Comparative Standards of Evidence In Social Work

Comparative Standards of Evidence 1

Comparative Standards of Evidence in Social Work

ABSTRACT

This manuscript analyzes relevant and reliable evidence on the effects of the preferable

treatment customized to each client. In doing so, the authors look at four major standards of

evidence: (1) Evidence-based practice (EBP), (2) collaboration models (i.e., the Cochrane

Collaboration and the Campbell Collaboration), (3) knowledge translation (KT), and (4) the

Social Work Article Club (SWAC). The ultimate goal of these standards of evidence is to

successfully transfer research into practice. Currently, there is a gap between research and

practice as a result of a lack of collaboration. Most social workers do not possess the skills to

implement change into practice based on research evidence. The authors’ objective is to increase

understanding by instilling, in part, positive feelings towards research.

Key words: administration, Campbell Collaboration, Cochrane Collaboration, evidence-based

practice, knowledge translation, research, social work


Comparative Standards of Evidence in Social Work

Introduction

This manuscript analyzes relevant and reliable evidence on the effects of the preferable

treatment customized to each client. In doing so, the authors look at four major standards of

evidence: (1) Evidence-based practice (EBP), (2) collaboration models (i.e., the Cochrane

Collaboration and the Campbell Collaboration), (3) knowledge translation (KT), and (4) the

Social Work Article Club (SWAC). The ultimate goal of these standards of evidence is to

successfully transfer research into practice. Currently, there is a gap between research and

practice as a result of a lack of collaboration. Most social workers do not possess the skills to

implement change into practice based on research evidence. The authors’ objective is to increase

understanding by instilling, in part, positive feelings towards research.

Evidence-based practice (EBP) refers to the use of mental and behavioral interventions

for which thorough and methodical empirical research provides evidence of statistically

significant value as treatments for social problems. By and large, EBP involves meticulous

observation and thorough questioning (Gray, Plath, & Webb, 2009). Likewise, the two

collaboration models (i.e., the Cochrane Collaboration and the Campbell Collaboration) were

designed to bridge the gap between research and practice. The objective of the Cochrane

Collaboration is to assist people in making educated decisions about healthcare by preparing,

keeping, and supporting the openness of systematic reviews of the impacts of healthcare

interventions. The Campbell Collaboration helps people collaborate through open

communication, interdisciplinary support, removing bias, constant updating, disseminating

knowledge, and quality. Knowledge translation (KT) involves processes by which new

knowledge is put into action, whether in new practices, policies, or procedures. KT involves


three elements essential to the field of social work: knowledge transfer, knowledge exchange,

and research utilization. Lastly, the goal of the Social Work Article Club (SWAC) is to assist

social workers in fully understanding how to read and critically appraise research articles.

This analysis begins with a rationale for conducting this analysis. Then, it investigates, in

detail, the role of theory and empirical evidence in EBPs, its developmental phases, and its

systematic reviews. What comes subsequently is a description of the Cochrane Collaboration and

the Campbell Collaboration. This section is followed by a description of knowledge translation

(KT). The last standard of evidence examined by the authors is the Social Work Article Club

(SWAC). In this respect, five themes – comprehension, circulation, facilitating, implementation,

and surveillance – are enlightened as they represent basic processes required to initiate and

maintain a successful article club. The authors also demonstrate that SWAC has many

similarities with PARIHS, a theoretical framework that promotes actions on research

implementation in health services. This analysis ends with a discussion section that also offers

suggestions for future research.

Rationale for Conducting this Analysis

Professionals in social work are confronted with a choice of multiple treatments for a

diversity of patients. To properly ground this choice, social workers must seek relevant and

reliable evidence on the effects of the preferable treatment customized to each client. A broad

range of additional factors including the social workers’ experience, the patients’ preference, and

the availability of treatments alter the decision-making process. Critical to sound decision-

making are three factors: (1) the availability of appropriate empirically-based guidelines or

evidence based practice (EBP), (2) adequate training of the social worker in the critical

assessment of the available literature, and (3) an evaluation process that enables critical


assessment of the implementation of such guidelines or EBP. Informed decision-making is

desired for professionals in moments where time limits intensive research and investigation

(Strong, 2008). Ideally, the evidence to underpin this aspect of informed decision-making should

come from well conducted randomized trials – unless the interventions are so different that their

diverse effects would be obvious, even in the presence of the biases inherent in some other study

designs (Clarke, 2007). Each decision requires more than a single randomized trial. Generally,

social workers will need an up-to-date, well-conducted systematic review of randomized trials in

order to truly maximize effective decision-making (Clarke, 2007).

The fields in which human service is exercised are increasingly moving towards

empirically grounded intervention planning, which includes the assumption held by proponents

that further research utilization results in more efficient social services (Gibbs & Gambrill, 1999;

2002). Magill (2006) suggests that the primary model of research and practice integration, EBP,

continues to move further into the spotlight. The idea of practice being guided by relevant

knowledge on an identified condition is not only a potential time-and-cost-saving effort, but also

an ethical standard underemphasized by many practitioners (Gambrill, 2006). Advancing

accessible technologies and funding constraints addressed through managed accountability

systems will create a different field of social work than the one that exists today (Mullen &

Streiner, 2004).

