In other cases, we made an initial judgement, based on the abstract or a Google text fragment, that the paper was not about an empirical, real-life, knowledge translation or implementation project. This scheme may be useful for similar studies examining theory use. And if so, how?. The Journal of Continuing Education in the Health Professions 2006, 26, p. 19. Copyright 2015 Wiley Periodicals, Inc., A Wiley Company Can J Cardiol. In addition, this suggests conceptual frameworks do not have to be mutually exclusive. One hundred and forty-six studies described usage to varying degrees, ranging from referenced to integrated. This study sought to identify and describe available full-spectrum KT TMFs to subsequently guide users. Leah Crockett is a doctoral student in the Department of Community Health Sciences at the University of Manitoba. Skip to Keyser SE: The Implementation of a Delirium Knowledge Translation Project for Families of the Elderly. Petzold, A., Korner-Bitensky, N., & Menon, A. Knowledge producers . We focus on all things knowledge translation (KT) and patient engagement (PE), from a health research and healthcare perspective. KG is a professor of nursing research at the University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust where she leads the Translating Knowledge into Action theme of NIHR CLAHRC for Yorkshire and Humber. However, as shown by our study, citation searching in isolation from citation analysisthe detailed examination of full-textis unable to discriminate between where a model is simply mentioned in passing or even for cosmetic reasons and where it represents an explicit intellectual and conceptual contribution. the site home page. It may be useful for them to consider the extent to which they wish to follow or be guided by a conceptual framework before embarking on a knowledge translation project, especially regarding outcome measures because .the focus of knowledge into action is ultimately to enhance health status [1 p. 18]. Offering up to 36-month product lifecycle support and 6-month end-of-life notice to allow . California Privacy Statement, Can J Speech-Language Pathol Audiol. Any differences were discussed and resolved by consensus. However, our review focused primarily on examining how a conceptual framework had been used in practice. 10.1136/bmjqs-2013-001862. Tailoring knowledge was described in three studies [18],[20],[26]. Future research could examine the studies which we categorised as using the KTA Framework to a lesser degree, perhaps for conceptual or persuasive reasons rather than instrumentally. Bjrk IT, Lomborg K, Nielsen CM, Brynildsen G, Frederiksen A-MS, Larsen K, Reierson I, Sommer I, Stenholt B: From theoretical model to practical use: an example of knowledge translation. CDC Knowledge to Action Framework [PDF - 33 KB] An Organizing Framework for Translation in Public Health: The Knowledge to Action Framework Applying the Knowledge to Action (K2A) Framework: Questions to Guide Planning Tool [PDF - 3.57 MB] Glossary of Terms [DOC -17 KB] Page last reviewed: April 28, 2021 Russell DJ, Rivard LM, Walter SD, Rosenbaum PL, Roxborough L, Cameron D, Darrah J, Bartlett DJ, Hanna SE, Avery LM: Using knowledge brokers to facilitate the uptake of pediatric measurement tools into clinical practice: a before-after intervention study. School of Nursing, University of Ottawa, Ottawa, ON, Canada. One of the things that makes the KTA unique is that it begins with research evidence, the need to synthesize and translate that evidence - these are represented by the funnel in the middle of the cycle. 2012, 7: 50-10.1186/1748-5908-7-50. The Knowledge-to-Action (KTA) framework provides a logical structure and process to plan IS projects. This flexibility was intended, as Graham and colleagues [1] state the framework can also accommodate different phases being accomplished by different stakeholders and groups (working independently of each other) at different points in time (p. 18). The uptake of EBP is a complex process that can be facilitated by the use of the Knowledge to Action Process model. Glossary for Knowledge to Action Framework; Research Phase. The target audience included the public and patients, the families of older adults, health professionals, occupational therapists, speech and language therapists, physiotherapists and educationalists/academics within universities. There are a number of factors that can hinder or enhance the uptake of knowledge, including issues relating to the knowledge itself, factors relating to those who will be using the knowledge, and the context where the knowledge is to be used. Interventions can be of multiple sorts: educational (passive or active strategies), professional (reminders, audit and feedback), organizational (redesign services), and patient directed (health literacy, patient decision aids) [3]. Guide to Evidence Based Practice and Knowledge Translation for Public Health Nursing. Cite this article, Conceptual frameworks are recommended as a way of applying theory to enhance implementation efforts. The National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care for South Yorkshire (CLAHRC SY) used the KTA Framework to underpin a programme of knowledge translation work undertaken between 2008 and 2013 [12]. Google Scholar. Full-text articles were obtained for any article coded for inclusion and for any articles that appeared relevant but where it was unclear whether the KTA Framework had been actually used in practice. Included articles were re-examined and re-coded according to this more detailed classification. Implement Sci. Only ten studies reported and gave supportive examples of incorporating the KTA Framework in an integrated way. Philadelphia: Lea & Febiger. Rycroft-Malone J: The PARIHS framework: a framework for guiding the implementation of evidence based practice. Graham, J. Logan, M.B. Their findings suggested that the more domains that were targeted, the less effective the intervention was [9]. 