1
|
Minian N, Saiva A, Ahad S, Gayapersad A, Zawertailo L, Veldhuizen S, Ravindran A, de Oliveira C, Mulder C, Baliunas D, Selby P. Primary healthcare provider experience of knowledge brokering interventions for mood management. Health Psychol Behav Med 2023; 11:2265136. [PMID: 37811314 PMCID: PMC10557557 DOI: 10.1080/21642850.2023.2265136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023] Open
Abstract
Background Knowledge brokering is a knowledge translation strategy used in healthcare settings to facilitate the implementation of evidence into practice. How healthcare providers perceive and respond to various knowledge translation approaches is not well understood. This qualitative study used the Theoretical Domains Framework to examine healthcare providers' experiences with receiving one of two knowledge translation strategies: a remote knowledge broker (rKB); or monthly emails, for encouraging delivery of mood management interventions to patients enrolled in a smoking cessation program. Methods Semi-structured interviews were conducted with 21 healthcare providers recruited from primary care teams. We used stratified purposeful sampling to recruit participants who were allocated to receive either the rKB, or a monthly email-based knowledge translation strategy as part of a cluster randomized controlled trial. Interviews were structured around domains of the Theoretical Domains Framework (TDF) to explore determinants influencing practice change. Data were coded into relevant domains. Results Both knowledge translation strategies were considered helpful prompts to remind participants to deliver mood interventions to patients presenting depressive symptoms. Neither strategy appeared to have influenced the health care providers on the domains we probed. The domains pertaining to knowledge and professional identity were perceived as facilitators to implementation, while domains related to beliefs about consequences, emotion, and environmental context acted as barriers and/or facilitators to healthcare providers implementing mood management interventions. Conclusion Both strategies served as reminders and reinforced providers' knowledge regarding the connection between smoking and depressed mood. The TDF can help researchers better understand the influence of specific knowledge translation strategies on healthcare provider behavior change, as well as potential barriers and facilitators to implementation of evidence-informed interventions. Environmental context should be considered to address challenges and facilitate the movement of knowledge into clinical practice.
Collapse
Affiliation(s)
- Nadia Minian
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada
- Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
| | - Anika Saiva
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada
| | - Sheleza Ahad
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada
| | | | - Laurie Zawertailo
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada
- Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
| | - Scott Veldhuizen
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada
| | - Arun Ravindran
- Departments of Psychiatry & Pharmacology and Toxicology, University of Toronto, Toronto, Canada
- Institute of Medical Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Cambell Family Mental Health Research Centre, Centre for Addiction and Mental Health, Toronto, Canada
| | - Claire de Oliveira
- Cambell Family Mental Health Research Centre, Centre for Addiction and Mental Health, Toronto, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- ICES, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Carol Mulder
- Department of Family Medicine, Queen’s University, Kingston, Canada
| | - Dolly Baliunas
- School of Public Health, University of Queensland, Herston, Australia
- Addictions, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Peter Selby
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
- Addictions Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Departments of Family and Community Medicine and Psychiatry, and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| |
Collapse
|
2
|
Gaid D, Ahmed S, Thomas A, Bussières A. Barriers and Facilitators to Knowledge Brokering Activities: Perspectives from Knowledge Brokers Working in Canadian Rehabilitation Settings. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023; 43:87-95. [PMID: 36859412 DOI: 10.1097/ceh.0000000000000475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 09/29/2022] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Knowledge translation experts advocate for employing knowledge brokers (KBs) to promote the uptake of research evidence in health care settings. Yet, no previous research has identified potential barriers for KBs to promote the uptake of research evidence in rehabilitation settings. This study aimed to identify the barriers and facilitators for KBs in Canadian rehabilitation settings as perceived by individuals serving as KBs. METHODS Qualitative study using semistructured telephone interviews with individuals performing KB activities in rehabilitation settings across Canada. The interview topic guide was informed by the Consolidated Framework for Implementation Research (CFIR) and consisted of 20 questions covering three domains (characteristics of individuals, inner setting, and outer settings). We conducted qualitative descriptive analysis combining deductive coding guided by the CFIR. RESULTS Characteristics of individuals included having communication skills, clinical experience, research skills, and interpersonal features, in addition to being confident and motivated and receiving training. The inner setting domain included having constant networking with stakeholders and being aware of stakeholders' needs, in addition to resources availability, leadership engagement, knowledge accessibility, prioritizing brokering activities, and monitoring KBs' performance. Finally, the outer setting domain showed that KBs need to be connected to a community of practice to promote information exchange and avoid work duplications. DISCUSSION Factors likely to hinder or promote the optimal use of KBs within Canadian rehabilitation settings include skill sets and networking abilities; organizational culture, resources, and leadership engagement; and the need for specific training for KBs and for evaluation tools to monitor their performance.
Collapse
Affiliation(s)
- Dina Gaid
- Dr. Gaid: McGill University, School of Physical and Occupational Therapy, Montreal, Quebec, Canada, and The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada. Dr. Ahmed: McGill University, School of Physical and Occupational Therapy, Montreal, Quebec, Canada, and The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada, and Research Institute McGill University Health Center, Centre for Outcomes Research and Evaluation (CORE), Montreal, Quebec, Canada. Dr. Thomas: McGill University, School of Physical and Occupational Therapy, Montreal, Quebec, Canada, and The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada, and Institute of Health Sciences Education, Montreal, Quebec, Canada. Dr. Bussières: Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada, and McGill University, School of Physical and Occupational Therapy, Montreal, Quebec, Canada, and The Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
| | | | | | | |
Collapse
|
3
|
Gaid D, Ahmed S, Thomas A, Bussières A. Profiling knowledge brokers in the rehabilitation sector across Canada: A descriptive study. J Eval Clin Pract 2022; 28:303-314. [PMID: 34611962 DOI: 10.1111/jep.13621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/12/2021] [Indexed: 11/30/2022]
Abstract
RATIONALE Knowledge brokers (KBs) can help promote the uptake of the latest research evidence into clinical practice. Little is known about who they are, the types of roles they perform, and the training they receive. Establishing a portrait of Canadian KBs working in the rehabilitation sector may inform health care organizations and knowledge translation specialists on how best to advance KBs practices. The overall goal was to describe the profile of KBs working to promote the uptake of evidence within rehabilitation settings in Canada. Specifically, this study aimed to describe the sociodemographic and professional characteristics, work activities, and training of KBs. METHODS A cross-sectional online survey was administered to KBs working in rehabilitation settings across Canada. The survey included 20 questions covering sociodemographic and professional characteristics, work activities, and training opportunities. Response frequency and percentage were calculated for all categorical variables, and the weighted average (WA) for each role was calculated across participants. Descriptive analysis was conducted for all open-ended questions. RESULTS Of 475 participants accessing the website, 198 completed the survey questionnaire, including 99 clinicians, 35 researchers, and 26 managers. While over two-thirds of respondents had completed a graduate degree, only 38% reported receiving KBs-related training. The respondents' primary roles corresponded to a linking agent (WA = 1.84), followed by capacity builder (WA = 1.76), information manager (WA = 1.71), facilitator (WA = 1.41), and evaluator (WA = 1.32). CONCLUSIONS KBs are mostly expert clinicians who tend to perform brokering activities part-time targeting their peers. Participants mostly perform the linking agent, capacity builder, and information roles. Moreover, only a few participants received formal training to perform brokering activities.
