM -Mentorship -Leadership support -Communication regarding EIDM -Development of EIDM processes and resources -Funding for an EIDM champion one day per week -Setting goals and targets for EIDM -EIDM reporting and evaluation Qualitative: EIDM use, perceptions of organizational culture toward EIDM, EIDM facilitators and barriers (focus groups with clinicians and observations by the research team) Facilitators for EIDM: -EIDM integration into roles -Buy-in to EIDM impact -Developing goals for EIDM -Access to mentors -Supportive leadership -Breaking down EIDM into manageable tasks -Journal club to discuss EIDM processes Challenges to EIDM: -Lack of EIDM knowledge and skill -Perceived lack of capability -Perceived lack of time and training -Competing priorities -Challenges with staff rotating between clinical teams Moderate (Case report) Breckenridge-Sproat, 2015 (61) Single group pre-post study Military hospitals, Washington, District of Columbia, USA, 18 months; dates not specified Primary care Nurses across hospitals Unit-level mentors facilitated an educational mentoring program for EIDM. The intervention involved an organizational assessment, identification of facilitators and barriers, training EIDM mentors and EIDM implementation. Librarian support, evidence-based practice education material, training modules were provided and supervised study team evidence-based practice projects were completed. Quantitative: -EIDM beliefs (Evidence-Based Practice Beliefs) -Organizational readiness and barriers to EIDM (Organizational Readiness for System-wide Integration of Evidence-Based Practice) -EIDM implementation (Evidence-Based Practice Implementation Scales) Following the intervention, -Evidence based practice belief scores increased (p = 0.02) -Organizational readiness for EIDM scores increased (p < 0.01) Moderate (Quasi-experimental study) Brodowski, 2018 (72) Case report, no comparator Social service agencies, Kansas and Nebraska, USA, 2005–2011 Social work Social service providing organizations A workgroup of state-led agencies and federal partners developed a framework for infrastructure for EIDM, including federal policy for investing in evidence-based programs and quality improvement. Technical assistance was provided to community-based programs through a third party. Quantitative: Use of EIDM (annual reported funding for evidence-based programs) Qualitative: EIDM facilitators (interviews) The percentage of funded programs that were evidence-based increased from 29–63%. Facilitators for EIDM: -Strong infrastructure (outreach, training, fidelity assessment, supervision, management of the program -Availability of Technical Assistance: -Consideration of context when using EIDM to choose programs -Active engagement and collaboration with key stakeholders at all levels High (Case report) Brownson, 2017 (78) RCT, control group State health departments, USA, March 2014 and March 2015 Public health Program staff across organization State health departments randomized to: -Intervention group that received EIDM training workshop, and follow-up calls for technical assistance and supplemental activity planning and updates support -Control group that received links to electronic resources. Quantitative: perceived organizational skills and culture for EIDM (survey) Following the intervention, -Perceived skills gaps decreased (p = 0.02). -Perceived supervisory expectation for use of EIDM increased (p = 0.006) -Use of evidence increased (p = 0.008). Moderate (RCT) Clark, 2022 (62) Mixed methods, no comparator Public health units, Ontario, Canada, 2015–2018 Public health 4–8 Staff members from each of 10 public health units Senior leadership set organizational goals for EIDM during a facilitated focus group using the Is Research Working for you organizational assessment. Knowledge translation specialist mentors delivered a Knowledge Broker mentoring program, including workshops, webinars, consultations and completion of a rapid review. Quantitative: -Attainment of organizational goals for EIDM (semi-structured interviews) Qualitative: -EIDM facilitators and barriers (semi-structured interviews) Facilitators for EIDM: -Integration of EIDM into process through structures, processes, or templates -New or re-defined staff positions for EIDM -Leadership support -Culture of expectations of EIDM -Acceptance of time to learning and do EIDM Barriers to EIDM: -Lack of managers’ EIDM knowledge -Lack of protected time -Lack of staff buy-in -Lack of direction or plan for participants High (Qualitative) Dobbins, 2019 (57) Single group pre-post study 3 Public health units, Ontario, Canada, 2010–2012 Public health All staff at organization, senior leadership Knowledge Brokers deployed to public health units supported individual capacity and organizational culture for EIDM. Knowledge brokers held workshops, mentoring, meetings with senior management and developed policies and processes for EIDM. Quantitative: -Knowledge, skills and behavioral assessment (survey) Qualitative: -EIDM facilitators and barriers (analysis of knowledge brokers journals) Facilitators for EIDM: -Strong leadership support -Systematic integration of research evidence into decision-making processes -Access to librarian support -Committed financial and human resources -Staff interest and enthusiasm Moderate (Quasi-experimental study) Elliott, 2021 (50) Case report, no comparator Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD), Canada, dates not specified Primary care Clinicians, nurses An integrated KT network (Can-SOLVE CKD) was established, including: -Central knowledge translation committee available for consultation -Support from external partners -KT planning templates -KT champions -KT virtual community of practice -KT online learning module Findings were described in a narrative case report. Facilitators for EIDM: -Diverse knowledge base and members’ commitment to KT -Inclusion of patient’s perspectives Barriers to EIDM: -Generalizability to smaller project teams -Lack of KT skills among research and patient partners Moderate (Case report) Fernández, 2014 (75) Case report, no comparator The Cancer Prevention and Control Research Network, USA, dates not specified Public health National network Workgroups across the network facilitated activities, including: -building the capacity of service providers for EIDM -developing technical assistance for KT -developing research partnerships -investigating implementation processes from other studies Findings were described in a narrative case report. Successful EIDM activities were described, including the following. Network members translated and adapted the evidence-based Stanford Chronic Disease Self-Management program which was well attended and highly rated by participants. Cancer screening programs were adapted to the local context, increasing uptake among residents. Several partner universities have implemented workplace health promotion interventions. High (Case report) Flaherty, 2021 (77) Cluster RCT, control group Outpatient child mental health clinics, New York, USA, dates not specified Primary care 52 Child mental health care providers 4Rs and 2Ss Multiple Family Group intervention: -Providers received training and bimonthly supervision. -Clinic Implementation Teams operated at agencies randomized to the intervention arm. Quantitative: Frequency of use of new techniques (Training Exposure and Utilization Scale), and organizational climate (Organizational Readiness for Change Scale) Increased use of evidence-based interventions was associated with providers’ belief that organizational climate supported use of evidence-based interventions (b = − 0.33, SE = 0.11, p < 0.01). Moderate (RCT) Gallagher-Ford, 2014 (48) Case report, no comparator Large, complex healthcare system, USA, dates not specified Primary care Departments across an organization A nurse administrator promoted and sustained a culture of evidence-based practice through the following activities: -Organizational assessments -Developing clinical nurse specialists as EIDM champions -Mentoring individuals through the change process Findings were described in a narrative case report. Clinical nurse specialists have championed EIDM across the organizations. More than 13 projects for EIDM were initiated by clinical nurse specialists. Low (Case report) Gifford, 2014 (64) Qualitative Large community healthcare organization delivering home and community healthcare, Ontario, Canada, 20-weeks; dates not specified Public health Management and clinical leaders from 4 units Strategies to promote EIDM to nurse managers and clinical leaders in home healthcare were implemented, including, -Workshop on EIDM -Mentorship support from experienced “evidence facilitators” -Access to university library services -Information-sharing activities -Encouragement and recognition Quantitative: EIDM use (Is Research Working for You? A Self-assessment Tool and Discussion Guide for Health Services Management and Policy Organizations) Qualitative: Usefulness of intervention, EIDM barriers and facilitators (semi structured interviews) Following the intervention, participants reported: -More resources to conduct research -Staff contributions to EIDM discussions -More information about how evidence influenced decisions made in the organization (all p < 0.05) Facilitators for EIDM: -Ongoing education -Linking staff to EIDM experts -Social networking across organization -Recognition for EIDM work -Audit and feedback Barriers to EIDM: -Lack of time -Lack of knowledge, skills, and confidence -Conflicting priorities within the organization -Staff shortages High (Qualitative) Haynes, 2020 (79) Case report, no comparator Australian Prevention Partnership Centre, Australia, 5 years; dates not specified Public health Organization-wide, in partnership with research institutions Six components for cross-sector collaborative partnerships for EIDM: 1. Partners involved at all stages 2. Communication efforts, e.g., forums, narrative reports 3. Skill development through workshops, webinars with experts 4. Cross-sector project teams 5. High-quality evidence syntheses 6. Ongoing surveys and opportunities for feedback Quantitative: -Perceptions of leadership, governance, resource allocation, collaboration and engagement (Partnership survey) Qualitative: -Implementation and impact of projects (project evaluations) -Experiences and perceptions (semi-structured interviews) Partners reported: -Translation of research into policy was built into processes -Many projects involved partners from different sectors -Communication across sectors and teams was adequate -Capacity building activities were valuable -Synergies were identified across projects Moderate (Case report) Hitch, 2019 (51) Case report, no comparator Public mental health service, major city in Australia, 2014–2016 Occupational therapy Occupational therapists within the organization Leadership role in KT established to support EIDM, complete research projects, build research capacity and culture, and create a database of research activity. Quantitative: -Attitudes towards EIDM (Evidence Based Practice Attitude Scale) -EIDM use (Evidence Based Practice Implementation Scale) -Staff perceptions of the Lead Research Occupational therapist role (survey) After implementation of the KT role, -number of quality assurance and research activities increased (Cliffs Delta = 0.44; 95% CI = 0.22, 0.62) -no significant change in attitudes towards EIDM -staff viewed KT role positively -staff engaged in KT activities -greater diffusion of evidence across programs Moderate (Case report) Hooge, 2022 (53) Single group pre-post study Large academic health system, southeast region, USA, 12-week program; dates not specified Primary care 11 Advanced practice registered nurses Virtual mentoring program delivered via Microsoft Teams platform included synchronous training sessions, podcasts, blog and video tutorials, and additional research articles and educational material. Quantitative: -Knowledge and skill for EIDM (Evidence-based Practice Beliefs scale, Evidence-based Practice Implementation scale) -Organizational readiness for EIDM (Organizational Culture and Readiness for System-wide Integration of Evidence-based Practice scale) Qualitative -EIDM facilitators and barriers (open-ended survey) Compared to baseline, evidence-based practice beliefs scores increased (effect size = 0.71, p = 0.018). No significant change in evidence-based practice implementation and organizational culture and readiness for system-wide implementation of evidence-based practice scale scores. Barriers to EIDM: -Competing priorities -Time management High (Quasi-experimental study) Humphries, 2013 (47) Case report, no comparator Regina Qu’Appelle Health Region and Northern Health, Alberta and British Columbia, Canada, 2008–2011 Public health Management and staff at organizations The Value Add through Learning and Use of Evidence (VALUE) initiative: -Learning projects (to practice research literacy and skills) -Liaison roles -Research support -Protected time for EIDM activities -Inter-regional collaboration Findings were described in a narrative case report. Lessons learned included: -Staff turnover was a challenge -Potential benefit to promoting evidence use in staff orientation -Evidence use implementation needs to be directed at multiple levels within the organization -Strategies with ongoing real-time research expertise and support were valued by participants High (Case report) Irwin, 2013 (49) Case report, no comparator Various healthcare settings, USA, 2009–2010 Primary care Nursing teams Institute for Evidence-Based Practice Change program was provided to nurses. This program included a 2.5-day workshop on EIDM, literature searching, and development of an implementation plan, project management, and outcomes measurement. The program also provided an experience mentor for EIDM support for 12-months. Qualitative: -EIDM facilitators and barriers (log entries from the team champion) Facilitators for EIDM: -Adequate time -Organizational support -Engagement and teamwork -Communication and planning -Maintaining focus on EIDM goals Barriers to EIDM -Competing priorities -Data collection and measurement challenges -Staff turnover Low (Case report) Kaplan, 2014 (76) Case report, no comparator Magnet-designated hospital, USA, November 1, 2012 to May 10, 2013 Primary healthcare Nurses across organization All nurses received an electronic newsletter on EIDM every 2 weeks. A cohort of direct care nurses participated in a series of EIDM workshop to develop, implement, and disseminate an EIDM project. Quantitative: Organizational readiness for integration of EIDM (The Organizational Culture and Readiness for System-Wide Integration of Evidence-Based Practice Scale), EIDM knowledge and skill (Evidence-Based Practice Beliefs Scale), EIDM implementation (The Evidence-Based Practice implementation Scale) Following the intervention, perceptions of organizational increased. Confidence in implementing EIDM was not associated with EIDM use. Higher education levels was positively associated with nurses’ EIDM use. High (Case report) Kimber, 2012 (67) Qualitative Kinark Child and Family Services, Ontario, Canada, 2006–2010 Child and youth mental health Staff across organization Multiple EIDM interventions were implemented, including: -Leadership support -Appointing working group leaders -Dedicated time for EIDM Qualitative: -EIDM facilitators and barriers (survey) Facilitators for EIDM -Staff understanding the clinical transformation project and stages -Effective leadership -Change culture inclusive of staff and management, and various disciplines -Cross-program collaboration -Protected time -Evaluation to demonstrate benefits of change Challenges to EIDM: -Underutilization of internal staff -Lack of preparation for change Moderate (Qualitative) Mackay, 2019 (58) Single group pre-post study Haemodialysis unit of a hospital, Queensland, Australia, 2016–2018 Primary care All staff at organization A new nutrition service was established to translate nutrition guidelines into practice to support EIDM through: -Professional development -Evidence-informed recommendations -Multidisciplinary staff involvement -Integrated database prompts Quantitative: EIDM use, malnutrition prevalence (database audit, Patient-Generated Subjective Global Assessment tool) Qualitative: EIDM facilitators and barriers (clinic observation, team discussion) There was no significant change in malnutrition categories; most patients (72–80%) began the program well-nourished. Facilitators for EIDM: -Establishing processes for best practices -Buy-in from staff and management-in from staff and management -Regular monitoring and feedback Barriers to EIDM: -Limited prior knowledge -Limited time Moderate (Quasi-experimental study) Martin-Fernandez, 2021 (68) Case report, no comparator Regional health agencies, France, 2017–2019 Public health Health professionals and decision-makers across regional health agencies The Transfert de Connaissances en REGion (TC-REG) knowledge translation plan: -Improved access to scientific evidence -EIDM skill development through training, journal clubs and tutoring -Organizational culture development through collaborative workshops, processes, and incentives Qualitative: -EIDM facilitators and barriers (unstructured interviews) -Use of EIDM (semi-structured interviews) Facilitators for EIDM: -Understanding of scientific evidence -Confidence in using scientific evidence -Ability to search and find scientific evidence -Motivation to use scientific evidence -Belief that scientific evidence can help to improve practice, develop new frameworks, advocate for their professional activity, and create new partnerships Moderate (Case report) Melnyk, 2017 (60) Single group pre-post study Washington Hospital Healthcare System, USA, 12 months; dates not specified Primary care Service providers, administrators within organizations EIDM mentors were developed within the healthcare system, through intensive EIDM workshops. Teams of participants implemented and evaluated an EIDM change project within their hospital. Quantitative: Knowledge and skill for EIDM (evidence-based practice beliefs scale, evidence-based practice implementation scale), organizational readiness for EIDM (organizational culture and readiness for system-wide implementation of evidence-based practice scale), patient outcomes (aggregate data from the hospital’s medical records) Following implementation, -Organizational knowledge and skill for EIDM organization increased (effect size = 0.62; p = 0.00) -Organizational implementation of EIDM increased (effect size = 2.3; p = 0.00) -Organizational culture and readiness for EBP increased significantly from baseline ( M = 80.9; SD = 90.8) to follow-up ( M = 90.8; SD = 14.7; t = 3.9; p = 0.00; effect size = 0.70) The following trends were seen in patient outcomes, -Reduction in ventilator days -Decreased pressure ulcer rate -Reduced hospital readmissions for congestive health failure -Increase in patient reported quality of care -Reduced use of formula as a supplement -Decreased wait time for pain medication and decreased length of stay in emergency room Moderate (Quasi-experimental study) Miro, 2014 (55) Single group pre-post study Fraser Health, Island Health and Vancouver Coastal Health, British Columbia, Canada, 2010–2012 Public health Organization Regional health authorities were provided an expert consultant to foster EIDM in land use and transportation plans and policies. The expert worked with staff to develop and facilitate the implementation of the work plans, by conducting a situation assessment, developing and implementing capacity-building plan. Quantitative: Knowledge and skill for land use and transportation plans/policies (survey) Qualitative: Activities completed at the health units (interviews) Following the intervention, staff reported: -Increased knowledge and skills -Increased awareness of other organizations Facilitators for EIDM -New relationships with colleagues in other health authorities, governments and sectors -Increased opportunities for collaboration -Collaboration between health authorities and local governments -New insights on partnership work Barriers to EIDM -Lack of time and resources -Roles and partnerships not clearly defined -Lack of leadership support and integration across the organization High (Quasi-experimental study) Parke, 2015 (52) Case report, no comparator Island Health and the University of Alberta, British Columbia, Canada, 2012–2014 Primary care Whole organization Scholar-in-residence roles was established to integrate practice, education, and research through collaboration between a health region and a university. Activities included: -Unit-based research teams that conducted literature reviews, literature appraisal -Workshops on writing for publication, research methods skills -Funded research project proposal writing, ethics applications, data collection and analysis -Publications and presentations -Quality improvement through collaboration with community, hospitals and university Findings were described in a narrative case report. Barriers to EIDM: -Cultural differences between the healthcare and university system -Establishing protected time for research in the health organization -Building relationship between the scholar and hospital staff Moderate (Case report) Peirson, 2012 (5) Qualitative Peel Public Health, Ontario, Canada, September 2008 to February 2010 Public health All staff at organization, including leadership Multiple EIDM interventions were implemented, including: -Hiring new leadership supportive of EIDM -Strategic organizational plan for EIDM -Development of staff knowledge and skills Qualitative: EIDM facilitators (semi-structured interviews and focus groups, review of documents) Facilitators for EIDM: -Senior leadership driving EIDM initiatives -Organizational structures (e.g., journal clubs, workshops, library services) -Establishing EIDM specialist roles, training staff in EIDM and encouraging knowledge sharing with co-workers -Supportive organizational culture -Accessible knowledge and sharing knowledge across the organization -Communication around EIDM and its priority to the organization High (Qualitative) Plath, 2013 (66) Qualitative Non-governmental social service organization, Australia, dates not specified Social work Staff across organization Strategies to promote EIDM were implemented, including: -Leadership commitment to EIDM -Staff champions for EIDM -Establishment of EIDM “communities of practice” teams Qualitative: -EIDM facilitators and barriers and facilitators (interviews and focus groups) Facilitators for EIDM: -Dedicated staff roles for research and KT -Supportive leadership -Sufficient time, training and resources for EIDM -Audit and feedback of practices -Building frontline staff skills in EIDM -EIDM “communities of practice” Challenges to EIDM: -Competing priorities -Lack of knowledge and skills -Culture of responding to crises Moderate (Qualitative) Roberts, 2020 (56) Single group pre-post study Tennessee Department of Health, Tennessee, USA, 2012–2018 Public health Departments, teams, senior leadership across organization Volunteers were trained as “Baldrige examiners”, a similar role to knowledge broker. These volunteers supported teams at the local health departments evaluate and improve programming. Quantitative: -Employee satisfaction (survey) -Adoption of new processes (training records) -Integration of new programs (program process reports) Authors report diffusion of skills across the local health departments. Department staff reported satisfaction with their jobs at rates higher than national averages. Moderate (Quasi-experimental study) Traynor, 2014 (65) RCT with control group and case report with no comparator Public health units, Ontario, Canada, RCT 2003–2007 and case report 2009–2013 Public health Organization Two studies implemented Knowledge Brokers who conducted initial and ongoing needs assessments for EIDM, knowledge management and internal network development. Quantitative: social network data, EIDM skills, knowledge and behavior (survey) Qualitative: Knowledge, attitudes and behaviours for EIDM (interviews, journal analysis) . Knowledge brokering intervention was reported to result in increased use of EIDM. Tailoring knowledge broker approaches to the organizational context was most effective. Knowledge brokers were most effective if they were experts in research methodology and public health, as well as being approachable and patient. High (Qualitative) Van der Zwet, 2020 (69) Case report, no comparator Social work Organization, Netherlands, 2013–2015 Social work Research and development team Research and development department and long-term collaboration with a university were established to support EIDM. Qualitative: -EIDM facilitators and barriers (semi-structured interviews) Facilitators for EIDM: -Leadership commitment to research -Qualified staff in EIDM support roles -Research partnerships -Training in EIDM -Targeted recruitment of staff with diverse educational backgrounds Barriers to EIDM: -Negative attitudes towards EIDM -Preference for experiential vs. research knowledge -Culture of crisis-driven practice -Workload, time management, competing priorities High (Case report) Ward, 2012 (4) Case report, no comparator Peel Public Health, Ontario, Canada, 2010-11 (Year 4 of a 10-year initiative) Public health All staff at organization, including leadership Key elements of the EIDM strategic approach included: -Structured process for research review -Library reference service -Staff development in EIDM knowledge and skills -Dedicated staff time for EIDM -Active engagement with the research community -Accountability for EIDM at all levels of the organization Findings were described in a narrative case report. After 4 years of implementation, there was systematic and transparent application of research to more than 15 program decisions. EIDM was embedded as a cultural norm within the organization. Key lessons identified included: -Identify a senior, influential leader -Commit to a multiyear strategy -Be realistic about the infrastructure needed -Staff support for skill development -Make senior staff accountable for progress -Partner with leading researchers -Invest resources in change management. -Measure progress to communicate successes to staff Moderate (Case report) Waterman, 2015 (63) Qualitative The Greater Manchester Collaboration for Leadership in Applied Health Research and Care, Manchester, United Kingdom; dates not specified Public health Organization KT Associates facilitated the implementation of EIDM. KT Associates joined teams responsible for implementing EIDM along with the clinical lead, academic lead and program manager. Qualitative: -Evaluation of KT Associates’ role and impact (focus group and interviews) KT Associates contributed to 4 key stages: -Choosing an evidence-based intervention (collecting information, bringing stakeholders together, identify context, build up network) -Planning the evidence-based intervention (collecting evidence, testing the intervention, sharing info, expanding networks, stakeholder meetings) -Co-ordinating and implementing the evidence-based intervention recruit people and build relationships, individualized support, communication, understanding context) -Evaluating evidence-based intervention (data collection/report, patient and staff experiences, celebratory events, poster/presentations) High (Case report) Williams, 2020 (109) Single group pre-post study Outpatient children’s mental health clinics, Philadelphia, USA, 2013–2017 Primary care Senior leadership across agencies Development of organizational leadership and climate for EIDM through training, consultation and technical assistance. Quantitative: -EIDM use (Cognitive-behavioral therapy subscale of the Therapy Procedures Checklist-Family Revised) -Leadership for EIDM (Implementation Leadership Scale) -Organizations’ climates for EIDM (Implementation Climate Scale) -Perceptions of leader’s transformational leadership (Multifactor Leadership Questionnaire) -Attitudes toward EIDM (Evidence-based Practice Attitudes Scale) Organizational climates supportive of EIDM were associated with: -Strong leadership for EIDM (d = 0.92, p = 0.017) -Increased use of EIDM (d = 0.55, p = 0.007) There was no association between clinicians’ attitudes towards EIDM and their use of EIDM. High (Quasi-experimental study) Williams, 2019 (59) Single group pre-post study Metabolic specialist centres, Australia and New Zealand, 2015–2017 Primary care Metabolic dietetic service within organization The metabolic dietetic service established: -Electronic referral alert -Metabolic sick day nutrition plans available to all clinical staff -Metabolic diet codes and specialised formula recipes Quantitative: Admissions for patients with inborn errors of metabolism (chart audit) There was a reduction in total admissions of patients with inborn errors of metabolism (36 vs. 11 across the audit periods; unclear if this was a statistically significant finding.) Moderate (Quasi-experimental study) Williams, 2017 (54) Single group pre-post study Children’s mental health agencies, large midwestern urban area, USA, 2010–2013 Primary care CEOs and administrators, and front-line clinical teams at organizations External facilitators supported leadership, staff and an internal liaison. Principles of EIDM were integrated into the organizations’ operating procedures. Organizational infrastructure and tools to enable EIDM were developed. Staff and leadership mental models to support EIDM were enabled. Quantitative: Intentions to adopt EIDM, barriers to EIDM (surveys), Unit-level enactment of Availability, Responsiveness, and Continuity principles and completion of planned activities (ARC principles questionnaire), Organizational proficiency culture for EIDM (Organizational Social Context measure) Following implementation, clinicians exhibited: -Higher odds of adopting EIDM (OR = 3.19, p = 0.003) -Greater use of EIDM with clients (p = 0.003) -Fewer EIDM barriers (p = 0.026) Intention to use EIDM was the only predictor of EIDM adoption (p = 0.032) and EIDM use (p = 0.002). High (Quasi-experimental study) Studies of implementation of EIPs Connell, 2019 (110) Case report, no comparator Department of Children and Families, Connecticut, USA, 2011–2016 Social work All staff at organization Implementation of trauma-informed care, through workforce development, trauma screening procedures, policy changes, improved access to evidence-based trauma-focused treatments, and focused evaluation of changes. Quantitative: -Staff perceptions of individual and organizational use of trauma-informed practices (Trauma System Readiness Tool) -Staff perception of contributions of each intervention component to success of program (survey) Staff and organizational use of trauma-informed practices increased. Staff rated the availability of trauma-focused treatments in the community, integration of trauma-informed care into practice guides as the strongest contributors to organizational change. High (Case report) Damschroder, 2013 (111) Case report, no comparator Five Veteran Affairs facilities, USA, July and October 2007 Public health Organization Implementation of the MOVE! weight management program, a multi-tiered set of tools and treatment options based on published guidelines for obesity management. Qualitative: -Facilitators for implementation (semi-structured interviews with 24 key stakeholders) Facilitators for implementation, according to the Consolidated Framework for Implementation Research: 1. Inner setting: -Strong working relationships -Tension for change (seeking and welcoming new programming and improvements) -Priority of the change or program -Goals and feedback ( -Learning climate -Leadership engagement to support the program 2. Process: -Planning a formal implementation plan 3. External change agents: -Audit and feedback 4. Intervention characteristics: -Relative advantage over alternatives 5. Outer setting: -Staff who are aware of patient needs High (Case report) Darling, 2021 (112) Case report, no comparator Alongside Midwifery Unit, Markham Stouffville Hospital, Markham, Ontario, Canada. November 2018-May 2020 Primary care Unit within a large community hospital Implementation of the first Alongside Midwifery Unit in Canada: -Frequent and open communication -Dedicated project management -Leadership engagement -Ongoing evaluation and adaptation. Qualitative -Facilitators (document analysis and key informant interviews) Facilitators for implementation: -sociopolitical climate, desire for change, effective project support, dedicated time and resources, ongoing program evaluation and feedback, communication with leadership, involving all staff in planning and decision making. Moderate (Case report) Fabbruzzo-Cota, 2016 (113) Single group pre-post study Mount Sinai Hospital, Toronto, Ontario, Canada, 2012–2014 Primary care Organization An advanced practice nurse-led interprofessional initiative to reduce hospital-acquired pressure ulcers using evidence-based practice: -Clinical experience integrated with theory, research and expert opinion -Synthesizing, critiquing and applying research - Involvement of interprofessional teams and senior leadership -Funding -Education Quantitative: -Incidence of pressure ulcers (Quarterly pressure ulcer prevalence and incidence audits) -Uptake of change in clinical practice (audits) Findings included: -80% decrease in hospital acquired pressure ulcers since the implementation. -63% of at-risk patients had a turning click posted at the bedside. -All units had the Positioning Decision Tree for Patients at Risk available -28 Skin and wound nurse champions -2 Nurses joined Skin and Wound Care Steering Committee Moderate (Quasi-experimental) Fearing, 2014 (114) Case report, no comparator Kinark Child and Family Services Ontario, Canada 2006–2009 Social work Organization This report explores the process of an evidence-based practice implementation effort in all clinical services. Implementation was driven by multidisciplinary implementation teams. Qualitative: -Managers perceptions (audio recording of management meetings) Facilitators for implementation: -Clearer understanding of the organization’s clinical supervision model -Development of sustainability plans -Practice Lead and Peer Coach -Organizational culture change Barriers to implementation: -Staff workload -Limited resources High (Case report) Hurlburt, 2014 (115) Case report, no comparator Large children’s service system, California, USA, 2008–2009 Social work 27 Stakeholders (community, directors, supervisors, trainers, coaches, front line providers) The Interagency Collaborative Team (ICT) model was used to implement an evidence-based child neglect intervention (SafeCare): -Stakeholder education and alignment -Practice fit assessment -Resource support -Skill development -Monitoring and feedback. -Distributed local leadership -Program adaptation. Qualitative: personal-, organizational- and system-level factors affecting implementation (semi-structured interviews) Facilitators for implementation: -Initial commitment and collaboration among stakeholders -Cross-level leadership -Practice fit to the local context -Ongoing negotiation of rights, roles, responsibilities, and interests among stakeholder organizations -Early successes Barriers to implementation: -Insufficient communication High (Case report) Kane, 2017 (116) Case report, no comparator Public health departments, USA, 2010–2012 Public health Organization The Communities Putting Prevention to Work (CPPW) Initiatives program was implemented to increase high-impact, evidence-based, population-wide environmental improvement strategies. The program implemented strategies through partnerships with local, community and state organizations. Quantitative: Completion of work plan objectives, leadership support, collaboration, staff turnover (site visits and interviews) The following conditions were found to lead to successful completion of objectives 88.2% of the time: -Having public health improvement and topical experience and having a history of collaboration with partners 2)Not having public health improvement and topical experience and having leadership support Moderate (Case report) Kegeles, 2015 (117) Single group pre-post study Community-based organizations, USA, 2-year data collection period; dates not specified Public health 2–4 Individuals (coordinators, leadership, volunteers) from 72 community- based organizations The Mpowerment Project, a multi-level HIV prevention intervention, was implemented. Implementation included education for providers, resources for providers, e.g., manuals and videos. The community-based organizations implementing the program were involved in planning the implementation. Qualitative: barriers and facilitators to implementation (semi-structured interviews, notes and commentaries from technical assistance providers) Facilitators for implementation: -Buy-in from service providers -Planning prior to implementation -Evaluation of intervention -Organizational stability Barriers to implementation: -Program complexity -Program adaptability Moderate (Quasi-experimental) McAllen, 2018 (118) Single group pre-post study 532-bed, acute care tertiary teaching hospital, midwestern USA, dates not specified Primary care 3 Units within the hospital A bedside report was implemented in standard nursing care. Staff were involved in implementation planning and provided education. Quantitative: -Compliance (audits) -Number of patient falls (hospital incident reporting system) -Patient satisfaction (a combination of questions from the Press Ganey® and Hospital Consumer Assessment of Healthcare Providers and Systems surveys) -Nurse satisfaction (survey) Findings included: -Program compliance rate of 94% -Patient falls decreased by 24% in the four months after implementation -One unit had improvement in patient satisfaction (p = 0.03) -Significant reduction in the proportion of nurses who reported having enough time for report (80–59.6%, p = 0.008) Moderate (Quasi-experimental) McCarthy, 2021 (119) Case report, no comparator Child welfare system, Victoria, Australia, dates not specified Social work Organization This case report explores the adoption and implementation of evidence-based practice within the child welfare system. Implementation was initiated by new leadership. A new role dedicated to implementation was established. Staff recruitment focused on hiring individuals with experience implementing evidence-based practices. Qualitative: -Facilitators for implementation (interviews) Facilitators for implementation: -Consistent communication and messaging -Adaptive management -Building a shared understanding of evidence -Development of a learning culture -Investment in staff skilled in evidence-based practice -Building relationships -Transformational leadership approach Moderate (Case report) McConnell, 2015 (120) Case report, no comparator Health and social care trust, Northern Ireland, 2011–2012 Palliative care Two policymakers from the Department of Health, Social Services and Public Safety, and 22 participants from two service groups (Cancer and Specialist Services, and Acute Services) The Liverpool Care Pathway was implemented to improve best practice in end-of-life care. Implementation involved a dedicated program facilitator, education for staff, regular evaluation and feedback. Qualitative: facilitators and barriers for implementation (realist evaluation, semi-structured interviews) Facilitators for implementation: -Visibility and availability of program facilitator as a reminder to use pathway and support staff -Sharing positive feedback -Supportive senior management Barriers to implementation: -Lack of resources -Differing needs and expectations -Ambivalence toward pathway approach from medical providers -Lack of ongoing senior management support and withdrawal of program facilitators -Social barriers (i.e., negative public perceptions in response to negative media) Moderate (Case report) Nelson, 2016 (121) Case report, no comparator Alberta Health Services, Alberta, Canada, February 2013-December 2014 Primary care Within a single health care system for colorectal surgery A guideline for enhanced recovery after colorectal surgery was implemented. Implementation included an multidisciplinary implementation team and ongoing audit and feedback. Quantitative: -Length of stay, complications, and 30-day post-discharge 30-day post-discharge readmissions (Interactive Audit System) -Guideline compliance (interview audit) Findings at 15 months of implementation: -Median length of stay reduced from 6 days to 4.5 days (p < 0.0001) -Reduction in the risk of readmission (adjusted RR = 1.73; 95% CI = 1.09, 2.73) -Reduction patients who develop a complication (-11.7%, 95% CI = 2.5%, 21%) -Net cost savings between $ 2806 and $ 5898 USD/patient -Median overall guideline compliance increased from 39–60% High (Case report) Poehler, 2020 (122) Case report, no comparator Local health departments, Missouri, USA, January-April 2017 Public health Organization Twenty diabetes-related evidence-based programs and policies were implemented in local health departments. Staff capacity to implement these programs was developed through training and provision of resources. Qualitative: -Facilitators, barriers and capacities to use evidence-based programs and policies (interviews with directors and diabetes/chronic disease practitioners) Facilitators for implementation: -Knowledge of evidence-based programs and policies -Leadership support -Targeted messaging -Staff capacity building for EIDM evidence-based decision making -Access to professional development/training -Regular staff communications/ meetings -Meetings with internal and community decision makers -Community-relevant evidence Barriers to implementation: -Community perception/buy-in -Limited resources (funding and staff) Moderate (Case report) Pullyblank, 2022 (123) Single group pre-post study Clinical health departments and community-based organizations, rural New York state, USA, March 2017- Nov 2019 Primary care Organization Multi-sector collaboration between a rural health care system and a network of community-based organizations, and establishment of a central recruitment, referral and coordinating office for the region. Quantitative: Number of referrals (electronic health records), implementation, training, workshop schedules, quality assurance (Living Well internal documents), Workshop attendance and completion (program records) The number of program workshops offered increased from 4–6/year to 23 by 2019. The number of community-based organizations grew from 4 to 6 counties. The number of non-referring clinics fell from 27 to 9. Health care providers and community-based organizations integrated the Living Well program into their culture of care. Multi-sector approach using a central hub supported implementation of evidence-based programs in rural locations. High (Quasi-experimental) Rodriguez-Quintana, 2022 (124) Single group pre-post study Wolverine Human Services juvenile residential facilities, Michigan, USA, 2013–2018 Social work Organization A cognitive behavioural therapy program was implemented. The program was adapted fit the needs of the population and the multidisciplinary health team. Strategies used to support the programs integrated all team members. Qualitative: -Implementation facilitators (site visits by the cognitive behavioral therapy intermediary and implementation research team for an intensive immersion) Facilitators for EIDM: -Dedicated implementation teams -Progress monitoring -Adapting the program to meet organization’s needs -Training/supervision -Consultation calls to support implementation -Train-the-trainers approach Moderate (Quasi-experimental) Schreiber, 2015 (125) Case report, no comparator Pediatric outpatient facility with one primary and three satellite clinics, USA, 6-month duration; dates not specified Primary care 17 physical therapists A multicomponent KT program was implemented to increase the use of standardized outcome measures and address inconsistency of frequency and duration of physical therapist services. The KT program included: barrier identification, use of a knowledge broker, workshops / practice sessions, online and hard-copy resources, and an ongoing program evaluation with communication of results. Quantitative: knowledge assessment (baseline, 8-month follow-up), self-report surveys, chart review data on use of outcome measures Knowledge assessment scores increased from 54.1 to 81.8 (p < 0.001). Self-reported knowledge improved for test selection (p = 0.003), administration (p = 0.001), interpretation (p = 0.001), and sharing of results (p = 0.022). Self-reported performance of testing and measurement improved for test selection (p = 0.001), administration (p < 0.001), and interpretation (p = 0.006). Frequency of administration increased for all outcome measures for 8-month program duration. High (Case report) Scott, 2022 (126) Case report, no comparator Wolverine Human Services juvenile residential facilities, Michigan, USA, 2013–2018 Social work Organization Cognitive behavioral therapy was implemented across facilities. Adaptation involved an implementation team, needs assessment, development of an implementation template, site training and ongoing reassessment. Quantitative: -EIDM needs assessment (Evidence-Based Practice Attitude Scale, Attitudes Toward Standardized Assessment Scale, Organizational Culture Survey, Survey of Organizational Functioning and Infrastructure Survey and Sociometric Opinion Leader Survey) Qualitative: -Perceived effectiveness of implementation strategies, organizational culture and readiness for change, and impact of infrastructure (Focus group interviews with clinicians and operations staff) The needs assessment identified 76 barriers; 23 were prioritized and addressed. On reassessment, 24 of the barriers showed statistically significant improvement. Barriers to implementation: -Lack of training in evidence-based practice -Poor communication -Low morale among staff -Lack of teamwork -Lack of incentive -High staff turnover Moderate (Quasi-experimental) Stevans, 2015 (127) Case report, no comparator The University of Pittsburgh Medical Center, Centers for Rehab Services, Pennsylvania, USA, 2005 Primary care Organization The Low Back Pain Quality Improvement Initiative project was implemented. A local consensus process engaged providers in planning. Implementation champions supported the program. Providers were provided with education for the project. Implementation was evaluated regularly, and feedback applied to adjust strategies. Qualitative: Facilitators for implementation (interviews) Facilitators for implementation: -Understanding the complex nature of the clinical setting from a systems perspective to identify implementation barriers. -Multicomponent intervention strategy -Vision, leadership, and commitment from all the members of the organization -Iterative measurement, reassessment, and refinement of strategies. High (Case report) Wilkinson, 2019 (128) Qualitative Two regional sites, Queensland, Australia, dates not specified Primary care Team A medical nutrition therapy model of care for gestational diabetes mellitus was implemented at local regional sites. The implementation strategy included developing local consensus processes, self-monitoring clinician behaviour, prompts and cues, adjusting and reorganising clinic environment. Qualitative: stakeholder experiences and learnings (semi-structured interviews) Facilitators for implementation: -Engagement with an external project team -Robust project methodology and guided process to overcome local barriers -Wide, ongoing site stakeholder engagement and local networking -Multi-disciplinary higher-level management support and engagement -Positive attitude -Building confidence and capacity of local implementers through regular contact High (Qualitative) Wilkinson, 2018 (129) Single group pre-post study South-East Queensland Hospital, Queensland, Australia, 2016–2017 Primary care Organization A medical nutrition therapy model of care for gestational diabetes mellitus was adapted at local regional sites. The adaptation strategy included a needs assessment, barrier analysis and adaptation to local context. Quantitative: service attendance metrics, anthropometry, diet quality, interventions delivered (hospital records) Guideline adherence increased over time (4.4% − 50%, p < 0.001). High (Qualitative) Williams, 2018 (130) Case report, no comparator Department of Behavioral Health and Intellectual DisAbility Services, Philadelphia, Pennsylvania, USA, 2 years; dates not specified Primary care Network of clinics Policy initiative for 4 psychotherapy protocols was initiated. A dedicated role for implementation was established. Clinicians were trained in the new psychotherapy protocols. Quantitative: impact of work environment on personal well-being and strategic implementation climate, perceptions of organizational for EIDM (survey) In organizations with more supportive work environments, organizational support for EIDM predicted implementation. In organizations with less positive work environments, there was no association between implementation and organizational support. High (Case report) Study designs included case reports (n = 30), single group pre-/post-test studies (n = 16), qualitative studies (n = 11), and randomized controlled trials (RCTs) (n = 2). Both RCTs evaluated the implementation of organizational EIDM. Studies reported quantitative (n = 19), qualitative (n = 29), or both quantitative and qualitative results (n = 11). For the studies that reported quantitative results, measures included EIDM implementation, EIDM-related beliefs and behaviours, organizational priorities for EIDM, use of EIPs, and patient care quality indicators. Quantitative measures were heterogenous and did not allow meta-analysis. Qualitative findings were generated through formal qualitative analysis (n = 33) or descriptive case reports (n = 16). Most qualitative results included facilitators and barriers to implementation (n = 32). Study Quality The critical appraisal checklist used to assess each study is indicated in Table 1 . Single group, pre-/post-test studies were evaluated according to the JBI Checklist for Quasi-experimental Studies ( 42 ). For studies of organization-wide implementation of EIDM, a lack of control groups contributed to a higher risk of bias. Most included studies were rated Moderate or High quality according to their respective quality assessment tools. Therefore, the overall methodological quality for this body of literature was rated as Moderate. Likewise, studies of EIP implementation also lacked a control group, contributing to a higher risk of bias. Included studies were rated Moderate or High quality according to their respective quality assessment tools but given that this literature was dominated by case reports with non-systematic assessments of outcomes, the overall methodological quality for this body of literature was rated as Low. Strategies for implementing organization-wide EIDM Due to the heterogeneity of study designs, interventions, and outcomes, it was not possible to determine which EIDM implementation strategies are more effective compared to others. Implementation strategies included the establishment of Knowledge Broker-type roles, building the EIDM capacity of staff, and research or academic partnerships. Evaluation of strategies implemented by studies in this review was often qualitative and described facilitators and barriers, rather than quantitatively measuring effectiveness. However, it is possible to explore EIDM implementation strategies and factors that appear to contribute to or inhibit success. The most common strategy implemented in included studies was the establishment of Knowledge Broker-type roles, which was the primary strategy in 22 studies ( 46 – 67 ). Studies described roles differently, e.g., “Evidence-based Practice Facilitator”, “Evidence Facilitator”, “EIDM Mentor”. These roles all served to support EIDM across organizations though knowledge sharing, evidence synthesis, implementation, and other EIDM-related activities. In some studies, new staff were hired to Knowledge Broker roles, or developed among existing staff, while in others, Knowledge Brokers were contracted from external organizations. Knowledge Broker strategies were mostly implemented in parallel with other EIDM implementation strategies, such as capacity building for staff, integrating EIDM into decision-making processes and development of leadership to support EIDM. When these strategies were evaluated quantitatively for organizational capacity, culture and implementation of EIDM, most studies found positive results, such as increased scores for organizational climates supporting EIDM, improved attitudes toward EIDM, or the integration of EIDM into processes( 51 , 54 , 56 , 59 – 61 , 64 , 65 ), although some studies found no change ( 53 , 58 ) following implementation of Knowledge Broker roles. Qualitatively, most studies described facilitators and barriers to EIDM, either through formal qualitative analysis or case report ( 5 , 46 , 49 , 50 , 52 , 53 , 57 , 58 , 62 , 64 , 66 – 74 ) Facilitators included organizational culture with supportive leadership and staff buy-in, expectations to use evidence to inform decisions, accessible knowledge, and integration of EIDM into processes and templates. Barriers included limited time and competing priorities, staff turnover, and lack of understanding and support from management. Ten included studies focused primarily on building EIDM capacity of existing staff at the organization, often at multiple levels (e.g., front-line service providers, managers, and leadership) ( 4 , 5 , 68 , 70 , 71 , 73 – 78 ). Capacity building was typically done through EIDM-focused workshops, often with ongoing follow up support from workshop facilitators. While studies often measured changes in individual knowledge and skill for EIDM for workshop participants, organizational change for EIDM was reported qualitatively, either through formal qualitative analysis or through a case report. Facilitators for EIDM in these ten studies included organizational culture with supportive leadership and staff buy-in, dedicated staff roles to support EIDM, opportunities to meet and discuss EIDM (e.g., communities of practice, journal clubs), knowledge sharing across the organization, expectations to use evidence to inform decisions, accessible knowledge, and integration of EIDM into processes and templates. Barriers included limited time and competing priorities, staff turnover, and negative attitudes toward EIDM. Research or academic partnerships and networks were the main strategy described in three case reports ( 69 , 72 , 79 ). These involved establishing collaborations, either through universities or non-governmental health organizations, that provided direct EIDM support. These strategies were not evaluated quantitatively but described facilitators and barriers to effective cross-sector collaborations. Facilitators for EIDM included supportive leadership and management, dedicated staff roles to support EIDM, EIDM knowledge and skill development for staff, and regular communication between partners. Barriers included limited time and competing priorities, preference for experiential over research evidence, and negative attitudes toward EIDM. Overall, studies described successes in implementing EIDM across organizations, citing several common key facilitators and barriers. To instigate behaviour change, strategies must address capability for change, which may be achieved by building staff capacity, establishing dedicated support roles, improving access to evidence, and sharing knowledge across the organization. Strategies must also enable opportunities for change, which may be supported through forums for EIDM learning and practice, protecting time for EIDM, integrating EIDM into new or existing roles, and adding EIDM to processes and templates. Behaviour change also requires motivation, which may be built through a supportive organizational culture, expectations to use EIDM, recognition and positive reinforcement, and strong support from leadership. Strategies for implementing EIPs Studies of implementing EIPs in public health, health or social care organizations reveal the complexity of implementation strategies. Many included implementation studies describe multiple concurrent strategies. The most common strategy used in studies of EIP implementation was the establishment of a dedicated role or team to support implementation (n = 11). These dedicated staff or teams were responsible for implementation planning, management, and evaluation. The next most common strategy was workforce education (n = 8), which typically involved workshops for staff at multiple levels of the organization, providing orientation to and the impetus for the new practice. Supplemental resources (e.g., manuals and visual prompts) were provided to staff in several studies (n = 5). Another strategy for implementation was the engagement of providers and staff at organizations in the development of implementation plans(n = 7). In some studies, implementation planning for EIPs was adapted to organizational context (n = 4) or informed by barrier analysis (n = 2). Many implementation strategies included ongoing evaluation of implementation while providing feedback to providers (n = 5). In terms of facilitators for successful implementation of evidence-informed practice, many studies describe the strategies listed above as facilitators. Additional facilitators include staff desire for change, supportive leadership, consistent communication and messaging, and a culture of learning. Barriers for implementation were fairly consistent across studies. Barriers included a lack of staff knowledge and understanding of the new program, poor communication between the implementation team and providers or staff, staff turnover and loss of knowledge, lack of both time and personnel, and complexity of programs. Key considerations for implementing EIDM and EIPs Many of the facilitators and barriers to EIDM and EIP implementation are common across strategies explored by the studies included in this review. To conceptualize these factors, they are presented according to the COM-B model for behaviour change ( 26 ) in Fig. 2 . Discussion Strategies to implement both EIDM or EIPs across organizations include establishing specialized roles, providing staff education and training, developing processes or mechanisms to support new practices, and demonstrating leadership support. Facilitators and barriers for these strategies align with the COM-B model for behaviour change, which outlines capability, opportunity, and motivation as influencers of behaviour (Fig. 2 ). The COM-B model provides a comprehensive framework for the factors that influence behaviour change and has provided a valuable structure for evaluating barriers and facilitators to behaviour change in public health and related fields ( 28 , 80 – 82 ). The capability section of the COM-B model reflects whether the intended audience possess the knowledge and skill for a new behaviour. Findings from this review establish facilitators for EIDM and EIP implementation capability, including the development of staff knowledge and skill, establishing specialized roles, and knowledge sharing across the organization. The development of staff knowledge and skill for EIDM are a necessary component to ensure EIDM in practice, however, literature has found that the organization-wide impact of conducting only individual-level knowledge and skill development is limited ( 83 – 85 ). While knowledge and skill development are a necessary component to EIDM practice, they must be supported by other components to have an impact beyond the individual. Other strategies that support the use of newly gained knowledge and skills include the establishment of specialized roles for EIDM. Knowledge Broker roles have been used across diverse contexts and show promise in supporting organization-wide EIDM and EIP implementation ( 35 , 62 , 65 , 86 – 90 ). Factors that influence the success of staff in Knowledge Broker roles align with those mapped to opportunity and motivation in the COM-B model, including the integration of EIDM into processes, knowledge sharing, and supportive organizational culture ( 23 , 35 , 57 , 62 , 65 , 91 ). Knowledge Brokers can also help facilitate knowledge sharing across the organization, which was another facilitator mapped to the capability level of the model ( 23 , 57 , 62 , 91 ). Knowledge sharing refers to the shared learning, knowledge products and resources for EIDM. At large public health organizations, it can be challenging to facilitate knowledge sharing between teams and departments ( 92 , 93 ). Integrating technology can help; there have been some advances driven by the COVID-19 pandemic, such as the development of knowledge sharing platforms ( 94 – 97 ). Public health organizations seeking to implement EIDM or EIPs should invest in their knowledge sharing infrastructure. Barriers to the capability for EIDM and EIP behaviours include staff turnover and subsequent knowledge loss. Staff turnover is especially challenging for interventions that involve staff in dedicated Knowledge Broker roles and interventions that build the knowledge and skill for staff to engage in evidence use ( 5 , 47 , 62 , 91 ). In some cases, individuals who are trained in the Knowledge Broker role are then promoted to new roles or management and have fewer opportunities to apply their Knowledge Broker skills ( 62 ). Organizations that implement these strategies should be cognizant of the potential for knowledge loss due to staff turnover when selecting staff for Knowledge Broker roles or capacity building opportunities. The opportunity portion of the COM-B model reflects whether there is opportunity for new behaviour to occur. Facilitators for organizational EIDM and EIP include the development of processes or mechanisms to support new practices, forums for learning and skill development, and protected time. The development of processes and mechanisms that support new practices can act as a reminder for staff, and may include re-design of planning or decision-making templates to capture supporting evidence, or adding EIPs to agendas for regular meetings ( 46 , 57 , 58 , 79 ). The use of reminders for organizational behaviour change and implementation of clinical practice guidelines has been shown to be an effective strategy across many contexts ( 98 – 101 ). Organizations seeking to implement EIDM or EIPs should consider revising current templates and processes to support their initiatives. Forums for learning and skill development provide staff with opportunities to gain knowledge and practice newly acquired skills in supportive settings, such as communities of practice or journal clubs. Other literature shows that these forums can be effective in developing knowledge and skill and should foster an environment of learning without fear of reprisal for making mistakes ( 102 , 103 ). Finally, protected time to apply EIDM and EIPs was found to be a facilitator for opportunity in the COM-B model, while competing priorities were found to be a barrier. In public health practice, staff are often challenged with high workloads, so that EIDM may be viewed as an additional burden rather than a means to improve practice ( 11 , 104 ). For an EIDM approach to be practiced, staff must be provided with sufficient time to apply and practice skills. Organizations should consider involving middle management who oversee staff time allocations, rather than only senior leadership, to help ensure that staff are provided with the time they need and that expectations are adjusted accordingly ( 62 , 89 ). The final influencer in the COM-B model, motivation, reflects whether there is sufficient motivation for a new behaviour to occur. Facilitators include supportive organizational culture, expectations for new practices to occur, recognition and positive reinforcement, and strong leadership support. The influence of organizational culture on evidence-informed practice at health organizations has been explored in a previous systematic review by Li et al ( 105 ). This systematic review of organizational contextual factors that influence evidence-based practice included 36 studies conducted in healthcare settings. Findings align with facilitators identified above, especially leadership support, which was found to impact evidence-based practice as well as all other factors that influence evidence-based practice ( 105 ). The review also found that monitoring and feedback contributed to implementation of evidence-based practice, which aligns with recognition and positive reinforcement in the COM-B model above ( 105 ). Notably, another factor that was mapped to the COM-B model was the expectation for new practices to occur, which was not explicitly identified as an influence on practice ( 105 ). While Li et al acknowledge that leadership that neglects to hold staff accountable are detrimental to implementation of EIDM, this accountability and clear expectations for change practice were a stronger finding in this current rapid systematic review. Barriers to motivation included a lack of understanding or support from management. This aligns with the need for leadership support and ties in with opportunity, since it is often management that determine the allocation of staff time for EIDM and EIP work ( 62 , 89 ). Another barrier was negative attitudes toward new practices. Attitudes and the belief that EIDM is associated with positive outcomes is a key factor in overall competence for EIDM ( 106 ). Efforts to address negative attitudes within staff, especially at the leadership level, may improve implementation of EIDM and EIP. While this review provides a comprehensive overview of interventions to support EIDM and EIP in public health and related organizations, it does have some limitations. Given the heterogeneity of included studies, it was not possible to discern which implementation strategies for EIDM or EIP are more effective compared to others. Knowledge Broker roles, building capacity for EIDM, and research-academic partnerships were all shown to contribute to EIDM and EIP, but study findings do not support that one strategy is superior to others. Given the highly contextual nature of these interventions, it is likely that the relative effectiveness of different interventions depends on the organization’s unique set of characteristics. Evaluation of efforts is also critical to determine if change efforts are successful or need to be adjusted. It is possible that a combination of strategies would maximize the likelihood that diverse needs of staff are met, though rigorous studies to evaluate this hypothesis are needed. Most studies included in this review are non-randomized studies of interventions. Given the importance of context in organizational change, randomized controlled trial designs may not be well-suited to evaluate studies of EIDM and EIP implementation ( 107 ). High-quality single-group studies, such as prospective cohort analytic studies evaluated with validated measures or qualitative descriptive analyses of case studies with thorough descriptions of interventions and context, may be more appropriate designs for designing future initiatives in this field. However, arguments have been made for the use of randomized trial designs in implementation research ( 108 ). Foy et al advocate for overcoming contextual barriers by using innovative trial designs, such as the multiphase optimization strategy approach, where a series of trials identify the most promising single or combined intervention components, or the sequential multiple assignment randomized trial approach, where early results inform tailoring of adaptive interventions ( 108 ). These designs may be a promising approach to conducting trials within highly contextual settings. This review provides a comprehensive, in-depth analysis of facilitators and barriers for the implementation of EIDM and EIP in public health and related organizations. Mapping facilitators and barriers to the COM-B model for behaviour change provides a helpful framework for implementation considerations. This work will support the implementation of future EIDM and EIP initiatives. Conclusion This review explored the implementation of EIDM at the organizational level, as well as the implementation of selected EIPs across organizations. Despite the similarity of these implementation challenges, studies used distinct strategies for implementation. The facilitators and barriers are consistent across included studies and provide insight for planning and achieving successful implementation. Abbreviations EIDM: Evidence-informed Decision Making EBP: Evidence-based Practice EIP: Evidence-informed Practice GRADE: Grading of Recommendations, Assessment, Development and Evaluations JBI: Joanna Briggs Institute KT: Knowledge Translation RCT: Randomized Controlled Trial Declarations Ethics approval and consent to participate Not applicable. Consent for publication Not applicable. Availability of data and materials All data generated or analysed during this study are included in this published article [and its supplementary information files. Competing interests None declared. Funding The National Collaborating Centre for Methods and Tools is hosted by McMaster University and funded by the Public Health Agency of Canada. