School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.
Hunter New England Population Health, Wallsend, Australia.
J Med Internet Res. 2020 Jul 31;22(7):e17274. doi: 10.2196/17274.
Knowledge translation (KT) aims to facilitate the use of research evidence in decision making. Changes in technology have provided considerable opportunities for KT strategies to improve access and use of evidence in decision making by public health policy makers and practitioners. Despite this opportunity, there have been no reviews that have assessed the effects of digital technology-enabled KT (TEKT) in the field of public health.
This study aims to examine the effectiveness of digital TEKT strategies in (1) improving the capacity for evidence-based decision making by public health policy makers and practitioners, (2) changing public health policy or practice, and (3) changes in individual or population health outcomes.
A search strategy was developed to identify randomized trials assessing the effectiveness of digital TEKT strategies in public health. Any primary research study with a randomized trial design was eligible. Searches for eligible studies were undertaken in multiple electronic bibliographic databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], Excerpta Medica dataBASE [EMBASE], PsycINFO, Cumulative Index to Nursing and Allied Health Literature [CINAHL], and Scopus) and the reference lists of included studies. A hand search of 2 journals (Implementation Science and Journal of Medical Internet Research) and a gray literature search were also conducted. Pairs of independent review authors screened studies, assessed the risk of bias, and extracted data from relevant studies.
Of the 6819 citations screened, 8 eligible randomized trials were included in the review. The studies examined the impact of digital TEKT strategies on health professionals, including nurses, child care health consultants, physiotherapists, primary health care workers, and public health practitioners. Overall, 5 of the interventions were web-training programs. The remaining 3 interventions included simulation games, access to digital resource materials and the use of tailored messaging, and a web-based registry. The findings suggest that digital TEKT interventions may be effective in improving the knowledge of public health professionals, relative to control, and may be as effective as a face-to-face KT approach. The effectiveness of digital TEKT strategies relative to a control or other digital KT interventions on measures of health professional self-efficacy to use evidence to enhance practice behavior or behavioral intention outcomes was mixed. The evidence regarding the effects on changes to health policy or practice following exposure to digital TEKT was mixed. No trials assessed the effects on individual or population-level health outcomes.
This review is the first to synthesize the effectiveness of digital TEKT interventions in a public health setting. Despite its potential, relatively few trials have been undertaken to investigate the impacts of digital TEKT interventions. The findings suggest that although a digital TEKT intervention may improve knowledge, the effects of such interventions on other outcomes are equivocal.
知识转化（KT）旨在促进研究证据在决策中的应用。技术的变革为 KT 策略提供了相当多的机会，以改善公共卫生政策制定者和从业者获取和使用证据的能力。尽管有这样的机会，但还没有审查评估数字技术支持的 KT（TEKT）在公共卫生领域的效果。
本研究旨在考察数字 TEKT 策略在以下方面的有效性：（1）提高公共卫生政策制定者和从业者循证决策的能力，（2）改变公共卫生政策或实践，以及（3）个体或人群健康结果的变化。
制定了搜索策略，以确定评估数字 TEKT 策略在公共卫生中有效性的随机试验。任何采用随机试验设计的原始研究都符合条件。在多个电子书目数据库（医学文献分析和检索系统在线[MEDLINE]、医学文摘数据库[EMBASE]、心理信息数据库[PsycINFO]、护理与联合健康文献累积索引[CINAHL]和 Scopus）和纳入研究的参考文献中进行了合格研究的检索。还对手册搜索了 2 种期刊（实施科学和医学互联网研究杂志）和灰色文献搜索。
在筛选的 6819 条引文，有 8 项符合条件的随机试验纳入了综述。这些研究考察了数字 TEKT 策略对健康专业人员的影响，包括护士、儿童保健健康顾问、物理治疗师、初级卫生保健工作者和公共卫生从业人员。总体而言，5 项干预措施是网络培训计划。其余 3 项干预措施包括模拟游戏、获取数字资源材料和使用定制消息传递以及基于网络的登记册。研究结果表明，数字 TEKT 干预措施可能在提高公共卫生专业人员的知识方面有效，与对照组相比，并且可能与面对面的 KT 方法一样有效。关于数字 TEKT 策略相对于对照组或其他数字 KT 干预措施对健康专业人员使用证据增强实践行为或行为意向结果的自我效能感的影响的证据好坏参半。关于接触数字 TEKT 后对卫生政策或实践变化的影响的证据好坏参半。没有试验评估对个体或人群健康结果的影响。
这是首次综合评估数字 TEKT 干预措施在公共卫生环境中的有效性。尽管有其潜力，但相对较少的试验已经进行了调查数字 TEKT 干预措施的影响。研究结果表明，尽管数字 TEKT 干预措施可能会提高知识，但这些干预措施对其他结果的影响好坏参半。