The future of social work may not involve the flexibility that is present today (Mullen &

Steiner, 2004). Twenty years ago, systematic reviews were rare; now, there are thousands of

them – published countless journals (Clarke, 2007). Because of the vast quantity of research

conducted across the world, a critical eye must be adopted in order to find the evidence on

effects that will assist every social worker in making the best informed decision possible (Clarke,


2007). At present, there are databases, organizations, and professional journals devoted solely to

clinical intervention informed by research (Magill, 2006). Nonetheless, studies on knowledge use

in direct practice continue to suggest limitations in the consultation of external evidence

(Sheldon & Chilvers, 2002).

The role of research in the everyday decision making of the social worker is an issue still

under debate (Magill, 2006). Criticism of the research agenda is often located within larger

issues of legitimacy and efficiency (Karger 1983). Proponents of EBP align it with a more

standardized approach to human service delivery; the aim is to bring greater credibility,

accountability, and rigor to social work practice (Magill, 2006). The very definition of EBP

consists of assumptions which create controversy in the context of an ideology that emphasizes

the indefinable qualities of work (Rosen, 1994). The field of social work has to escape the

thinking of ideological concepts and move back and forth between the practical and the

ideological, with valuable feedback and participation from the consumer (Magill, 2006). The

next section will look at the role of theory and empirical evidence in EBPs.

The Value of Evidence-Based Practice (EBP)

Every vehicle of knowledge inherently contains natural limitations. To elevate the value

of one knowledge vehicle over another is to ignore the imperfections of any method in gathering

information. This understanding is not always evident in writings that continue to associate the

influence of scientific principles with superior knowledge-gathering methods. The term

“vehicle” refers to the method of transferring knowledge from one agent to another (Kogut &

Zander, 2003). An agent can be the researcher, practitioner, or the client (French & Bell, 1973).

The issue for debate is research, its differential methods, functions, and limitations, and the

development of a common framework for its utilization (Magill, 2006). This analysis places


great emphasis on evidence-based practice in social work. EBP refers to the use of mental and

behavioral interventions for which thorough and methodical empirical research provides

evidence of statistically significant value as treatments for social problems. On the whole, EBP

involves meticulous observation and thorough questioning (Gray et al., 2009).

EBP is best viewed in light of an awareness of the potentials and limits of science and the

function of each philosophical orientation within the knowledge pursuit. Because science is the

tool by which researchers discover information, often the knowledge retrieved from the scientific

discovery process exists within the same limitations that plague the very tool from which it is

derived. Limitations can generate through a range of issues depending on the topic, time limit,

financial resources, and inadequate methodologies – just to name a few. Therefore, many factors

are considered during the decision-making process. Influences may include religion, education

level, ideology, and expert opinions. The evidence-based practice approach stresses moving

beyond these factors to also consider the results of scientific studies (Petrosino et al., 2001). The

goal is to understand how these orientations function both uniquely and collectively in the

development of knowledge to steer direct practice.

Evidence-based practice rests on the reliance of the most recent and effective studies for

informing-decision makers. However, there is a bit of work to be done in reforming the process

of collecting the most recent scientific knowledge. The relevant evaluations are not tidily

reported in a single source that can be accessed easily (Petrosino et al., 2001). Additionally,

some studies are not even published and, consequently, are not included in the collection of

informative studies. Government reports, dissertations, master’s theses, and conference papers

constitute fugitive literature (Sechrest, White, & Brown, 1979). These forms of research are not

quickly usable when social workers need the most recent scientific evidence to assist in decision-


making. Proponents of EBP must not make the mistake of looking down on such fugitive

research. Value is frequently placed on the type, form, or vehicle of knowledge as if there existed

an unbiased database of knowledge by which practitioners access to make informed decisions.

Much high quality research is conducted by private research firms which offer incentives for

particular results, thereby falsifying the integrity of the study. Researchers in fugitive literature

do not have organizational incentives to publish in peer-reviewed journals, as professors or

university-based researchers do (Petrosino et al., 2001). Research must also make a more

concerted effort to reach across disciplines to increase the utility of the results in a real life

decision moment.

EBP describes a philosophy and process designed to forward effective use of professional

judgment in integrating information regarding each participant’s unique characteristics,

circumstances, preferences, and actions and external research findings (Gambrill, 2006). EBP is

a move from relying on one source to establishing a chain of information sharing. EBP

encourages researchers to seek a diversity of topics and disciplines (e.g., through RCT

[randomized controlled trial]) while encouraging the practitioner to evaluate the utility of a large

collection of knowledge to assist in making decisions (Otto, Polutta, & Ziegler, 2009). Some

may agree that EBP also encourages the combined efforts of the practitioner and researcher to

help develop an informed client participant. However, EBP still places high value on RCT

knowledge-gathering results while creating a hierarchical knowledge structure. The evidence is

coming from the top down. Social scientists conduct statistically-based experiments and create

mandates from the results for the local social worker. In social work, the practitioner is the

receiver of the knowledge (evidence) rather than a partner in the sharing of information. This gap

between research and practice is a result of a lack of collaboration. The local actors in the field of


social work are overlooked and forced to use a generalized best practice. The difficulty of

producing generalizable messages from evaluations undertaken in specific contexts emphasizes

the importance of assessing the local applicability of individual examples of the use of EBP

(Gray et al., 2009).

Developmental Phases of EBPs

The implementation of evidence-based practice in social work is subject to roughly three

preconditions. First, the conducted scientific evidence must be relevant to social work practice;

otherwise, it is meaningless and a waste of practitioners’ time to use it (Yunong & Fengzhi,

2009). Much thought is needed for the correct system needed for the convenient use of EBP in

the daily practice of social work. So, not only should the research be relevant but the method by

which the research is access must also be conducive to efficient and improved decision-making.

