Knowledge translation of climate change research into public health action: a scoping review

Knowledge translation (KT) refers to the process of moving knowledge into healthcare practice and policy. The practice of KT is about helping decision-makers become aware of knowledge and facilitating their use of it in their day-to-day work. The science of KT is about studying the determinants of knowledge use and investigating strategies to support the adoption, implementation, and sustained use of knowledge in healthcare practice and policy. An increasing number of trainees are developing careers in KT practice and/or KT research. Given the infancy of this field, there may be unique challenges that trainees face as they develop their careers in KT. This paper is one of two from a study about KT trainees’ perspectives on KT research and practice. The purpose of this paper was to identify challenges that KT trainees face in their KT practice or research

BackgroundResearch funders, educators, investigators and decision makers worldwide have identified the need to improve the quality of health care by building capacity for knowledge translation (KT) research and practice. Peer-based mentorship represents a vehicle to foster KT capacity. The purpose of this exploratory study is to identify mentoring models that could be used to build KT capacity, consult with putative mentee stakeholders to understand their KT mentorship needs and preferences, and generate recommendations for the content and format of KT mentorship strategies or programs, and how they could be tested through future research.MethodsA conceptual framework was derived based on mentoring goals, processes and outcomes identified in the management and social sciences literature, and our research on barriers and facilitators of academic mentorship. These concepts will inform data collection and analysis. To identify useful models by which to design, implement and evaluate KT mentorship, we will review the social sciences, management, and nursing literature from 1990 to current, browse tables of contents of relevant journals, and scan the references of all eligible studies. Eligibility screening and data extraction will be performed independently by two investigators. Semi-structured interviews will be used to collect information about KT needs, views on mentorship as a knowledge sharing strategy, preferred KT mentoring program elements, and perceived barriers from clinician health services researchers representing different disciplines. Qualitative analysis of transcripts will be performed independently by two investigators, who will meet to compare findings and resolve differences through discussion. Data will be shared and discussed with the research team, and their feedback incorporated into final reports.DiscussionThese findings could be used by universities, research institutes, funding agencies, and professional organizations in Canada and elsewhere to develop, implement, and evaluate mentorship for KT research and practice. This research will establish a theoretical basis upon which we and others can compare the cost-effectiveness of interventions that enhance KT mentorship. If successful, this program of research may increase knowledge about, confidence in, and greater utilization of KT processes, and the quality and quantity of KT research, perhaps ultimately leading to better implementation and adoption of recommended health care services.

Defining 'best practice' is one of the first and crucial steps in any Knowledge Translation (KT) research project. Without a sound understanding of what exactly should happen in practice, it is impossible to measure the extent of existing gaps between 'desired' and 'actual' care, set implementation goals, and monitor performance. The aim of this paper is to present a practical, stepped and interactive process to develop best practice recommendations that are actionable, locally applicable and in line with the best available research-based evidence, with a view to adapt these into process measures (quality indicators) for KT research purposes. Our process encompasses the following steps: (1) identify current, high-quality clinical practice guidelines (CPGs) and extract recommendations; (2) select strong recommendations in key clinical management areas; (3) update evidence and create evidence overviews; (4) discuss evidence and produce agreed 'evidence statements'; (5) discuss the relevance of the evidence with local stakeholders; and (6) develop locally applicable actionable best practice recommendations, suitable for use as the basis of quality indicators. Actionable definitions of local best practice are a prerequisite for doing KT research. As substantial resources go into rigorously synthesizing evidence and developing CPGs, it is important to make best use of such available resources. We developed a process for efficiently developing locally applicable actionable best practice recommendations from existing high-quality CPGs that are in line with current research evidence.

Knowledge translation approaches and practices in Indigenous health research: A systematic review

IntroductionAcademic–government partnerships are important to advance timely, responsive and relevant evidence for decision-making (policy, guideline, law and regulation) deliberations. Deliberate and strategic integrated knowledge translation (KT) approaches within such partnerships...

