The theme of this project was synthesis and the thesis encompasses knowledge generation and knowledge translation. Systematic review methodology was employed. The initial two systematic reviews compared antidepressant medication and cognitive-behaviour therapy for the acute treatment of depression. A further comparison of a combination of the two interventions with each treatment on its own was also conducted, with the bulk of the evidence favouring the psychotherapy. Moving to the topic of knowledge translation, the main theme of the thesis, the barriers, facilitators, and interventions impacting on systematic review uptake were identified. The evidence from these three systematic reviews, using diverse methodologies, was then combined to identify the interventions that overcame specific obstacles and built on highlighted facilitators in order to improve the uptake of evidence from systematic reviews. Juxtaposing barriers and facilitators alongside effectiveness studies in this final, mixed-methods systematic review allowed a number of interventions to be recommended. The synthesis also allowed strategies to be highlighted that required further development. Interventions with a statistically significant effect such as educational visits, summaries of systematic reviews, and targeted messaging, addressed a wide range of the identified barriers and facilitators. These interventions were recommended. Promising uptake strategies requiring further development were also identified. Furthermore, large gaps in the evidence base regarding systematic review utilization were highlighted. Fewer of the facilitators identified as part of this project, such as the medico-legal protection provided by systematic reviews, appear to have been built on in order to increase review uptake. Finally, all the preceding evidence was drawn on in order to develop a proposal focused on improving the uptake of evidence from systematic reviews and meta-analyses. This doctoral project offers a menu or range of evidence-based factors that can be considered by organisations and researchers when planning strategies aimed at increasing the uptake of pre-appraised, synthesized evidence.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:647529 |
| Date | January 2013 |
| Creators | Wallace, John |
| Contributors | Clarke, Mike |
| Publisher | University of Oxford |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://ora.ox.ac.uk/objects/uuid:e2966148-851a-4f00-ab6a-2992fd21c3a3 |
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