10.2340/16501977-0451. All ten studies reported applying the Action Cycle, describing at least five of the seven possible phases (see Table 5). Duplicates between records from the databases were identified and the most complete record was retained for the subsequent sift process. Each article was scrutinised and mapped against the corresponding phases within the Knowledge Creation and Action Cycle components of the framework. Google Scholar. For an example of how these might be developed, check out our earlier post. As part of this programme, the first author (BF) undertook a knowledge translation project that sought to identify examples of the use of the KTA Framework in practice. Between 2009 and 2013, she was a Knowledge Translation Project Lead with the NIHR CLAHRC SY. 2009, 4: Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N: Changing the behavior of healthcare professionals: the use of theory in promoting the uptake of research findings. Ian D. Graham PhD, Ian D. Graham PhD. IL 2010, 5: 14-10.1186/1748-5908-5-14. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, Altman DG, Barbour V, Macdonald H, Johnston M, Lamb SE, Dixon-Woods M, McCulloch P, Wyatt JC, Chan A-W, Michie S: Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. Google Scholar. Graham I, Logan J, Harrison M, Straus S, Tetroe J, Caswell W, Robinson N: Lost in knowledge translation: time for a map?. 10.2522/ptj.20070056. Methods Closer examination revealed that usage varied considerably, ranging from simple attribution via a reference through to being integral to most aspects of the implementation work. Edited by: Straus S, Tetroe J, Graham I. The KTA Framework comprises two distinct but related components: (i) Knowledge Creation (represented by the funnel) surrounded by (ii) the Action Cycle (Figure 1). The data were extracted from the integrated studies where the KTA Framework was applied in practice. They and we resorted to a simple taxonomy to describe the level and type of usage based on explicit reporting. Knowledge Translation in Health Care: Moving from Evidence to Practice. Four of the ten studies [17],[19],[21],[23] reported gaining ethical approval, suggesting that these had been independently characterised as research. 10.1111/j.1553-2712.2007.tb02369.x. Graham et al. The views and opinions expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The Knowledge to Action Cycle (KTA) breaks down the implementation process into 7 actionable phases starting with determining the knowledge-practice/policy gap through to sustaining the change. 2012, 7: 87-10.1186/1748-5908-7-87. These include things like clinical practice guidelines, decision aids and videos. Quality assessment of the integrated studies proved problematic given that many papers did not report research questions, traditional research designs or recruitment and selection of participants as required by the criteria [16]. 2014, 9: 2-10.1186/1748-5908-9-2. A secondary concern was theory fidelity [13], which relates to how this conceptual framework was being used in practice, specifically whether the KTA Framework was articulated in a way that was true to the source paper [1]. We acknowledge that there are multiple choices available when conducting citation searches. 2002). 2010, Dissertation for Masters of Science, School of Nursing, Queens University, Ontario, Canada. Tugwell PS, Santesso NA, OConnor AM, Wilson AJ: Knowledge translation for effective consumers. Upper Saddle River, NJ: Prentice Hall. 2002, 16: 38-43. A few authors have attempted this, such as McEvoy and colleagues [43] who examined benefits reported by authors using the Normalization Process Theory. From 2008 to 2013, she led the Translating Knowledge into Action theme of NIHR CLAHRC SY. The Knowledge to Action KTF The Knowledge to Action (KTA)4 is an overarching framework that includes both knowledge creation and implementation. This was necessary given the limited resources available to support the review process. 