Slide 1Prepared by Noni MacDonald MD FRCPc,
Professor Pediatrics, Dalhousie University
Define knowledge translation
Outline the basic KT questions for a KT plan
List major audiences for KT with different types of types of research
List barriers to knowledge translation
Describe factors that enhance knowledge translation
2012
within a complex system of interactions among researchers and users
to accelerate the capture of the benefits of research for Canadians
through improved health, more effective services and products, and a strengthened health care system.
cihr-irsc.gc.ca/e/26574.html#defining
About ensuring that:
Stakeholders are aware of and use research evidence to inform their decision making
Research is informed by current available evidence and the experiences and information needs of stakeholders
Jeremy Grimshaw OHRI
Graham et al 2006
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Penicillin: discovered 1922
>30,000 medical journals
-annual increase –7%
-estimate in 2005
an MD would need to read 19 original articles each day to keep abreast of their field
Choi B. J Epidemiol Community Health. 2005;59:93
Tsunami of Information
Identify, review and select knowledge or research relevant to problem
Adapt to local context
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Select, tailor and implement interventions to promote use of knowledge
Monitor knowledge use
8. Sustain ongoing knowledge use
2012
www.cihr-irsc.gc.ca/e/39158.html
2012
Lost in knowledge translation:
time for a map?
Lost in knowledge translation:
time for a map?
Lost in knowledge translation:
time for a map?
What?
KT initiatives should be saved for interventions of known efficacy that are documented by systematic reviews….
Tugwell et al WHO Bulletin 2006;84:643-651
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2012
CONTANDRIOPOULOS D et al. Knowledge Exchange Processes in Organizations and Policy Arenas: A Narrative Systematic Review of the Literature The Milbank Quarterly, Vol. 88, No. 4, 2010 (pp. 444–483)
To Whom?
Intervention
Predisposing
Enabling
Reinforcing
Awareness
Agreement
Adoption
Researchers
Research
users
Researchers
Researcher
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clear.msu.edu
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clear.msu.edu
Every 2 year report card for provinces
Chose topics to rate prov/fed gov’t based on CPS statements
No province perfect,
http://www.cps.ca/English/Advocacy/StatusReport.htm
change in behaviour HCW
change in behaviour patients
new law or regulation
Political instability,
Censorship and control
J Continuing Education in the Health Professions 2006;26:87-96
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Local indigenous knowledge- may support or undermine KT
Variation in incentives /motivation to change
Lack communication with researchers
Negative feelings about research,mistrust
Lack of skills to apply and use research
Santesso and Tugwell KT in Developing Countries
J Continuing Education in the Health Professions 2006;26:87-96
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Politicalization of research
Credible evidence
Inaccessible formats
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“evidence favors rejection of a
causal relationship at the population
level between MMR vaccine and autistic
spectrum disorder (ASD)….”
conclusion does not exclude the possibility
that MMR vaccine could contribute to ASD
in a small number of children….”
MacDonald N, Picard A. CMAJ 2009; 180:697-8
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Clarity Requires Clear, Plain Language
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Translate message to fit locale culture
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Handbook for Clinicians Chapter 18.
Choi B. Understanding the basic principles of knowledge translation J Epidemiol Community Health. 2005;59:93. http://jech.bmj.com/content/59/2/93.full
Graham et al Lost in knowledge translation: time for a map? JCEHP 2006:26:13-24 (not free online but much of this at http://www.cihr-irsc.gc.ca/e/29529.html )
Tugwell et al. Systematic reviews and knowledge translation. WHO Bulletin 2006;84:643-651 http://www.who.int/bulletin/volumes/84/8/05-026658.pdf
Davis et al. The Case for knowledge translation: Shortening the journey from evidence to effect. BMJ 2003;327:33-35. http://www.bmj.com/content/327/7405/33.full.pdf
2012
2011
Knowledge Translation and Exchange
Lavis et al. Assessing country-level efforts to link research to action. WHO Bulletin 2006;84:620-628. http://www.who.int/bulletin/volumes/84/8/06-030312.pdf
Canadian Paediatric Society: Are we doing enough? http://www.cps.ca/English/Advocacy/StatusReport.htm
Santesso and Tugwell KT in Developing Countries. J Continuing Education in the Health Professions 2006;26:87-96. http://www.ccghr.ca/docs/KT_in_LMICs_module_en.pdf
MacDonald N, Picard A.A plea for clear language on vaccine safety. CMAJ 2009; 180:697-8