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada. The funder had no role in the design of the study, collection, analysis, or interpretation of data or in writing the manuscript. Authors' contributions E.C.C. and M.D. designed the study. E.C.C., L.H., R.B., R.T., and T.B. completed screening, quality assessment and data extraction. E.C. and M.D. analyzed study results. E.C.C. and T.B. wrote the manuscript in consultation with M.D. All authors read and approved the final manuscript. Acknowledgements The authors would like to acknowledge the NCCMT’s Rapid Evidence Service, particularly Alyssa Kostopoulos, Sophie Neumann and Selin Akaraci, for their contributions to this review. References Public Health Agency of Canada. Core Competencies for Public Health in Canada. 1 ed2008. National Collaborating Centre for Methods and Tools. Evidence-Informed Decision Making in Public Health 2022 [Available from: https://www.nccmt.ca/tools/eiph. World Health Organization. WHO guide for evidence-informed decision-making. Evidence, policy, impact [Internet]. 2021. Ward M, Mowat D. Creating an organizational culture for evidence-informed decision making. Healthc Manage Forum. 2012;25(3):146-50. Peirson L, Ciliska D, Dobbins M, Mowat D. Building capacity for evidence informed decision making in public health: a case study of organizational change. BMC Public Health. 2012;12:137. Li S, Cao M, Zhu X. Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses-systematic review. Medicine (Baltimore). 2019;98(39):e17209. Mathieson A, Grande G, Luker K. Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis. Prim Health Care Res Dev. 2019;20:e6. Brownson RC, Gurney JG, Land GH. Evidence-based decision making in public health. J Public Health Manag Pract. 1999;5(5):86-97. Kohatsu ND, Robinson JG, Torner JC. Evidence-based public health: an evolving concept. Am J Prev Med. 2004;27(5):417-21. Cummings GG, Estabrooks CA, Midodzi WK, Wallin L, Hayduk L. Influence of organizational characteristics and context on research utilization. Nurs Res. 2007;56(4 Suppl):S24-39. Brownson RC, Fielding JE, Green LW. Building Capacity for Evidence-Based Public Health: Reconciling the Pulls of Practice and the Push of Research. Annu Rev Public Health. 2018;39:27-53. Titler MG. The Evidence for Evidence-Based Practice Implementation. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Advances in Patient Safety. Rockville (MD)2008. Pan American Health Organization. A Guide for Evidence-Informed Decision-Making, Including in Health Emergencies.2022. Saunders H, Gallagher-Ford L, Kvist T, Vehvilainen-Julkunen K. Practicing Healthcare Professionals' Evidence-Based Practice Competencies: An Overview of Systematic Reviews. Worldviews Evid Based Nurs. 2019;16(3):176-85. Paci M, Faedda G, Ugolini A, Pellicciari L. Barriers to evidence-based practice implementation in physiotherapy: a systematic review and meta-analysis. Int J Qual Health Care. 2021;33(2). Allen P, Parks RG, Kang SJ, Dekker D, Jacob RR, Mazzucca-Ragan S, et al. Practices Among Local Public Health Agencies to Support Evidence-Based Decision Making: A Qualitative Study. J Public Health Manag Pract. 2023;29(2):213-25. Ellen ME, Leon G, Bouchard G, Ouimet M, Grimshaw JM, Lavis JN. Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study. Implement Sci. 2014;9:179. Sadeghi-Bazargani H, Tabrizi JS, Azami-Aghdash S. Barriers to evidence-based medicine: a systematic review. J Eval Clin Pract. 2014;20(6):793-802. Barzkar F, Baradaran HR, Koohpayehzadeh J. Knowledge, attitudes and practice of physicians toward evidence-based medicine: A systematic review. J Evid Based Med. 2018;11(4):246-51. Moraes FDS, Marengo LL, Moura MDG, Bergamaschi CC, de Sa Del Fiol F, Lopes LC, et al. ABCDE and ABCDEF care bundles: A systematic review of the implementation process in intensive care units. Medicine (Baltimore). 2022;101(25):e29499. de Wit K, Curran J, Thoma B, Dowling S, Lang E, Kuljic N, et al. Review of implementation strategies to change healthcare provider behaviour in the emergency department. CJEM. 2018;20(3):453-60. Brownson RC, Fielding JE, Maylahn CM. Evidence-based public health: a fundamental concept for public health practice. Annu Rev Public Health. 2009;30:175-201. Sarkies MN, Robins LM, Jepson M, Williams CM, Taylor NF, O'Brien L, et al. Effectiveness of knowledge brokering and recommendation dissemination for influencing healthcare resource allocation decisions: A cluster randomised controlled implementation trial. PLoS Med. 2021;18(10):e1003833. White J, Grant K, Sarkies M, Haines T, Evidence Translation in Allied Health G. Translating evidence into practice: a longitudinal qualitative exploration of allied health decision-making. Health Res Policy Syst. 2021;19(1):38. Liang L, Bernhardsson S, Vernooij RW, Armstrong MJ, Bussieres A, Brouwers MC, et al. Use of theory to plan or evaluate guideline implementation among physicians: a scoping review. Implement Sci. 2017;12(1):26. Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6:42. Flannery C, McHugh S, Anaba AE, Clifford E, O'Riordan M, Kenny LC, et al. Enablers and barriers to physical activity in overweight and obese pregnant women: an analysis informed by the theoretical domains framework and COM-B model. BMC Pregnancy Childbirth. 2018;18(1):178. De Leo A, Bayes S, Bloxsome D, Butt J. Exploring the usability of the COM-B model and Theoretical Domains Framework (TDF) to define the helpers of and hindrances to evidence-based practice in midwifery. Implement Sci Commun. 2021;2(1):7. Pearse BL, Keogh S, Rickard CM, Fung YL. Barriers and facilitators to implementing evidence based bleeding management in Australian Cardiac Surgery Units: a qualitative interview study analysed with the theoretical domains framework and COM-B model. BMC Health Serv Res. 2021;21(1):550. Advani SD, Winters A, Turner NA, Smith BA, Seidelman J, Schmader K, et al. Using the COM-B model to identify barriers to and facilitators of evidence-based nurse urine-culture practices. Antimicrob Steward Healthc Epidemiol. 2023;3(1):e62. McDonagh LK, Saunders JM, Cassell J, Curtis T, Bastaki H, Hartney T, et al. Application of the COM-B model to barriers and facilitators to chlamydia testing in general practice for young people and primary care practitioners: a systematic review. Implement Sci. 2018;13(1):130. Mersha AG, Gould GS, Bovill M, Eftekhari P. Barriers and Facilitators of Adherence to Nicotine Replacement Therapy: A Systematic Review and Analysis Using the Capability, Opportunity, Motivation, and Behaviour (COM-B) Model. Int J Environ Res Public Health. 2020;17(23). Pirotta S, Joham AJ, Moran LJ, Skouteris H, Lim SS. Implementation of evidence-based PCOS lifestyle management guidelines: Perceived barriers and facilitators by consumers using the Theoretical Domains Framework and COM-B Model. Patient Educ Couns. 2021;104(8):2080-8. Dubois A, Lévesque, M. Canada's National Collaborating Centres: Facilitating evidence-informed decision-making in public health. Canada communicable disease report. 2020;46(2-3):31-5. Dobbins M, Hanna SE, Ciliska D, Manske S, Cameron R, Mercer SL, et al. A randomized controlled trial evaluating the impact of knowledge translation and exchange strategies. Implement Sci. 2009;4:61. Martin W, Wharf Higgins J, Pauly BB, MacDonald M. "Layers of translation" - evidence literacy in public health practice: a qualitative secondary analysis. BMC Public Health. 2017;17(1):803. van der Graaf P, Forrest LF, Adams J, Shucksmith J, White M. How do public health professionals view and engage with research? A qualitative interview study and stakeholder workshop engaging public health professionals and researchers. BMC Public Health. 2017;17(1):892. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. Lizarondo L, Stern, C., Carrier, J., Godfrey, C., Rieger, K., Salmond, S., Apostolo, J., Kirkpatrick, P., Loveday, H. Chapter 8: Mixed methods systematic reviews. Aromataris E MZ, editor2020. Neil-Sztramko SE, Belita E, Traynor RL, Clark E, Hagerman L, Dobbins M. Methods to support evidence-informed decision-making in the midst of COVID-19: creation and evolution of a rapid review service from the National Collaborating Centre for Methods and Tools. BMC Med Res Methodol. 2021;21(1):231. Organisation for Economic Co-operation and Development. List of OECD Member countries - Ratification of the Convention on the OECD 2021 [Available from: https://www.oecd.org/about/document/ratification-oecd-convention.htm. Joanna Briggs Institute. [Available from: https://jbi.global/critical-appraisal-tools. McKenzie JE, Brennan S.E. Chapter 12. Synthesizing and presenting findings using other methods. 2021. Brogly C, Bauer MA, Lizotte DJ, Press ML, MacDougall A, Speechley M, et al. An App-Based Surveillance System for Undergraduate Students' Mental Health During the COVID-19 Pandemic: Protocol for a Prospective Cohort Study. JMIR Res Protoc. 2021;10(9):e30504. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383-94. Augustino LR, Braun L, Heyne RE, Shinn A, Lovett-Floom L, King H, et al. Implementing Evidence-Based Practice Facilitators: A Case Series. Mil Med. 2020;185(Suppl 2):7-14. Humphries S, Hampe T, Larsen D, Bowen S. Building organizational capacity for evidence use: the experience of two Canadian healthcare organizations. Healthc Manage Forum. 2013;26(1):26-32. Gallagher-Ford L. Implementing and sustaining EBP in real world healthcare settings: transformational evidence-based leadership: redesigning traditional roles to promote and sustain a culture of EBP. Worldviews Evid Based Nurs. 2014;11(2):140-2. Irwin MM, Bergman RM, Richards R. The experience of implementing evidence-based practice change: a qualitative analysis. Clin J Oncol Nurs. 2013;17(5):544-9. Elliott MJ, Allu S, Beaucage M, McKenzie S, Kappel J, Harvey R, et al. Defining the Scope of Knowledge Translation Within a National, Patient-Oriented Kidney Research Network. Can J Kidney Health Dis. 2021;8:20543581211004803. Hitch D, Lhuede K, Vernon L, Pepin G, Stagnitti K. Longitudinal evaluation of a knowledge translation role in occupational therapy. BMC Health Serv Res. 2019;19(1):154. Parke B, Stevenson L, Rowe M. Scholar-in-Residence: An Organizational Capacity-Building Model to Move Evidence to Action. Nurs Leadersh (Tor Ont). 2015;28(2):10-22. Hooge N, Allen DH, McKenzie R, Pandian V. Engaging advanced practice nurses in evidence-based practice: An e-mentoring program. Worldviews Evid Based Nurs. 2022;19(3):235-44. Williams NJ, Glisson C, Hemmelgarn A, Green P. Mechanisms of Change in the ARC Organizational Strategy: Increasing Mental Health Clinicians' EBP Adoption Through Improved Organizational Culture and Capacity. Adm Policy Ment Health. 2017;44(2):269-83. Miro A, Perrotta K, Evans H, Kishchuk NA, Gram C, Stanwick RS, et al. Building the capacity of health authorities to influence land use and transportation planning: Lessons learned from the Healthy Canada by Design CLASP Project in British Columbia. Can J Public Health. 2014;106(1 Suppl 1):eS40-52. Roberts M, Reagan DR, Behringer B. A Public Health Performance Excellence Improvement Strategy: Diffusion and Adoption of the Baldrige Framework Within Tennessee Department of Health. J Public Health Manag Pract. 2020;26(1):39-45. Dobbins M, Greco L, Yost J, Traynor R, Decorby-Watson K, Yousefi-Nooraie R. A description of a tailored knowledge translation intervention delivered by knowledge brokers within public health departments in Canada. Health Res Policy Syst. 2019;17(1):63. Mackay HJ, Campbell KL, van der Meij BS, Wilkinson SA. Establishing an evidenced-based dietetic model of care in haemodialysis using implementation science. Nutr Diet. 2019;76(2):150-7. Williams C, van der Meij BS, Nisbet J, McGill J, Wilkinson SA. Nutrition process improvements for adult inpatients with inborn errors of metabolism using the i-PARIHS framework. Nutr Diet. 2019;76(2):141-9. Melnyk BM, Fineout-Overholt E, Giggleman M, Choy K. A Test of the ARCC(c) Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes. Worldviews Evid Based Nurs. 2017;14(1):5-9. Breckenridge-Sproat ST, Throop MD, Raju D, Murphy DA, Loan LA, Patrician PA. Building a Unit-Level Mentored Program to Sustain a Culture of Inquiry for Evidence-Based Practice. Clin Nurse Spec. 2015;29(6):329-37. Clark EC, Dhaliwal B, Ciliska D, Neil-Sztramko SE, Steinberg M, Dobbins M. A pragmatic evaluation of a public health knowledge broker mentoring education program: a convergent mixed methods study. Implement Sci Commun. 2022;3(1):18. Waterman H, Boaden R, Burey L, Howells B, Harvey G, Humphreys J, et al. Facilitating large-scale implementation of evidence based health care: insider accounts from a co-operative inquiry. BMC Health Serv Res. 2015;15:60. Gifford W, Lefebre N, Davies B. An organizational intervention to influence evidence-informed decision making in home health nursing. J Nurs Adm. 2014;44(7/8):395-402. Traynor R, DeCorby K, Dobbins M. Knowledge brokering in public health: a tale of two studies. Public Health. 2014;128(6):533-44. Plath D. Organizational processes supporting evidence-based practice. . Administration in social work. 2013;37(2):171-88. Kimber M, Barwick M, Fearing G. Becoming an evidence-based service provider: staff perceptions and experiences of organizational change. J Behav Health Serv Res. 2012;39(3):314-32. Martin-Fernandez J, Aromatario O, Prigent O, Porcherie M, Ridde V, Cambon L. Evaluation of a knowledge translation strategy to improve policymaking and practices in health promotion and disease prevention setting in French regions: TC-REG, a realist study. BMJ Open. 2021;11(9):e045936. van der Zwet RJM, Beneken genaamd Kolmer, D.M., Schalk, R., Van Regenmortel, T. . Implementing Evidence-Based Practice in a Dutch Social Work Organisation: A Shared Responsibility. The British Journal of Social Work. 2020;50(7):2212-32. Allen P, Jacob RR, Lakshman M, Best LA, Bass K, Brownson RC. Lessons Learned in Promoting Evidence-Based Public Health: Perspectives from Managers in State Public Health Departments. J Community Health. 2018;43(5):856-63. Allen P, O'Connor JC, Best LA, Lakshman M, Jacob RR, Brownson RC. Management Practices to Build Evidence-Based Decision-Making Capacity for Chronic Disease Prevention in Georgia: A Case Study. Prev Chronic Dis. 2018;15:E92. Brodowski ML, Counts, J.M., Gillam, R.J., Baker, L., Collins, V.S., Winkle, E., Skala, J., Stokes, K., Gomez, R., Redmon, J. Translating Evidence-Based Policy to Practice: A Multilevel Partnership Using the Interactive Systems Framework. The Journal of Contemporary Social Services. 2018;94(3):141-9. Bennett S, Whitehead M, Eames S, Fleming J, Low S, Caldwell E. Building capacity for knowledge translation in occupational therapy: learning through participatory action research. BMC Med Educ. 2016;16(1):257. Awan S, Samokhvalov AV, Aleem N, Hendershot CS, Irving JA, Kalvik A, et al. Development and Implementation of an Ambulatory Integrated Care Pathway for Major Depressive Disorder and Alcohol Dependence. Psychiatr Serv. 2015;66(12):1265-7. Fernandez ME, Melvin CL, Leeman J, Ribisl KM, Allen JD, Kegler MC, et al. The cancer prevention and control research network: An interactive systems approach to advancing cancer control implementation research and practice. Cancer Epidemiol Biomarkers Prev. 2014;23(11):2512-21. Kaplan L, Zeller E, Damitio D, Culbert S, Bayley KB. Improving the culture of evidence-based practice at a Magnet(R) hospital. J Nurses Prof Dev. 2014;30(6):274-80; quiz E1-2. Flaherty HB, Bornheimer LA, Hamovitch E, Garay E, Mini de Zitella ML, Acri MC, et al. Examining Organizational Factors Supporting the Adoption and Use of Evidence-Based Interventions. Community Ment Health J. 2021;57(6):1187-94. Brownson RC, Allen P, Jacob RR, deRuyter A, Lakshman M, Reis RS, et al. Controlling Chronic Diseases Through Evidence-Based Decision Making: A Group-Randomized Trial. Prev Chronic Dis. 2017;14:E121. Haynes A, Rowbotham S, Grunseit A, Bohn-Goldbaum E, Slaytor E, Wilson A, et al. Knowledge mobilisation in practice: an evaluation of the Australian Prevention Partnership Centre. Health Res Policy Syst. 2020;18(1):13. Alexander KE, Brijnath B, Mazza D. Barriers and enablers to delivery of the Healthy Kids Check: an analysis informed by the Theoretical Domains Framework and COM-B model. Implement Sci. 2014;9:60. McArthur C, Bai Y, Hewston P, Giangregorio L, Straus S, Papaioannou A. Barriers and facilitators to implementing evidence-based guidelines in long-term care: a qualitative evidence synthesis. Implement Sci. 2021;16(1):70. Moffat A, Cook EJ, Chater AM. Examining the influences on the use of behavioural science within UK local authority public health: Qualitative thematic analysis and deductive mapping to the COM-B model and Theoretical Domains Framework. Front Public Health. 2022;10:1016076. Morshed AB, Ballew P, Elliott MB, Haire-Joshu D, Kreuter MW, Brownson RC. Evaluation of an online training for improving self-reported evidence-based decision-making skills in cancer control among public health professionals. Public Health. 2017;152:28-35. Jones K, Armstrong R, Pettman T, Waters E. Knowledge Translation for researchers: developing training to support public health researchers KTE efforts. J Public Health (Oxf). 2015;37(2):364-6. Dreisinger M, Leet TL, Baker EA, Gillespie KN, Haas B, Brownson RC. Improving the public health workforce: evaluation of a training course to enhance evidence-based decision making. J Public Health Manag Pract. 2008;14(2):138-43. Mendell J, Richardson L. Integrated knowledge translation to strengthen public policy research: a case study from experimental research on income assistance receipt among people who use drugs. BMC Public Health. 2021;21(1):153. Russell DJ, Rivard LM, Walter SD, Rosenbaum PL, Roxborough L, Cameron D, et al. Using knowledge brokers to facilitate the uptake of pediatric measurement tools into clinical practice: a before-after intervention study. Implement Sci. 2010;5:92. Brown KM, Elliott SJ, Robertson-Wilson J, Vine MM, Leatherdale ST. Can knowledge exchange support the implementation of a health-promoting schools approach? Perceived outcomes of knowledge exchange in the COMPASS study. BMC Public Health. 2018;18(1):351. Dobbins M, Traynor RL, Workentine S, Yousefi-Nooraie R, Yost J. Impact of an organization-wide knowledge translation strategy to support evidence-informed public health decision making. BMC Public Health. 2018;18(1):1412. Langeveld K, Stronks K, Harting J. Use of a knowledge broker to establish healthy public policies in a city district: a developmental evaluation. BMC Public Health. 2016;16:271. Bornbaum CC, Kornas K, Peirson L, Rosella LC. Exploring the function and effectiveness of knowledge brokers as facilitators of knowledge translation in health-related settings: a systematic review and thematic analysis. Implement Sci. 2015;10:162. Jansen MW, De Leeuw E, Hoeijmakers M, De Vries NK. Working at the nexus between public health policy, practice and research. Dynamics of knowledge sharing in The Netherlands. Health Res Policy Syst. 2012;10:33. Sibbald SL, Kothari A. Creating, Synthesizing, and Sharing: The Management of Knowledge in Public Health. Public Health Nurs. 2015;32(4):339-48. Barnes SJ. Information management research and practice in the post-COVID-19 world. Int J Inf Manage. 2020;55:102175. Dwivedi YH, DL; Coombs, C; Constantiniou, I; Duan, Y; Edwards, JS; Gupta, B; Lal, B; Misra, S; Prashant, P; Raman, R; Rana, NP; Sharma, SK; Upadhyay, N. Impact of COVID-19 pandemic on information management research and practice: Transforming education, work and life. International Journal of Information Management. 2020;55(102211). Krausz M, Westenberg JN, Vigo D, Spence RT, Ramsey D. Emergency Response to COVID-19 in Canada: Platform Development and Implementation for eHealth in Crisis Management. JMIR Public Health Surveill. 2020;6(2):e18995. Smith RW, Jarvis T, Sandhu HS, Pinto AD, O'Neill M, Di Ruggiero E, et al. Centralization and integration of public health systems: Perspectives of public health leaders on factors facilitating and impeding COVID-19 responses in three Canadian provinces. Health Policy. 2023;127:19-28. Pereira VC, Silva SN, Carvalho VKS, Zanghelini F, Barreto JOM. Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews. Health Res Policy Syst. 2022;20(1):13. Tomsic I, Heinze NR, Chaberny IF, Krauth C, Schock B, von Lengerke T. Implementation interventions in preventing surgical site infections in abdominal surgery: a systematic review. BMC Health Serv Res. 2020;20(1):236. Harrison R, Fischer S, Walpola RL, Chauhan A, Babalola T, Mears S, et al. Where Do Models for Change Management, Improvement and Implementation Meet? A Systematic Review of the Applications of Change Management Models in Healthcare. J Healthc Leadersh. 2021;13:85-108. Correa VC, Lugo-Agudelo LH, Aguirre-Acevedo DC, Contreras JAP, Borrero AMP, Patino-Lugo DF, et al. Individual, health system, and contextual barriers and facilitators for the implementation of clinical practice guidelines: a systematic metareview. Health Res Policy Syst. 2020;18(1):74. Valizadeh L, Zamanzadeh V, Alizadeh S, Namadi Vosoughi M. Promoting evidence-based nursing through journal clubs: an integrative review. J Res Nurs. 2022;27(7):606-20. Portela Dos Santos O, Melly P, Hilfiker R, Giacomino K, Perruchoud E, Verloo H, et al. Effectiveness of Educational Interventions to Increase Skills in Evidence-Based Practice among Nurses: The EDITcare Systematic Review. Healthcare (Basel). 2022;10(11). Shelton RC, Lee M. Sustaining Evidence-Based Interventions and Policies: Recent Innovations and Future Directions in Implementation Science. Am J Public Health. 2019;109(S2):S132-S4. Li SA, Jeffs L, Barwick M, Stevens B. Organizational contextual features that influence the implementation of evidence-based practices across healthcare settings: a systematic integrative review. Syst Rev. 2018;7(1):72. Belita E, Yost J, Squires JE, Ganann R, Dobbins M. Development and content validation of a measure to assess evidence-informed decision-making competence in public health nursing. PLoS One. 2021;16(3):e0248330. Dobbins M, Robeson P, Ciliska D, Hanna S, Cameron R, O'Mara L, et al. A description of a knowledge broker role implemented as part of a randomized controlled trial evaluating three knowledge translation strategies. Implement Sci. 2009;4:23. Foy R, Ivers NM, Grimshaw JM, Wilson PM. What is the role of randomised trials in implementation science? Trials. 2023;24(1):537. Williams NJ, Wolk CB, Becker-Haimes EM, Beidas RS. Testing a theory of strategic implementation leadership, implementation climate, and clinicians' use of evidence-based practice: a 5-year panel analysis. Implement Sci. 2020;15(1):10. Connell CM, Lang JM, Zorba B, Stevens K. Enhancing Capacity for Trauma-informed Care in Child Welfare: Impact of a Statewide Systems Change Initiative. Am J Community Psychol. 2019;64(3-4):467-80. Damschroder LJ, Lowery JC. Evaluation of a large-scale weight management program using the consolidated framework for implementation research (CFIR). Implement Sci. 2013;8:51. Darling EK, Easterbrook R, Grenier LN, Malott A, Murray-Davis B, Mattison CA. Lessons learned from the implementation of Canada's first alongside midwifery unit: A qualitative explanatory study. Midwifery. 2021;103:103146. Fabbruzzo-Cota C, Frecea M, Kozell K, Pere K, Thompson T, Tjan Thomas J, et al. A Clinical Nurse Specialist-Led Interprofessional Quality Improvement Project to Reduce Hospital-Acquired Pressure Ulcers. Clin Nurse Spec. 2016;30(2):110-6. Fearing G, Barwick M, Kimber M. Clinical transformation: Manager's perspectives on implementation of evidence-based practice. Adm Policy Ment Health. 2014;41(4):455-68. Hurlburt M, Aarons GA, Fettes D, Willging C, Gunderson L, Chaffin MJ. Interagency Collaborative Team Model for Capacity Building to Scale-Up Evidence-Based Practice. Child Youth Serv Rev. 2014;39:160-8. Kane H, Hinnant L, Day K, Council M, Tzeng J, Soler R, et al. Pathways to Program Success: A Qualitative Comparative Analysis (QCA) of Communities Putting Prevention to Work Case Study Programs. J Public Health Manag Pract. 2017;23(2):104-11. Kegeles SM, Rebchook G, Tebbetts S, Arnold E, Team T. Facilitators and barriers to effective scale-up of an evidence-based multilevel HIV prevention intervention. Implement Sci. 2015;10:50. McAllen ER, Stephens, K., Swanson-Biearman, B., Kerr, K., Whiteman, K. . Moving Shift Report to the Bedside: An Evidence-Based Quality Improvement Project. The Online Journal of Issues in Nursing. 2018;23. McCarthy S, Griffiths, L.J. The Journey to Evidence: Adopting Evidence-Based Programs in an Australian Child Welfare Organization. . Human Service Organizations: Management, Leadership & Governance. 2021;45:273-80. McConnell T, O'Halloran P, Donnelly M, Porter S. Factors affecting the successful implementation and sustainability of the Liverpool Care Pathway for dying patients: a realist evaluation. BMJ Support Palliat Care. 2015;5(1):70-7. Nelson G, Kiyang LN, Crumley ET, Chuck A, Nguyen T, Faris P, et al. Implementation of Enhanced Recovery After Surgery (ERAS) Across a Provincial Healthcare System: The ERAS Alberta Colorectal Surgery Experience. World J Surg. 2016;40(5):1092-103. Poehler AR, Parks RG, Tabak RG, Baker EA, Brownson RC. Factors Facilitating or Hindering Use of Evidence-Based Diabetes Interventions Among Local Health Departments. J Public Health Manag Pract. 2020;26(5):443-50. Pullyblank K, Brunner W, Wyckoff L, Krupa N, Scribani M, Strogatz D. Implementation of Evidence-Based Disease Self-Management Programs in a Rural Region: Leveraging and Linking Community and Health Care System Assets. Health Educ Behav. 2022:10901981221078516. Rodriguez-Quintana N, Lewis CC, Scott K, Marriot B, Wahlen S, Hindman R. Implementation of the Wolverine Mental Health Program, Part 2: Implementation Phase. Cogn Behav Pract. 2022;29(1):227-43. Schreiber J, Marchetti GF, Racicot B, Kaminski E. The use of a knowledge translation program to increase use of standardized outcome measures in an outpatient pediatric physical therapy clinic: administrative case report. Phys Ther. 2015;95(4):613-29. Scott K, Lewis CC, Rodriguez-Quintana N, MarAriott BR, Hindman RK. Implementation of the Wolverine Mental Health Program, Part 1: Adoption Phase. Cogn Behav Pract. 2022;29(1):214-26. Stevans JM, Bise CG, McGee JC, Miller DL, Rockar P, Jr., Delitto A. Evidence-based practice implementation: case report of the evolution of a quality improvement program in a multicenter physical therapy organization. Phys Ther. 2015;95(4):588-99. Wilkinson SA, O'Brien M, McCray S, Harvey D. Implementing a best-practice model of gestational diabetes mellitus care in dietetics: a qualitative study. BMC Health Serv Res. 2019;19(1):122. Wilkinson SA, Hughes E, Moir J, Jobber C, Ackerie A. Process of knowledge translation within routine clinical care: Implementing best practice in weight management. Nutr Diet. 2018;75(4):363-71. Williams NJ, Ehrhart MG, Aarons GA, Marcus SC, Beidas RS. Linking molar organizational climate and strategic implementation climate to clinicians' use of evidence-based psychotherapy techniques: cross-sectional and lagged analyses from a 2-year observational study. Implement Sci. 2018;13(1):85. Additional Declarations No competing interests reported. Supplementary Files ClarkPRISMAChecklist20231024.docx ClarkSupplementaryAppendix120231024.docx ClarkSupplementaryAppendix220231024.docx Cite Share Download PDF Status: Published Journal Publication published 01 Apr, 2024 Read the published version in BMC Health Services Research → Version 1 posted Editorial decision: Major revision 25 Oct, 2023 Submission checks completed at journal 24 Oct, 2023 Editor assigned by journal 24 Oct, 2023 First submitted to journal 23 Oct, 2023 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3482543","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":242604353,"identity":"45b807f1-7cd4-4a53-b4de-036752e60f7d","order_by":0,"name":"Emily C Clark","email":"","orcid":"","institution":"National Collaborating Centre for Methods and Tools","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Emily","middleName":"C","lastName":"Clark","suffix":""},{"id":242604354,"identity":"c5bd327c-0c2b-4392-b896-9621f42e29c2","order_by":1,"name":"Trish Burnett","email":"","orcid":"","institution":"National Collaborating Centre for Methods and Tools","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Trish","middleName":"","lastName":"Burnett","suffix":""},{"id":242604355,"identity":"d7bbd8ad-b4b0-45cd-974f-adf03f5415c5","order_by":2,"name":"Rebecca Blair","email":"","orcid":"","institution":"National Collaborating Centre for Methods and Tools","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Rebecca","middleName":"","lastName":"Blair","suffix":""},{"id":242604356,"identity":"57ec3864-2d1d-4d33-8dc4-f7cc2f825980","order_by":3,"name":"Robyn L Traynor","email":"","orcid":"","institution":"National Collaborating Centre for Methods and Tools","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Robyn","middleName":"L","lastName":"Traynor","suffix":""},{"id":242604357,"identity":"206046d7-33fa-48e5-9130-e2a46da76b1a","order_by":4,"name":"Leah Hagerman","email":"","orcid":"","institution":"National Collaborating Centre for Methods and Tools","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Leah","middleName":"","lastName":"Hagerman","suffix":""},{"id":242604360,"identity":"32862db8-a5bf-4abc-a0a8-450fb6ed0e8a","order_by":5,"name":"Maureen Dobbins","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA00lEQVRIiWNgGAWjYDCCAzxsDAlAmp90LZINYK4BkVrAag8Qq4XveO+xBw931EUbXzv8dMOPP3/kzBuYH37Ap0XyzLl0g8Qzh3O33U4zu9nbZmAsc4DNWAKfFoMbOWYSiW0HgFpy2G7wNhgkzmDgYSBGS13u5tk5bDf//DGoB2ph/kGEFubcDdI5bLd52AwSJBh42PDaAvFL2+HcGUC/3JZtMzacwcxmZoFPCyjEHv4EOqx/dvKzm2/+yMlLsDc/voFPCxbATKL6UTAKRsEoGAWYAADPdE2rhf+aRwAAAABJRU5ErkJggg==","orcid":"","institution":"National Collaborating Centre for Methods and Tools","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Maureen","middleName":"","lastName":"Dobbins","suffix":""}],"badges":[],"createdAt":"2023-10-23 16:44:22","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3482543/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3482543/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12913-024-10841-3","type":"published","date":"2024-04-01T15:01:42+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":45377674,"identity":"fc13b7c3-ec15-4c46-9363-c5bec1423f3e","added_by":"auto","created_at":"2023-10-28 17:40:59","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":32027,"visible":true,"origin":"","legend":"\u003cp\u003ePRISMA 2020 Flow chart\u003c/p\u003e\n\u003cp\u003e*Reasons for exclusion of articles during full-text assessment for\u0026nbsp;eligibility were not recorded as per the rapid review protocol.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-3482543/v1/4eb61234be597236ea819ffc.png"},{"id":45377675,"identity":"0a413fb5-ca66-4dc7-ad82-5deda41a0560","added_by":"auto","created_at":"2023-10-28 17:40:59","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":98759,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCOM-B Model for behaviour change with facilitators and barriers for implementation of organization-wide EIDM or EIPs.