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Chalmers S, Hill J, Connell L, Ackerley S, Kulkarni A, Roddam H. The value of allied health professional research engagement on healthcare performance: a systematic review. BMC Health Serv Res 2023; 23:766. [PMID: 37464444 PMCID: PMC10355072 DOI: 10.1186/s12913-023-09555-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 05/16/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Existing evidence suggests that clinician and organisation engagement in research can improve healthcare performance. With the increase in allied health professional (AHP) research activity, it is imperative for healthcare organisations, clinicians, managers, and leaders to understand research engagement specifically within allied health fields. This systematic review aims to examine the value of research engagement by allied health professionals and organisations on healthcare performance. METHODS This systematic review had a two-stage search strategy. Firstly, the papers from a previous systematic review examining the effect of research engagement in healthcare were screened to identify papers published pre-2012. Secondly, a multi-database search was used to conduct a re-focused update of the previous review, focusing specifically on allied health to identify publications from 2012-2021. Studies which examined the value of allied health research engagement on healthcare performance were included. All stages of the review were conducted by two reviewers independently. Each study was assessed using the appropriate Joanna Briggs Institute critical appraisal tool. A narrative synthesis was completed to analyse the similarities and differences between and within the different study types. RESULTS Twenty-two studies were included, comprising of mixed research designs, of which six were ranked as high importance. The findings indicated that AHP research engagement appears related to positive findings in improvements to processes of care. The review also identified the most common mechanisms which may link research engagement with these improvements. DISCUSSION This landmark systematic review and narrative synthesis suggests value in AHP research engagement in terms of both processes of care and more tentatively, of healthcare outcomes. While caution is required because of the lack of robust research studies, overall the findings support the agenda for growing AHP research. Recommendations are made to improve transparent reporting of AHP research engagement and to contribute essential evidence of the value of AHP research engagement. TRIAL REGISTRATION This systematic review protocol was registered with the international prospective register of systematic reviews, PROSPERO (registration number CRD42021253461 ).
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Affiliation(s)
- S Chalmers
- University of Central Lancashire; Allied Health Research Unit, School of Health Sciences, University of Central Lancashire, Fylde Rd, Preston, PR1 2HE, UK.
- Bolton NHS Foundation Trust, Minerva Road, Farnworth, Bolton, Greater Manchester, BL4 0JR, UK.
| | - J Hill
- University of Central Lancashire; Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Fylde Rd, Preston, PR1 2HE, UK
| | - L Connell
- University of Central Lancashire; Allied Health Research Unit, School of Health Sciences, University of Central Lancashire, Fylde Rd, Preston, PR1 2HE, UK
- East Lancashire Hospitals NHS Trust, Burnley, BB10 2PQ, UK
| | - S Ackerley
- University of Central Lancashire; Allied Health Research Unit, School of Health Sciences, University of Central Lancashire, Fylde Rd, Preston, PR1 2HE, UK
| | - A Kulkarni
- Royal College of Speech & Language Therapists, 2-3 White Hart Yard, London, SE1 1NX, UK
| | - H Roddam
- Subject Matter Expert for AHP Research, Health Education England, Manchester, UK
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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.
