Evaluation and comparison of knowledge translation patterns in selected countries with Iran: A comparative study

Background: Despite significant expansion, indigenous research regarding health system still faces challenges in the field of research application. They include lack of reliable evidence, late arrival of evidence by policymakers or inappropriate language of evidence related to the field of knowledge exchange and translation. The aim of this study is to investigate the status of knowledge translation in research centers of Kerman University of Medical Sciences.
 Methods: This was a cross-sectional study conducted in 2020 in research centers affiliated with Kerman University of Medical Sciences. Centers entered the study through census and a standard questionnaire of self-assessment regarding knowledge-producing organizations was used. It contained 50 questions in 4 areas of research question, knowledge production, knowledge transfer and promotion of using evidence. After collecting and coding, the data were entered into SPSS 25 software and analyzed using descriptive statistics and non-parametric Mann-Whitney U test.
 Results: 20 clinical research centers and 6 non-clinical centers participated in this study. Only 3.85 % of the centers scored more than 80 % in total. Regarding the research question, knowledge production, knowledge transfer and promotion of using evidence, the mean standard deviation of scores were 35/85 ± 9/93, 31/50 ± 7/54, 76/65 ± 16/35 and 9/31 ± 3/27, respectively. The best situation was related to knowledge production with 70 % of the score. Findings of the Mann-Whitney U test showed that the mean of all domains in the two groups were not different.
 Conclusion: This study demonstrated a moderate level of knowledge translation. But, factors such as creating a structure for knowledge translation committee, considering the process of exchange, translation and transfer of knowledge in the process of approving student dissertations and research projects, reviewing research policies and creation of motivational mechanisms to promote the status of researchers can play an important facilitating role in achieving the appropriate level of knowledge exchange and translation.

Recently, one of the challenges in the health system of the country is the need for research contributing to policy-making. Therefore, it is crucial to develop activities in the field of knowledge Translation (KT). This study aimed to propose KT improvement strategies in universities of medical sciences in Iran. In this qualitative study, 18 semi-structured interviews were conducted with key informants from the medical universities in Iran during January-July 2018. The transcribed documents were analyzed using the Gale framework analysis approach. Data organization was carried out using MAXQDA version 10 software. According to framework analysis, six KT improvement strategies were identified including improving the abilities and skills of researchers, improving the processes and quality of knowledge production, revising policies and laws, improving the prerequisites, culture-building, and promoting the use of evidence. Given the challenges and strategies outlined in this study, it seems that the mechanism of KT and its effects on improving health plans for policymakers and researchers has not been elucidated yet. Therefore, considerable changes in prerequisites, knowledge production processes, academic procedures, policies and laws are necessary for implementing KT in universities of medical sciences in Iran.

Healthcare is an information and knowledge intensive industry where software systems are playing increasingly important roles. Thus the risks of harm are increasing. Previously, we have proposed a knowledge translation (KT) model to help bridge the gap between software engineering and clinicians. This paper highlights the application of our proposed knowledge translation loop. We have enacted it through a series of two studies: 1. A randomized control trial to evaluate a software-based decision support function in an electronic medical record (EMR) and 2. A lead user based user interface and safety design study to create an improved design for an EMR medication module. We also provide lessons learned and future directions on integrating our KT model in regular software quality management systems.

Knowledge Translation, Evidence-Based Practice, and You

The workshop that this paper reports, held in Iran in May of 2011, at the 1st Inter-national and 4th National Congress on Health Education and Promotion, had three main objec-tives: 1) to introduce participants to the knowledge translation (KT) concept, along with its mod-els and methods; 2) to enhance participants' knowledge of how KT could apply to public health education and promotion ; and 3) to learn from different participating stakeholder groups about the factors that facilitate or impede effective KT in public health education and promotion in Iran. The workshop consisted of three components: introducing the KT concept, assessing the KT capacity of participants, and facilitating a discussion of the important contextual factors that promote and impede effective KT. Of the 26 individuals from across the country participat-ing in the workshop, 17 took part in a KT capacity assessment activity. They classified them-selves into one of the following three stakeholder groups: administrators and policymakers (n=6), practitioners (n=2), and researchers (n=9). There were different capacities for KT across the three stakeholder groups. The re-ported challenges for effective KT include "lack of resources and funding"; "lack of time"; "poor quality of relationships and lack of trust between health policymakers, administrators, re-searchers, and clinicians"; "inadequate skills possessed by healthcare professionals and adminis-trators for assessment and adaptation of research findings"; and "poor involvement of commu-nity partners in the research process." There is a great need to develop effective strategies to overcome the reported barri-ers for effective KT.