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-3482543/v1/949a81150760c4c728303f2c.png"},{"id":54303933,"identity":"4f7a9cec-76d1-4cb9-9e87-1c6fbbfca929","added_by":"auto","created_at":"2024-04-08 15:12:49","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1228508,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3482543/v1/73c3dd0b-fcf2-4244-a2d3-bd253885496a.pdf"},{"id":45377676,"identity":"55edad08-f521-461a-8479-aefebdc946d1","added_by":"auto","created_at":"2023-10-28 17:40:59","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":42172,"visible":true,"origin":"","legend":"","description":"","filename":"ClarkPRISMAChecklist20231024.docx","url":"https://assets-eu.researchsquare.com/files/rs-3482543/v1/3c78e1e789cc5b665c8df107.docx"},{"id":45377677,"identity":"3150768a-3d33-4a3e-8d3f-1c4b11ab07c8","added_by":"auto","created_at":"2023-10-28 17:40:59","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":33396,"visible":true,"origin":"","legend":"","description":"","filename":"ClarkSupplementaryAppendix120231024.docx","url":"https://assets-eu.researchsquare.com/files/rs-3482543/v1/38d45b2ec83350f1e4f01108.docx"},{"id":45378127,"identity":"cf1efded-9a3e-4c0a-9d3a-8caabfdc852b","added_by":"auto","created_at":"2023-10-28 17:48:59","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":108972,"visible":true,"origin":"","legend":"","description":"","filename":"ClarkSupplementaryAppendix220231024.docx","url":"https://assets-eu.researchsquare.com/files/rs-3482543/v1/01e13a21fb31f6899b6ff72f.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Strategies to implement evidence-informed practice at organizations: A rapid systematic review","fulltext":[{"header":"Background","content":"\u003cp\u003eThere exist expectations from elected officials and their constituents that public health decisions and programs are informed by the best available evidence from research, local context, and political will (\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). To achieve evidence-informed public health, it is important that the organization engages in and supports evidence-informed decision making (EIDM) and evidence-informed practice or programs (EIP) (\u003cspan additionalcitationids=\"CR5 CR6\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). EIDM, at an organizational level, involves the integration of evidence into all practice decisions by identifying and synthesizing evidence, then developing and executing plans to implement and evaluate changes to practice (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). EIP, on the other hand, refers to a specific practice or program with proven evidence of effectiveness that has been selected or mandated for implementation (\u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Evidence-based practice (EBP) and evidence-based decision making (EBDM) are similar processes however, EBP and EBDM implies a greater focus on research evidence whereas EIDM and EIP focus on research evidence along with other factors such as context, resources, experience, and patient/community input to influence decision making and program implementation (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). When implemented, EIDM and EIP result in efficient use of scarce resources, encourage stakeholder involvement resulting in more effective programs and decisions, improve transparency and accountability of organizations, improve health outcomes and reduce harm (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Therefore, it is important that EIDM and EIP are integrated into public health organizations.\u003c/p\u003e \u003cp\u003eIntegration of EIDM and EIP into practice is challenging due to the need for multifaceted interventions (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Systematic reviews have been completed on the barriers and facilitators to EIDM. Mathieson \u003cem\u003eet al\u003c/em\u003e and Li \u003cem\u003eet al\u003c/em\u003e examined the barriers and facilitators to evidence-based practice (EBP) implementation in community nursing and Paci \u003cem\u003eet al\u003c/em\u003e examined barriers in physiotherapy (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Li \u003cem\u003eet al\u003c/em\u003e found that EBP implementation is associated with an organizational culture for EBP, where staff at all levels value and contribute to EBP (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Similarly, Mathieson \u003cem\u003eet al\u003c/em\u003e and Paci \u003cem\u003eet al\u003c/em\u003e found that that organizational context plays an important role in EBP implementation along with organizational support and resources for EBP (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Strategies to implement EBP may also build capacity for staff to find, interpret and synthesize evidence to develop practice and program recommendations (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Saunders \u003cem\u003eet al\u003c/em\u003e completed an overview of systematic reviews on health care professionals\u0026rsquo; EBP competencies (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). The authors found that implementation of EBP across studies was low (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Participants reported insufficient EBP knowledge and skills to implement EBP in daily practice even though participants also reported positive EBP beliefs and attitudes (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Sadeghi-Bazargani \u003cem\u003eet al\u003c/em\u003e and Barzkar \u003cem\u003eet al\u003c/em\u003e also explored the implementation of EBP and found similar results, listing inadequate skills and lack of knowledge amongst the most common barriers to EBP (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Moraes \u003cem\u003eet al\u003c/em\u003e explored the implementation of an EIP in Intensive Care Units and de Wit \u003cem\u003eet al\u003c/em\u003e examined how to best implement EIPs in the emergency department (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Both reviews found that effective strategies for the successful implementation of an EIP include staff training, transparency, and inclusion of staff in the planning and implementation process (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Change initiatives for the implementation of an EIP must also address challenges such as resistance from staff or lack of staff expertise, as well as tailor strategies to specific organizational climates and structures (20\u0026ndash;24).\u003c/p\u003e \u003cp\u003eAt least two streams of research have emerged in this field: one focused on understanding the processes and mechanisms for achieving organization-wide EIDM, (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) and the other exploring strategies to implement specific EIPs into practice (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). These two streams of research, however, appear to converge in organizational change. For example, whether one is aspiring to achieve EIDM or to implement an EIP, significant organizational change is usually necessary, resulting in substantial impact on the entire organization, as well as for individuals working there. However, there is minimal synthesized evidence of EIDM and EIP implementation at the organizational level. This review seeks to address this research gap by identifying, appraising, and summarizing research evidence from studies seeking to understand the EIDM process at an organizational level, as well as studies exploring how to best implement EIPs across health organizations.\u003c/p\u003e \u003cp\u003eThe COM-B model for behaviour change was used as a guide for contextualizing the findings across studies. This model is designed to guide organizational change initiatives and distill complex systems that influence behaviour into simpler, visual representations. Specifically, this model looks at capability (C), opportunity (O) and motivation (M) as three key influencers of behaviour (B). The capability section of the COM-B model reflects whether the intended audience possess the knowledge and skill for a new behaviour. Opportunity reflects whether there is opportunity for new behaviour to occur. Motivation reflects whether there is sufficient motivation for a new behaviour to occur. All three components interact to create behaviour and behaviours can, in turn, alter capability, motivation and opportunity (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). The COM-B model has been used often to map findings related to organizational and behavioural change in both EIP implementation (\u003cspan additionalcitationids=\"CR28 CR29\" citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e)and in mapping findings from systematic reviews examining the barriers and facilitators of various health interventions including nicotine replacement, chlamydia testing and lifestyle management of polycystic ovary syndrome (\u003cspan additionalcitationids=\"CR32\" citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOverall, EIDM and EIP are expected to be used in public health to achieve optimal health of populations. However, the capacity of public health organizations to realize EIDM and to implement EIP varies considerably from organization to organization (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan additionalcitationids=\"CR35 CR36\" citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). This rapid review aims to examine the implementation of EIDM at the organizational level, as well as the implementation of EIP across organizations, to inform change efforts at Canadian public health organizations. The findings of this review can be applied more broadly and will support public health organizations beyond Canada implement change efforts to practice in an evidence-informed way.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design\u003c/h2\u003e \u003cp\u003eThe review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO; Registration CRD42022318994). The review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting systematic reviews and meta-analyses (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). Given the nature of the research question, a mixed methods systematic review approach was taken, with guidance from the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eInformation sources and search strategy\u003c/h2\u003e \u003cp\u003eThe search was conducted on March 18, 2022. The following databases were searched from 2012 onward: Medline, Embase, Emcare, Global Health Database, PsycINFO, Web of Science. Each database was searched using combinations and variations of the terms \u0026ldquo;implement*\u0026rdquo;, \u0026ldquo;knowledge broker*\u0026rdquo;, \u0026ldquo;transform*\u0026rdquo;, \u0026ldquo;organizational culture\u0026rdquo;, \u0026ldquo;change management\u0026rdquo;, \u0026ldquo;evidence-based\u0026rdquo;, \u0026ldquo;knowledge translation\u0026rdquo;, and \u0026ldquo;knowledge mobilization\u0026rdquo;. Additionally, publications by key contributors to the field were reviewed. The full search strategy is included in \u003cb\u003eAppendix 1\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eStudies were screened using DistillerSR software. Titles and abstracts of retrieved studies were screened by a single reviewer. Full texts of included studies were screened by a second reviewer and reviewed by a third. Screening was not completed in duplicate, consistent with a rapid review protocol (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eEligibility criteria\u003c/h2\u003e \u003cp\u003eEnglish-language, published primary studies with experimental or observational designs were eligible for inclusion. Review papers, such as literature and systematic reviews, were excluded. Grey literature was not included.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003ePopulation\u003c/h2\u003e \u003cp\u003eStudies conducted with public sector health-related service-delivery organizations were eligible for inclusion. This included public health departments and authorities, health care settings and social services. Studies focused on departments or teams within an organization, or on entire organizations, were also eligible for inclusion. Studies conducted in private sectors or academic institutions were excluded.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eIntervention\u003c/h2\u003e \u003cp\u003eInterventions designed and implemented to shift teams, departments, or organizations to EIDM or EIP were eligible for inclusion. For studies focused on implementation of EIPs, interventions implemented by external organizations were excluded because the overall objective of this review was to inform internal strategies for EIDM or EIPs.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eOutcomes\u003c/h2\u003e \u003cp\u003eOutcomes measured either quantitatively or qualitatively were considered. These included behaviour change, confidence and skills, patient-level data such as quality indicators, evidence of EIDM embedded in organizational and decision-making processes, changes in organizational culture, and changes to budget allocation. Studies that reported primarily on implementation fidelity were excluded, since these would not inform the drivers for organizational change.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eSetting\u003c/h2\u003e \u003cp\u003eStudies conducted in the 38 member countries of the Organization for Economic Co-operation and Development (OECD) were included in this review to best align with the Canadian context and to inform organizational change efforts in public health within Canada (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec10\" class=\"Section3\"\u003e \u003ch2\u003eQuality Assessment\u003c/h2\u003e \u003cp\u003eThe methodological rigour of included studies was evaluated using the JBI suite of critical appraisal tools (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e). Ratings of low, moderate, or high quality were assigned based on the critical appraisal results. Quality assessment was completed by one reviewer and verified by a second. Conflicts were resolved through discussion or by consulting a third reviewer.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eData extraction\u003c/h2\u003e \u003cp\u003eData extraction was completed by a single reviewer and reviewed by a second. Data on the study design, setting, sector (e.g., public health, primary care, etc.), participants, intervention (e.g., description of learning initiatives, implementation strategies, etc.), outcome measures, and findings were extracted.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eStudies were grouped according to whether they reported on implementation of EIDM or an EIP. Quantitative and qualitative data were synthesized simultaneously, using a convergent integrated approach (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). Quantitative data underwent narrative synthesis, where findings that caused benefit were compared with those that caused harm or no effect (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e). Vote counting based on the direction of effect was used to determine whether most studies found a positive or negative effect {McKenzie, 2021 #613}. Findings were reviewed for trends in reported facilitators and barriers. Emerging themes in facilitators and barriers were mapped to the COM-B model for behaviour change (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDue to the heterogeneity in study outcomes, the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e) approach was not used for this review. Overall certainty of evidence was determined based on the risk of bias of included study designs and study quality.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eDatabase searching retrieved 7067 records. After removing duplicates, 4174 records were screened by title and abstract, resulting in 1370 reports for full text review. Of those 1370 records, 55 articles were included. Scanning the publication lists of key authors retrieved 187 records, of which eight were retrieved for full text review and four were included, for a total of 59 articles included in this review. See Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e1\u003c/span\u003e for a PRISMA flow chart illustrating the article search and selection process.\u003c/p\u003e \u003cp\u003eOf the 59 articles in this review, 38 studies explore the implementation of EIDM at the organizational level, while 21 studies report on the implementation of selected EIPs across organizations.\u003c/p\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eStudy Characteristics\u003c/h2\u003e \u003cp\u003eThe overall characteristics of included studies are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Of 59 included studies, most were conducted in primary care settings (n\u0026thinsp;=\u0026thinsp;26) and public health settings (n\u0026thinsp;=\u0026thinsp;20), with some in social services (n\u0026thinsp;=\u0026thinsp;10), child and youth mental health (n\u0026thinsp;=\u0026thinsp;1), occupational health (n\u0026thinsp;=\u0026thinsp;1), and palliative care (n\u0026thinsp;=\u0026thinsp;1). In public health, studies of organization-wide implementation of EIDM (n\u0026thinsp;=\u0026thinsp;16) were more common than studies of EIP implementation (n\u0026thinsp;=\u0026thinsp;4). Most studies were conducted in the USA (n\u0026thinsp;=\u0026thinsp;30), followed by Canada (n\u0026thinsp;=\u0026thinsp;16), Australia (n\u0026thinsp;=\u0026thinsp;8), and Europe (n\u0026thinsp;=\u0026thinsp;5).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eIncluded studies of organization-wide implementation of EIDM and implementation of EIPs\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudy design, comparison\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSetting, timeline\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSector\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eParticipants\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eIntervention\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eOutcomes (Measurement tool)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFindings\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eQuality Rating (Tool)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003eStudies of organization-wide implementation of EIDM\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAllen, 2018 (71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eState health department,\u003c/p\u003e \u003cp\u003eGeorgia, USA, 2013\u0026ndash;2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eProgram staff across organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eProgram staff received training for EIDM that included lectures, and small group problem-solving and discussion.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative: EIDM facilitators and barriers (interviews)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for EIDM:\u003c/p\u003e \u003cp\u003e-Leadership support\u003c/p\u003e \u003cp\u003e-Consistent internal messaging on EIDM\u003c/p\u003e\u003cp\u003e-Close partnerships with evaluation teams\u003c/p\u003e \u003cp\u003e-Requirement for evidence in proposals\u003c/p\u003e\u003cp\u003eBarriers to EIDM:\u003c/p\u003e\u003cp\u003e-Competing priorities\u003c/p\u003e \u003cp\u003e-Limited budget for staff\u003c/p\u003e \u003cp\u003e-Political conflicts in state and local agendas\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAllen, 2018 (70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQualitative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eState health departments,\u003c/p\u003e \u003cp\u003eUSA, 2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLeaders and program managers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eState health departments to an intervention group that received EIDM training and support (See Brownson, 2017).\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative: EIDM facilitators and barriers (structured interviews)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for EIDM:\u003c/p\u003e \u003cp\u003e-Leadership support\u003c/p\u003e \u003cp\u003e-Developing structures and culture incorporating evidence based public health\u003c/p\u003e\u003cp\u003e-Ongoing training\u003c/p\u003e \u003cp\u003e-Building and maintaining partnerships with external partners\u003c/p\u003e\u003cp\u003eBarriers to EIDM:\u003c/p\u003e\u003cp\u003e-Funding/budget cuts\u003c/p\u003e\u003cp\u003e-Lack of time\u003c/p\u003e\u003cp\u003e-Lack of political will/support\u003c/p\u003e\u003cp\u003e-Staff turnover\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Qualitative)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAugustino, 2020 (46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMilitary treatment facilities, USA, 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNursing staff at 4 facilities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAn evidence-based practice facilitator role supported organization-wide EIDM teams through training, mentoring, and encouraging EIDM.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFindings were described in a narrative case report.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for EIDM:\u003c/p\u003e \u003cp\u003e-Incorporating the evidence-based practice facilitator into existing practice\u003c/p\u003e \u003cp\u003e-Involving evidence-based practice facilitator in nursing meetings and committees\u003c/p\u003e\u003cp\u003e-Aligning the evidence-based practice facilitator\u0026rsquo;s work with organizational priorities\u003c/p\u003e\u003cp\u003eBarriers to EIDM:\u003c/p\u003e\u003cp\u003e-Staff turnover\u003c/p\u003e\u003cp\u003e-Lack of standardized evaluation of EIDM use\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAwan, 2015 (74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCentre for Addiction and Mental Health, Toronto, Ontario, Canada, 2013\u0026ndash;2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eService providers, researchers at organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAn integrated care pathway, which relies on EIDM, was implemented for patients with concurrent major depressive disorder and alcohol dependence. Development of the integrated care pathway included evidence reviews, knowledge translation, process reengineering and change management.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative:\u003c/p\u003e \u003cp\u003e-patient symptom assessment and medication titration (Penn Alcohol Craving Scale, Quick Inventory for Depressive Symptoms scores and Beck Depression Inventory)\u003c/p\u003e \u003cp\u003eQualitative:\u003c/p\u003e \u003cp\u003e-Facilitators and barriers (focus groups)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eEvaluation of patient care found:\u003c/p\u003e \u003cp\u003e-Lower program dropout (78\u0026ndash;46% p\u0026thinsp;\u0026lt;\u0026thinsp;0.05)\u003c/p\u003e \u003cp\u003e-Reduction in depressive symptom severity (p-value not reported)\u003c/p\u003e \u003cp\u003e-Reduction in heavy drinking days (42\u0026ndash;23%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.04)\u003c/p\u003e \u003cp\u003eFacilitators for EIDM:\u003c/p\u003e \u003cp\u003e-Inclusion and frontline clinicians\u003c/p\u003e \u003cp\u003e-Use of tools/templates (e.g., process maps, medication algorithms)\u003c/p\u003e \u003cp\u003e-Team meetings\u003c/p\u003e \u003cp\u003eBarriers to EIDM:\u003c/p\u003e\u003cp\u003e-Lack of knowledge and skill for EIDM\u003c/p\u003e\u003cp\u003e-Communication with referring providers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBennett, 2016 (73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLarge urban hospital, Australia,\u003c/p\u003e \u003cp\u003e18 months; dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOccupational therapists in hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAn EIDM capacity building program was implemented. The program included:\u003c/p\u003e \u003cp\u003e-Educational outreach across organization\u003c/p\u003e \u003cp\u003e-Teams working on clinical case studies\u003c/p\u003e \u003cp\u003e-Allocating time for EIDM\u003c/p\u003e \u003cp\u003e-Mentorship\u003c/p\u003e \u003cp\u003e-Leadership support\u003c/p\u003e \u003cp\u003e-Communication regarding EIDM\u003c/p\u003e \u003cp\u003e-Development of EIDM processes and resources\u003c/p\u003e \u003cp\u003e-Funding for an EIDM champion one day per week\u003c/p\u003e \u003cp\u003e-Setting goals and targets for EIDM\u003c/p\u003e \u003cp\u003e-EIDM reporting and evaluation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative: EIDM use, perceptions of organizational culture toward EIDM, EIDM facilitators and barriers (focus groups with clinicians and observations by the research team)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for EIDM:\u003c/p\u003e \u003cp\u003e-EIDM integration into roles\u003c/p\u003e \u003cp\u003e-Buy-in to EIDM impact\u003c/p\u003e \u003cp\u003e-Developing goals for EIDM\u003c/p\u003e \u003cp\u003e-Access to mentors\u003c/p\u003e \u003cp\u003e-Supportive leadership\u003c/p\u003e \u003cp\u003e-Breaking down EIDM into manageable tasks\u003c/p\u003e\u003cp\u003e-Journal club to discuss EIDM processes\u003c/p\u003e\u003cp\u003eChallenges to EIDM:\u003c/p\u003e\u003cp\u003e-Lack of EIDM knowledge and skill\u003c/p\u003e\u003cp\u003e-Perceived lack of capability\u003c/p\u003e \u003cp\u003e-Perceived lack of time and training\u003c/p\u003e\u003cp\u003e-Competing priorities\u003c/p\u003e \u003cp\u003e-Challenges with staff rotating between clinical teams\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBreckenridge-Sproat, 2015 (61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle group pre-post study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMilitary hospitals,\u003c/p\u003e \u003cp\u003eWashington, District of Columbia, USA, 18 months; dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNurses across hospitals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eUnit-level mentors facilitated an educational mentoring program for EIDM. The intervention involved an organizational assessment, identification of facilitators and barriers, training EIDM mentors and EIDM implementation.\u003c/p\u003e \u003cp\u003eLibrarian support, evidence-based practice education material, training modules were provided and supervised study team evidence-based practice projects were completed.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative:\u003c/p\u003e \u003cp\u003e-EIDM beliefs (Evidence-Based Practice Beliefs)\u003c/p\u003e \u003cp\u003e-Organizational readiness and barriers to EIDM (Organizational Readiness for System-wide Integration of Evidence-Based Practice)\u003c/p\u003e \u003cp\u003e-EIDM implementation (Evidence-Based Practice Implementation Scales)\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFollowing the intervention,\u003c/p\u003e \u003cp\u003e-Evidence based practice belief scores increased (p\u0026thinsp;=\u0026thinsp;0.02)\u003c/p\u003e \u003cp\u003e-Organizational readiness for EIDM scores increased\u003c/p\u003e \u003cp\u003e(p\u0026thinsp;\u0026lt;\u0026thinsp;0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Quasi-experimental study)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrodowski, 2018 (72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSocial service agencies, Kansas and Nebraska, USA, 2005\u0026ndash;2011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSocial work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSocial service providing organizations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eA workgroup of state-led agencies and federal partners developed a framework for infrastructure for EIDM, including federal policy for investing in evidence-based programs and quality improvement. Technical assistance was provided to community-based programs through a third party.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative: Use of EIDM (annual reported funding for evidence-based programs)\u003c/p\u003e \u003cp\u003eQualitative: EIDM facilitators (interviews)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eThe percentage of funded programs that were evidence-based increased from 29\u0026ndash;63%.\u003c/p\u003e \u003cp\u003eFacilitators for EIDM:\u003c/p\u003e \u003cp\u003e-Strong infrastructure (outreach, training, fidelity assessment, supervision, management of the program\u003c/p\u003e \u003cp\u003e-Availability of Technical Assistance:\u003c/p\u003e \u003cp\u003e-Consideration of context when using EIDM to choose programs\u003c/p\u003e \u003cp\u003e-Active engagement and collaboration with key stakeholders at all levels\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrownson, 2017 (78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRCT, control group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eState health departments, USA,\u003c/p\u003e \u003cp\u003eMarch 2014 and March 2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eProgram staff across organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eState health departments randomized to:\u003c/p\u003e \u003cp\u003e-Intervention group that received EIDM training workshop, and follow-up calls for technical assistance and supplemental activity planning and updates support\u003c/p\u003e \u003cp\u003e-Control group that received links to electronic resources.\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative: perceived organizational skills and culture for EIDM (survey)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFollowing the intervention,\u003c/p\u003e \u003cp\u003e-Perceived skills gaps decreased (p\u0026thinsp;=\u0026thinsp;0.02).\u003c/p\u003e \u003cp\u003e-Perceived supervisory expectation for use of EIDM increased (p\u0026thinsp;=\u0026thinsp;0.006)\u003c/p\u003e \u003cp\u003e-Use of evidence increased (p\u0026thinsp;=\u0026thinsp;0.008).\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (RCT)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClark, 2022 (62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMixed methods, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePublic health units, Ontario, Canada, 2015\u0026ndash;2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u0026ndash;8 Staff members from each of 10 public health units\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSenior leadership set organizational goals for EIDM during a facilitated focus group using the Is Research Working for you organizational assessment.\u003c/p\u003e \u003cp\u003eKnowledge translation specialist mentors delivered a Knowledge Broker mentoring program, including workshops, webinars, consultations and completion of a rapid review.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative:\u003c/p\u003e \u003cp\u003e-Attainment of organizational goals for EIDM (semi-structured interviews)\u003c/p\u003e \u003cp\u003eQualitative:\u003c/p\u003e \u003cp\u003e-EIDM facilitators and barriers (semi-structured interviews)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for EIDM:\u003c/p\u003e \u003cp\u003e-Integration of EIDM into process through structures, processes, or templates\u003c/p\u003e \u003cp\u003e-New or re-defined staff positions for EIDM\u003c/p\u003e\u003cp\u003e-Leadership support\u003c/p\u003e\u003cp\u003e-Culture of expectations of EIDM\u003c/p\u003e\u003cp\u003e-Acceptance of time to learning and do EIDM\u003c/p\u003e\u003cp\u003eBarriers to EIDM:\u003c/p\u003e\u003cp\u003e-Lack of managers\u0026rsquo; EIDM knowledge\u003c/p\u003e \u003cp\u003e-Lack of protected time\u003c/p\u003e\u003cp\u003e-Lack of staff buy-in\u003c/p\u003e\u003cp\u003e-Lack of direction or plan for participants\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Qualitative)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDobbins, 2019 (57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle group pre-post study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 Public health units, Ontario, Canada, 2010\u0026ndash;2012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAll staff at organization, senior leadership\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eKnowledge Brokers deployed to public health units supported individual capacity and organizational culture for EIDM. Knowledge brokers held workshops, mentoring, meetings with senior management and developed policies and processes for EIDM.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative:\u003c/p\u003e \u003cp\u003e-Knowledge, skills and behavioral assessment (survey)\u003c/p\u003e \u003cp\u003eQualitative:\u003c/p\u003e \u003cp\u003e-EIDM facilitators and barriers (analysis of knowledge brokers journals)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for EIDM:\u003c/p\u003e \u003cp\u003e-Strong leadership support\u003c/p\u003e \u003cp\u003e-Systematic integration of research evidence into decision-making processes\u003c/p\u003e \u003cp\u003e-Access to librarian support\u003c/p\u003e\u003cp\u003e-Committed financial and human resources\u003c/p\u003e \u003cp\u003e-Staff interest and enthusiasm\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Quasi-experimental study)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElliott, 2021 (50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCanadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD), Canada, dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eClinicians, nurses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAn integrated KT network (Can-SOLVE CKD) was established, including:\u003c/p\u003e \u003cp\u003e-Central knowledge translation committee\u0026nbsp;available for consultation\u003c/p\u003e \u003cp\u003e-Support from external partners\u003c/p\u003e \u003cp\u003e-KT planning templates\u003c/p\u003e \u003cp\u003e-KT champions\u003c/p\u003e \u003cp\u003e-KT virtual community of practice\u003c/p\u003e\u003cp\u003e-KT online learning module\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFindings were described in a narrative case report.