Over the last 15 years there has been an increasingly energetic search for theories and definitions in the burgeoning area of knowledge translation (KT) in the health care context. The focus has been on the design and evaluation of KT activities with little attention to developing a considered KT theoretical/methodological approach that takes a more distanced critical inquiry to the studying of KT interventions. As such, what has been overlooked in the health professions KT literature to date is a suitably complex conceptualisation of translation that encompasses the multiplicity of KT interventions, the dynamic environments in which they are occurring, and the production of new knowledge which arises from their interactions. Attending to these epistemological issues; i.e. issues of the type of knowledge and how it is produced, is crucial to developing a relational understanding of the production and emergence of context-specific clinical knowledge and practice in KT processes. Such an approach is compared to the traditional KT evaluations by KT practitioners themselves of the compliance or non-compliance of individual and organisational behaviour change. A Sociology of KT (SKT) is proposed to complement the applied and evaluative research practice of implementing planned action KT activities. The purpose of a SKT basic research agenda is to understand both the context-specific nature of KT interventions and the epistemological premises of the activities of KT implementers themselves, in order to advance the science of KT and inform, complement and add to the success of applied and evaluative KT research in the future.

Knowledge Translation, Evidence-Based Practice, and You

The development of a dynamic leadership coalition between practitioners and researchers/scientists – which is known in Canada as integrated knowledge translation (KT) – can play a major role in bridging the know-do gap in the health care and public health sectors. In public health, and especially in globally oriented public health, integrated KT is a dynamic, interactive (collaborative), and nonlinear phenomenon that goes beyond a reductionist vision of knowledge translation, to attain inter-, multi-, and even transdisciplinary status. Intimately embedded in its socioenvironmental context and closely connected with the complex interventions of multiple actors, the nonlinear process of integrated KT is based on a double principle: (1) the principle of transcendence of frontiers (sectorial, disciplinary, geographic, cultural, and cognitive), and (2) the principle of integration of knowledge beyond these frontiers. However, even though many authors agree on the overriding importance of integrated KT, there is as yet little understanding of the causal framework of integrated KT. Here, one can ask two general questions. Firstly, what “determines” integrated KT? Secondly, even if one wanted to apply a “transfrontier knowledge translation” vision, how should one go about doing so? For example, what would be the nature and qualities of a representative research program that applied a “transfrontier collaboration” approach? This paper focuses on the determinants of integrated KT within the burgeoning field of knowledge translation research (KT research). The paper is based on the results of a concurrent mixed method design which dealt with the complexity of building and sustaining effective coalitions and partnerships in the health care and public health sectors. The aims of this paper are: (1) to present an “integrated KT” conceptual framework which is global-context-sensitive, and (2) to promote the incorporation of a new “transfrontier knowledge translation” approach/vision designed primary for globally oriented public health researchers and health scientists.

BackgroundThe Knowledge Translation Innovation Incubator (KTII) initiative, launched by the Knowledge Translation program of the CHILD-BRIGHT Strategy for Patient-Oriented Research Network, provided funding support for researchers and partners to experiment with various approaches and strategies to support the development of innovative knowledge translation (KT) research in the context of neurodevelopmental disabilities.ObjectiveWe aimed to describe the process and contexts of innovation development in integrated knowledge translation (iKT) practices in patient-oriented research.MethodsWe applied an iKT practice to conduct the collective case study of 7 KTII-funded projects. We interviewed 10 researchers, 4 research trainees, 2 clinicians, 2 parentpartners, 2 patient-partners (1 adult and 1 youth), 1 community partner, 1 KT specialist, 1 designer, and 1 research program manager at the middle and the end of the project period. We conducted qualitative content analysis using the Consolidated Framework for Implementation Research to identify and assess patterns of determinants of (1) drivers of innovation, (2) facilitators and barriers to innovation development, and (3) enablers for sustainability of KT products.ResultsInnovative KT was majorly driven by the identified know-do gap to meet the needs of people with lived experience. Outer setting constructs, such as funding and partnerships and connections, were not only drivers but also facilitators to innovation development. iKT practices presented in this case study were fostered by researchers’ approach to participatory design, involving iterations of listening to emerging ideas and feedback of patient-partners and other partners, and researchers’ continuous reflections on their roles in knowledge creation. Despite the challenges in building consensus and the limited time of the fluid process, researchers’ strong passion for engagement and value placed on lived experience led to flexible engagement and open communication to create KT products. Intangible outcomes included further relationships at individual and organizational levels, capacity building of young people, and a collective voice to influence communities. Sustainment of the KT products requires not only accessibility and adaptability of the product itself but also mechanisms at inner settings, such as training, continued interest of patient-partners and the community, and institutional partnerships to support the further uptake of the product.ConclusionsThis study illustrates the critical roles of researchers in addressing power dynamics and making the research partners’ tacit knowledge visible for successful innovative KT. The research landscape should also change in terms of funding and timeline in order to foster researchers’ mental models in designing thinking and actions on collaborative research engagement.

