| Community health managers |
Lack of access and availability of applicable research evidence59 Lack of timely research output81,87 Lack of credibility of the evidence81,97
|
Negative perceptions of research utilization: i.e. perceived as a bureaucratic/timely process59,96 Lack of joint understanding between researchers and decision-makers88,96,98 Lack of motivation, awareness, and skills to seek, appraise, and interpret the evidence/systematic reviews96 Formal evaluation of KT activities seen as highly challenging33
|
The culture of decision-making (i.e. resistance to change)11,87 Practical constraints87 Lack of accountability in the use of evidence87
|
Competing influences on decision- making87, role of the media98
a
Lack of cultural appropriateness, accept ability or applicability in practice35,41,66,96
a
Conflicts of interest87
a
Few agencies involving users/general public in KT activities33
|
| Health policy-makers |
Lack of access and availability of applicable research evidence87,96 Lack of timely research output81,87 Lack of credibility of the evidence81,97
|
Negative perceptions of research utilization: i.e. perceived as a bureaucratic/timely process96,96 Lack of motivation awareness, and skills to seek, appraise, and interpret systematic reviews96 (i.e. belief that it is too time consuming)96,11 Formal evaluation of KT activities seen as highly challenging33
|
The culture of decision-making (i.e. resistance to change)11,87 Lack of resources or organizational support11,81,100 Lack of accountability in the use of evidence87
|
a
Lack of relevance to policy needs (i.e. locally useful, evidence on costs)98,81
a
Legislative constraints81,97
a
Short-sighted considerations of political support or feasibility97 Competing influences on decision-making87,104,105 Role of the media98
|
| Clinicians and allied health professionals |
Lack of database access109 Lack of rapidly available, and suitably filtered information22
a
Complex nature of some evidence-based therapies or guidelines72
|
Lack of skills to appraise, understand and apply research evidence (including digital skills)22 Lack of awareness or agreement with the guidelines22;
a
Familiarity or confidence in the effectiveness of a particular evidence-based therapy72
a
Limited skills or competence to use a particular therapy72; Knowledge practice gaps77
|
Time, aclinical workload and other pressures41. Insufficient capacity for implementation38 Organizational resistance to change70,72,73; ainadequate peer support, organizational or institutional level support72,22,41 Lack of infrastructure, limited medical facilities to support evidence uptake72
|
a
Patient needs, preferences and adherence to treatment when these interfere with evidence-based recommendations22,56,72
|
