Introduction: In a mixed-methods study I assessed the role of social networks as predictors and outcomes of the implementation of an intervention to promote evidence-informed decision-making (EIDM) in three public health departments in Ontario, Canada. The quantitative strand included the analysis of the role of staff’s position in networks on the adoption of EIDM, the longitudinal evolution of networks, and the association between the name generators’ position in surveys and respondents’ motivation to answer survey questions. The qualitative strand aimed to explain and contextualize the quantitative findings.
Methods: A tailored intervention was implemented in the public health departments, including the mentoring of staff through the EIDM process by a knowledge broker. The staff participated in three online surveys before and after the 22-month intervention, providing the names of peers to whom they turned to seek information, whom they considered as experts, and their friends. I assessed the dynamic evolution of social networks, and the role of local opinion leaders (OL) in promoting the adoption of EIDM. I interviewed key network actors about their interpretation and experience regarding the quantitative findings.
Results: Overall, there was no statistically significant impact on EIDM behavior and skill in health departments. However, the analysis of the role of OLs in behaviour change showed that non-engaged staff who were connected to highly engaged OLs, and those OLs who communicated with each other improved their EIDM behavior. Social networks became more centralized around already popular staff due to selective training of recognized experts. Highly engaged staff tended to connect to each other, and to limit their connections within organizational divisions over time. In the department where multiple activities were being implemented to support EIDM, the highly engaged staff became more popular due to department-wise presentations and informal information spread. I also found that when name generator questions are asked later in surveys then respondents are more likely to refuse, indicate they do not know anyone, or provide fewer names than when these questions are asked earlier Conclusion: Social network analysis showed the structure of information-seeking relations, the impact of opinion leaders on the EIDM behavior of their peers, and underlying social changes through implementing an EIDM intervention. These findings can inform the design and tailoring of EIDM interventions in public health organizations. / Thesis / Doctor of Philosophy (PhD) / In three public health departments in Ontario, where we offered an intervention to a group of staff on how to use more research evidence in practice, I studied how the pattern of communication among staff influenced their use of evidence, how those communications changed over time, and how the staff themselves viewed those changes. In the department that largely promoted staff engagement in the intervention, the staff who were engaged became more popular over time. In all departments, already popular staff became more popular. The staff who sought information from popular people engaged in the intervention, and those popular people who communicated with each other used more research evidence over time. Network analysis helped reveal the social structure and identify popular staff and could be used to inform similar interventions. It also showed how selecting and training a group of staff can change the way people communicate in health departments.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/18318 |
| Date | 11 1900 |
| Creators | Yousefi Nooraie, Reza |
| Contributors | Dobbins, Maureen, Clinical Epidemiology/Clinical Epidemiology & Biostatistics |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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