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One of the most common findings from health services research is a failure to routinely translate research findings into daily practice. Previous systematic reviews of strategies to promote the uptake of research findings suffered from a range of methodologic problems that have been addressed in a more recent systematic review of guideline dissemination and implementation strategies. Changes in practitioner behavior; in the desired direction, were reported in 86% of the comparisons made. The median effect size overall was approximately 10% improvement in absolute terms. The review suggests that interventions that were previously thought to be ineffective (e.g., dissemination of educational materials) may have modest but worthwhile benefits. Also, multifaceted interventions, previously thought to be more effective than single interventions, were found to be no more effective than single interventions. Overall, there is an imperfect evidence base for decision makers to work from. Many studies had methodologic weaknesses, and reporting of this kind of research is generally poor, making the generalizability of study findings frequently uncertain. A better theoretical underpinning of studies would make this body of research more useful.

Objective: To compare the efficacy of a decision-making aid with an information document from the Society of Obstetricians and Gynaecologists of Canada (SOGC) with regard to decisions about hormone replacement therapy (HRT)., Design: Randomized clinical trial., Setting: Quebec city region., Participants: Menopausal Francophone women 45 to 69 years old., Interventions: Subjects were given a manual and an audiocassette describing a six-step approach to making a decision about HRT., Main Outcome Measures: Amount of anxiety over the decision (main outcome), general knowledge of the risks and benefits of HRT, personal expectations and values concerning these risks and benefits, and women's views on HRT., Results: Anxiety levels were significantly reduced in both groups, but the difference between the effectiveness of the two interventions was not significant (P = .77). Percentages of women whose general knowledge increased and of women with realistic expectations were significantly higher in the experimental group (P < .003 and P < .0001, respectively). Congruence between personal values and decisions about HRT increased significantly more in the experimental group (P < or = .003)., Conclusion: The six-step approach to decision making was more helpful than the SOGC's information document in increasing subjects' knowledge of the risks and benefits of HRT, in creating more realistic expectations of HRT, and in increasing the congruence between subjects' personal values and their decisions on HRT.