Mandy M. Archibald

Development of a checklist to assess the quality of reporting of knowledge translation interventions using the Workgroup for Intervention Development and Evaluation Research (WIDER) recommendations

BackgroundInfluenced by an important paper by Michie et al., outlining the rationale and requirements for detailed reporting of behavior change interventions now required by Implementation Science, we created and refined a checklist to operationalize the Workgroup for Intervention Development and Evaluation Research (WIDER) recommendations in systematic reviews. The WIDER recommendations provide a framework to identify and provide detailed reporting of the essential components of behavior change interventions in order to facilitate replication, further development, and scale-up of the interventions.FindingsThe checklist was developed, applied, and improved over the course of four systematic reviews of knowledge translation (KT) strategies in a variety of healthcare settings conducted by Scott and associates. The checklist was created as one method of operationalizing the work of the WIDER in order to facilitate comparison across heterogeneous studies included in these systematic reviews. Numerous challenges were encountered in the process of creating and applying the checklist across four stages of development. The resulting improvements have produced a ‘user-friendly’ and replicable checklist to assess the quality of reporting of KT interventions in systematic reviews using the WIDER recommendations.ConclusionsWith journals, such as Implementation Science, using the WIDER recommendations as publication requirements for evaluation reports of behavior change intervention studies, it is crucial to find methods of examining, measuring, and reporting the quality of reporting. This checklist is one approach to operationalize the WIDER recommendations in systematic review methodology.

Investigator Triangulation A Collaborative Strategy With Potential for Mixed Methods Research

The purpose of this article is to explore investigator triangulation (IT), a collaborative strategy with potential for mixed methods research (MMR). A critical review of the literature was conducted to identify IT’s core elements and its use in MMR. Five databases, 2 MMR journals, and 13 MMR texts were searched for evidence of IT according to preestablished inclusion criteria. IT descriptions and applications were inconsistent and lacked detailed reporting. Incongruence between IT procedures and associated claims were present. IT was generally limited to single-strand data analysis and was used predominantly to reduce researcher bias. IT’s potential as a generative and pragmatic research strategy used to engage with tensions emerging through diversity in MMR is explored and reporting guidelines are presented.

Mapping the waters: A scoping review of the use of visual arts in pediatric populations with health conditions

Objectives: Visual art is a powerful and expressive communication tool with utility in pediatric settings. We undertook a scoping review to understand how visual arts (e.g. drawing, painting) are used in pediatric populations with health (i.e. medical and psychiatric) conditions. Methods: CINAHL, SCOPUS and PubMed were searched (2001–2011). We used systematic methods for study selection and data extraction. We conducted a descriptive analysis and categorized studies according to the purpose of the artistic intervention. Results: Of 1767 articles retrieved, 16 met the inclusion criteria. Visual art was most commonly used with the conditions of autism and post-traumatic stress disorder. Findings illuminate the use of art visual as a mechanism to facilitate or reduce specific child attributes (e.g. self-efficacy, anxiety) and to facilitate understanding through communication or assessment. Conclusions: This review provides information about the uses of visual art in pediatric populations with health conditions, as well as gaps in existing research.

Current mixed methods practices in qualitative research: A content analysis of leading journals

Mixed methods research (MMR) has become increasingly popular in recent years. Yet, methodological challenges of mixing qualitative and quantitative data remain. Understanding how MMR is approached in qualitative research journals provides insights into lingering mixing issues. In this article, we content analyzed five leading qualitative research journals from 2003 to 2014, which represents the reflective period of MMR. Of the 5,254 articles published, 94, or 1.79%, were mixed methods in nature, comprising 44 theoretically oriented articles and 50 empirical articles. In terms of theoretical articles, five content-based themes were identified: (a) MMR advocacy, (b) philosophy issues, (c) procedural suggestions, (d) practical issues and best practices, and (e) future directions. In terms of empirical articles, 36% used exploratory sequential designs, primarily to develop instruments, and 52% explicitly identified as MMR. None of the studies included MMR questions, and development (21%) and complementarity (14%) were the primary rationales for mixing. In virtually all studies (98%), mixing occurred at the data interpretation stage through some comparison of qualitative and quantitative research. Qualitative data were prioritized in 86% of the studies. Based on these findings, it appears that MMR affects qualitative research most directly by influencing study design and study purpose; however, there is a strong tendency to conduct and publish qualitative and quantitative studies separately. Recommendations for publishing future MMR are discussed.

