Table 4.

Implementation support strategies used in studies reporting sustained and unsustained changes in clinical behavior

Implementation support strategy	Studies reporting sustained results	Studies reporting unsustained results
Educational meetings (lectures, meetings, workshop)	[35–55]a	[12, 56–61]a
Audit and feedback	[35, 37–42, 44–46, 49–55]a	[12, 57]
Training/practice	[35, 36, 38, 39, 41–45, 48, 50–53]a	[12, 56, 57, 59, 60, 62]a
Resources (templates, patient information, access to databases, IT-support)	[35, 36, 38, 40, 42–44, 48, 50, 51, 53, 54]a	[12, 57, 61]
Problem solving	[35, 38, 40, 42–44, 47, 50, 51, 53, 55]a	[57]
Demonstration/modeling	[38, 41, 42, 44, 45, 47, 50–53, 55]a	[12, 56, 61]
Educational materials/Written information/Instructions	[35, 38–43, 49, 52, 53]	[12, 56, 58, 61]a
Communities of practice (case conferences, journal club, small group work, peer assessment/support)	[35, 38–40, 44, 46–49, 51, 54]a	[12, 57, 58]
Local opinion leaders/knowledge brokers/champions	[37, 38, 40, 42, 46, 48, 49, 51, 55]	[59, 61, 62]
Reminders	[38, 40, 42, 45, 50, 51]	-
Environmental modifications	[37, 44, 50–52, 54]	-
Mentoring/one-on-one support	[42, 47–49, 55]	[57, 58]
Goal setting	[35, 37, 51, 54]	[12, 57]
Organizational support (process changes)	[37, 47, 51, 54]	-
Leadership support	[39, 45, 54]	[12]
Action plan	[35, 47]	-
Local consensus processes	[37, 50]	-
Rewards	[54]	-
Support to local opinion leaders/knowledge brokers/champions	[55]	-
Financial resources	[48]	-
Monitoring the performance of the delivery of health care	[45]	[12]
Written assignments	-	[58]

^aImplementation support strategies used in at least 50% of the studies reporting sustained or unsustained changes in clinical behavior