Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.
Implement Sci. 2008 Oct 2;3:41. doi: 10.1186/1748-5908-3-41.
There is an emerging knowledge base on the effectiveness of strategies to close the knowledge-practice gap. However, less is known about how attributes of an innovation and other contextual and situational factors facilitate and impede an innovation's adoption. The Healthy Heart Kit (HHK) is a risk management and patient education resource for the prevention of cardiovascular disease (CVD) and promotion of cardiovascular health. Although previous studies have demonstrated the HHK's content validity and practical utility, no published study has examined physicians' uptake of the HHK and factors that shape its adoption.
Conceptually informed by Rogers' Diffusion of Innovation theory, and Theory of Planned Behaviour, this study had two objectives: (1) to determine if specific attributes of the HHK as well as contextual and situational factors are associated with physicians' intention and actual usage of the HHK kit; and (2), to determine if any contextual and situational factors are associated with individual or environmental barriers that prevent the uptake of the HHK among those physicians who do not plan to use the kit.
A sample of 153 physicians who responded to an invitation letter sent to all family physicians in the province of Alberta, Canada were recruited for the study. Participating physicians were sent a HHK, and two months later a study questionnaire assessed primary factors on the physicians' clinical practice, attributes of the HHK (relative advantage, compatibility, complexity, trialability, observability), confidence and control using the HHK, barriers to use, and individual attributes. All measures were used in path analysis, employing a causal model based on Rogers' Diffusion of Innovations Theory and Theory of Planned Behaviour.
115 physicians (follow up rate of 75%) completed the questionnaire. Use of the HHK was associated with intention to use the HHK, relative advantage, and years of experience. Relative advantage and the observability of the HHK benefits were also significantly associated with physicians' intention to use the HHK. Physicians working in solo medical practices reported experiencing more individual and environmental barriers to using the HHK.
The results of this study suggest that future information innovations must demonstrate an advantage over current resources and the research evidence supporting the innovation must be clearly visible. Findings also suggest that the innovation adoption process has a social element, and collegial interactions and discussions may facilitate that process. These results could be valuable for knowledge translation researchers and health promotion developers in future innovation adoption planning.
关于缩小知识与实践差距的策略的有效性，已经有了一些新兴知识。然而，人们对创新的属性以及其他情境因素如何促进和阻碍创新的采用知之甚少。“健康心脏工具包”（HHK）是一种用于预防心血管疾病（CVD）和促进心血管健康的风险管理和患者教育资源。尽管先前的研究已经证明了 HHK 的内容有效性和实际效用，但没有发表的研究考察过医生对 HHK 的采用情况以及影响其采用的因素。
受罗杰斯创新扩散理论和计划行为理论的启发，本研究有两个目的：（1）确定 HHK 的特定属性以及情境因素是否与医生使用 HHK 工具包的意愿和实际使用有关；（2）确定任何情境因素是否与那些不计划使用 HHK 工具包的医生的个人或环境障碍有关。
本研究招募了 153 名对发给加拿大艾伯塔省所有家庭医生的邀请信做出回应的医生。参与研究的医生收到了一个 HHK，两个月后，一份研究问卷评估了医生临床实践的主要因素、HHK 的属性（相对优势、兼容性、复杂性、可试验性、可观察性）、使用 HHK 的信心和控制、使用障碍以及个人属性。所有措施均用于路径分析，采用基于罗杰斯创新扩散理论和计划行为理论的因果模型。
115 名医生（随访率为 75%）完成了问卷。HHK 的使用与使用 HHK 的意愿、相对优势和工作年限有关。HHK 的相对优势和可观察性也与医生使用 HHK 的意愿显著相关。在单独行医的医生报告说，在使用 HHK 方面遇到了更多的个人和环境障碍。
这项研究的结果表明，未来的信息创新必须展示出优于当前资源的优势，并且必须清楚地看到支持创新的研究证据。研究结果还表明，创新采用过程具有社会元素，同事之间的互动和讨论可能会促进这一过程。这些结果对于未来创新采用规划中的知识转化研究人员和健康促进开发者可能具有价值。