Secondly, social work practitioners should have adequate time and financial resources (Webb,

2001). Generally, acquiring research to utilize either in the field of social work is financially

taxing. The financial burden of using EBP in social work decision-making can be a large barrier

to preventing this vehicle of knowledge. If funding is not a possibility, then it is advantageous for

social services to integrate EBP implementation into the daily work routine, as much as it is

feasible, in small increments. This brings us to the last precondition where the benefits for using

evidence for social workers should outweigh or at least be equal to the costs of using it (Yunong

& Fengzhi, 2009). When a tool appears to be out of reach or unattainable, the natural human

response can sometimes downplay the importance of the utility of the tool.

Now that the three conditions have been met, let us examine the hierarchy of evidence.

An explicit assumption of EBP is that research can be placed into hierarchal order according to

quality of methodology and, implicitly, clinical utility (Magill, 2006). This system is unsuitable


to the needs of social work because of its alignment with the principles of the physical sciences

(Smith, 2002). Yet, how does one balance the needs of both scientific rigor and practice

applicability? EBP creates value-based levels to particular vehicles of knowledge. The EBP

hierarchy endorses designs deemed “gold standard” for guiding a range of practice concerns

including intervention choice (Magill, 2006). The underlining issues arise from the idea that

proponents behind EBP create “gold standards.” This gold standard is definitely subjective to

scientific inquiry over the practical experience by the practitioner. The EBP rankings prioritize

those that meet current standards for establishing internal validity such as randomization,

experimental control, treatment manualization, and sufficient follow-up (Reynolds, 2000).

These characteristics of rankings ignite objections from practitioners because they are

inherently subjective to a controlled research environment and not the actual day-to-day

uncontrolled settings. Practitioners are in the frontline, experiencing the most relevant issues

facing the field of social work. Effective utilization of the EBP framework will require

guidelines connecting a range of social work treatment questions with the appropriate

methodologies to address them (Magill, 2006). There are nuances in the daily service context of

social work that is misplaced in the implementation details of the randomly controlled trials in

EBP. As frontline workers, practitioners are in the position to engage in research that truly

captures the needs of the direct practitioner.

In a similar vein, practitioners are in the best position to involve the client as an

additional player in the goal to reach the best practice. EBP often bounces relevant knowledge

from the practitioner to the researcher, skipping the client who is actually receiving the service.

Researchers tend to be separated from the other two stakeholders (the practitioner and the client).

As a result, assumptions are created in the research results, which may not necessarily be the


correct practice. The distance between the researcher, practitioner, and the participant slows

down the efforts to collectively address complex social issues. Thus, without further

advancement in the empirical arena, social work will continue to borrow a large portion of its

knowledge for practice from other disciplines (Schinke, 1994). EBP’s efforts to overcome the

problems of the relevance of research in the daily practice of social work come in the form of

systematic reviews.

Systematic Reviews

There is a consensus, among EBP advocates, that systematic reviews are an important

tool (Davies, 1999). In systematic reviews, researchers attempt to gather evaluative studies,

critically appraise them, and come to judgments about what works using explicit, transparent,

and state-of-the-art- methods (Houser, 2007). Systematic reviews allow the generalizability and

consistency of research findings to be assessed and data inconsistencies to be explored. In

systematic reviews, details of every stage of the decision process with the questions that guided

the review and the methods used to search for reports are included. One can even find how

conclusions were reached with full analysis. Social scientists believe that the foremost advantage

of systematic reviews is that, when done well and with full integrity, they provide the most

reliable and comprehensive statement about what works (Petrosino et al., 2001).

In regards to subjective statements about reliability and integrity, in an attempt to make

research more accessible to practitioners, researchers are placing value on the dominance of the

scientific research methods over practical experience of the practitioner. What constitutes

“reliable integrity” and what constitutes “full integrity”? When a definition is reached for both

terms, how practical is it for researchers to operate under those conditions? Systematic reviews

have their usefulness. However, we must remain cautious of making any vehicle of knowledge


the supreme avenue of knowledge gathering. Systematic reviews do an adequate job at

rigorously applying methods which are employed to summarize, analyze, and combine study

findings. Two top collaborations exist to bridge the gap between research and practice: the

Cochrane Collaboration and the Campbell Collaboration.

Cochrane Collaboration

The Cochrane Collaboration was initiated by Archie Cochrane who persuasively wrote

about the need for practitioners to take scientific evidence into account in their practice (Higgins

& Green, 2008). Cochrane felt that randomized trials had proven to be effective in the daily

practice. The objective of the Cochrane Collaboration is to assist people in making educated

decisions about healthcare by preparing, keeping, and supporting the openness of systematic

reviews of the impacts of healthcare interventions. The Cochrane Collaboration has organized

thousands of research reports for the use of identifying the best practice according to the results

of studies conducted. It has also addressed some challenges to using systematic reviews in

evidence-based practice. The Cochrane Collaboration contributed to the furthering of the

systematic reviewing process, making it more usable in daily decision-making. Empirical studies

have reported that Cochrane syntheses are more rigorous than non-Cochrane systematic reviews

and meta-analyses published in medical journals (Trinder & Reynolds, 2000).

