BACKGROUND. Increasing recognition of the failure to translate research fin
dings into practice has led to greater awareness of the importance of using
active dissemination and implementation strategies. Although there is a gr
owing body of research evidence about the effectiveness of different strate
gies, this is not easily accessible to policy makers and professionals.
OBJECTIVES. To identify, appraise, and synthesize systematic reviews of pro
fessional educational or quality assurance interventions to improve quality
of care.
RESEARCH DESIGN. An overview was made of systematic reviews of professional
behavior change interventions published between 1966 and 1998.
RESULTS. Forty-one reviews were identified covering a wide range of interve
ntions and behaviors. In general, passive approaches are generally ineffect
ive and unlikely to result in behavior change. Most other interventions are
effective under some circumstances; none are effective under all circumsta
nces. Promising approaches include educational outreach (for prescribing) a
nd reminders. Multifaceted interventions targeting different barriers to ch
ange are more likely to be effective than single interventions.
CONCLUSIONS. Although the current evidence base is incomplete, it provides
valuable insights into the likely effectiveness of different interventions.
Future quality improvement or educational activities should be informed by
the findings of systematic reviews of professional behavior change interve
ntions.