Research Dissemination and Knowledge Translation Dr Christine Leong

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Research Dissemination and Knowledge Translation Dr. Christine Leong, Pharm. D, BSc. Pharm, BSc Assistant

Research Dissemination and Knowledge Translation Dr. Christine Leong, Pharm. D, BSc. Pharm, BSc Assistant Professor, College of Pharmacy August 22, 2018

Objectives By the end of this presentation, you will be able to: 1. Recognize

Objectives By the end of this presentation, you will be able to: 1. Recognize strategies for effective research dissemination and knowledge translation 2. Develop a research dissemination and knowledge translation plan

What is knowledge translation? A. B. C. D. E. F. Research dissemination Research translation

What is knowledge translation? A. B. C. D. E. F. Research dissemination Research translation Continuing education Translational research All of the above None of the above

What is knowledge translation? A. B. C. D. E. F. Research dissemination Research translation

What is knowledge translation? A. B. C. D. E. F. Research dissemination Research translation Continuing education Translational research All of the above Not completely any of the above

Terms applied to the KT process • • • Knowledge transfer Knowledge exchange Research

Terms applied to the KT process • • • Knowledge transfer Knowledge exchange Research utilization Implementation research Research translation Research dissemination Diffusion Continuing education Continuing professional development Commercialization Graham ID, et al. J Contin Educ Health Prof 2006; 26: 13 -24; Straus SE, et al. Knowledge Translation in Health Care

What is knowledge translation? A. B. C. D. E. F. Research dissemination – spread

What is knowledge translation? A. B. C. D. E. F. Research dissemination – spread of knowledge Research translation – research vs all ways of knowing Continuing education – one strategy for implementation Translational research – basic science to clinical application All of the above Not completely any of the above

Knowledge Translation • A dynamic and iterative process • • Synthesis Dissemination Exchange Ethically-sound

Knowledge Translation • A dynamic and iterative process • • Synthesis Dissemination Exchange Ethically-sound application Knowledge To improve health To provide more effective health services and products To strengthen the health care system Straus SE, et al. Knowledge Translation in Health Care, 2 nd ed. ; CIHR. http: //www. cihr-irsc. gc. ca/e/29418. html#ktap

Knowledge-to-Action Cycle 1. Knowledge Creation 1. Knowledge Application CIHR. http: //www. cihr-irsc. gc. ca/e/29418.

Knowledge-to-Action Cycle 1. Knowledge Creation 1. Knowledge Application CIHR. http: //www. cihr-irsc. gc. ca/e/29418. html#ktap; Graham ID, et al. J Contin Educ Health Prof 2006; 26: 13 -24

Why is KT important • Health systems fail to optimally use evidence – Inefficiencies

Why is KT important • Health systems fail to optimally use evidence – Inefficiencies – Quantity and quality of life Underused Overused Misuse of therapies • Adults received <55% of recommended care gap KNOW DO Health care practice Health system management • KT is the method for closing knowledge-toaction gap – Optimize the return on investment in research Straus SE, et al. Knowledge Translation in Health Care, 2 nd ed.

Knowledge Translation Level of engagement vary in intensity, complexity Depends on nature of research

Knowledge Translation Level of engagement vary in intensity, complexity Depends on nature of research and information needs Knowledge Users Researchers Anyone who can use, benefit from, or be impacted by study results Generates knowledge Knowledge 1. Synthesis 2. Dissemination 3. Exchange 4. Ethically-sound application Graham ID, et al. J Contin Educ Health Prof 2006; 26: 13 -24

Types of Knowledge Users • Practitioner (e. g. , doctors, nurses, PTs, social worker)

Types of Knowledge Users • Practitioner (e. g. , doctors, nurses, PTs, social worker) • Policy-maker • Educator • Decision-maker (e. g. , program manager) • Community leader • Whole communities • Health organizations • Individual in a health charity • Patient group • Caregivers • Professional colleges/associations • Health care administrator • Institutions/organizations (e. g. , hospitals, clinics) • Research funders • Private sector organization • Industry • Media outlet • General public • Other researchers

Two Approaches to KT 1. End-of-Project KT Raise awareness Promote action 2. Integrated KT

Two Approaches to KT 1. End-of-Project KT Raise awareness Promote action 2. Integrated KT (i. KT) Problem-based Curiosity-driven Both types require a dissemination plan to share results of the project with interested knowledge users

End-of-project KT Methods • • • Conference presentations Peer-reviewed journal publications Workshops Academic detailing

End-of-project KT Methods • • • Conference presentations Peer-reviewed journal publications Workshops Academic detailing Tool development Websites Creative media Podcast, webinars Media (TV, radio, print, social media) Principal modes of communication to researchers vs. Where there are potential knowledge users beyond research community