By requiring detailed protocols, the Cochrane Collaboration addresses the lack of

transparency in most systematic reviews of research (Petrosino et al., 2001). The most

impressive aspect of the Cochrane Collaboration is the quick research updates due in part to

electronic publishing, where dissemination is quick. The Cochrane Collaboration updates any

outdated research that has been disproved through new evidence. Most Cochrane reviews are

produced by multidisciplinary teams that bring the perspectives and expertise of different


stakeholders to the review process. The Cochrane Collaboration strives to make high-quality

evidence accessible around the globe (Bero & Rennie, 1995). Its effectiveness does not stand

alone but owes some credit to knowledge translation. The Cochrane Collaboration is the

repository for evidence while the knowledge translation is the implementation of the

information. In that regard, EBP gives the evidence of what works best while the knowledge

translations are the tools to implement and accurately interpret the evidence.

Within the Cochrane Collaboration, options allow for a stakeholder to undertake

systematic reviews of the effects of knowledge translation activities, including professional

interventions (continuing education), organizational interventions (professional substitution),

financial interventions (reimbursement adjustments), and regulatory interventions (Effective

Practice and Organization of Care Group, 2006). Knowledge translation removes more hidden

information in research to the hands of the practitioners. The term “hidden” refers to the

information not known by each stakeholder collectively. Furthermore, hidden knowledge refers

to the information exclusively known to one stakeholder and not the others. This is evident in the

one stakeholder overlooked in knowledge translation: the client. Nonetheless, knowledge

translation creates a flexible system that may be able to adjust to informing not only the

practitioner but the client as well. Knowledge translation should be informed by the totality of

relevant research evidence. The total evidence creates a flexible choice selection and

implementation strategy for both practitioners and clients (Rycroft-Malone & Bucknall, 2010).

Campbell Collaboration

A number of individuals across different fields and professions organized the Campbell

Collaboration to address the gap between research and practice. The first three Campbell

Collaborations were created to facilitate systematic reviews in their areas: education, social


welfare, and crime and justice (Littell, Corcoran, & Pillai, 2008). Campbell was founded on

similar principles to the Cochrane: collaborating through open communication, interdisciplinary

support, removing bias, constant updating, disseminating knowledge, and quality. The Campbell

Collaboration Methods Group was developed to increase the precision of Campbell reviews by

evaluating the role of methodological and statistical procedures used in systematic reviews, as

well as characteristics in original studies (Boruch, Soydan, & de Moya, 2004).

A decade ago, the Campbell Collaboration was in the process of securing funding to

develop a Campbell Center for Mediterranean nations where their objectives included facilitating

reviews through training, indentifying end users and collaborators, and promoting dissemination

and utilization (Petrosino et al., 2001). Today, the Campbell Collaboration is attempting to reach

the level of Cochrane through rigorous quality control and protocols. Maintaining reviews,

taking into account evidence worldwide, and preparing reviews using the best science available

should enhance the use of Campbell reviews (Testa & Poertner, 2010).

Knowledge Translation

Knowledge translation (KT) involves processes by which new knowledge is put into

action, whether in new practices, policies, or procedures (Leahey & Svavarsdottir, 2009). KT is

an ever-evolving term which is understood by some to stand for a dynamic and iterative process

that includes synthesis, dissemination, exchange and ethically-sound application of knowledge to

improve the health of clients (Canadian Institute of Health Research, 2005). KT requires a fair

amount of concentration on knowledge, research, process, and variety of key factors. The

emergence of the KT concept has roots in an interdisciplinary mix of theories and methods with

the task of making clinical processes more effective (Kitson & Bisby, 2008). Three elements of

KT are essential to the field of social work. First, knowledge transfer is the systematic approach


to encapsulating, gathering, and transmitting tacit knowledge in order for it to become explicit

knowledge. Second, knowledge exchange centers on collaborative problem-solving among

participants such as researchers and social workers or administrators through linkage and

exchange. Third, research utilization is used to describe the process by which specific science is

implemented in practice (Leahey & Svavarsdottir, 2009).

There is a distinct difference between the adoption of research and the dissemination of

research. While adoption of research refers to implementation, dissemination is characterized as

the spreading of knowledge through scientific journals and conferences (Graham et al., 2006).

Outlining the knowledge creation cycle and the action cycle for implementation is helpful for

social workers who desire to spread human services knowledge into clinical practice. Graham et

al. (2006) suggest that the knowledge creation cycle consists of inquiry, synthesis, and the

development of knowledge tools or products. The knowledge cycle is a streaming process where

each phase allows for the knowledge producers to customize their activities to the needs of

potential users (Straus, Tetroe, & Graham, 2009). The action cycle precedes and often leads to

implementation. Examples of activities included in the action phase are identifying a problem

that needs addressing, selecting knowledge or research findings relevant to the problem, adapting

identified findings to local context, assessing barriers to using knowledge, tailoring and

implementing the change to use the knowledge, tailoring and implementing the change to use the

knowledge, monitoring and evaluating outcomes, and sustaining ongoing knowledge use. The

knowledge and action cycle diagrams the relationships between practice and knowledge

translation (Leahey & Svavarsdottir, 2009).

This relationship between practice and research must be valued because the “fund and

forget” approach leading to “all breakthrough and no follow through” (Woolf, 2006, p. B3) in


evidence-based practice needs to end. The aim of KT should entail the locating of practical

solutions and the eliminating of barriers from evidence based practices (Leahey & Svavarsdottir,

2009). Ideally, KT is for the research focus to be intertwined with the client’s specific needs and

created collaboratively by the social workers, administrators, clients, managers, and researchers.

