Using the Knowledge to Action Framework in practice: a citation analysis and systematic review, https://doi.org/10.1186/s13012-014-0172-2, http://www.rcn.org.uk/__data/assets/pdf_file/0014/512600/2013_RCN_research_W06.pdf, https://epoc.cochrane.org/sites/epoc.cochrane.org/files/uploads/EPOC%20Taxonomy%20of%20Interventions%202002.pdf, http://www.cihr-irsc.gc.ca/e/47332.html#a2.1, http://creativecommons.org/licenses/by/4.0, http://creativecommons.org/publicdomain/zero/1.0/. 10.1016/j.amepre.2012.05.024. The first component of the model is the knowledge creation funnel, which represents the production and synthesis of knowledge. Action Cycle within the KTA Model The second step involves adapting the validated knowledge to the local context. And if so, how?. Jacqueline Tetroe MA, Estabrooks and colleagues [28] comment that the Canadian research funding organisation had adopted the KTA Framework to guide knowledge translation, deploying specific grant mechanisms to ensure involvement of knowledge users with researchers throughout the research process (p. 2). The benefits of theory-informed KT practice are not limited to providing a deliberate map for interventions, but also allow for increased validity and rigor and more seamless integration of KT-related evidence into the ever-growing body of implementation literature. Social support interventions. Two studies reported using all phases of Knowledge Creation [20],[26] (see Table 4). The one-hour conversation between Dr. Marianne Farkas of Boston University's Center for Psychiatric Rehabilitation and Dr. Ian Graham was presented in . 2014, 348: g1687-10.1136/bmj.g1687. A few authors have attempted this, such as McEvoy and colleagues [43] who examined benefits reported by authors using the Normalization Process Theory. Single studies at this stage are not ready to be translated into practice on a broad scale, but are necessary to inform future research and feed into the larger evidence base. 2009, 41: 1024-1032. The data were extracted from the integrated studies where the KTA Framework was applied in practice. Knowledge Translation Portfolio, Canadian Institutes of Health Research, Ottawa, ON, Canada. Tailoring knowledge was described in three studies [18],[20],[26]. Rather, we focused on the application of, and theory fidelity to, the KTA Framework. Claude KM, Juvenal KL, Hawkes M: Applying a knowledge-to-action framework for primary prevention of spina bifida in tropical Africa. Each article was scrutinised and mapped against the corresponding phases within the Knowledge Creation and Action Cycle components of the framework. Unfortunately, an implemented change is not usually self-sustaining and requires ongoing monitoring and effort. Refresh the page, check Medium 's site status, or find. For example, Eccles et al. Health Psychol. Knowledge creation has three phases: (1) knowledge inquiry, (2) knowledge synthesis, and (3) knowledge tools and products. Implementation Sci 9, 172 (2014). As Kate has described previously, knowledge synthesis (second generation knowledge) involves synthesizing results from individual research studies and interpreting them within the context of global evidence. Straus S, Tetroe J, Graham ID: Knowledge Translation in Health Care. This frequency of use in Canada could be explained by the influence of national Canadian networks and dissemination activities. IL We initially included 146 studies that reported using the KTA Framework. 2013, 23 (4): 290-298. For an overview of other determinant frameworks that are useful in this phase, see the determinant frameworks section of Nilsens paper [7]. Effectiveness: The extent to which the intended effect or benefits that were achieved under optimal . Data were extracted and mapped against each phase of the framework for studies where it was integral to the implementation project. However, there are multiple KT TMFs and little guidance on which to select. IL Based on knowledge to action, there were 3 phases to the study implementation: problem identification (lack of routine checklist use in Cameroonian hospitals), multifaceted implementation strategy (3-day multidisciplinary training course, coaching, facilitated leadership engagement, and support networks), and outcome evaluation 4 months The National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care for South Yorkshire (CLAHRC SY) used the KTA Framework to underpin a programme of knowledge translation work undertaken between 2008 and 2013 [12]. BMJ. IL The KTA Framework is a framework for guiding the process of KT, adopted by the Canadian Institutes of Health Research (CIHR) and other organizations worldwide. 2011, 71 (Suppl 1): S20-S33. Data collection Crosby R, Noar SM: Theory development in health promotion: are we there yet?. 2010, 5: 14-10.1186/1748-5908-5-14. Associated knowledge tools included summaries of evidence targeted at specific audiences, continuing health care education modules, information posted on websites and decision aids. The knowledge to action cycle is one framework for knowledge translation that integrates policy makers throughout the research cycle. Med Care Res Rev. Do they work? Rycroft-Malone J, Harvey G, Kitson A, McCormack B, Seers K, Titchen A: Getting evidence into practice: ingredients for change. Action model learning (sometimes abbreviated action learning) is an area of machine learning concerned with creation and modification of software agent 's knowledge about effects and preconditions of the actions that can be executed within its environment. 