DISSEMINATION OF EFFECTIVENESS AND OUTCOMES RESEARCH

Effectiveness and outcomes research seeks to improve patients' health outcomes by improving the quality of the health care they receive. Dis semination of the findings of such research is a necessary step in tha t process. This paper reviews what is known about designing and dissem inating effective information packages aimed at health care providers (mainly physicians), where effectiveness means promoting behavior chan ge on the part of practitioners that leads to better patient care. Pra ctice-relevant research information is delivered to providers through publication of results from randomized clinical trials, dissemination of consensus recommendations, development and use of computer-based ai ds to clinical decision making, and provision of continuing medical ed ucation. Each of these areas offers numerous examples of the exceeding ly modest behavioral response that can be expected from the mere provi sion of information. The literature also offers some principles that m ay improve the chances for success, including the desirability of tech niques that involve face-to-lace interaction, promoting the active inv olvement of the learner, repeating the message, making recommendations explicit and relevant to clinical practice, and making use of opinion leaders and peer influence. Little basic research has been done on pr oviders' motivations and actual decision-making processes. Research ai med at furthering a behavioral science of providers could yield new in sights on effective dissemination strategies as well.