Having the results implemented directly into practice through integrated management structures,

processes, and procedures would bridge the two solitudes (Kitson & Bisby, 2008). What follows

is the use of Social Work Article Clubs in the field of social work.

Social Work Article Clubs

One way of increasing the influence of research in the decision of social workers is to

immerse the study of research within the duty of the social worker. The knowledge obtained

from research will not consume the practical expertise of the social worker, but it will

complement the existing skills acquired through experience. This concept can occur through an

organizational program called the Social Work Article Club (SWAC). The idea of a journal club

was suggested by Julia Rogers (2009). The SWAC offers incentives to practitioners who become

members. Like nursing journal clubs, the SWAC will focus on improving the decision-making of

social workers. Participation in SWACs may increase research knowledge, dissemination of the

knowledge, and the implementation of evidence into practice. SWACs extend the reach of the

practitioner both in the direction of the researcher and the client. Five major themes emerge:

comprehension, circulation, facilitating, implementation, and surveillance. These five themes

represent basic processes that are needed to initiate and maintain a successful article club.

Comprehension

A comprehension of how to read the literature is crucial. As Montgomery et al. (2001)

put it, a “lack of awareness of current research results represents a loss of potential for improving


patient care” (p.126). The aim of social work should be to increase the practitioner’s skills

regarding critiquing and evaluating research. The workload and time constraints on practitioners

cause the attitudes towards research and development to be substandard. A program such as

SWAC can assist social work professionals in fully understanding how to read and critically

appraise research articles. Practitioners’ approaches to research utilization and implementation

should concentrate on critiquing research articles and implementing research into practice

(Karkos & Peters, 2006). Participants will improve their ability to generate questions that are

meaningful to practice and to perform research in a rigorous manner when necessary (Milne,

Krishnasamy, Johnston, & Aranda, 2007).

Comparable to nursing journal clubs, SWAC’s fundamental goal is to critically appraise

research (Rajpal, Resnick, & Baskaya, 2007). There is an urgent need to provide social workers

with the necessary skills and knowledge to locate, appraise, and implement research knowledge

with a close intertwining of practical experience. Improving attitudes towards research must be

an initiative of the SWAC. Social workers need to feel confident about implementing change

based on research findings, as well as having positive feelings about connecting experience with

evidence. The SWAC is an intervention that allows participants to have a better perception of the

patterns of random trial research. Thanks to this, increased understanding should be accompanied

by positive feelings towards research. Social workers who participate in research activities such

as the SWAC are more accustomed to use research evidence in practice because of the increased

confidence in understanding research (Fink, Thompson, & Bonnes, 2005).

Circulation

If SWACs have a high participation rate, they will allow for greater dissemination of

research information. Online SWAC clubs may even open the possibility of interconnecting


social work offices in different cities. Information will become easily accessible and exchanged

through the process of posting journal articles over the internet. Authors can also discuss

circulation of evidence through dissemination of research knowledge (Rajpal et al., 2007). Rajpal

et al. (2007) explained the positive impact on dissemination of research knowledge through the

assistance of journal club meetings. The meetings allotted time to circulate ideas about changing

services based on the evidence presented. Thompson, Esabrooks, & Degner (2006) found that

“interpersonal contact may play a pivotal role in knowledge diffusion and utilization” (p. 692).

Implementation

Social workers can augment client outcomes by improving client care and staff

development through implementation of EBPs. The studies revealed that positive effects can

occur from participating in a small-group interactive educational activity (Grol & Grimshaw,

2003). Change is a result of a well-designed intervention. Social workers should feel capable of

changing ineffective practice through reading journals that provide new research findings that

affect their decision-making. Most social workers have a lack of knowledge of how to implement

change into practice based on research evidence. Therefore, SWAC will provide the bridge

between research and practice through promoting research in the frontline of service delivery.

Facilitation

Facilitation is a goal-oriented dynamic process in which participants work together in an

atmosphere of genuine mutual respect in order to learn through critical reflection. Here, the role

of the facilitator is to work with groups of people toward change (Rogers, 2009). The person

leading the SWAC needs to be familiar with how to conduct a literature search, critique an

article, and be familiar with policies and procedures in the facility. The leader should be a

member of the organization to ensure that he or she earns the trust of the staff and becomes


capable to implement new ideas. Inferior research awareness could be remedied by proper

facilitation and role modeling (Camiah, 1997). The leading practitioners in facilitating research

awareness can act as role models (Jolly, 2002). Managing social work practitioners will be able

to provide useful resources of information, and frontline workers will trust the advice provided

by the leading practitioners (Thompson et al., 2006).

Key players to the information sharing are the leading practitioners. However,

organizational support is also crucial in facilitating research dissemination and implementation.

It was noted within the study conducted by Fink et al. (2005) that a barrier to research utilization

is the organizational culture. Encouraging and supporting social work practitioners to use

research can assist in advancing the field of social work and enhance the quality and efficiency

of service provided. To initiate interest in social work, offices can conduct monthly research

study groups to cultivate interest in research knowledge. The social workers in the role of

facilitator need advanced experience in translation, synthesizing, and contextualizing research for

a variety of users. Facilitators also need to have strong communication skills, networks, and

credibility within their own organization and to be involved in linking users and creators of

knowledge (Thompson et al., 2006). The lead social work practitioner seems to be the key

element in facilitating a successful SWAC. The research-focused practitioner acts as a liaison

between the two fundamental elements of facilitation, the frontline social work staff,

administration, participant and the researcher.