Collapse
Affiliation(s)
- Dina Gaid
- McGill University, School of Physical and Occupational Therapy, The Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montreal, Québec, Canada
| | - Sara Ahmed
- McGill University, School of Physical and Occupational Therapy, The Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montreal, Québec, Canada
| | - Aliki Thomas
- McGill University, School of Physical and Occupational Therapy, The Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montreal, Québec, Canada
| | - André Bussières
- McGill University, School of Physical and Occupational Therapy, The Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montreal, Québec, Canada
| |
Collapse
|
4
|
Dugle G, Wulifan JK, Tanyeh JP, Quentin W. A critical realist synthesis of cross-disciplinary health policy and systems research: defining characteristic features, developing an evaluation framework and identifying challenges. Health Res Policy Syst 2020; 18:79. [PMID: 32664988 PMCID: PMC7359589 DOI: 10.1186/s12961-020-00556-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 03/27/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Health policy and systems research (HPSR) is an inherently cross-disciplinary field of investigation. However, conflicting conceptualisations about inter-, multi- and transdisciplinary research have contributed to confusion about the characteristics of cross-disciplinary approaches in HPSR. This review was conducted to (1) define the characteristic features of context-mechanism-outcome (CMO) configurations in cross-disciplinary HPSR, (2) develop criteria for evaluating cross-disciplinarity and (3) synthesise emerging challenges of the approach. METHOD The paper is a critical realist synthesis conducted in three phases, as follows: (1) scoping the literature, (2) searching for and screening the evidence, and (3) extracting and synthesising the evidence. Five databases, namely the International Bibliography of the Social Sciences and Web of Science, PubMed central, Embase and CINHAL, and reference lists of studies that qualified for inclusion in the review were searched. The search covered peer-reviewed original research, reviews, commentary papers, and institutional or government reports published in English between January 1998 and January 2020. RESULTS A total of 7792 titles were identified in the online search and 137 publications, comprising pilot studies as well as anecdotal and empirical literature were selected for the final review. The review draws attention to the fact that cross-disciplinary HPSR is not defined by individual characteristics but by the combination of a particular type of research question and setting (context), a specific way of researchers working together (mechanism), and research output (outcome) that is superior to what could be achieved under a monodisciplinary approach. This CMO framework also informs the criteria for assessing whether a given HPSR is truly cross-disciplinary. The challenges of cross-disciplinary HPSR and their accompanying coping mechanisms were also found to be context driven, originating mainly from conceptual disagreements, institutional restrictions, communication and information management challenges, coordination problems, and resource limitations. CONCLUSION These findings have important implications. First, the CMO framework of cross-disciplinary HPSR can provide guidance for researchers engaging in new projects and for policy-makers using their findings. Second, the proposed criteria for evaluating theory and practice of cross-disciplinary HPSR may inform the systematic development of new research projects and the structured assessment of existing ones. Third, a better understanding of the challenges of cross-disciplinary HPSR and potential response mechanisms may help researchers to avoid these problems in the future.
Collapse
Affiliation(s)
- Gordon Dugle
- Department of Management Studies, School of Business and Law, University for Development Studies, Box UPW 36, Wa Campus, Wa, Ghana
- Nottingham University Business School, Jubilee Campus, Nottingham, NG8 1BB UK
| | - Joseph Kwame Wulifan
- Department of Management Studies, School of Business and Law, University for Development Studies, Box UPW 36, Wa Campus, Wa, Ghana
| | - John Paul Tanyeh
- Department of Management Studies, School of Business and Law, University for Development Studies, Box UPW 36, Wa Campus, Wa, Ghana
| | - Wilm Quentin
- Department of Healthcare Management, TU, Berlin, Germany
- European Observatory on Health Systems and Policies, Berlin, Germany
| |
Collapse
|
5
|
Newman K, DeForge R, Van Eerd D, Mok YW, Cornelissen E. A mixed methods examination of knowledge brokers and their use of theoretical frameworks and evaluative practices. Health Res Policy Syst 2020; 18:34. [PMID: 32216781 PMCID: PMC7099818 DOI: 10.1186/s12961-020-0545-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 02/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Knowledge brokering is a knowledge translation approach that includes making connections between researchers and decision-makers to facilitate the latter's use of evidence in health promotion and the provision of healthcare. Despite knowledge brokering being well-established in Canada, many knowledge gaps exist, including understanding what theoretical frameworks have been developed and which evaluative practices knowledge brokers (KBs) use. METHODS This study used a mixed methods design to examine how KBs in Canada (1) use frameworks, models and theories in their practice and (2) how they evaluate knowledge brokering interventions. We gathered interview and survey data from KB practitioners to better understand their perspectives on effective practices. Our analysis focused on understanding the theoretical frameworks used by KBs. RESULTS This study demonstrates that KBs in Canada tend not to rely on theories or models that are specific to knowledge brokering. Rather, study participants/respondents draw on (sometimes multiple) theories and models that are fundamental to the broader field of knowledge translation - in particular, the Knowledge to Action model and the Promoting Action Research in Health Sciences framework. In evaluating the impact of their own knowledge brokering practice, participants/respondents use a wide variety of mechanisms. Evaluation was often seen as less important than supporting knowledge users and/or paying clients in accessing and utilising evidence. CONCLUSIONS Knowledge brokering as a form of knowledge translation continues to expand, but the impact on its targeted knowledge users has yet to be clearly established. The quality of engagement between KBs and their clients might increase - the knowledge brokering can be more impactful - if KBs made efforts to describe, understand and evaluate their activities using theories or models specific to KB.
