Are multifaceted interventions more effective than single-component interventions in changing health-care professionals’ behaviours? An overview of systematic reviews

BackgroundOne of the greatest challenges in healthcare is how to best translate research evidence into clinical practice, which includes how to change health-care professionals' behaviours. A commonly held view is that multifaceted interventions are more effective than single-component interventions. The purpose of this study was to conduct an overview of systematic reviews to evaluate the effectiveness of multifaceted interventions in comparison to single-component interventions in changing health-care professionals' behaviour in clinical settings.MethodsThe Rx for Change database, which consists of quality-appraised systematic reviews of interventions to change health-care professional behaviour, was used to identify systematic reviews for the overview. Dual, independent screening and data extraction was conducted. Included reviews used three different approaches (of varying methodological robustness) to evaluate the effectiveness of multifaceted interventions: (1) effect size/dose-response statistical analyses, (2) direct (non-statistical) comparisons of multifaceted to single interventions and (3) indirect comparisons of multifaceted to single interventions.ResultsTwenty-five reviews were included in the overview. Three reviews provided effect size/dose-response statistical analyses of the effectiveness of multifaceted interventions; no statistical evidence of a relationship between the number of intervention components and the effect size was found. Eight reviews reported direct (non-statistical) comparisons of multifaceted to single-component interventions; four of these reviews found multifaceted interventions to be generally effective compared to single interventions, while the remaining four reviews found that multifaceted interventions had either mixed effects or were generally ineffective compared to single interventions. Twenty-three reviews indirectly compared the effectiveness of multifaceted to single interventions; nine of which also reported either a statistical (dose-response) analysis (N = 2) or a non-statistical direct comparison (N = 7). The majority (N = 15) of reviews reporting indirect comparisons of multifaceted to single interventions showed similar effectiveness for multifaceted and single interventions when compared to controls. Of the remaining eight reviews, six found single interventions to be generally effective while multifaceted had mixed effectiveness.ConclusionThis overview of systematic reviews offers no compelling evidence that multifaceted interventions are more effective than single-component interventions.

• Publication year

  2014

• Venue

  Implementation Science

• Publication date

  2014-10-06

• Fields of study

  Medicine

• Identifiers
  DOI 10.1186/s13012-014-0152-6PMID 25287951PMCID 4194373
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Interventions to improve antibiotic prescribing practices for hospital inpatients.

  2017cited by this paper
• Systematic review finds overlapping reviews were not mentioned in every other overview.

  2014cited by this paper
• Improving Patient Care: The Implementation of Change in Health Care

  2013cited by this paper
• Overview of systematic reviews of the effectiveness of reminders in improving healthcare professional behavior

  2012influential reference
• Knowledge translation of research findings

  2012cited by this paper
• The overview of reviews: unique challenges and opportunities when research syntheses are the principal elements of new integrative scholarship.

  2012cited by this paper
• A Descriptive Analysis of Overviews of Reviews Published between 2000 and 2011

  2012cited by this paper
• Patients’ Perceptions of Sharing in Decisions

  2012cited by this paper
• Audit and feedback: effects on professional practice and healthcare outcomes.

  2012influential reference
• Local opinion leaders: effects on professional practice and health care outcomes.

  2011cited by this paper
• Methodology in conducting a systematic review of systematic reviews of healthcare interventions

  2011cited by this paper
• Initiatives to shorten duration of untreated psychosis: systematic review

  2011cited by this paper
• Effectiveness of interventions to improve the detection and treatment of osteoporosis in primary care settings: a systematic review and meta-analysis

  2011cited by this paper
• Clinical practice guidelines we can trust

  2011cited by this paper
• Interventions for improving the appropriate use of imaging in people with musculoskeletal conditions.

  2010influential reference
• The impact of pharmacy computerised clinical decision support on prescribing, clinical and patient outcomes: a systematic review of the literature

  2010cited by this paper
• Interventions in health care professionals to improve treatment in children with upper respiratory tract infections.

  2010cited by this paper
• The Rx for Change database: a first-in-class tool for optimal prescribing and medicines use

  2010influential reference
• A systematic review of integrated use of disease-management interventions in asthma and COPD.

