Decision-to-Implement Worksheet for Evidence-based Interventions: From the WWAMI Region Practice and Research Network

J Am Board Fam Med. 2016 Sep-Oct;29(5):553-62. doi: 10.3122/jabfm.2016.05.150327.


Background: Health-related scientific discoveries are often not applied in clinical settings after publication, even when recommended by a trusted journal or professional association. This article describes an assessment tool we developed for use by primary care clinicians and practice administrators to evaluate whether to implement recommended evidence-based interventions in their practices.

Methods: We used dissemination and implementation theory to develop a worksheet to guide decision making about whether interventions are suitable for implementation in primary care practice settings. We tested the tool by analyzing how members of a primary care practice-based research network rated 4 evidence-based interventions.

Results: The median likelihood of implementation ranged from 2 to 3.5 on a scale of 1 (low) to 5 (high). Raters' level of agreement with statements about 3 intervention characteristics was associated (P < .05) with a higher likelihood of implementation using Spearman rank-order correlation: simple to implement, testable before fully implementing, and modifiable to meet the needs of the practice. Raters found the worksheet helpful in thinking through potential implementation, especially the prompts about modifiability and relevance to the practice's patients and priorities.

Conclusions: The Decision-to-Implement Worksheet provides a new resource for primary care practices that want to assess whether evidence-based interventions are suitable to adopt or adapt to meet their needs.

Keywords: Decision Making; Evidence-Based Medicine; Practice-based Research; Primary Health Care; Translational Medical Research.

MeSH terms

  • Clinical Decision-Making*
  • Evidence-Based Medicine / organization & administration*
  • Evidence-Based Medicine / standards
  • Health Services Research / organization & administration*
  • Health Services Research / standards
  • Humans
  • Models, Organizational
  • Practice Guidelines as Topic
  • Primary Health Care / organization & administration*
  • Primary Health Care / standards
  • Process Assessment, Health Care / methods*
  • Process Assessment, Health Care / organization & administration
  • Process Assessment, Health Care / standards