Key components of knowledge transfer and exchange in health services research: Findings from a systematic scoping review

Knowledge-seeking and knowledge sharing of health services across social networks and communities: a scoping review

INTRODUCTION

Lay people's knowledge influences healthcare service utilisation, but the literature on people's knowledge-seeking and sharing about different healthcare services across social networks is patchy and not well integrated. This scoping review was undertaken to map how different studies report healthcare service -related (healthcare) knowledge-seeking or sharing in social circles and to identify evidence gaps for further research.

METHOD

Levac's enhanced scoping review framework was adapted to develop a comprehensive electronic search strategy. Four electronic databases-Medline, Web of Science, PsychINFO, and CINAHL were searched as well as Grey literature. Five per cent of all titles and abstracts screened were screened by a blinded second reviewer. After full-text screening, data were extracted and summarised.

RESULTS

The review included 14 quantitative, 23 qualitative, 2 mixed-method studies, one literature review and one report [N = 41]. Theories included within studies ranged from the socio-ecological model to bricolage. The concept of healthcare-related knowledge was generally ill defined and usually positioned within the concept of health literacy more generally. Lay people's healthcare knowledge was not generally considered as a distinct entity in a holistic sense, with only two studies identified which investigated healthcare knowledge exclusively at inter-personal (meso) levels. However, included studies showed that people's healthcare knowledge in everyday life is co-constructed when they engage in inter-personal interactions with informal social network ties. People tend to acquire healthcare knowledge from others who share similar lived experiences of using healthcare services, which binds the knowledge seekers through homophily. Due to the social responsibility to help others being ingrained within the community, people (predominantly women), support each other, providing emotional and instrumental support in addition to essential healthcare information. This then builds holistic healthcare literacy, which people conventionally do not gain solely from the knowledge transmitted by healthcare professionals.

CONCLUSION

People in diverse community settings acquired, co-constructed, transmitted, or suppressed knowledge about various healthcare services with the support of informal networks, mostly family and friends, combined with mass media sources. Therefore, people's healthcare knowledge is not an individual asset but a shared resource among their social circles. It is multi-faceted and acquired from diverse sources available in the local and online communities and not limited only to individually held lay accounts of using healthcare services.

A scoping review of knowledge translation in strengthening health policy and practice: sources, platforms, tools, opportunities, and challenges

BACKGROUND

Knowledge translation (KT) interventions encompass a variety of activities, platforms, tools, approaches, and strategies designed to leverage research evidence to enhance health policy and practice. This study aims to review and synthesize existing evidence regarding the sources of evidence for KT, platforms and tools, and their opportunities and challenges in strengthening health policy and practice.

METHODS

A qualitative synthesis of the literature was conducted, adhering to scoping review guidelines. Relevant articles were identified through searches in seven databases (PubMed, Scopus, Embase, CINAHL, Cochrane, PsycINFO, and Web of Science) utilizing keywords combined with Boolean operators. Additional articles were searched in Google Scholar. The search included articles published globally up to July 30, 2023, and was restricted to English-language publications. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist was followed. Thematic analysis was performed, organizing emerging themes into four overarching categories: the source of evidence for KT, platforms and tools, opportunities, and challenges.

RESULTS

The final review included 64 articles. Several themes emerged in each category of analysis. For instance, the source of evidence for KT interventions was primarily derived from review-informed findings and tacit knowledge. KT interventions were facilitated through various platforms and tools, such as advisory committees, review and monitoring meetings, policy dialogues, frameworks, and digital tools including social media. Identified opportunities for KT included health system leadership, knowledge co-production, partnerships, organizational readiness, and evidence contextualization. Conversely, challenges included inadequate institutionalization of integrated approaches, organizational hierarchies, and fragmentation of KT efforts.

CONCLUSIONS

This study synthesizes insights into the sources of knowledge, KT platforms, and institutional arrangements, as well as the opportunities and challenges associated with KT interventions. The synthesized knowledge, drawn from reviews and experiential learning, can serve as a valuable resource for KT, disseminated through diverse platforms. Collaborative partnerships among evidence producers, users, and knowledge brokers, supported by appropriate frameworks, are essential for enhancing KT and improving health policy and practice.

International perspective on social cognition in schizophrenia: current stage and the next steps

In the last decades, research from cognitive science, clinical psychology, psychiatry, and social neuroscience has provided mounting evidence that several social cognitive abilities are impaired in people with schizophrenia and contribute to functional difficulties and poor clinical outcomes. Social dysfunction is a hallmark of the illness, and yet, social cognition is seldom assessed in clinical practice or targeted for treatment. In this article, 17 international experts, from three different continents and six countries with expertise in social cognition and social neuroscience in schizophrenia, convened several meetings to provide clinicians with a summary of the most recent international research on social cognition evaluation and treatment in schizophrenia, and to lay out primary recommendations and procedures that can be integrated into their practice. Given that many extant measures used to assess social cognition have been developed in North America or Western Europe, this article is also a call for researchers and clinicians to validate instruments internationally and we provide preliminary guidance for the adaptation and use of social cognitive measures in clinical and research evaluations internationally. This effort will assist promoting scientific rigor, enhanced clinical practice, and will help propel international scientific research and collaboration and patient care.