10.1002/chp.47. Child Health, Health Equity, Integrated Knowledge Translation, Canadian Institutes of Health Research (CIHR, https://www.ncbi.nlm.nih.gov/pubmed/16557505, practical guide to designing a KT intervention. It was cited 470 unique times across the three databases, indicating the bibliometric impact of the source paper. Google Scholar. The KTA Framework is being used in practice with varying degrees of completeness. Such work may require additional funding for longer term monitoring or strategies to sustain knowledge use over time. The KTA Framework was enacted in a variety of ways, from informing to full integration, showing flexibility of use and that it can fit local circumstances and need. AB is Reader in Evidence Based Information Practice at the School of Health and Related Research (ScHARR), University of Sheffield, where he leads on systematic review and evidence synthesis activities. Papers could be scrutinised according to how their aims and objectives had been operationalised. This reinforces the importance of theory fidelity and that authors refer to established taxonomies or reporting standards [36],[37],[40],[41] so we can understand how conceptual frameworks, theories and models are really used to guide practice or inform research. "Knowledge translation is defined as a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system.. 2009, 338: a3152-10.1136/bmj.a3152. Guideline adaptation: an approach to enhance efficiency in guideline development and improve utilisation, Validation of the theoretical domains framework for use in behaviour change and implementation research, Theoretical domains framework to assess barriers to change for planning health care quality interventions: a systematic literature review. On this basis, all ten studies were judged as having described their projects clearly. Citations were excluded where there was insufficient information to make a judgment about inclusion/exclusion criteria. Eight of the ten studies were conducted in Canada, one in the Democratic Republic of Congo [17] and one in Denmark [18]. We acknowledge that faced with the same task, another review team might choose to include papers reporting a single knowledge translation strategy. The KTA Framework [1] is being used in practice with varying degrees of completeness and theory fidelity when the conceptual framework is integrated into the implementation project. This is noteworthy given Canadian research may be published in French language journals. 10.1002/chp.179. The KTA Framework [1] was developed in Canada by Graham and colleagues in the 2000s in response to the confusing multiplicity of terms used to describe the process of moving knowledge into action [1]. It is important that KT is maximized in health care to improve patient outcomes. PO Box 1649, Peoria, Exploring the impact of the KTA Framework, and other conceptual frameworks, on patients and the public in terms of health improvement and outcomes would also be worthwhile, as would exploring their involvement in the application of the framework, not just as recipients of services but as key stakeholders in each phase. All ten studies reported using the Action Cycle. As part of this programme, the first author (BF) undertook a knowledge translation project that sought to identify examples of the use of the KTA Framework in practice. Keyser SE: The Implementation of a Delirium Knowledge Translation Project for Families of the Elderly. However, as shown by our study, citation searching in isolation from citation analysisthe detailed examination of full-textis unable to discriminate between where a model is simply mentioned in passing or even for cosmetic reasons and where it represents an explicit intellectual and conceptual contribution. For example, difficulties in applying exclusion/inclusion criteria were discussed by the team and all subsequent decisions were then resolved by consensus. Data extraction and presenting results according to the phases were also challenging, given that the framework is dynamic, and can be non-sequential with overlap between phases [1]. This study sought to identify and describe available full-spectrum KT TMFs to subsequently guide users. When thinking about program planning and implementation, there are several important concepts that need to be considered. In summary, KTA is applying knowledge to real life situations. 2009, Wiley-Blackwell BMJ Books, Chichester, UK, 83-93. Four of the ten studies [17],[19],[21],[23] reported gaining ethical approval, suggesting that these had been independently characterised as research. Included articles were re-examined and re-coded according to this more detailed classification. Petzold A, Korner-Bitensky N, Menon A: Using the knowledge to action process model to incite clinical change. The index citation for the original paper was identified on three databasesWeb of Science, Scopus and Google Scholarwith the facility for citation searching. McCormack B, Kitson A, Harvey G, Rycroft-Malone J, Titchen A, Seers K: Getting evidence into practice: the meaning of context. 2002, 38: 94-104. However, adaptation of guidelines also runs the risk of deviating from the original evidence base to address this, a systematic approach to guideline adoption has been developed by a Canadian collaboration called ADAPTE [4]. 