Collapse
Affiliation(s)
- Kristine Newman
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Canada
| | - Ryan DeForge
- World Health Innovation Network, Odette School of Business, University of Windsor, Windsor, Canada.
| | | | - Yan Wei Mok
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Canada
| | - Evelyn Cornelissen
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| |
Collapse
|
6
|
Sibbald SL, Kang H, Graham ID. Collaborative health research partnerships: a survey of researcher and knowledge-user attitudes and perceptions. Health Res Policy Syst 2019; 17:92. [PMID: 31775829 PMCID: PMC6880346 DOI: 10.1186/s12961-019-0485-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 09/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Integrated knowledge translation describes the process of partnered research between different stakeholders with the goal of producing research that ultimately achieves a greater impact when put into practice. A better understanding of research partnerships and integrated knowledge translation has implications for future partnerships and collaborative initiatives in practice. Our research describes and expands upon previous work done to identify barriers and attitudes toward collaboration in the context of research funding opportunities that required researcher-knowledge-user partnerships. METHODS A survey was sent out to researchers funded by the Canadian Institutes of Health Research and knowledge-users who worked collaboratively on their research projects. There were two mirror versions of the survey, one for researchers and one for knowledge-users. Descriptive statistics, χ2 analysis and Mann-Whitney U analysis were used to understand the processes, barriers, perceived impact and sustainability of the partnerships. RESULTS The results revealed that, although there were differences in the roles of researchers and knowledge-users, both groups felt very positive towards their partnerships. Some of the barriers identified as inhibiting effective partnerships were resource constraints (funding/time) and differences in contribution and involvement amongst team members. Despite these barriers, both researchers and knowledge-users felt that the partnership was not only sustainable, but also helped create an impact. CONCLUSIONS Our results provide useful information for funding agencies launching opportunities requiring or encouraging collaborative research projects between researchers and knowledge-users.
Collapse
Affiliation(s)
- Shannon L Sibbald
- University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada.
| | - Hosung Kang
- University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada
| | - Ian D Graham
- University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| |
Collapse
|
7
|
Mc Sween-Cadieux E, Dagenais C, Somé DT, Ridde V. A health knowledge brokering intervention in a district of Burkina Faso: A qualitative retrospective implementation analysis. PLoS One 2019; 14:e0220105. [PMID: 31349363 PMCID: PMC6660220 DOI: 10.1371/journal.pone.0220105] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 07/09/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND A knowledge brokering (KB) intervention was implemented in Burkina Faso. By creating partnerships with health system actors in one district, the broker was expected to assess their knowledge needs, survey the literature to provide the most recent research evidence, produce various knowledge translation tools, and support them in using research to improve their actions. The purpose of this study was to analyze the key factors that influenced the KB project and to make recommendations for future initiatives. METHODS The qualitative design involved a single case study in which the KB intervention implementation was evaluated retrospectively. Data came from interviews with the intervention team (n = 4) and with various actors involved in the intervention (n = 16). Data from formative evaluations conducted during the KB implementation and observation data from a two-month field mission were also used. Two conceptual frameworks were combined to guide the analysis: the Consolidated Framework for Implementation Research (Damschroder et al., 2009) and the Ecological Framework (Durlak & DuPre, 2008). RESULTS Various KB activities were conducted during the first two years of implementation at the local level. The project came to an early end following vain efforts to relocate the intervention at the central level in order to further influence the policy process. Certain shortcomings in the implementation team negatively influenced the implementation: inadequate leadership, no shared vision regarding the reorientation of the intervention, challenges related to the KB role, and lack of frank communications internally. Other impediments to the intervention's deployment included local actors' lack of decision-making authority, the unavailability of resources and of organizational incentives for involvement in the KB intervention, and contextual challenges in accessing the central level. However, the KB strategy presented several strengths: collaborative development, support provided to local partners by the broker, and training opportunities and support provided to the broker. CONCLUSIONS More attention must be paid to intervention planning, partners' engagement, human, financial and technical resources availability, continuous development of skills and of communications within the KB team, and periodic assessment of potential obstacles related to the complexity of the system within which the intervention has been implemented. Using implementation science frameworks when developing KB strategies in the West African context should be promoted.
Collapse
Affiliation(s)
| | - Christian Dagenais
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Donmozoun Télesphore Somé
- Agence de Formation de Recherche et d’Expertise en Santé pour l’Afrique (AFRICSanté), Bobo-Dioulasso, Burkina Faso
| | - Valéry Ridde
- French Institute for Research on Sustainable Development (IRD), CEPED (IRD-Université Paris Descartes), Universités Paris Sorbonne Cités, ERL INSERM SAGESUD, Paris, France
- University of Montreal Public Health Research Institute (IRSPUM), Montreal, Quebec, Canada
| |
Collapse
|
8
|
Dobbins M, Greco L, Yost J, Traynor R, Decorby-Watson K, Yousefi-Nooraie R. A description of a tailored knowledge translation intervention delivered by knowledge brokers within public health departments in Canada. Health Res Policy Syst 2019; 17:63. [PMID: 31221187 PMCID: PMC6585045 DOI: 10.1186/s12961-019-0460-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 05/15/2019] [Indexed: 11/24/2022] Open
Abstract
Background While there is an expectation to demonstrate evidence-informed public health there is an ongoing need for capacity development. The purpose of this paper is to provide a description of a tailored knowledge translation intervention implemented by knowledge brokers (KBs), and reflections on the factors that facilitated or hindered its implementation. Methods The 22-month knowledge translation intervention, implemented by two KBs, sought to facilitate evidence-informed public health decision-making. Data on outcomes were collected using a knowledge, skills and behavioural assessment survey. In addition, the KBs maintained reflective journals noting which activities appeared successful or not, as well as factors related to the individual or the organisation that facilitated or hindered evidence-informed decision-making. Results Tailoring of the knowledge translation intervention to address the needs, preferences and structure of each organisation resulted in three unique interventions being implemented. A consistent finding across organisations was that each site needed to determine where evidence-informed decision-making ‘fit’ within pre-existing organisational processes. Components of the intervention consistent across the three organisations included one-to-one mentoring of teams through rapid evidence reviews, large group workshops and regular meetings with senior management. Components that varied included the frequency of the KB being physically onsite, the amount of time staff spent with the KB and proportion of time spent one-to-one with a KB versus in workshops. Key facilitating factors for implementation included strong leadership, influential power of champions, supportive infrastructure, committed resources and staff enthusiasm. Conclusions The results of this study illustrate the importance of working collaboratively with organisations to tailor knowledge translation interventions to best meet unique needs, preferences, organisational structures and contexts. Organisational factors such as leadership, champions and supportive infrastructure play a key role in determining the impact of the knowledge translation interventions. Future studies should explore how these factors can be fostered and/or developed within organisations. While KBs implemented the knowledge translation intervention in this study, more research is needed to understand the impact of all change agent roles including KBs, as well as how these roles can be maintained in the long-term if proven effective.
