What is it and why is it important? Nov November 6, 6, 20 2014 - - PDF document

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“Knowledge Translation: What is it and why is it important?”

Nov November 6, 6, 20 2014 14

Pr Presen esentation

• n to:

Kno nowle ledge Mobi

• bili

lizatio ion Wor

• rking Group

Ron

• nald

ld R. Lind ndstrom, PhD hD, FCC CCHL Pro Profess ssor r and nd Direc ector, Ce Centr tre e for

• r Healt

lth Leader ership ip & & Resea search Henri i M. Tou

• upi

pin Resea search Fello low in n Health lth Syst stem ems s Leadersh ship Schoo

• ol of
• f Leader

ership ip Stud udies es Roy

• yal Roa
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s Uni niversi sity Victoria ria, BC BC

Outline

• What is KT?
• Why is KT important?
• The research – practice gaps
• The five key questions of KT
• Summary

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What is KT?

The terms and definitions have evolved over many years, e.g.,

• Knowledge transfer
• Knowledge linkage & exchange
• Knowledge brokering
• Knowledge utilization
• Knowledge mobilization
• Knowledge transformation
• Knowledge to Action (K2A)
• Knowledge translation
• Implementation research/science

What is KT, con’t.?

Knowledge translation

• e.g., “…a dynamic and iterative process that includes

synthesis, dissemination, exchange and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system.” “This process takes place within a complex system of interactions between researchers and knowledge users…”

(CIHR, 2009)

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CIHR – Integrated and End-of-Grant KT (CIHR, 2014)

Integrated KT:

• Stakeholders engaged in entire research process, eg, questions,

methodology, data gathering, interpreting findings, dissemination of results End-of-Grant KT:

• Building awareness by communicating to knowledge users at the end
• f the project, eg, conferences, journals, educational sessions,

journalistic media, social media, knowledge brokers, commercialization, etc.

Evidence-based decision-making (EBDM)

• Popularized in the 1990s
• Extension of evidence-based medicine (EBM)
• A focus of earlier efforts by Canadian Health Services Research

Foundation (CHSRF) (CHSRF, 2000)

NB: Unfortunately, the opposite is sometimes true: Decision-based Evidence-making (DBEM) where a decision is made and then evidence is made/found to support it.

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Evidence-informed decision-making (EIDM)

• Expands EBDM to include diverse contextual information held

by multiple stakeholders, e.g., stories, experiences, and

• realities. (CHSRF, 2004)

Why is KT important?

To close “Knowledge – Action” gaps

• “Two-communities theory” (Caplan, 1979): social

scientists/policy-makers in separate worlds; different/conflicting values; different reward systems; different languages; and, different cultures

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Why is KT important, con’t.?

• “Knowledge translation is about turning knowledge into

action and encompasses the processes of both knowledge creation and knowledge application.” (Graham, et al, 2006, p. 22)

• Knowledge-to-action [KTA] is about an exchange of

knowledge between relevant stakeholders that results in action.” (Graham, et al, 2006, p. 22)

Why is KT important, con’t.? To whom?

Key Stakeholders: Researchers, e.g.,

• Qualitative/quantitative
• Disciplinary/multi,inter,trans
• Theoretical/applied
• Wet lab/dry lab

Knowledge users, e.g.,

• Policy (including gov’t)
• Managerial
• Clinical
• Public
• Industry
• Media

Funders, e.g.,

• Canadian Institutes of Health Research (CIHR)
• Canadian Health Services Research Foundation (CHSRF)
• Michael Smith Foundation for Health Research (MSFHR)

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Why are there gaps between research and practice?

Things that hinder decision-makers’ use of research evidence:

• Lack of pertinent evidence, e.g., outdated; not readily

accessible

• Lack of consensus amongst decision-makers, e.g., values,

interests, experiences

• Inappropriate use of evidence, e.g., misinformation; strongly

held beliefs

• Lag times between research and its application, e.g.,

geographical disparities; who reads what

• Being overwhelmed with information, e.g., little time, skills,

tools to make sense

Why are there gaps between research and practice, con’t.?

• Failure to keep health outcomes in mind, e.g., influences of

media, advertising and private industry

• Different and changing values, e.g., lack of shared interests

and values

• Lack of accountability for decisions, e.g., lag times between

decision and outcomes

• Reliance on tradition and judgment, e.g., professionalism
• Protection of privacy and confidentiality, e.g., turf wars; lack
• f public trust; data protection issues
• Poorly coordinated health information systems, e.g., lack of

standardized and linked data (National Forum on Health, 1997)

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Five key questions of KT (Lavis, et al, 2003; Grimshaw, et al, 2012))

• What should be transferred? Eg, s/b in context of global knowledge;

tailor message and language to specific target audiences.

• To whom should research knowledge be transferred? Eg, differs

depending on stakeholders involved

• By whom should research knowledge be transferred? Eg, varies

depending on target audience – needs to be credible; needs research knowledge infrastructures (tools, programs, etc)

• How should research knowledge be transferred? Eg, plan, identify

barriers, choose appropriate methods, tools & change strategies,

• With what effect should research knowledge be transferred? Eg,

should result in context –dependent evidence-based or evidence- informed decision-making

Summary

• KT means different things to different stakeholders; keep this in

mind at all times and clarify as you must

• KT involves multiple stakeholders throughout the entire

research – to – action process; it is collective action

• KT is about working in the ‘research – practice gap’; this is

difficult and largely uncharted territory, but get to know it and tailor methods accordingly; context is key

• KT is not an endpoint; it is a continual and iterative process of

engaging the right stakeholders at the right time to do the right thing for the right reason

• KT works, but only if you pay close attention to people, process

and context; ++ dynamic

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References

Canadian Health Services Research Foundation. (2000). Health services research and...evidence-based decision-making. Retrieved February 6, 2003, from http://www.chsrf.ca/docs/resource/EBDM_e.pdf Canadian Health Services Research Foundation. (2004). What counts?: Interpreting evidence-based decision-making for management and policy. Report of the 6th CHSRF Annual Invitational Workshop. Vancouver, B.C. :Author. Canadian Institutes of Health Research. (2009, 2014). More about knowledge translation at CIHR. http://www.cihr-irsc.gc.ca/e/39033.html Caplan, N. (1979). The two-communities theory and knowledge utilization. American Behavioral Scientist, 22, 459-470. Retrieved January 7, 2003, from EBSCOhost database. Graham, I.D., Logan, J., Harrison, M.B., Straus, S.E., Tetroe, J., Caswell, W., & Robinson, N. (2006). Lost in knowledge translation: Time for a map? The Journal of Continuing Education in the Health Professions 26(1), 13-24. Grimshaw, J.M., Eccles, M.P., Lavis, J.M., Hill, S.J., & Squires, J.E. (2012). Knowledge translation of research

• findings. Implementation Science 7:50 doi: 10.1186/1748-5908-7-50

Lavis, J.N., Robertson, D., Woodside, J.M., McLeod, C.B. & Abelson, J. (2003). How can research

• rganizations more effectively transfer research knowledge to decision makers? The Milbank Quarterly

81, 221-248. National Forum on Health. (1997). Canada health action: Building on the legacy . Vol. II. Synthesis Reports and Issues Papers: Creating a Culture of Evidence-Based Decision Making in Health. Ottawa, ON: Author.