Protocol for a systematic review of the use of narrative storytelling and visual-arts-based approaches as knowledge translation tools in healthcare

BackgroundThe arts are powerful, accessible forms of communication that have the potential to impart knowledge by attracting interest and developing meaningful connections. Knowledge translation aims to reduce the ‘evidence-practice’ gap by developing, implementing and evaluating strategies designed to enhance awareness and promote behavior change congruent with research evidence. Increasingly, innovative approaches such as narrative storytelling and other arts-based interventions are being investigated to bridge the growing gap between practice and research. This study is the first to systematically identify and synthesize current research on narrative storytelling and visual art to translate and disseminate health research.MethodsA health research librarian will develop and implement search strategies designed to identify relevant evidence. Studies will be included if they are primary research employing narrative storytelling and/or visual art as a knowledge translation strategy in healthcare. Two reviewers will independently perform study selection, quality assessment, and data extraction using standard forms. Disagreements will be resolved through discussion or third party adjudication. Data will be grouped and analyzed by research design, type of knowledge translation strategy (that is, a narrative or visual-arts-based approach), and target audience. An overall synthesis across all studies will be conducted.DiscussionThe findings from this research project will describe the ‘state of the science’ regarding the use of narrative storytelling and visual art as knowledge translation strategies. This systematic review will provide critical information for: (1) researchers conducting knowledge translation intervention studies; (2) nursing, medicine, and allied healthcare professionals; (3) healthcare consumers, including patients and families; and (4) decision makers and knowledge users who are charged to increase use of the latest research in healthcare settings.

The Development of a Classification Schema for Arts‐Based Approaches to Knowledge Translation

Background Arts-based approaches to knowledge translation are emerging as powerful interprofessional strategies with potential to facilitate evidence uptake, communication, knowledge, attitude, and behavior change across healthcare provider and consumer groups. These strategies are in the early stages of development. To date, no classification system for arts-based knowledge translation exists, which limits development and understandings of effectiveness in evidence syntheses. Purpose We developed a classification schema of arts-based knowledge translation strategies based on two mechanisms by which these approaches function: (a) the degree of precision in key message delivery, and (b) the degree of end-user participation. We demonstrate how this classification is necessary to explore how context, time, and location shape arts-based knowledge translation strategies. Discussion Classifying arts-based knowledge translation strategies according to their core attributes extends understandings of the appropriateness of these approaches for various healthcare settings and provider groups. The classification schema developed may enhance understanding of how, where, and for whom arts-based knowledge translation approaches are effective, and enable theorizing of essential knowledge translation constructs, such as the influence of context, time, and location on utilization strategies. Linking Evidence to Action The classification schema developed may encourage systematic inquiry into the effectiveness of these approaches in diverse interprofessional contexts.BACKGROUND Arts-based approaches to knowledge translation are emerging as powerful interprofessional strategies with potential to facilitate evidence uptake, communication, knowledge, attitude, and behavior change across healthcare provider and consumer groups. These strategies are in the early stages of development. To date, no classification system for arts-based knowledge translation exists, which limits development and understandings of effectiveness in evidence syntheses. PURPOSE We developed a classification schema of arts-based knowledge translation strategies based on two mechanisms by which these approaches function: (a) the degree of precision in key message delivery, and (b) the degree of end-user participation. We demonstrate how this classification is necessary to explore how context, time, and location shape arts-based knowledge translation strategies. DISCUSSION Classifying arts-based knowledge translation strategies according to their core attributes extends understandings of the appropriateness of these approaches for various healthcare settings and provider groups. The classification schema developed may enhance understanding of how, where, and for whom arts-based knowledge translation approaches are effective, and enable theorizing of essential knowledge translation constructs, such as the influence of context, time, and location on utilization strategies. LINKING EVIDENCE TO ACTION The classification schema developed may encourage systematic inquiry into the effectiveness of these approaches in diverse interprofessional contexts.