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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
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Regalado ICR, Lindquist AR, Cardoso R, Longo E, Lencucha R, Hunt M, Thomas A, Bussières A, Boruff JT, Shikako K. Knowledge translation in rehabilitation settings in low, lower-middle and upper-middle-income countries: a scoping review. Disabil Rehabil 2023; 45:376-390. [PMID: 35188861 DOI: 10.1080/09638288.2022.2030415] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE This review aims to identify the barriers and facilitators to knowledge use and Knowledge Translation (KT) strategies in rehabilitation in low, lower-middle, and upper-middle-income countries (LMICs). MATERIALS AND METHODS A scoping review of studies of KT in rehabilitation in LMICs contexts using the Arksey and O'Malley Framework was conducted. A comprehensive search of MEDLINE and 10 other databases was undertaken to identify studies conducted primarily in LMICs. RESULTS From the initial 15.606 titles identified; 27 articles were included for final analysis. Our analysis identified the following themes: Professional culture and context; KT interventions; and the conceptualization and application of KT and Evidence Based Practice (EBP). Individual-level barriers to KT included lack of skills, knowledge about EBP and English language, lack of motivation, and decision-making power. Facilitators to KT included positive attitudes and motivation. Organization-level barriers included lack of time, lack of financial resources, limited access to scientific journals, and applicability of research to rural settings. Facilitators included adequate financial and physical resources, a supportive management environment, and the existence of training and continuing education programs. CONCLUSION This review identified common and unique barriers and facilitators to KT in LMICs when compared to KT studies conducted in high-income settings.IMPLICATIONS FOR REHABILITATIONKnowledge Translation from academic institutions to rehabilitation clinical practice in low and upper-middle-income countries is important to support evidence-based practice and patient outcomes.Barriers at the individual level include professionals' ability to understand English and knowledge of the evidence-based practice.Organization-level barriers included lack of time to access and implement new practices, lack of financial and personal resources, limited access to scientific journals, and applicability of research to rural settings.Training and continuing education programs are needed to support rehabilitation professionals' efforts to achieve the application of evidence-based practice in clinical practice.
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Affiliation(s)
- I C R Regalado
- Department of Physiotherapy, Federal University of Rio Grande do Norte-UFRN, Avenida Senador Salgado Filho, Natal, Brazil
| | - A R Lindquist
- Department of Physiotherapy, Federal University of Rio Grande do Norte-UFRN, Avenida Senador Salgado Filho, Natal, Brazil
| | - R Cardoso
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - E Longo
- Department of Health of Children, Federal University of Rio Grande do Norte-UFRN/FACISA, Santa Cruz, Brazil
| | - R Lencucha
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - M Hunt
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - A Thomas
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - A Bussières
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - J T Boruff
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - K Shikako
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
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Howlett O, O’Brien C, Gardner M, Neilson C. The use of mentoring for knowledge translation by allied health: a scoping review. INT J EVID-BASED HEA 2022; 20:250-261. [DOI: 10.1097/xeb.0000000000000334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Knowledge and attitudes of Implementation Support Practitioners-Findings from a systematic integrative review. PLoS One 2022; 17:e0267533. [PMID: 35544529 PMCID: PMC9094539 DOI: 10.1371/journal.pone.0267533] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 04/10/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND It requires thoughtful planning and work to successfully apply and sustain research-supported interventions like healthcare treatments, social support, or preventive programs in practice. Implementation support practitioners (ISPs) such as facilitators, technical assistance providers, knowledge brokers, coaches or consultants may be involved to actively support the implementation process. This article presents knowledge and attitudes ISPs bring to their work. METHODS Building on a previously developed program logic, a systematic integrative review was conducted. Literature was sourced by searching nine electronic data bases, organizational websites, and by launching a call for publications among selected experts and social media. Article screening was performed independently by two researchers, and data from included studies were extracted by members of the research team and quality-assured by the lead researcher. The quality of included RCTs was assessed based on a framework by Hodder and colleagues. Thematic Analysis was used to capture information on knowledge and attitudes of ISPs across the included studies. Euler diagrams and heatmaps were used to present the results. RESULTS Results are based on 79 included studies. ISPs reportedly displayed knowledge about the clinical practice they work with, implementation / improvement practice, the local context, supporting change processes, and facilitating evidence-based practice in general. In particular, knowledge about the intervention to be implemented and its target population, specific improvement / implementation methods and approaches, organizational structures and sensitivities, training, and characteristics of (good) research was described in the literature. Seven themes describing ISPs' attitudes were identified: 1) professional, 2) motivated / motivating / encouraging / empowering, 3) empathetic / respectful / sensitive, 4) collaborative / inclusive, 5) authentic, 6) creative / flexible / innovative / adaptive, and 7) frank / direct / honest. Pertaining to a professional attitude, being responsive and focused were the most prevalent indicators across included publications. CONCLUSION The wide range and complexity of knowledge and attitudes found in the literature calls for a comprehensive and systematic approach to collaboratively develop a professional role for ISPs across disciplines. Embedding the ISP role in different health and social welfare settings will enhance implementation capacities considerably.
