A blended knowledge translation initiative to improve colorectal cancer staging [ISRCTN56824239]
A blended knowledge translation initiative to improve colorectal cancer staging [ISRCTN56824239]
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DOI：
10.1186/1472-6963-6-4
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发表时间：
2006-01-16
影响因子：
2.8
通讯作者：
Smith, AJ
中科院分区：
文献类型：
--
作者：
Wright, FC;Law, CHL;Smith, AJ
背景：在最佳实践和实际手术实践之间存在着显著的差距。我们的小组确定安大略省的结直肠癌分期是次优的，随后利用社会营销原则和专家和当地结直肠癌意见领袖的影响制定了知识翻译策略。方法/设计：使用Hiss方法确定意见领袖。安大略省的医院被随机分组到两个干预组中的一个。两组都接受了由结直肠癌专家意见领袖主持的正式的继续医学教育课程。在治疗组，当地大肠癌意见领袖由大肠癌专家意见领袖详细介绍，并获得工具包。42个中心同意让结直肠癌专家意见领袖前来进行持续50分钟至4小时的正式继续医学教育。没有中心拒绝干预。每个中心的大多数外科医生、病理学家和其他保健专业人员普遍参加了这些会议。此外，除了一名直肠癌的当地意见领袖外，其他所有人都与直肠癌的专家意见领袖进行了学术详细讨论会议持续了15到30分钟。讨论：我们制定了一项独特的研究，试图通过一种适应的社会营销模式来诱导外科医生和病理学家的实践变化，该模式利用了专家和当地意见领袖在大地理区域内不同实践环境下对结直肠癌的影响。
Background: A significant gap has been documented between best practice and the actual practice of surgery. Our group identified that colorectal cancer staging in Ontario was suboptimal and subsequently developed a knowledge translation strategy using the principles of social marketing and the influence of expert and local opinion leaders for colorectal cancer.Methods/Design: Opinion leaders were identified using the Hiss methodology. Hospitals in Ontario were cluster-randomized to one of two intervention arms. Both groups were exposed to a formal continuing medical education session given by the expert opinion leader for colorectal cancer. In the treatment group the local Opinion Leader for colorectal cancer was detailed by the expert opinion leader for colorectal cancer and received a toolkit. Forty-two centres agreed to have the expert opinion leader for colorectal cancer come and give a formal continuing medical education session that lasted between 50 minutes and 4 hours. No centres refused the intervention. These sessions were generally well attended by most surgeons, pathologists and other health care professionals at each centre. In addition all but one of the local opinion leaders for colorectal cancer met with the expert opinion leader for colorectal cancer for the academic detailing session that lasted between 15 and 30 minutes.Discussion: We have enacted a unique study that has attempted to induce practice change among surgeons and pathologists using an adapted social marketing model that utilized the influence of both expert and local opinion leaders for colorectal cancer in a large geographic area with diverse practice settings.