61801, 2016 The Board of Trustees of the University of Illinois. Knowledge Translation in Health Care: Moving from Evidence to Practice. BMJ Qual Saf. However, the target audiences were primarily patients, the public and the nursing and allied health professions. It may also be a reflection of the challenges for defining and reporting outcomes for knowledge translation projects. Kitson AL, Rycroft-Malone J, Harvey G, McCormack B, Seers K, Titchen A: Evaluating the successful implementation of evidence into practice using the PARiHS framework: theoretical and practical challenges. Estabrooks and colleagues [28] comment that the Canadian research funding organisation had adopted the KTA Framework to guide knowledge translation, deploying specific grant mechanisms to ensure involvement of knowledge users with researchers throughout the research process (p. 2). Knowledge synthesis is essential when considering an initiatives potential for widespread implementation and collates existing knowledge using rigorous methodologies. Crosby R, Noar SM: Theory development in health promotion: are we there yet?. Knowledge creation has three phases: (1) knowledge inquiry, (2) knowledge synthesis, and (3) knowledge tools and products. 2009, 6: Paper 10-10.2202/1548-923X.1741. J Contin Educ Health Prof. 2010, 30: 167-71. [http://www.rcn.org.uk/__data/assets/pdf_file/0014/512600/2013_RCN_research_W06.pdf]. From the perspective of the psychology of knowledge (e.g., Strube & Wender, 1993), knowledge is a competence for action, a . All these described the Action Cycle and seven referred to Knowledge Creation, articulating the KTA Framework in a way that was true to the source paper [1]. BF is a researcher at the School of Health and Related Research (ScHARR), University of Sheffield, and also an occupational therapist. Tabak RG, Khoong EC, Chambers DA, Brownson RC: Bridging research and practice: models for dissemination and implementation research. Each study applied the framework in an idiosyncratic way. Moving from Evidence to Practice. 2012, 7: 48-10.1186/1748-5908-7-48. In contrast, they wanted to evaluate the impact of their intervention on peoples ability to understand their choices and make informed decisions about treatment. 10.1111/j.1740-8709.2010.00271.x. The KTA Framework [1] is being used in practice with varying degrees of completeness and theory fidelity when the conceptual framework is integrated into the implementation project. Implement Sci. J Contin Educ Health Prof. 2006, 26: 13-24. The Knowledge to Action Framework. Data collection The citation search for the original source paper [1] yielded 1,787 records. A citation search of three databases tracking the source paper Lost in knowledge translation: time for a map? identified 1,787 records between 2006 and July 2013. Molfenter and colleagues [23] describe a strategy to assist clinicians with patient selection which could be interpreted as seeking to influence organisational barriers such as competing priorities, as well as addressing knowledge-related barriers. In summary, KTA is applying knowledge to real life situations. Potential benefits from applying a conceptual framework include making the process of knowledge translation more systematic, with greater likelihood of changed practice and spread of evidence [4],[6]-[9]. 2002, 38: 94-104. 10.1016/j.cjca.2012.03.011. 2014, 348: g1687-10.1136/bmj.g1687. Building a conceptual model Forms of knowledge Research evidence Clinician knowledge, skills, experience However, because KT interventions are usually tailored to local contexts, and mapped to specific barriers/facilitators, effectiveness in one context does not guarantee success in another. 10.1097/00001786-200410000-00002. The index citation for the source paper for the KTA Framework Lost in knowledge translation: time for a map? by Graham and colleagues [1] was identified on each of three databases that offered functionality for citation searching. Next, 911 records were excluded at the sift stage. The knowledge to action cycle begins with the identification of a problem (usually a gap in care provision). 10.1177/1077558711430690. 2004, 19: 297-304. The framework has two components: Knowledge Creation and an Action Cycle, each of which comprises multiple phases. The Action Cycle focuses on the processes needed to implement knowledge in healthcare settings including identifying problems; assessing determinants of KT; selecting, tailoring, implementing, and evaluating KT interventions; and determining strategies for ensuring sustained knowledge use. The inclusion criteria were based on an affirmative answer to two questions Does the paper describe a KT project? and Is the KTA Framework a fundamental guide to this project? The initial sift phase was carried out by one researcher (BF), with another researcher coding a proportion of these (II). The KTA process has two components: Knowledge Creation and Action. All citations identified were screened by title and available information according to agreed criteria. In the absence of formal comparisons of citation search techniques, we decided to operationalise citation searching using Google Scholar. administrative databases) and/or active measurement (e.g. Implement Sci. The action cycle includes a range of activities needed for knowledge implementation. Inevitably, decisions about including or excluding studies were reliant on subjective judgements about whether the KTA Framework had been reported in an integrated way, or not. Over time, barriers to knowledge use may change from those initially identified, so sustaining knowledge use includes an ongoing feedback loop that cycles back through the action phases. Addressing sustainability also involves planning for both the spread and scaling up of knowledge use, and concerns whether an innovation continues to be used beyond the initial implementation.