Background Over the last few years, increased international attention has been paid to bridging the gap between health research and policy-making. The situation analysis on evidence-informed policy-making (EIP) in Poland aims to increase understanding of interactions among a country’s research and policy-making communities, to determine where and how to best establish a knowledge translation platform (KTP), i.e. an organization or network that through its structure and functioning brings the worlds of research and policy together. Methods The methods were guided by the EVIPNet Europe Situation Analysis Manual and included a literature review, key-informant interviews and survey data analysis. Results In Poland, the existence of incentives or requirements stipulating the use of research evidence in health policy varies, depending on the type of policy. The use of evidence is a standard practice in drug policy, and in decisions related to the inclusion of services in the health benefit package. In other areas, some good practice examples of using evidence in policy can be identified. Yet these are rather individual, isolated and bottom-up initiatives, which neither occur systematically, nor routinely. Key challenges in view of strengthening a systemic approach to EIP relate to: overlapping mandates of key health system and research institutions, generally low research capacity and lack of knowledge translation skills. Conclusions Establishing and operationalizing a KTP can be an effective means of supporting sustainable EIP. Building such infrastructure, however, is a longer-term and complex process that needs to be based on the current characteristics of the country’s EIP landscape. The proposed model of a future KTP in Poland is a network with a joint secretariat within the Ministry of Health. Such form can take advantage of existing organizations’ competencies via information exchange and cooperation. Key messages Although systemic mechanisms for evidence-informed health policy are missing in Poland, its importance is recognized among major health system stakeholders. The proposed model of a future knowledge translation platform in Poland is a network with a joint secretariat within the Ministry of Health.

Knowledge translation (KT) was traditionally framed as a problem of moving research results into policy and practice. The impetus for the flow of knowledge originated with researchers constructing new knowledge and seeing its utility, or with policymakers and administrators seeing problems in practice and looking to researchers for solutions. In the 1970s, a shift in focus away from knowledge use was exemplified by Caplan’s (1979) two-communities theory, which posits that researchers and policymakers comprise two different communities with two different languages (Jacobson, Butterill, & Goering, 2003). A shift back to knowledge use with a new focus on user-centered design is evident in more recent KT models that provide frameworks for researcher and user interaction in order to build better understanding between diverse groups. The flow of knowledge from its construction in one context to its use in another context has been variously termed knowledge translation, knowledge exchange, knowledge transfer, research transfer, technology transfer, knowledge transformation, knowledge dissemination, knowledge mobilization, knowledge utilization, and research utilization. The terms are often used synonymously, but a specific term is sometimes used because it highlights a particular component of the knowledge flow process. For example, knowledge exchange implies a sharing of information between partners of equal value and focuses on the movement of knowledge between them, whereas research utilization implies the transformation of research results into usable knowledge and focuses on embedding the usable knowledge in practice. Information technologies have the potential to support knowledge translation in powerful ways. Key processes in the translation of knowledge include: (1) knowledge creation, management, and dissemination; (2) recognition of links between existing knowledge and its potential application to problems or practice; (3) translation into usable knowledge in practice; and (4) change in practice. Information technologies are a natural solution for these knowledge translation processes. For example, group and social software such as blogs and wikis support collaborative construction and sharing of knowledge; knowledge management systems support capture, storage, accessibility, and maintenance of constructed knowledge; and most Internet-based technologies support dissemination of information. Well-designed virtual communities provide online environments for the kinds of human interaction that enable collaborative exploration of ideas, that foster recognition of potential links between existing knowledge and its application to solve problems or change practice, and that inspire people to transform their practice. Data mining and artificial intelligence techniques can be used to enhance identification of potential links between knowledge in one context and problems in another context.