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for EIDM:\u003c/p\u003e \u003cp\u003e-Diverse knowledge base and members\u0026rsquo; commitment to KT\u003c/p\u003e \u003cp\u003e-Inclusion of patient\u0026rsquo;s perspectives\u003c/p\u003e \u003cp\u003eBarriers to EIDM:\u003c/p\u003e \u003cp\u003e-Generalizability to smaller project teams\u003c/p\u003e \u003cp\u003e-Lack of KT skills among research and patient partners\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFern\u0026aacute;ndez, 2014 (75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eThe Cancer Prevention and Control Research Network, USA, dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNational network\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWorkgroups across the network facilitated activities, including:\u003c/p\u003e \u003cp\u003e-building the capacity of service providers for EIDM\u003c/p\u003e \u003cp\u003e-developing technical assistance for KT\u003c/p\u003e \u003cp\u003e-developing research partnerships\u003c/p\u003e \u003cp\u003e-investigating implementation processes from other studies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFindings were described in a narrative case report.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eSuccessful EIDM activities were described, including the following. Network members translated and adapted the evidence-based Stanford Chronic Disease Self-Management program which was well attended and highly rated by participants. Cancer screening programs were adapted to the local context, increasing uptake among residents. Several partner universities have implemented workplace health promotion interventions.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFlaherty, 2021 (77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCluster RCT, control group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOutpatient child mental health clinics, New York, USA, dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e52 Child mental health care providers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4Rs and 2Ss Multiple Family Group intervention:\u003c/p\u003e \u003cp\u003e-Providers received training and bimonthly supervision.\u003c/p\u003e \u003cp\u003e-Clinic Implementation Teams operated at agencies randomized to the intervention arm.\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative: Frequency of use of new techniques (Training Exposure and Utilization Scale), and organizational climate (Organizational Readiness for Change Scale)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eIncreased use of evidence-based interventions was associated with providers\u0026rsquo; belief that organizational climate supported use of evidence-based interventions\u003c/p\u003e \u003cp\u003e(b\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;0.33, SE\u0026thinsp;=\u0026thinsp;0.11, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (RCT)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGallagher-Ford, 2014 (48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLarge, complex healthcare system,\u003c/p\u003e \u003cp\u003eUSA, dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDepartments across an organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eA nurse administrator promoted and sustained a culture of evidence-based practice through the following activities:\u003c/p\u003e \u003cp\u003e-Organizational assessments\u003c/p\u003e \u003cp\u003e-Developing clinical nurse specialists as EIDM champions\u003c/p\u003e \u003cp\u003e-Mentoring individuals through the change process\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFindings were described in a narrative case report.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eClinical nurse specialists have championed EIDM across the organizations. More than 13 projects for EIDM were initiated by clinical nurse specialists.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eLow (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGifford, 2014 (64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQualitative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLarge community\u003c/p\u003e \u003cp\u003ehealthcare organization\u003c/p\u003e \u003cp\u003edelivering home and community\u003c/p\u003e \u003cp\u003ehealthcare, Ontario, Canada, 20-weeks; dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eManagement and clinical leaders from 4 units\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eStrategies to promote EIDM to nurse managers and clinical leaders in home healthcare were implemented, including,\u003c/p\u003e \u003cp\u003e-Workshop on EIDM\u003c/p\u003e \u003cp\u003e-Mentorship support from experienced \u0026ldquo;evidence facilitators\u0026rdquo;\u003c/p\u003e \u003cp\u003e-Access to university library services\u003c/p\u003e \u003cp\u003e-Information-sharing activities\u003c/p\u003e\u003cp\u003e-Encouragement and recognition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative: EIDM use (Is Research Working for You? A Self-assessment Tool and Discussion Guide for Health Services Management and Policy Organizations)\u003c/p\u003e \u003cp\u003eQualitative: Usefulness of intervention, EIDM barriers and facilitators (semi structured interviews)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFollowing the intervention, participants reported:\u003c/p\u003e \u003cp\u003e-More resources to conduct research\u003c/p\u003e \u003cp\u003e-Staff contributions to EIDM discussions\u003c/p\u003e \u003cp\u003e-More information about how evidence influenced decisions made in the organization (all p\u0026thinsp;\u0026lt;\u0026thinsp;0.05)\u003c/p\u003e \u003cp\u003eFacilitators for EIDM:\u003c/p\u003e \u003cp\u003e-Ongoing education\u003c/p\u003e \u003cp\u003e-Linking staff to EIDM experts\u003c/p\u003e \u003cp\u003e-Social networking across organization\u003c/p\u003e \u003cp\u003e-Recognition for EIDM work\u003c/p\u003e \u003cp\u003e-Audit and feedback\u003c/p\u003e \u003cp\u003eBarriers to EIDM:\u003c/p\u003e\u003cp\u003e-Lack of time\u003c/p\u003e \u003cp\u003e-Lack of knowledge, skills, and confidence\u003c/p\u003e \u003cp\u003e-Conflicting priorities within the organization\u003c/p\u003e\u003cp\u003e-Staff shortages\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Qualitative)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHaynes, 2020 (79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAustralian Prevention Partnership Centre,\u003c/p\u003e \u003cp\u003eAustralia, 5 years; dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOrganization-wide, in partnership with research institutions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSix components for cross-sector collaborative partnerships for EIDM:\u003c/p\u003e \u003cp\u003e1. Partners involved at all stages\u003c/p\u003e \u003cp\u003e2. Communication efforts, e.g., forums, narrative reports\u003c/p\u003e \u003cp\u003e3. Skill development through workshops, webinars with experts\u003c/p\u003e \u003cp\u003e4. Cross-sector project teams\u003c/p\u003e \u003cp\u003e5. High-quality evidence syntheses\u003c/p\u003e \u003cp\u003e6. Ongoing surveys and opportunities for feedback\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative:\u003c/p\u003e \u003cp\u003e-Perceptions of leadership,\u003c/p\u003e \u003cp\u003egovernance, resource\u003c/p\u003e \u003cp\u003eallocation, collaboration and\u003c/p\u003e \u003cp\u003eengagement (Partnership survey)\u003c/p\u003e \u003cp\u003eQualitative:\u003c/p\u003e \u003cp\u003e-Implementation and impact of projects (project evaluations)\u003c/p\u003e \u003cp\u003e-Experiences and perceptions (semi-structured interviews)\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ePartners reported:\u003c/p\u003e \u003cp\u003e-Translation of research into policy was built into processes\u003c/p\u003e \u003cp\u003e-Many projects involved partners from different sectors\u003c/p\u003e \u003cp\u003e-Communication across sectors and teams was adequate\u003c/p\u003e \u003cp\u003e-Capacity building activities were valuable\u003c/p\u003e\u003cp\u003e-Synergies were identified across projects\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHitch, 2019 (51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePublic mental health service, major city in Australia, 2014\u0026ndash;2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOccupational therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOccupational therapists within the organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eLeadership role in KT established to support EIDM, complete research projects, build research capacity and culture, and create a database of research activity.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative:\u003c/p\u003e \u003cp\u003e-Attitudes towards EIDM (Evidence Based Practice Attitude Scale)\u003c/p\u003e \u003cp\u003e-EIDM use (Evidence Based Practice Implementation\u003c/p\u003e \u003cp\u003eScale)\u003c/p\u003e \u003cp\u003e-Staff perceptions of the Lead Research Occupational therapist role (survey)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eAfter implementation of the KT role,\u003c/p\u003e \u003cp\u003e-number of quality assurance and research activities increased (Cliffs Delta\u0026thinsp;=\u0026thinsp;0.44; 95% CI\u0026thinsp;=\u0026thinsp;0.22, 0.62)\u003c/p\u003e \u003cp\u003e-no significant change in attitudes towards EIDM\u003c/p\u003e\u003cp\u003e-staff viewed KT role positively\u003c/p\u003e\u003cp\u003e-staff engaged in KT activities\u003c/p\u003e \u003cp\u003e-greater diffusion of evidence across programs\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHooge, 2022 (53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle group pre-post study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLarge\u0026nbsp;academic health system, southeast region, USA, 12-week program; dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11 Advanced practice registered nurses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eVirtual mentoring program delivered via Microsoft Teams platform included synchronous training sessions, podcasts, blog and video tutorials, and additional research articles and educational material.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative:\u003c/p\u003e \u003cp\u003e-Knowledge and skill for EIDM (Evidence-based Practice Beliefs scale, Evidence-based Practice Implementation scale)\u003c/p\u003e \u003cp\u003e-Organizational readiness for EIDM (Organizational Culture and Readiness for System-wide Integration of Evidence-based Practice scale)\u003c/p\u003e\u003cp\u003eQualitative\u003c/p\u003e\u003cp\u003e-EIDM facilitators and barriers (open-ended survey)\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eCompared to baseline, evidence-based practice beliefs scores increased (effect size\u0026thinsp;=\u0026thinsp;0.71, p\u0026thinsp;=\u0026thinsp;0.018). No significant change in evidence-based practice implementation and organizational culture and readiness for system-wide implementation of evidence-based practice scale scores.\u003c/p\u003e \u003cp\u003eBarriers to EIDM:\u003c/p\u003e \u003cp\u003e-Competing priorities\u003c/p\u003e \u003cp\u003e-Time management\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Quasi-experimental study)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHumphries, 2013 (47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRegina Qu\u0026rsquo;Appelle Health Region and Northern Health,\u003c/p\u003e \u003cp\u003eAlberta and British Columbia, Canada,\u003c/p\u003e \u003cp\u003e2008\u0026ndash;2011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eManagement and staff at organizations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eThe Value Add through Learning and Use of Evidence (VALUE) initiative:\u003c/p\u003e \u003cp\u003e-Learning projects (to practice research literacy and skills)\u003c/p\u003e \u003cp\u003e-Liaison roles\u003c/p\u003e \u003cp\u003e-Research support\u003c/p\u003e \u003cp\u003e-Protected time for EIDM activities\u003c/p\u003e \u003cp\u003e-Inter-regional collaboration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFindings were described in a narrative case report.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLessons learned included:\u003c/p\u003e \u003cp\u003e-Staff turnover was a challenge\u003c/p\u003e \u003cp\u003e-Potential benefit to promoting evidence use in staff orientation\u003c/p\u003e \u003cp\u003e-Evidence use implementation needs to be directed at multiple levels within the organization\u003c/p\u003e\u003cp\u003e-Strategies with ongoing real-time research expertise and support were valued by participants\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIrwin, 2013 (49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eVarious healthcare settings, USA, 2009\u0026ndash;2010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNursing teams\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eInstitute for Evidence-Based Practice Change program was provided to nurses. This program included a 2.5-day workshop on EIDM, literature searching, and development of an implementation plan, project management, and outcomes measurement. The program also provided an experience mentor for EIDM support for 12-months.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative:\u003c/p\u003e \u003cp\u003e-EIDM facilitators and barriers (log entries from the team champion)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for EIDM:\u003c/p\u003e \u003cp\u003e-Adequate time\u003c/p\u003e \u003cp\u003e-Organizational support\u003c/p\u003e \u003cp\u003e-Engagement and teamwork\u003c/p\u003e \u003cp\u003e-Communication and planning\u003c/p\u003e\u003cp\u003e-Maintaining focus on EIDM goals\u003c/p\u003e\u003cp\u003eBarriers to EIDM\u003c/p\u003e\u003cp\u003e-Competing priorities\u003c/p\u003e\u003cp\u003e-Data collection and measurement challenges\u003c/p\u003e\u003cp\u003e-Staff turnover\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eLow (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKaplan, 2014 (76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMagnet-designated hospital, USA,\u003c/p\u003e \u003cp\u003eNovember 1, 2012 to May 10, 2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary healthcare\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNurses across organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAll nurses received an electronic newsletter on EIDM every 2 weeks. A cohort of direct care nurses participated in a series of EIDM workshop to develop, implement, and disseminate an EIDM project.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative: Organizational readiness for integration of EIDM (The Organizational Culture and Readiness for System-Wide Integration of Evidence-Based Practice Scale), EIDM knowledge and skill (Evidence-Based Practice Beliefs Scale), EIDM implementation (The Evidence-Based Practice implementation Scale)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFollowing the intervention, perceptions of organizational increased. Confidence in implementing EIDM was not associated with EIDM use. Higher education levels was positively associated with nurses\u0026rsquo; EIDM use.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKimber, 2012 (67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQualitative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eKinark Child and Family Services,\u003c/p\u003e \u003cp\u003eOntario, Canada, 2006\u0026ndash;2010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eChild and youth mental health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eStaff across organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMultiple EIDM interventions were implemented, including:\u003c/p\u003e \u003cp\u003e-Leadership support\u003c/p\u003e \u003cp\u003e-Appointing working group leaders\u003c/p\u003e \u003cp\u003e-Dedicated time for EIDM\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative:\u003c/p\u003e \u003cp\u003e-EIDM facilitators and barriers (survey)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for EIDM\u003c/p\u003e \u003cp\u003e-Staff understanding the clinical transformation project and stages\u003c/p\u003e \u003cp\u003e-Effective leadership\u003c/p\u003e \u003cp\u003e-Change culture inclusive of staff and management, and various disciplines\u003c/p\u003e \u003cp\u003e-Cross-program collaboration\u003c/p\u003e \u003cp\u003e-Protected time\u003c/p\u003e\u003cp\u003e-Evaluation to demonstrate benefits of change\u003c/p\u003e\u003cp\u003eChallenges to EIDM:\u003c/p\u003e\u003cp\u003e-Underutilization of internal staff\u003c/p\u003e\u003cp\u003e-Lack of preparation for change\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Qualitative)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMackay, 2019 (58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle group pre-post study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHaemodialysis unit of a hospital, Queensland, Australia,\u003c/p\u003e \u003cp\u003e2016\u0026ndash;2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAll staff at organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eA new nutrition service was established to translate nutrition guidelines into practice to support EIDM through:\u003c/p\u003e \u003cp\u003e-Professional development\u003c/p\u003e \u003cp\u003e-Evidence-informed recommendations\u003c/p\u003e \u003cp\u003e-Multidisciplinary staff involvement\u003c/p\u003e \u003cp\u003e-Integrated database prompts\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative: EIDM use, malnutrition prevalence (database audit, Patient-Generated Subjective Global Assessment tool)\u003c/p\u003e \u003cp\u003eQualitative: EIDM facilitators and barriers (clinic observation, team discussion)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eThere was no significant change in malnutrition categories; most patients (72\u0026ndash;80%) began the program well-nourished.\u003c/p\u003e \u003cp\u003eFacilitators for EIDM:\u003c/p\u003e \u003cp\u003e-Establishing processes for best practices\u003c/p\u003e \u003cp\u003e-Buy-in from staff and management-in from staff and management\u003c/p\u003e\u003cp\u003e-Regular monitoring and feedback\u003c/p\u003e\u003cp\u003eBarriers to EIDM:\u003c/p\u003e\u003cp\u003e-Limited prior knowledge\u003c/p\u003e \u003cp\u003e-Limited time\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Quasi-experimental study)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMartin-Fernandez, 2021 (68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRegional health agencies, France, 2017\u0026ndash;2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHealth professionals and decision-makers across regional health agencies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eThe Transfert de Connaissances en REGion (TC-REG) knowledge translation plan:\u003c/p\u003e \u003cp\u003e-Improved access to scientific evidence\u003c/p\u003e \u003cp\u003e-EIDM skill development through training, journal clubs and tutoring\u003c/p\u003e \u003cp\u003e-Organizational culture development through collaborative workshops, processes, and incentives\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative:\u003c/p\u003e \u003cp\u003e-EIDM facilitators and barriers (unstructured interviews)\u003c/p\u003e \u003cp\u003e-Use of EIDM (semi-structured interviews)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for EIDM:\u003c/p\u003e \u003cp\u003e-Understanding of scientific evidence\u003c/p\u003e \u003cp\u003e-Confidence in using scientific evidence\u003c/p\u003e \u003cp\u003e-Ability to search and find scientific evidence\u003c/p\u003e \u003cp\u003e-Motivation to use scientific evidence\u003c/p\u003e \u003cp\u003e-Belief that scientific evidence can help to improve practice, develop new frameworks, advocate for their professional activity, and create new partnerships\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMelnyk, 2017 (60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle group pre-post study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWashington Hospital Healthcare\u003c/p\u003e \u003cp\u003eSystem, USA,\u003c/p\u003e \u003cp\u003e12 months; dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eService providers, administrators within organizations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eEIDM mentors were developed within the healthcare system, through intensive EIDM workshops. Teams of participants implemented and evaluated an EIDM change project within their hospital.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative: Knowledge and skill for EIDM (evidence-based practice beliefs scale, evidence-based practice implementation scale), organizational readiness for EIDM (organizational culture and readiness for system-wide implementation of evidence-based practice scale), patient outcomes (aggregate data from the hospital\u0026rsquo;s medical records)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFollowing implementation,\u003c/p\u003e \u003cp\u003e-Organizational knowledge and skill for EIDM organization increased (effect size\u0026thinsp;=\u0026thinsp;0.62;\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.00)\u003c/p\u003e\u003cp\u003e-Organizational implementation of EIDM\u003c/p\u003e\u003cp\u003eincreased (effect size\u0026thinsp;=\u0026thinsp;2.3; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.00)\u003c/p\u003e\u003cp\u003e-Organizational culture and readiness for EBP increased significantly\u003c/p\u003e\u003cp\u003efrom baseline (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;80.9; \u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;90.8) to follow-up (\u003cem\u003eM\u003c/em\u003e\u0026thinsp;=\u0026thinsp;90.8; \u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;14.7; \u003cem\u003et\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.9; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.00; effect size\u0026thinsp;=\u0026thinsp;0.70)\u003c/p\u003e\u003cp\u003eThe following trends were seen in patient outcomes,\u003c/p\u003e\u003cp\u003e-Reduction in ventilator days\u003c/p\u003e\u003cp\u003e-Decreased pressure ulcer rate\u003c/p\u003e\u003cp\u003e-Reduced hospital readmissions for congestive health failure\u003c/p\u003e\u003cp\u003e-Increase in patient reported quality of care\u003c/p\u003e\u003cp\u003e-Reduced use of formula as a supplement\u003c/p\u003e \u003cp\u003e-Decreased wait time for pain medication and decreased length of stay in emergency room\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Quasi-experimental study)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiro, 2014 (55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle group pre-post study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFraser Health, Island Health and\u003c/p\u003e \u003cp\u003eVancouver Coastal Health, British Columbia, Canada,\u003c/p\u003e \u003cp\u003e2010\u0026ndash;2012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOrganization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRegional health authorities were provided an expert consultant to foster EIDM in land use and transportation plans and policies. The expert worked with staff to develop and facilitate the implementation of the work plans, by conducting a situation assessment, developing and implementing capacity-building plan.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative: Knowledge and skill for land use and transportation plans/policies (survey)\u003c/p\u003e \u003cp\u003eQualitative: Activities completed at the health units (interviews)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFollowing the intervention, staff reported:\u003c/p\u003e \u003cp\u003e-Increased knowledge and skills\u003c/p\u003e \u003cp\u003e-Increased awareness of other organizations\u003c/p\u003e\u003cp\u003eFacilitators for EIDM\u003c/p\u003e\u003cp\u003e-New relationships with colleagues in other health authorities, governments and sectors\u003c/p\u003e\u003cp\u003e-Increased opportunities for collaboration\u003c/p\u003e\u003cp\u003e-Collaboration between health authorities and local governments\u003c/p\u003e\u003cp\u003e-New insights on partnership work\u003c/p\u003e\u003cp\u003eBarriers to EIDM\u003c/p\u003e\u003cp\u003e-Lack of time and resources\u003c/p\u003e\u003cp\u003e-Roles and partnerships not clearly defined\u003c/p\u003e\u003cp\u003e-Lack of leadership support and integration across the organization\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Quasi-experimental study)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParke, 2015 (52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIsland Health and the University of Alberta, British Columbia, Canada,\u003c/p\u003e \u003cp\u003e2012\u0026ndash;2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eWhole organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eScholar-in-residence roles was established to integrate practice, education, and research through collaboration between a health region and a university. Activities included:\u003c/p\u003e \u003cp\u003e-Unit-based research teams that conducted literature reviews, literature appraisal\u003c/p\u003e \u003cp\u003e-Workshops on writing for publication, research methods skills\u003c/p\u003e \u003cp\u003e-Funded research project proposal writing, ethics applications, data collection and analysis\u003c/p\u003e \u003cp\u003e-Publications and presentations\u003c/p\u003e \u003cp\u003e-Quality improvement through collaboration with community, hospitals and university\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFindings were described in a narrative case report.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eBarriers to EIDM:\u003c/p\u003e \u003cp\u003e-Cultural differences between the healthcare and university system\u003c/p\u003e \u003cp\u003e-Establishing protected time for research in the health organization\u003c/p\u003e \u003cp\u003e-Building relationship between the scholar and hospital staff\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePeirson, 2012 (5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQualitative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePeel Public Health,\u003c/p\u003e \u003cp\u003eOntario, Canada, September 2008 to February 2010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAll staff at organization, including leadership\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMultiple EIDM interventions were implemented, including:\u003c/p\u003e \u003cp\u003e-Hiring new leadership supportive of EIDM\u003c/p\u003e \u003cp\u003e-Strategic organizational plan for EIDM\u003c/p\u003e\u003cp\u003e-Development of staff knowledge and skills\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative: EIDM facilitators (semi-structured interviews and focus groups, review of documents)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for EIDM:\u003c/p\u003e \u003cp\u003e-Senior leadership driving EIDM initiatives\u003c/p\u003e \u003cp\u003e-Organizational structures (e.g., journal clubs, workshops, library services)\u003c/p\u003e \u003cp\u003e-Establishing EIDM specialist roles, training staff in EIDM and encouraging knowledge sharing with co-workers\u003c/p\u003e \u003cp\u003e-Supportive organizational culture\u003c/p\u003e \u003cp\u003e-Accessible knowledge and sharing knowledge across the organization\u003c/p\u003e\u003cp\u003e-Communication around EIDM and its priority to the organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Qualitative)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlath, 2013 (66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQualitative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon-governmental social service organization, Australia, dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSocial work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eStaff across organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eStrategies to promote EIDM were implemented, including:\u003c/p\u003e \u003cp\u003e-Leadership commitment to EIDM\u003c/p\u003e \u003cp\u003e-Staff champions for EIDM\u003c/p\u003e \u003cp\u003e-Establishment of EIDM \u0026ldquo;communities of practice\u0026rdquo; teams\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative:\u003c/p\u003e \u003cp\u003e-EIDM facilitators and barriers and facilitators (interviews and focus groups)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for EIDM:\u003c/p\u003e \u003cp\u003e-Dedicated staff roles for research and KT\u003c/p\u003e \u003cp\u003e-Supportive leadership\u003c/p\u003e \u003cp\u003e-Sufficient time, training and resources for EIDM\u003c/p\u003e\u003cp\u003e-Audit and feedback of practices\u003c/p\u003e\u003cp\u003e-Building frontline staff skills in EIDM\u003c/p\u003e\u003cp\u003e-EIDM \u0026ldquo;communities of practice\u0026rdquo;\u003c/p\u003e \u003cp\u003eChallenges to EIDM:\u003c/p\u003e\u003cp\u003e-Competing priorities\u003c/p\u003e \u003cp\u003e-Lack of knowledge and skills\u003c/p\u003e\u003cp\u003e-Culture of responding to crises\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Qualitative)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRoberts, 2020 (56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle group pre-post study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTennessee Department of Health, Tennessee, USA, 2012\u0026ndash;2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDepartments, teams, senior leadership across organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eVolunteers were trained as \u0026ldquo;Baldrige examiners\u0026rdquo;, a similar role to knowledge broker. These volunteers supported teams at the local health departments evaluate and improve programming.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative:\u003c/p\u003e \u003cp\u003e-Employee satisfaction (survey)\u003c/p\u003e \u003cp\u003e-Adoption of new processes (training records)\u003c/p\u003e \u003cp\u003e-Integration of new programs (program process reports)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eAuthors report diffusion of skills across the local health departments. Department staff reported satisfaction with their jobs at rates higher than national averages.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Quasi-experimental study)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTraynor, 2014 (65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRCT with control group and case report with no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePublic health units, Ontario, Canada,\u003c/p\u003e \u003cp\u003eRCT 2003\u0026ndash;2007 and case report 2009\u0026ndash;2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOrganization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eTwo studies implemented Knowledge Brokers who conducted initial and ongoing needs assessments for EIDM, knowledge management and internal network development.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative: social network data, EIDM skills, knowledge and behavior (survey)\u003c/p\u003e \u003cp\u003eQualitative: Knowledge, attitudes and behaviours for EIDM (interviews, journal analysis)\u003c/p\u003e \u003cp\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eKnowledge brokering intervention was reported to result in increased use of EIDM. Tailoring knowledge broker approaches to the organizational context was most effective. Knowledge brokers were most effective if they were experts in research methodology and public health, as well as\u003c/p\u003e \u003cp\u003ebeing approachable and patient.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Qualitative)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVan der Zwet, 2020 (69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSocial work\u003c/p\u003e \u003cp\u003eOrganization, Netherlands, 2013\u0026ndash;2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSocial work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eResearch and development team\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eResearch and development department and long-term collaboration with a university were established to support EIDM.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative:\u003c/p\u003e \u003cp\u003e-EIDM facilitators and barriers\u003c/p\u003e \u003cp\u003e(semi-structured interviews)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for EIDM:\u003c/p\u003e \u003cp\u003e-Leadership commitment to research\u003c/p\u003e \u003cp\u003e-Qualified staff in EIDM support roles\u003c/p\u003e \u003cp\u003e-Research partnerships\u003c/p\u003e \u003cp\u003e-Training in EIDM\u003c/p\u003e \u003cp\u003e-Targeted recruitment of staff with diverse educational backgrounds\u003c/p\u003e \u003cp\u003eBarriers to EIDM:\u003c/p\u003e \u003cp\u003e-Negative attitudes towards EIDM\u003c/p\u003e \u003cp\u003e-Preference for experiential vs. research knowledge\u003c/p\u003e \u003cp\u003e-Culture of crisis-driven practice\u003c/p\u003e\u003cp\u003e-Workload, time management, competing priorities\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWard, 2012 (4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePeel Public Health,\u003c/p\u003e \u003cp\u003eOntario, Canada,\u003c/p\u003e \u003cp\u003e2010-11 (Year 4 of a 10-year initiative)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAll staff at organization, including leadership\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eKey elements of the EIDM strategic approach included:\u003c/p\u003e \u003cp\u003e-Structured process for research review\u003c/p\u003e \u003cp\u003e-Library reference service\u003c/p\u003e \u003cp\u003e-Staff development in EIDM knowledge and skills\u003c/p\u003e \u003cp\u003e-Dedicated staff time for EIDM\u003c/p\u003e \u003cp\u003e-Active engagement with the research community\u003c/p\u003e \u003cp\u003e-Accountability for EIDM at all levels of the organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFindings were described in a narrative case report.