An impact review of a Western Australian research translation program

Assessment of current patient reported outcome measures for three core outcome domains for single-sided deafness device intervention trials

BACKGROUND

Outcome reporting in clinical trials of auditory interventions for adults with Single-Sided Deafness (SSD) is inconsistent. The Core Rehabilitation Outcome Set for Single-Sided Deafness (CROSSSD) initiative has recommended three outcome domains as a minimum standard in the design of SSD intervention clinical trials. These are, Spatial orientation, Group conversations in noisy social situations, and Impact on social situations. The study objectives were to (i) understand exactly what the outcome domains mean to SSD experts, and (ii) identify and assess candidate PROMs in terms of how well they measure the experts' conceptualisation of those SSD outcome domains.

METHODOLOGY

Stakeholder representatives participated in two semi-structured online focus groups. Participants were four adults diagnosed with SSD with experience of auditory interventions, two healthcare professionals working in the field, and one clinical researcher with experience in evaluating interventions. Thematic analysis was used to determine conceptual elements of each domain. COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) initiative recommendations were adopted to assess the relevance and comprehensiveness (content validity) of available candidate instruments.

RESULTS

Multiple key concepts were identified for each outcome domain, and presented as a taxonomy. To be acceptable, any measurement instrument would need to achieve good coverage of all concepts in this taxonomy. From the 76 candidate instruments reviewed, none met accepted standards for content validity for SSD. The best performing candidates were (i) Spatial orientation: the Spatial Hearing Questionnaire and two variants of the Speech, Spatial and Qualities scale (SSQ-12, SSQ-18-C), (ii) Group conversations in noisy situations: the Communication Profile for Hearing Impaired (CPHI) questionnaire, SSQ-12, SSQ-18-C, and a multi-item questionnaire developed by Schafer and colleagues, and (iii) Impact on social situations: the CPHI questionnaire.

CONCLUSIONS

Multi-dimensional outcome domains introduce specific considerations for how they should be measured. Although some candidates instruments had reasonable comprehensiveness, modification is needed to ensure that there is overall greater relevance to the key concepts.

Models and approaches for building knowledge translation capacity and capability in health services: a scoping review

BACKGROUND

Building healthcare service and health professionals' capacity and capability to rapidly translate research evidence into health practice is critical to the effectiveness and sustainability of healthcare systems. This review scoped the literature describing programmes to build knowledge translation capacity and capability in health professionals and healthcare services, and the evidence supporting these.

METHODS

This scoping review was undertaken using the Joanna Briggs Institute scoping review methodology. Four research databases (Ovid MEDLINE, CINAHL, Embase, and PsycInfo) were searched using a pre-determined strategy. Eligible studies described a programme implemented in healthcare settings to build health professional or healthcare service knowledge translation capacity and capability. Abstracts and full texts considered for inclusion were screened by two researchers. Data from included papers were extracted using a bespoke tool informed by the scoping review questions.

RESULTS

Database searches yielded 10,509 unique citations, of which 136 full texts were reviewed. Thirty-four papers were included, with three additional papers identified on citation searching, resulting in 37 papers describing 34 knowledge translation capability building programmes. Programmes were often multifaceted, comprising a combination of two or more strategies including education, dedicated implementation support roles, strategic research-practice partnerships and collaborations, co-designed knowledge translation capability building programmes, and dedicated funding for knowledge translation. Many programmes utilised experiential and collaborative learning, and targeted either individual, team, organisational, or system levels of impact. Twenty-seven programmes were evaluated formally using one or more data collection methods. Outcomes measured varied significantly and included participant self-reported outcomes, perceived barriers and enablers of knowledge translation, milestone achievement and behaviour change. All papers reported that programme objectives were achieved to varying degrees.

CONCLUSIONS

Knowledge translation capacity and capability building programmes in healthcare settings are multifaceted, often include education to facilitate experiential and collaborative learning, and target individual, team, organisational, or supra-organisational levels of impact. Although measured differently across the programmes, the outcomes were positive. The sustainability of programmes and outcomes may be undermined by the lack of long-term funding and inconsistent evaluation. Future research is required to develop evidence-informed frameworks to guide methods and outcome measures for short-, medium- and longer-term programme evaluation at the different structural levels.