Think about the last time you made a decision to try something new or change an old habit. Chances are the way you felt, or what you thought, about the new behaviour impacted whether you decided to do it. For example, a person may be more inclined to act on research that shows that a more active lifestyle leads to health benefits if they thought exercise was enjoyable. It’s also possible that you have even made decisions that were contrary to what you knew to be the best thing to do. For example, perhaps that same person chose not to change their lifestyle, even though they were aware that a certain level of physical activity has health benefits.
Our attitudes play a major role in our decisions around what we do with the information we have available to us. The way people consider using evidence in practice is no different. “Attitudes” can be defined as one’s thoughts and beliefs about whether engaging in a behaviour will have positive or negative outcomes, whether those outcomes be for ourselves, another person, or an organization. Attitudes may also be influenced by our emotions; that is, how we feel about the behaviour itself.
Attitudes are a well-known influence on one’s engagement with, and use of, evidence in practice. One’s attitudes can directly impact behaviour, making it more or less likely that we will engage with a new evidence-based practice or intervention. Consider the example of vaccination pain management for children. Having an attitude or belief that needle pain is not severe enough to warrant intervention may result in a health professional being less likely to offer evidence-pain management strategies, even if the child experiences pain. A more favourable attitude, however, might mean that the health professional is more likely to offer intervention, or support the parent who wishes to use one.
Our attitudes toward evidence may also impact how effectively we utilize the knowledge or evidence we have. Attitudes are known to influence how quickly evidence is adopted, the integrity with which evidence is applied, and ultimately, the degree to which the evidence impacts outcomes for the group or individual. For example, if a health professional has a mixed attitude toward managing vaccination pain, they may be willing to share evidence, but may be less impactful when it comes to supporting the parent in using those strategies.
It is also possible that our attitude varies toward different pieces of evidence that go together as part of a practice. That is, while we can believe that there are positive outcomes to be gained by engaging with one particular piece of evidence or practice, we may not feel the same about another. For example, while a parent or caregiver may hold positive attitudes toward psychological vaccination pain management strategies such as distraction, they may hold less favourable attitudes toward pharmacological strategies, such as topical anesthetic.
Recognizing our attitudes is critical to understanding how they influence our decisions and practices. To identify and manage attitudes, one can consider their own thoughts, feelings, expectations, and any assumptions about the evidence and the corresponding behaviour. When working with others who may hold different attitudes, it is helpful to look for common goals around why the evidence and behaviour may be useful to engage with, ensure everyone has the best available evidence to learn from, and provide opportunities to have questions answered.
Our thoughts and feelings directly impact the behaviours we engage in. Decision making in health care settings are not so different. While health providers always strive to act on the best available evidence, attitudes may still play a role in whether change happens, and how it happens. Checking in with ourselves and others about our attitudes can help us to ensure we are making the best decisions possible for ourselves and the settings we work in.
