Please mind the gap between guidelines & behavior change: a systematic review and a consideration on effectiveness in healthcare
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Laboratorio MeS, Management e Sanità, Sant'Anna School of Advanced Studies, Pisa, Italy
Sant'Anna School of Advanced Studies, Pisa, Italy
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A629
Background and Objectives: This study is a systematic review, following the PRISMA Methodology, to explore and take stock of extant scholarship on the relationship between practice guidelines and behavior change in the context of healthcare provision.   Methods: Scopus and Web of Science were researched according to our PICO(T) Keywords. The initial search yielded 624 Results, which were then reevaluated based on inclusion criteria to remove duplicates, items besides research articles, and items outside the scope of the review. A total of 67 articles were analyzed in depth. Results: The 67 studies in our final sample come from 25 countries, with the UK, Australia, Canada, and the US being the most represented. In terms of populations of interest, about 45% of the studies in our sample specifically focus on medical doctors, and some 37% generically target healthcare workers. Prescription is the most frequently investigated behavior, followed by hand hygiene. Guidelines significantly influence behavior in the intended direction in less than half of the studies; Results are mixed in more than one-fifth of the cases and significant but contrary to expectations in 18% of reviewed articles. In terms of research design, most studies are based on quantitative methodologies, followed by qualitative work, literature reviews, and theoretical contributions. Conclusions: The study speaks to academics and healthcare professionals alike, aiming to improve the effectiveness of guidelines as a tool for positively changing behavior in the healthcare context. It provides an exhaustive mapping of the relationship between guidelines and behavioral changes in health professionals, including the factors that mediate or moderate this relationship and the methodologies adopted in this research area.