Evidence-based knowledge in the context of social practice.

AIMS: Social practitioners require evidence-based knowledge as a guide to the development of social policies and practices. This article aims to identify: (1) knowledge domains needed for the development and use of evidence-based knowledge in social practice; (2) promising research methods for such knowledge development; (3) a framework for linking evidence-based practice, systematic reviews, and practice guidelines, as well as standards for systematic reviews and guidelines; (4) issues influencing use of evidence-based knowledge in social practice. METHODS: This analysis is based on examination of conceptualisations of social practice in a transdisciplinary, evidence-based practice context. Also examined are recent national level reports pertaining to comparative effectiveness research. RESULTS: This review identifies key knowledge domains pertinent to a transdisciplinary systems conceptualisation of evidence-based practice and promising comparative effectiveness research methods pertaining to those domains. An integrative conceptualisation of evidence-based practice is proposed including linkages to systematic reviews and practice guidelines. CONCLUSIONS: The development of evidence-based knowledge for social practice can benefit from the use of comparative effectiveness research strategies using a range of research methods tailored to specific questions and resource requirements, and which examine effectiveness and cost-effectiveness. An integrating conceptualisation of evidence-based practice that includes a linked process including planned and targeted systematic reviews and guideline development for decision making is needed to facilitate knowledge development and use. Evidence-based research regarding social intervention outcomes can benefit by using conceptual models that view intervention effects as contingent on sets of interacting domains including environmental, organisational, intervener, client-system, technology, and technique variables.

Implementing evidence-based practice: practitioner assessment of an agency-based training program.

Responding to the call for evidence-based practice (EBP) in social work, the authors conducted a multiphase exploratory study to test the acceptability of a training-based collaborative agency-university partnership strategy supporting EBP. The Bringing Evidence for Social Work Training (BEST) study includes an agency training component consisting of 10 modules designed to support the implementation of EBP in social agencies. Qualitative data from post-training participant focus groups were analyzed in order to describe practitioner perceptions of the 10 training modules and trainer experiences of implementation. Based on the findings from this study the authors suggest that the BEST training was generally acceptable to agency team members, but not sufficient to sustain the use of EBP in practice.

Toward a transdisciplinary model of evidence-based practice.

CONTEXT: This article describes the historical context and current developments in evidence-based practice (EBP) for medicine, nursing, psychology, social work, and public health, as well as the evolution of the seminal "three circles" model of evidence-based medicine, highlighting changes in EBP content, processes, and philosophies across disciplines. METHODS: The core issues and challenges in EBP are identified by comparing and contrasting EBP models across various health disciplines. Then a unified, transdisciplinary EBP model is presented, drawing on the strengths and compensating for the weaknesses of each discipline. FINDINGS: Common challenges across disciplines include (1) how "evidence" should be defined and comparatively weighted; (2) how and when the patient's and/or other contextual factors should enter the clinical decision-making process; (3) the definition and role of the "expert"; and (4) what other variables should be considered when selecting an evidence-based practice, such as age, social class, community resources, and local expertise. CONCLUSIONS: A unified, transdisciplinary EBP model would address historical shortcomings by redefining the contents of each model circle, clarifying the practitioner's expertise and competencies, emphasizing shared decision making, and adding both environmental and organizational contexts. Implications for academia, practice, and policy also are discussed.