Digital endpoints in clinical trials: emerging themes from a multi-stakeholder Knowledge Exchange event

BACKGROUND

Digital technologies, such as wearable devices and smartphone applications (apps), can enable the decentralisation of clinical trials by measuring endpoints in people's chosen locations rather than in traditional clinical settings. Digital endpoints can allow high-frequency and sensitive measurements of health outcomes compared to visit-based endpoints which provide an episodic snapshot of a person's health. However, there are underexplored challenges in this emerging space that require interdisciplinary and cross-sector collaboration. A multi-stakeholder Knowledge Exchange event was organised to facilitate conversations across silos within this research ecosystem.

METHODS

A survey was sent to an initial list of stakeholders to identify potential discussion topics. Additional stakeholders were identified through iterative discussions on perspectives that needed representation. Co-design meetings with attendees were held to discuss the scope, format and ethos of the event. The event itself featured a cross-disciplinary selection of talks, a panel discussion, small-group discussions facilitated via a rolling seating plan and audience participation via Slido. A transcript was generated from the day, which, together with the output from Slido, provided a record of the day's discussions. Finally, meetings were held following the event to identify the key challenges for digital endpoints which emerged and reflections and recommendations for dissemination.

RESULTS

Several challenges for digital endpoints were identified in the following areas: patient adherence and acceptability; algorithms and software for devices; design, analysis and conduct of clinical trials with digital endpoints; the environmental impact of digital endpoints; and the need for ongoing ethical support. Learnings taken for next generation events include the need to include additional stakeholder perspectives, such as those of funders and regulators, and the need for additional resources and facilitation to allow patient and public contributors to engage meaningfully during the event.

CONCLUSIONS

The event emphasised the importance of consortium building and highlighted the critical role that collaborative, multi-disciplinary, and cross-sector efforts play in driving innovation in research design and strategic partnership building moving forward. This necessitates enhanced recognition by funders to support multi-stakeholder projects with patient involvement, standardised terminology, and the utilisation of open-source software.

[Acquisition, status and transfer of knowledge in compression therapy : Cross-sectional study in healthcare professions using phlebological compression therapy]

BACKGROUND

Due to scientific progress, healthcare professionals should regularly undergo appropriate continuing education. For this, knowledge transfer is essential. Therefore, the aim of this cross-sectional study was to investigate the acquisition, status and transfer of knowledge of professional groups applying phlebological compression therapy in Germany.

MATERIALS AND METHODS

Healthcare professionals (physicians, nurses and medical assistants) received a questionnaire developed for this study, which queried different aspects of acquisition, status and transfer of knowledge.

RESULTS

Responses from 522 participants were analysed. The topic of compression therapy was not taught in the nursing or medical education of 43.3%. Specialist journals that address compression therapy were read regularly (at least 6 times/year) by 16.1% of the participants; 63.0% had no specialist books on this subject. Only 6.7% were aware of AWMF ("Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften") guidelines on the topic and 16.3% of the corresponding DNQP ("Deutsches Netzwerk für Qualitätsentwicklung in der Pflege") expert standard. In all, 41.2% participated in at least one internal training on compression therapy per year, 72.0% in external training and 19.2% in online training. A total of 30.7% stated that they did not use any information sources to acquire knowledge.

CONCLUSIONS

Possible sources of knowledge about compression therapy in Germany are insufficiently known within the investigated healthcare professional groups studied or are not regularly used. The result is a considerable knowledge deficit with a discrepancy between the current state of science and practice.

Promoting knowledge translation: An ecosystem approach to evidence in health

The dissemination and implementation of evidence in health contexts have been a concern of several international organizations responsible for recommending actions to health policymakers. World Health Organization has been advocating for an ecosystem of evidence to improve clinical practice and health professional education. Thus, in this article, we address the challenges to developing the evidence ecosystem from the point of view of health professional education, considering the contexts of practice and teaching, focused on knowledge translation. There are three pivotal challenges: producing qualified knowledge; adequate communication of the synthesized evidence; and institutional policy to sustain the implemented evidence in continuous and updated flow. The evidence ecosystem helps to understand these flows between the production and implementation of knowledge, based on the capacity and resources of different health systems. It needs to be developed in the field of health professional education, feedback in the contexts of practice and teaching, to contribute to third-generation knowledge being used by different users of health services.

The effectiveness of knowledge-sharing techniques and approaches in research funded by the National Institute for Health and Care Research (NIHR): a systematic review

BACKGROUND

The National Institute of Health and Care Research (NIHR), funds, enables and delivers world-leading health and social care research to improve people's health and wellbeing. To achieve this aim, effective knowledge sharing (two-way knowledge sharing between researchers and stakeholders to create new knowledge and enable change in policy and practice) is needed. To date, it is not known which knowledge sharing techniques and approaches are used or how effective these are in creating new knowledge that can lead to changes in policy and practice in NIHR funded studies.

METHODS

In this restricted systematic review, electronic databases [MEDLINE, The Health Management Information Consortium (including the Department of Health's Library and Information Services and King's Fund Information and Library Services)] were searched for published NIHR funded studies that described knowledge sharing between researchers and other stakeholders. One researcher performed title and abstract, full paper screening and quality assessment (Critical Appraisal Skills Programme qualitative checklist) with a 20% sample independently screened by a second reviewer. A narrative synthesis was adopted.

RESULTS

In total 9897 records were identified. After screening, 17 studies were included. Five explicit forms of knowledge sharing studies were identified: embedded models, knowledge brokering, stakeholder engagement and involvement of non-researchers in the research or service design process and organisational collaborative partnerships between universities and healthcare organisations. Collectively, the techniques and approaches included five types of stakeholders and worked with them at all stages of the research cycle, except the stage of formation of the research design and preparation of funding application. Seven studies (using four of the approaches) gave examples of new knowledge creation, but only one study (using an embedded model approach) gave an example of a resulting change in practice. The use of a theory, model or framework to explain the knowledge sharing process was identified in six studies.

