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Clark EC, Burnett T, Blair R, Traynor RL, Hagerman L, Dobbins M. Strategies to implement evidence-informed decision making at the organizational level: a rapid systematic review. BMC Health Serv Res 2024; 24:405. [PMID: 38561796 PMCID: PMC10983660 DOI: 10.1186/s12913-024-10841-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Achievement of evidence-informed decision making (EIDM) requires the integration of evidence into all practice decisions by identifying and synthesizing evidence, then developing and executing plans to implement and evaluate changes to practice. This rapid systematic review synthesizes evidence for strategies for the implementation of EIDM across organizations, mapping facilitators and barriers to the COM-B (capability, opportunity, motivation, behaviour) model for behaviour change. The review was conducted to support leadership at organizations delivering public health services (health promotion, communicable disease prevention) to drive change toward evidence-informed public health. METHODS A systematic search was conducted in multiple databases and by reviewing publications of key authors. Articles that describe interventions to drive EIDM within teams, departments, or organizations were eligible for inclusion. For each included article, quality was assessed, and details of the intervention, setting, outcomes, facilitators and barriers were extracted. A convergent integrated approach was undertaken to analyze both quantitative and qualitative findings. RESULTS Thirty-seven articles are included. Studies were conducted in primary care, public health, social services, and occupational health settings. Strategies to implement EIDM included the establishment of Knowledge Broker-type roles, building the EIDM capacity of staff, and research or academic partnerships. Facilitators and barriers align with the COM-B model for behaviour change. Facilitators for capability include the development of staff knowledge and skill, establishing specialized roles, and knowledge sharing across the organization, though staff turnover and subsequent knowledge loss was a barrier to capability. For opportunity, facilitators include the development of processes or mechanisms to support new practices, forums for learning and skill development, and protected time, and barriers include competing priorities. Facilitators identified for motivation include supportive organizational culture, expectations for new practices to occur, recognition and positive reinforcement, and strong leadership support. Barriers include negative attitudes toward new practices, and lack of understanding and support from management. CONCLUSION This review provides a comprehensive analysis of facilitators and barriers for the implementation of EIDM in organizations for public health, mapped to the COM-B model for behaviour change. The existing literature for strategies to support EIDM in public health illustrates several facilitators and barriers linked to realizing EIDM. Knowledge of these factors will help senior leadership develop and implement EIDM strategies tailored to their organization, leading to increased likelihood of implementation success. REVIEW REGISTRATION PROSPERO CRD42022318994.
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Affiliation(s)
- Emily C Clark
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Trish Burnett
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Rebecca Blair
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Robyn L Traynor
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Leah Hagerman
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Maureen Dobbins
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada.
- School of Nursing, McMaster University, Health Sciences Centre, 2J20, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada.
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Yau K, Wang C, Al Batran R, Macphee A, Beaucage M, Farragher JF. Knowledge Translation in Glomerulonephritis: Successes in Translational Research From the Bench to Bedside. Can J Kidney Health Dis 2023; 10:20543581231191839. [PMID: 37637870 PMCID: PMC10457520 DOI: 10.1177/20543581231191839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/28/2023] [Indexed: 08/29/2023] Open
Abstract
Purpose of review Glomerulonephritis refers to a rare group of diseases characterized by glomerular inflammation, which collectively are a common cause of kidney failure. Until recently, there was a lack of high-quality clinical trials to inform the care of patients with glomerulonephritides. We identified examples of successful translational research spanning from basic science to clinical applications, and highlight gaps in implementation science. Sources of information The focus of our review was derived from discussions between health care professionals, researchers, and patient partners. We also performed literature searches pertaining to the treatment of glomerulonephritis in PubMed and Google Scholar. Methods Examples of successful knowledge translation were generated through review of new evidence in the past 5 years and by iterative discussions by the authors. We then conducted a narrative review of several themes related to knowledge translation in glomerulonephritis. This was complemented by an interview with a patient partner to provide an example of a patient's perspective living with glomerulonephritis. Key findings We summarized selected recent advances in glomerulonephritis and its knowledge translation in the following domains: (1) identification of auto-antibodies in membranous nephropathy and minimal change disease; (2) clinical trials of novel targeted therapies for IgA nephropathy and lupus nephritis, which have led to approval of new treatments; (3) developments in research networks and clinical trials in glomerulonephritis; (4) recognition of the importance in developing standardized patient reported outcome measures in clinical trials; and (5) barriers in knowledge translation including access to medication. Limitations A systematic search of the literature and formal assessment of quality of evidence were beyond the scope of this review.
