Implementation guideline evidence-based health information
Duration: 15.06.2018 – 14.12.2020, extended to 14.06.2022
Project management: Prof. Dr. phil. Anke Steckelberg
Martin Luther University Halle-Wittenberg, Institute for Health and Nursing Science
External funding: Innovationsfonds (Healthcare Research), funding code: 01VSF17047
Background
Evidence-based health information (EBHI) is a prerequisite for informed and mutual decision-making. Although the EBGI quality criteria have been defined for years, the implementation into practice is at the moment not very successful. The guideline evidence-based health information is intended for creators of health information with the aim of improving the quality of information material. Parallel to developing the guideline, the competences of the information creators were explored, resulting in setting up a five-day training course with an EbM training module and a module on using the guideline.
Aim of the project was to evaluate the implementation of the guideline evidence-based health information in conjunction with a training course for the creators of health information. We assumed that, by supporting the development of EBHI with the guideline and complementary training, the quality of the information material will improve when compared to that created without any training.
Methods
The methodological approach followed the guidelines of the UK Medical Research Council (MRC) for the development and evaluation of complex interventions. Following a qualitative pilot study (1), a randomised-controlled study (2) was conducted.
- In the qualitative pilot study, the 5-day training course was adapted to a Blended Learning Format and shortened by two attendance days; in two courses with providers of health information it was piloted with respect to feasibility and acceptance. Data was collected through structured observations and focus group interviews, the analysis followed the structuring qualitative content analysis according to Mayring.
Due to the COVID-19 pandemic, the training program was switched to a pure e-learning offer. - The randomized-controlled study (ISRCTN [link: http://www.isrctn.com/ISRCTN96941060], study protocol) should include 26 groups of health information providers (about 1 – 10 individual persons per group) in order to be able to compare the intervention (guideline and training course in an e-learning format) with the standard where the guideline is publicly accessible.
The primary endpoint was the degree of implementation of the guideline recommendations. For this, each group of creators developed within the frame of the study an EBHI on a self-chosen topic. The evaluation instrument MAPPinfo, based on the recommendations of the guideline, was also developed and validated within the frame of the study (AsPREDICTED [link: https://aspredicted.org/3zz4g.pdf.], publication). The instrument contains criteria for transparence, contents and presentation styles for health information.
A qualitative process evaluation is being conducted at the same time. Interviews were conducted with participants in the intervention group and critical health competence was assessed using the Critical Health Competence Test before and after the training.
Results
A total of 18 groups of health information providers (9 intervention, 9 control) with 54 individual participants were included, heterogeneous in terms of organizational form and the objectives and formats of the health information. No difference was shown between the groups for the primary outcome.
The intervention group showed an increase in critical health literacy. Individual and structural barriers to the implementation of the guideline recommendations were identified (e.g. methodological uncertainties, lack of resources, conflicting interests).
Conclusions
There was no effect on the quality of health information. The training content was rated as relevant and there was an increase in critical health literacy. A limiting factor is that the target sample size was not achieved. With regard to implementation, the structural barriers in particular should be addressed.
Status: 23.04.2025
