The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States of America.
The Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States of America.
PLoS One. 2024 Nov 22;19(11):e0311442. doi: 10.1371/journal.pone.0311442. eCollection 2024.
Leaders of healthcare organizations play a key role in developing, prioritizing, and implementing plans to adopt new evidence-based practices. This study examined whether a letter with peer comparison data and social norms messaging impacted healthcare leaders' decision to access a website with resources to support evidence-based practice adoption.
Pragmatic, parallel-group, randomized controlled trial completed from December 2019 -June 2020. We randomized 2,387 healthcare leaders from health systems, hospitals, and physician practices in the United States, who had previously responded to our national survey of healthcare organizations, in a 1:1 allocation ratio to receive one of two cover letter versions via postal mail (all) and email (for the 60.6% with an email address), accompanying a report with their survey results. The "nudge" letter included messaging that highlighted how an organization's results compared to peers using text, color, and icons. Both nudge and control letters included links to a resource website. We interviewed 14 participants to understand how the letter and report impacted behaviors.
Twenty-two of 1,194 leaders (1.8%) sent the nudge letter accessed online resources, compared to 17 of 1193 (1.4%) sent the control letter (p = 0.424). Nine of the 14 interviewed leaders stated that viewing the letter (regardless of version) and accompanying report influenced their decision to take a subsequent action other than accessing the website. Seven leaders forwarded the report or discussed the results with colleagues; two leaders stated that receiving the letter and report resulted in a concrete practice change.
Receiving cover letters with a behavioral nudge did not increase the likelihood that organizational leaders accessed a resource website. Qualitative results suggested that the survey report's peer comparison data may have been a motivator for prioritizing and delegating implementation activities, but leaders themselves did not access our online resources.
医疗保健组织的领导者在制定、优先考虑和实施采用新的基于证据的实践的计划方面发挥着关键作用。本研究考察了一封附有同行比较数据和社会规范信息的信是否会影响医疗保健领导者访问支持基于证据的实践采用资源网站的决定。
这是一项从 2019 年 12 月至 2020 年 6 月进行的实用、平行组、随机对照试验。我们以 1:1 的比例随机分配 2387 名来自美国卫生系统、医院和医师实践的医疗保健领导者，他们之前曾回应我们对医疗保健组织的全国调查，分配到两个覆盖信件版本之一的比例为 1:1（全部）和电子邮件（对于 60.6%有电子邮件地址的人），附有一份附有他们调查结果的报告。“推动”信包括使用文本、颜色和图标突出显示组织结果与同行相比的信息。推动信和控制信都包含到资源网站的链接。我们采访了 14 名参与者，以了解信和报告如何影响行为。
在收到推动信的 1194 名领导者中，有 22 名（1.8%）访问了在线资源，而在收到对照信的 1193 名领导者中，有 17 名（1.4%）（p=0.424）。在接受采访的 14 名领导者中，有 9 名表示查看了信（无论版本如何）和随附的报告影响了他们采取除访问网站之外的后续行动的决定。7 名领导者转发了报告或与同事讨论了结果；两名领导者表示收到信和报告导致了具体的实践改变。
收到带有行为推动的封面信件并没有增加组织领导者访问资源网站的可能性。定性结果表明，调查报告的同行比较数据可能是优先考虑和委托实施活动的动力，但领导者自己并未访问我们的在线资源。