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Zolfaghari E, Armaghanian N, Waller D, Medlow S, Hobbs A, Perry L, Nguyen K, Steinbeck K. Implementation science in adolescent healthcare research: an integrative review. BMC Health Serv Res 2022; 22:598. [PMID: 35505305 PMCID: PMC9066920 DOI: 10.1186/s12913-022-07941-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background Multiple theories, models and frameworks have been developed to assist implementation of evidence-based practice. However, to date there has been no review of implementation literature specific to adolescent healthcare. This integrative review therefore aimed to determine what implementation science theories, models and frameworks have been applied, what elements of these frameworks have been identified as influential in promoting the implementation and sustainability of service intervention, and to what extent, in what capacity and at what time points has the contribution of adolescent consumer perspectives on evidence implementation been considered. Methods An integrative design was used and reported based on a modified form of the PRISMA (2020) checklist. Seven databases were searched for English language primary research which included any implementation science theory, model or framework developed for/with adolescents or applied in relation to adolescent healthcare services within the past 10 years. Content and thematic analysis were applied with the Consolidated Framework for Implementation Research (CFIR) used to frame analysis of the barriers and facilitators to effective implementation of evidence-informed interventions within youth health settings. Results From 8717 citations, 13 papers reporting 12 studies were retained. Nine different implementation science theories, frameworks or approaches were applied; six of 12 studies used the CFIR, solely or with other models. All CFIR domains were represented as facilitators and barriers for implementation in included studies. However, there was little or no inclusion of adolescents in the development or review of these initiatives. Only three mentioned youth input, occurring in the pre-implementation or implementation stages. Conclusions The few studies found for this review highlight the internationally under-developed nature of this topic. Flagging the importance of the unique characteristics of this particular age group, and of the interventions and strategies to target it, the minimal input of adolescent consumers is cause for concern. Further research is clearly needed and must ensure that youth consumers are engaged from the start and consistently throughout; that their voice is prioritised and not tokenistic; that their contribution is taken seriously. Only then will age-appropriate evidence implementation enable innovations in youth health services to achieve the evidence-based outcomes they offer. Trial Registration PROSPERO 2020 CRD42020201142 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=201142 Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07941-3.
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Affiliation(s)
- Elham Zolfaghari
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
| | - Natasha Armaghanian
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia. .,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia.
| | - Daniel Waller
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia.,Faculty of Health, University of Technology Sydney, Broadway, Ultimo, NSW, 2007, Australia
| | - Sharon Medlow
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
| | - Annabelle Hobbs
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
| | - Lin Perry
- Faculty of Health, University of Technology Sydney, Broadway, Ultimo, NSW, 2007, Australia.,South East Sydney Local Health District, Prince of Wales Hospital, Randwick, NSW, 2316, Australia
| | - Katie Nguyen
- Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
| | - Katharine Steinbeck
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
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Curran JA, Gallant AJ, Wong H, Shin HD, Urquhart R, Kontak J, Wozney L, Boulos L, Bhutta Z, Langlois EV. Knowledge translation strategies for policy and action focused on sexual, reproductive, maternal, newborn, child and adolescent health and well-being: a rapid scoping review. BMJ Open 2022; 12:e053919. [PMID: 35039297 PMCID: PMC8765012 DOI: 10.1136/bmjopen-2021-053919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to identify knowledge translation (KT) strategies aimed at improving sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) and well-being. DESIGN Rapid scoping review. SEARCH STRATEGY A comprehensive and peer-reviewed search strategy was developed and applied to four electronic databases: MEDLINE ALL, Embase, CINAHL and Web of Science. Additional searches of grey literature were conducted to identify KT strategies aimed at supporting SRMNCAH. KT strategies and policies published in English from January 2000 to May 2020 onwards were eligible for inclusion. RESULTS Only 4% of included 90 studies were conducted in low-income countries with the majority (52%) conducted in high-income countries. Studies primarily focused on maternal newborn or child health and well-being. Education (81%), including staff workshops and education modules, was the most commonly identified intervention component from the KT interventions. Low-income and middle-income countries were more likely to include civil society organisations, government and policymakers as stakeholders compared with high-income countries. Reported barriers to KT strategies included limited resources and time constraints, while enablers included stakeholder involvement throughout the KT process. CONCLUSION We identified a number of gaps among KT strategies for SRMNCAH policy and action, including limited focus on adolescent, sexual and reproductive health and rights and SRMNCAH financing strategies. There is a need to support stakeholder engagement in KT interventions across the continuum of SRMNCAH services. Researchers and policymakers should consider enhancing efforts to work with multisectoral stakeholders to implement future KT strategies and policies to address SRMNCAH priorities. REGISTRATION The rapid scoping review protocol was registered on Open Science Framework on 16 June 2020 (https://osf.io/xpf2k).
