knowledge to action model
A further eighteen (12%) were categorised as directed because the KTA Framework influenced the project design or helped to plan, structure or conceptualise what was done, but with no examples given. 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. 2010, 33: 259-263. 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). 2010, Dissertation for Masters of Science, School of Nursing, Queens University, Ontario, Canada. The citation search for the original source paper [1] yielded 1,787 records. 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 A taxonomy categorising the continuum of usage was developed. One hundred and forty-six studies described usage to varying degrees, ranging from referenced to integrated. This reflects the spread of the framework across a range of settings, to different health care services and systems and larger scale and smaller projects. The purpose of translation is to provide the best outcomes and value, and lower risks to our patient population. School of Nursing, University of Ottawa, Ottawa, ON, Canada. However, citation figures do not reflect how this conceptual framework has actually been applied in practice. The first component of the model is the knowledge creation funnel, which represents the production and synthesis of knowledge. 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. Phys Ther. contextualize the Evidence Based Review of Stroke Rehabilitation and Rehabilitation Knowledge to Action Project within the KTA model and (2) show how this process led . In ten studies, the KTA Framework was integral to the design, delivery and evaluation of the implementation activities. We did not include the many papers about clinical practice guidelines for two interrelated reasons. Although there may be some small variation in the actual sets of references retrieved by different citation searches, we have no reason to believe that we have systematically under- or over-represented particular types of studies in our sample. Data for each phase were then synthesised across studies to help understand how the framework had been used in practice. This can be achieved through observation (e.g. 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. Involvement of stakeholders, and tailoring knowledge to the needs of people who are going to use it, is crucial. 61656, Rockford, BMJ. J Behav Med. 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]. to the Between 2009 and 2013, she was a Knowledge Translation Project Lead with the NIHR CLAHRC SY. Rycroft-Malone J, Harvey G, Kitson A, McCormack B, Seers K, Titchen A: Getting evidence into practice: ingredients for change. One can also move between the knowledge creation phase and the action cycle, in an iterative fashion. Guideline adaptation: an approach to enhance efficiency in guideline development and improve utilisation, Validation of the theoretical domains framework for use in behaviour change and implementation research, Theoretical domains framework to assess barriers to change for planning health care quality interventions: a systematic literature review. The Knowledge to Action Framework. 10.1111/j.1752-7325.2011.00223.x. 61801, 2016 The Board of Trustees of the University of Illinois. Discovery: The original biomedical, behavioral, or epidemiologic factor that stimulated development of an intervention (1).. Efficacy: The extent to which the intended effect or benefits were achieved under optimal conditions (2).. J Contin Educ Health Prof. 2008, 28: 117-122. Non-English language studies were excluded, reducing access to examples of applying the KTA Framework published in other languages. The papers were coded according to the taxonomy in Table 1. This produced a subset of studies that contained examples of using the KTA Framework in an integral way. The citation search yielded 1,787 records. The KTA process has two components: Knowledge Creation and Action. 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. 2013, Wiley-Blackwell BMJ Books, Oxford, 2, Book Molfenter S, Ammoury A, Yeates E, Steele C: Decreasing the knowledge to action gap through research-clinical partnerships in speech-language pathology. It sets out the key II is an occupational therapist. Search for more papers by this author. Copyright 2015 Wiley Periodicals, Inc., A Wiley Company Lgar [32] recommends using established taxonomies developed for barriers and facilitators within knowledge translation projects. Overview of the Knowledge to Action Cycle. J Adv Nurs. The framework has two components: Knowledge Creation and an Action Cycle, each of which comprises multiple phases. Secondly, multifaceted strategies are more likely to be successful than a single strategy [27],[46],[47], as they target different barriers [40], which reflects our interest in the real-world use of the KTA Framework, where it is probably impossible to control and isolate one strategy [48]. 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]. Action Cycle within the KTA Model The second step involves adapting the validated knowledge to the local context. PubMed Central The lead author (BF) contributed to this study while undertaking the National Institute for Health Research/Health Education England Clinical Academic Training Programme Master in Clinical Research scheme. Tugwell and colleagues [26] highlight this particular challenge, commenting that most outcomes in arthritis research are about pain and function. The action cycle includes a range of activities needed for knowledge implementation. Health professionals across the globe share the challenges of translating the best available evidence into actual health interventions in a timely way to provide the most effective care and service. The result set was reduced to 1,057 records following removal of duplicate and non-English language records. Knowledge becomes more refined as it moves through these three steps. Google Scholar. BMJ. It may also be a reflection of the challenges for defining and reporting outcomes for knowledge translation projects. 