  2009cited by this paper
• Effects of evidence-based clinical practice guidelines on quality of care: a systematic review

  2009cited by this paper
• Continuing education meetings and workshops: effects on professional practice and health care outcomes.

  2009cited by this paper
• The effects of on-screen, point of care computer reminders on processes and outcomes of care.

  2009influential reference
• Guideline implementation in allied health professions: a systematic review of the literature

  2008cited by this paper
• External Validation of a Measurement Tool to Assess Systematic Reviews (AMSTAR)

  2007cited by this paper
• Effects of implementation of psychiatric guidelines on provider performance and patient outcome: systematic review

  2007influential reference
• Effectiveness of continuing medical education.

  2007influential reference
• Educational outreach visits: effects on professional practice and health care outcomes.

  2007influential reference
• Implementation Science

  2007cited by this paper
• Healthcare professionals’ views on clinician engagement in quality improvement

  2007cited by this paper
• Improving Antibiotic Selection: A Systematic Review and Quantitative Analysis of Quality Improvement Strategies

  2006cited by this paper
• Audit and feedback: effects on professional practice and health care outcomes.

  2006influential reference
• Improving health care quality for racial/ethnic minorities: a systematic review of the best evidence regarding provider and organization interventions

  2006influential reference
• Interventions to improve antibiotic prescribing practices in ambulatory care.

  2005cited by this paper
• Effectiveness and efficiency of guideline dissemination and implementation strategies

  2004influential reference
• Audit and feedback: effects on professional practice and health care outcomes.

  2003cited by this paper
• The role of method in treatment effectiveness research: evidence from meta-analysis.

  2001influential reference
• Interventions to implement prevention in primary care.

  2001influential reference
• The effectiveness of interventions aimed at increasing handwashing in healthcare workers - a systematic review.

  2001cited by this paper
• Techniques to improve physicians' use of diagnostic tests: a new conceptual framework.

  1998cited by this paper
• Changing physician performance. A systematic review of the effect of continuing medical education strategies.

  1995cited by this paper
• Single and combined strategies for implementing changes in primary care: a literature review.

  1994influential reference

• Using a Multicomponent Implementation Strategy to Increase Adoption and Effectiveness of a Universal Mental Health Prevention Program in Australian Primary Schools: a Cluster Randomized Trial Using a Type-3 Hybrid Design.

  2026cites this paper
• Effects of lifestyle interventions in pregnancy on gestational diabetes: individual participant data and network meta-analysis

  2026cites this paper
• How to improve teachers’ noticing effectively: A meta-analysis of teacher noticing interventions

  2026cites this paper
• Implementation of a post-stroke upper limb outcome measure: A qualitative multiple case study

  2025cites this paper
• Improving hydration among hospitalised older adults in an acute geriatric ward with a bundled multi-component intervention

  2025cites this paper
• TRAUMA: making trauma clinical guidance more implementable

  2025cites this paper
• Examining the use of implementation science in autism intervention research: A scoping review

  2025cites this paper
• Impact of a Decision Aid on Perceptions of Shared Decision‐Making in the Primary Care Management of Patients With Subacromial Pain Syndrome: A Two‐Phased Multi‐Methods Study

  2025cites this paper
• Evidence adaptation and tailored implementation of family bereavement support in specialised palliative care: A multi-method study

  2025cites this paper
• Capabilities, opportunities and motivations in implementing guideline-oriented biopsychosocial low back pain management: perceptions of occupational healthcare professionals after an educational intervention

  2025cites this paper
• The design and implementation of culturally-safe dementia risk reduction strategies for immigrant women: a theoretical review

  2025cites this paper
• Implementation of a Quality Improvement and Clinical Decision Support Tool for Cancer Diagnosis in Primary Care: Process Evaluation

  2025cites this paper
• A cluster-randomized controlled trial assessing the effectiveness of a multifaceted versus a discrete implementation strategy on fidelity to an occupational guideline for the prevention of mental health problems at the workplace: a dual perspective from Swedish schools

  2025cites this paper
• Implementation of the Maynard-Based Risk Assessment Model for Venous Thromboembolism Inpatient Prophylaxis: A Before-and-After Study

  2025cites this paper
• Impact of quality clusters on antibiotic prescribing patterns. A difference-in-differences study from Danish general practice.