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Affiliation(s)
- Janet A Curran
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
- Pediatrics, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Allyson J Gallant
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Helen Wong
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Robin Urquhart
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Julia Kontak
- Maritime SPOR SUPPORT Unit, Halifax, Nova Scotia, Canada
| | - Lori Wozney
- Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Leah Boulos
- Maritime SPOR SUPPORT Unit, Halifax, Nova Scotia, Canada
| | - Zulfiqar Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Etienne V Langlois
- The Partnership for Maternal, Newborn & Child Health, World Health Organization, Geneva, Switzerland
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Reitzel M, Letts L, Di Rezze B, Phoenix M. Critically Examining the Person–Environment Relationship and Implications of Intersectionality for Participation in Children's Rehabilitation Services. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:709977. [PMID: 36188778 PMCID: PMC9397911 DOI: 10.3389/fresc.2021.709977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/16/2021] [Indexed: 01/03/2023]
Abstract
Participation of children in rehabilitation services is associated with positive functional and developmental outcomes for children with disabilities. Participation in therapy is at risk when the personal and environmental contexts of a child create barriers to accessing services. The International Classification of Functioning, Disability and Health (ICF) provides a framework for conceptualizing the personal and environmental factors linked to a child. However, it does not facilitate critical examination of the person–environment relationship and its impact on participation in children's rehabilitation. This perspective study proposes the use of intersectionality theory as a critical framework in complement with the ICF to examine the impact of systemic inequities on the participation in therapy for children with disabilities. Clinicians are called to be critical allies working alongside children and families to advocate for inclusive participation in children's rehabilitation by identifying and transforming systemic inequities in service delivery.