Collapse
Affiliation(s)
- Maureen Dobbins
- Faculty of Health Sciences, School of Nursing, McMaster University, 175 Longwood Road South, Suite 210A, Hamilton, Ontario, Canada.
| | - Lori Greco
- Region of Peel - Public Health, 7120 Hurontario Street, Mississauga, Ontario, Canada
| | - Jennifer Yost
- M. Louise Fitzpatrick College of Nursing, Villanova University, Driscoll Hall, Room 330, 800 Lancaster Avenue, Villanova, PA, United States of America
| | - Robyn Traynor
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kara Decorby-Watson
- Centre for Person-Centered Practice Research, Queen Margaret University Edinburgh and Affiliate Member, Queen Margaret University, Edinburgh, United Kingdom
| | - Reza Yousefi-Nooraie
- Department of Public Health Sciences, University of Rochester, School of Medicine, 265 Crittenden Blvd., CU 420644, Rochester, New York, 14642, United States of America
| |
Collapse
|
9
|
Prihodova L, Guerin S, Tunney C, Kernohan WG. Key components of knowledge transfer and exchange in health services research: Findings from a systematic scoping review. J Adv Nurs 2019; 75:313-326. [PMID: 30168164 PMCID: PMC7379521 DOI: 10.1111/jan.13836] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 06/28/2018] [Accepted: 08/06/2018] [Indexed: 12/22/2022]
Abstract
AIMS To identify the key common components of knowledge transfer and exchange in existing models to facilitate practice developments in health services research. BACKGROUND There are over 60 models of knowledge transfer and exchange designed for various areas of health care. Many of them remain untested and lack guidelines for scaling-up of successful implementation of research findings and of proven models ensuring that patients have access to optimal health care, guided by current research. DESIGN A scoping review was conducted in line with PRISMA guidelines. Key components of knowledge transfer and exchange were identified using thematic analysis and frequency counts. DATA SOURCES Six electronic databases were searched for papers published before January 2015 containing four key terms/variants: knowledge, transfer, framework, health care. REVIEW METHODS Double screening, extraction and coding of the data using thematic analysis were employed to ensure rigour. As further validation stakeholders' consultation of the findings was performed to ensure accessibility. RESULTS Of the 4,288 abstracts, 294 full-text articles were screened, with 79 articles analysed. Six key components emerged: knowledge transfer and exchange message, Stakeholders and Process components often appeared together, while from two contextual components Inner Context and the wider Social, Cultural and Economic Context, with the wider context less frequently considered. Finally, there was little consideration of the Evaluation of knowledge transfer and exchange activities. In addition, specific operational elements of each component were identified. CONCLUSIONS The six components offer the basis for knowledge transfer and exchange activities, enabling researchers to more effectively share their work. Further research exploring the potential contribution of the interactions of the components is recommended.
Collapse
Affiliation(s)
- Lucia Prihodova
- UCD School of PsychologyUniversity College DublinDublinIreland
- Palliative Care Research NetworkAll Ireland Institute for Hospice and Palliative CareDublinIreland
| | - Suzanne Guerin
- UCD School of PsychologyUniversity College DublinDublinIreland
- Palliative Care Research NetworkAll Ireland Institute for Hospice and Palliative CareDublinIreland
- UCD Centre for Disability StudiesUniversity College DublinDublinIreland
| | - Conall Tunney
- UCD Centre for Disability StudiesUniversity College DublinDublinIreland
| | - W. George Kernohan
- Palliative Care Research NetworkAll Ireland Institute for Hospice and Palliative CareDublinIreland
- Institute of Nursing and Health ResearchUlster UniversityBelfastNorthern Ireland
| |
Collapse
|
10
|
Becker M, Haworth-Brockman M, Keynan Y. The value of program science to optimize knowledge brokering on infectious diseases for public health. BMC Public Health 2018; 18:567. [PMID: 29716567 PMCID: PMC5930755 DOI: 10.1186/s12889-018-5493-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 04/20/2018] [Indexed: 12/03/2022] Open
Abstract
Background Knowledge translation (KT) and related terms have variously been defined as process and as products. In this paper we contribute to debates on effective KT, specifically knowledge brokering, by describing an adaptation of Program Science that aligns with the real-world of public health activities. Main abstract We describe an adaptation of the Program Science framework to our knowledge translation and brokering planning and projects at the National Collaborating Centre for Infectious Diseases. The systematic approach allows for layering of knowledge year to year and translating knowledge from one infectious disease content area to another. Using a recent forum on syphilis outbreaks as an example, we also demonstrate the value of using Program Science to shape the design and delivery of the knowledge brokering event. Conclusion The use of scientific knowledge to improve public health program design, implementation and evaluation forms the basis for the program science framework. Providing the right public health information to the right audience at the right time can foster long-term outcomes of networks and new partnerships which can potentially improve delivery of public health services.
