Table 3. Results in the second round among the 183 participants.

Corresponding barriers	Possible solutions of promoting EBPin the rehabilitation profession in Japan	Strongly disagree	Disagree	Neither agree nor disagree	Agree	Strongly agree
Busy staff schedule	A formal decision from the upper management to authorize and include EBP in PT/OT/ST	2	13	45	35	5
	Creating specific workplace rules to reduce clinical workloads in order to afford EBP implementation	1	15	45	46	8
	Time management (e.g., assigning less work to two therapists so that they can perform EBP tasks)	2	10	30	49	9
	Reducing the amount of time for clinical work to afford the implementation of EBP	6	26	38	27	3
Lack of communication skills of some therapists	Improving communication skills with medical staffs, patients, and academic PTs/OTs/STs	0	6	14	56	24
	Running awareness campaigns to improve collaboration among medical staff and with patients to increase patient confidence	3	14	41	34	8
Need for propermanagement	Gradually applying new practices in therapists to ensure accuracy, completeness, and continuance	0	1	25	65	9
	Offering continuous support	1	2	23	64	10
	Setting up training sessions and workshops that do not specify a place or time	1	2	23	60	14
	Creating a qualification to teach the EBP implementation	2	7	55	32	4
	Observing how people are actively implementing EBP (e.g. medical doctors)	1	5	31	54	9
	Establishing an association or other subsidy scheme to create opportunities to learn about EBP at the workplace	1	4	29	51	15
	Developing apps that are useful for EBP implementation	2	8	28	52	10
	Strengthening efforts by associations and other organizations to promote research activities that demonstrate the benefits of healthcare services to promote EBP	0	3	37	51	9
Lack of motivation	Offering incentives at early stages	5	12	33	40	10
	Holding awareness sessions to motivate staff and increase their willingness to provide the best care to patients	2	5	30	53	10
	Creating a system to quantify the extent to the EBP implementation, so that as adherence increases, each employee is evaluated in the workplace accordingly	4	9	39	40	8
	Creating a system that allows us to get continuing education points not only when we attend EBP workshops, but also when we subsequently hold transmitter workshops at our workplaces	3	9	32	49	7
	Creating a system to quantify the degree of EBP implementation and to increase healthcare fees from the government according to the degree of compliance	2	9	33	42	14
Lack of interestin adding new practices	Making students of healthcare professionals strongly aware of the need for EBP from training school stage	1	3	26	52	18
	Arranging workshops, local or abroad, for those staff who are willing to gain EBP knowledge and skills	0	5	28	58	9
	Organizing awareness sessions for staff to highlight the positive outcomes of EBP	1	7	34	52	6
	Promoting awareness among therapists of the concept of EBP and the objective usefulness of practice guidelines as a tool to implement EBP	0	1	20	64	15
Lack of promotion of EBP	Making information on EBP and practice guidelines more publicly available to therapists and patients	0	5	22	60	13
	Representing information on EBP by well-known persons through accessible media (e.g. YouTube) in a format that everyone can understand	2	9	35	45	9
Patient attitudes	Involving patients in the treatment process	1	8	31	47	13
	Developing awareness guidelines about EBP for patients and disseminate them through bulletin boards, brochures, and roll-up banners	0	8	43	43	6
	Creating public awareness that implementing EBP is essential by widely highlighting EBP usefulness in mass media such as TV, newspapers, and magazines	2	11	44	35	8
	Enabling patients to understand the quality of healthcare services with respect to the level of EBP implementation	0	5	37	50	8

Values are presented in the proportion of the 183 participants.

EBP: Evidence-based practice; PT: physical therapist; OT: occupational therapist; ST: speech therapist.