Understanding the barriers to knowledge uptake and implementation strategies, as well as facilitators of change, are critical to effective knowledge translation activities. Straus S, Graham I: Development of a mentorship strategy: a knowledge translation case study. J Nurs Care Qual. 2009, 33: 82-88. The search results are illustrated in Figure 2, the PRISMA flow chart. 2007, 87: 1728-38. 2012, 69: 123-157. The KTA Framework is being used in practice with varying degrees of completeness. 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]. Citation searches were limited to the period from 2006 (the date of publication of the source paper) to July 2013. 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. Non-English language studies were excluded, reducing access to examples of applying the KTA Framework published in other languages. However, it is worth noting that clinical guidelines could be categorised as knowledge tools/products and/or implementation strategies depending on if, and how, the guideline features in the framework. Petzold A, Korner-Bitensky N, Menon A: Using the knowledge to action process model to incite clinical change. 2010, Dissertation for Masters of Science, School of Nursing, Queens University, Ontario, Canada. The search strategy was limited to citation searching of three databases. 2002). These goals are to increase (a) the use of evidence-based research and (b) the understanding and use of KT principles. 2008, 3: 1-10.1186/1748-5908-3-1. The authors declare that they have no competing interests. Disconnect between Knowledge and Action Gap between what we know and what we do Under-use of effective treatments -5-50 years to change practice . Several strategies were used to counter this risk. Interestingly, a recent evaluation of the Canadian Institutes of Health Research (CIHR) Knowledge Translation Funding Program [38] presented results relating to knowledge translation products, academic outputs and capacity building together, giving the appearance, in our interpretation, that these different dimensions may be regarded as equally important. Share your thoughts in the comments section below, or by tweeting at us at @KnowledgeNudge. However, there are multiple KT TMFs and little guidance on which to select. Rycroft-Malone J, Bucknall T: Models and Frameworks for Implementing Evidence-Based Practice. Non-stop action: The best choice for iCaf, configure-to-order gaming systems and quality-driven businesses; Non-stop durability: . CLAHRC YH would also like to acknowledge the participation and resources of our partner organisations. 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. This may reflect a publication bias, between reporting process and outcomes. Child Health, Health Equity, Integrated Knowledge Translation, Canadian Institutes of Health Research (CIHR, https://www.ncbi.nlm.nih.gov/pubmed/16557505, practical guide to designing a KT intervention. This study is a citation analysis and systematic review. It may also be a reflection of the challenges for defining and reporting outcomes for knowledge translation projects. A prospective design would strengthen research studies. Damschroder LJ, Aron DC, Keith , Rosalind E, Kirsh SR, Alexander JA, Lowery JC: Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Seven described using both the Knowledge Creation and the Action Cycle components [18],[20]-[24],[27]. This review is designed to address this knowledge gap. For example, in the context of clinical practice guidelines (CPGs), adapting existing national guidelines (which may lack applicability and how organizations need to change to adopt guidelines) to fit local circumstances serves not only to increase the relevance and applicability of guidelines, but also gives end-users a sense of ownership to help promote implementation. 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. BMJ. 2009, 338: a3152-10.1136/bmj.a3152. It was cited 470 unique times across all databases. -[http://www.cihr-irsc.gc.ca/e/39033.html]. 10.1136/bmjqs-2013-001862. Within KTA, knowledge creation - or the production of knowledge - is composed of three phases: knowledge inquiry (first-generation knowledge), knowledge synthesis (second-generation knowledge), and creation of knowledge tools and/or products (third-generation knowledge). 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. Nine of the studies reported assessing barriers to change [17]-[19],[21]-[26]. Studies were published between 2007 and 2013. . The quality of reporting was assessed using criteria adapted from Carroll and colleagues [16]. For example, the creation of websites, interactive e-learning modules, training packages and a protocol were reported as part of the Action Cycle [19],[23],[24], yet they could be knowledge tools/products. Health Psychol. As weve discussed in a previous post, there are many theories, models and frameworks used in the field of knowledge translation (KT). PubMedGoogle Scholar. research findings not being translated. PubMed Central The KTA Framework is one of many frameworks, models, and theories that provides KT researchers with a practical yet systematic method of implementation. CIHR also provides a practical guide to designing a KT intervention for health researchers, with relevant examples of its application. We have chosen to report the aggregate number of excluded papers on the PRISMA flow diagram (Figure 2). Action Cycle within the KTA Model The second step involves adapting the validated knowledge to the local context. Involvement of stakeholders, and tailoring knowledge to the needs of people who are going to use it, is crucial. Copyright 2015 Wiley Periodicals, Inc., A Wiley Company 2013, 23 (4): 290-298. Given the incomplete abstracts obtained via Google Scholar, a rule-out strategy was employed. Application of knowledge translation (KT) theories, models, and frameworks (TMFs) is one method for successfully incorporating evidence into clinical care. As Kate has described previously, knowledge synthesis (second generation knowledge) involves synthesizing results from individual research studies and interpreting them within the context of global evidence. Each implementation study was very different (see Table 3). Key factors present in sustaining knowledge use can include perceived benefits and risks, relevance, leadership, policy integration, resources and politics. Two were concerned with public health or health promotion [17],[20]; three focused on clinical academic or nurse education [18],[21],[22]. The KTA could also be used as a literacy device to structure reporting of the framework. A total of 1,057 titles and abstracts were screened. The citation search for the original source paper [1] yielded 1,787 records. 2002, 38: 94-104. Hua D, Carter S, Bellerive J, Allu SO, Reid D, Tremblay G, Lindsay P, Tobe SW: Bridging the gap: innovative knowledge translation and the Canadian hypertension education program. Rycroft-Malone J: The PARIHS framework: a framework for guiding the implementation of evidence based practice. Terms and Conditions, 10.1111/j.1553-2712.2007.tb02369.x. Developed by Ian Graham and colleagues [1], the KTA Framework is based on the commonalities of over 30 planned-action theories (which make up the action cycle) with the addition of a knowledge creation component. Today well highlight one of the most highly cited conceptual frameworks in Canada the Knowledge-to-Action (KTA) Framework. 