Conducting Research To Create Evidence for Social Work Practice February 9, 2007
Posted by Matt Conn in Uncategorized.trackback
Below are PowerPoint presentations from the February 8, 2007 Research Brown Bag Seminar held at the UMB School of Social Work. The presentations addressed the topic, “Conducting Research To Create Evidence for Social Work Practice.”
Rick Barth, PhD: Terms for Research Presentation | CDC Definition of Terms (e-mail the presenter)
Diane DePanfilis, PhD: Quantitative Methods for Developing Evidence for Social Work Practice (e-mail the presenter)
Debbie Gioia, PhD: Qualitative Methods for Developing Evidence for Social Work Practice (e-mail the presenter)
Charles Smith, PhD: Synthesizing Research to Summarize the Evidence for Social Work Practice (e-mail the presenter)
Joan Zlotnik, PhD: Evidence Based Practice(s): A Response (e-mail the presenter)
Hi everyone-
I just wanted to thank the organizers for putting together such a wonderful panel and discussion at the research brown bag today. I really appreciated the different perspectives and also the thought that all the speakers covered their topics amazing well given the time constraints. The presentations definitely gave me lots of food for thought:
1. A couple of people mentioned the importance studying the implementation of evidence-based practice. This is a critical issue for the field and an area that is only recently getting more attention. Much more research in this area is clearly needed. We need to better understand the complex set of facilitating factors and barriers to the successful/ unsuccessful uptake of an EBP or even “evidence-informed” programs and practice. This is actually the most important point for me since simply disseminating information about EBPs actually has no relationship to whether anyone will use that information in day-to-day practice. There is a growing body of research in medicine regarding the effectiveness and implementation of practice guidelines. Basically, findings from a couple of systematic reviews indicate that (not surprisingly) passive dissemination approaches do not work and it requires much more active engagement and interaction with the people who actually need to implement the practice guidelines in order for it to be utilized. Karen Blasé from the National Implementation Research Network says that the dissemination of information about EBPs is necessary, but not sufficient to insure the successful implementation of the particular practice.
2. Along those lines, we also need to think about the kinds of infrastructure that must be in place within agencies (and schools) desiring to adopt (or teach) the EBP or “innovation”. Several people raised this issue and we do need to be sensitive to the individual, organizational, and community factors that can support or hinder the adoption of the EBP. Factors related to the organizational culture, management and supervision, training, staffing, and community support are all important and influence the implementation process. This again reinforces the need for more implementation research needed to answer the “what does it really take to implement EBPs” questions – because that is what the community and agencies want to know.
3. I like the idea of practice guidelines for social work – however, I would advocate that we build upon and learn from the experience of health, mental health and other disciplines that already utilize practice guidelines and use that body of knowledge to complement our own social work knowledge. There is a chapter in the 2003 Rosen and Proctor book, Developing Practice Guidelines for Social Work Intervention, which speaks to this issue and advocates for social work to try not to reinvent the wheel. Truthfully, the current evidence base in social work is slim– and even the systematic reviews on various topics are far from being conclusive so it’s hard to see what the practitioner is supposed to do with information that is inconclusive or have more cautionary conclusions from the research. It is critical that we help practitioners engage in more reflective practice to make more informed decisions about the research available. Again, simply disseminating information and research about EBPs is not enough.
4. I also wanted to share that at the Children’s Bureau, we are working with our Community-Based Child Abuse Prevention (CBCAP) grantees on exactly this whole topic of EBPs. We actually have a performance measure for OMB that is “to increase the percentage of program funding going to support evidence-based and evidence-informed programs and practices.” Grantees will be reporting on how much they are spending along four different levels of EBP and evidence-informed practices (based on the strength of the evidence) – and we will have annual targets to try and meet. We’ve developed lots of written material for our grantees— though we know we have much more work to do to help them understand what all this means for them. We said that the three primary goals for this effort are to:
a. Promote more efficient use of CBCAP funding by investing in programs and practices with evidence that it produces positive outcomes for children and families.
b. Promote critical thinking and analysis across the CBCAP Lead Agencies and their funded programs so that they can be more informed funders, consumers, and community partners to prevent child abuse and neglect.
c. Foster a culture of continuous quality improvement by promoting ongoing evaluation and quality assurance activities across the CBCAP Lead Agencies and their funded programs.
It’s been a tremendous learning process and the prevention grantees are actually quite receptive to these concepts. We’ve subcontracted with the folks from the National Implementation Research Network to help us build the capacity of the States in navigating through the process and reinforce the idea that this is a long term systemic change process. If anyone wants to know more about this, feel free to contact me.
5. Finally, here are some excellent readings I have come across which really address the implementation issues:
Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation Research: A Synthesis of the Literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231).
Available at: http://nirn.fmhi.usf.edu/resources/publications/Monograph/
Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations. Milbank Quarterly, 82(4), 581-629.
I hope this is helpful— this program has been excellent and I have enjoyed all the discussions among the faculty and students. I look forward to more!
Melissa Brodowski
Melissa -
Thank you for your thoughtful comments about the presentation. It would have been wonderful to engage in some discussion and learning from the audience. The dissemination/translation/implementation discussion is one I would like to join. Perhaps some subgroups might emerge from the large group interest we witnessed on Thurs.
Thanks for the resources. I have read the Greenhalgh but not the Fixsen monograph.
During the Brown Bag on the evidence-based practice, concerns for little attention be given to macro practice.
Although I think we tend to focus clinical practice when we talk about evidence-based practice, I’m finding that it is very applicable to macro practice as well. In fact, I find the concept of evidence-based policy is well accepted in Europe and Canada. Although limited, I also see that there is such effort for evidence-based policy making in the U.S.as well. So I wanted to share that with everybody. You may know these already, but just in case, you haven’t seen them, here are the websites for some of groups that utilize and promote evidence-based policy making.
Center for Evidence Based Policy (http://www.ohsu.edu/policycenter/home.htm)
Coalition for Evidence-Based Policy (http://coexgov.securesites.net/index.php?keyword=a432fbc34d71c7)
Evidence-Base Policy Help Desk
(http://www.evidencebasedpolicy.org/)
I appreciate the comments above and had only one specific reaction to Melissa Brodkowski’s excellent critique–I really do not think that there is “no relationship” between the availability of ESIs and their use. That may seem to be the case because we are starting at such a low point with regard to clinician skill at taking on these ESIs, but I expect that if they were at least one or two that agencies had implemented, then the next ones would come much easier. So, if that is true, then the development of ESIs would have a higher value, even if there was not a lot of experience with uptake/adoption by the agency and there was not a sophisticated plan for putting these skills in place.