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eAfter 4 years of implementation, there was systematic and transparent application of research to more than 15 program decisions. EIDM was embedded as a cultural norm within the organization.\u003c/p\u003e \u003cp\u003eKey lessons identified included:\u003c/p\u003e \u003cp\u003e-Identify a senior, influential leader\u003c/p\u003e \u003cp\u003e-Commit to a multiyear strategy\u003c/p\u003e \u003cp\u003e-Be realistic about the infrastructure needed\u003c/p\u003e \u003cp\u003e-Staff support for skill development\u003c/p\u003e \u003cp\u003e-Make senior staff accountable for progress\u003c/p\u003e \u003cp\u003e-Partner with leading researchers\u003c/p\u003e \u003cp\u003e-Invest resources in change management.\u003c/p\u003e \u003cp\u003e-Measure progress to communicate successes to staff\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWaterman, 2015 (63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQualitative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eThe Greater Manchester Collaboration for Leadership\u003c/p\u003e \u003cp\u003ein Applied Health Research and Care, Manchester, United Kingdom; dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOrganization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eKT Associates facilitated the implementation of EIDM. KT Associates joined teams responsible for implementing EIDM along with the clinical lead, academic lead and program manager.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative:\u003c/p\u003e \u003cp\u003e-Evaluation of KT Associates\u0026rsquo; role and impact (focus group and interviews)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eKT Associates contributed to 4 key stages:\u003c/p\u003e \u003cp\u003e-Choosing an evidence-based intervention (collecting information, bringing stakeholders together, identify context, build up network)\u003c/p\u003e \u003cp\u003e-Planning the evidence-based intervention (collecting evidence, testing the intervention, sharing info, expanding networks, stakeholder meetings)\u003c/p\u003e \u003cp\u003e-Co-ordinating and implementing the evidence-based intervention recruit people and build relationships, individualized support, communication, understanding context)\u003c/p\u003e \u003cp\u003e-Evaluating evidence-based intervention (data collection/report, patient and staff experiences, celebratory events, poster/presentations)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWilliams, 2020 (109)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle group pre-post study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOutpatient children\u0026rsquo;s mental health clinics,\u003c/p\u003e \u003cp\u003ePhiladelphia, USA,\u003c/p\u003e \u003cp\u003e2013\u0026ndash;2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSenior leadership across agencies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDevelopment of organizational leadership and climate for EIDM through training, consultation and technical assistance.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative:\u003c/p\u003e \u003cp\u003e-EIDM use (Cognitive-behavioral therapy subscale\u003c/p\u003e \u003cp\u003eof the Therapy Procedures Checklist-Family Revised)\u003c/p\u003e \u003cp\u003e-Leadership for EIDM (Implementation Leadership Scale)\u003c/p\u003e \u003cp\u003e-Organizations\u0026rsquo; climates for EIDM (Implementation Climate Scale)\u003c/p\u003e \u003cp\u003e-Perceptions of leader\u0026rsquo;s transformational leadership (Multifactor Leadership Questionnaire)\u003c/p\u003e \u003cp\u003e-Attitudes toward EIDM (Evidence-based Practice Attitudes Scale)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eOrganizational climates supportive of EIDM were associated with:\u003c/p\u003e \u003cp\u003e-Strong leadership for EIDM (d\u0026thinsp;=\u0026thinsp;0.92, p\u0026thinsp;=\u0026thinsp;0.017)\u003c/p\u003e \u003cp\u003e-Increased use of EIDM (d\u0026thinsp;=\u0026thinsp;0.55, p\u0026thinsp;=\u0026thinsp;0.007)\u003c/p\u003e \u003cp\u003eThere was no association between clinicians\u0026rsquo; attitudes towards EIDM and their use of EIDM.\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Quasi-experimental study)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWilliams, 2019 (59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle group pre-post study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMetabolic specialist centres,\u003c/p\u003e \u003cp\u003eAustralia and New Zealand, 2015\u0026ndash;2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMetabolic dietetic service within organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eThe metabolic dietetic service established:\u003c/p\u003e \u003cp\u003e-Electronic referral alert\u003c/p\u003e \u003cp\u003e-Metabolic sick day nutrition plans available to all clinical staff\u003c/p\u003e\u003cp\u003e-Metabolic diet codes and specialised formula recipes\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative: Admissions for patients with inborn errors of metabolism (chart audit)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eThere was a reduction in total admissions of patients with inborn errors of metabolism (36 vs. 11 across the audit periods; unclear if this was a statistically significant finding.)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Quasi-experimental study)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWilliams, 2017 (54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle group pre-post study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eChildren\u0026rsquo;s mental health agencies, large midwestern urban area, USA, 2010\u0026ndash;2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCEOs and administrators, and front-line clinical teams at organizations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eExternal facilitators supported leadership, staff and an internal liaison. Principles of EIDM were integrated into the organizations\u0026rsquo; operating procedures. Organizational infrastructure and tools to enable EIDM were developed. Staff and leadership mental models to support EIDM were enabled.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative: Intentions to adopt EIDM, barriers to EIDM (surveys), Unit-level enactment of Availability, Responsiveness, and Continuity principles and completion of planned activities (ARC principles questionnaire), Organizational proficiency culture for EIDM (Organizational Social Context measure)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFollowing implementation, clinicians exhibited:\u003c/p\u003e \u003cp\u003e-Higher odds of adopting EIDM (OR\u0026thinsp;=\u0026thinsp;3.19, p\u0026thinsp;=\u0026thinsp;0.003)\u003c/p\u003e \u003cp\u003e-Greater use of EIDM with clients (p\u0026thinsp;=\u0026thinsp;0.003)\u003c/p\u003e \u003cp\u003e-Fewer EIDM barriers (p\u0026thinsp;=\u0026thinsp;0.026)\u003c/p\u003e\u003cp\u003eIntention to use EIDM was the only predictor of EIDM adoption (p\u0026thinsp;=\u0026thinsp;0.032) and EIDM use (p\u0026thinsp;=\u0026thinsp;0.002).\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Quasi-experimental study)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003eStudies of implementation of EIPs\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConnell, 2019 (110)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepartment of Children and Families, Connecticut, USA, 2011\u0026ndash;2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSocial work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAll staff at organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eImplementation of trauma-informed care, through workforce development, trauma screening procedures, policy changes,\u003c/p\u003e \u003cp\u003eimproved access to evidence-based trauma-focused treatments, and focused evaluation of changes.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative:\u003c/p\u003e \u003cp\u003e-Staff perceptions of individual and organizational use of trauma-informed practices (Trauma System Readiness Tool)\u003c/p\u003e \u003cp\u003e-Staff perception of contributions of each intervention component to success of program (survey)\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eStaff and organizational use of trauma-informed practices increased. Staff rated the availability of trauma-focused treatments in the community, integration of trauma-informed care into practice guides as the strongest contributors to organizational change.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDamschroder, 2013 (111)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFive Veteran Affairs facilities, USA, July and October\u003c/p\u003e \u003cp\u003e2007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOrganization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eImplementation of the MOVE! weight management program, a multi-tiered set of tools and treatment options based on published guidelines for obesity management.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative:\u003c/p\u003e \u003cp\u003e-Facilitators for implementation (semi-structured interviews with 24 key stakeholders)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for implementation, according to the Consolidated Framework for Implementation Research:\u003c/p\u003e \u003cp\u003e1. Inner setting:\u003c/p\u003e \u003cp\u003e-Strong working relationships\u003c/p\u003e \u003cp\u003e-Tension for change (seeking and welcoming new programming and improvements)\u003c/p\u003e \u003cp\u003e-Priority of the change or program\u003c/p\u003e \u003cp\u003e-Goals and feedback (\u003c/p\u003e\u003cp\u003e-Learning climate\u003c/p\u003e \u003cp\u003e-Leadership engagement to support the program\u003c/p\u003e\u003cp\u003e2. Process:\u003c/p\u003e\u003cp\u003e-Planning a formal implementation plan\u003c/p\u003e\u003cp\u003e3. External change agents:\u003c/p\u003e\u003cp\u003e-Audit and feedback\u003c/p\u003e \u003cp\u003e4. Intervention characteristics:\u003c/p\u003e\u003cp\u003e-Relative advantage over alternatives\u003c/p\u003e\u003cp\u003e5. Outer setting:\u003c/p\u003e\u003cp\u003e-Staff who are aware of patient needs\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDarling, 2021 (112)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAlongside Midwifery Unit,\u003c/p\u003e \u003cp\u003eMarkham Stouffville Hospital,\u003c/p\u003e \u003cp\u003eMarkham, Ontario, Canada. November 2018-May 2020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eUnit within a large community hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eImplementation of the first Alongside Midwifery Unit in Canada:\u003c/p\u003e \u003cp\u003e-Frequent and open communication\u003c/p\u003e \u003cp\u003e-Dedicated project management\u003c/p\u003e \u003cp\u003e-Leadership engagement\u003c/p\u003e \u003cp\u003e-Ongoing evaluation and adaptation.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative\u003c/p\u003e \u003cp\u003e-Facilitators (document analysis and key informant interviews)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for implementation:\u003c/p\u003e \u003cp\u003e-sociopolitical climate, desire for change, effective project support, dedicated time and resources, ongoing program evaluation and feedback, communication with leadership, involving all staff in planning and decision making.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFabbruzzo-Cota, 2016 (113)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle group pre-post study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMount Sinai Hospital,\u003c/p\u003e \u003cp\u003eToronto, Ontario, Canada, 2012\u0026ndash;2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOrganization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAn advanced practice nurse-led interprofessional initiative to reduce hospital-acquired pressure ulcers using evidence-based practice:\u003c/p\u003e \u003cp\u003e-Clinical experience integrated with theory, research and expert opinion\u003c/p\u003e \u003cp\u003e-Synthesizing, critiquing and applying research\u003c/p\u003e \u003cp\u003e- Involvement of interprofessional teams and senior leadership\u003c/p\u003e \u003cp\u003e-Funding\u003c/p\u003e \u003cp\u003e-Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative:\u003c/p\u003e \u003cp\u003e-Incidence of pressure ulcers (Quarterly pressure ulcer prevalence and incidence audits)\u003c/p\u003e \u003cp\u003e-Uptake of change in clinical practice (audits)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFindings included:\u003c/p\u003e \u003cp\u003e-80% decrease in hospital acquired pressure ulcers since the implementation.\u003c/p\u003e \u003cp\u003e-63% of at-risk patients had a turning click posted at the bedside.\u003c/p\u003e \u003cp\u003e-All units had the Positioning Decision Tree for Patients at Risk available\u003c/p\u003e \u003cp\u003e-28 Skin and wound nurse champions\u003c/p\u003e \u003cp\u003e-2 Nurses joined Skin and Wound Care Steering Committee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Quasi-experimental)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFearing, 2014 (114)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eKinark Child and Family Services\u003c/p\u003e \u003cp\u003eOntario, Canada\u003c/p\u003e \u003cp\u003e2006\u0026ndash;2009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSocial work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOrganization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eThis report explores the process of an evidence-based practice implementation effort in all clinical services.\u003c/p\u003e \u003cp\u003eImplementation was driven by multidisciplinary implementation teams.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative:\u003c/p\u003e \u003cp\u003e-Managers perceptions (audio recording of management meetings)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for implementation:\u003c/p\u003e \u003cp\u003e-Clearer understanding of the organization\u0026rsquo;s clinical supervision model\u003c/p\u003e \u003cp\u003e-Development of sustainability plans\u003c/p\u003e \u003cp\u003e-Practice Lead and Peer Coach\u003c/p\u003e \u003cp\u003e-Organizational culture change\u003c/p\u003e \u003cp\u003eBarriers to implementation:\u003c/p\u003e\u003cp\u003e-Staff workload\u003c/p\u003e\u003cp\u003e-Limited resources\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHurlburt, 2014 (115)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLarge children\u0026rsquo;s service system,\u003c/p\u003e \u003cp\u003eCalifornia, USA, 2008\u0026ndash;2009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSocial work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27 Stakeholders (community, directors, supervisors, trainers, coaches, front line providers)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eThe Interagency Collaborative Team (ICT) model was used to implement an evidence-based child neglect intervention (SafeCare):\u003c/p\u003e \u003cp\u003e-Stakeholder education and alignment\u003c/p\u003e \u003cp\u003e-Practice fit assessment\u003c/p\u003e \u003cp\u003e-Resource support\u003c/p\u003e \u003cp\u003e-Skill development\u003c/p\u003e\u003cp\u003e-Monitoring and feedback.\u003c/p\u003e\u003cp\u003e-Distributed local leadership\u003c/p\u003e\u003cp\u003e-Program adaptation.\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative: personal-, organizational- and system-level factors affecting implementation (semi-structured interviews)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for implementation:\u003c/p\u003e \u003cp\u003e-Initial commitment and collaboration among stakeholders\u003c/p\u003e \u003cp\u003e-Cross-level leadership\u003c/p\u003e \u003cp\u003e-Practice fit to the local context\u003c/p\u003e \u003cp\u003e-Ongoing negotiation of rights, roles, responsibilities, and interests among stakeholder organizations\u003c/p\u003e \u003cp\u003e-Early successes\u003c/p\u003e \u003cp\u003eBarriers to implementation:\u003c/p\u003e \u003cp\u003e-Insufficient communication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKane, 2017 (116)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePublic health departments, USA,\u003c/p\u003e \u003cp\u003e2010\u0026ndash;2012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOrganization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eThe Communities Putting Prevention to Work (CPPW) Initiatives program was implemented to increase high-impact, evidence-based, population-wide environmental improvement strategies. The program implemented strategies through partnerships with local, community and state organizations.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative: Completion of work plan objectives, leadership support, collaboration, staff turnover (site visits and interviews)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eThe following conditions were found to lead to successful completion of objectives 88.2% of the time:\u003c/p\u003e \u003cp\u003e-Having public health improvement and topical experience and having a history of collaboration with partners\u003c/p\u003e \u003cp\u003e2)Not having public health improvement and topical experience and having leadership support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKegeles, 2015 (117)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle group pre-post study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCommunity-based organizations, USA, 2-year data collection period; dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u0026ndash;4 Individuals (coordinators, leadership, volunteers) from 72 community- based organizations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eThe Mpowerment Project, a multi-level HIV prevention intervention, was implemented. Implementation included education for providers, resources for providers, e.g., manuals and videos. The community-based organizations implementing the program were involved in planning the implementation.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative: barriers and facilitators to implementation (semi-structured interviews, notes and commentaries from technical assistance providers)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for implementation:\u003c/p\u003e \u003cp\u003e-Buy-in from service providers\u003c/p\u003e \u003cp\u003e-Planning prior to implementation\u003c/p\u003e\u003cp\u003e-Evaluation of intervention\u003c/p\u003e\u003cp\u003e-Organizational stability\u003c/p\u003e\u003cp\u003eBarriers to implementation:\u003c/p\u003e\u003cp\u003e-Program complexity\u003c/p\u003e\u003cp\u003e-Program adaptability\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Quasi-experimental)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMcAllen, 2018 (118)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle group pre-post study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e532-bed, acute care tertiary teaching hospital, midwestern USA, dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 Units within the hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eA bedside report was implemented in standard nursing care.\u003c/p\u003e \u003cp\u003eStaff were involved in implementation planning and provided education.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative:\u003c/p\u003e \u003cp\u003e-Compliance (audits)\u003c/p\u003e \u003cp\u003e-Number of patient falls (hospital incident reporting system)\u003c/p\u003e \u003cp\u003e-Patient satisfaction (a combination of questions from the Press Ganey\u0026reg; and Hospital Consumer Assessment of Healthcare Providers\u003c/p\u003e \u003cp\u003eand Systems surveys)\u003c/p\u003e \u003cp\u003e-Nurse satisfaction (survey)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFindings included:\u003c/p\u003e \u003cp\u003e-Program compliance rate of 94%\u003c/p\u003e \u003cp\u003e-Patient falls decreased by 24% in the four months after implementation\u003c/p\u003e \u003cp\u003e-One unit had improvement in patient satisfaction (p\u0026thinsp;=\u0026thinsp;0.03)\u003c/p\u003e \u003cp\u003e-Significant reduction in the proportion of nurses who reported having enough time for report (80\u0026ndash;59.6%, p\u0026thinsp;=\u0026thinsp;0.008)\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Quasi-experimental)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMcCarthy, 2021 (119)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eChild welfare system, Victoria, Australia, dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSocial work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOrganization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eThis case report explores the adoption and implementation of evidence-based practice within the child welfare system.\u003c/p\u003e \u003cp\u003eImplementation was initiated by new leadership. A new role dedicated to implementation was established. Staff recruitment focused on hiring individuals with experience implementing evidence-based practices.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative:\u003c/p\u003e \u003cp\u003e-Facilitators for implementation (interviews)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for implementation:\u003c/p\u003e \u003cp\u003e-Consistent communication and messaging\u003c/p\u003e \u003cp\u003e-Adaptive management\u003c/p\u003e\u003cp\u003e-Building a shared understanding of evidence\u003c/p\u003e\u003cp\u003e-Development of a learning culture\u003c/p\u003e\u003cp\u003e-Investment in staff skilled in evidence-based practice\u003c/p\u003e\u003cp\u003e-Building relationships\u003c/p\u003e\u003cp\u003e-Transformational leadership approach\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMcConnell, 2015 (120)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHealth and social care trust,\u003c/p\u003e \u003cp\u003eNorthern Ireland, 2011\u0026ndash;2012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePalliative care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTwo policymakers from the Department of Health, Social Services and Public Safety, and 22 participants from two service groups (Cancer and Specialist Services, and Acute Services)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eThe Liverpool Care Pathway was implemented to improve best practice in end-of-life care. Implementation involved a dedicated program facilitator, education for staff, regular evaluation and feedback.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative: facilitators and barriers for implementation (realist evaluation, semi-structured interviews)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for implementation:\u003c/p\u003e \u003cp\u003e-Visibility and availability of program facilitator as a reminder to use pathway and support staff\u003c/p\u003e \u003cp\u003e-Sharing positive feedback\u003c/p\u003e \u003cp\u003e-Supportive senior management\u003c/p\u003e \u003cp\u003eBarriers to implementation:\u003c/p\u003e\u003cp\u003e-Lack of resources\u003c/p\u003e\u003cp\u003e-Differing needs and expectations\u003c/p\u003e\u003cp\u003e-Ambivalence toward pathway approach from medical providers\u003c/p\u003e\u003cp\u003e-Lack of ongoing senior management support and withdrawal of program facilitators\u003c/p\u003e\u003cp\u003e-Social barriers (i.e., negative public perceptions in response to negative media)\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNelson, 2016 (121)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAlberta Health Services, Alberta, Canada, February 2013-December 2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eWithin a single health care system for colorectal surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eA guideline for enhanced recovery after colorectal surgery was implemented. Implementation included an multidisciplinary implementation team and ongoing audit and feedback.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative:\u003c/p\u003e \u003cp\u003e-Length of stay, complications, and 30-day post-discharge 30-day post-discharge readmissions (Interactive\u003c/p\u003e \u003cp\u003eAudit System)\u003c/p\u003e \u003cp\u003e-Guideline compliance (interview audit)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFindings at 15 months of implementation:\u003c/p\u003e \u003cp\u003e-Median length of stay reduced from 6 days to 4.5 days (p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001)\u003c/p\u003e \u003cp\u003e-Reduction in the risk of readmission (adjusted RR\u0026thinsp;=\u0026thinsp;1.73; 95% CI\u0026thinsp;=\u0026thinsp;1.09, 2.73)\u003c/p\u003e \u003cp\u003e-Reduction patients who develop a complication (-11.7%, 95% CI\u0026thinsp;=\u0026thinsp;2.5%, 21%)\u003c/p\u003e \u003cp\u003e-Net cost savings between \u003cspan\u003e$\u003c/span\u003e2806 and \u003cspan\u003e$\u003c/span\u003e5898 USD/patient\u003c/p\u003e \u003cp\u003e-Median overall guideline compliance increased from 39\u0026ndash;60%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoehler, 2020 (122)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLocal health departments, Missouri, USA, January-April 2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePublic health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOrganization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eTwenty diabetes-related evidence-based programs and policies were implemented in local health departments. Staff capacity to implement these programs was developed through training and provision of resources.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative:\u003c/p\u003e \u003cp\u003e-Facilitators, barriers and capacities to use evidence-based programs and policies (interviews with\u003c/p\u003e \u003cp\u003edirectors and diabetes/chronic disease practitioners)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for implementation:\u003c/p\u003e \u003cp\u003e-Knowledge of evidence-based programs and policies\u003c/p\u003e \u003cp\u003e-Leadership support\u003c/p\u003e \u003cp\u003e-Targeted messaging\u003c/p\u003e \u003cp\u003e-Staff capacity building for EIDM evidence-based decision making\u003c/p\u003e \u003cp\u003e-Access to professional development/training\u003c/p\u003e \u003cp\u003e-Regular staff communications/ meetings\u003c/p\u003e\u003cp\u003e-Meetings with internal and community decision makers\u003c/p\u003e\u003cp\u003e-Community-relevant evidence\u003c/p\u003e\u003cp\u003eBarriers to implementation:\u003c/p\u003e\u003cp\u003e-Community perception/buy-in\u003c/p\u003e \u003cp\u003e-Limited resources (funding and staff)\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePullyblank, 2022 (123)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle group pre-post study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eClinical health departments and community-based organizations, rural New York state, USA, March 2017- Nov 2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOrganization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMulti-sector collaboration between a rural health care system and a network\u003c/p\u003e \u003cp\u003eof community-based organizations, and establishment of a central recruitment, referral and coordinating office for the region.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative: Number of referrals (electronic health records), implementation, training, workshop schedules, quality assurance (Living Well internal documents), Workshop attendance and completion (program records)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eThe number of program workshops offered increased from 4\u0026ndash;6/year to 23 by 2019. The number of community-based organizations grew from 4 to 6 counties. The number of non-referring clinics fell from 27 to 9.\u003c/p\u003e \u003cp\u003eHealth care providers and community-based organizations integrated the Living Well program into their culture of care.\u003c/p\u003e \u003cp\u003eMulti-sector approach using a central hub supported implementation of evidence-based programs in rural locations.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Quasi-experimental)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRodriguez-Quintana, 2022 (124)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle group pre-post study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWolverine Human Services juvenile residential facilities, Michigan, USA, 2013\u0026ndash;2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSocial work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOrganization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eA cognitive behavioural therapy program was implemented.\u003c/p\u003e \u003cp\u003eThe program was adapted fit the needs of the population and the multidisciplinary health team. Strategies used to support the programs integrated all team members.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative:\u003c/p\u003e \u003cp\u003e-Implementation facilitators (site visits by the cognitive behavioral therapy intermediary and\u003c/p\u003e \u003cp\u003eimplementation research team for an intensive immersion)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for EIDM:\u003c/p\u003e \u003cp\u003e-Dedicated implementation teams\u003c/p\u003e \u003cp\u003e-Progress monitoring\u003c/p\u003e\u003cp\u003e-Adapting the program to meet organization\u0026rsquo;s needs\u003c/p\u003e\u003cp\u003e-Training/supervision\u003c/p\u003e \u003cp\u003e-Consultation calls to support implementation\u003c/p\u003e \u003cp\u003e-Train-the-trainers approach\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Quasi-experimental)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSchreiber, 2015 (125)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePediatric outpatient facility with one primary and three satellite clinics, USA, 6-month duration; dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17 physical therapists\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eA multicomponent KT program was implemented to increase the use of standardized outcome measures and address inconsistency of frequency and duration of physical therapist services.\u003c/p\u003e \u003cp\u003eThe KT program included: barrier identification, use of a knowledge broker, workshops / practice sessions, online and hard-copy resources, and an ongoing program evaluation with communication of results.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative: knowledge assessment (baseline, 8-month follow-up), self-report surveys, chart review data on use of outcome measures\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eKnowledge assessment scores increased from 54.1 to 81.8 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003eSelf-reported knowledge improved for test selection (p\u0026thinsp;=\u0026thinsp;0.003), administration (p\u0026thinsp;=\u0026thinsp;0.001), interpretation (p\u0026thinsp;=\u0026thinsp;0.001), and sharing of results (p\u0026thinsp;=\u0026thinsp;0.022). Self-reported performance of testing and measurement improved for test selection (p\u0026thinsp;=\u0026thinsp;0.001), administration (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and interpretation (p\u0026thinsp;=\u0026thinsp;0.006).\u003c/p\u003e \u003cp\u003eFrequency of administration increased for all outcome measures for 8-month program duration.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eScott, 2022 (126)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWolverine Human Services juvenile residential facilities, Michigan, USA, 2013\u0026ndash;2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSocial work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOrganization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCognitive behavioral therapy was implemented across facilities.\u003c/p\u003e \u003cp\u003eAdaptation involved an implementation team, needs assessment, development of an implementation template, site training and ongoing reassessment.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative:\u003c/p\u003e \u003cp\u003e-EIDM needs assessment (Evidence-Based Practice Attitude Scale, Attitudes\u003c/p\u003e \u003cp\u003eToward Standardized Assessment Scale, Organizational Culture Survey, Survey of Organizational\u003c/p\u003e \u003cp\u003eFunctioning and Infrastructure Survey and Sociometric Opinion Leader Survey)\u003c/p\u003e \u003cp\u003eQualitative:\u003c/p\u003e \u003cp\u003e-Perceived effectiveness of implementation strategies, organizational culture and readiness for change, and impact of infrastructure (Focus group interviews with clinicians and operations staff)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eThe needs assessment identified 76 barriers; 23 were prioritized and addressed. On reassessment, 24 of the barriers showed statistically significant improvement.\u003c/p\u003e \u003cp\u003eBarriers to implementation:\u003c/p\u003e \u003cp\u003e-Lack of training in evidence-based practice\u003c/p\u003e \u003cp\u003e-Poor communication\u003c/p\u003e \u003cp\u003e-Low morale among staff\u003c/p\u003e \u003cp\u003e-Lack of teamwork\u003c/p\u003e \u003cp\u003e-Lack of incentive\u003c/p\u003e \u003cp\u003e-High staff turnover\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eModerate (Quasi-experimental)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStevans, 2015 (127)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eThe University of Pittsburgh Medical Center, Centers\u003c/p\u003e \u003cp\u003efor Rehab Services, Pennsylvania, USA, 2005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOrganization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eThe Low Back Pain Quality Improvement Initiative project was implemented. A local consensus process engaged providers in planning. Implementation champions supported the program. Providers were provided with education for the project. Implementation was evaluated regularly, and feedback applied to adjust strategies.