Surveillance

After implementing new procedures and improved practice routines as a result of SWAC,

there must be a reporting system to surveil the effect of the new treatment from all stakeholders’

perspectives. A monthly report-card listing of the new procedures and practice objectives under


surveillance is a result of SWAC to all stakeholders. Stakeholders include the practitioner, client,

and frontline social worker. The researcher will collect all results and use the data to initiate

innovative research in the field of social work. Client respondents should be chosen at random to

either receive a card by post or email. This feedback process between the client, researcher, and

the practitioner should answer questions about the effectiveness and optimal time for treatment.

This feedback will shed light into the perspective of the client, opening all available treatment

options needed to create effective change in the field of social work. In addition, the

respondent’s views about the surveillance process should be obtained to continually critique the

process and to assure that the procedures are improving the field of social work while utilizing

EBP. Adopting an electronic reporting system will increase the response speed of all

stakeholders. This feedback mechanism allows every stakeholder to more accurately interpret the

other stakeholders’ intentions and perspectives (Vandiver, 2008).

Similarities between SWAC and PARIHS

The five processes identified - comprehension, circulation, facilitating, implementation,

and surveillance – have similarities to the healthcare-based Promoting Action on Research

Implementation in Health Service (PARIHS) framework with an addition of surveillance. The

framework, initially developed by Kitson et al. (2008), and revised by Rycroft-Malone et al.

(2002), has three elements essential to successful implementation of evidence into practice. The

three elements of PARIHS framework are context, evidence, and facilitation. Context is used to

refer to the environment or setting in which the proposed change is to be implemented (Rogers,

2009). This fits with SWAC’s themes of circulation and implementation. Evidence is

scientifically robust and matches professional consensus and patient needs; the concept that

coincides with this element is the concept of understanding. Facilitation is a technique by which


one person makes things easier for others (Rogers, 2009). In EBP, this is thought to promote

individual and organizational change (Rycroft-Malone et al., 2002). This links with the theme of

facilitation. Research-focused practitioners can use the PARHIS framework with an addition of

surveillance as the platform on which to build bridge-linking research to practice.

To further understand how SWAC bridges the research-to-practice gap, this analysis has

adopted a model for visual interpretation (Figure 1), as proposed by Rogers (2009).

Figure 1: BRIDGE model

BRIDGE stands for “Bringing Research into Diverse Groups Effectively.” Its foundation

to bring research into practice is akin to the PARIHS theoretical framework. The three constructs

of the framework – context, evidence, and facilitation – support the structure of the bridge. The

model begins with individual expertise, evidence, and patient experiences as a representation of

three important roads leading to bridging the gap between research and practice. The bridge


starts with research, and a SWAC is formed to create a change in practice through utilization of

the five processes illuminated in this analysis: understanding, circulation, implementation,

facilitation, and surveillance. Once the research has been implemented into practice, the road is

filled with improved patient outcomes, social worker excellence, and EBP. The model illustrates

how SWACs have the capability of transitioning research findings into best practices. Research

conducted by social work practitioners, disseminated to broad populations of social service

providers, and then used by frontline social workers who provide direct service to participants,

represents the ideal triad of research-based practice. Frontline social workers with increased

awareness in research are more apt to apply research findings into practice.

Discussion and Future Directions

What this manuscript has demonstrated is that, presently, the gap between research and

practice is a result of a lack of collaboration. Most social workers lack knowledge of how to

implement change into practice based on research evidence. For this reason, the four standards of

evidence presented by the authors offer a better perception of the patterns of random trial

research. Thanks to this, increased understanding can be accompanied by positive feelings

towards research. Social Work Article Clubs (SWACs), for example, improve research

understanding, increase the circulation of research knowledge, promote practice change, and

require facilitators who are leaders, role models, and change agents to overcome the innate

ability lacking to implement the evidence into practice. Now, more than likely, social workers

who participate in research activities such as the SWAC are more accustomed to use research

evidence in practice because of the increased confidence in understanding research (Fink,

Thompson, & Bonnes, 2005).


The history of debate on the role of science in direct practice has fostered a number of

positive developments en route to integration. Although a wealth of resources exists in terms of

effectiveness models of practice decision-making, there is much ground to be covered in the field

of social work in closing the research-practice gap. According to Milne et al. (2007),

practitioners became more confident in using EBP in the delivery of care after they received

appropriate education on how to appropriately disseminate research findings. Although not many

studies have focused on the importance of research study for the social work practitioner, further

experimentation will prove that there is a significant link between research attitudes in

practitioners and understanding the processes of research utilization. Social work practitioners

have only to benefit from an increase exposure to research knowledge. The exposure of the

practitioner will filter down to the benefit of the clients who receive services, creating a belt of

research knowledge recycling.

By the same token, the authors’ evaluation of SWACs advances the scope of practical

implications in the implementation process. Very little has been written on the implementation

and integration of research in the field of social work. This analysis advances social work

practitioners’ knowledge by showing that successful SWAC ascertain five processes:

understanding, circulation, facilitation, implementation, and surveillance. It is evident that the

research focused practitioners’ role is critical in each of these processes. As we have seen, the

five processes identified have similarities to the health field Promoting Action on Research

Implementation in Health Service (PARIHS) framework with an addition of surveillance. The

framework, initially developed by Kitson et al. (2008), and revised by Rycroft-Malone et al.

(2002), has three key elements essential to successful implementation of evidence into practice.


