Tailoring Research Evidence and Theory (TREAT) into Allied Health Journal Clubs: A Hybrid Effectiveness-Implementation Study

BackgroundAllied Health Professionals (AHPs) commonly use journal clubs (JCs) to support Evidence-Based Practice (EBP). There is however little research regarding implementing JCs in the long term, and their impact on EBP use and skills in AHPs. This study investigated the impact of implementing a structured JC format, called “TREAT” that was specifically tailored for each club, on EBP skills, confidence, use and resultant changes in clinical practice over 16 sessions for AHPs in a public health service. The study also investigated AHP’s attendance, adherence, satisfaction and barriers and enablers to implementing the format.MethodsA mixed methods hybrid-effectiveness implementation design was employed, guided by the Knowledge-to-Action cycle. EBP skills, confidence, use, and attitudes were assessed (Adapted Fresno Test, EBPQ, tailored journal club culture questionnaire) at baseline, and after 10 and 16-monthly JC sessions. Satisfaction and impact on clinical practice were explored using questionnaires at the latter two time-points, with free-form responses identifying enablers and barriers to EBP culture and implementation. Data on attendance and adherence to the TREAT format were also collected. ResultsSix JCs comprising a total of 132 unique participants from seven Allied Health professions were assessed across three time points. EBP skills significantly improved on the Adapted Fresno Test after 10-monthly (6.6 points: 95% CI, 0.43 to 12.7) and 16-monthly sessions (7.8 points, 95% CI, 0.85 to 14.7), and on self-reported total EBPQ ratings of confidence at 10-months (4.9 points: 95% CI, 2.2 to 7.5) and 16-months (5.7 points: 95% CI 2.7 to 8.7). Across sessions, 88 AHPs reported adopting new treatments/resources and 64 AHPs reported updating clinical procedures. Mean attendance was 5.7 sessions (SD= 3.8), and average adherence to TREAT components each session was 86% (95% CI, 83 to 89). Most participants recommended the format and reported desire to continue TREAT JCs. Enablers to the JC included using clinically relevant topics and active participation, while reported barriers included limited time to prepare. ConclusionsTREAT JCs can be implemented and sustained by AHPs for 16 monthly-sessions. Participation improved EBP skills and confidence and led to changes in clinical practice. Contextual enablers and barriers should be considered when implementing locally.