2002). As knowledge moves through three stages (inquiry, synthesis, tools/products), it becomes more user-friendly. Michie S, Prestwich A: Are interventions theory-based? When the framework was integral to knowledge translation, it guided action in idiosyncratic ways and there was theory fidelity. Implement Sci. 2010, 5: 92-10.1186/1748-5908-5-92. Molfenter and colleagues [23] describe a strategy to assist clinicians with patient selection which could be interpreted as seeking to influence organisational barriers such as competing priorities, as well as addressing knowledge-related barriers. These goals are to increase (a) the use of evidence-based research and (b) the understanding and use of KT principles. Share your thoughts in the comments section below, or by tweeting at us at @KnowledgeNudge. Neither did we seek out grey literature or search specific thesis/dissertation databases. Article Discovery: The original biomedical, behavioral, or epidemiologic factor that stimulated development of an intervention (1).. Efficacy: The extent to which the intended effect or benefits were achieved under optimal conditions (2).. Finfgeld-Connett D, Johnson ED: Literature search strategies for conducting knowledge-building and theory-generating qualitative systematic reviews. PubMedGoogle Scholar. 2012, 8: 174-84. Finally, knowledge tools and products, considered third generation knowledge, are the most refined form of knowledge, based on earlier stages of the funnel. The search results are illustrated in Figure 2, the PRISMA flow chart. Those excluded at this stage included literature reviews and conceptual, descriptive or commentary papers, papers describing a single knowledge translation strategy or not topically relevant. Thomas A, Menon A, Boruff J, Rodriguez AM, Ahmed S: Applications of social constructivist learning theories in knowledge translation for healthcare professionals: a scoping review. Reprinted with permission from John Wiley and Sons. However, the method is replicable and could be repeated to update the review in future. It is possible some potentially relevant studies were excluded during the initial sift stage. Five studies applied one or more phases [18],[20],[22],[24],[26]. So-called action (or planned action) models are process models that facilitate implementation by offering practical guidance in the planning and execution of implementation endeavours and/or implementation strategies. 2008, 3: 1-10.1186/1748-5908-3-1. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. This presents an interpretation challenge both for those seeking to learn from such projects and systematic reviewers. It may also be a reflection of the challenges for defining and reporting outcomes for knowledge translation projects. Each component involves several phases which overlap and can be iterative; Graham and colleagues [1] describe the phases as dynamiccan influence each other (p. 20). Russell DJ, Rivard LM, Walter SD, Rosenbaum PL, Roxborough L, Cameron D, Darrah J, Bartlett DJ, Hanna SE, Avery LM: Using knowledge brokers to facilitate the uptake of pediatric measurement tools into clinical practice: a before-after intervention study. There were occasions when we sensed that aspects of Knowledge Creation and Action Cycle had been done or combined, but as this was not explicit, we excluded these data. Graham ID, Tetroe J: Some theoretical underpinnings of knowledge translation. The framework has two components: Knowledge Creation and an Action Cycle, each of which comprises multiple phases. This reflects the spread of the framework across a range of settings, to different health care services and systems and larger scale and smaller projects. As the process of KT is iterative, not only can (i) inform (ii), but components of the action cycle also feed back to inform knowledge creation [2, 3]. This was necessary given the limited resources available to support the review process. For Web of Science and Scopus citations, full abstracts were identified. -[http://www.cihr-irsc.gc.ca/e/39033.html]. The Knowledge to Action Framework [1] (the KTA Framework) is a conceptual framework intended to help those concerned with knowledge translation deliver sustainable, evidence-based interventions. Upper Saddle River, NJ: Prentice Hall. The authors attribution of use was variable, with most merely referencing the framework or describing how it was used to inform or structure projects. Collaboration for Leadership in Applied Health Research and Care for South Yorkshire, Collaboration for Leadership in Applied Health Research and Care for Yorkshire and Humber. Questionnaires, interviews, workshops, focus groups and needs assessment were used to identify barriers to change. Referred to as first generation knowledge and vastly out of scale (considering that the body of new, original knowledge in healthcare is enormous part of the reason we need KT), knowledge inquiry refers to primary studies and represents the majority of research that is conducted. The knowledge to action (KTA) process proposed by Graham et al (2006) is a framework to facilitate the development and application of research evidence into clinical practice. Addressing sustainability also involves planning for both the spread and scaling up of knowledge use, and concerns whether an innovation continues to be used beyond the initial implementation. II provided BF with clinical supervision for her MSc dissertation. Due to overlapping categories (e.g. Google Scholar. Action includes identifying and appraising the problem and the known research, identifying barriers and successes, planning and executing, and finally monitoring, evaluating, and adjusting. Understanding the barriers to knowledge uptake and implementation strategies, as well as facilitators of change, are critical to effective knowledge translation activities. Each implementation study was very different (see Table 3). (Dignan, M.B & Carr, P.A. Only four studies detailed Knowledge Creation, yet existing knowledge was utilised in the other studies to identify knowledge-practice gaps, or as part of the Action Cycle. Finding Health Statistics: Going Beyond the Literature, Learning, Leadership, and Professionalism, NExT Online Course for