Factors affecting the utilization of systematic reviews - A study of public health decision makers

Objective: To determine the extent to which public health decision makers u sed five systematic reviews to make policy decisions, and to determine whic h characteristics predict their use. Methods: This cross-sectional follow-up study of public health decision mak ers in Ontario collected primary data using a telephone survey and a short, self-administered organizational demographics questionnaire completed by t he administrative assistant for each Medical Officer of Health. Independent variables included characteristics of the innovation, organization, enviro nment, and individual. Data were entered into a computerized database devel oped specifically for this study, and multiple logistic regression analysis was conducted. Results: The participation rate was very high, with 85% of public health un its and 96% of available decision makers completing the survey. In addition , 63% of respondents stated they had used at least one of the systematic re views in the previous 2 years to make a decision. The most important predic tors of use were one's position, expecting to use a review in the future, a nd perceptions that the reviews were easy to use and that they overcame the barrier of limited critical appraisal skills. Conclusions: Utilization of the systematic reviews in Ontario was very high . The utilization rates found in this study were significantly higher than those reported in previous utilization studies. One's position was found to be the strongest predictor of use, identifying program managers and direct ors as the most appropriate audience for systematic reviews.