10.1136/bmjqs-2013-001862. PubMed Implent Sci. Regardless of the approach, its critical to ensure that interventions are tailored to address the specific issue, audience and context to enhance uptake. 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. Lost in knowledge Translation: time for a map? Implementation researchers and health professionals can learn from this flexibility. We have chosen to report the aggregate number of excluded papers on the PRISMA flow diagram (Figure 2). Data collection We recommend using the latest version of IE11, Edge, Chrome, Firefox or 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. Most of the theories were interdisciplinary or from nursing and were published between 1983 and 2006 [11]. 2014, 11: 26-34. Claude and colleagues [17] stated that these phases were beyond the scope of their project. Conventional views support the use of theories, models and conceptual frameworks to underpin the process of change, yet in practice, their application seems more limited [40],[43]-[45]. 2012, 7: 87-10.1186/1748-5908-7-87. Powell BJ, McMillen C, Proctor E, Carpenter CR, Griffley RT, Bunger AC, Glass JE, York JL: A compilation of strategies for implementing clinical innovations in health and mental health. References to non-English language articles were removed. 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. Four of the ten studies [17],[19],[21],[23] reported gaining ethical approval, suggesting that these had been independently characterised as research. Implementation Science 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. 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. Do they work? Can J Speech-Language Pathol Audiol. This study sought to identify and describe available full-spectrum KT TMFs to subsequently guide users. 2014, 9: 2-10.1186/1748-5908-9-2. No existing systematic review was found on this subject. All ten studies reported using the Action Cycle. Springer Nature. Understanding if and how these theoretical tools add value to implementation endeavours and outcomes merits further research. Article Further details can be found at www.clahrc-yh.nihr.ac.uk. However, none of these knowledge translation strategies, designed to target different barriers, featured in the included studies, with one exception. The KTA Framework comprises two distinct but related components: (i) Knowledge Creation (represented by the funnel) surrounded by (ii) the Action Cycle (Figure 1). Measuring this practice gap can include the use of administrative data, questionnaires, or conducting chart audits, to name a few. 2014, 348: g1687-10.1136/bmj.g1687. Booth A, Harris J, Croot E, Springett J, Campbell F, Wilkins E: Towards a methodology for cluster searching to provide conceptual and contextual richness for systematic reviews of complex interventions: case study (CLUSTER). Celebrate the work you have accomplished. 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 . As weve discussed in a previous post, there are many theories, models and frameworks used in the field of knowledge translation (KT). 10.1037/a0016939. Any differences were discussed and resolved by consensus. We did not follow up references (including book chapters) or contact authors of included or excluded studies. A notable feature of the KTA Framework is the development of knowledge tools or products as part of Knowledge Creation. More About Knowledge Translation at CIHRCIHR. J Contin Educ Health Prof. 2010, 30: 167-71. The KTA Framework is composed of two distinct, but related components: (i) Knowledge Creation, and (ii) the Action Cycle. 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. Implement Sci. 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. Implement Sci. 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. We chose citation searching as our preferred method to identify reports of practical applications of a model or framework [14],[15]. Finally, knowledge tools and products, considered third generation knowledge, are the most refined form of knowledge, based on earlier stages of the funnel. This may be an artefact of reporting, indicating that prospective, primary research is needed to explore the real value of the KTA Framework and similar tools. BMC Med Res Methodol. Rycroft-Malone J: The PARIHS framework: a framework for guiding the implementation of evidence based practice. The knowledge to action cycle begins with the identification of a problem (usually a gap in care provision). Only ten studies were integrated, signifying that the KTA Framework was integral to the design, delivery and evaluation of the implementation activities. The taxonomy enabled us to refine the inclusion criteria to identify studies that reported explicit application of the KTA Framework. Initial screening out by title and abstract on the basis of partial information from Google Scholar may also have excluded relevant studies. J Contin Educ Health Prof. 2006, 26: 13-24. These include things like clinical practice guidelines, decision aids and videos. Upper Saddle River, NJ: Prentice Hall. Ilott I, Gerrish K, Booth A, Field B: Testing the consolidated framework for implementation research on health care innovations from South Yorkshire. 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. Implement Sci. Due to overlapping categories (e.g. 