In line with these contentions, evidence-based practice (EBP) encourages examination of

social services delivery routines and, when justified, allows implementation of new practices that

are grounded in scientific research. Too, EBP should encourage innovate strategies in including

the client in the research discovery and process. To implement change, social workers must first

know the basics of research utilization. To make research utilization possible, social workers in

all public services must be educationally prepared on how to locate research findings. Rewards

of collaboration models such as the Cochrane Collaboration and the Campbell Collaboration

include increased passion about research and excitement about what is happening in the field of

social work. There is a need in social work to continuously improve the quality of social service

delivery. The challenge is to find ways to overcome the barriers through utilization of innovative

mediums. Exploration into collaboration models and other avenues to increase research

utilization, dissemination of knowledge, and implementation of research into practice is

warranted. Social workers need to increase their awareness of research to improve current

practices, stimulate professionalism, and increase the quality of service delivery, all of which can

be accomplished with a well-designed standard of evidence.

For future research, it might prove interesting to include a more developed decisional

framework, but one that is informed by the practitioner and client alike. Very little is known

about the benefit of the client’s informed input in decisions made in naturalistic social work

settings. It is the role of practitioners to further our notions of practical decision making through

operationalized decisional models and case analyses of applied standards of evidence (e.g.,

EBP). Likewise, we still have to approach the question as to how the Campbell addresses the

client who is also a stakeholder in the decision-making process. Campbell is a non-health

reflection of the Cochrane Collaboration. Although great contributions can be made by both


types of Collaboration, much help is needed in creating a tighter link between the researcher,

practitioner and the client.

Finally, empirical research studies need to be conducted on SWAC accomplishments

including implementation of the evidence into the daily practice of social service delivery.

Research-focused practitioners must be vigilant in conducting research that uncovers the most

advantageous methods used to bridge the research-to-practice gap. Future research could be

conducted on specific constructs of the framework. Research must also be incorporated into

social work programs across the world for future practitioners to understand, appreciate, use, and

implement research. In like fashion, much work is needed to increase the awareness of how

useful it is to include the client in the circle of knowledge transportation in the field of social

work. One way to begin this inclusion of the client is through SWAC. The PARIHS framework

along with the BRIDGE model can be used to initiate or transform a SWAC. Surveillance

expands the utility of the BRIDGE model to including the client and receiving immediate

feedback from all stakeholders.


References

Bero, L, & Rennie D. (1995). The Cochrane Collaboration. Preparing, maintaining, and

disseminating systematic reviews of the effects of health care. JAMA: The Journal of the

American Medical Association, 274(24), 1935-1938.

Boruch, R., Soydan, H., & de Moya, D. (2004). The Campbell Collaboration. Brief Treatment

and Crisis Intervention, 4, 277-287.

Camiah, S. (1997). Utilization of nursing research in practice and application strategies to raise

research awareness amongst nurse practitioners: A model for success. Journal of

Advanced Nursing, 26, 1193-1202.

Canadian Institute of Health Research (2005). About knowledge translation. Retrieved March 26,

2009, from www.cihr-irsc.gc.ca/e/29418.html

Clarke, M. (2007). The Cochrane Collaboration and systematic review. British Journal of

Surgery, 94, 391-392.

Davies, P. (1999). What is evidence-based education? British Journal of Educational Studies, 47,

108-121.

Effective Practice and Organization of Care Group (2005). Retrieved January 8, 2006 from

http://www.epoc.uottawa.ca.

Fink, R., Thompson, C. J., & Bonnes, D. (2005). Overcoming barriers and promoting the use of

research in practice. Journal of Nursing Administration, 35(3), 121-129.

French, W. L., & Bell, C. H. (1973). Organization development: Behavioral science

interventions for organization improvement. Englewood Cliffs, NJ: Prentice-Hall.

Gambrill, E. D. (2006). Critical thinking in clinical practice: Improving the quality of judgments

and decisions. New York: Wiley.

http://www.cihr-irsc.gc.ca/e/29418.html

http://www.epoc.uottawa.ca/


Gibbs, L., & Gambrill, E. D. (1999). Critically thinking for social workers: Exercises for the

helping professions. Thousand Oaks, CA: Pine Forge Press.

Gibbs, L., & Gambrill, E. D. (2002). Evidence-based practice: Counterarguments to objections.

Research on Social Work Practice, 12(3), 452-476.

Graham, I. D., Logan, J., Harrison, M. B., Stratus, S. E., Tetroe, J., Caswell, W., & Robinson, N.

(2006). Lost in knowledge translation: Time for a map? Journal of Continuing Education

in the Health Professions, 26, 13-24.

Gray, M., Plath, D., & Webb, S. A. (2009). Evidence-based social work: A critical stance. New

York: Routledge.

Grol, R., & Grimshaw J. (2003). From best evidence to best practice: effective implementation

of change in patients care. Lancet, 362, 1225-1230.

Higgins, J. P. T., & Green, S. (2008). Cochrane handbook for systematic reviews of

interventions. New York: Wiley.

Houser, J. (2007). Nursing research: Reading, using, and creating evidence. Boston: Jones &

Bartlett Publishers.

Howe, D. (1994). Modernity, postmodernity and social work. British Journal of Social Work,

24(5), 513-532.

Jolly, S. (2002). Raising research awareness: A strategy for nurses. Nursing Standard, 16(33),

33-39.

Karger, H. J. (1983). Science, research, and social work: Who controls the profession? Social

Work, 28(3), 200-205.

