Knowledge translation Flashcards
Knowledge translation
Wide scale dissemination and implementation of evidence into practice
Integrated KT/Co-production
Collaboration between researchers and users in every step to increase relevance and improve uptake
Practice development
Continuous process of improvement towards increased effectiveness in patient care
Knowledge to action framework (KTA)
Framework used to guide knowledge translation
* Consists of two parts, knowledge creation and the action cycle
* First identify problem, review and synthesise knowledge, identify gaps
* Adapt to local context (stakeholders, observation, data monitoring)
* Assess for barriers/facilitators
* Tailor and implement intervention (marketing, auditing, adaption, reach) –> pilot testing
* Monitor and evaluate outcomes (audits, records, interviews)
Consolidated framework for implementation research (CFIR)
Practical theory based guide for assessing potential barriers and facilitators to guide implementation
Considers 4 aspects
* Inner setting (climate)
* Outer setting (networking, resources, policy)
* individual characteristics (knowledge, self-efficacy)
* Intervention characteristics (complexity, advantage)
Logic model
Display of relationship between program and outcomes, used to plan and implement programs & achieve intended goals
- Identify determinants using CFIR or equivalent
- Determine implementation strategies and mechanisms (inputs and activities)
- Identify target outcomes and impact
Top-down implementation strategies
- Education materials (small effect)
- PD (small)
- Audit and feedback (small but important improvements)
- Financial incentives (limitations)
- Hospital nurse-staffing models (low evidence)
- On screen reminders (requires more evidence)
- Clinical pathways
Potential issues with interventions
- Slow uptake
- Premature or continued uptake of ineffective/harmful interventions
- Failure to keep up with changes in health care & emerging evidence
Bottom up approach
New strategy to change behaviour (top down isnt very effective)
To consider
* Who’s behaviour needs to change
* What are the barriers and facilitators to the behaviour
* How can you overcome barriers and leverage enablers
* How to evaluate intervention
Theoretical domain framework
Exploring barriers and enablers from bottom level
* assess behaviour factors that influence implementation
* Assess cognitive, affective and environmental factors that influence behaviour = apply behavioural theories for behavioural change
Assess: knowledge, skills, self-efficacy & understanding of consequences, motivations and goals, social influences, emotions
Use these indentifiers to tailor to the problem
End of grant KT
Dissemination of research findings once a project is complete (more than just publishing and presenting)
Plan
* Establish goals, targets
* How and when you wil engage
* How you will implement
* How you will evaluate
* Resources required