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. IL 2010, 5: 82-10.1186/1748-5908-5-82. The index citation for the original paper was identified on three databasesWeb of Science, Scopus and Google Scholarwith the facility for citation searching. Wensing M, Bosch M, Grol R: Selecting, tailoring, and implementing knowledge translation interventions. Journal of Continuing Education in the Health Professions, 30, 167-171. doi:10 These were the question and study design, recruitment and selection and methods of data collection and analysis. 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. IL Next, 911 records were excluded at the sift stage. The KTA process has two components: (1) knowledge creation and (2) action. Assessment of barriers can be done quantitatively and qualitatively using a variety of conceptual models and instruments. Only one study [26] reported using decision support tools as a knowledge translation strategy, although it is possible others did not report all the details of strategies they used to promote the adoption of their interventions. None described applying every phase of the KTA Framework. Yet, this method may prove challenging, often because of limited and imprecise reporting. Field, B., Booth, A., Ilott, I. et al. 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]. BMJ Qual Saf. 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). School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK, You can also search for this author in These include things like clinical practice guidelines, decision aids and videos. No existing systematic review was found on this subject. IL 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. The KTA Framework was enacted in a variety of ways, from informing to full integration, showing flexibility of use and that it can fit local circumstances and need. Regardless of the approach, its critical to ensure that interventions are tailored to address the specific issue, audience and context to enhance uptake. Reprinted with permission from John Wiley and Sons. 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 2012, 7: 87-10.1186/1748-5908-7-87. 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. All authors read and approved the final manuscript. 2005, 58: 107-12. The action cycle is iterative and includes the deliberate application of knowledge to cause change in behaviours and/or attitudes. Cookies policy. It is possible some potentially relevant studies were excluded during the initial sift stage. 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. Knowledge producers . Why use theory to guide the process of moving evidence into action? Authors identified many barriers relating to environmental factors [32] such as lack of time and/or resources. This review sought to answer two questions: Is the KTA Framework used in practice? Nine were published in peer-reviewed journals with the exception being a Master of Science degree dissertation [19]. We did not assess the research rigour of the individual knowledge translation projects. 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. Graham I, Logan J, Harrison M, Straus S, Tetroe J, Caswell W, Robinson N: Lost in knowledge translation: time for a map?. 60612, One Illini Drive Eight of the ten studies were conducted in Canada, one in the Democratic Republic of Congo [17] and one in Denmark [18]. The final list of integrated studies was agreed by two authors (BF and II), and the synthesis was discussed in detail by the team. Retrieved from http://www.nccmt.ca/registry/view/eng/70.html. 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]. Tugwell and colleagues [26] highlight this particular challenge, commenting that most outcomes in arthritis research are about pain and function. Safari. Education was the most frequently employed strategy albeit in a variety of forms. In summary, KTA is applying knowledge to real life situations. In the context of healthcare, the Theoretical Domains Framework (which we break down in another post) is one example of a comprehensive, validated, and integrative model for assessing barriers to change that can be used to inform the development of strategies for changing attitudes and behaviours [5, 6]. Three studies illustrated each phase of the Action Cycle or explained their reasons for not doing so [18],[23],[25]. 10.7748/ns2002.05.16.37.38.c3201. 10.2340/16501977-0451. One hundred and forty-six studies described usage to varying degrees, ranging from referenced to integrated. 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 Knowledge to Action (KTA) Framework was developed in Canada by Graham and colleagues in the 2000s, following a review of 31 planned action theories. 2014, 9: 2-10.1186/1748-5908-9-2. knowledge to action gap through research-clinical partnerships in speech-language pathology. 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. However, none of these knowledge translation strategies, designed to target different barriers, featured in the included studies, with one exception. Primary studies, exploring the direct experience and perceptions of different stakeholders in implementation projects, which have been guided by conceptual frameworks, or theories, would add to our understanding of the utility and impact of these tools. Rycroft-Malone J, Harvey G, Kitson A, McCormack B, Seers K, Titchen A: Getting evidence into practice: ingredients for change. The integrated studies described different ways of integrating the KTA Framework, particularly the Action Cycle. statement and Data extraction and presenting results according to the phases were also challenging, given that the framework is dynamic, and can be non-sequential with overlap between phases [1]. Based on knowledge to action, there were 3 phases to the study implementation: problem identification (lack of routine checklist use in Cameroonian hospitals), multifaceted implementation strategy (3-day multidisciplinary training course, coaching, facilitated leadership engagement, and support networks), and outcome evaluation 4 months 10.2522/ptj.20070056. 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 2012, 7: 50-10.1186/1748-5908-7-50. There were occasions when we sensed that aspects of Knowledge Creation and Action Cycle had been done or combined, but as this was not explicit, we excluded these data. (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. 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. 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. 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. 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. When thinking about program planning and implementation, there are several important concepts that need to be considered. However, citation figures do not reflect how this conceptual framework has actually been applied in practice. This is a limitation of using Google Scholar for citation searches. 1, EPOC Taxonomy of Professional and OrganisationalInterventions.[https://epoc.cochrane.org/sites/epoc.cochrane.org/files/uploads/EPOC%20Taxonomy%20of%20Interventions%202002.pdf]. By using this website, you agree to our 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]. 2007, 14: 936-941. Implement Sci. 1, Lgar F: Assessing barriers and facilitators to knowledge use. This study sought to identify and describe available full-spectrum KT TMFs to subsequently guide users.
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