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. Data collection The result set was reduced to 1,057 records following removal of duplicate and non-English language records. Monitoring the use of knowledge is critical in understanding how and to what extent the KT strategy has had an impact on outcomes (the next phase in the action cycle). (2013), "The effectiveness of knowledge translation strategies used in public health: a systematic review" (2012), "Uncovering Tacit Knowledge: A Pilot Study to Broaden the Concept of Knowledge in Knowledge Translation" (2011), "Assessing the public health impact of health promotion initiatives" (2010), Agency for Healthcare Research and Quality (AHRQ) - Translating Research into Practice, Canadian Institute for Health Research (CIHR) - Knowledge Translation & Commercialization, Center on Knowledge Translation for Disability and Rehabilitation Reseach (KTDRR) - KT Library, Cochrane Public Health Group - Knowledge Translation, McMaster University - Collaborations for Health (CfH) - Knowledge Translation, National Collaborating Centre for Methods and Tools - Knowledge Translation Methods and Tools for Public Health, University of Alberta - Knowledge Utilization Studies Program, Develop a PLAN - determine key stakeholders, expertise & support, Measure/collect data - baseline, process, outcomes, expenses, Implement - DO - pilot roll-out, educate, support, navigate, Manage & Adjust - ACT - Adapt, Adopt or Abandon based on evidence, Sustain & Grow - Share the results, get feedback, embed in standards or policies, spread more broadly. Steps involved in Translating the Evidence into Practice: The Knowledge to Action (KTA) Framework is used for facilitating the use of research knowledge by several stakeholders, such as practitioners, policymakers, patients and the public. A few authors have attempted this, such as McEvoy and colleagues [43] who examined benefits reported by authors using the Normalization Process Theory. BMC Med Res Methodol. Implementation Sci 9, 172 (2014). The Journal of Continuing Education in the Health Professions 2006, 26, p. 19. 2012, 43: 337-50. 10.1037/a0016939. The KTA Framework is a framework for guiding the process of KT, adopted by the Canadian Institutes of Health Research (CIHR) and other organizations worldwide. Implement Sci. Studies were published between 2007 and 2013. IL Harrison, S.E. The Knowledge to Action (KTA) framework is an effective approach in the implementation science literature to methodically guide the translation of evidence-based research findings into practice, putting knowledge into practical use. The KTA process has two components: Knowledge Creation and Action. Evaluating outcomes is an area of KT that requires more attention and involves evaluating whether application of the knowledge is actually impacting the desired outcome be it patient or practitioner behaviour, health outcomes, or system-level changes. 2002, 16: 38-43. Interest in using systematic literature reviews to investigate theories, models and conceptual frameworks has increased in recent years [7],[39]. The citation search for the original source paper [1] yielded 1,787 records. Two researchers (BF and II) conducted an initial assessment of the full-text articles. "The KT Library is designed to provide information to NIDRR grantees and interested members of the public about a wide spectrum of knowledge translation and evidence-based resources.". looked at 10 behaviour change interventions where explicit use of theory was absent, and mapped these strategies to domains of the Theoretical Domains Framework. The Knowledge to Action Framework. 61801, 2016 The Board of Trustees of the University of Illinois. This involves valuing the utility of the knowledge to the problem, setting and circumstances, as well as tailoring the knowledge to the specific situation. Associated knowledge tools included summaries of evidence targeted at specific audiences, continuing health care education modules, information posted on websites and decision aids. This scheme may be useful for similar studies examining theory use. This MCHRI framework for impact has been adapted form multiple sources and from internal learnings and is underpinned by the Canadian knowledge to action process. California Privacy Statement, Overlaying the Consolidated Framework for Implementation Research (CFIR) on the KTA framework offers a comprehensive methodology to identify barriers and facilitators and evaluation of the project. Correspondence to 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. review papers, conceptual or descriptive papers and those describing a single knowledge translation strategy or not topically relevant), we excluded against a single criterion, even when multiple criteria applied, as practical considerations rendered it unnecessary to exhaustively document all possible reasons for exclusion for each paper. The first phase explores the creation of knowledge tools or products, such as an intervention or a clinical guideline . When using the Knowledge to Action Process model to effect an evidence-based change (e.g., in a clinical practice), one of the factors that knowledge users (e.g., clinicians) may site as an impediment is an absence of the evidence appraisal and statistical analysis skills that are required in the knowledge inquiry phase. 