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Four systematic reviews included studies using local opinion leaders as part of multifaceted interventions, and had inconsistent and ambiguous findings.
Ten of 13 studies in this review were multifaceted interventions and six of these achieved an improvement in an objective health outcome measure.
Multifaceted interventions and post training support have the potential to improve attitudes and behaviour to EBP, thus a post training online support has been designed for the participants.
Research evidence also suggests a higher efficacy of multifaceted interventions and underlines the importance of tailoring interventions to specific barriers and particular settings [ 1, 2].
First, studies that used multifaceted interventions and did not examine separate components, making it difficult to know exactly what resulted in the beneficial effect observed.
"The complexity of this emergency necessitates multifaceted interventions and sustained commitment in order to effectively assist those who are not able to fend for themselves," said Abdelmajid Tibouti, officer-in-charge, UNICEF Ethiopia.
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Levels of anxiety did not differ between couples receiving the multifaceted intervention and those receiving standard care for in vitro fertilisation.
Network meta-analysis is particularly relevant to this, given that exercise is a complex and multifaceted intervention and the number of trials comparing the same exercise interventions is small.
Moreover, even if guideline dissemination alone has a less important effect on prescribing patterns [ 9, 33, 34], it has proved to be effective as part of a multifaceted intervention and as a predisposing foundation for other strategies.
Our results will provide an overall response regarding the effectiveness of our multifaceted intervention and we should be able to suggest an organization and mode of operation of NST.
The CONFUCIUS study strengths are the following: it takes place in different surgical wards (orthopaedic, urology and digestive surgery), it assesses a multifaceted intervention and it uses an original stepped wedge randomised controlled trial.
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