  2025cites this paper
• ‘Overhaul Medicare and perhaps train us better’: a qualitative study of primary care general practitioners’ perspectives on how to implement the low back pain clinical care standards

  2025cites this paper
• Intervention co-design to reduce the impact of heat exposure on pregnant and postpartum women and newborns in Burkina Faso

  2025cites this paper
• Enhancing Engagement With Endocrine Guidelines and Fostering Medical Student Interest Through Concise Medical Information Cines: Qualitative Co-Design Study

  2025cites this paper
• Interventions to improve referrals from primary care to outpatient specialist services for chronic conditions: a systematic review and framework synthesis update

  2025cites this paper
• Role of the Health Belief Model in the Management of Hypertension: A Systematic Review

  2025cites this paper
• Lessons learned from the promotion of Essential Emergency and Critical Care in Tanzania – a qualitative study

  2025cites this paper
• Interventions on Fruit and Vegetable Intake in Low-, Middle-, and High-Income Countries: A Scoping Review of Evidence and Knowledge Gaps

  2025cites this paper
• Electronic Health Record Interventions to Reduce Risk of Hospital Readmissions

  2025cites this paper
• A critical analysis of construction incident trends and strategic interventions for enhancing safety

  2025cites this paper
• The impact of a multi-faceted intervention on non-prescription dispensing of antibiotics by urban community pharmacies in Indonesia: a mixed methods evaluation

  2024cites this paper
• Effects of implementation strategies on nursing practice and patient outcomes: a comprehensive systematic review and meta-analysis

  2024cites this paper
• Estrategia de implantación multifacética para promover los cuidados basados en la evidencia: protocolo de investigación en implantación

  2024cites this paper
• Enhancing mathematical problem posing competence: a meta-analysis of intervention studies

  2024cites this paper
• The effect of infection prevention and control programme for childcare workers in daycare centres: A systematic review.

  2024cites this paper
• Co-designing planning interventions to facilitate participation in mail-out bowel cancer screening

  2024cites this paper
• The American Society for Microbiology collaboration with the CDC Laboratory Medicine Best Practices initiative for evidence-based laboratory medicine

  2024cites this paper
• Stimulating implementation of clinical practice guidelines in hospital care from a central guideline organization perspective: A systematic review.

  2024cites this paper
• Developing a low back pain guideline implementation programme in collaboration with physiotherapists and chiropractors using the Behaviour Change Wheel: a theory-driven design study

  2024cites this paper
• Integrated behavioral interventions for adults with alcohol use disorder: A systematic review.

  2024cites this paper
• Point-of-care tests to manage acute respiratory tract infections in primary care: a systematic review and qualitative synthesis of healthcare professional and patient views

  2024cites this paper
• Axial spondyloarthritis guidelines – aiming for maximum impact

  2024cites this paper
• Scoping review of interventions to de-implement potentially harmful non-steroidal anti-inflammatory drugs (NSAIDs) in healthcare settings

  2024cites this paper
• Multilevel Interventions Targeting Obesity: State of the Science and Future Directions.

  2024cites this paper
• Knowledge translation strategies used for sustainability of an evidence-based intervention in child health: a multimethod qualitative study

  2024cites this paper
• ‘It depends’: what 86 systematic reviews tell us about what strategies to use to support the use of research in clinical practice

  2024influential citation
• Potentially Inappropriate Prescription and Impact of Physician Training on Usage of Prescribing Screening Tools for the Elderly in a Secondary Healthcare Facility

  2024cites this paper
• The co-design of a digitally supported intervention for selecting implementation tools and actions for standards (SITAS)

  2024cites this paper
• [Implementing systematically: To what extent can implementation science make an educational contribution to health care practice?]