CONCLUSIONS

Five knowledge sharing techniques and approaches were reported in the included NIHR funded studies, and seven studies identified the creation of new knowledge. However, there was little investigation of the effectiveness of these approaches in influencing change in practice or policy.

A scoping review of implementation science theories, models, and frameworks - an appraisal of purpose, characteristics, usability, applicability, and testability

BACKGROUND

A proliferation of theories, models, and frameworks (TMFs) have been developed in the implementation science field to facilitate the implementation process. The basic features of these TMFs have been identified by several reviews. However, systematic appraisals on the quality of these TMFs are inadequate. To fill this gap, this study aimed to assess the usability, applicability, and testability of the current TMFs in a structured way.

METHODS

A scoping review method was employed. Electronic databases were searched to locate English and Chinese articles published between January 2000 and April 2022. Search terms were specific to implementation science. Additionally, hand searches were administered to identify articles from related reviews. Purpose and characteristics such as the type of TMF, analytical level, and observation unit were extracted. Structured appraisal criteria were adapted from Birken et al.'s Theory Comparison and Selection Tool (T-CaST) to conduct an in-depth analysis of the TMFs' usability, applicability, and testability.

RESULTS

A total of 143 TMFs were included in this analysis. Among them, the most common purpose was to identify barriers and facilitators. Most TMFs applied the descriptive method to summarize the included constructs or the prescriptive method to propose courses of implementation actions. TMFs were mainly mid-range theories built on existing conceptual frameworks or demonstrated grand theories. The usability of the TMFs needs to be improved in terms of the provision of conceptually matched strategies to barriers and facilitators and instructions on the TMFs usage. Regarding the applicability, little attention was paid to the constructs of macro-level context, stages of scale-up and sustainability, and implementation outcomes like feasibility, cost, and penetration. Also, fewer TMFs could propose recommended research and measurement methods to apply the TMFs. Lastly, explicit hypotheses or propositions were lacking in most of the TMFs, and empirical evidence was lacking to support the claimed mechanisms between framework elements in testability.

CONCLUSIONS

Common limitations were found in the usability, application, and testability of the current TMFs. The findings of this review could provide insights for developers of TMFs for future theoretical advancements.

Comparing research and development, launch, and scale up timelines of 18 vaccines: lessons learnt from COVID-19 and implications for other infectious diseases

Over the next decade, millions of deaths could be prevented by increasing access to vaccines in low-income and middle-income countries (LMICs). The COVID-19 pandemic has demonstrated that the research and development (R&D), launch and scale up timelines of vaccines can be drastically shortened. This study compares such timelines for eighteen vaccines and identifies lessons and implications for accelerating the R&D, launch and scale up process for other vaccine candidates. To replicate the rapid R&D process of the COVID-19 vaccines, future vaccine R&D should capitalise on public-private knowledge sharing partnerships to promote technology innovation, establish regional clinical trial centres and data sharing networks to optimise clinical trial efficiency, and create a funding mechanism to support research into novel vaccine platforms that may prove valuable to quickly developing vaccine candidates in future global health emergencies. To accelerate the launch timeline, future efforts to bring safe and efficacious vaccines to market should include LMICs in the decision-making processes of global procurement and delivery alliances to optimise launch in these countries, strengthen the WHO prequalification and Emergency Use Listing programs to ensure LMICs have a robust and transparent regulatory system to rely on, and invest in LMIC regulatory and manufacturing capacity to ensure these countries are vaccine self-sufficient. Lastly, efforts to accelerate scale up of vaccines should include the creation of regional pooled procurement mechanisms between LMICs to increase purchasing power among these countries and an open line of clear communication with the public regarding pertinent vaccine information to combat misinformation and vaccine hesitancy.

The EGPRN Research Strategy for general practice in Europe

The European General Practice Research Network (EGPRN) has recently published an updated research strategy with the overall aim being to promote relevant research of the highest quality within general practice/family medicine (GP/FM). The Research Strategy indicates a global direction and serves as a basis for more detailed plans in individual countries that will take into account the characteristics of a country, its specific needs and the level of current research capacity. This paper aims to provide a summary of the EGPRN Research Strategy.The Research Strategy suggests that it is necessary to consider what the knowledge deficits are and to set research priorities. Research capacity building (RCB) is required at all levels. Research in GP/FM will also have to reflect the changes in the profession. An innovative and sustainable-oriented approach to conducting research is needed. Use of existing toolkits and engagement with patient platforms and representative groups are necessary to ensure meaningful user involvement. Knowledge transfer and exchange (KTE) is an important component to ensure a process of exchange between researchers and knowledge users.Working to improve leadership, to support the creation of a research culture in GP/FM and to increase national and international networking are considered as fundamental to ensuring a portfolio of high-quality research and for improving the impact of GP/FM research. The recommendations in the Research Strategy are based on a review of the literature on general practice research from 2010 to 2019 and are set in the context of a theoretical framework.