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Affiliation(s)
- Meaghan Reitzel
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- *Correspondence: Meaghan Reitzel
| | - Lori Letts
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Briano Di Rezze
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Michelle Phoenix
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Bloorview Research Institute, Toronto, ON, Canada
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Gaid D, Ahmed S, Alhasani R, Thomas A, Bussières A. Determinants that influence knowledge brokers' and opinion leaders' role to close knowledge practice gaps in rehabilitation: A realist review. J Eval Clin Pract 2021; 27:836-846. [PMID: 32975895 DOI: 10.1111/jep.13482] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 08/05/2020] [Accepted: 08/31/2020] [Indexed: 01/23/2023]
Abstract
RATIONALE Despite the available evidence to support optimal practices in rehabilitation, significant knowledge practice gaps persist. Opinion leaders (OLs) and knowledge brokers (KBs) can enhance the success of knowledge translation (KT) interventions and improve uptake of best practices among clinicians. However, the literature on the mechanisms underpinning OLs'/KBs' activities, and guidance on the type of support needed for successful implementation of these roles in rehabilitation contexts is scarce. This research aimed to highlight the differences and similarities between OLs and KBs with respect to context, mechanism, and outcomes as well as describe the common patterns of OLs and KBs by creating a context-mechanism-outcomes configuration. METHODS We conducted a realist review to synthesize the available evidence on OLs/KBs as active KT strategies. A search was conducted across five databases up to November 2019. Two independent reviewers extracted the data using a structured form. A context-mechanism-outcome configuration was used to conceptualize a cumulative portrait of the features of OLs/KBs roles. RESULTS The search identified 3282 titles after removing duplicates. Seventeen studies (reported in 20 articles) were included in the review. Findings suggest a number of desirable features of OLs/KBs roles that may maximize the achievement of targeted outcomes namely being (a) embedded within their organization as "insiders"; (b) adequately skilled to perform their role; (c) identified as able to fulfil the role; (d) appropriately trained; and (e) able to use different KT interventions. CONCLUSION Findings of this realist review converge to create a context-mechanism-outcomes configuration with suggestions to optimally utilize OLs/KBs in rehabilitation. The configurations suggest desirable features that can lead to a greater potential to achieve targeted goals. It is preferable that OLs/KBs be embedded in the organization and that they are adequately skilful and well-trained. Also, OLs/KBs should perform the required roles using KT interventions adapted to the local context.
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Affiliation(s)
- Dina Gaid
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.,The Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montreal, Quebec, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.,The Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montreal, Quebec, Canada
| | - Rehab Alhasani
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.,Department of Rehabilitation Sciences, Faculty of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Aliki Thomas
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.,The Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montreal, Quebec, Canada
| | - André Bussières
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.,The Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montreal, Quebec, Canada
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O'Donoghue C, O'Leary J, Lynch H. Occupational Therapy Services in School-Based Practice: A Pediatric Occupational Therapy Perspective from Ireland. Occup Ther Int 2021; 2021:6636478. [PMID: 34220382 PMCID: PMC8221888 DOI: 10.1155/2021/6636478] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/07/2021] [Accepted: 05/22/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE School is a primary setting for pediatric occupational therapy practice, yet little is known about the provision of school-based occupational therapy in many countries internationally. The purpose of this study was to explore current school-based occupational therapy practice for the first time in Ireland to gain insight into current and potential service provision and to identify new directions and potential pathways for development. METHODS This descriptive quantitative study utilized a cross-sectional online survey to gain the perspectives of the population of pediatric occupational therapists working regularly in schools across Ireland. Respondents were recruited through convenience and snowball sampling. Data were analysed through qualitative content analysis and descriptive statistics. RESULTS The survey elicited 35 responses, yielding a 21.2% estimated response rate. Findings demonstrated that respondents provided therapy services in schools most commonly on a weekly (28.6%) or monthly (34.3%) basis, with only 5.0% working in the same school on a weekly or fortnightly basis. The majority of respondents (54.3%) used a direct therapy approach with a child, rather than coaching or modelling, to primarily address sensory, hand function, or daily living needs. None used a whole class or whole school (universal or tiered) approach. While respondents (54.3%) generally viewed collaborative practice as a strength of school-based practice, they also identified barriers to collaboration in schools. A core barrier is related to how services are constructed across health and education, with differing philosophies of service provision. The majority of respondents (75.0%) reported that they had not received any training to deliver evidence-based practice in therapy provision specific to school-based practice. Implications for Practice. This study indicates that therapists require continual education on evidence-based school practice as it applies in an Irish context. Furthermore, clarification of school therapy roles and service delivery models are required in order to determine how they contrast with traditional clinic roles. This will enable therapists to strengthen the coordination of service delivery between health and educational services to maximize the outcomes of school-based practice.