  2024cites this paper
• Implementation of an audit and feedback module targeting low-value clinical practices in a provincial trauma quality assurance program: a cost-effectiveness study

  2024cites this paper
• Knowledge translation strategies used to promote evidence-based interventions for children with cerebral palsy: a scoping review

  2024influential citation
• Enrollment, adherence and retention rates among musculoskeletal disorders rehabilitation practitioners in knowledge translation studies: a systematic review and meta-regression

  2024cites this paper
• Effect of the implementation of infection prevention measures by an infection prevention link physician in trauma/orthopaedics surgery on hygiene-relevant processes and nosocomial infections

  2024cites this paper
• Utilizing the arts to improve health, resilience, and well-being (HeRe We Arts®): a randomized controlled trial in community-dwelling individuals with chronic medical conditions

  2024cites this paper
• Knowledge Translation Interventions to Increase the Uptake of Evidence-Based Practice Among Pediatric Rehabilitation Professionals: A Systematic Review

  2024cites this paper
• Training approaches for the dissemination of clinical guidelines for NSSI: a quasi-experimental trial

  2024cites this paper
• Identifying Barriers and Implementation Strategies to Inform TBI Screening Adoption in Behavioral Healthcare Settings

  2024cites this paper
• Adherence-enhancing interventions for pharmacological and oxygen therapy in patients with COPD: a systematic review and component network meta-analyses

  2024cites this paper
• From ‘strong recommendation’ to practice: A pre-test post-test study examining adherence to stroke guidelines for fever, hyperglycaemia, and swallowing (FeSS) management post-stroke

  2024cites this paper
• Evaluation of an Educator Mental Health Literacy Online Training Package

  2024cites this paper
• Effectiveness of Interventions Promoting Dietary Intake, Physical Activity, and Healthy Weight Status of Children in Family Child Care: A Systematic Review.

  2024cites this paper
• Applying the Cognitive Walkthrough for Implementation Strategies Methodology to Inform the Redesign of a Selection-Quality Implementation Toolkit for Use in Schools

  2024cites this paper
• Applying the Cognitive Walkthrough for Implementation Strategies methodology to inform the redesign of a selection-quality implementation toolkit for use in schools

  2024cites this paper
• The barriers and facilitators for the implementation of clinical practice guidelines in healthcare: an umbrella review of qualitative and quantitative literature.

  2023cites this paper
• Interventions to Improve Provider Competence in Low-and-Middle-Income Countries (LMICs): A Scoping Review

  2023cites this paper
• Models, frameworks and theories in the implementation of programs targeted to reduce formal coercion in mental health settings: a systematic review

  2023cites this paper
• Evaluating the effectiveness of a multifaceted intervention to reduce low-value care in adults hospitalized following trauma: a protocol for a pragmatic cluster randomized controlled trial

  2023cites this paper
• Comparing in-person, blended and virtual training interventions; a real-world evaluation of HIV capacity building programs in 16 countries in sub-Saharan Africa

  2023cites this paper
• Evaluation of a theory-informed implementation of a nursing discharge teaching intervention for older adults.

  2023cites this paper
• The Commit to Be Fit framework: a community case study of a multi-level, holistic school-based wellness initiative in rural Virginia

  2023cites this paper
• Nudging Interventions on Alcohol and Tobacco Consumption in Adults: A Scoping Review of the Literature

  2023cites this paper
• Evaluating remote facilitation intensity for multi-national translation of nurse-initiated stroke protocols (QASC Australasia): a protocol for a cluster randomised controlled trial

  2023cites this paper
• Intervening for sustainable change: Tailoring strategies to align with values and principles of communities

  2023cites this paper
• Knowledge translation strategies to support the sustainability of evidence-based interventions in healthcare: a scoping review

  2023cites this paper
• A Network of Sites and Upskilled Therapists to Deliver Best-Practice Stroke Rehabilitation of the Arm: Protocol for a Knowledge Translation Study

  2023cites this paper
• Interventions for the uptake of evidence-based recommendations in acute stroke settings.