Translating knowledge into practice for communication skills training for health care professionals

Despite the evidence that person-centred communication underpins all that we do in our interactions with patients, caregivers and team members, the knowledge about the implementation of systematic communication skills training is still in its infancy. This position paper describes some of the main contextual facilitators for translating knowledge about communication skills training for health care professionals (HCP) and recommends ways to guide practical implementation. Based on the literature that has been published over the last two decades, it seems evident that communication skills training programs should be underpinned by clinician self-reflection, be experiential, and focused on behaviour change and implementation of new skills into practice. The programs should be delivered by trainers possessing an understanding of communication micro skills, the skills and confidence to observe interactions, and coach learners through the rehearsal of alternative approaches. Communication skills programs should be flexible to adapt to individual learners, local needs, and circumstances. Interventions should not be limited to the empowerment of individual HCP but should be a part of the organisational quality assurance framework, e.g., by including communication skills in clinical audits. Implementation science frameworks may provide tools to align programs to the context and to address the determinants important for a sustained implementation process. Programs need to be embedded as 'core business', otherwise the culture change will be elusive and sustainability under threat if they are only dependent on provisional funding.

The role of information communication technologies as a moderator of knowledge creation and knowledge sharing in improving the quality of healthcare services

This study examines the role of knowledge creation, knowledge sharing and information communication technologies, which are organizational factors that influence the quality of healthcare services. In today’s knowledge-intensive environment, understanding and gaining in-depth knowledge on how to improve the quality of healthcare services is gaining in importance and recognition. Quantitative data collected in 2019 with 151 respondents employed in healthcare organizations was used. Running a series of hierarchical linear regression models, we found a significant positive relationship between knowledge creation and quality of healthcare services, and a significant positive relationship between knowledge sharing and quality of healthcare services. Empirical data additionally provides support for information communication technologies that act as a moderator both in the relationship between knowledge creation and knowledge sharing with quality of healthcare services. With our data, we provide empirical backing for the impact of knowledge creation, knowledge sharing and information communication technologies on the quality of healthcare services that are provided by Montenegrin healthcare organizations. Our paper offers theoretical and practical implications derived from our research study.

Transforming Health Data to Actionable Information: Recent Progress and Future Opportunities in Health Information Exchange

OBJECTIVES

Provide a systematic review of literature pertaining to health information exchange (HIE) since 2018. Summarize HIE-associated literature for most frequently occurring topics, as well as within the context of the COVID-19 pandemic and health equity. Finally, provide recommendations for how HIE can advance the vision of a digital healthcare ecosystem.

METHODS

A computer program was developed to mediate a literature search of primary literature indexed in MEDLINE that was: (1) indexed with "Health Information Exchange" MeSH descriptor as a major topic; and (2) published between January 2018 and December 2021. Frequency of MeSH descriptors was then used to identify and to rank topics associated with the retrieved literature. COVID-19 literature was identified using the general COVID-19 PubMed Clinical Query filter. Health equity literature was identified using additional MeSH descriptor-based searches. The retrieved literature was then reviewed and summarized.

RESULTS

A total of 256 articles were retrieved and reviewed for this survey. The major thematic areas summarized were: (1) Information Dissemination; (2) Delivery of Health Care; (3) Hospitals; (4) Hospital Emergency Service; (5) COVID-19; (6) Health Disparities; and (7) Computer Security and Confidentiality. A common theme across all areas examined for this survey was the maturity of HIE to support data-driven healthcare delivery. Recommendations were developed based on opportunities identified across the reviewed literature.

CONCLUSIONS

HIE is an essential advance in next generation healthcare delivery. The review of the recent literature (2018-2021) indicates that successful HIE improves healthcare delivery, often resulting in improved health outcomes. There remain major opportunities for expanded use of HIE, including the active engagement of clinical and patient stakeholders. The maturity of HIE reflects the maturity of the biomedical informatics and health data science fields.

How blogs support the transfer of knowledge into practice in the field of dementia palliative care: a survey of facilitators and barriers

Background

Blogging can help to maximise the impact of one’s work in academia and beyond by making research findings accessible for multiple knowledge users, such as healthcare professionals and the public, as well as other researchers. As part of the knowledge exchange and dissemination activities of the Model for Dementia Palliative Care Project, this study explored stakeholders’ views of blogs as a means to translate research findings.

Methods

A web-based survey was developed, piloted, and revised. It was distributed electronically via key dementia and palliative care organisations websites, newsletters, social media platforms, and within the staff mailing lists of five Universities in Ireland. Data were analysed using descriptive statistics and content analysis.

Results

Complete responses were received from 128 participants. The majority of respondents were healthcare researchers (n = 53), followed by healthcare providers (n = 46). The preferred methods of reviewing research findings were scientific papers, websites and news articles. Respondents read healthcare blogs “sometimes” (39.1%), with < 19% reading them “often” or “very often”. Receiving an email notification might increase the likelihood of reading a new blog post for 83% of respondents. Barriers to engaging with blogs included lack of time, preference for other media, lack of awareness regarding available blogs, and concerns about the credibility and source of information. An appropriate length and the author of the blog were key features that encouraged engagement with a blog.

Conclusions

Despite respondents choosing a scientific paper as their preferred method to consume research findings, many indicated an openness to reading blogs on their area of interest. Creating concise, relevant, and credible blogs, and suitably promoting them, could increase the impact and reach of healthcare research, such as in the emerging field of dementia palliative care, and thus promote translation of research findings into practice.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12904-022-01001-7.