BackgroundSeveral countries in Sub Saharan Africa have abolished user fees for health care but the extent to which such a policy decision is guided by evidence needs further exploration. We explored the barriers and facilitating factors to uptake of evidence in the process of user fee abolition in Uganda and how the context and stakeholders involved shaped the uptake of evidence. This study builds on previous work in Uganda that led to the development of a middle range theory (MRT) outlining the main facilitating factors for knowledge translation (KT). Application of the MRT to the case of abolition of user fees contributes to its refining.MethodsEmploying a theory-driven inquiry and case study approach given the need for in-depth investigation, we reviewed documents and conducted interviews with 32 purposefully selected key informants. We assessed whether evidence was available, had or had not been considered in policy development and the reasons why and; assessed how the actors and the context shaped the uptake of evidence.ResultsSymbolic, conceptual and instrumental uses of evidence were manifest. Different actors were influenced by different types of evidence. While technocrats in the ministry of health (MoH) relied on formal research, politicians relied on community complaints. The capacity of the MoH to lead the KT process was weak and the partnerships for KT were informal. The political window and alignment of the evidence with overall government discourse enhanced uptake of evidence. Stakeholders were divided, seemed to be polarized for various reasons and had varying levels of support and influence impacting the uptake of evidence.ConclusionEvidence will be taken up in policy development in instances where the MoH leads the KT process, there are partnerships for KT in place, and the overall government policy and the political situation can be expected to play a role. Different actors will be influenced by different types of evidence and their level of support and influence will impact the uptake of evidence. In addition, the extent to which a policy issue is contested and, whether stakeholders share similar opinions and preferences will impact the uptake of evidence.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-014-0639-5) contains supplementary material, which is available to authorized users.

Clinicians are faced with using the current best evidence to make treatment decisions, yet synthesis of knowledge translation (KT) strategies that influence professional practice behaviors in rehabilitation disciplines remains largely unknown. The purposes of this study were: (1) to examine the state of science for KT strategies used in the rehabilitation professions (physical therapy, occupational therapy, speech-language pathology), (2) to identify the methodological approaches utilized in studies exploring KT strategies, and (3) to report the extent that KT interventions are described. Eight electronic databases (MEDLINE, CINAHL, ERIC, PASCAL, EMBASE, IPA, Scopus, and CENTRAL) were searched from January 1985 to May 2013 using language (English) restriction. Eligibility criteria specified articles evaluating interventions or strategies with a primary purpose of translating research or enhancing research uptake into clinical practice. Two reviewers independently screened the titles and abstracts, reviewed full-text articles, performed data extraction, and performed quality assessment. The published descriptions of the KT interventions were compared with the Workgroup for Intervention Development and Evaluation Research's (WIDER) Recommendations to Improve the Reporting of the Content of Behaviour Change Interventions. Of a total of 2,793 articles located and titles and abstracts screened, 26 studies were included in the systematic review. Eighteen articles reported interventions that used a multicomponent KT strategy. Education-related components were the predominant KT intervention regardless of whether it was a single or multicomponent intervention. Few studies used reminders or audit and feedback intervention (n=3). Only one study's primary outcome measure was an economic evaluation. No clear delineation of the effect on KT strategies was seen. Diverse studies were included; however, the heterogeneity of the studies was not conducive to pooling the data. The modest-to-low methodological quality assessed in the studies underscores the gaps in KT strategies used in rehabilitation and highlights the need for rigorously designed studies that are well reported.