Collapse
Affiliation(s)
- Marissa Becker
- Centre for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.,National Collaborating Centre for Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.,Section of Infectious Diseases, Faculty of Medicine, University of Manitoba, Winnipeg, Canada.,Departments of Internal Medicine, Medical Microbiology and Community Health Sciences, Winnipeg, Canada
| | - Margaret Haworth-Brockman
- National Collaborating Centre for Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
| | - Yoav Keynan
- National Collaborating Centre for Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.,Section of Infectious Diseases, Faculty of Medicine, University of Manitoba, Winnipeg, Canada.,Departments of Internal Medicine, Medical Microbiology and Community Health Sciences, Winnipeg, Canada
| |
Collapse
|
11
|
Moore G, Redman S, D'Este C, Makkar S, Turner T. Does knowledge brokering improve the quality of rapid review proposals? A before and after study. Syst Rev 2017; 6:23. [PMID: 28129795 PMCID: PMC5273818 DOI: 10.1186/s13643-017-0411-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 01/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rapid reviews are increasingly being used to help policy makers access research in short time frames. A clear articulation of the review's purpose, questions, scope, methods and reporting format is thought to improve the quality and generalisability of review findings. The aim of the study is to explore the effectiveness of knowledge brokering in improving the perceived clarity of rapid review proposals from the perspective of potential reviewers. To conduct the study, we drew on the Evidence Check program, where policy makers draft a review proposal (a pre knowledge brokering proposal) and have a 1-hour session with a knowledge broker, who re-drafts the proposal based on the discussion (a post knowledge brokering proposal). METHODS We asked 30 reviewers who had previously undertaken Evidence Check reviews to examine the quality of 60 pre and 60 post knowledge brokering proposals. Reviewers were blind to whether the review proposals they received were pre or post knowledge brokering. Using a six-point Likert scale, reviewers scored six questions examining clarity of information about the review's purpose, questions, scope, method and format and reviewers' confidence that they could meet policy makers' needs. Each reviewer was allocated two pre and two post knowledge brokering proposals, randomly ordered, from the 60 reviews, ensuring no reviewer received a pre and post knowledge brokering proposal from the same review. RESULTS The results showed that knowledge brokering significantly improved the scores for all six questions addressing the perceived clarity of the review proposal and confidence in meeting policy makers' needs; with average changes of 0.68 to 1.23 from pre to post across the six domains. CONCLUSIONS This study found that knowledge brokering increased the perceived clarity of information provided in Evidence Check rapid review proposals and the confidence of reviewers that they could meet policy makers' needs. Further research is needed to identify how the knowledge brokering process achieves these improvements and to test the applicability of the findings in other rapid review programs.
Collapse
Affiliation(s)
- Gabriel Moore
- School of Public Health, Sydney Medical School, The University of Sydney, Edward Ford Building (A27), Sydney, NSW, 2006, Australia. .,The Sax Institute, Level 13, Building 10, 235 Jones Street, Ultimo, NSW, 2007, Australia.
| | - Sally Redman
- The Sax Institute, Level 13, Building 10, 235 Jones Street, Ultimo, NSW, 2007, Australia
| | - Catherine D'Este
- National Centre for Epidemiology and Population Health (NCEPH), Research School of Population Health, The Australian National University, 62 Mills Road, Acton, ACT, 0200, Australia
| | - Steve Makkar
- The Sax Institute, Level 13, Building 10, 235 Jones Street, Ultimo, NSW, 2007, Australia
| | - Tari Turner
- School of Public Health and Preventive Medicine, Monash University, Level 1, 549 St Kilda Road, Melbourne, VIC, 3004, Australia
| |
Collapse
|
12
|
Van Eerd D, Newman K, DeForge R, Urquhart R, Cornelissen E, Dainty KN. Knowledge brokering for healthy aging: a scoping review of potential approaches. Implement Sci 2016; 11:140. [PMID: 27756358 PMCID: PMC5070130 DOI: 10.1186/s13012-016-0504-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 10/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Developing a healthcare delivery system that is more responsive to the future challenges of an aging population is a priority in Canada. The World Health Organization acknowledges the need for knowledge translation frameworks in aging and health. Knowledge brokering (KB) is a specific knowledge translation approach that includes making connections between people to facilitate the use of evidence. Knowledge gaps exist about KB roles, approaches, and guiding frameworks. The objective of the scoping review is to identify and describe KB approaches and the underlying conceptual frameworks (models, theories) used to guide the approaches that could support healthy aging. METHODS Literature searches were done in PubMed, EMBASE, PsycINFO, EBM reviews (Cochrane Database of systematic reviews), CINAHL, and SCOPUS, as well as Google and Google Scholar using terms related to knowledge brokering. Titles, abstracts, and full reports were reviewed independently by two reviewers who came to consensus on all screening criteria. Documents were included if they described a KB approach and details about the underlying conceptual basis. Data about KB approach, target stakeholders, KB outcomes, and context were extracted independently by two reviewers. RESULTS Searches identified 248 unique references. Screening for inclusion revealed 19 documents that described 15 accounts of knowledge brokering and details about conceptual guidance and could be applied in healthy aging contexts. Eight KB elements were detected in the approaches though not all approaches incorporated all elements. The underlying conceptual guidance for KB approaches varied. Specific KB frameworks were referenced or developed for nine KB approaches while the remaining six cited more general KT frameworks (or multiple frameworks) as guidance. CONCLUSIONS The KB approaches that we found varied greatly depending on the context and stakeholders involved. Three of the approaches were explicitly employed in the context of health aging. Common elements of KB approaches that could be conducted in healthy aging contexts focussed on acquiring, adapting, and disseminating knowledge and networking (linkage). The descriptions of the guiding conceptual frameworks (theories, models) focussed on linkage and exchange but varied across approaches. Future research should gather KB practitioner and stakeholder perspectives on effective practices to develop KB approaches for healthy aging.
Collapse
Affiliation(s)
- Dwayne Van Eerd
- Institute for Work and Health, 481 University Avenue, Suite 800, Toronto, Ontario, Canada, M5G 2E9. .,School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada, N2L 3G1.
| | - Kristine Newman
- Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University, 350 Victoria Street, Toronto, Ontario, Canada, M5B 2K3
| | - Ryan DeForge
- World Health Innovation Network, Odette School of Business, University of Windsor, 401 Sunset Avenue, Windsor, Ontario, Canada, N9B 3P4
| | - Robin Urquhart
- Department of Surgery, Dalhousie University, 6299 South Street, Halifax, Nova Scotia, Canada, B3H 4R2
| | - Evelyn Cornelissen
- Department of Family Practice, Faculty of Medicine, University of British Columbia, 2312 Pandosy Street, Kelowna, British Columbia, Canada, V1Y 1T3
| | - Katie N Dainty
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, Ontario, Canada, M5B 1T8.,Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, Ontario, Canada, M5T 3M6
| |
Collapse
|
13
|
Abstract
Deploying knowledge brokers to bridge the ‘gap’ between researchers and practitioners continues to be seen as an unquestionable enabler of evidence-based practice and is often endorsed uncritically. We explore the ‘dark side’ of knowledge brokering, reflecting on its inherent challenges which we categorize as: (1) tensions between different aspects of brokering; (2) tensions between different types and sources of knowledge; and (3) tensions resulting from the ‘in-between’ position of brokers. As a result of these tensions, individual brokers may struggle to maintain their fragile and ambiguous intermediary position, and some of the knowledge may be lost in the ‘in-between world’, whereby research evidence is transferred to research users without being mobilized in their day-to-day practice. To be effective, brokering requires an amalgamation of several types of knowledge and a multidimensional skill set that needs to be sustained over time. If we want to maximize the impact of research on policy and practice, we should move from deploying individual ‘brokers’ to embracing the collective process of ‘brokering’ supported at the organizational and policy levels.