2011, 71 (Suppl 1): S20-S33. Finfgeld-Connett D, Johnson ED: Literature search strategies for conducting knowledge-building and theory-generating qualitative systematic reviews. Collaboration for Leadership in Applied Health Research and Care for South Yorkshire, Collaboration for Leadership in Applied Health Research and Care for Yorkshire and Humber. The citation search yielded 1,787 records. Russell and colleagues [25] describe use of a knowledge broker, an example of a linkage and exchange-type strategy. Bartholomew and Mullen [42] suggest that the prevailing wisdom in the field of health-related behaviour change is that well-designed and effective interventions are guided by theory (p. S20). Knowledge to Action Framework - Monash Centre for Health Research and Leah Crockett is a doctoral student in the Department of Community Health Sciences at the University of Manitoba. The full text of the 146 papers was examined to establish the extent to which the use of the KTA Framework was attributed by the authors. Some indication of the impact of this article can be gained from constructing a normalised citation count for comparison purposes. Ilott I, Gerrish K, Booth A, Field B: Testing the consolidated framework for implementation research on health care innovations from South Yorkshire. These include things like clinical practice guidelines, decision aids and videos. This showed that the degree of usage varied from merely citing the KTA Framework to full integration into the study. (2010). The benefits of theory-informed KT practice are not limited to providing a deliberate map for interventions, but also allow for increased validity and rigor and more seamless integration of KT-related evidence into the ever-growing body of implementation literature. ASUS Corporate Stable Model (CSM) is a commercial program designed to provide stable and reliable motherboards. 10.1111/j.1740-8709.2010.00271.x. Michie S, Prestwich A: Are interventions theory-based? This can be achieved through observation (e.g. In the absence of formal comparisons of citation search techniques, we decided to operationalise citation searching using Google Scholar. And if so, how?. IL to the Worldviews Evid Based Nurs. 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]. Knowledge creation has three phases: (1) knowledge inquiry, (2) knowledge synthesis, and (3) knowledge tools and products. 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. The impact of a strategy should be assessed using explicit, rigorous qualitative and quantitative methods, beginning with formulation of a defined question of interest. Initial screening out by title and abstract on the basis of partial information from Google Scholar may also have excluded relevant studies. Using the knowledge to action process model to incite clinical change. Conceptual frameworks are recommended as a way of preparing for the multiple, dynamic and interactive factors that influence the uptake of evidence in practice [3]-[5]. 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. However, citation figures do not reflect how this conceptual framework has actually been applied in practice. Rycroft-Malone J, Bucknall T: Models and Frameworks for Implementing Evidence-Based Practice. 2013, 69: 194-204. 2002). The index citation for the original paper was identified on three databasesWeb of Science, Scopus and Google Scholarwith the facility for citation searching. Implementation researchers and health professionals can learn from this flexibility. The MCHRI framework includes 6 Key Steps summarised below: Steps 1 & 2 - Formative Research: engage stakeholders to identify problem from all perspectives, to scope and prioritise . 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. Google Scholar also enabled access to book chapters whereas Scopus and Web of Science only indexed peer-reviewed journal articles. 