Translation, Adaptation, and Psychometric Validation of the Spanish Version of the Attitudes towards Research and Development within Nursing Questionnaire

The promotion of research competence is essential for the development of the nursing profession and discipline. The aim of this study was to translate into Spanish, adapt, and validate an instrument measuring nurses’ attitudes towards nursing research and development. A quantitative, cross-sectional, analytical design was used for the cross-cultural adaptation and cultural validation of the instrument. A total of 367 participants were selected using intentional sampling. A process of translation, back-translation, expert consultation, and pilot testing was followed. Subsequently, reliability and statistical validity were assessed, a new factor structure was proposed, and means were compared to assess the power to discriminate between factors by groups of participants. The results showed internal consistency tests with a Cronbach’s alpha of 0.913. Confirmatory factor analysis of the comparative fit index (CFI = 0.549) and Tucker–Lewis index (TLI = 0.491) indicate that the factors did not match the original clustering model. The new factor structure consisted of seven factors. Between-group comparisons revealed statistically significant differences. In conclusion, the instrument exhibits high levels of statistical reliability and validity compared to the original instrument. The new factorial proposal is consistent, but further research is needed to verify its replicability in other contexts.

General Practice/Family Medicine Research During the Pandemic: Showing The Links to the EGPRN Research Strategy

General Practice/Family Medicine is at the forefront of the clinical response to the COVID-19 crisis just as it is known to be a critical component of healthcare systems globally. A large number of COVID-19 related papers have been published and dedicated funding calls were available in many countries and across the European Union. However, General Practice/Family Medicine does not feature as strongly as it should in COVID-19 high impact publications or successful funding applications. In this paper, we take a look at the findings on which the recommendations of the “European General Practice Research Network (EGPRN) Research Strategy for General Practice in Europe 2021” are based and highlight how these align with the COVID-19 experience of General Practice/Family research. To elaborate on this, the issues identified and the recommendations of the EGPRN Research Strategy are grouped into three broad areas on which we need to focus – capacity, collaboration, and complexity (3-Cs). Apparent or presumed deficiencies in these 3-Cs are possibly why the General Practice/Family research impact during COVID-19 does not match its position on the ground in fighting the pandemic and supporting patients. The EGPRN Research Strategy identifies how we might work to position ourselves better in the future and gain the recognition deserved, in terms of publications, research funding, and prominence. Keywords: general practice, research, pandemics, publications, financing

Functional Brain Network Analysis of Knowledge Transfer While Engineering Problem-Solving

As a complex cognitive activity, knowledge transfer is mostly correlated to cognitive processes such as working memory, behavior control, and decision-making in the human brain while engineering problem-solving. It is crucial to explain how the alteration of the functional brain network occurs and how to express it, which causes the alteration of the cognitive structure of knowledge transfer. However, the neurophysiological mechanisms of knowledge transfer are rarely considered in existing studies. Thus, this study proposed functional connectivity (FC) to describe and evaluate the dynamic brain network of knowledge transfer while engineering problem-solving. In this study, we adopted the modified Wisconsin Card-Sorting Test (M-WCST) reported in the literature. The neural activation of the prefrontal cortex was continuously recorded for 31 participants using functional near-infrared spectroscopy (fNIRS). Concretely, we discussed the prior cognitive level, knowledge transfer distance, and transfer performance impacting the wavelet amplitude and wavelet phase coherence. The paired t-test results showed that the prior cognitive level and transfer distance significantly impact FC. The Pearson correlation coefficient showed that both wavelet amplitude and phase coherence are significantly correlated to the cognitive function of the prefrontal cortex. Therefore, brain FC is an available method to evaluate cognitive structure alteration in knowledge transfer. We also discussed why the dorsolateral prefrontal cortex (DLPFC) and occipital face area (OFA) distinguish themselves from the other brain areas in the M-WCST experiment. As an exploratory study in NeuroManagement, these findings may provide neurophysiological evidence about the functional brain network of knowledge transfer while engineering problem-solving.

The usability and applicability of knowledge translation theories, models, and frameworks for research in the context of a national health service

BACKGROUND

Translating research findings into service improvements for patients and/or policy changes is a key challenge for health service organizations. The Health Service Executive (HSE) in Ireland launched the Action Plan for Health Research 2019-2029, as reported by Terrés (HSE, Dublin, 2019), one of the goals of which is to maximize the impact of the research that takes place within the service to achieve improvements in patient care, services, or policy change. The purpose of this research is to review the literature on knowledge translation theories, models, and frameworks (TMFs) and to assess the suitability of the TMFs for HSE use, selecting one or more for this purpose. The aim is to produce guidance for HSE researchers and other health services staff, validate the usability of the framework(s) with researchers, and review and implement the guidance. It was hoped that identifying a suitable methodology would provide the means to increase the uptake and application of research findings, and reduce research wastage. This paper reports on the first part of the study: the review, assessment, and selection of knowledge translation TMFs for a national health service.

METHODS

An interdisciplinary working group of academic experts in implementation science, research wastage, and knowledge translation, along with key representatives from research funders (Health Research Board) and HSE personnel with expertise in quality improvement and research management, undertook a three-stage review and selection process to identify a knowledge translation TMF that would be suitable and usable for HSE purposes. The process included a literature review, consensus exercise, and a final consensus workshop. The review group adopted the Theory Comparison and Selection Tool (T-CaST) developed by Birken et al. (Implement Sci 13: 143, 2018) to review knowledge translation theories, models, and frameworks.