Collapse
Affiliation(s)
- Roman Kislov
- 1 Research Fellow, Alliance Manchester Business School, University of Manchester, UK
| | - Paul Wilson
- 1 Research Fellow, Alliance Manchester Business School, University of Manchester, UK
| | - Ruth Boaden
- 2 Professor, Alliance Manchester Business School, University of Manchester, UK
| |
Collapse
|
14
|
Bornbaum CC, Kornas K, Peirson L, Rosella LC. Exploring the function and effectiveness of knowledge brokers as facilitators of knowledge translation in health-related settings: a systematic review and thematic analysis. Implement Sci 2015; 10:162. [PMID: 26589972 PMCID: PMC4653833 DOI: 10.1186/s13012-015-0351-9] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 11/11/2015] [Indexed: 11/30/2022] Open
Abstract
Background Knowledge brokers (KBs) work collaboratively with key stakeholders to facilitate the transfer and exchange of information in a given context. Currently, there is a perceived lack of evidence about the effectiveness of knowledge brokering and the factors that influence its success as a knowledge translation (KT) mechanism. Thus, the goal of this review was to systematically gather evidence regarding the nature of knowledge brokering in health-related settings and determine if KBs effectively contributed to KT in these settings. Methods A systematic review was conducted using a search strategy designed by a health research librarian. Eight electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, ERIC, Scopus, SocINDEX, and Health Business Elite) and relevant grey literature sources were searched using English language restrictions. Two reviewers independently screened the abstracts, reviewed full-text articles, extracted data, and performed quality assessments. Analysis included a confirmatory thematic approach. To be included, studies must have occurred in a health-related setting, reported on an actual application of knowledge brokering, and be available in English. Results In total, 7935 records were located. Following removal of duplicates, 6936 abstracts were screened and 240 full-text articles were reviewed. Ultimately, 29 articles, representing 22 unique studies, were included in the thematic analysis. Qualitative (n = 18), quantitative (n = 1), and mixed methods (n = 6) designs were represented in addition to grey literature sources (n = 4). Findings indicated that KBs performed a diverse range of tasks across multiple health-related settings; results supported the KB role as a ‘knowledge manager’, ‘linkage agent’, and ‘capacity builder’. Our systematic review explored outcome data from a subset of studies (n = 8) for evidence of changes in knowledge, skills, and policies or practices related to knowledge brokering. Two studies met standards for acceptable methodological rigour; thus, findings were inconclusive regarding KB effectiveness. Conclusions As knowledge managers, linkage agents, and capacity builders, KBs performed many and varied tasks to transfer and exchange information across health-related stakeholders, settings, and sectors. How effectively they fulfilled their role in facilitating KT processes is unclear; further rigourous research is required to answer this question and discern the potential impact of KBs on education, practice, and policy. Electronic supplementary material The online version of this article (doi:10.1186/s13012-015-0351-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Catherine C Bornbaum
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada. .,Health & Rehabilitation Sciences, Western University, Elborn College, Room 2200, London, ON, N6A 1H1, Canada.
| | - Kathy Kornas
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada.
| | - Leslea Peirson
- McMaster Evidence Review and Synthesis Centre, School of Nursing, McMaster University Faculty of Health Sciences, 1280 Main St. W., Hamilton, ON, L8S 4L8, Canada.
| | - Laura C Rosella
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada. .,Public Health Ontario, Santé publique Ontario, 480 University Avenue, Suite 300, Toronto, ON, M5G 1V2, Canada. .,Institute for Clinical Evaluative Sciences (ICES), G1 06, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
| |
Collapse
|
15
|
Elueze IN. Evaluating the effectiveness of knowledge brokering in health research: a systematised review with some bibliometric information. Health Info Libr J 2015; 32:168-81. [PMID: 25753773 DOI: 10.1111/hir.12097] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 01/27/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to identify the effectiveness of knowledge brokering as a knowledge translation (KT) strategy used in promoting evidence-based decision-making, evidence-based practice or collaboration between researchers, health practitioners and policymakers. METHODS A systematised review of literature was performed using MEDLINE (through ProQuest Dialog), PubMed and Scopus electronic databases. A search strategy was developed to identify primary studies indexed in these databases on knowledge translation that reported the implementation of knowledge brokering. Sixty-two titles related to knowledge brokering were identified from the search after the removal of duplicates, and 24 articles met the eligibility criteria following the review of the full text documents. The findings were then synthesised using a narrative approach. RESULTS It was found that knowledge brokering has been an effective strategy for knowledge translation. CONCLUSION Although this review shows that knowledge brokering has been an effective strategy for KT, it advocates for more empirical studies to compare the effectiveness of specific knowledge brokering approaches with others. It also calls for empirical studies to explicate the role of library and information science professionals in knowledge brokering.
Collapse
Affiliation(s)
- Isioma N Elueze
- Library and Information Science, University of Western Ontario, London, ON, Canada
| |
Collapse
|
16
|
Schleifer Taylor J, Verrier MC, Landry MD. What Do We Know about Knowledge Brokers in Paediatric Rehabilitation? A Systematic Search and Narrative Summary. Physiother Can 2014; 66:143-52. [PMID: 24799751 DOI: 10.3138/ptc.2012-71] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To conduct a systematic review of the literature related to the use of knowledge brokers within paediatric rehabilitation, and specifically to determine (1) how knowledge brokers are defined and used in paediatric rehabilitation and (2) whether knowledge brokers in paediatric rehabilitation have demonstrably improved the performance of health care providers or organizations. METHODS The MEDLINE, CINAHL, EMBASE, and AMED databases were systematically searched to identify studies relating to knowledge brokers or knowledge brokering within paediatric rehabilitation, with no restriction on the study design or primary aim. Following review of titles and abstracts, those studies identified as potentially relevant were assessed based on the inclusion criteria that they: (1) examined some aspect of knowledge brokers/brokering in paediatric rehabilitation; (2) included sufficient descriptive detail on how knowledge brokers/brokering were used; and(3) were peer-reviewed and published in English. RESULTS Of 1513 articles retrieved, 4 met the inclusion criteria, 3 of which referenced the same knowledge broker initiative. Two papers used mixed methods, one qualitative methodology, and one case presentation. Because of the different methods used in the included studies, the findings are presented in a narrative summary. CONCLUSIONS This study provides an overview of the limited understanding of knowledge brokers within paediatric rehabilitation. Knowledge broker initiatives introduced within paediatric rehabilitation have been anchored in different theoretical frameworks, and no conclusions can be drawn as to the optimum combination of knowledge brokering activities and methods, nor about optimal duration, for sustained results.
