Translating Research into PracticeJuly 14, 2004
Moving Toward an Evidence-Based Public Health System in Canada
Maureen Dobbins RN, PhD, Kara DeCorby, MSc,Donna Ciliska, RN, PhD, Helen Thomas, RN, MSc,
and the Knowledge Transfer Research Team
Translating Research into PracticeJuly 14, 2004
Setting the Scene
• Knowledge transfer from a theoretical perspective
• Findings from current studies
• Looking to the present and future
• Strategic planning for progress
Translating Research into PracticeJuly 14, 2004
Knowledge Persuasion Decision Implementation Confirmation
Research Dissemination
Evidence-basedDecision-making
Research Utilization
Outcomes
Dissemination strategies
Innovation characteristics
Organizationalcharacteristics
Environmental characteristics
Individual characteristics
type of decisionvalues/beliefsevidenceculturedecision-making styletype of innovation
Knowledge Transfer and Uptake Framework
Translating Research into PracticeJuly 14, 2004
Barriers to Evidence Based Decision Making
• Time
• Availability of research results
• Resources to implement research findings
• Relevance
• Timeliness (having research when needed)
(Ciliska et al, 1999)
Translating Research into PracticeJuly 14, 2004
Facilitators of Evidence Based Decision Making
Systematic reviews overcome barriers• Time (82%)
• Timeliness (62%)
• Relevance (46%)
• Availability of research results (30%)
• Resources to implement research (22%)
(Ciliska et al, 1999)
Translating Research into PracticeJuly 14, 2004
Facilitators (cont’d)
Significant Predictors of Use• Position in organization
• Critical appraisal skills
• Reviews easy to use
• Expectation to use reviews in future
(Dobbins et al, 2001)
Translating Research into PracticeJuly 14, 2004
Other Important Characteristics
• Perception that research is relevant to decisions
• Perception that the organization values the use of research evidence
• Routine reading of the literature
• Overcome issues of time
(Dobbins et al, 2001)
Translating Research into PracticeJuly 14, 2004
Questions for target users:
• What are decision makers’ preferences for receiving research evidence?
• How can we promote use and overcome barriers to use?
• How can ownership of knowledge be distributed amongst users?
Translating Research into PracticeJuly 14, 2004
Sample• Canadian public health and health promotion
decision makers:
• CMOHs and MOHs• Program managers/directors/coordinators• Federal and provincial/territorial government
decision makers• Executive directors, program/project
coordinators in NGOs
Translating Research into PracticeJuly 14, 2004
Results (interviews)
• 54 Decision-makers
• Representation from most provinces/territories
• Representation from all decision-making levels
Translating Research into PracticeJuly 14, 2004
User’s Preferences• Short summaries
• Access to full document
• Divided on issue of hard copy vs. electronic
• Commentary, and rating of methodological quality
• Need practical, implementation-related information• E-mailed updates
• Interest in being able to indicate areas of interest so that only relevant research is received
Translating Research into PracticeJuly 14, 2004
Challenges faced by decision makers:“I don’t need to hear a lot about what further research needs to be
done or a lot of tentativeness. I have to make decisions today...I think that reality has to be taken into account when research findings are presented to decision makers...It simply doesn’t help me to know all of the problems.”
“we’re flooded with information. The information age has meant a lot in information and so absolutely anything that is done needs an executive summary and provide the information in a short and sweet format and it needs to be very clear.”
Translating Research into PracticeJuly 14, 2004
Designing and Testing a Strategy:
• Incorporation of decision makers’ preferences
• Consultation with marketing and graphic design firm
• Distribution to focus group participants
Translating Research into PracticeJuly 14, 2004
Overview of focus groups:
• 9 focus groups in 7 Canadian cities: Halifax, Montreal, Ottawa, Winnipeg, Calgary, Edmonton, Vancouver, Oct 2002 -Jan 2003
• 5-7 participants• Range of decision making levels • Semi-structured interview guide• Audiotaped sessions with interview notes
Translating Research into PracticeJuly 14, 2004
What decision makers liked most:
• Length, writing style, plain language use
• Could pass it on without having to ‘translate’
• 2-page synthesis of each review
• Issue framed in a Canadian context
• Implications spelled out
• Contact information for asking questions
Translating Research into PracticeJuly 14, 2004
Main theme - Time
Key features:– credibility– high quality design– customizability– applicability– timeliness– reliability & consistency– accessibility
Challenges:– information management– skill building– list serves not universally
appealing
Translating Research into PracticeJuly 14, 2004
High Quality Design
Content• current• all info dated• jargon-free• transparent• + and - findings• ranked by strength• cost data• Canadian
Format• well-written• concise• understandable to all• well-organized• lends itself to quick visual
scanning
Translating Research into PracticeJuly 14, 2004
Products:
• Online resource to be launched in September 2004 as an interactive web site URL: www.health-evidence.ca
web site is part of a multi-component strategy for – Knowledge translation– Supporting users in accessing and interpreting research
evidence– Facilitating connections among users– Facilitating connection between researchers and users
Translating Research into PracticeJuly 14, 2004
Implications:
• Opportunities to receive updates of new research in a program area
• Contact information for authors and document links where available
• Venue to facilitate online communities of practice
Translating Research into PracticeJuly 14, 2004
Translating Research into PracticeJuly 14, 2004
Translating Research into PracticeJuly 14, 2004
Translating Research into PracticeJuly 14, 2004
Translating Research into PracticeJuly 14, 2004
Translating Research into PracticeJuly 14, 2004
Next Steps:
• maintain and market the online registry
• refine the site’s functionality and locate and reach potential users
• a 3-year, CIHR-funded RCT evaluating effectiveness of knowledge transfer strategies among public health and health promotion decision makers across Canada
• First evaluation of its kind in Canada to evaluate quantitatively the impact of a knowledge broker