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

11/6/14 “Knowledge Translation: What is it and why is it important?” Nov November 6, 6, 20 2014 14 Pr Presen esentation on to: Kno nowle ledge Mobi obili lizatio ion Wor orking Group Ron onald ld R. Lind ndstrom, PhD hD, FCC CCHL Profess Pro ssor r and nd Direc ector, Ce Centr tre e for or Healt lth Leader ership ip & & Resea search Henri i M. Tou oupi pin Resea search Fello low in n Health lth Syst stem ems s Leadersh ship Schoo ool of of Leader ership ip Stud udies es Roy oyal Roa oads 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 1

11/6/14 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) 2

11/6/14 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 of 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. 3

11/6/14 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 4

11/6/14 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) 5

11/6/14 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 of public trust; data protection issues • Poorly coordinated health information systems, e.g., lack of standardized and linked data (National Forum on Health, 1997) 6

11/6/14 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 7

11/6/14 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 6 th 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 organizations 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. 8