Collapse
Affiliation(s)
| | - Molly C Verrier
- Graduate Department of Rehabilitation Science ; Department of Physical Therapy and Graduate Department of Rehabilitation Science, Faculty of Medicine, University of Toronto ; Toronto Rehabilitation Institute-University Health Network, Toronto
| | - Michel D Landry
- Graduate Department of Rehabilitation Science ; Department of Physical Therapy and Graduate Department of Rehabilitation Science, Faculty of Medicine, University of Toronto ; Doctor of Physical Therapy Division, School of Medicine, Duke University, Durham, N.C
| |
Collapse
|
17
|
Traynor R, DeCorby K, Dobbins M. Knowledge brokering in public health: a tale of two studies. Public Health 2014; 128:533-44. [PMID: 24684852 DOI: 10.1016/j.puhe.2014.01.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 11/29/2013] [Accepted: 01/29/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVES A Knowledge Broker is one approach for facilitating the integration of evidence-informed decision making in public health practice. In this paper, the findings from two studies investigating a Knowledge Broker intervention as a means of enhancing capacity for evidence-informed decision making are presented. Contextual factors that facilitate this strategy are also identified. STUDY DESIGN This paper describes work done through a single mixed-methods study (randomized controlled trial with a qualitative component) and a case study. METHODS The Health Evidence team conducted two studies examining Knowledge Broker impact in Canadian public health departments. The effectiveness of knowledge translation strategies of varying intensities for promoting the use of research evidence in decisions related to child obesity prevention were explored via a randomized controlled trial with a fundamental descriptive component (2003-2007). In a case study (2010-2013), the authors partnered with three health departments to develop and implement tailored strategies targeted at the organization. Knowledge Brokers worked with designated staff in these studies via one-on-one consultations, small group meetings, and/or workshops and presentations. The Knowledge Broker role was assessed by analysing data from close-ended surveys, interviews, organizational documents, and reflective journals. RESULTS In this paper, the authors focus on findings from the qualitative analysis of implementing the Knowledge Broker role in both studies and explore several contextual factors that impacted study outcomes. Knowledge Brokers were shown to enhance individual capacity by improving knowledge and skill in searching for, critically appraising, and applying research evidence to practice-based issues. Organizational capacity was also enhanced with strong management support and policies. Effective Knowledge Broker attributes included both expertise in research methodology and public health, as well as intangible traits such as approachability and patience. Finally, optimal positioning and ways of working were identified, including the importance of in-person meetings and neutrality of the Knowledge Broker. CONCLUSIONS Knowledge brokering is a potentially promising knowledge translation strategy for public health, though additional feasibility and cost-effectiveness data are still needed. The research presented here further highlights the importance of context and adopting a tailored approach to implement a Knowledge Broker strategy.
Collapse
Affiliation(s)
- R Traynor
- Faculty of Health Sciences, McMaster University, 1200 Main Street West, Hamilton, Canada.
| | - K DeCorby
- Faculty of Health Sciences, McMaster University, 1200 Main Street West, Hamilton, Canada.
| | - M Dobbins
- Faculty of Health Sciences, McMaster University, 1200 Main Street West, Hamilton, Canada.
| |
Collapse
|
18
|
Urquhart R, Grunfeld E, Jackson L, Sargeant J, Porter G. Cross-disciplinary research in cancer: an opportunity to narrow the knowledge-practice gap. Curr Oncol 2013; 20:e512-21. [PMID: 24311951 PMCID: PMC3851347 DOI: 10.3747/co.20.1487] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Health services researchers have consistently identified a gap between what is identified as "best practice" and what actually happens in clinical care. Despite nearly two decades of a growing evidence-based practice movement, narrowing the knowledge-practice gap continues to be a slow, complex, and poorly understood process. Here, we contend that cross-disciplinary research is increasingly relevant and important to reducing that gap, particularly research that encompasses the notion of transdisciplinarity, wherein multiple academic disciplines and non-academic individuals and groups are integrated into the research process. The assimilation of diverse perspectives, research approaches, and types of knowledge is potentially effective in helping research teams tackle real-world patient care issues, create more practice-based evidence, and translate the results to clinical and community care settings. The goals of this paper are to present and discuss cross-disciplinary approaches to health research and to provide two examples of how engaging in such research may optimize the use of research in cancer care.
Collapse
Affiliation(s)
- R. Urquhart
- Department of Surgery, Department of Community Health and Epidemiology, and Division of Medical Education, Dalhousie University, Halifax, NS
| | - E. Grunfeld
- Ontario Institute for Cancer Research, and Department of Family and Community Medicine, University of Toronto, Toronto, ON
| | - L. Jackson
- School of Health and Human Performance, Dalhousie University; and Atlantic Health Promotion Research Centre, Dalhousie University, Halifax, NS
| | - J. Sargeant
- Continuing Medical Education, Dalhousie University; and Division of Medical Education, Dalhousie University, Halifax, NS
| | - G.A. Porter
- Department of Surgery, Dalhousie University; and Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS
| |
Collapse
|
19
|
Jaruseviciene L, Liseckiene I, Valius L, Kontrimiene A, Jarusevicius G, Lapão LV. Teamwork in primary care: perspectives of general practitioners and community nurses in Lithuania. BMC FAMILY PRACTICE 2013; 14:118. [PMID: 23945286 PMCID: PMC3751467 DOI: 10.1186/1471-2296-14-118] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 08/12/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND A team approach in primary care has proven benefits in achieving better outcomes, reducing health care costs, satisfying patient needs, ensuring continuity of care, increasing job satisfaction among health providers and using human health care resources more efficiently. However, some research indicates constraints in collaboration within primary health care (PHC) teams in Lithuania. The aim of this study was to gain a better understanding of the phenomenon of teamwork in Lithuania by exploring the experiences of teamwork by general practitioners (GPs) and community nurses (CNs) involved in PHC. METHODS Six focus groups were formed with 29 GPs and 27 CNs from the Kaunas Region of Lithuania. Discussions were recorded and transcribed verbatim. A thematic analysis of these data was then performed. RESULTS The analysis of focus group data identified six thematic categories related to teamwork in PHC: the structure of a PHC team, synergy among PHC team members, descriptions of roles and responsibilities of team members, competencies of PHC team members, communications between PHC team members and the organisational background for teamwork. These findings provide the basis for a discussion of a thematic model of teamwork that embraces formal, individual and organisational factors. CONCLUSIONS The need for effective teamwork in PHC is an issue receiving broad consensus; however, the process of teambuilding is often taken for granted in the PHC sector in Lithuania. This study suggests that both formal and individual behavioural factors should be targeted when aiming to strengthen PHC teams. Furthermore, this study underscores the need to provide explicit formal descriptions of the roles and responsibilities of PHC team members in Lithuania, which would include establishing clear professional boundaries. The training of team members is an essential component of the teambuilding process, but not sufficient by itself.