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Affiliation(s)
- Kevin Yau
- Division of Nephrology, University of Toronto, Toronto, ON, Canada
| | - Carol Wang
- Division of Nephrology, Western University, London, ON, Canada
| | - Rami Al Batran
- Faculte de Pharmacie, Universite de Montreal, Montreal, QC, Canada
| | - Anne Macphee
- Kidney Research Scientist Core Education and National Training Patient Community Advisory Network, Montreal, QC, Canada
| | - Mary Beaucage
- Kidney Research Scientist Core Education and National Training Patient Community Advisory Network, Montreal, QC, Canada
- Patient Governance Council, Indigenous Peoples’ Engagement and Research Council, Can-SOLVE CKD, Vancouver, BC, Canada
- The Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada
- Provincial Patient and Family Advisory Council, Ontario Renal Network, Toronto, Ontario, Canada
| | - Janine F. Farragher
- Department of Occupational Science & Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Gallant SM, Cassidy C, Al-Rassi J, Moody E, Shin HD, Best S, Steenbeek A. Integrated knowledge translation guidelines for trainees in health research: an environmental scan. Health Res Policy Syst 2023; 21:74. [PMID: 37452332 PMCID: PMC10349463 DOI: 10.1186/s12961-023-01024-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 06/23/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Collaborative health research, such as integrated knowledge translation (IKT), requires researchers to have specific knowledge and skills in working in partnership with knowledge users. Graduate students are often not provided with the opportunity to learn skills in how to establish collaborative relationships with knowledge users in the health system or communities, despite its importance in research. The objective of this environmental scan is to identify available guidelines for graduate trainees to use an IKT approach in their research. METHODS We conducted an environmental scan with three separate systematic searches to identify guidelines available to support graduate students in engaging in an IKT approach to research: (i) a customized Google search; (ii) a targeted Canadian university website search; and (iii) emails to administrators of graduate studies programmes asking for available guidelines and documents designed for graduate students. Data were extracted using a standardized data extraction tool and analysed using a directed content analysis approach. Due to the minimal results included based on the a priori eligibility criteria, we returned to the excluded records to further review the current state of the environment on trainee support for IKT research. RESULTS Our search strategy yielded 22 900 items, and after a two-step screening process with strict inclusion criteria three documents met the eligibility criteria. All three documents highlighted the need for an IKT plan for knowledge user involvement throughout the research process. Furthermore, documents emphasized the need for tangible steps to guide graduate students to engage in effective communication with knowledge users. Due to the lack of documents retrieved, we conducted a post hoc content analysis of relevant IKT documents excluded and identified five themes demonstrating increased education and engagement in an IKT approach at an interpersonal and organizational level. CONCLUSION We identified three documents providing guidance to trainees using a collaborative approach in their health research. This scan highlighted two key findings including the importance of supporting trainees to engage knowledge users in research and preparing an IKT plan alongside a research plan. Further research is needed to co-design guidelines to support graduate students and trainees in engaging in an IKT approach.
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Affiliation(s)
- Sarah Madeline Gallant
- School of Nursing, Dalhousie University, Halifax, NS, Canada.
- The Strengthening Transitions in Care Lab, IWK Health, Halifax, NS, Canada.
