Barriers and Facilitators for the Implementation of a Concept to Promote Evidence-based Practice in Physiotherapy - A Mixed-methods Study

Background There is a need for theoretically and scientifically sound implementation strategies to promote evidence-based practice (EBP) in physiotherapy in Germany. It is necessary to identify and address context-specific determinants for implementation, when designing such strategies. To this end, the "science4practice " concept was developed; a concept designed to promote EBP in physiotherapy facilities.Aim To examine barriers and facilitators for the implementation of the "science4practice " concept.Methods In this mixed-methods study qualitative semi-structured interviews and a quantitative survey using an online and a paper-based questionnaire were conducted. Managing directors, physiotherapy practice leaders and physiotherapists without management responsibility were interviewed. Physiotherapists without management responsibility participated in the quantitative survey. Data of the interviews were analyzed using thematic content analysis. Data of the quantitative survey were analyzed descriptively.Results Fifteen interviews were conducted. A lack of skills in literature search and critical appraisal, negative experiences with change processes and insufficient access to scientific literature were identified as barriers. Support from supervisors and the availability of resources were identified as facilitating factors for the implementation of the concept. In total 47 physiotherapists without management responsibility participated in the survey. The results showed cumulative agreement values ( "fully agree " and "rather agree ") between 83 % and 91 % for the willingness to implement the "science4practice " concept. Integrating quantitative and qualitative results, the team's willingness to implement the concept was classified as a facilitator for implementation.Conclusions The study revealed barriers and facilitators from the perspective of participants with and without management responsibility. the results underline barriers identified nationally and internationally such as the lack of scientific competences or insufficient access to scientific literature. However, the results also point towards the potential of the concept as an implementation project for physiotherapy in Germany. In the next step, studies should be conducted to examine the concept's feasibility.