Clinical practice guidelines in the social sciences: Knowledge, attitudes, and experiences of policy makers and professionals in Quebec

Clinical practice CPGs (CPGs) are valuable resources that are intended to guide practitioners in making decisions regarding assessment and treatment (Beauchamp et al., 2012; Field & Lohr, 1992; Graham et al., 2011). They offer solutions to inherent issues in clinical practice and provide considerable related benefits. The manner in which CPGs are developed and the quality of the CPGs themselves determine their level of utility (Alonso-Coello et al., 2010; Brouwers et al., 2010). CPGs should be based on empirical evidence and represent best practices (Alonso-Coello et al., 2010; Hollon et al., 2014). Although their development has skyrocketed over the years (Beauchamp et al., 2011; Colón-Emeric et al., 2007), empirical research on guideline development, methodological rigour, evaluation and approval process and quality, as well as their uptake in practice, is lagging within the social science domain (especially when compared to medicine; Parry et al., 2003; Proctor et al., 2009). Obtaining the knowledge, attitudes, and experiences of policy makers who develop and approve CPGs, as well as of the professionals who are expected to use them, would provide valuable insight into these areas. To our knowledge, research has yet to examine policy makers’ and professionals’ knowledge, attitudes, and experiences of CPGs in Quebec and in the social science domain as a whole. Building on these important gaps in the literature, the current dissertation consisted of three studies aimed at investigating these areas. Study 1 surveyed 34 members of the board of directors across the five regulatory bodies in Quebec and in the social sciences. The survey focused on their knowledge of guideline methods and development, their attitudes, and experiences of development and approval of the CPGs produced by these regulatory bodies. The results showed that board members have variable familiarity of key components of guideline development and are unfamiliar with guideline development methods. Their attitudes toward guideline objectives were mostly positive, and their attitudes and experiences toward guideline development and approval processes were largely positive. Study 2 examined the existing social science literature specific to professionals’ knowledge, attitudes, and guideline uptake and related barriers and facilitators via a systematic scoping review. Peer-reviewed and grey literature was searched and systematically assessed for 35 articles using five electronic databases. The findings indicated global interest in this area over more recent years, despite the limited available research overall and poor representation of social science professions. The results also showed varied guideline topics, mixed levels of knowledge and a slight preference for positive attitudes towards CPGs among professionals, a lack of uptake of CPGs, and various barriers and facilitators to guideline uptake. Study 3 surveyed 954 professionals across the five regulatory bodies in Quebec and in the social sciences pertaining to CPGs. The survey focused on their knowledge, attitudes, and use and implementation of the CPGs produced by these regulatory bodies. The results illustrated that professionals were knowledgeable of CPGs and development methods, and mostly had positive attitudes towards guideline objectives, development, and credibility. While most CPGs were relevant to practice, some were irrelevant, suggesting the need for improved CPGs and more conscientious use of resources. The most relevant CPGs were largely used by professionals. Several barriers and facilitators to guideline uptake were also found. Findings from these three studies highlight the discrepancy between members of the board of directors’ and professionals’ knowledge and attitudes, and the existing literature on guideline development and quality

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