Two Approaches to KT 1. End-of-Project KT Raise awareness Promote action 2. Integrated KT

Two Approaches to KT 1. End-of-Project KT Raise awareness Promote action 2. Integrated KT (i. KT) Problem-based Curiosity-driven Both types require a dissemination plan to share results of the project with interested knowledge users

Strong Integrated KT Projects • Demonstrate established relationship with participating knowledge users • Specify

Strong Integrated KT Projects • Demonstrate established relationship with participating knowledge users • Specify how the knowledge user will be involved • • • Developing the research question Collecting and analyzing data Interpreting results Crafting overall message Developing recommendations Identifying audiences for dissemination

Determining your KT Strategy Expected findings + KT Strategy Knowledge User CIHR. Guide to

Determining your KT Strategy Expected findings + KT Strategy Knowledge User CIHR. Guide to Knowledge Translation Planning at CIHR: Integrated and End-of-Grant Approaches http: //www. cihr-irsc. gc. ca/e/45321. html.

What is knowledge dissemination? 1. Diffusion 2. Dissemination 3. Implementation

What is knowledge dissemination? 1. Diffusion 2. Dissemination 3. Implementation

What is knowledge dissemination? 1. Diffusion “Let it happen” 2. Dissemination 3. Implementation E.

What is knowledge dissemination? 1. Diffusion “Let it happen” 2. Dissemination 3. Implementation E. g. , Publications, conferences Onus is on the potential adopter

What is knowledge dissemination? 1. Diffusion 2. Dissemination “Helping it happen” 3. Implementation E.

What is knowledge dissemination? 1. Diffusion 2. Dissemination “Helping it happen” 3. Implementation E. g. , Knowledge exchange workshop Target and tailor message about findings to a specific audience

What is knowledge dissemination? 1. Diffusion 2. Dissemination 3. Implementation “Making it happen” Active

What is knowledge dissemination? 1. Diffusion 2. Dissemination 3. Implementation “Making it happen” Active and systematic process Encourage adoption of research Identify and overcome barriers

Knowledge Dissemination Plan 1. Goal(s) – raise awareness vs. promote action 2. Knowledge user

Knowledge Dissemination Plan 1. Goal(s) – raise awareness vs. promote action 2. Knowledge user audience – who, roles, state of current knowledge 3. Strategies – diffusion, dissemination, application 4. Expertise – to help deliver on strategies 5. Resources – to show that KT activities can be delivered ($, HR, access) Straus et al. Knowledge Translation in Healthcare, 2 nd ed.

Further Information on KT • Straus SE, et al. Knowledge Translation in Health Care:

Further Information on KT • Straus SE, et al. Knowledge Translation in Health Care: Moving from Evidence to Practice, 2 nd edition. • Graham ID, et al. J Contin Educ Health Prof 2006; 26: 13 -24 • CIHR. KT Learning and Guides. http: //www. cihr-irsc. gc. ca/e/49443. html

Evidence-based interventions for behaviour change in healthcare https: //www. cadth. ca/rx-change

Evidence-based interventions for behaviour change in healthcare https: //www. cadth. ca/rx-change

KT Planning Template http: //melaniebarwick. com/training. php

KT Planning Template http: //melaniebarwick. com/training. php

Thank you! Dr. Christine Leong • Assistant Professor • College of Pharmacy, University of

Thank you! Dr. Christine Leong • Assistant Professor • College of Pharmacy, University of Manitoba • christine. leong@umanitoba. ca

EXTRA SLIDES

EXTRA SLIDES

Other terms applied to the KT process: Knowledge transfer • Process of getting knowledge

Other terms applied to the KT process: Knowledge transfer • Process of getting knowledge used by stakeholders • Sounds unidirectional • Some may interpret as dissemination vs. use of knowledge (putting it into action) Knowledge exchange • Assumes researchers and stakeholders are two separate groups with distinct cultures/perspectives on knowledge • Purpose is to ensure knowledge created is relevant and applicable to stakeholders and useful to researchers • Collaborative research approach; researcher and stakeholder engaged from research question to knowledge application Research utilization • Subset of knowledge use with a research base to substantiate it • Focused on moving research findings into action Implementation research (UK, Europe) • Method to promote the systematic uptake of clinical research findings and other evidence-based practices in to routine practice to improve the quality and effectiveness of healthcare

Knowledge-to-Action Process Monitor Knowledge Use Evaluate Outcomes ow led ge Knowledge Inquiry Adapt Knowledge