| | - Christine Cassidy
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- The Strengthening Transitions in Care Lab, IWK Health, Halifax, NS, Canada
| | - Joyce Al-Rassi
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Elaine Moody
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - Hwayeon Danielle Shin
- Management, and Evaluation, Institute of Health Policy, University of Toronto, Toronto, ON, Canada
- Centre for Complex Care Interventions, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
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Elliott MJ, McCarron TL, Schick-Makaroff K, Getchell L, Manns B, Fernandez N. The dynamic nature of patient engagement within a Canadian patient-oriented kidney health research network: Perspectives of researchers and patient partners. Health Expect 2023; 26:905-918. [PMID: 36704935 PMCID: PMC10010076 DOI: 10.1111/hex.13716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 01/12/2023] [Accepted: 01/17/2023] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD) is a pan-Canadian health research network that engages patients as partners across 18 unique projects and core infrastructure. In this qualitative study, we explored how research teams integrated patient partners into network research activities to inform our patient engagement approach. METHODS To capture a breadth of perspectives, this qualitative descriptive study purposively sampled researchers and patient partners across 18 network research teams. We conducted 4 focus groups (2 patients and 2 researchers; n = 26) and 28 individual telephone interviews (n = 12 patient partners; n = 16 researchers). Transcripts were coded in duplicate, and themes were developed through an inductive, thematic analysis approach. RESULTS We included 24 patient partners and 24 researchers from 17 of the 18 projects and all core committees within the network. Overarching concepts relate participants' initial impressions and uncertainty about patient engagement to an evolving appreciation of its value, impact and sustainability. We identified four themes with subthemes that characterized the dynamic nature of patient engagement and how participants integrated patients across network initiatives: (1) Reinforcing a shared purpose (learning together, collective commitment, evolving attitudes); (2) Fostering a culture of responsive and innovative research (accessible supports, strengthened process and product); (3) Aligning priorities, goals and needs (amenability to patient involvement, mutually productive relationships, harmonizing expectations); (4) Building a path to sustainability (value creation, capacity building, sustaining knowledge use). CONCLUSIONS Our findings demonstrate the dynamic and adaptive processes related to patient engagement within a national, patient-oriented kidney health research network. Optimization of support structures and capacity are key factors to promote sustainability of engagement processes within and beyond the network. PATIENT OR PUBLIC CONTRIBUTION This project was conceived in collaboration with a Can-SOLVE CKD patient partner (N. F.), with lived experience of kidney failure. He also co-designed the study's protocol, led focus groups and researcher interviews, and contributed to data analysis. L. G. has lived experience as a caregiver for a person with CKD and facilitated patient partner focus groups. The patient partners, both of whom are listed authors, provided important insights that shaped our interpretation and presentation of study findings.
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Affiliation(s)
- Meghan J Elliott
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Tamara L McCarron
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | | | - Leah Getchell
- CanSOLVE CKD Network, Patient Partner, Vancouver, BC, Canada
| | - Braden Manns
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Nicolas Fernandez
- CanSOLVE CKD Network, Patient Partner, Vancouver, BC, Canada.,Department of Family Medicine and Emergency Medicine, Université de Montréal, Quebec, Montreal, Canada
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Crews DC, Patzer RE, Cervantes L, Knight R, Purnell TS, Powe NR, Edwards DP, Norris KC. Designing Interventions Addressing Structural Racism to Reduce Kidney Health Disparities: A Report from a National Institute of Diabetes and Digestive and Kidney Diseases Workshop. J Am Soc Nephrol 2022; 33:2141-2152. [PMID: 36261301 PMCID: PMC9731627 DOI: 10.1681/asn.2022080890] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Structural racism embodies the many ways in which society fosters racial discrimination through "mutually reinforcing inequitable systems" that limit access to resources and opportunities that can promote health and well being among marginalized communities. To achieve health equity, and kidney health equity more specifically, structural racism must be eliminated. In February 2022, the National Institute of Diabetes and Digestive and Kidney Diseases convened the "Designing Interventions that Address Structural Racism to Reduce Kidney Health Disparities" workshop, which was aimed at describing the mechanisms through which structural racism contributes to health and health care disparities for people along the continuum of kidney disease and identifying actionable opportunities for interventional research focused on dismantling or addressing the effects of structural racism. Participants identified six domains as key targets for interventions and future research: (1) apply an antiracism lens, (2) promote structural interventions, (3) target multiple levels, (4) promote effective community and stakeholder engagement, (5) improve data collection, and (6) advance health equity through new health care models. There is an urgent need for research to develop, implement, and evaluate interventions that address the unjust systems, policies, and laws that generate and perpetuate inequities in kidney health.
