Jacqueline Tetroe

Lost in Knowledge Translation: Time for a Map?

&NA; There is confusion and misunderstanding about the concepts of knowledge translation, knowledge transfer, knowledge exchange, research utilization, implementation, diffusion, and dissemination. We review the terms and definitions used to describe the concept of moving knowledge into action. We also offer a conceptual framework for thinking about the process and integrate the roles of knowledge creation and knowledge application. The implications of knowledge translation for continuing education in the health professions include the need to base continuing education on the best available knowledge, the use of educational and other transfer strategies that are known to be effective, and the value of learning about planned‐action theories to be better able to understand and influence change in practice settings.

Defining knowledge translation

We cannot pick up a magazine or surf the Internet without facing reminders of the challenges to health care and the “sorry state” of health systems. [1][1] All health care systems are faced with the challenges of improving quality of care and reducing the risk of adverse events. [2][2] Globally

Some Theoretical Underpinnings of Knowledge Translation

A careful analysis of the definition of knowledge translation highlights the importance of the judicious translation of research into practice and policy. There is, however, a considerable gap between research and practice. Closing the research-to-practice gap involves changing clinical practice, a complex and challenging endeavor. There is increasing recognition that efforts to change practice should be guided by conceptual models or frameworks to better understand the process of change. The authors conducted a focused literature search, developed inclusion criteria to identify planned action theories, and then extracted data from each theory to determine the origins, examine the meaning, judge the logical consistency, and define the degree of generalizability, parsimony, and testability. An analysis was conducted of the concepts found in each theory, and a set of action categories was developed that form the phases of planned action. Thirty-one planned action theories were identified that formed the basis of the analyses. An Access database was created, as well as a KT Theories Users Guide that synthesizes all the planned change models and theories, identifies common elements of each, and provides information on their use. There are many planned change models and frameworks with many common elements and action categories. Whenever any planned change model is used, change agents should consider documenting their experiences with the model so as to advance understanding of how useful the model is and to provide information to others who are attempting a similar project.

Monitoring use of knowledge and evaluating outcomes.

In the knowledge-to-action cycle, after the intervention related to knowledge translation has been implemented, uptake of knowledge should be monitored. [1][1] This step is necessary to determine how and to what extent the knowledge is used by the decision-makers. [1][1] How we measure uptake of

An international survey indicated that unpublished systematic reviews exist

OBJECTIVE To determine the frequency of unpublished systematic reviews (SRs) and explore factors contributing to their occurrence. STUDY DESIGN AND SETTING First or corresponding authors from a sample of SRs published in 2005 were asked to participate in a 26-item survey administered through the Internet, facsimile, and postal mail. Outcomes included median and range of published and unpublished SRs, and barriers, facilitators, and reasons for not publishing SRs. Descriptive analyses were performed. RESULTS 55.7% (348 of 625) of those invited participated, half of which were from Europe and 22.7% were from the United States. Participants reported 1,405 published (median: 2.0, range: 1-150) and 199 unpublished (median: 2.0, range: 1-33) SRs. Lack of time and lack of funding and organizational support were barriers, whereas time availability and self-motivation were facilitators to publishing reviews. For most recent unpublished SRs (n=52), the reasons for not publishing included lack of time (12 of 52, 23.0%), the manuscript being rejected (10 of 52, 19.0%), and operational issues (six of 52, 11.5%). CONCLUSION Unpublished SRs do exist. Lack of time, funding, and organizational support were consistent reasons for not publishing SRs. Statistical significance of SR results was not reported as being a major barrier or reason for not publishing. Further research on unpublished SRs is warranted.

Whither knowledge translation: an international research agenda.

The articles in this supplement illustrate the potential value of developing an international research agenda on the science of knowledge translation. Building on the suggestions made by the contributors to the supplement, we offer a number of topics for such an agenda.

