Influences on the implementation of evidence-based guidelines: Highlights from state tobacco control programs

Awareness and availability of guidelines and research does not directly translate to implementation in practice. The evidence base in the field of tobacco control is extensive but under-utilized, in part due to implementation barriers. Thus, informing guideline development with input from the end-users of the product is essential to improving utilization of the guideline by intended stakeholders and, ultimately, to decreasing the burden of tobacco use. There are a number of evidence-based guidelines for tobacco control, however little is known about their dissemination and use at the state and local level. As part of a NACDD-funded evaluation, the Center for Tobacco Policy Research at Washington University in St. Louis examined factors influencing the implementation of evidence-based guidelines. The evaluation collected qualitative and quantitative data through in-depth, semi-structured interviews with 202 partners, representing an average of 17 agencies in seven states and the District of Columbia. The findings from this evaluation indicated that while partners were aware of many guidelines and used them to guide the general framework of their efforts, they encountered many challenges to implementing specific evidence-based practices. Such challenges included limited flexibility, the slow process of translating research into an evidence base, and tailoring practices to disparate populations. This presentation will address the foremost barriers to implementing evidence-based practices as well as highlight factors that encouraged guideline use. Additionally, the presentation will review the information and resources requested by partners to facilitate implementation and provide recommendations for future guideline development.