Collapse
Affiliation(s)
- Lina Jaruseviciene
- Department of Family Medicine, Lithuanian University of Health Sciences (LUHS), Mickeviciaus 9, Kaunas LT 44307, Lithuania
| | - Ida Liseckiene
- Department of Family Medicine, Lithuanian University of Health Sciences (LUHS), Mickeviciaus 9, Kaunas LT 44307, Lithuania
| | - Leonas Valius
- Department of Family Medicine, Lithuanian University of Health Sciences (LUHS), Mickeviciaus 9, Kaunas LT 44307, Lithuania
| | - Ausrine Kontrimiene
- Department of Family Medicine, Lithuanian University of Health Sciences (LUHS), Mickeviciaus 9, Kaunas LT 44307, Lithuania
| | - Gediminas Jarusevicius
- Department of Cardiology, Lithuanian University of Health Sciences, Mickeviciaus 9, Kaunas LT 44307, Lithuania
| | - Luís Velez Lapão
- WHO Collaborating Center for Health Workforce Policy and Planning, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal, Rua da Junqueira 100, Lisbon 1349-008, Portugal
| |
Collapse
|
20
|
Facilitating implementation of the translational research pipeline in neurological rehabilitation. Curr Opin Neurol 2013; 25:676-81. [PMID: 23041959 DOI: 10.1097/wco.0b013e32835a35f2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Knowledge translation is a growing area of specialisation. This review summarises the field perspectives and highlights recent work that has particular relevance to neurological rehabilitation. RECENT FINDINGS Research in knowledge translation can usefully be organised into three overlapping perspectives, namely a linear transfer of codified knowledge, a social interaction perspective, or a multilevel implementation perspective that incorporates contextual factors. Although systematic reviews remain foundational in supporting knowledge translation, they often lack structured updating and can be problematic to implement in complex cases. Knowledge brokers play an important role in evidence use; these may be managers or administrators of rehabilitation services. Organisational support that sustains and structures knowledge brokering roles has been found lacking. Numerous contextual factors influence knowledge translation, including leadership, fidelity monitoring, and divergent stakeholder perspectives. Integrative frameworks have been developed that consolidate the multiple contingencies. SUMMARY Knowledge translation is a complex process with an incomplete knowledge base; its uniprofessional focus is particularly limiting for neurological rehabilitation. Developing accessible systematic reviews remains central, as well as supporting knowledge brokers, being aware of stakeholder absorptive capacity in developing translational strategies and using integrative frameworks to guide knowledge translation for complex interventions.
Collapse
|
21
|
Urquhart R, Kendell C, Sargeant J, Buduhan G, Johnson P, Rayson D, Grunfeld E, Porter GA. How do surgeons decide to refer patients for adjuvant cancer treatment? Protocol for a qualitative study. Implement Sci 2012; 7:102. [PMID: 23098262 PMCID: PMC3503754 DOI: 10.1186/1748-5908-7-102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Accepted: 10/22/2012] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Non-small cell lung cancer, breast cancer, and colorectal cancer are commonly diagnosed cancers in Canada. Patients diagnosed with early-stage non-small cell lung, breast, or colorectal cancer represent potentially curable populations. For these patients, surgery is the primary mode of treatment, with (neo)adjuvant therapies (e.g., chemotherapy, radiotherapy) recommended according to disease stage. Data from our research in Nova Scotia, as well as others', demonstrate that a substantial proportion of non-small cell lung cancer and colorectal cancer patients, for whom practice guidelines recommend (neo)adjuvant therapy, are not referred for an oncologist consultation. Conversely, surveillance data and clinical experience suggest that breast cancer patients have much higher referral rates. Since surgery is the primary treatment, the surgeon plays a major role in referring patients to oncologists. Thus, an improved understanding of how surgeons make decisions related to oncology services is important to developing strategies to optimize referral rates. Few studies have examined decision making for (neo)adjuvant therapy from the perspective of the cancer surgeon. This study will use qualitative methods to examine decision-making processes related to referral to oncology services for individuals diagnosed with potentially curable non-small cell lung, breast, or colorectal cancer. METHODS A qualitative study will be conducted, guided by the principles of grounded theory. The study design is informed by our ongoing research, as well as a model of access to health services. The method of data collection will be in-depth, semi structured interviews. We will attempt to recruit all lung, breast, and/or colorectal cancer surgeons in Nova Scotia (n ≈ 42), with the aim of interviewing a minimum of 34 surgeons. Interviews will be audiotaped and transcribed verbatim. Data will be collected and analyzed concurrently, with two investigators independently coding and analyzing the data. Analysis will involve an inductive, grounded approach using constant comparative analysis. DISCUSSION The primary outcomes will be (1) identification of the patient, surgeon, institutional, and health-system factors that influence surgeons' decisions to refer non-small cell lung, breast, and colorectal cancer patients to oncology services when consideration for (neo)adjuvant therapy is recommended and (2) identification of potential strategies that could optimize referral to oncology for appropriate individuals.
Collapse
Affiliation(s)
- Robin Urquhart
- Cancer Outcomes Research Program, Cancer Care Nova Scotia, Halifax, Nova Scotia, Canada
| | - Cynthia Kendell
- Cancer Outcomes Research Program, Cancer Care Nova Scotia, Halifax, Nova Scotia, Canada
| | - Joan Sargeant
- Division of Medical Education, Dalhousie University, Halifax, Nova Scotia, Canada
- Continuing Medical Education, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gordon Buduhan
- Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Paul Johnson
- Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Daniel Rayson
- Division of Medical Oncology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Eva Grunfeld
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Geoffrey A Porter
- Cancer Outcomes Research Program, Cancer Care Nova Scotia, Halifax, Nova Scotia, Canada
- Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|