Strengthening Evidence-Use In Practice: An Evidence-Informed Decision-Making Framework.

This framework is a decision-making or service-delivery framework to guide practitioners who work with parents and caregivers. It is based on an extensive review of evidence-based practice and what is known about effective processes of service delivery (Moore, 2016). Evidence-based practice has often been interpreted as the use of interventions that have been proven to be efficacious according to the most rigorous standards of evidence. However, there is now a consensus that evidence-based practice is broader than this, and involves the integration of three elements: best research evidence, clinical expertise and client values. Thus, selecting an effective intervention strategy is not simply a matter of choosing an intervention from a list of ‘proven’ strategies. Instead, one must take account of all contributing factors, including the outcome that is desired, the circumstances in which the intervention is to be implemented, and the values and preferences of those involved. Combining all these factors in the decision-making process is not a simple matter. Based on this analysis, what is needed is an evidence-informed decision-making framework that includes the following elements: • Services need to be aligned with family values, and address what the family sees as most important for them. • Practitioners need to be attuned and responsive to the views and circumstances of families, and engage them as partners. • There should be a purposeful process of joint decision-making in identifying goals to work on and choosing strategies to use. • Families should be offered a choice from a range of evidence-based strategies and program modules to address the goals that have been agreed. • The extent to which the service offered reflects these principles should be continuously monitored, and any deviation corrected promptly. This guide presents a decision-making framework that meets these criteria. This does not claim to be a totally original service framework, since it bears a ‘family resemblance’ to several other existing services delivery models. However, what it does provide is a way of understanding how the three elements of the broader understanding of evidence-informed practice can be reconciled in practice.