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Affiliation(s)
- Deidra C. Crews
- Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Rachel E. Patzer
- Department of Epidemiology, Rollins School of Public Health and School of Medicine, Emory University, Atlanta, Georgia
- Department of Surgery, School of Medicine, Emory University, Atlanta, Georgia
| | - Lilia Cervantes
- Division of Hospital Medicine and General Internal Medicine, University of Colorado School of Medicine, Denver, Colorado
| | - Richard Knight
- American Association of Kidney Patients, Tampa, Florida
- College of Business, Bowie State University, Bowie, Maryland
| | - Tanjala S. Purnell
- Departments of Epidemiology and Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Neil R. Powe
- Department of Medicine, University of California San Francisco School of Medicine, San Francisco, California
| | | | - Keith C. Norris
- Department of Medicine, University of California Los Angeles, Los Angeles, California
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Getchell LE, Fowler E, Reich M, Allu S, Boucher C, Burns K, Desjarlais A, L’Esperance A, Elliott M, Robinson-Settee H, Chiu HHL, Rosenblum ND, Settee C, Murdoch A, Dew S, Green A, Franson L, Bernstein E, Sparkes D, Turner C, Fernandez N, Sapir-Pichhadze R. Program Report: Can-SOLVE CKD Network Presents an Inclusive Method for Developing Patient-Oriented Research Tools. Can J Kidney Health Dis 2022; 9:20543581221074566. [PMID: 35173970 PMCID: PMC8842461 DOI: 10.1177/20543581221074566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 12/09/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose of program: Given the growing interest in patient-oriented research (POR) initiatives, there is a need to provide relevant training and education on how to engage with patients as partners on research teams. Sources of information: As part of its mandate to develop appropriate training materials, the patient-oriented renal research network, Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD), established a training and Mentorship Committee (TMC). Methods: The committee brings together a unique combination of Indigenous and non-Indigenous patient partners (including caregivers, family members, and living donors), researchers, as well as patient engagement and knowledge translation experts, combining a multitude of perspectives and expertise. Following an assessment of training needs within the network, the TMC undertook the co-development of 5 learning modules to address the identified gaps. Subsequently, the committee divided into working groups tasked with developing content using a consultive and iterative approach informed by the DoTTI framework for building web-based tools for patients. In addition, the TMC embodied the guiding principles of inclusiveness, support, mutual respect, and co-building as set out by the Patient Engagement Framework through the Strategy for Patient-Oriented Research (SPOR) of the Canadian Institutes of Health Research. Key findings: The 5 new modules include: A Patient Engagement Toolkit, Storytelling for Impact, Promoting Kidney Research in Canada (KidneyPRO), Wabishki Bizhiko Skaanj Learning Pathway, and Knowledge Translation. The TMC’s approach to developing these modules demonstrates how a diverse group of stakeholders working together can create tools to support high-quality POR. This also provides a roadmap for other health research entities interested in developing similar tools within their unique domains. Limitations: The landscape of patient engagement in research is constantly evolving. This underscores the need for sustained resources to keep POR tools and training relevant and up-to-date. Sustaining such resources may not be feasible for all research entities. Implications: Collaborative approaches integrating patients in the development of POR tools ensure the content is relevant and meaningful to patients. Broader adoption of such approaches has great potential to address existing gaps and enhance the Canadian POR landscape.
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Affiliation(s)
| | | | | | - Selina Allu
- Can-SOLVE CKD Network, Vancouver, BC, Canada
- University of Calgary, Medicine, AB, Canada
| | | | - Kevin Burns
- Can-SOLVE CKD Network, Vancouver, BC, Canada
- Department of Nephrology, The Ottawa Hospital, ON, Canada
| | | | - Audrey L’Esperance
- Can-SOLVE CKD Network, Vancouver, BC, Canada
- Centre of Excellence on Partnership With Patients and the Public, Quebec, QC, Canada
| | - Meghan Elliott
- Can-SOLVE CKD Network, Vancouver, BC, Canada
- University of Calgary, Medicine, AB, Canada
| | | | - Helen Hoi-Lun Chiu
- Can-SOLVE CKD Network, Vancouver, BC, Canada
- BC Renal, Vancouver, BC, Canada
| | - Norman D. Rosenblum
- Can-SOLVE CKD Network, Vancouver, BC, Canada
- Hospital for Sick Children, Toronto, ON, Canada
| | | | | | - Simone Dew
- Can-SOLVE CKD Network, Vancouver, BC, Canada
| | | | | | | | | | | | - Nicolas Fernandez
- Can-SOLVE CKD Network, Vancouver, BC, Canada
- Department of Family Medicine and Emergency Medicine, Université de Montréal, QC, Canada
| | - Ruth Sapir-Pichhadze
- Can-SOLVE CKD Network, Vancouver, BC, Canada
- Division of Nephrology and Multiorgan Transplant Program, Department of Medicine, McGill University, Montreal, QC, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of McGill University Health Centre, Montreal, QC, Canada
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