Karkos, B., & Peters, K. (2006). A magnet community hospital: fewer barriers to nursing

research utilization. Journal of Nursing Administration, 36, 377-382.


Kitson, A., & Bisby, M. (2008). Speeding up the spread: Putting KT research into practice and

developing an integrated KT collaborative research agenda. Alberta, Canada: Alberta

Heritage Foundation for Medical Research.

Kitson, A., Rycroft-Malone, J., Harvey, G., McCormack, B., Seers, K., & Titchen, A. (2008).

Evaluating the successful implementation of evidence into practice using the PARIHS

framework: Theoretical and practical challenges. Implementation Science, 3(1).

Kogut, B., & Zander, U. (2003). Knowledge of the firm and the evolutionary theory of the

multinational corporation. Journal of International Business Studies, 34(6), 516-529.

Leahey, M., & Svavarsdottir, E. K. (2009). Implementing family nursing: How do we translate

knowledge into clinical practice? Journal of Family Nursing, 15(4), 445-460.

Littell, J. H., Corcoran, J., & Pillai, V. (2008). Systematic reviews and meta-analysis. Oxford:

Oxford University Press.

Magill, M. (2006). The future of evidence-based practice. Journal of Social Work, 6(2), 101-115.

Milne, D. J., Krishnasamy, M., Johnston, L., & Aranda, S. (2007) Promoting evidence-based

care through a clinical fellowship program. Journal of Clinical Nursing, 16(9), 1629-

1639.

Montgomery, K. S., Eddy, N. L., Jackson, E., Nelson, E., Reed, K., Stark, T. L., & Thomsen, C.

(2001). Global research dissemination and utilization: Recommendations for nurses and

nurse educators. Nursing and Health Care Perspectives, 22(3), 124-129.

Mullen, E. J., & Streiner, D. L. (2004). The evidence for and against evidence-based practice.

Brief Treatment and Crisis Intervention, 4(2), 111-121.

Otto, H. U., Polutta, A., & Ziegler, H. (2009). Evidence-based practice: Modernising the

knowledge base of social work? Farmington Hills, MI: Barbara Budrich.


Petrosino, A., Boruch, R., Soydan, H., Duggan, L., & Sanchez-Meca, J. (2001). Meeting the

challenges of evidence-based policy: The Campbell Collaboration. Annals of the

American Academy of Political and Social Science, 578, 14-34.

Rajpal, S., Resnick, D. K., & Baskaya, M. K. (2007). The role of the journal club in

neurosurgical training. Neurosurgery, 61(2), 397-403.

Reynolds, S. (2000). Evidence-based practice and psychotherapy research. Journal of Mental

Health, 9(3), 257-266.

Rogers, J. L. (2009). Transferring research into practice: An integrative review. Clinical Nurse

Specialist, 23(4), 192-199.

Rosen, A. (1994). Knowledge use in direct practice. Social Service Review, 68(4), 560-577.

Rycroft-Malone, J., & Bucknall, T. (2010). Models and frameworks for implementing evidence-

based practice: Linking evidence to action. New York: Blackwell.

Rycroft-Malone, J., Kitson, A., Harvey, G., McCormack, B., Seers, K., Titchen, A., &

Estabrooks, C. (2002). Ingredients for change: Revisiting a conceptual framework.

Quality and Safety in Health Care, 11, 174-180.

Schinke, S. P. (1994). Are some research methodologies inherently more worthy of professional

endorsement than others? In W. H. Hudson & P. S. Nurios (Eds.), Controversial issues in

social work research (pp. 225-229). Boston: Allyn & Bacon.

Sechrest, L., White, S. O., & Brown, E. D. (1979). The rehabilitation of criminal offenders:

Problems and prospects. Washington, D.C.: National Academy of Sciences.

Sheldon, B., & Chilvers, R. (2002). An empirical study of the obstacles to evidence-based

practice. Social Work and Social Sciences Review, 10(1), 2-26.


Smith, D. (2002). The limits of positivism revisited. Social Work and Social Sciences Review,

10(1), 27-37.

Straus, S., Tetroe, J., & Graham, I. D. (2009). Knowledge translation in health care: Moving

from evidence to practice. New York: Wiley-Blackwell.

Strong, R. A. (2008). Portfolio construction, management, and protection. Chula Vista, CA:

South-Western College Publishing.

Testa, M. F., & Poertner, J. (2010). Fostering accountability: Using evidence to guide and

improve child welfare policy. Oxford: Oxford University Press.

Thompson, G. N., Esabrooks, C. A., & Degner, L. F. (2006). Clarifying the concepts in

knowledge transfer: A literature review. Journal of Advanced Nursing, 53, 691-701.

Trinder, L., & Reynolds, S. (2000). Evidence-based practice: A critical appraisal. New York:

Wiley-Blackwell.

Vandiver, V. L. (2008). Integrating health promotion and mental health: An introduction to

policies, principles, and practices. Oxford: Oxford University Press.

Webb, S. A. (2001). Some considerations on the validity of evidence-based practice in social

work. British Journal of Social Work, 31, 57-79.

Woolf, S. H. (2006, January 8). Unhealthy medicine: All breakthrough and now follow through.

Washington Post, p. B3.

Yunong, H., & Fengzhi, M. (2009). A reflection on reasons, preconditions, and effects of

implementing evidence-based practice in social work. National Association for Social

Workers, 2(54), 177-181.

Documents

Comparative Standards of Evidence In Social Work