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Affiliation(s)
- Carol O'Donoghue
- Department of Occupational Science and Occupational Therapy, University College Cork, College Road, Cork, Ireland
| | - Jennifer O'Leary
- Department of Occupational Science and Occupational Therapy, University College Cork, College Road, Cork, Ireland
| | - Helen Lynch
- Department of Occupational Science and Occupational Therapy, University College Cork, College Road, Cork, Ireland
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Anaby D, Khetani M, Piskur B, van der Holst M, Bedell G, Schakel F, de Kloet A, Simeonsson R, Imms C. Towards a paradigm shift in pediatric rehabilitation: Accelerating the uptake of evidence on participation into routine clinical practice. Disabil Rehabil 2021; 44:1746-1757. [PMID: 33832391 DOI: 10.1080/09638288.2021.1903102] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Evidence for the importance of focusing on participation to promote health and wellbeing in childhood-onset disability exists, but practice is slow to change. This paper provides a knowledge translation roadmap to accelerate uptake of participation evidence into day-to-day practice. MATERIALS AND METHODS A structured roadmap to guide knowledge translation initiatives for implementing participation-based practices in co-creation with service users was developed based on elements from: the Five-factorframework for predicting implementation outcomes, the Cultural Cone framework, and the Knowledge-to-Action model. RESULTS Guiding principles paired with examples of multi-component knowledge implementation strategies to facilitate readiness for change by stakeholders at the micro (e.g., client/family, service providers), meso (e.g., administrators within organisations such as rehabilitation centres, hospitals, schools) and macro (e.g., local and governmental policy, regulatory bodies) levels are introduced. Solution-based strategies are provided to facilitate "readiness to change" for each stakeholder group. The strategies are examples for successful implementation of evidence-based interventions/approaches that can be contextualized across settings. CONCLUSIONS The knowledge translation roadmap can assist children and families, service providers, administrators, and policymakers to bridge existing knowledge-to-practice gaps surrounding participation. Partnering and collaborating through a "family-clinician-manager-community leader-policymaker" synergy is key for achieving strategic practice change focussed on participation.Implications for RehabilitationSound evidence surrounding the topic of participation, including effective assessments and interventions, is available and ready for use.Shifting towards participation-focused practices for children and youth with disabilities requires a systemic multi-level KT approach.Our Participation-KT roadmap, comprised of a framework and a list of principles and strategies for implementation, can be used to guide all stakeholders to foster a shift in practice.Forming partnerships and working collaboratively with all stakeholders is key for successful implementation.
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Affiliation(s)
- D Anaby
- School of Physical and Occupation Therapy, McGill University, Quebec, Canada
| | - M Khetani
- University of Illinois at Chicago, Chicago, IL, USA
| | - B Piskur
- Research Center Autonomy and Participation, Faculty of Health Care, Zuyd University of Applied Sciences, Heerlen, Netherlands
| | - M van der Holst
- Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, Netherlands.,Basalt Rehabilitation Center, The Hague, Netherlands
| | - G Bedell
- Department of Occupational Therapy, Tufts University, Medford, MA, USA
| | - F Schakel
- Basalt Rehabilitation Center, The Hague, Netherlands
| | - A de Kloet
- Basalt Rehabilitation Center, The Hague, Netherlands.,The Hague University of Applied Sciences, The Haag, Netherlands
| | - R Simeonsson
- University of North Carolina, Chapel hill, NC, USA
| | - C Imms
- Faculty of Medicine Dentistry and Health Sciences Melbourne, University of Melbourne, Parkville, Australia
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Moore JL, Mbalilaki JA, Graham ID. Knowledge Translation in Physical Medicine and Rehabilitation: A Citation Analysis of the Knowledge-to-Action Literature. Arch Phys Med Rehabil 2021; 103:S256-S275. [PMID: 33556348 DOI: 10.1016/j.apmr.2020.12.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/15/2020] [Accepted: 12/28/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To (1) provide an overview of the use of the Knowledge-to-Action Cycle (KTA) to guide a clinical implementation project; (2) identify activities performed in each phase of the KTA; and (3) provide suggestions to improve KTA activities in physical medicine and rehabilitation. DATA SOURCES Google Scholar and PubMed were searched through December 31, 2019. STUDY SELECTION Two reviewers screened titles, abstracts, and full-text articles to identify published studies that used the KTA to implement a project. DATA EXTRACTION Two reviewers examined full-text articles. Data extraction included activities performed in each phase of the KTA, including measurements used to evaluate the project's effectiveness. DATA SYNTHESIS Commonly performed KTA activities were identified and country of study, area of rehabilitation, and other factors related to the use of the KTA in rehabilitation were described. A total of 46 articles that met the study's inclusion criteria provided an overview of the use of the KTA in rehabilitation. Strengths and weaknesses of the articles are discussed and recommendations for improved KTA use are provided. CONCLUSIONS Implementation of evidence-based practice requires focused engineering and efforts. This review provides an overview of the knowledge translation activities occurring in physical medicine and rehabilitation and considerations to improve knowledge translation research and practice.