  2023cites this paper
• What works for and what hinders deimplementation of low-value care in emergency medicine practice? A scoping review

  2023cites this paper
• Implementation matters: assessing the effectiveness and sustainment of an obstetric triage program at a high-volume facility in Ghana

  2023cites this paper
• Education interventions and emergency nurses' clinical practice behaviours: A scoping review.

  2023cites this paper
• A sequential, multiple assignment randomized trial comparing web-based education to mobile video interpreter access for improving provider interpreter use in primary care clinics: the mVOCAL hybrid type 3 study protocol

  2023cites this paper
• Real world evidence supports waking salivary cortisone as a screening test for adrenal insufficiency

  2023cites this paper
• Is more better? The impact of implementing more interventions for hypertension control in a practice facilitation study for small- and medium-sized practices

  2023cites this paper
• In-hospital interventions to promote relational practice with families in acute care settings: A scoping review

  2022cites this paper
• Effectiveness of Interventions to Reduce Potentially Inappropriate Medication in Older Patients: A Systematic Review

  2022cites this paper
• American Physical Therapy Association Clinical Practice Guideline Implementation for Neck and Low Back Pain in Outpatient Physical Therapy: A Nonrandomized, Cross-sectional Stepped-Wedge Pilot Study.

  2022cites this paper
• Les interventions éducationnelles pour améliorer la communication infirmière-patient en santé sexuelle auprès de la clientèle gynéco-oncologique : une revue narrative

  2022cites this paper
• Educational interventions to improve communication about sexual health between nurses and gynecologic oncology patients: A narrative review.

  2022cites this paper
• A Competency-Based Education Case Study: A Mathematics Intervention for a Five-Year-Old with Autism Spectrum Disorder (ASD)

  2022cites this paper
• Effects and Working Mechanisms of a Multilevel Implementation Program for Applying Shared Decision-Making while Discussing Systemic Treatment in Breast Cancer

  2022cites this paper
• Trends in guideline implementation: an updated scoping review

  2022cites this paper
• Investigating strategies to increase general education teachers' adherence to evidence-based social-emotional behavior practices: A meta-analysis of the single-case literature.

  2022cites this paper
• Increasing physical activity levels in care homes for older people: a quantitative scoping review of intervention studies to guide future research

  2022cites this paper
• Oilcloth sessions as an implementation strategy: a qualitative study in Denmark

  2022cites this paper
• Longitudinal Effects of a Motivationally Focused Strategy to Increase the Yield of Training and Consultation on Teachers’ Adoption and Fidelity of a Universal Program

  2022cites this paper
• Use of the behaviour change wheel to improve everyday person-centred conversations on physical activity across healthcare

  2022cites this paper
• The Better By Moving study: A multifaceted intervention to improve physical activity in adults during hospital stay

  2022cites this paper
• Does the Quality of Postpartum Hemorrhage Local Protocols Improve the Identification and Management of Blood Loss after Vaginal Deliveries? A Multicenter Cohort Study

  2022cites this paper
• Implementation of communication routines facilitating person‐centred care in long‐term residential care: A pilot study

  2022cites this paper
• The use of mentoring for knowledge translation by allied health: a scoping review.

  2022cites this paper
• Deploying a telemedicine collaborative care intervention for posttraumatic stress disorder in the U.S. Department of Veterans Affairs: A stepped wedge evaluation of an adaptive implementation strategy.

  2022cites this paper
• The design and impact of culturally-safe community-based physical activity promotion for immigrant women: descriptive review

  2022cites this paper
• Effectiveness of a multifaceted implementation strategy for improving adherence to the guideline for prevention of mental ill-health among school personnel in Sweden: a cluster randomized trial

  2022cites this paper
• How to improve hospital admission screening for patients at risk of multidrug-resistant organism carriage: a before-and-after interventional study and cost-effectiveness analysis

  2022cites this paper
• Determining the requirements of a medical records electronic deficiency management system: a mixed-method study

  2022cites this paper
• Using theories and frameworks to understand how to reduce low-value healthcare: a scoping review

  2022cites this paper
• The effectiveness of adjunctive measures in managing peri-implant mucositis: an umbrella review

  2022cites this paper