Nursing Journal on an EBP Process: Together

¶ … Nursing Journal on an EBP Process:

Together with his colleagues at the University of Washington, Jeffrey R. Harris developed and published an article regarding the most appropriate means for disseminating evidence-based practices. The framework was geared towards spreading evidence-based practices that focus on health promotion. The authors argued that the basis for widespread adoption of evidence-based health promotion practices is mainly dependent on developing and evaluating effective dissemination approaches. Consequently, they created a practical framework based on existing literature on dissemination and their experiences in conducting such practices. The framework is commonly known as the Health Promotion Research Center (HPRC) framework, which was developed by the Prevention Research Center at the University of Washington and funded by the Center for Disease Control. CDC funded the development of this evidence-based health promotion framework to carry out research on community-based prevention and management of chronic diseases.

Summary of the Article's Key Points:

One of the most important points of the publication by Jeffrey R. Harris and his colleagues is the significance of developing and examining effective dissemination approaches in broad adoption of evidence-based, health promotion practices (Harris et. al., 2012). As a result, they developed a framework that would help in the establishment of evidence-based health promotion practices. As a practical structure, the HPRC model is based on literature on dissemination and the individual experiences of the authors in the distribution of evidence-based practices in nursing.

Secondly, the HPRC framework is based some major elements including a close partnership between researchers and a distribution organization that owns the dissemination process. The other element of the framework is the utilization of social marketing principles to work together with probable user organizations. As a result, this evidence-based, health promotion practice has three major actors i.e. researchers, disseminating organizations, and user organizations (Harris et. al., 2012). Researchers play a crucial role in the model by seeking to develop new knowledge to help in the dissemination of best practices. On the other hand, disseminating organizations or disseminators would use the knowledge to direct and guide dissemination initiatives. These organizations may be non-profit organizations that market the practices or governmental agencies that finance user organizations to promote adoption. Notably, researchers will still be involved in the final aspects of the process to examine the implementation of these practices.

However, the authors state that researchers and disseminating organizations should develop mutually beneficial collaborative partnerships in order to enhance the effectiveness of the processes and practices. While such partnerships can be instigated by either party, they tend to be most effective when both parties are attempting to reach similar user organizations and demonstrate willingness to learn about the resources and objectives of each other. Through this, researchers and disseminating organizations are better equipped to develop and analyze the various approaches that fit these goals and ability.

Third, the authors argue that successful dissemination of these practices in a user organization involves a flow of several steps or initiatives. These steps or measures include adoption, implementation, and maintenance and are based on recognition of the fixed elements of the user organization. During this process, the state and the willingness of the organization is examined including the available human and financial resources before the dissemination. Generally, the by-product of this flow is personal behaviors and organizational practices that contribute to better health and extra benefits for organizational members such as employees and the consumers it serves.

Fourth, together with his colleagues, Jeffrey R. Harris provides two examples to demonstrate the dissemination framework. In this case, they have focused on EnhanceFitness, which enhances physical activity among older adults and American Cancer Society (ACS) Workplace Solutions (WPS) that improves the prevention of chronic disease among employees. For EnhanceFitness, the disseminating organization was Senior Services while the user organizations included senior centers, non-profit and for-profit fitness organizations, and community centers. The process involved creating and testing chair-based model of EF, online version of EF instructor training, and evaluation of EnhanceMobility. The use of the HPRC framework resulted in the provision of the service at 523 community locations in 32 states that served more than 23,000 participants. For American Cancer Society (ACS) Workplace Solutions (WPS), the disseminating organizations were the Great West Division of this organization and its national home office. Since the user organizations were employers, the process involved surveying workers in mid-sized and low-wage industries and interviewing the organization's staff members to evaluate their willingness and training needs. The outcome of the process is that more than 1,000 workers participated and reached more than 2.5 million workers (Harris et. al., 2012).

List of Steps Taken by Nursing to Develop and Implement an EBP:

Based on this article, the development of the HPRC evidence-based health promotion practices by nursing is achieved through two major steps. First, the framework is developed through close partnerships between nursing researchers and disseminating organizations that are in charge of distribution process. The second step in developing this framework in nursing involves using the principle of social marketing to work closely with probable user organizations. The effectiveness and success of this development process requires close relationships and working together between researchers, disseminating organizations or disseminators, and user organizations.

With regards to the implementation process, the authors have noted that successful dissemination of evidence-based, health promotion practices involves a cascade of phases. These dissemination phases include adoption, implementation, and maintenance by the user organizations in light of guidance provided by researchers and disseminating organizations. Notably, the process includes analysis of willingness factors that motivate adoption and promote execution and maintenance. The process also involves market analysis, segmentation at the individual or organizational level, and targeting by the disseminating organization.