Medicines and universal health coverage: challenges and opportunities.

There is a significant knowledge-to-action gap in cancer survivorship care for First Nations (FN) communities. To date, many approaches to survivorship have not been culturally responsive or community-based. This study is using an Indigenous knowledge translation (KT) approach to mobilize community-based knowledge about cancer survivorship into health-care programs. Our team includes health-care providers and cancer survivors from an FN community in Canada and an urban hospital that delivers Cancer Care Ontario’s Aboriginal Cancer Program. Together, we will study the knowledge-to-action process to inform future KT research with Indigenous peoples for improving health-care delivery and outcomes. The study will be conducted in settings where research relations and partnerships have been established through our parent study, The National Picture Project. The inclusion of community liaisons and the continued engagement of participants from our parent study will foster inclusiveness and far-reaching messaging. Knowledge about unique cancer survivorship needs co-created with FN people in the parent study will be mobilized to improve cancer follow-up care and to enhance quality of life. Findings will be used to plan a large-scale implementation study across Canada.

Community engagement: learning from low-income countries

Pain is inadequately managed in pediatric populations across health care settings. Although training programs to improve health care provider knowledge and skills have been developed and evaluated, clinical practices have not always kept pace with advancing knowledge. Consequently, the goal of this review was to systematically examine the pediatric pain literature of knowledge translation (KT) programs targeting health care providers. Systematic searches of PubMed, Web of Science, CINAHL, and PsycINFO were undertaken. KT initiatives directed toward health care providers and in which the primary focus was on pediatric pain were included. Primary outcomes, intervention characteristics, and risk of bias were examined across studies. Study outcomes were conceptually organized and a narrative synthesis of results was conducted. A total of 15,191 abstracts were screened for inclusion with 98 articles retained on the basis of predetermined criteria. Across studies, KT approaches varied widely in format and focus. Knowledge-level changes and self-reported increases in comfort or confidence in skills/knowledge were consistently achieved. Practice-level changes were achieved in many areas with varying success. Design and reporting issues were identified in the majority of studies. Examination of patient-related outcomes and of the long-term impact of pediatric pain KT programs was limited across studies. KT programs vary in quality and impact. Although several successful programs have been developed, many studies include a high risk of bias due to study quality. Evidence-based KT program implementation and a focus on sustainability of outcomes must be given greater consideration in the field of pediatric pain.

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.

BackgroundMaps and mapping tools through geographic information systems (GIS) are highly valuable for turning data into useful information that can help inform decision-making and knowledge translation (KT) activities. However, there are several challenges involved in incorporating GIS applications into the decision-making process. We highlight the challenges and opportunities encountered in implementing a mapping innovation as a KT strategy within the non-profit (public) health sector, reflecting on the processes and outcomes related to our KT innovations.MethodsA case study design, whereby the case is defined as the data analyst and manager dyad (a two-person team) in selected Ontario Early Year Centres (OEYCs), was used. Working with these paired individuals, we provided a series of interventions followed by one-on-one visits to ensure that our interventions were individually tailored to personal and local decision-making needs. Data analysis was conducted through a variety of qualitative assessments, including field notes, interview data, and maps created by participants. Data collection and data analysis have been guided by the Ottawa Model of Research Use (OMRU) conceptual framework.ResultsDespite our efforts to remove all barriers associated with our KT innovation (maps), our results demonstrate that both individual level and systemic barriers pose significant challenges for participants. While we cannot claim a causal association between our project and increased mapping by participants, participants did report a moderate increase in the use of maps in their organization. Specifically, maps were being used in decision-making forums as a way to allocate resources, confirm tacit knowledge about community needs, make financially-sensitive decisions more transparent, evaluate programs, and work with community partners.ConclusionsThis project highlights the role that maps can play and the importance of communicating the importance of maps as a decision support tool. Further, it represents an integrated knowledge project in the community setting, calling to question the applicability of traditional KT approaches when community values, minimal resources, and partners play a large role in decision making. The study also takes a unique perspective--where research producers and users work as dyad-pairs in the same organization--that has been under-explored to date in KT studies.