The evolution of social networks through the implementation of evidence-informed decision-making interventions: a longitudinal analysis of three public health units in Canada

被引:25
|
作者
Yousefi-Nooraie, Reza [1 ]
Dobbins, Maureen [2 ,3 ]
Marin, Alexandra [4 ]
Hanneman, Robert [5 ]
Lohfeld, Lynne [3 ]
机构
[1] McMaster Univ, Fac Hlth Sci, Hlth Res Methodol Program, Hamilton, ON, Canada
[2] McMaster Univ, Sch Nursing, Hamilton, ON, Canada
[3] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
[4] Univ Toronto, Dept Sociol, Toronto, ON M5S 1A1, Canada
[5] Univ Calif Riverside, Dept Sociol, Coll Humanities Arts & Social Sci, Riverside, CA 92521 USA
来源
IMPLEMENTATION SCIENCE | 2015年 / 10卷
基金
加拿大健康研究院;
关键词
Evidence-informed decision-making; Social network analysis; Stochastic actor-oriented modeling; Social selection; Longitudinal analysis; KNOWLEDGE TRANSLATION; INFORMATION-SEEKING; PRIMARY-CARE;
D O I
10.1186/s13012-015-0355-5
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: We studied the evolution of information-seeking networks over a 2-year period during which an organization-wide intervention was implemented to promote evidence-informed decision-making (EIDM) in three public health units in Ontario, Canada. We tested whether engagement of staff in the intervention and their EIDM behavior were associated with being chosen as information source and how the trend of inter-divisional communications and the dominance of experts evolved over time. Methods: Local managers at each health unit selected a group of staff to get engage in Knowledge Broker-led workshops and development of evidence summaries to address local public health problems. The staff were invited to answer three online surveys (at baseline and two annual follow-ups) including name generator questions eliciting the list of the staff they would turn to for help integrating research evidence into practice. We used stochastic actor-oriented modeling to study the evolution of networks. We tested the effect of engagement in the intervention, EIDM behavior scores, organizational divisions, and structural dynamics of social networks on the tendency of staff to select information sources, and the change in its trend between year 1 and year 2 of follow-up. Results: In all the three health units, and especially in the two units with higher levels of engagement in the intervention, the network evolved towards a more centralized structure, with an increasing significance of already central staff. The staff showed greater tendencies to seek information from peers with higher EIDM behavior scores. In the public health unit that had highest engagement and stronger leadership support, the engaged staff became more central. In all public health units, the engaged staff showed an increasing tendency towards forming clusters. The staff in the three public health units showed a tendency towards limiting their connections within their divisions. Conclusions: The longitudinal analysis provided us with a means to study the microstructural changes in public health units, clues to the sustainability of the implementation. The hierarchical transformation of networks towards experts and formation of clusters among staff who were engaged in the intervention show how implementing organizational interventions to promote EIDM may affect the knowledge flow and distribution in health care communities, which may lead to unanticipated consequences.
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页数:12
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