60612, One Illini Drive Citation searches were limited to the period from 2006 (the date of publication of the source paper) to July 2013. For example, Eccles et al. This was necessary given the limited resources available to support the review process. It includes the production, synthesis and interpretation of knowledge. Molfenter S, Ammoury A, Yeates E, Steele C: Decreasing the knowledge to action gap through research-clinical partnerships in speech-language pathology. Jacqueline Tetroe MA, However, the target audiences were primarily patients, the public and the nursing and allied health professions. Google Scholar references often included an incomplete text fragment rather than a more traditional abstract. 2014, 9: 2-10.1186/1748-5908-9-2. We thank Jennifer Read who provided BF with academic supervision for her MSc dissertation. Nine of the studies reported assessing barriers to change [17]-[19],[21]-[26]. The study was funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for South Yorkshire and Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Yorkshire and Humber. Celebrate the work you have accomplished. Citation searching can circumvent the problems of variation in terminology (a retrieval problem) or uninformative abstracts (a reporting problem) typically encountered in topic-based searches of bibliographic databases. Knowledge Creation includes knowledge inquiry, knowledge synthesis, and knowledge tools/products. It is one of the most frequently cited conceptual frameworks for knowledge translation. Implement Sci. Lgar [32] recommends using established taxonomies developed for barriers and facilitators within knowledge translation projects. Knowledge Translation in Health Care: Moving from Evidence to Practice. All ten described using the Action Cycle and seven referred to Knowledge Creation. Assessing the public health impact of health promotion initiatives. In contrast, they wanted to evaluate the impact of their intervention on peoples ability to understand their choices and make informed decisions about treatment. Claude and colleagues [17] stated that these phases were beyond the scope of their project. 10.1111/wvn.12016. PDF Introduction to Knowledge into Action - The Centre for Evidence-Based Overview of the Knowledge to Action Cycle. Rycroft-Malone J: The PARIHS framework: a framework for guiding the implementation of evidence based practice. 1, Lgar F: Assessing barriers and facilitators to knowledge use. 2009, 41: 1024-1032. 2012, 7: 87-10.1186/1748-5908-7-87. All ten studies reported applying the Action Cycle, describing at least five of the seven possible phases (see Table 5). However, adaptation of guidelines also runs the risk of deviating from the original evidence base to address this, a systematic approach to guideline adoption has been developed by a Canadian collaboration called ADAPTE [4]. Applying the Knowledge-to-Action Framework to Engage Stakeholders and Solve Shared Challenges with Person-Centered Advance Care Planning in Long-Term Care Homes Authors George A Heckman 1 2 , Veronique Boscart 1 3 , Patrick Quail 4 , Heather Keller 1 5 , Clare Ramsey 6 , Vanessa Vucea 2 , Seema King 7 , Ikdip Bains 2 , Nora Choi 6 , Allan Garland 6 IL It is important to note that Graham and colleagues have continued to publish on applications of the framework and the multiple factors to be considered [29]. 2009, 338: a3152-10.1136/bmj.a3152. It was cited 470 unique times across the three databases, indicating the bibliometric impact of the source paper. Refresh the page, check Medium 's site status, or find. Understanding the barriers to knowledge uptake and implementation strategies, as well as facilitators of change, are critical to effective knowledge translation activities. In these studies, the KTA Framework appeared to provide a practical yet flexible guide to getting research findings into practice, allowing it to be applied in idiosyncratic ways. 2008, 3: 1-10.1186/1748-5908-3-1. Preventing Chronic Disease: March 2011: 10_0012 We developed a taxonomy to categorise this variation (see Table 1). Ian D. Graham PhD, Ian D. Graham PhD. Knowing your audience and assessing the value, usefulness and appropriateness of the particular knowledge is critical to its uptake and sustained use. J Contin Educ Health Prof. 2010, 30: 167-71. Moving from Evidence to Practice. In ten studies, the KTA Framework was integral to the design, delivery and evaluation of the implementation activities. Why use theory to guide the process of moving evidence into action? Each implementation study was very different (see Table 3). PubMed "Knowledge translation is defined as 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.. However, none of these knowledge translation strategies, designed to target different barriers, featured in the included studies, with one exception. Seventeen studies (12%) were noted as adapted or combined where the KTA Framework had either been modified or blended with another conceptual framework. They