Biomed II Concerted Action on Changing Professional Practice.

"The CPP Perceptions Library"

A Catalogue of Survey Items Assessing Attitudes Towards Guidelines and Perceived Barriers and Facilitators to Implementation.

Dr. H. Claudia Pagliari (University of Aberdeen)
Prof. James P. Kahan (RAND Europe)
For the CPP Network Resource

 

Introduction

These web pages contain a selection of survey instruments that have been used to assess health professionals’ attitudes towards clinical practice guidelines and the factors which they perceive to be barriers and facilitators to guideline implementation. These were identified from a comprehensive review of the literature addressing attitudinal and perceptual barriers and facilitators to implementation. This is described in two associated publications, both of which are reproduced on the CPP website. The review identified approximately 90 studies which had used structured survey methods to examine attitudes and perceived barriers and facilitators to implementation and a further 40 or so which had examined these factors using less structured methods, such as semi-structured interviews and focus groups. Only a relatively small proportion of the 130+ studies we identified focused specifically on guidelines (c. 30%) and many of these utilised existing questionnaires. The 28 instruments described here are those which we believe to be most pertinent to the remit of our project and most useful to researchers wishing to identify attitudinal or perceptual barriers as a precursor to a tailored guideline implementation strategy. We have chosen to avoid duplication by excluding those studies which have used the same standard questionnaires and focused, instead, on the original sources. Where new questionnaires have been developed only partially on the basis of an older instrument, the new instrument is included. Not all instruments are fully reproduced in their original format, since many contain items which are irrelevant to our remit. In all cases, however, the instrument and its purpose are broadly described and all items pertaining to attitudes or barriers and facilitators are given in full.

Of the instruments included in this ‘Perceptions Library’, 25 focus specifically on guidelines. We have chosen to include three additional measures relating to the broader issue of evidence-based medicine which, of course, encompasses guidelines. The latter instruments may be easily adapted for use in the context of guideline implementation and their similarities to measures developed for guidelines research illustrate the generalisability of such perceptual factors to EBM as a whole. Summary details of a wider range of survey instruments examining attitudinal and perceptual barriers and facilitators to implementation can be found in our Annotated Bibliography.

____________________
¹Pagliari H.C. & Kahan J.P.(1999).  Changing Professional Practice in Health Care: Annotated Bibliography of Studies of Perceptions in Guideline Implementation.   Leiden: RAND Europe Report 99.008.

²Pagliari H.C. & Kahan J.P.(1999).  Researching Perceived Barriers and Facilitators to Implementation: A Coded Review.  In T. Thorsen & M. Mäkäla (Eds.) Theory and Practice of Guidelines Implementation. Copenhagen: DSI - Danish Institute for Health Services Research and Development

 

Questionnaires reproduced in full or in part on the website,
listed by source publication, focus and object

(Double click on table entry to view).

LINKS

CPP Home Page http://www.dsi.dk/projects/CPP/cpp.htm

Annotated Bibliography. (Detailed descriptions of 130+ studies examining perceived and attitudinal barriers to implementation of health care technologies.)

Coded Review. (Abbreviated database of studies, as above, coded for ease of reference by focus, objects, methods, and subject)