Despite increased emphasis on evidence-based practice (EBP), the limited implementation of EBP is a well-known reality. EBP is considered to be a comprehensive concept including, but not restricted to the use of empirically supported treatments (ESTs). Also policy and values directives, practice principles, common factors, common practice elements and specific practice knowledge are considered as parts of EBP (Barth et al., 2011). This latter nuance is important since it identifies one of the most controversial topics in the field, namely, the high-fidelity implementation of empirically supported intervention protocols (Borntrager, Chorpita, Higa-McMillan, & Weisz, 2009). It is often suggested in the literature that practitioners should have knowledge of and favorable attitudes toward EBP before they adopt it into practice.
The current study addresses several research questions. First, what provider background characteristics predict knowledge of EBP and attitudes toward EBPs/ESTs? Second, how are providers’ knowledge of EBP and attitudes toward EBPs/ESTs associated? Third, how are providers’ knowledge of EBP and attitudes toward EBPs/ESTs associated to the use of EBPs/ESTs?
Three self-report measures were completed by 74 special youth care practitioners. The EBPQ was used to assess practitioners’ knowledge of, attitudes toward and use of the process of EBP influencing EBP uptake and implementation. With the EBPAS, practitioners’ attitudes toward manualized interventions were measured. Finally, a practitioner background questionnaire was developed to gather information about provider’s demographic characteristics, work setting, education, experience and use of ESTs.
In general it was found that few practitioner background variables were related to knowledge of and attitudes toward EBP and EST. The results of multivariate regression analysis showed that degree (t=3.24, p<.01) and gender (t=-2.03, p<.05) of the provider predicted the knowledge of EBP significantly. Next, years of work experience (t=1.84, p<.05) and age (t=1.73, p<.05) predicted the attitudes of practitioners toward EBP. No provider background variables were associated with their attitudes toward ESTs.
Concerning the relationship between providers’ knowledge of EBP and attitudes toward EBPs/ESTs, some positive associations were found. The attitudes of practitioners toward ESTs and EBPs appeared positively related (rs=.31, p<.01). The correlation between EBP attitudes and EBP knowledge was also significant but small (rs=.26, p<.05). There was no significant relation found between providers’ attitudes toward manualized interventions and knowledge of EBP.
Finally, some associations were found between providers’ knowledge of EBP and attitudes toward EBPs/ESTs and their use of it. Using multivariate linear regression analysis, providers’ knowledge of EBP (t=4.42, p<.01) predicted providers’ use of EBP, while attitudes toward EBP approached the significance cutoff (t=1.78, p=.08). Attitudes towards manualized programs and the use of ESTs did not significantly predict providers’ use of EBP.
With regard to the use of ESTs, no single variable predicted the use of manualized programs when entered simultaneously in the multivariate model. Nevertheless, the negative association between attitudes of practitioners toward EBP and their use of ESTs approached the significance cutoff (B=-.03, p=.08). The more positive practitioners are towards EBP, the less they use an EST in a high-fidelity way.
Together these findings confirm that enhancing the knowledge base of practitioners and positively influencing their attitudes toward EBP are two of the tracks for closing the gap between research and practice (Kazdin, 2008; Newnham & Page, 2010). On the other hand, the findings also demonstrate that in practice EBP and ESTs are barely related to each other. We believe that the debate would benefit from more attention to the broader picture of EBP, more specifically the relations between all concepts of EBP instead of an overly exclusive attention to ESTs (Barth et al., 2011; Lilienfeld et al., 2013).
Prevention and family intervention programs , Program evaluation and quality in child welfare