RESULTS

From 247 knowledge translation TMFs initially identified, the first stage of the review identified 18 that met the criteria of validity, applicability, relevance, usability, and ability to be operationalized in the local context. A further review by a subgroup of the working group reduced this number to 11. A whole-group review selected six of these to be reviewed at a facilitated consensus workshop, which identified three that were suitable and applicable for HSE use. These were able to be mapped onto the four components of the HSE knowledge translation process: knowledge creation, knowledge into action, transfer and exchange of knowledge, and implementation and sustainability.

CONCLUSION

The multiplicity of knowledge translation TMFs presents a challenge for health service researchers in making decisions about the appropriate methods for disseminating their research. Building a culture that uses research knowledge and evidence is important for organizations seeking to maximize the benefits from research. Supporting researchers with guidance on how to disseminate and translate their research can increase the uptake and application of research findings. The use of robust selection criteria enabled the HSE to select relevant TMFs and develop a process for increasing the dissemination and translation of research knowledge. The guidance developed to inform and educate researchers and knowledge users is expected to increase organizational capacity to promote a culture of research knowledge and evidence use within the HSE.

Benefits of Structured Engagement with Target Audiences of a Health Website: Study Design for a Multi-Case Study

Access to evidence and practice knowledge precedes use, but availability does not guarantee reach and uptake by intended audiences. The CareSearch project provides online palliative care evidence and information to support health and aged care professionals as well as patients, carers and families to make informed decisions about care at the end of life. Already established in the palliative care sector, CareSearch commenced planning to extend its reach, and ensure website use is maximised for different audiences. This paper reports on the development of the Engagement Framework which will be used to guide and deliver an Engagement Project which will actively seek feedback and insights from intended users in a structured process. The process for developing the Engagement Framework commenced with a literature review of approaches used in knowledge translation, implementation science, and social marketing. The Engagement Framework comprising eight steps was then developed. The Engagement Framework outlines the series of tasks to be undertaken by team members when working with three target groups (Aged Care; Allied Health; and Patients, Carers and Families). A process/formative evaluation collecting data using qualitative methods is also described for use in the subsequent Engagement Project. The evaluation will explore the experiences of project participants as well as staff implementing the engagement activities. The three target groups will enable a cross-case comparison of the strengths and weaknesses of the approach. Planning, implementing and evaluating engagement with intended audiences, offers one mechanism to identify ways to increase interaction and integration with knowledge users.

The implementation of reciprocal imitation training in a Part C early intervention setting: A stepped-wedge pragmatic trial

Despite the development of several evidence-based Naturalistic Developmental Behavioral Interventions (NDBIs), very few have been adapted for use in community-based settings. This study examines the implementation of Reciprocal Imitation Training (RIT)-an NDBI-by community Early Intervention (EI; IDEA Part C) providers serving toddlers from birth to 3 years. Of the 87 EI providers enrolled from 9 agencies in 4 counties across Washington State, 66 were included in the current sample. A stepped-wedge design was used to randomly assign counties to the timing of RIT training workshops. Self-report measures of practice and self-efficacy regarding ASD care were collected at baseline (T1, T2) and 6-months and 12-months post-training (T3, T4). At T3 and T4, providers reported on RIT adoption and rated items about RIT feasibility and perceived RIT effectiveness; at T4, they also reported on child characteristics that led to RIT use and modifications. From pre-training to post-training, there were significant increases in providers' self-efficacy in providing services to children with ASD or suspected ASD. At T3 and T4, provider ratings indicated high levels of RIT adoption, feasibility, and perceived RIT effectiveness. At T4, providers indicated that they most commonly: (a) initiated RIT when there were social-communication or motor imitation delays, or an ASD diagnosis; and (b) made modifications to RIT by repeating elements, blending it with other therapies, and loosening its structure. While additional research is needed, RIT may help families get an early start on accessing specialized treatment within an established infrastructure available across the United States. LAY SUMMARY: Reciprocal imitation training (RIT) is an evidence-based treatment for ASD that might be a good fit for use by intervention providers in widely accessible community-based settings. After attending an educational workshop on RIT, providers reported feeling more comfortable providing services to families with ASD concerns, used RIT with over 400 families, and believed that RIT improved important social communication behaviors.

Upscaling communication skills training - lessons learned from international initiatives

OBJECTIVE

To collect experiences and to identify the main facilitators and barriers for the implementation process of large scale communication training programs.

METHODS

Using a multiple case study design, data was collected from leaders of the individual programs in Australia, Ireland, Austria and Denmark. The RE-AIM framework was used to evaluate the components: Reach, Effectiveness, Adoption, Implementation, and Maintenance of the programs.

RESULTS

The programs, all based on the Calgary-Cambridge Guide, succeeded in reaching the intended target groups corresponding to between 446 and 3000 healthcare workers. New courses are planned and so far the outcome of the intervention has been investigated in two countries. The fact that implementation, including educating trainers, relies on a few individuals was identified as the main challenge.

CONCLUSION

Large scale communication training programs based on the Calgary-Cambridge Guide can be implemented and adopted in multiple different healthcare settings across a national health system culture. The importance of standardized trainer education and adaption of the programs to clinical practice was highlighted.

PRACTICE IMPLICATIONS

In order to address the sustainability of the programs and to allow the intervention to scale up, it is important to prioritise and allocate resources at the political and organizational level.

Adaptation and Piloting for Hospice Social Workers of Aliviado Dementia Care, a Dementia Symptom Management Program

BACKGROUND

Forty-five percent of hospice patients currently have a primary or secondary diagnosis of Alzheimer's disease or related disorders. However, few programs have focused specifically on assisting hospices in providing evidence-based symptom management to persons living with dementia (PLWD).

