Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Supervisor

Kothari, Anita

Abstract

Though important to Environmental Health Officer (EHO) practice, few research articles explore what evidence-informed practice looks like in environmental health or the factors that influence it. This study set out to understand the barriers to, and facilitators of, research utilization (RU) experienced by EHOs by asking: how do EHO practitioner perceptions of the barriers to RU change during an emergency; what factors influence evidence use during an emergency; and what can be done to ensure access to evidence and support effective and appropriate practice decision-making?

These questions were answered through three studies that used quantitative and qualitative methods. The Barriers to Research Utilization Scale was used to collect data during a typical practice year (2012) and again during the COVID-19 pandemic (2020).

Study one, asked EHOs to rate the barriers to RU experienced in practice. The data were analyzed to identify if findings changed during the pandemic. Lack of authority, lack of time to review research, and lack of time to implement findings, were the top three barriers to RU experienced by EHOs at both times.

Study two, considered the relationships between variables to reduce findings into simplified factors representing the barriers influencing EHO practice. Four factors were found to influence RU in EHO practice. These factors aligned with two of the six Active Implementation Frameworks (AIFs): the Implementation Drivers Framework and the Useful Innovations Framework.

Study three assessed the other barriers to RU experienced by EHOs in 2012 and 2020. The top three themes from the open-ended responses included: Legislative policy, programs, and services; Political and structural barriers; and EHO practitioners in sufficient numbers to enable practice delivery while exploring the evidence. The top barriers aligned with the following AIFs: Implementation Drivers Framework; Systemic Change Framework, and Usable Innovations Framework. The final finding was that during emergencies, EHOs require: Processes to engage the impacted community; Strong leaders to support change; Emerging evidence that is relevant and applicable; A culture that enables organizational innovation; and Project, change, and implementation management.

Overall, these studies show the pervasive nature of the barriers to RU for EHOs in every day and emergency conditions. In emergencies, EHOs require access to emergent evidence, implementation pathways, opportunities to engage with impacted communities, and strong leadership support. Targeting interventions at the systemic and organizational levels will help increase RU by EHOs.

Summary for Lay Audience

This study sought to understand the barriers to, and facilitators of, evidence use by Environmental Health Officers (EHOs) in Canada in their everyday and emergency practice. Overarching findings include the fact that barriers are particularly embedded in the EHO work context, both in emergency and day-to-day work conditions. These barriers are heavily related to organizational factors (e.g., leadership, time, etc.), systemic issues (e.g., legislation, political influence, etc.), and conditions of the evidence (e.g., relevance, access, etc.). However, there are unique barriers that arise in emergencies including a lack of: strong leadership, a culture that supports change, embedded processes to support change, and human resources. It is important to identify ways to reduce the impact of these barriers to support evidence-informed decision-making and meet community needs.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.

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