Increasing recognition of these issues has led to attempts to effect behavior, practice, or policy change. Changing behavior is a complex process requiring evaluation of the
entire health system, including systematic barriers to change (such as lack of integrated health information systems), and targeting of all those involved in decision making including clinicians, policy makers, and patients. Efforts must be made to close the knowledge-to-practice gaps by effective knowledge translation interventions and thereby improve health outcomes. These initiatives must include all aspects of care, including access to and implementation of valid evidence and organizational and systems issues.