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Affiliation(s)
- Jennifer L Moore
- Southeastern Norway Regional Center for Knowledge Translation in Rehabilitation, Oslo, Norway; Institute for Knowledge Translation, Carmel, IN, United States.
| | - Julia A Mbalilaki
- Southeastern Norway Regional Center for Knowledge Translation in Rehabilitation, Oslo, Norway
| | - Ian D Graham
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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13
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Hurtubise K, Brousselle A, Camden C. Using collaborative logic analysis evaluation to test the program theory of an intensive interdisciplinary pain treatment for youth with pain‐related disability. PAEDIATRIC AND NEONATAL PAIN 2020; 2:113-130. [PMID: 35548259 PMCID: PMC8975192 DOI: 10.1002/pne2.12018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 03/09/2020] [Accepted: 03/27/2020] [Indexed: 12/26/2022]
Abstract
Intensive interdisciplinary pain treatment (IIPT) involves multiple stakeholders. Mapping the program components to its anticipated outcomes (ie, its theory) can be difficult and requires stakeholder engagement. Evidence is lacking, however, on how best to engage them. Logic analysis, a theory‐based evaluation, that tests the coherence of a program theory using scientific evidence and experiential knowledge may hold some promise. Its use is rare in pediatric pain interventions, and few methodological details are available. This article provides a description of a collaborative logic analysis methodology used to test the theoretical plausibility of an IIPT designed for youth with pain‐related disability. A 3‐step direct logic analysis process was used. A 13‐member expert panel, composed of clinicians, teachers, managers, youth with pain‐related disability, and their parents, were engaged in each step. First, a logic model was constructed through document analysis, expert panel surveys, and focus‐group discussions. Then, a scoping review, focused on pediatric self‐management, building self‐efficacy, and fostering participation, helped create a conceptual framework. An examination of the logic model against the conceptual framework by the expert panel followed, and recommendations were formulated. Overall, the collaborative logic analysis process helped raiseawareness of clinicians’ assumptions about the program causal mechanisms, identified program components most valued by youth and their parents, recognized the program features supported by scientific and experiential knowledge, detected gaps, and highlighted emerging trends. In addition to providing a consumer‐focused program evaluation option, collaborative logic analysis methodology holds promise as a strategy to engage stakeholders and to translate pediatric pain rehabilitation evaluation research knowledge to key stakeholders.