The Potential for Nurse Practitioners in Health Care Reform

In Canada, health care reform is underway to address escalating costs, access and quality of care issues, and existing personnel shortages in various health disciplines. One response of the nursing profession to these stimuli has been the development of the advanced practice nurse, namely, the nurse practitioner (NP). NPs are in an excellent position to address current shortcomings through increasing points of access to the health care system, providing an emphasis on education and disease prevention, and delivering high-quality, cost-effective care in a multitude of practice settings. With an emphasis on the social determinants of health, NPs are in a prime position to provide care to underserved and vulnerable populations across Canada. Despite the potential for NPs to be instrumental in health care reform, there is a lack of support and regulation necessary for their optimal use. Barriers to mobilizing NPs in Canada exist and impede the integration of NPs into the Canadian health care system, which has both quality of care and social justice implications.

Stories – a novel approach to transfer complex health information to parents: A qualitative study

Objective: To identify the beneficial attributes and mechanisms of storytelling through understanding the parental experiences of using a storybook knowledge translation intervention. Method: An exploratory descriptive design involving 23 parents of children presenting to two emergency departments for treatment of croup. Parents received a set of three storybooks, each representing a different severity level of croup (mild, moderate, and severe). Results: The storybooks were evaluated favorably. Parents were better able to understand the progression and treatment of croup by reading the stories, thus reducing uncertainty and alleviating anxiety about their childs condition. Parents consistently reported four positive outcomes associated with using the storybooks: (1) feeling reassured that they had done the right thing, (2) reduced uncertainty, (3) a normalization of the experience, and (4) feeling empowered. Conclusion: The “storybook” presentation of health information was regarded favorably by parents as a learning tool. Practice implications: The storybook format is a useful knowledge translation device.

Systematic Review of Knowledge Translation Strategies to Promote Research Uptake in Child Health Settings

UNLABELLED Strategies to assist evidence-based decision-making for healthcare professionals are crucial to ensure high quality patient care and outcomes. The goal of this systematic review was to identify and synthesize the evidence on knowledge translation interventions aimed at putting explicit research evidence into child health practice. METHODS A comprehensive search of thirteen electronic databases was conducted, restricted by date (1985-2011) and language (English). Articles were included if: 1) studies were randomized controlled trials (RCT), controlled clinical trials (CCT), or controlled before-and-after (CBA) studies; 2) target population was child health professionals; 3) interventions implemented research in child health practice; and 4) outcomes were measured at the professional/process, patient, or economic level. Two reviewers independently extracted data and assessed methodological quality. Study data were aggregated and analyzed using evidence tables. RESULTS Twenty-one studies (13 RCT, 2 CCT, 6 CBA) were included. The studies employed single (n=9) and multiple interventions (n=12). The methodological quality of the included studies was largely moderate (n=8) or weak (n=11). Of the studies with moderate to strong methodological quality ratings, three demonstrated consistent, positive effect(s) on the primary outcome(s); effective knowledge translation interventions were two single, non-educational interventions and one multiple, educational intervention. CONCLUSIONS This multidisciplinary systematic review in child health setting identified effective knowledge translation strategies assessed by the most rigorous research designs. Given the overall poor quality of the research literature, specific recommendations were made to improve knowledge translation efforts in child health.

Five lessons from art for better research

What can art teach us, not just for life: but also for research? The Arts are used to understand and represent human experience (Leavy 2013) and in health research and practice (Archibald et al. 2014). But false dichotomies abound: of art vs. science, aesthetics vs. method and expression vs. discipline. We highlight five lessons from art that can bring valuable benefits to research for meaning, creativity and motivation.