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. Russell and colleagues [25] describe use of a knowledge broker, an example of a linkage and exchange-type strategy. Straus S, Graham I: Development of a mentorship strategy: a knowledge translation case study. Google Scholar. Such work may require additional funding for longer term monitoring or strategies to sustain knowledge use over time. Taylor MJ, McNicholas C, Nicolay C, Darzi A, Bell D, Reed JE: Systematic review of the application of the plan-do-study-act method to improve quality in healthcare. Can J Cardiol. As the process of KT is iterative, not only can (i) inform (ii), but components of the action cycle also feed back to inform knowledge creation [2, 3]. 2004, 19: 297-304. Knowing your audience and assessing the value, usefulness and appropriateness of the particular knowledge is critical to its uptake and sustained use. Worldviews Evid Based Nurs. Three studies illustrated each phase of the Action Cycle or explained their reasons for not doing so [18],[23],[25]. Graham ID, Tetroe J: Some theoretical underpinnings of knowledge translation. Matern Child Nutr. 10.1111/wvn.12016. The KTA could also be used as a literacy device to structure reporting of the framework. 2009, 41: 1024-1032. Implement Sci. 10.1016/j.cjca.2012.03.011. 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. 2013, 13: 118-10.1186/1471-2288-13-118. 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]. 2010, 29: 1-8. This involved checking whether the four elements were described. The KTA process has two components: (1) knowledge creation and (2) action. Google Scholar. The following analysis focuses on results relating to these ten integrated studies. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Importantly, these integrated studies included examples to illustrate how the KTA Framework had been used as a guide. Edited by: Straus S, Tetroe J, Graham I. 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. Knowledge producers . Share your thoughts in the comments section below, or by tweeting at us at @KnowledgeNudge. Firstly, there is a risk of bias and subsequent error given the lead author conducted most of the initial screening, all data extraction and synthesis. Once an understanding of the potential barriers and facilitators to adoption has been achieved, the next phase involves planning and carrying out interventions to bring about the intended change. ASUS Corporate Stable Model (CSM) is a commercial program designed to provide stable and reliable motherboards. 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]. Using the framework itself as a device through which to examine how it had been used seemed an appropriate and pragmatic approach for our purposes. Action is the deeds or decisions made based on knowledge and information. J Nurs Care Qual. From the perspective of the psychology of knowledge (e.g., Strube & Wender, 1993), knowledge is a competence for action, a . 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). 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. The Action Cycle outlines a process, representing the activities needed for knowledge to be applied in practice; knowledge is adapted to the local context, and barriers and facilitators to its use are explicitly assessed. 2013, 19: 915-24. PubMed Knowledge Creation includes knowledge inquiry, knowledge synthesis, and knowledge tools/products. Implement Sci. Davidoff F, Batalden P, Stevens D, Ogrinc G, Mooney SE: Publication guidelines for quality improvement studies in health care: evolution of the SQUIRE project. So in terms of doing theory-informed KT, as the saying goes if you dont have time to do it right, when will you have time to do it over?, *ISLAGIATT: Attributed to Dr. Martin P. Eccles. Field, B., Booth, A., Ilott, I. et al. "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.. Correspondence to 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 Referred to as first generation knowledge and vastly out of scale (considering that the body of new, original knowledge in healthcare is enormous part of the reason we need KT), knowledge inquiry refers to primary studies and represents the majority of research that is conducted. However, supplementary hypertext links could be followed up from Google Scholar to either an abstract or, optimally, to the full text. They and we resorted to a simple taxonomy to describe the level and type of usage based on explicit reporting. The search strategy was limited to citation searching of three databases. Firstly, we were interested in the practical application of the KTA Framework and thus in identifying papers where the KTA Framework appeared to be a fundamental guide to the work reported. Studies were published between 2007 and 2013. The final list of integrated studies was agreed by two authors (BF and II), and the synthesis was discussed in detail by the team. Each study applied the framework in an idiosyncratic way. (Dignan, M.B & Carr, P.A. Education was the most frequently employed strategy albeit in a variety of forms. An exception was the study by Russell and colleagues [25] who reported using a questionnaire to assess a range of potential barriers and facilitators. All citations identified were screened by title and available information according to agreed criteria. California Privacy Statement, 2013, 69: 2336-47. Rather, papers typically stated aims and objectives, which often related to closing evidence/knowledge-practice gaps. We focus on all things knowledge translation (KT) and patient engagement (PE), from a health research and healthcare perspective.
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