reviewed 31 planned action theories about the process of change. BMJ. Minimizing the knowledge-to-action gap; identification of interventions Worldviews Evid Based Nurs. Adapting to local context is a critical step in the process. A notable feature of the KTA Framework is the development of knowledge tools or products as part of Knowledge Creation. Becky Field. Exploring the impact of the KTA Framework, and other conceptual frameworks, on patients and the public in terms of health improvement and outcomes would also be worthwhile, as would exploring their involvement in the application of the framework, not just as recipients of services but as key stakeholders in each phase. McEvoy R, Ballini L, Maltoni S, O Donnell CA, Mair FS, Macfarlane A: A qualitative systematic review of studies using the normalization process theory to research implementation processes. Seven described using both the Knowledge Creation and the Action Cycle components [18],[20]-[24],[27]. Springer Nature. This frequency of use in Canada could be explained by the influence of national Canadian networks and dissemination activities. 2009, Wiley-Blackwell BMJ Books, Chichester, UK, 83-93. PubMedGoogle Scholar. Safari. Unfortunately, an implemented change is not usually self-sustaining and requires ongoing monitoring and effort. Provided by the Springer Nature SharedIt content-sharing initiative. This review is designed to address this knowledge gap. Davies P, Walker AE, Grimshaw JM: A systematic review of the use of theory in the design of guideline dissemination and implementation strategies and interpretation of the results of rigorous evaluations. BF is a researcher at the School of Health and Related Research (ScHARR), University of Sheffield, and also an occupational therapist. Judging between informed and directed was difficult, suggesting further refinement of the categories is required. From Graham I, Logan J, Harrison M, Strauss S, Tetroe J, Caswell W, Robinson N: Lost in knowledge translation: time for a map? Graham I, Logan J, Harrison M, Straus S, Tetroe J, Caswell W, Robinson N: Lost in knowledge translation: time for a map?. Although the terms conceptual frameworks, theories and models are often used interchangeably, conceptual frameworks are broad and descriptive, whereas theories and models are more specific and amenable to hypothesis testing [6]. This inner component of the model is broken down into 3 phases: (1) knowledge inquiry, (2) knowledge synthesis, and (3) the creation of knowledge tools and products. Google Scholar. Data-Information-Knowledge-Action Model | SpringerLink This study also reinforces the importance of reporting standards [8],[36], such as the new TIDieR checklist [37] to facilitate more explicit reporting of implementation studies and their subsequent inclusion in systematic reviews. This review sought to answer two questions: Is the KTA Framework used in practice? We further identified a need to use taxonomies when analysing or evaluating knowledge translation strategies [33],[34]. 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]. However, our review focused primarily on examining how a conceptual framework had been used in practice. knowledge to action gap through research-clinical partnerships in speech-language pathology. The quality of reporting was assessed using criteria adapted from Carroll and colleagues [16]. All results were imported and combined into an Excel spreadsheet for review by two reviewers. The least reported phase, or the phase carried out least often, was sustain knowledge use. Offering up to 36-month product lifecycle support and 6-month end-of-life notice to allow . This may explain the varying degrees to which the framework was used. This presents an interpretation challenge both for those seeking to learn from such projects and systematic reviewers. The taxonomy enabled us to refine the inclusion criteria to identify studies that reported explicit application of the KTA Framework. The "Knowledge to Action" Cycle: A Conversation with Dr. Ian Graham The production of knowledge tools and products uses synthesized knowledge to present evidence in concise and user-friendly formats tailored to meet end-user informational needs. Ullrich PM, Sahay A, Stetler CB: Use of implementation theory: a focus on PARIHS. It is possible some potentially relevant studies were excluded during the initial sift stage. As weve discussed in a previous post, there are many theories, models and frameworks used in the field of knowledge translation (KT). Journal of Continuing Education in the Health Professions, 30, 167-171. doi:10 Google Scholar. McCormack B, Kitson A, Harvey G, Rycroft-Malone J, Titchen A, Seers K: Getting evidence into practice: the meaning of context.