OBJECTIVE

To adapt and pilot the training component of Aliviado Dementia Care, a dementia symptom management quality improvement program originally developed for home healthcare, for use by social workers as part of the hospice interdisciplinary team.

DESIGN

A prospective pre-post design was utilized, measuring knowledge, confidence, and attitudes at baseline, and immediately and 1-month post-training. Analysis was performed using paired t-tests and repeated measures ANOVA.

SUBJECTS

Hospice social workers currently practicing in the United States with at least 1 year of experience.

MEASUREMENTS

The Dementia Symptom Knowledge Assessment and a post-training continuing education evaluation form.

RESULTS

Forty-six subjects were enrolled, of whom 26 completed the first post-test and 23 both post-tests. There was a poor baseline level of knowledge and confidence in caring for PLWD. Significant improvements occurred following training, particularly in implementing non-pharmacologic interventions for behavioral and psychological symptoms of dementia (BPSD) (16.64% increase, p < .0001) and confidence in managing behavioral symptoms (16.86%, p = .01) and depression (25.18%, p < .0001). Changes were maintained over time. All respondents were either very satisfied or satisfied with the quality and content of the program.

CONCLUSIONS

The training modules of Aliviado Dementia Care were successfully tailored for use by hospice social workers, showing significant improvement in knowledge and confidence in caring for behavioral symptoms in PLWD. Future work will examine whether the larger program, including this training, can subsequently improve patient outcomes in hospice.

The use of the PARIHS framework in implementation research and practice-a citation analysis of the literature

BACKGROUND

The Promoting Action on Research Implementation in Health Services (PARIHS) framework was developed two decades ago and conceptualizes successful implementation (SI) as a function (f) of the evidence (E) nature and type, context (C) quality, and the facilitation (F), [SI = f (E,C,F)]. Despite a growing number of citations of theoretical frameworks including PARIHS, details of how theoretical frameworks are used remains largely unknown. This review aimed to enhance the understanding of the breadth and depth of the use of the PARIHS framework.

METHODS

This citation analysis commenced from four core articles representing the key stages of the framework's development. The citation search was performed in Web of Science and Scopus. After exclusion, we undertook an initial assessment aimed to identify articles using PARIHS and not only referencing any of the core articles. To assess this, all articles were read in full. Further data extraction included capturing information about where (country/countries and setting/s) PARIHS had been used, as well as categorizing how the framework was applied. Also, strengths and weaknesses, as well as efforts to validate the framework, were explored in detail.

RESULTS

The citation search yielded 1613 articles. After applying exclusion criteria, 1475 articles were read in full, and the initial assessment yielded a total of 367 articles reported to have used the PARIHS framework. These articles were included for data extraction. The framework had been used in a variety of settings and in both high-, middle-, and low-income countries. With regard to types of use, 32% used PARIHS in planning and delivering an intervention, 50% in data analysis, 55% in the evaluation of study findings, and/or 37% in any other way. Further analysis showed that its actual application was frequently partial and generally not well elaborated.

CONCLUSIONS

In line with previous citation analysis of the use of theoretical frameworks in implementation science, we also found a rather superficial description of the use of PARIHS. Thus, we propose the development and adoption of reporting guidelines on how framework(s) are used in implementation studies, with the expectation that this will enhance the maturity of implementation science.

Nurse-Led Randomized Controlled Trials in the Perioperative Setting: A Scoping Review

PURPOSE

Nurses provide care at each phase of the complex, perioperative pathway and are well placed to identify areas of care requiring investigation in randomized controlled trials. Yet, currently, the scope of nurse-led randomized controlled trials conducted within the perioperative setting are unknown. This scoping review aims to identify areas of perioperative care in which nurse-led randomized controlled trials have been conducted, to identify issues impacting upon the quality of these trials and identify gaps for future investigation.

METHODS

This scoping review was conducted in reference to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Searches were conducted in PubMed, Embase, Cumulative Index for Nursing and Allied Health Literature and the Cochrane Central Register of Controlled Trials, with a date range of 2014-19. Sources of unpublished literature included Open Grey, and ProQuest Dissertation and Theses, Clinical Trials.gov and the Australian and New Zealand Clinical Trials Registry. After title and abstract checking, full-text retrieval and data extraction, studies were appraised using the Joanna Briggs Institute Critical Appraisal Checklists for randomized controlled trials. Data were synthesized according to the main objectives. Key information was tabulated.

RESULTS

From the 86 included studies, key areas where nurses have led randomized controlled trials include patient or caregiver anxiety; postoperative pain relief; surgical site infection prevention: patient and caregiver knowledge; perioperative hypothermia prevention; postoperative nausea and vomiting; in addition to other diverse outcomes. Issues impacting upon quality (including poorly reported randomization), and gaps for future investigation (including a focus on vulnerable populations), are evident.

CONCLUSION

Nurse-led randomized controlled trials in the perioperative setting have focused on key areas of perioperative care. Yet, opportunities exist for nurses to lead experimental research in other perioperative priority areas and within different populations that have been neglected, such as in the population of older adults undergoing surgery.

Knowledge translation: Radiographers compared to other healthcare professionals

OBJECTIVES

This narrative review examines the current status of evidence-based practice and knowledge translation in diagnostic radiography. It explores knowledge translation efforts in the allied health professions aimed at systematically implementing evidence-based practice and suggests ways that these may be applied within diagnostic radiography.

