International Journal of Technology Assessment in Health Care


(A Study of Public Health Decision Makers)

Maureen Dobbins a1 1 , Rhonda Cockerill a2 and Jan Barnsley a2
a1 McMaster University
a2 University of Toronto


Objective: To determine the extent to which public health decision makers used five systematic reviews to make policy decisions, and to determine which characteristics predict their use.

Methods: This cross-sectional follow-up study of public health decision makers in Ontario collected primary data using a telephone survey and a short, self-administered organizational demographics questionnaire completed by the administrative assistant for each Medical Officer of Health. Independent variables included characteristics of the innovation, organization, environment, and individual. Data were entered into a computerized database developed specifically for this study, and multiple logistic regression analysis was conducted.

Results: The participation rate was very high, with 85% of public health units and 96% of available decision makers completing the survey. In addition, 63% of respondents stated they had used at least one of the systematic reviews in the previous 2 years to make a decision. The most important predictors of use were one's position, expecting to use a review in the future, and 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 directors as the most appropriate audience for systematic reviews.

Key Words: Evidence-based practice; Diffusion of innovations; Evidence-based decision making; Public health.


1 This research was made possible by Health Canada through a National Health Research and Development Program (NHRDP) Research Training Award, the Central East Health Information Partnership (CEHIP), and the Hamilton-Wentworth Regional Department of Public Health Services.