Knowledge translation (KT) in healthcare is a complex process. Building the KT capacity of the workforce is fundamental to closing the gaps between research and evidence-based practice. This evaluation aimed to describe the impact of a KT capacity building program (Allied Health Translating Research into Practice, AH-TRIP) on allied health professionals and health services and systems, with the secondary aim of identifying barriers and enablers to program impact. Multi methods evaluation using online surveys and semi-structured interviews with 20 program participants and their managers. The interview guide was underpinned by the Framework to Assess the Impact from Translational health research (FAIT). Deductive content analysis was used to categorise impact against FAIT, with barriers and enablers mapped to an implementation framework. Six domains of impact were identified: Individual Capacity Building, Workforce Capacity Building, Enhanced Networks, Clinical Practice Change, Patient/Community Benefits, and Economic Benefits. Enablers of impact were program design (flexibility, access to mentors, funding opportunities), local contexts supporting research (manager support, access to local experts), and previous exposure to KT. Consistent barriers included a lack of clinician time and confidence in KT, staff turnover (particularly in regional/rural areas), lack of organisational research culture, and short-term funding cycles. Using FAIT methodology, we have demonstrated significant impact achieved by a KT capacity building program for individual health professionals and the broader allied health workforce and health services and systems. Impact could be further optimised by strategies targeted at managers to create supportive contexts for KT through improving research literacy in health decision and policy contexts and innovative workforce planning.

Many nurse researchers have designed strategies to assist health care practitioners to move evidence into practice. While many have been identified as "models," most do not have a conceptual framework. They are unidirectional, complex, and difficult for novice research users to understand. These models have focused on empirical knowledge and ignored the importance of practitioners' tacit knowledge. The Communities of Practice conceptual framework allows for the integration of tacit and explicit knowledge into practice. This article describes the development of a new translation model, the Multisystem Model of Knowledge Integration and Translation, supported by the Communities of Practice conceptual framework.

This article about inter-country peer learning and knowledge translation is excerpted from the Gavi Zero-Dose Learning Hub publication "Knowledge Translation for Zero-Dose Immunization Research". The Geneva Learning Foundation (TGLF) hosted the first ZDLH Inter-Country Peer Learning Exchange session (ZDLH-X), in May 2023 with a focus on Bangladesh and Mali.

Purpose To evaluate the implementation of an integrated multidisciplinary Movement Disorder Clinic using a model of knowledge translation. Methods A mixed methods design was used to evaluate implementation outcomes. After recognising poor referral rates to allied health, Movement Disorder Clinic team-members identified implementation barriers. Team- and process-level implementation strategies were designed and tailored to address these barriers. The primary outcome measure was the change in the proportion of patients referred to allied health, determined by comparing pre- and post-implementation documentation audits. Secondary outcome measures included clinician and consumer surveys to identify ongoing implementation barriers and stakeholder satisfaction. Results Documentation from 90 medical records was included in the audits (post-intervention n = 45). There was a significant improvement in the referral rates to allied health from 53% to 84% (mean improvement 31%, p = 0.003, Fisher's exact test). However, documentation of disease education decreased by 38% (p = 0.000, Fisher's exact test). Movement Disorder Clinic team-members identified three main barriers to ongoing implementation: “memory and automaticity”, “environmental context and resources” and “beliefs about capabilities”. Thirty-seven consumer surveys were completed, showing high levels of satisfaction (86%) but ongoing educational needs (51%). Conclusions Implementation of an integrated multidisciplinary Movement Disorder Clinic was facilitated by a knowledge translation framework, leading to improved allied health referral rates and high levels of staff and consumer satisfaction, but unmet educational needs of consumers. Future research in the field of multidisciplinary healthcare for people with movement disorders is needed to determine the impact of these changes on patients’ healthcare outcomes. Implications for rehabilitation Multidisciplinary integrated healthcare models may lead to better outcomes in progressive diseases such as Parkinson’s disease, however, can be challenging to implement. A knowledge translation framework facilitated successful implementation of an integrated multidisciplinary Movement Disorders Clinic, leading to significantly improved rates of appropriate referrals to allied health, and staff and consumer satisfaction. Team-members identified three main barriers to ongoing implementation – “memory and automaticity”, “environmental context and resources,” and “beliefs about capabilities” – which may impact sustainability and should be considered in future implementation efforts.