Public Health Nursing, Program planning for health education and promotion, Special Collections & University Archives, Nursing Experts: Translating the Evidence - Public Health Nursing, The Canadian Institute of Health Research, https://pubmed.ncbi.nlm.nih.gov/16557505/, https://medium.com/knowledgenudge/kt-101-the-knowledge-to-action-framework-7fbe399723e8, "Knowledge translation strategies to improve the use of evidence in public health decision making in local government: intervention design and implementation plan" (2013), "Knowledge translation within a population health study: how do you do it?" 2012, 7: 48-10.1186/1748-5908-7-48. One can also move between the knowledge creation phase and the action cycle, in an iterative fashion. (2006) proposed the knowledge-to-action (KTA) process conceptual framework that could be useful for facilitating the use of research knowledge by several stakeholders, such as practitioners, policymakers, patients, and the public. Full-text articles were obtained for any article coded for inclusion and for any articles that appeared relevant but where it was unclear whether the KTA Framework had been actually used in practice. It is focused on ensuring research findings are implemented in practice and aims to reduce the knowledge to action gap i.e. Article Action phases may be carried out sequentially or simultaneously; knowledge phases may impact on the action phases. Throughout each of these stages, researchers can take an integrated approach, tailoring their activities (be they developing research questions, messages or dissemination strategies) to that of the end-users. The relation between knowledge and action. 60612, One Illini Drive Manage cookies/Do not sell my data we use in the preference centre. Download scientific diagram | Knowledge-to-Action Model (Adapted from I.D. 10.1097/00001786-200410000-00002. From the perspective of the psychology of knowledge (e.g., Strube & Wender, 1993), knowledge is a competence for action, a . However, supplementary hypertext links could be followed up from Google Scholar to either an abstract or, optimally, to the full text. Correspondence to They and we resorted to a simple taxonomy to describe the level and type of usage based on explicit reporting. In the context of healthcare, the Theoretical Domains Framework (which we break down in another post) is one example of a comprehensive, validated, and integrative model for assessing barriers to change that can be used to inform the development of strategies for changing attitudes and behaviours [5, 6]. From 2008 to 2013, she led the Translating Knowledge into Action theme of NIHR CLAHRC SY. Implement Sci. All these described the Action Cycle and seven referred to Knowledge Creation, articulating the KTA Framework in a way that was true to the source paper [1]. The action cycle includes a range of activities needed for knowledge implementation. Google Scholar references often included an incomplete text fragment rather than a more traditional abstract. Note that action steps may not be sequential, and one can start at any phase of the cycle. 2010, Dissertation for Masters of Science, School of Nursing, Queens University, Ontario, Canada. Glossary for Knowledge to Action Framework; Research Phase. knowledge to action gap through research-clinical partnerships in speech-language pathology. Inevitably, decisions about including or excluding studies were reliant on subjective judgements about whether the KTA Framework had been reported in an integrated way, or not. Part of Russell and colleagues [25] describe use of a knowledge broker, an example of a linkage and exchange-type strategy. Nilsens paper provides an overview of evaluation frameworks to guide evaluation of implementation strategies [7]. 61107, 102 Medical Sciences Building, 506 S. Mathews, Urbana, Stacey D, Higuchi K, Menard P: Integrating patient decision support in an undergraduate nursing curriculum: an implementation project. This can be achieved through observation (e.g. (2010). Google Scholar also enabled access to book chapters whereas Scopus and Web of Science only indexed peer-reviewed journal articles. This involves valuing the utility of the knowledge to the problem, setting and circumstances, as well as tailoring the knowledge to the specific situation. The databases were Scopus, Web of Science and Google Scholar. 2012, 7: 50-10.1186/1748-5908-7-50. This model provides a sequence of phases for researchers and clinicians to . Consequently, we recommend that the phase select, tailor, implement intervention be amended to include define and select outcomes and knowledge use measures, as a prompt to those using the KTA Framework to specify such outcomes when selecting which knowledge translation strategies to use. However, we were interested in the real-world application of the KTA Framework as a guide to implementation activities in health care and whether it was used in a way that was true to the framework. J Adv Nurs. J Contin Educ Health Prof. 2006, 26: 13-24. Non-English language studies were excluded, reducing access to examples of applying the KTA Framework published in other languages. 10 at the Canadian Institutes for Health Research. Hua D, Carter S, Bellerive J, Allu SO, Reid D, Tremblay G, Lindsay P, Tobe SW: Bridging the gap: innovative knowledge translation and the Canadian hypertension education program. 10.2522/ptj.20070056. 2010, 29: 1-8. Canadian Journal of Speech-Language Pathology . The production of knowledge tools and products uses synthesized knowledge to present evidence in concise and user-friendly formats tailored to meet end-user informational needs.

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