KEY FINDINGS

Knowledge translation in diagnostic radiography is in its infancy with numerous examples of key findings of rigorous studies not implemented in practice. Utilising frameworks, models and theories to systematically translate knowledge into evidence-based practice has been shown to be effective in other allied health professions. Whilst few studies in diagnostic radiography report utilising these systematic approaches to implementing evidence-based practice, those that do, show promising results. Attitudes towards evidence-based practice within diagnostic radiography are becoming more positive and it is important to use this positive shift in attitudes to create real evidence-based change in the profession.

CONCLUSION

The potential benefits of systematically translating knowledge into evidence-based practice in diagnostic radiography are wide reaching with positive implications for our patients, the profession and wider community. Leaders at all levels of radiography must work towards implementing evidence-based practice in their daily work.

IMPLICATIONS FOR PRACTICE

Systematic approaches to knowledge translation should be adopted and reported in diagnostic radiography in order to more effectively translate knowledge into evidence-based practice.

Proactive and systematic multidimensional needs assessment in patients with advanced cancer approaching palliative care: a study protocol

INTRODUCTION

The benefits of palliative care rely on how healthcare professionals assess patients' needs in the initial encounter/s; crucial to the design of a personalised therapeutic plan. However, there is currently no evidence-based guideline to perform this needs assessment. We aim to design and evaluate a proactive and systematic method for the needs assessment using quality guidelines for developing complex interventions. This will involve patients, their relatives and healthcare professionals in all phases of the study and its communication to offer clinical practice a reliable approach to address the palliative needs of patients.

METHODS AND ANALYSIS

To design and assess the feasibility of an evidence-based, proactive and systematic Multidimensional needs Assessment in Palliative care (MAP) as a semistructured clinical interview guide for initial palliative care encounter/s in patients with advanced cancer. This is a two-phase multisite project conducted over 36 months between May 2019 and May 2022. Phase I includes a systematic review, discussions with stakeholders and Delphi consensus. The evidence gathered from phase I will be the basis for the initial versions of the MAP, then submitted to Delphi consensus to develop a preliminary guide of the MAP for the training of clinicians in the feasibility phase. Phase II is a mixed-methods multicenter feasibility study that will assess the MAP's acceptability, participation, practicality, adaptation and implementation. A nested qualitative study will purposively sample a subset of participants to add preliminary clues about the benefits and barriers of the MAP. The evidence gathered from phase II will build a MAP user guide and educational programme for use in clinical practice.

ETHICS AND DISSEMINATION

Ethical approval for this study has been granted by the university research ethics committee where the study will be carried out (approval reference MED-2018-10). Dissemination will be informed by the results obtained and communication will occur throughout.

EMTReK: An Evidence-based Model for the Transfer & Exchange of Research Knowledge-Five Case Studies in Palliative Care

Knowledge transfer is recognized as a vital stage in evidence-informed nursing with several models available to guide the process. Although the main components commonly involve identification of messages, stakeholders, processes and contexts, the underpinning models remain largely unrefined and untested; and they need to be evaluated. We set out to explore the use of our “Evidence-based Model for Transfer & Exchange of Research Knowledge” (EMTReK) within palliative care research. Between January 2016 and May 2017, data were collected from five case studies which used the EMTReK model as a means to transfer knowledge relating to palliative care research, undertaken in Ireland. A qualitative approach was taken with thematic analysis of case documentation, semistructured interviews, and field notes from the case studies. Qualitative analysis supports the core components of EMTReK as a model of knowledge transfer and exchange in palliative care. Results focused upon identification of messages to be transferred to defined stakeholders through interactive processes that take account of context. Case study findings show how the model was interpreted and operationalized by participants and demonstrate its impact on knowledge transfer and exchange. Eight themes were drawn from the data: Credibility of the Model, Model Accessibility, Applicability to Palliative Care, A Matter of Timing, Positive Role of Facilitation, Required Resources, Enhancing Research Quality, Limitations or Areas for Further Consideration. Study participants found EMTReK to be a useful guide when making knowledge transfer plans. Success depended upon adequate facilitation and guidance. Further exploration of the model's utility is warranted.

Key components of knowledge transfer and exchange in health services research: Findings from a systematic scoping review

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.

Findings From a Thematic Synthesis of Key Messages From a Palliative Care Research Network: The KINDLE Project

BACKGROUND

Effective palliative care requires a strong evidence base to advance clinical practice and policy-making. Calls for more collaborative and strategic approaches to research have resulted in the development of research networks at national and wider regional levels.

AIM

The aim was to synthesize the learning arising from the activities of the Palliative Care Research Network from the island of Ireland, in order to identify the overarching messages from these activities. The ultimate aim is to promote the communication of these messages to practice.

DESIGN

The study developed a systematic search process influenced by Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, with analysis of data adopting a qualitative critical interpretative synthesis approach using thematic synthesis.

PARTICIPANTS

In total, 142 dissemination products were sourced from 22 associated projects, including peer-reviewed publications, conference presentations, reports, and web/social media posts.

RESULTS

The synthesis of dissemination products identified 4 key themes relating to palliative care research and practice: (1) addressing the needs of patients while recognizing the caregiver role, (2) equal access to connected services, (3) general and specific needs in palliative care research, and (4) challenges in palliative care research.

CONCLUSIONS

The key themes identified relate to challenges in both practice and research, highlighting the complexity of palliative care provision that aims to support both patients and carers, and research in this area. However, an important implication is the need for a broader approach to dissemination (beyond traditional academic activities) to ensure that research in palliative care is well placed to inform both practice and policy.