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative: Facilitators for implementation (interviews)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for implementation:\u003c/p\u003e \u003cp\u003e-Understanding the complex nature of\u003c/p\u003e \u003cp\u003ethe clinical setting from a systems perspective to identify implementation barriers.\u003c/p\u003e \u003cp\u003e-Multicomponent intervention strategy\u003c/p\u003e \u003cp\u003e-Vision, leadership, and commitment from all the\u003c/p\u003e \u003cp\u003emembers of the organization\u003c/p\u003e\u003cp\u003e-Iterative measurement, reassessment,\u003c/p\u003e\u003cp\u003eand refinement of strategies.\u003c/p\u003e\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWilkinson, 2019 (128)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQualitative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTwo regional sites,\u003c/p\u003e \u003cp\u003eQueensland, Australia, dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTeam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eA medical nutrition therapy model of care for gestational diabetes mellitus was implemented at local regional sites.\u003c/p\u003e \u003cp\u003eThe implementation strategy included developing local consensus processes, self-monitoring clinician behaviour, prompts and cues, adjusting and reorganising clinic environment.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQualitative: stakeholder experiences and learnings (semi-structured interviews)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eFacilitators for implementation:\u003c/p\u003e \u003cp\u003e-Engagement with an external project team\u003c/p\u003e \u003cp\u003e-Robust project methodology and guided process to overcome local barriers\u003c/p\u003e \u003cp\u003e-Wide, ongoing site stakeholder engagement and local networking\u003c/p\u003e \u003cp\u003e-Multi-disciplinary higher-level management support and engagement\u003c/p\u003e \u003cp\u003e-Positive attitude\u003c/p\u003e \u003cp\u003e-Building confidence and capacity of local implementers through regular contact\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Qualitative)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWilkinson, 2018 (129)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle group pre-post study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSouth-East Queensland Hospital, Queensland, Australia, 2016\u0026ndash;2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOrganization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eA medical nutrition therapy model of care for gestational diabetes mellitus was adapted at local regional sites.\u003c/p\u003e \u003cp\u003eThe adaptation strategy included a needs assessment, barrier analysis and adaptation to local context.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative: service attendance metrics, anthropometry, diet quality, interventions delivered (hospital records)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eGuideline adherence increased over time (4.4% \u0026minus;\u0026thinsp;50%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Qualitative)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWilliams, 2018 (130)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase report, no comparator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepartment of Behavioral Health\u003c/p\u003e \u003cp\u003eand Intellectual DisAbility Services,\u003c/p\u003e \u003cp\u003ePhiladelphia, Pennsylvania, USA, 2 years; dates not specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrimary care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNetwork of clinics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePolicy initiative for 4 psychotherapy protocols was initiated. A dedicated role for implementation was established. Clinicians were trained in the new psychotherapy protocols.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eQuantitative: impact of work environment on personal well-being and strategic implementation climate, perceptions of organizational for EIDM (survey)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eIn organizations with more supportive work environments, organizational support for EIDM predicted implementation. In organizations with less positive work environments, there was no association between implementation and organizational support.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eHigh (Case report)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eStudy designs included case reports (n\u0026thinsp;=\u0026thinsp;30), single group pre-/post-test studies (n\u0026thinsp;=\u0026thinsp;16), qualitative studies (n\u0026thinsp;=\u0026thinsp;11), and randomized controlled trials (RCTs) (n\u0026thinsp;=\u0026thinsp;2). Both RCTs evaluated the implementation of organizational EIDM.\u003c/p\u003e \u003cp\u003eStudies reported quantitative (n\u0026thinsp;=\u0026thinsp;19), qualitative (n\u0026thinsp;=\u0026thinsp;29), or both quantitative and qualitative results (n\u0026thinsp;=\u0026thinsp;11). For the studies that reported quantitative results, measures included EIDM implementation, EIDM-related beliefs and behaviours, organizational priorities for EIDM, use of EIPs, and patient care quality indicators. Quantitative measures were heterogenous and did not allow meta-analysis. Qualitative findings were generated through formal qualitative analysis (n\u0026thinsp;=\u0026thinsp;33) or descriptive case reports (n\u0026thinsp;=\u0026thinsp;16). Most qualitative results included facilitators and barriers to implementation (n\u0026thinsp;=\u0026thinsp;32).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eStudy Quality\u003c/h2\u003e \u003cp\u003eThe critical appraisal checklist used to assess each study is indicated in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Single group, pre-/post-test studies were evaluated according to the JBI Checklist for Quasi-experimental Studies (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFor studies of organization-wide implementation of EIDM, a lack of control groups contributed to a higher risk of bias. Most included studies were rated Moderate or High quality according to their respective quality assessment tools. Therefore, the overall methodological quality for this body of literature was rated as Moderate.\u003c/p\u003e \u003cp\u003eLikewise, studies of EIP implementation also lacked a control group, contributing to a higher risk of bias. Included studies were rated Moderate or High quality according to their respective quality assessment tools but given that this literature was dominated by case reports with non-systematic assessments of outcomes, the overall methodological quality for this body of literature was rated as Low.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eStrategies for implementing organization-wide EIDM\u003c/h2\u003e \u003cp\u003eDue to the heterogeneity of study designs, interventions, and outcomes, it was not possible to determine which EIDM implementation strategies are more effective compared to others. Implementation strategies included the establishment of Knowledge Broker-type roles, building the EIDM capacity of staff, and research or academic partnerships. Evaluation of strategies implemented by studies in this review was often qualitative and described facilitators and barriers, rather than quantitatively measuring effectiveness. However, it is possible to explore EIDM implementation strategies and factors that appear to contribute to or inhibit success.\u003c/p\u003e \u003cp\u003eThe most common strategy implemented in included studies was the establishment of Knowledge Broker-type roles, which was the primary strategy in 22 studies (\u003cspan additionalcitationids=\"CR47 CR48 CR49 CR50 CR51 CR52 CR53 CR54 CR55 CR56 CR57 CR58 CR59 CR60 CR61 CR62 CR63 CR64 CR65 CR66\" citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e67\u003c/span\u003e). Studies described roles differently, e.g., \u0026ldquo;Evidence-based Practice Facilitator\u0026rdquo;, \u0026ldquo;Evidence Facilitator\u0026rdquo;, \u0026ldquo;EIDM Mentor\u0026rdquo;. These roles all served to support EIDM across organizations though knowledge sharing, evidence synthesis, implementation, and other EIDM-related activities. In some studies, new staff were hired to Knowledge Broker roles, or developed among existing staff, while in others, Knowledge Brokers were contracted from external organizations. Knowledge Broker strategies were mostly implemented in parallel with other EIDM implementation strategies, such as capacity building for staff, integrating EIDM into decision-making processes and development of leadership to support EIDM. When these strategies were evaluated quantitatively for organizational capacity, culture and implementation of EIDM, most studies found positive results, such as increased scores for organizational climates supporting EIDM, improved attitudes toward EIDM, or the integration of EIDM into processes(\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan additionalcitationids=\"CR60\" citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e, \u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e, \u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e), although some studies found no change (\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e) following implementation of Knowledge Broker roles. Qualitatively, most studies described facilitators and barriers to EIDM, either through formal qualitative analysis or case report (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e, \u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e, \u003cspan additionalcitationids=\"CR67 CR68 CR69 CR70 CR71 CR72 CR73\" citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e74\u003c/span\u003e) Facilitators included organizational culture with supportive leadership and staff buy-in, expectations to use evidence to inform decisions, accessible knowledge, and integration of EIDM into processes and templates. Barriers included limited time and competing priorities, staff turnover, and lack of understanding and support from management.\u003c/p\u003e \u003cp\u003eTen included studies focused primarily on building EIDM capacity of existing staff at the organization, often at multiple levels (e.g., front-line service providers, managers, and leadership) (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e, \u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e70\u003c/span\u003e, \u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e, \u003cspan additionalcitationids=\"CR74 CR75 CR76 CR77\" citationid=\"CR73\" class=\"CitationRef\"\u003e73\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e78\u003c/span\u003e). Capacity building was typically done through EIDM-focused workshops, often with ongoing follow up support from workshop facilitators. While studies often measured changes in individual knowledge and skill for EIDM for workshop participants, organizational change for EIDM was reported qualitatively, either through formal qualitative analysis or through a case report. Facilitators for EIDM in these ten studies included organizational culture with supportive leadership and staff buy-in, dedicated staff roles to support EIDM, opportunities to meet and discuss EIDM (e.g., communities of practice, journal clubs), knowledge sharing across the organization, expectations to use evidence to inform decisions, accessible knowledge, and integration of EIDM into processes and templates. Barriers included limited time and competing priorities, staff turnover, and negative attitudes toward EIDM.\u003c/p\u003e \u003cp\u003eResearch or academic partnerships and networks were the main strategy described in three case reports (\u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e, \u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e, \u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e79\u003c/span\u003e). These involved establishing collaborations, either through universities or non-governmental health organizations, that provided direct EIDM support. These strategies were not evaluated quantitatively but described facilitators and barriers to effective cross-sector collaborations. Facilitators for EIDM included supportive leadership and management, dedicated staff roles to support EIDM, EIDM knowledge and skill development for staff, and regular communication between partners. Barriers included limited time and competing priorities, preference for experiential over research evidence, and negative attitudes toward EIDM.\u003c/p\u003e \u003cp\u003eOverall, studies described successes in implementing EIDM across organizations, citing several common key facilitators and barriers. To instigate behaviour change, strategies must address capability for change, which may be achieved by building staff capacity, establishing dedicated support roles, improving access to evidence, and sharing knowledge across the organization. Strategies must also enable opportunities for change, which may be supported through forums for EIDM learning and practice, protecting time for EIDM, integrating EIDM into new or existing roles, and adding EIDM to processes and templates. Behaviour change also requires motivation, which may be built through a supportive organizational culture, expectations to use EIDM, recognition and positive reinforcement, and strong support from leadership.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eStrategies for implementing EIPs\u003c/h2\u003e \u003cp\u003eStudies of implementing EIPs in public health, health or social care organizations reveal the complexity of implementation strategies. Many included implementation studies describe multiple concurrent strategies. The most common strategy used in studies of EIP implementation was the establishment of a dedicated role or team to support implementation (n\u0026thinsp;=\u0026thinsp;11). These dedicated staff or teams were responsible for implementation planning, management, and evaluation. The next most common strategy was workforce education (n\u0026thinsp;=\u0026thinsp;8), which typically involved workshops for staff at multiple levels of the organization, providing orientation to and the impetus for the new practice. Supplemental resources (e.g., manuals and visual prompts) were provided to staff in several studies (n\u0026thinsp;=\u0026thinsp;5). Another strategy for implementation was the engagement of providers and staff at organizations in the development of implementation plans(n\u0026thinsp;=\u0026thinsp;7). In some studies, implementation planning for EIPs was adapted to organizational context (n\u0026thinsp;=\u0026thinsp;4) or informed by barrier analysis (n\u0026thinsp;=\u0026thinsp;2). Many implementation strategies included ongoing evaluation of implementation while providing feedback to providers (n\u0026thinsp;=\u0026thinsp;5).\u003c/p\u003e \u003cp\u003eIn terms of facilitators for successful implementation of evidence-informed practice, many studies describe the strategies listed above as facilitators. Additional facilitators include staff desire for change, supportive leadership, consistent communication and messaging, and a culture of learning.\u003c/p\u003e \u003cp\u003eBarriers for implementation were fairly consistent across studies. Barriers included a lack of staff knowledge and understanding of the new program, poor communication between the implementation team and providers or staff, staff turnover and loss of knowledge, lack of both time and personnel, and complexity of programs.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eKey considerations for implementing EIDM and EIPs\u003c/h2\u003e \u003cp\u003eMany of the facilitators and barriers to EIDM and EIP implementation are common across strategies explored by the studies included in this review. To conceptualize these factors, they are presented according to the COM-B model for behaviour change (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e) in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eStrategies to implement both EIDM or EIPs across organizations include establishing specialized roles, providing staff education and training, developing processes or mechanisms to support new practices, and demonstrating leadership support. Facilitators and barriers for these strategies align with the COM-B model for behaviour change, which outlines capability, opportunity, and motivation as influencers of behaviour (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The COM-B model provides a comprehensive framework for the factors that influence behaviour change and has provided a valuable structure for evaluating barriers and facilitators to behaviour change in public health and related fields (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan additionalcitationids=\"CR81\" citationid=\"CR80\" class=\"CitationRef\"\u003e80\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR82\" class=\"CitationRef\"\u003e82\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe capability section of the COM-B model reflects whether the intended audience possess the knowledge and skill for a new behaviour. Findings from this review establish facilitators for EIDM and EIP implementation capability, including the development of staff knowledge and skill, establishing specialized roles, and knowledge sharing across the organization. The development of staff knowledge and skill for EIDM are a necessary component to ensure EIDM in practice, however, literature has found that the organization-wide impact of conducting only individual-level knowledge and skill development is limited (\u003cspan additionalcitationids=\"CR84\" citationid=\"CR83\" class=\"CitationRef\"\u003e83\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR85\" class=\"CitationRef\"\u003e85\u003c/span\u003e). While knowledge and skill development are a necessary component to EIDM practice, they must be supported by other components to have an impact beyond the individual. Other strategies that support the use of newly gained knowledge and skills include the establishment of specialized roles for EIDM. Knowledge Broker roles have been used across diverse contexts and show promise in supporting organization-wide EIDM and EIP implementation (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan additionalcitationids=\"CR87 CR88 CR89\" citationid=\"CR86\" class=\"CitationRef\"\u003e86\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR90\" class=\"CitationRef\"\u003e90\u003c/span\u003e). Factors that influence the success of staff in Knowledge Broker roles align with those mapped to opportunity and motivation in the COM-B model, including the integration of EIDM into processes, knowledge sharing, and supportive organizational culture (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e, \u003cspan citationid=\"CR91\" class=\"CitationRef\"\u003e91\u003c/span\u003e). Knowledge Brokers can also help facilitate knowledge sharing across the organization, which was another facilitator mapped to the capability level of the model (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan citationid=\"CR91\" class=\"CitationRef\"\u003e91\u003c/span\u003e). Knowledge sharing refers to the shared learning, knowledge products and resources for EIDM. At large public health organizations, it can be challenging to facilitate knowledge sharing between teams and departments (\u003cspan citationid=\"CR92\" class=\"CitationRef\"\u003e92\u003c/span\u003e, \u003cspan citationid=\"CR93\" class=\"CitationRef\"\u003e93\u003c/span\u003e). Integrating technology can help; there have been some advances driven by the COVID-19 pandemic, such as the development of knowledge sharing platforms (\u003cspan additionalcitationids=\"CR95 CR96\" citationid=\"CR94\" class=\"CitationRef\"\u003e94\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR97\" class=\"CitationRef\"\u003e97\u003c/span\u003e). Public health organizations seeking to implement EIDM or EIPs should invest in their knowledge sharing infrastructure.\u003c/p\u003e \u003cp\u003eBarriers to the capability for EIDM and EIP behaviours include staff turnover and subsequent knowledge loss. Staff turnover is especially challenging for interventions that involve staff in dedicated Knowledge Broker roles and interventions that build the knowledge and skill for staff to engage in evidence use (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan citationid=\"CR91\" class=\"CitationRef\"\u003e91\u003c/span\u003e). In some cases, individuals who are trained in the Knowledge Broker role are then promoted to new roles or management and have fewer opportunities to apply their Knowledge Broker skills (\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e). Organizations that implement these strategies should be cognizant of the potential for knowledge loss due to staff turnover when selecting staff for Knowledge Broker roles or capacity building opportunities.\u003c/p\u003e \u003cp\u003eThe opportunity portion of the COM-B model reflects whether there is opportunity for new behaviour to occur. Facilitators for organizational EIDM and EIP include the development of processes or mechanisms to support new practices, forums for learning and skill development, and protected time. The development of processes and mechanisms that support new practices can act as a reminder for staff, and may include re-design of planning or decision-making templates to capture supporting evidence, or adding EIPs to agendas for regular meetings (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e, \u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e79\u003c/span\u003e). The use of reminders for organizational behaviour change and implementation of clinical practice guidelines has been shown to be an effective strategy across many contexts (\u003cspan additionalcitationids=\"CR99 CR100\" citationid=\"CR98\" class=\"CitationRef\"\u003e98\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR101\" class=\"CitationRef\"\u003e101\u003c/span\u003e). Organizations seeking to implement EIDM or EIPs should consider revising current templates and processes to support their initiatives. Forums for learning and skill development provide staff with opportunities to gain knowledge and practice newly acquired skills in supportive settings, such as communities of practice or journal clubs. Other literature shows that these forums can be effective in developing knowledge and skill and should foster an environment of learning without fear of reprisal for making mistakes (\u003cspan citationid=\"CR102\" class=\"CitationRef\"\u003e102\u003c/span\u003e, \u003cspan citationid=\"CR103\" class=\"CitationRef\"\u003e103\u003c/span\u003e). Finally, protected time to apply EIDM and EIPs was found to be a facilitator for opportunity in the COM-B model, while competing priorities were found to be a barrier. In public health practice, staff are often challenged with high workloads, so that EIDM may be viewed as an additional burden rather than a means to improve practice (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR104\" class=\"CitationRef\"\u003e104\u003c/span\u003e). For an EIDM approach to be practiced, staff must be provided with sufficient time to apply and practice skills. Organizations should consider involving middle management who oversee staff time allocations, rather than only senior leadership, to help ensure that staff are provided with the time they need and that expectations are adjusted accordingly (\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan citationid=\"CR89\" class=\"CitationRef\"\u003e89\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe final influencer in the COM-B model, motivation, reflects whether there is sufficient motivation for a new behaviour to occur. Facilitators include supportive organizational culture, expectations for new practices to occur, recognition and positive reinforcement, and strong leadership support. The influence of organizational culture on evidence-informed practice at health organizations has been explored in a previous systematic review by Li \u003cem\u003eet al\u003c/em\u003e (\u003cspan citationid=\"CR105\" class=\"CitationRef\"\u003e105\u003c/span\u003e). This systematic review of organizational contextual factors that influence evidence-based practice included 36 studies conducted in healthcare settings. Findings align with facilitators identified above, especially leadership support, which was found to impact evidence-based practice as well as all other factors that influence evidence-based practice (\u003cspan citationid=\"CR105\" class=\"CitationRef\"\u003e105\u003c/span\u003e). The review also found that monitoring and feedback contributed to implementation of evidence-based practice, which aligns with recognition and positive reinforcement in the COM-B model above (\u003cspan citationid=\"CR105\" class=\"CitationRef\"\u003e105\u003c/span\u003e). Notably, another factor that was mapped to the COM-B model was the expectation for new practices to occur, which was not explicitly identified as an influence on practice (\u003cspan citationid=\"CR105\" class=\"CitationRef\"\u003e105\u003c/span\u003e). While Li et al acknowledge that leadership that neglects to hold staff accountable are detrimental to implementation of EIDM, this accountability and clear expectations for change practice were a stronger finding in this current rapid systematic review.\u003c/p\u003e \u003cp\u003eBarriers to motivation included a lack of understanding or support from management. This aligns with the need for leadership support and ties in with opportunity, since it is often management that determine the allocation of staff time for EIDM and EIP work (\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan citationid=\"CR89\" class=\"CitationRef\"\u003e89\u003c/span\u003e). Another barrier was negative attitudes toward new practices. Attitudes and the belief that EIDM is associated with positive outcomes is a key factor in overall competence for EIDM (\u003cspan citationid=\"CR106\" class=\"CitationRef\"\u003e106\u003c/span\u003e). Efforts to address negative attitudes within staff, especially at the leadership level, may improve implementation of EIDM and EIP.\u003c/p\u003e \u003cp\u003eWhile this review provides a comprehensive overview of interventions to support EIDM and EIP in public health and related organizations, it does have some limitations. Given the heterogeneity of included studies, it was not possible to discern which implementation strategies for EIDM or EIP are more effective compared to others. Knowledge Broker roles, building capacity for EIDM, and research-academic partnerships were all shown to contribute to EIDM and EIP, but study findings do not support that one strategy is superior to others. Given the highly contextual nature of these interventions, it is likely that the relative effectiveness of different interventions depends on the organization\u0026rsquo;s unique set of characteristics. Evaluation of efforts is also critical to determine if change efforts are successful or need to be adjusted. It is possible that a combination of strategies would maximize the likelihood that diverse needs of staff are met, though rigorous studies to evaluate this hypothesis are needed.\u003c/p\u003e \u003cp\u003eMost studies included in this review are non-randomized studies of interventions. Given the importance of context in organizational change, randomized controlled trial designs may not be well-suited to evaluate studies of EIDM and EIP implementation (\u003cspan citationid=\"CR107\" class=\"CitationRef\"\u003e107\u003c/span\u003e). High-quality single-group studies, such as prospective cohort analytic studies evaluated with validated measures or qualitative descriptive analyses of case studies with thorough descriptions of interventions and context, may be more appropriate designs for designing future initiatives in this field. However, arguments have been made for the use of randomized trial designs in implementation research (\u003cspan citationid=\"CR108\" class=\"CitationRef\"\u003e108\u003c/span\u003e). Foy \u003cem\u003eet al\u003c/em\u003e advocate for overcoming contextual barriers by using innovative trial designs, such as the multiphase optimization strategy approach, where a series of trials identify the most promising single or combined intervention components, or the sequential multiple assignment randomized trial approach, where early results inform tailoring of adaptive interventions (\u003cspan citationid=\"CR108\" class=\"CitationRef\"\u003e108\u003c/span\u003e). These designs may be a promising approach to conducting trials within highly contextual settings.\u003c/p\u003e \u003cp\u003eThis review provides a comprehensive, in-depth analysis of facilitators and barriers for the implementation of EIDM and EIP in public health and related organizations. Mapping facilitators and barriers to the COM-B model for behaviour change provides a helpful framework for implementation considerations. This work will support the implementation of future EIDM and EIP initiatives.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis review explored the implementation of EIDM at the organizational level, as well as the implementation of selected EIPs across organizations. Despite the similarity of these implementation challenges, studies used distinct strategies for implementation. The facilitators and barriers are consistent across included studies and provide insight for planning and achieving successful implementation.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eEIDM: Evidence-informed Decision Making\u003cbr\u003e\u0026nbsp;EBP: Evidence-based Practice\u003c/p\u003e\n\u003cp\u003eEIP: Evidence-informed Practice\u003c/p\u003e\n\u003cp\u003eGRADE: Grading of Recommendations, Assessment, Development and Evaluations\u003c/p\u003e\n\u003cp\u003eJBI: Joanna Briggs Institute\u003c/p\u003e\n\u003cp\u003eKT: Knowledge Translation\u003c/p\u003e\n\u003cp\u003eRCT: Randomized Controlled Trial\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthics approval and consent to participate\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eConsent for publication\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eAvailability of data and materials\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analysed during this study are included in this published article [and its supplementary information files.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eCompeting interests\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone declared.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eFunding\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe National Collaborating Centre for Methods and Tools is hosted by McMaster University and funded by the Public Health Agency of Canada. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada. The funder had no role in the design of the study, collection, analysis, or interpretation of data or in writing the manuscript.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003e\u003cem\u003eAuthors\u0026apos; contributions\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eE.C.C. and M.D. designed the study. E.C.C., L.H., R.B., R.T., and T.B. completed screening, quality assessment and data extraction. E.C. and M.D. analyzed study results. E.C.C. and T.B. wrote the manuscript in consultation with M.D.\u0026nbsp;All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003e\u003cem\u003eAcknowledgements\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to acknowledge the NCCMT\u0026rsquo;s Rapid Evidence Service, particularly Alyssa Kostopoulos, Sophie Neumann and Selin Akaraci, for their contributions to this review.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003ePublic Health Agency of Canada. Core Competencies for Public Health in Canada. 1 ed2008.\u003c/li\u003e\n\u003cli\u003eNational Collaborating Centre for Methods and Tools. Evidence-Informed Decision Making in Public Health 2022 [Available from: https://www.nccmt.ca/tools/eiph.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. WHO guide for evidence-informed decision-making. Evidence, policy, impact [Internet]. 2021.\u003c/li\u003e\n\u003cli\u003eWard M, Mowat D. Creating an organizational culture for evidence-informed decision making. Healthc Manage Forum. 2012;25(3):146-50.\u003c/li\u003e\n\u003cli\u003ePeirson L, Ciliska D, Dobbins M, Mowat D. Building capacity for evidence informed decision making in public health: a case study of organizational change. BMC Public Health. 2012;12:137.\u003c/li\u003e\n\u003cli\u003eLi S, Cao M, Zhu X. Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses-systematic review. Medicine (Baltimore). 2019;98(39):e17209.\u003c/li\u003e\n\u003cli\u003eMathieson A, Grande G, Luker K. Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis. Prim Health Care Res Dev. 2019;20:e6.\u003c/li\u003e\n\u003cli\u003eBrownson RC, Gurney JG, Land GH. Evidence-based decision making in public health. J Public Health Manag Pract. 1999;5(5):86-97.\u003c/li\u003e\n\u003cli\u003eKohatsu ND, Robinson JG, Torner JC. Evidence-based public health: an evolving concept. Am J Prev Med. 2004;27(5):417-21.\u003c/li\u003e\n\u003cli\u003eCummings GG, Estabrooks CA, Midodzi WK, Wallin L, Hayduk L. Influence of organizational characteristics and context on research utilization. Nurs Res. 2007;56(4 Suppl):S24-39.