Dissemination strategies of clinical practice guidelines-mixed methods evidence synthesis protocol

Clinical practice guidelines (CPGs) are shared through various dissemination strategies using a range of dissemination products and channels. However, users may have different needs for accessing and understanding them. Patients and carers from low- and middle-income countries might face challenges in accessing CPGs such as inadequate systems for printed book distribution and insufficient and substandard photocopies. Many organizations offer lengthy documents, but busy healthcare workers may prefer shorter, digital versions. Digital CPGs can be sent through different channels such as email, newsletters, or social media. How users feel about these products (e.g., clinical protocol, educational material or decision aids) and how it affects the usage of CPGs is not well understood. In addition to these issues, most of the previous systematic reviews on this topic have clubbed the dissemination strategies along with the adoption of recommendations or implementation aspects. There is a need for evidence on the existing dissemination strategies disentangled from the implementation aspects. We aim to conduct a mixed-methods systematic review to identify documented dissemination strategies for CPGs, barriers and facilitators to access such strategies and the expectations and needs of end users regarding dissemination needs. We will search literature from MEDLINE, Embase, CINAHL, Web of Science, Scopus, Epistemonikos, Agency for Healthcare Research and Quality and Medical Guidelines Clearing house. We will critically appraise all the included studies using appropriate tools based on the study design. We will use manifest content analysis to identify documented dissemination strategies and latent content analysis to understand the barriers, facilitators, preferences of end-users. We intend to follow the convergent matrix model approach for this mixed methods evidence synthesis. We anticipate that this mixed-methods systematic review will highlight the various strategies of dissemination of CPGs and the associated barriers and facilitators.