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Affiliation(s)
- Karen Hurtubise
- Faculté de Médecine et Sciences de la Santé Université de Sherbrooke Sherbrooke QC Canada
| | - Astrid Brousselle
- Faculté de Médecine et Sciences de la Santé Université de Sherbrooke Sherbrooke QC Canada
- School of Public Administration University of Victoria Victoria BC Canada
| | - Chantal Camden
- Faculté de Médecine et Sciences de la Santé Université de Sherbrooke Sherbrooke QC Canada
- CanChild Centre for Childhood Disability Research McMaster University Hamilton ON Canada
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Kolehmainen N, Marshall J, Hislop J, Fayed N, Kay D, Ternent L, Pennington L. Implementing participation-focused services: A study to develop the Method for using Audit and Feedback in Participation Implementation (MAPi). Child Care Health Dev 2020; 46:37-45. [PMID: 31797401 DOI: 10.1111/cch.12723] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 11/26/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND It is widely agreed that children's services should use participation-focused practice, but that implementation is challenging. This paper describes a method for using audit and feedback, an evidence-based knowledge translation strategy, to support implementation of participation-focused practice in front-line services, to identify barriers to implementation, and to enable international benchmarking of implementation and barriers. METHOD Best-practice guidelines for using audit and feedback were followed. For audit, participation-focused practice was specified as clinicians' three observable behaviours: (a) targets participation outcomes; (b) involves child/parent in setting participation outcomes; and (c) measures progress towards participation outcomes. For barrier identification, the Theoretical Domains Framework Questionnaire (TDFQ) of known implementation barriers was used. A cycle of audit and barrier identification was piloted in three services (n = 25 clinicians) in a large U.K. healthcare trust. From each clinician, up to five randomly sampled case note sets were audited (total n = 122), and the clinicians were invited to complete the TDFQ. For feedback, data on the behaviours and barriers were shared visually and verbally with managers and clinicians to inform action planning. RESULTS A Method for using Audit and feedback for Participation implementation (MAPi) was developed. The MAPi audit template captured clinicians' practices: Clinicians targeted participation in 37/122 (30.3%) of the sampled cases; involved child/parent in 16/122 (13.1%); and measured progress in 24/122 (19.7%). Barriers identified from the TDFQ and fed back to managers and clinicians included clinicians' skills in participation-focused behaviours (median = 3.00-5.00, interquartile range [IQR] = 2.25-6.00), social processes (median = 4.00, IQR = 3.00-5.00), and behavioural regulation (median = 4.00-5.00, IQR = 3.00-6.00). CONCLUSIONS MAPi provides a practical, off-the-shelf method for front-line services to investigate and support their implementation of participation-focused practice. Furthermore, as a shared, consistent template, MAPi provides a method for generating cumulative and comparable, across-services evidence about levels and trends of implementation and about enduring barriers to implementation, to inform future implementation strategies.
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Affiliation(s)
- Niina Kolehmainen
- Newcastle University, Newcastle upon Tyne, UK.,Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Joanne Marshall
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Nora Fayed
- Queen's University, Kingston, ON, Canada
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Anaby D, Korner-Bitensky N, Steven E, Tremblay S, Snider L, Avery L, Law M. Current Rehabilitation Practices for Children with Cerebral Palsy: Focus and Gaps. Phys Occup Ther Pediatr 2017; 37:1-15. [PMID: 26865220 DOI: 10.3109/01942638.2015.1126880] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS To describe the focus of therapy practices in occupational and physical therapy for school-aged children with cerebral palsy, and better understand whether it is congruent with recommended practices. METHODS A Canada-wide Web-based survey was completed by 62 occupational and 61 physical therapists to identify problems, assessments, and treatment interventions for two case-based scenarios. Data were coded using the International Classification of Functioning, Disability and Health (ICF) definitions for "body functions and structure," "activity and participation," and "environment." RESULTS Physical therapists, in comparison to occupational therapists, were more likely to select interventions classed in the "body functions and structure" category (34-42% and 18-20%, respectively). Both professions focused on "activity and participation" (34-61%) when identifying problems, assessing, and intervening; attention, however, was mainly directed towards task-oriented activities such as activities of daily living and mobility. Participation in leisure or community-based activities received less attention (2-15%). The environment received limited attention for problems and assessments (4-25%), though it was an important focus of intervention (19-37%). CONCLUSIONS While body functions and structure are well-addressed, other ICF elements, specifically participation, are poorly integrated into practice. The emerging focus on the environment in therapy intervention, by modifying the context rather than changing aspects of the child, is consistent with current approaches and evidence. Knowledge translation implementation initiatives are recommended to bridge identified gaps.
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Affiliation(s)
- Dana Anaby
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Nicol Korner-Bitensky
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Emma Steven
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Stephanie Tremblay
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Laurie Snider
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Lisa Avery
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Mary Law
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
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