BackgroundThe existing gap between research evidence and public health practice has attributed to the unmet Millennium Development Goals in Africa and consequently, has stimulated the development of frameworks to enhance knowledge translation. These efforts aim at maximising health research utilisation in policy and practice to address the world’s disease burdens, including malaria. This study aimed at developing a contextual framework to improve the utilisation of malaria research for policy development in Malawi.MethodsThe study used two approaches including: two case studies of policy analysis exploring the policy-making process in Malawi, utilisation of local malaria research, and the role of key stakeholders in policy formulation process; and the assessment of facilitating factors and barriers to malaria research utilisation for policy-making in Malawi.ResultsFrom the case studies’ lessons and elements identified during the assessment of facilitating factors and barriers, a framework is developed to promote an integrated approach to knowledge translation. In this framework the Ministry of Health is considered as the main user of knowledge from research through the demand created by the research directorate and the National Malaria Control Programme. Key documents identified as being particularly relevant to the Ministry of Health for purposes of knowledge translation include the National Health Research Agenda, Guidelines for Policy Development and Analysis, and Guidelines for Evidence Use in Policy-making. Institutions conducting academic and policy-relevant malaria research in Malawi are identified and a consolidation of their linkages with the users of research is established through the Knowledge Translation Unit, the Evidence Informed decision-making Centre, and the African Institute for Development Policy. Equally, key players in this framework are the funding partners for both research and programmes that need to see accountability and impact of their support. Independent advisors, partners, and consultants also have their vital role in the process.ConclusionThe framework offers a practical basis for the factors identified and their linkages to promote a co-ordinated approach to malaria research utilisation in policy-making. Its applicability and success hinges on its wider dissemination and ownership by the government through the National Malaria Control Programme.

BackgroundNonadherence to treatment remains high among patients with musculoskeletal conditions with negative impact on the treatment outcomes, use of personal and cost of care. An active knowledge translation (KT) strategy may be an effective strategy to support practice change. The purpose of this study was to deliver a brief, interactive, multifaceted and targeted KT program to improve physiotherapist knowledge and confidence in performing adherence enhancing activities related to risk, barriers, assessment and interventions.MethodsWe utilised a 2-phase approach in this KT project. Phase 1 involved the development of an adherence tool kit following a synthesis of the literature and an iterative process involving 47 end-users. Clinicians treating patients with musculoskeletal conditions were recruited from two Physiotherapy and Occupational therapy national conferences in Canada. The intervention, based on the acronym SIMPLE TIPS was tested on 51 physiotherapists in phase 2. A pre- and post-repeated measures design was used in Phase 2. Graham’s knowledge-to-action cycle was used as the conceptual framework. Participants completed a pre—intervention assessment, took part in a 1-h educational session and completed a post—intervention assessment. A questionnaire was used to measure knowledge of evidence—based treatment adherence barriers, interventions and measures and confidence to perform evidence—based adherence practice activities. Data was analysed using descriptive statistics (frequency and percentage), Fisher’s exact test and Wilcoxon Sign-Ranked tests.ResultsBarriers and facilitators of adherence were identified under three domains (therapist, patient, health system) in phase 1. Seventy percent of the participants completed the questionnaire. Results indicated that 46.8% of respondents explored barriers including the use of behaviour change strategies and 45.7% reported that they measured adherence but none reported the use of validated outcomes. A significant improvement in post-self-efficacy scores for the four adherence enhancing activities was observed immediately after the workshop.ConclusionThe use of a multi-modal KT intervention is feasible in an educational setting. A brief interactive educational session was successfully implemented using a toolkit and caused a significant increase in physiotherapists’ knowledge and confidence at performing adherence enhancing activities in the very short-term. Further testing of SIMPLE TIPS on long-term adherence practices could help advance best practices specific to treatment adherence in MSK practice.