US chiropractors’ attitudes, skills and use of evidence-based practice

Evidence based practice (EBP) is being used more frequently by health care professionals as a means of improving the quality of health care. The introduction of EBP principles into the chiropractic profession is a relatively recent phenomenon. At this time there is a lack of information about the EBP literacy level of US chiropractors and the barriers/facilitators to the use of EBP in the chiropractic profession. A total of 1,314 US chiropractors completed the EBASE survey; the sample appeared to be representative of the US chiropractic profession. Respondents were predominantly white (94.3%), male (75%), 47 (+/- 11.6) years of age, and in practice for more than 10 years (60%). EBASE sub-score means (possible ranges) were: attitudes, 31.4 (8-40); skills, 44.3 (13-65); and use, 10.3 (0-24). Survey participants typically held favorable attitudes toward EBP, but reported less use of EBP. A minority of participants suggested that EBP coursework (17%) and critical thinking (29%) were a significant part of their chiropractic education. The most frequently reported barrier to the use of EBP was “lack of time”. Almost 90% of the sample suggested that they had an interest in improving their EBP skills.

American chiropractors seem similar to chiropractors in other countries, and other health professionals regarding their favorable attitudes towards EBP, while expressing barriers related to EBP skills such as research relevance and lack of time. This indicates that the design of future EBP educational interventions ought to capitalize on the growing body of EBP implementation research developing in other health disciplines. It is likely that this will include broadening the approach beyond a sole focus on EBP education, and taking a multilevel approach that also targets professional, organizational and health policy domains.