\u003c/li\u003e\n\u003cli\u003eBrownson RC, Fielding JE, Green LW. Building Capacity for Evidence-Based Public Health: Reconciling the Pulls of Practice and the Push of Research. Annu Rev Public Health. 2018;39:27-53.\u003c/li\u003e\n\u003cli\u003eTitler MG. The Evidence for Evidence-Based Practice Implementation. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Advances in Patient Safety. Rockville (MD)2008.\u003c/li\u003e\n\u003cli\u003ePan American Health Organization. A Guide for Evidence-Informed Decision-Making, Including in Health Emergencies.2022.\u003c/li\u003e\n\u003cli\u003eSaunders H, Gallagher-Ford L, Kvist T, Vehvilainen-Julkunen K. Practicing Healthcare Professionals\u0026apos; Evidence-Based Practice Competencies: An Overview of Systematic Reviews. Worldviews Evid Based Nurs. 2019;16(3):176-85.\u003c/li\u003e\n\u003cli\u003ePaci M, Faedda G, Ugolini A, Pellicciari L. Barriers to evidence-based practice implementation in physiotherapy: a systematic review and meta-analysis. Int J Qual Health Care. 2021;33(2).\u003c/li\u003e\n\u003cli\u003eAllen P, Parks RG, Kang SJ, Dekker D, Jacob RR, Mazzucca-Ragan S, et al. Practices Among Local Public Health Agencies to Support Evidence-Based Decision Making: A Qualitative Study. J Public Health Manag Pract. 2023;29(2):213-25.\u003c/li\u003e\n\u003cli\u003eEllen ME, Leon G, Bouchard G, Ouimet M, Grimshaw JM, Lavis JN. Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study. Implement Sci. 2014;9:179.\u003c/li\u003e\n\u003cli\u003eSadeghi-Bazargani H, Tabrizi JS, Azami-Aghdash S. Barriers to evidence-based medicine: a systematic review. J Eval Clin Pract. 2014;20(6):793-802.\u003c/li\u003e\n\u003cli\u003eBarzkar F, Baradaran HR, Koohpayehzadeh J. Knowledge, attitudes and practice of physicians toward evidence-based medicine: A systematic review. J Evid Based Med. 2018;11(4):246-51.\u003c/li\u003e\n\u003cli\u003eMoraes FDS, Marengo LL, Moura MDG, Bergamaschi CC, de Sa Del Fiol F, Lopes LC, et al. ABCDE and ABCDEF care bundles: A systematic review of the implementation process in intensive care units. Medicine (Baltimore). 2022;101(25):e29499.\u003c/li\u003e\n\u003cli\u003ede Wit K, Curran J, Thoma B, Dowling S, Lang E, Kuljic N, et al. Review of implementation strategies to change healthcare provider behaviour in the emergency department. CJEM. 2018;20(3):453-60.\u003c/li\u003e\n\u003cli\u003eBrownson RC, Fielding JE, Maylahn CM. Evidence-based public health: a fundamental concept for public health practice. Annu Rev Public Health. 2009;30:175-201.\u003c/li\u003e\n\u003cli\u003eSarkies MN, Robins LM, Jepson M, Williams CM, Taylor NF, O\u0026apos;Brien L, et al. Effectiveness of knowledge brokering and recommendation dissemination for influencing healthcare resource allocation decisions: A cluster randomised controlled implementation trial. PLoS Med. 2021;18(10):e1003833.\u003c/li\u003e\n\u003cli\u003eWhite J, Grant K, Sarkies M, Haines T, Evidence Translation in Allied Health G. Translating evidence into practice: a longitudinal qualitative exploration of allied health decision-making. Health Res Policy Syst. 2021;19(1):38.\u003c/li\u003e\n\u003cli\u003eLiang L, Bernhardsson S, Vernooij RW, Armstrong MJ, Bussieres A, Brouwers MC, et al. Use of theory to plan or evaluate guideline implementation among physicians: a scoping review. Implement Sci. 2017;12(1):26.\u003c/li\u003e\n\u003cli\u003eMichie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6:42.\u003c/li\u003e\n\u003cli\u003eFlannery C, McHugh S, Anaba AE, Clifford E, O\u0026apos;Riordan M, Kenny LC, et al. Enablers and barriers to physical activity in overweight and obese pregnant women: an analysis informed by the theoretical domains framework and COM-B model. BMC Pregnancy Childbirth. 2018;18(1):178.\u003c/li\u003e\n\u003cli\u003eDe Leo A, Bayes S, Bloxsome D, Butt J. Exploring the usability of the COM-B model and Theoretical Domains Framework (TDF) to define the helpers of and hindrances to evidence-based practice in midwifery. Implement Sci Commun. 2021;2(1):7.\u003c/li\u003e\n\u003cli\u003ePearse BL, Keogh S, Rickard CM, Fung YL. Barriers and facilitators to implementing evidence based bleeding management in Australian Cardiac Surgery Units: a qualitative interview study analysed with the theoretical domains framework and COM-B model. BMC Health Serv Res. 2021;21(1):550.\u003c/li\u003e\n\u003cli\u003eAdvani SD, Winters A, Turner NA, Smith BA, Seidelman J, Schmader K, et al. Using the COM-B model to identify barriers to and facilitators of evidence-based nurse urine-culture practices. Antimicrob Steward Healthc Epidemiol. 2023;3(1):e62.\u003c/li\u003e\n\u003cli\u003eMcDonagh LK, Saunders JM, Cassell J, Curtis T, Bastaki H, Hartney T, et al. Application of the COM-B model to barriers and facilitators to chlamydia testing in general practice for young people and primary care practitioners: a systematic review. Implement Sci. 2018;13(1):130.\u003c/li\u003e\n\u003cli\u003eMersha AG, Gould GS, Bovill M, Eftekhari P. Barriers and Facilitators of Adherence to Nicotine Replacement Therapy: A Systematic Review and Analysis Using the Capability, Opportunity, Motivation, and Behaviour (COM-B) Model. Int J Environ Res Public Health. 2020;17(23).\u003c/li\u003e\n\u003cli\u003ePirotta S, Joham AJ, Moran LJ, Skouteris H, Lim SS. Implementation of evidence-based PCOS lifestyle management guidelines: Perceived barriers and facilitators by consumers using the Theoretical Domains Framework and COM-B Model. Patient Educ Couns. 2021;104(8):2080-8.\u003c/li\u003e\n\u003cli\u003eDubois A, L\u0026eacute;vesque, M. Canada\u0026apos;s National Collaborating Centres: Facilitating evidence-informed decision-making in public health. Canada communicable disease report. 2020;46(2-3):31-5.\u003c/li\u003e\n\u003cli\u003eDobbins M, Hanna SE, Ciliska D, Manske S, Cameron R, Mercer SL, et al. A randomized controlled trial evaluating the impact of knowledge translation and exchange strategies. Implement Sci. 2009;4:61.\u003c/li\u003e\n\u003cli\u003eMartin W, Wharf Higgins J, Pauly BB, MacDonald M. \u0026quot;Layers of translation\u0026quot; - evidence literacy in public health practice: a qualitative secondary analysis. BMC Public Health. 2017;17(1):803.\u003c/li\u003e\n\u003cli\u003evan der Graaf P, Forrest LF, Adams J, Shucksmith J, White M. How do public health professionals view and engage with research? A qualitative interview study and stakeholder workshop engaging public health professionals and researchers. BMC Public Health. 2017;17(1):892.\u003c/li\u003e\n\u003cli\u003ePage MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.\u003c/li\u003e\n\u003cli\u003eLizarondo L, Stern, C., Carrier, J., Godfrey, C., Rieger, K., Salmond, S., Apostolo, J., Kirkpatrick, P., Loveday, H. Chapter 8: Mixed methods systematic reviews. Aromataris E MZ, editor2020.\u003c/li\u003e\n\u003cli\u003eNeil-Sztramko SE, Belita E, Traynor RL, Clark E, Hagerman L, Dobbins M. Methods to support evidence-informed decision-making in the midst of COVID-19: creation and evolution of a rapid review service from the National Collaborating Centre for Methods and Tools. BMC Med Res Methodol. 2021;21(1):231.\u003c/li\u003e\n\u003cli\u003eOrganisation for Economic Co-operation and Development. List of OECD Member countries - Ratification of the Convention on the OECD 2021 [Available from: https://www.oecd.org/about/document/ratification-oecd-convention.htm.\u003c/li\u003e\n\u003cli\u003eJoanna Briggs Institute. [Available from: https://jbi.global/critical-appraisal-tools.\u003c/li\u003e\n\u003cli\u003eMcKenzie JE, Brennan S.E. Chapter 12. Synthesizing and presenting findings using other methods. 2021.\u003c/li\u003e\n\u003cli\u003eBrogly C, Bauer MA, Lizotte DJ, Press ML, MacDougall A, Speechley M, et al. An App-Based Surveillance System for Undergraduate Students\u0026apos; Mental Health During the COVID-19 Pandemic: Protocol for a Prospective Cohort Study. JMIR Res Protoc. 2021;10(9):e30504.\u003c/li\u003e\n\u003cli\u003eGuyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383-94.\u003c/li\u003e\n\u003cli\u003eAugustino LR, Braun L, Heyne RE, Shinn A, Lovett-Floom L, King H, et al. Implementing Evidence-Based Practice Facilitators: A Case Series. Mil Med. 2020;185(Suppl 2):7-14.\u003c/li\u003e\n\u003cli\u003eHumphries S, Hampe T, Larsen D, Bowen S. Building organizational capacity for evidence use: the experience of two Canadian healthcare organizations. Healthc Manage Forum. 2013;26(1):26-32.\u003c/li\u003e\n\u003cli\u003eGallagher-Ford L. Implementing and sustaining EBP in real world healthcare settings: transformational evidence-based leadership: redesigning traditional roles to promote and sustain a culture of EBP. Worldviews Evid Based Nurs. 2014;11(2):140-2.\u003c/li\u003e\n\u003cli\u003eIrwin MM, Bergman RM, Richards R. The experience of implementing evidence-based practice change: a qualitative analysis. Clin J Oncol Nurs. 2013;17(5):544-9.\u003c/li\u003e\n\u003cli\u003eElliott MJ, Allu S, Beaucage M, McKenzie S, Kappel J, Harvey R, et al. Defining the Scope of Knowledge Translation Within a National, Patient-Oriented Kidney Research Network. Can J Kidney Health Dis. 2021;8:20543581211004803.\u003c/li\u003e\n\u003cli\u003eHitch D, Lhuede K, Vernon L, Pepin G, Stagnitti K. Longitudinal evaluation of a knowledge translation role in occupational therapy. BMC Health Serv Res. 2019;19(1):154.\u003c/li\u003e\n\u003cli\u003eParke B, Stevenson L, Rowe M. Scholar-in-Residence: An Organizational Capacity-Building Model to Move Evidence to Action. Nurs Leadersh (Tor Ont). 2015;28(2):10-22.\u003c/li\u003e\n\u003cli\u003eHooge N, Allen DH, McKenzie R, Pandian V. Engaging advanced practice nurses in evidence-based practice: An e-mentoring program. Worldviews Evid Based Nurs. 2022;19(3):235-44.\u003c/li\u003e\n\u003cli\u003eWilliams NJ, Glisson C, Hemmelgarn A, Green P. Mechanisms of Change in the ARC Organizational Strategy: Increasing Mental Health Clinicians\u0026apos; EBP Adoption Through Improved Organizational Culture and Capacity. Adm Policy Ment Health. 2017;44(2):269-83.\u003c/li\u003e\n\u003cli\u003eMiro A, Perrotta K, Evans H, Kishchuk NA, Gram C, Stanwick RS, et al. Building the capacity of health authorities to influence land use and transportation planning: Lessons learned from the Healthy Canada by Design CLASP Project in British Columbia. Can J Public Health. 2014;106(1 Suppl 1):eS40-52.\u003c/li\u003e\n\u003cli\u003eRoberts M, Reagan DR, Behringer B. A Public Health Performance Excellence Improvement Strategy: Diffusion and Adoption of the Baldrige Framework Within Tennessee Department of Health. J Public Health Manag Pract. 2020;26(1):39-45.\u003c/li\u003e\n\u003cli\u003eDobbins M, Greco L, Yost J, Traynor R, Decorby-Watson K, Yousefi-Nooraie R. A description of a tailored knowledge translation intervention delivered by knowledge brokers within public health departments in Canada. Health Res Policy Syst. 2019;17(1):63.\u003c/li\u003e\n\u003cli\u003eMackay HJ, Campbell KL, van der Meij BS, Wilkinson SA. Establishing an evidenced-based dietetic model of care in haemodialysis using implementation science. Nutr Diet. 2019;76(2):150-7.\u003c/li\u003e\n\u003cli\u003eWilliams C, van der Meij BS, Nisbet J, McGill J, Wilkinson SA. Nutrition process improvements for adult inpatients with inborn errors of metabolism using the i-PARIHS framework. Nutr Diet. 2019;76(2):141-9.\u003c/li\u003e\n\u003cli\u003eMelnyk BM, Fineout-Overholt E, Giggleman M, Choy K. A Test of the ARCC(c) Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes. Worldviews Evid Based Nurs. 2017;14(1):5-9.\u003c/li\u003e\n\u003cli\u003eBreckenridge-Sproat ST, Throop MD, Raju D, Murphy DA, Loan LA, Patrician PA. Building a Unit-Level Mentored Program to Sustain a Culture of Inquiry for Evidence-Based Practice. Clin Nurse Spec. 2015;29(6):329-37.\u003c/li\u003e\n\u003cli\u003eClark EC, Dhaliwal B, Ciliska D, Neil-Sztramko SE, Steinberg M, Dobbins M. A pragmatic evaluation of a public health knowledge broker mentoring education program: a convergent mixed methods study. Implement Sci Commun. 2022;3(1):18.\u003c/li\u003e\n\u003cli\u003eWaterman H, Boaden R, Burey L, Howells B, Harvey G, Humphreys J, et al. Facilitating large-scale implementation of evidence based health care: insider accounts from a co-operative inquiry. BMC Health Serv Res. 2015;15:60.\u003c/li\u003e\n\u003cli\u003eGifford W, Lefebre N, Davies B. An organizational intervention to influence evidence-informed decision making in home health nursing. J Nurs Adm. 2014;44(7/8):395-402.\u003c/li\u003e\n\u003cli\u003eTraynor R, DeCorby K, Dobbins M. Knowledge brokering in public health: a tale of two studies. Public Health. 2014;128(6):533-44.\u003c/li\u003e\n\u003cli\u003ePlath D. Organizational processes supporting evidence-based practice. . Administration in social work. 2013;37(2):171-88.\u003c/li\u003e\n\u003cli\u003eKimber M, Barwick M, Fearing G. Becoming an evidence-based service provider: staff perceptions and experiences of organizational change. J Behav Health Serv Res. 2012;39(3):314-32.\u003c/li\u003e\n\u003cli\u003eMartin-Fernandez J, Aromatario O, Prigent O, Porcherie M, Ridde V, Cambon L. Evaluation of a knowledge translation strategy to improve policymaking and practices in health promotion and disease prevention setting in French regions: TC-REG, a realist study. BMJ Open. 2021;11(9):e045936.\u003c/li\u003e\n\u003cli\u003evan der Zwet RJM, Beneken genaamd Kolmer, D.M., Schalk, R., Van Regenmortel, T. . Implementing Evidence-Based Practice in a Dutch Social Work Organisation: A Shared Responsibility. The British Journal of Social Work. 2020;50(7):2212-32.\u003c/li\u003e\n\u003cli\u003eAllen P, Jacob RR, Lakshman M, Best LA, Bass K, Brownson RC. Lessons Learned in Promoting Evidence-Based Public Health: Perspectives from Managers in State Public Health Departments. J Community Health. 2018;43(5):856-63.\u003c/li\u003e\n\u003cli\u003eAllen P, O\u0026apos;Connor JC, Best LA, Lakshman M, Jacob RR, Brownson RC. Management Practices to Build Evidence-Based Decision-Making Capacity for Chronic Disease Prevention in Georgia: A Case Study. Prev Chronic Dis. 2018;15:E92.\u003c/li\u003e\n\u003cli\u003eBrodowski ML, Counts, J.M., Gillam, R.J., Baker, L., Collins, V.S., Winkle, E., Skala, J., Stokes, K., Gomez, R., Redmon, J. Translating Evidence-Based Policy to Practice: A Multilevel Partnership Using the Interactive Systems Framework. The Journal of Contemporary Social Services. 2018;94(3):141-9.\u003c/li\u003e\n\u003cli\u003eBennett S, Whitehead M, Eames S, Fleming J, Low S, Caldwell E. Building capacity for knowledge translation in occupational therapy: learning through participatory action research. BMC Med Educ. 2016;16(1):257.\u003c/li\u003e\n\u003cli\u003eAwan S, Samokhvalov AV, Aleem N, Hendershot CS, Irving JA, Kalvik A, et al. Development and Implementation of an Ambulatory Integrated Care Pathway for Major Depressive Disorder and Alcohol Dependence. Psychiatr Serv. 2015;66(12):1265-7.\u003c/li\u003e\n\u003cli\u003eFernandez ME, Melvin CL, Leeman J, Ribisl KM, Allen JD, Kegler MC, et al. The cancer prevention and control research network: An interactive systems approach to advancing cancer control implementation research and practice. Cancer Epidemiol Biomarkers Prev. 2014;23(11):2512-21.\u003c/li\u003e\n\u003cli\u003eKaplan L, Zeller E, Damitio D, Culbert S, Bayley KB. Improving the culture of evidence-based practice at a Magnet(R) hospital. J Nurses Prof Dev. 2014;30(6):274-80; quiz E1-2.\u003c/li\u003e\n\u003cli\u003eFlaherty HB, Bornheimer LA, Hamovitch E, Garay E, Mini de Zitella ML, Acri MC, et al. Examining Organizational Factors Supporting the Adoption and Use of Evidence-Based Interventions. Community Ment Health J. 2021;57(6):1187-94.\u003c/li\u003e\n\u003cli\u003eBrownson RC, Allen P, Jacob RR, deRuyter A, Lakshman M, Reis RS, et al. Controlling Chronic Diseases Through Evidence-Based Decision Making: A Group-Randomized Trial. Prev Chronic Dis. 2017;14:E121.\u003c/li\u003e\n\u003cli\u003eHaynes A, Rowbotham S, Grunseit A, Bohn-Goldbaum E, Slaytor E, Wilson A, et al. Knowledge mobilisation in practice: an evaluation of the Australian Prevention Partnership Centre. Health Res Policy Syst. 2020;18(1):13.\u003c/li\u003e\n\u003cli\u003eAlexander KE, Brijnath B, Mazza D. Barriers and enablers to delivery of the Healthy Kids Check: an analysis informed by the Theoretical Domains Framework and COM-B model. Implement Sci. 2014;9:60.\u003c/li\u003e\n\u003cli\u003eMcArthur C, Bai Y, Hewston P, Giangregorio L, Straus S, Papaioannou A. Barriers and facilitators to implementing evidence-based guidelines in long-term care: a qualitative evidence synthesis. Implement Sci. 2021;16(1):70.\u003c/li\u003e\n\u003cli\u003eMoffat A, Cook EJ, Chater AM. Examining the influences on the use of behavioural science within UK local authority public health: Qualitative thematic analysis and deductive mapping to the COM-B model and Theoretical Domains Framework. Front Public Health. 2022;10:1016076.\u003c/li\u003e\n\u003cli\u003eMorshed AB, Ballew P, Elliott MB, Haire-Joshu D, Kreuter MW, Brownson RC. Evaluation of an online training for improving self-reported evidence-based decision-making skills in cancer control among public health professionals. Public Health. 2017;152:28-35.\u003c/li\u003e\n\u003cli\u003eJones K, Armstrong R, Pettman T, Waters E. Knowledge Translation for researchers: developing training to support public health researchers KTE efforts. J Public Health (Oxf). 2015;37(2):364-6.\u003c/li\u003e\n\u003cli\u003eDreisinger M, Leet TL, Baker EA, Gillespie KN, Haas B, Brownson RC. Improving the public health workforce: evaluation of a training course to enhance evidence-based decision making. J Public Health Manag Pract. 2008;14(2):138-43.\u003c/li\u003e\n\u003cli\u003eMendell J, Richardson L. Integrated knowledge translation to strengthen public policy research: a case study from experimental research on income assistance receipt among people who use drugs. BMC Public Health. 2021;21(1):153.\u003c/li\u003e\n\u003cli\u003eRussell DJ, Rivard LM, Walter SD, Rosenbaum PL, Roxborough L, Cameron D, et al. Using knowledge brokers to facilitate the uptake of pediatric measurement tools into clinical practice: a before-after intervention study. Implement Sci. 2010;5:92.\u003c/li\u003e\n\u003cli\u003eBrown KM, Elliott SJ, Robertson-Wilson J, Vine MM, Leatherdale ST. Can knowledge exchange support the implementation of a health-promoting schools approach? Perceived outcomes of knowledge exchange in the COMPASS study. BMC Public Health. 2018;18(1):351.\u003c/li\u003e\n\u003cli\u003eDobbins M, Traynor RL, Workentine S, Yousefi-Nooraie R, Yost J. Impact of an organization-wide knowledge translation strategy to support evidence-informed public health decision making. BMC Public Health. 2018;18(1):1412.\u003c/li\u003e\n\u003cli\u003eLangeveld K, Stronks K, Harting J. Use of a knowledge broker to establish healthy public policies in a city district: a developmental evaluation. BMC Public Health. 2016;16:271.\u003c/li\u003e\n\u003cli\u003eBornbaum CC, Kornas K, Peirson L, Rosella LC. Exploring the function and effectiveness of knowledge brokers as facilitators of knowledge translation in health-related settings: a systematic review and thematic analysis. Implement Sci. 2015;10:162.\u003c/li\u003e\n\u003cli\u003eJansen MW, De Leeuw E, Hoeijmakers M, De Vries NK. Working at the nexus between public health policy, practice and research. Dynamics of knowledge sharing in The Netherlands. Health Res Policy Syst. 2012;10:33.\u003c/li\u003e\n\u003cli\u003eSibbald SL, Kothari A. Creating, Synthesizing, and Sharing: The Management of Knowledge in Public Health. Public Health Nurs. 2015;32(4):339-48.\u003c/li\u003e\n\u003cli\u003eBarnes SJ. Information management research and practice in the post-COVID-19 world. Int J Inf Manage. 2020;55:102175.\u003c/li\u003e\n\u003cli\u003eDwivedi YH, DL; Coombs, C; Constantiniou, I; Duan, Y; Edwards, JS; Gupta, B; Lal, B; Misra, S; Prashant, P; Raman, R; Rana, NP; Sharma, SK; Upadhyay, N. Impact of COVID-19 pandemic on information management research and practice: Transforming education, work and life. International Journal of Information Management. 2020;55(102211).\u003c/li\u003e\n\u003cli\u003eKrausz M, Westenberg JN, Vigo D, Spence RT, Ramsey D. Emergency Response to COVID-19 in Canada: Platform Development and Implementation for eHealth in Crisis Management. JMIR Public Health Surveill. 2020;6(2):e18995.\u003c/li\u003e\n\u003cli\u003eSmith RW, Jarvis T, Sandhu HS, Pinto AD, O\u0026apos;Neill M, Di Ruggiero E, et al. Centralization and integration of public health systems: Perspectives of public health leaders on factors facilitating and impeding COVID-19 responses in three Canadian provinces. Health Policy. 2023;127:19-28.\u003c/li\u003e\n\u003cli\u003ePereira VC, Silva SN, Carvalho VKS, Zanghelini F, Barreto JOM. Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews. Health Res Policy Syst. 2022;20(1):13.\u003c/li\u003e\n\u003cli\u003eTomsic I, Heinze NR, Chaberny IF, Krauth C, Schock B, von Lengerke T. Implementation interventions in preventing surgical site infections in abdominal surgery: a systematic review. BMC Health Serv Res. 2020;20(1):236.\u003c/li\u003e\n\u003cli\u003eHarrison R, Fischer S, Walpola RL, Chauhan A, Babalola T, Mears S, et al. Where Do Models for Change Management, Improvement and Implementation Meet? A Systematic Review of the Applications of Change Management Models in Healthcare. J Healthc Leadersh. 2021;13:85-108.\u003c/li\u003e\n\u003cli\u003eCorrea VC, Lugo-Agudelo LH, Aguirre-Acevedo DC, Contreras JAP, Borrero AMP, Patino-Lugo DF, et al. Individual, health system, and contextual barriers and facilitators for the implementation of clinical practice guidelines: a systematic metareview. Health Res Policy Syst. 2020;18(1):74.\u003c/li\u003e\n\u003cli\u003eValizadeh L, Zamanzadeh V, Alizadeh S, Namadi Vosoughi M. Promoting evidence-based nursing through journal clubs: an integrative review. J Res Nurs. 2022;27(7):606-20.\u003c/li\u003e\n\u003cli\u003ePortela Dos Santos O, Melly P, Hilfiker R, Giacomino K, Perruchoud E, Verloo H, et al. Effectiveness of Educational Interventions to Increase Skills in Evidence-Based Practice among Nurses: The EDITcare Systematic Review. Healthcare (Basel). 2022;10(11).\u003c/li\u003e\n\u003cli\u003eShelton RC, Lee M. Sustaining Evidence-Based Interventions and Policies: Recent Innovations and Future Directions in Implementation Science. Am J Public Health. 2019;109(S2):S132-S4.\u003c/li\u003e\n\u003cli\u003eLi SA, Jeffs L, Barwick M, Stevens B. Organizational contextual features that influence the implementation of evidence-based practices across healthcare settings: a systematic integrative review. Syst Rev. 2018;7(1):72.\u003c/li\u003e\n\u003cli\u003eBelita E, Yost J, Squires JE, Ganann R, Dobbins M. Development and content validation of a measure to assess evidence-informed decision-making competence in public health nursing. PLoS One. 2021;16(3):e0248330.\u003c/li\u003e\n\u003cli\u003eDobbins M, Robeson P, Ciliska D, Hanna S, Cameron R, O\u0026apos;Mara L, et al. A description of a knowledge broker role implemented as part of a randomized controlled trial evaluating three knowledge translation strategies. Implement Sci. 2009;4:23.\u003c/li\u003e\n\u003cli\u003eFoy R, Ivers NM, Grimshaw JM, Wilson PM. What is the role of randomised trials in implementation science? Trials. 2023;24(1):537.\u003c/li\u003e\n\u003cli\u003eWilliams NJ, Wolk CB, Becker-Haimes EM, Beidas RS. Testing a theory of strategic implementation leadership, implementation climate, and clinicians\u0026apos; use of evidence-based practice: a 5-year panel analysis. Implement Sci. 2020;15(1):10.\u003c/li\u003e\n\u003cli\u003eConnell CM, Lang JM, Zorba B, Stevens K. Enhancing Capacity for Trauma-informed Care in Child Welfare: Impact of a Statewide Systems Change Initiative. Am J Community Psychol. 2019;64(3-4):467-80.\u003c/li\u003e\n\u003cli\u003eDamschroder LJ, Lowery JC. Evaluation of a large-scale weight management program using the consolidated framework for implementation research (CFIR). Implement Sci. 2013;8:51.\u003c/li\u003e\n\u003cli\u003eDarling EK, Easterbrook R, Grenier LN, Malott A, Murray-Davis B, Mattison CA. Lessons learned from the implementation of Canada\u0026apos;s first alongside midwifery unit: A qualitative explanatory study. Midwifery. 2021;103:103146.\u003c/li\u003e\n\u003cli\u003eFabbruzzo-Cota C, Frecea M, Kozell K, Pere K, Thompson T, Tjan Thomas J, et al. A Clinical Nurse Specialist-Led Interprofessional Quality Improvement Project to Reduce Hospital-Acquired Pressure Ulcers. Clin Nurse Spec. 2016;30(2):110-6.\u003c/li\u003e\n\u003cli\u003eFearing G, Barwick M, Kimber M. Clinical transformation: Manager\u0026apos;s perspectives on implementation of evidence-based practice. Adm Policy Ment Health. 2014;41(4):455-68.\u003c/li\u003e\n\u003cli\u003eHurlburt M, Aarons GA, Fettes D, Willging C, Gunderson L, Chaffin MJ. Interagency Collaborative Team Model for Capacity Building to Scale-Up Evidence-Based Practice. Child Youth Serv Rev. 2014;39:160-8.\u003c/li\u003e\n\u003cli\u003eKane H, Hinnant L, Day K, Council M, Tzeng J, Soler R, et al. Pathways to Program Success: A Qualitative Comparative Analysis (QCA) of Communities Putting Prevention to Work Case Study Programs. J Public Health Manag Pract. 2017;23(2):104-11.\u003c/li\u003e\n\u003cli\u003eKegeles SM, Rebchook G, Tebbetts S, Arnold E, Team T. Facilitators and barriers to effective scale-up of an evidence-based multilevel HIV prevention intervention. Implement Sci. 2015;10:50.\u003c/li\u003e\n\u003cli\u003eMcAllen ER, Stephens, K., Swanson-Biearman, B., Kerr, K., Whiteman, K. . Moving Shift Report to the Bedside: An Evidence-Based Quality Improvement Project. The Online Journal of Issues in Nursing. 2018;23.\u003c/li\u003e\n\u003cli\u003eMcCarthy S, Griffiths, L.J. The Journey to Evidence: Adopting Evidence-Based Programs in an Australian Child Welfare Organization. . Human Service Organizations: Management, Leadership \u0026amp; Governance. 2021;45:273-80.\u003c/li\u003e\n\u003cli\u003eMcConnell T, O\u0026apos;Halloran P, Donnelly M, Porter S. Factors affecting the successful implementation and sustainability of the Liverpool Care Pathway for dying patients: a realist evaluation. BMJ Support Palliat Care. 2015;5(1):70-7.\u003c/li\u003e\n\u003cli\u003eNelson G, Kiyang LN, Crumley ET, Chuck A, Nguyen T, Faris P, et al. Implementation of Enhanced Recovery After Surgery (ERAS) Across a Provincial Healthcare System: The ERAS Alberta Colorectal Surgery Experience. World J Surg. 2016;40(5):1092-103.\u003c/li\u003e\n\u003cli\u003ePoehler AR, Parks RG, Tabak RG, Baker EA, Brownson RC. Factors Facilitating or Hindering Use of Evidence-Based Diabetes Interventions Among Local Health Departments. J Public Health Manag Pract. 2020;26(5):443-50.\u003c/li\u003e\n\u003cli\u003ePullyblank K, Brunner W, Wyckoff L, Krupa N, Scribani M, Strogatz D. Implementation of Evidence-Based Disease Self-Management Programs in a Rural Region: Leveraging and Linking Community and Health Care System Assets. Health Educ Behav. 2022:10901981221078516.\u003c/li\u003e\n\u003cli\u003eRodriguez-Quintana N, Lewis CC, Scott K, Marriot B, Wahlen S, Hindman R. Implementation of the Wolverine Mental Health Program, Part 2: Implementation Phase. Cogn Behav Pract. 2022;29(1):227-43.\u003c/li\u003e\n\u003cli\u003eSchreiber J, Marchetti GF, Racicot B, Kaminski E. The use of a knowledge translation program to increase use of standardized outcome measures in an outpatient pediatric physical therapy clinic: administrative case report. Phys Ther. 2015;95(4):613-29.\u003c/li\u003e\n\u003cli\u003eScott K, Lewis CC, Rodriguez-Quintana N, MarAriott BR, Hindman RK. Implementation of the Wolverine Mental Health Program, Part 1: Adoption Phase. Cogn Behav Pract. 2022;29(1):214-26.\u003c/li\u003e\n\u003cli\u003eStevans JM, Bise CG, McGee JC, Miller DL, Rockar P, Jr., Delitto A. Evidence-based practice implementation: case report of the evolution of a quality improvement program in a multicenter physical therapy organization. Phys Ther. 2015;95(4):588-99.\u003c/li\u003e\n\u003cli\u003eWilkinson SA, O\u0026apos;Brien M, McCray S, Harvey D. Implementing a best-practice model of gestational diabetes mellitus care in dietetics: a qualitative study. BMC Health Serv Res. 2019;19(1):122.\u003c/li\u003e\n\u003cli\u003eWilkinson SA, Hughes E, Moir J, Jobber C, Ackerie A. Process of knowledge translation within routine clinical care: Implementing best practice in weight management. Nutr Diet. 2018;75(4):363-71.\u003c/li\u003e\n\u003cli\u003eWilliams NJ, Ehrhart MG, Aarons GA, Marcus SC, Beidas RS. Linking molar organizational climate and strategic implementation climate to clinicians\u0026apos; use of evidence-based psychotherapy techniques: cross-sectional and lagged analyses from a 2-year observational study. Implement Sci. 2018;13(1):85.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Evidence-informed decision making, evidence-based practice, knowledge translation, knowledge mobilization, implementation, organizational change","lastPublishedDoi":"10.21203/rs.3.rs-3482543/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3482543/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAchievement of evidence-informed decision making (EIDM) requires the integration of evidence into all practice decisions by identifying and synthesizing evidence, then developing and executing plans to implement and evaluate changes to practice. Evidence-informed practice (EIP) involves implementing a specific practice or program with proven effectiveness. This rapid systematic review examines strategies for the implementation of EIDM and EIPs across organizations, mapping facilitators and barriers to the COM-B (capability, opportunity, motivation, behaviour) model for behaviour change.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA systematic search was conducted in multiple databases and by reviewing publications of key authors. Articles that describe interventions to shift teams, departments, or organizations to EIDM or EIP were eligible for inclusion. For each article, quality was assessed, and details of the intervention, setting, outcomes, facilitators and barriers were extracted from each included article. A convergent integrated approach was undertaken to analyze both quantitative and qualitative findings.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFifty-nine articles are included. Studies were conducted in primary care, public health, social services, occupational health, and palliative care settings. Strategies to implement EIDM and EIP included the establishment of Knowledge Broker-type roles, building the EIDM capacity of staff, and research or academic partnerships. Facilitators and barriers align with the COM-B model for behaviour change. Facilitators for capability include the development of staff knowledge and skill, establishing specialized roles, and knowledge sharing across the organization, though staff turnover and subsequent knowledge loss was a barrier to capability. For opportunity, facilitators include the development of processes or mechanisms to support new practices, forums for learning and skill development, and protected time, and barriers include competing priorities. Facilitators identified for motivation include supportive organizational culture, expectations for new practices to occur, recognition and positive reinforcement, and strong leadership support. Barriers include negative attitudes toward new practices, and lack of understanding and support from management.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis review provides a comprehensive, in-depth analysis of facilitators and barriers for the implementation of EIDM and EIP in public health and related organizations, mapped to the COM-B model for behaviour change. The facilitators and barriers described in the included studies establish key factors for realizing greater implementation success in the future.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRegistration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePROSPERO CRD42022318994\u003c/p\u003e","manuscriptTitle":"Strategies to implement evidence-informed practice at organizations: A rapid systematic review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-10-28 17:40:54","doi":"10.21203/rs.3.rs-3482543/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2023-10-25T12:03:46+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2023-10-24T20:42:16+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2023-10-24T20:42:16+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Health Services Research","date":"2023-10-23T16:36:42+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f3452de2-97e4-4715-b1de-a0533b849438","owner":[],"postedDate":"October 28th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-04-08T15:06:24+00:00","versionOfRecord":{"articleIdentity":"rs-3482543","link":"https://doi.org/10.1186/s12913-024-10841-3","journal":{"identity":"bmc-health-services-research","isVorOnly":false,"title":"BMC Health Services Research"},"publishedOn":"2024-04-01 15:01:42","publishedOnDateReadable":"April 1st, 2024"},"versionCreatedAt":"2023-10-28 17:40:54","video":"","vorDoi":"10.1186/s12913-024-10841-3","vorDoiUrl":"https://doi.org/10.1186/s12913-024-10841-3","workflowStages":[]},"version":"v1","identity":"rs-3482543","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3482543","identity":"rs-3482543","version":["v1"]},"buildId":"-HB7Z8yhvgn0wM9Nzuekk","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}