Grant: Operating Grant

Practice guidelines (PGs) are systematically developed statements intended to assist patient, practitioner, and policy decisions; they are a tool to facilitate best care and system performance. AGREE II is the new international gold standard for PG development, reporting, and evaluation. Interventions are needed to promote the use of the AGREE II. AGREE II focuses on methodological issues relevant to guideline development and reporting. However, there are no known reliable and valid strategies to evaluate the clinical appropriateness of PGs, another important component to their adoption. This proposal is comprised of two research units each aimed to advance the PG scientific enterprise and facilitate the application of PGs to improve quality of care. The objectives of AGREE Application and Action are to develop, execute, and evaluate the impact of two Web-based educational interventions designed to accelerate the capacity of stakeholders to use the AGREE II: i) an on-line interactive AGREE II training tool with a practice component (OR with practice activities) and ii) an on-line training Web site with a virtual coach. Learners' performance, satisfaction, self-efficacy, mental effort, and time-on-task will be measured and compared across groups. The objectives of AGREE Appropriateness and Action, are to design, test, and refine a measure of PG clinical appropriateness to serve as a companion tool to the AGREE II. The role of the tool will be to influence development of PGs, reporting of PGs, and evaluation of PGs. Using accepted health measurement methodology, a draft instrument will be tested by relevant stakeholders and data will be collected to evaluate if the instrument is reliable, valid, and useful. Together, this research will enhance the value of PGs as useful tools to improve health and healthcare systems.