Research funder required research partnerships: a qualitative inquiry

BackgroundResearchers and funding agencies are increasingly showing interest in the application of research findings and focusing attention on engagement of knowledge-users in the research process as a means of increasing the uptake of research findings. The expectation is that research findings derived from these researcher-knowledge-user partnerships will be more readily applied when they became available. The objective of this study was to investigate the experiences, perceived barriers, successes, and opinions of researchers and knowledge-users funded under the Canadian Institutes of Health Research’s integrated Knowledge Translation funding opportunities for a better understanding of these collaborations.MethodsParticipants, both researchers and knowledge-users, completed an online survey followed by an individual semi-structured phone interview supporting a mixed methods study. The interviews were analyzed qualitatively using a modified grounded theory approach.ResultsSurvey analysis identified three major partnership types: token, asymmetric, and egalitarian. Interview analysis revealed trends in perceived barriers and successes directly related to the partnership formation and style. While all partnerships experienced barriers, token partnerships had the most challenges and general poor perception of partnerships. The majority of respondents found that common goals and equality in partnerships did not remove barriers but increased participants’ ability to look for solutions.ConclusionsWe learned of effective mechanisms and strategies used by researchers and knowledge-users for mitigating barriers when collaborating. Funders could take a larger role in helping facilitate, nurture, and sustain the partnerships to which they award grants.

Understanding the performance and impact of public knowledge translation funding interventions: Protocol for an evaluation of Canadian Institutes of Health Research knowledge translation funding programs

BackgroundThe Canadian Institutes of Health Research (CIHR) has defined knowledge translation (KT) as a dynamic and iterative process that includes the 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 healthcare system. CIHR, the national health research funding agency in Canada, has undertaken to advance this concept through direct research funding opportunities in KT. Because CIHR is recognized within Canada and internationally for leading and funding the advancement of KT science and practice, it is essential and timely to evaluate this intervention, and specifically, these funding opportunities.DesignThe study will employ a novel method of participatory, utilization-focused evaluation inspired by the principles of integrated KT. It will use a mixed methods approach, drawing on both quantitative and qualitative data, and will elicit participation from CIHR funded researchers, knowledge users, KT experts, as well as other health research funding agencies. Lines of inquiry will include an international environmental scan, document/data reviews, in-depth interviews, targeted surveys, case studies, and an expert review panel. The study will investigate how efficiently and effectively the CIHR model of KT funding programs operates, what immediate outcomes these funding mechanisms have produced, and what impact these programs have had on the broader state of health research, health research uptake, and health improvement.DiscussionThe protocol and results of this evaluation will be of interest to those engaged in the theory, practice, and evaluation of KT. The dissemination of the study protocol and results to both practitioners and theorists will help to fill a gap in knowledge in three areas: the role of a public research funding agency in facilitating KT, the outcomes and impacts KT funding interventions, and how KT can best be evaluated.

What does it mean to transform knowledge into action in falls prevention research? Perspectives from the Canadian Institutes of Health Research.

INTRODUCTION The concept of knowledge translation as defined by the Canadian Institutes for Health Research and the Knowledge to Action Cycle, described by Graham et al (Graham et al., 2006), are used to make a case for the importance of using a conceptual model to describe moving knowledge into action in the area of falls prevention. METHOD There is a large body of research in the area of falls prevention. It would seem that in many areas it is clear what is needed to prevent falls and further syntheses can determine where the evidence is sufficiently robust to warrant its implementation as well as where the gaps are that require further basic research. CONCLUSION The phases of the action cycle highlight seven areas that should be paid attention to in order to maximize chances of successful implementation.

Nomenclature in Translational Research

Financial Disclosures: Dr Naghavi is chair of the Society for Heart Attack Prevention and Eradication (SHAPE), and Drs Falk and Shah are members of the board of directors of SHAPE; they reported receiving no compensation for these roles. Dr Naghavi reported being a shareholder of Volcano Corporation and Endothelix and president of American Heart Technologies. Dr Falk reported being a shareholder of Endothelix and a scientific advisor to BG Medicine and Boston Scientific. Dr Shah reported being a scientific advisor to Roche, BG Medicine, Kowa Pharmaceuticals, Resverlogix, Cardiovax, and BioInvent.