Knowledge-to-Action Process Monitor Knowledge Use Evaluate Outcomes ow led ge Knowledge Inquiry Adapt Knowledge to Local Context Product Tools Tai lor Synthesis Kn Assess Barriers to Knowledge Use KNOWLEDGE CREATION ing Select, Tailor, Implement Interventions Sustain Knowledge Use Identify Problem Identify, Review, Select Knowledge CIHR. http: //www. cihr-irsc. gc. ca/e/29418. html#ktap; ACTION Graham CYCLE ID, et al. J Contin Educ Health Prof 2006; 26: 13 -24

Examples • Statins post-stroke to reduce death and morbidity, but underprescibed • Antibiotics in

Examples • Statins post-stroke to reduce death and morbidity, but underprescibed • Antibiotics in children with URTIs, overprescribed • Many patients (26 -95%) were dissatisfied with information given

Types of. Example Knowledge types of projects Users Potential knowledge user Practitioners (e. g.

Types of. Example Knowledge types of projects Users Potential knowledge user Practitioners (e. g. MDs, RNs, PTs, OTs, Pharmacists) Research questions arising from health professionals, or a research project aiming to develop new treatment modalities intended to be used by them Patients (e. g. those patients attending a health centre) Research questions arising from patient concerns about the care they are receiving, or a research project aimed at improving patient care Patient organizations (e. g. disease specific) Assessing the daily problems faced by individuals with that disease Their caregivers Developing new treatment or adaptive strategies for community-dwelling patients with a particular disease Whole communities Collecting baseline data, evaluating interventions (e. g. for promoting healthy lifestyles) Decision makers (e. g. program managers) Evaluating how care is delivered by staff within the organization Policy makers Creating an intervention that necessitates changing the way the health care system is organized and/or funded Institutions/organizations (e. g. hospitals, primary care clinics) Starting a new outpatient health programme targeting a particular disease or problem Professional colleges/associations Evaluating implementation of treatment guidelines developed by members of a professional group Research funders Research that involves new approaches that do not fit well with existing funding models Industry Formally testing off-label use of an existing medication CIHR. http: //www. cihr-irsc. gc. ca/e/44954. html

Study Example • Tool developed, tested, and validated for assessing X for patients presenting

Study Example • Tool developed, tested, and validated for assessing X for patients presenting to primary care clinics to provide personalized recommendations, found a 50% drop in X if tool was used • Tool showed very good sensitivity and specificity and validated in a range of clinics across the country • Data published and presented in high impact peer reviewed journals and academic conferences • Uptake is low – GPs say tool is too long and no time to administer – Health planners say too expensive and would rather focus limited resources on primary prevention – Patients not sure what to do with tool results unless they are willing and able to pay for intervention or spend hours on website • • • Understanding the problem, the context and environment where results are to be appli Can identify potential facilitators and barriers to the uptake of findings Positioning to adopt new knowledge Capacity to tailor messages and interventions Able to evaluate the implementation process and outcomes

Elements of KT 1. Synthesis 2. Dissemination 3. Exchange 4. Ethically-sound application

Elements of KT 1. Synthesis 2. Dissemination 3. Exchange 4. Ethically-sound application

Elements of KT • Contextualization and integration 1. Synthesis of research findings of individual

Elements of KT • Contextualization and integration 1. Synthesis of research findings of individual research studies within the larger body of knowledge on the topic 2. Dissemination • Must be reproducible and transparent in its methods Systematic reviews 3. Exchange (qualitative/quantitative) Meta-analyses Consensus conference/expert panel 4. Ethically-sound application Practice guidelines Qualitative/quantitative results Realist syntheses Narrative syntheses CIHR. http: //www. cihr-irsc. gc. ca/e/29418. html#ktap,

Elements of KT 1. Synthesis 2. Dissemination • Identification of appropriate audience • Tailoring

Elements of KT 1. Synthesis 2. Dissemination • Identification of appropriate audience • Tailoring message and medium to audience 3. Exchange Summaries/briefings for stakeholders Educational sessions (patients, practitioners, and/or policy makers) 4. Ethically-sound application Engaging knowledge users (dissemination plan, tools, media) CIHR. http: //www. cihr-irsc. gc. ca/e/29418. html#ktap, Canadian Foundation for Healthcare Improvement. https: //www. cfhi-fcass. ca/Publications. And. Resources/Resources. And. Tools/Glossary. Knowledge. Exchange. aspx)

Elements of KT 1. Synthesis 2. Dissemination 3. Exchange • Interaction between knowledge user

Elements of KT 1. Synthesis 2. Dissemination 3. Exchange • Interaction between knowledge user and researcher mutual learning • Collaborative problem-solving between researchers and decision-makers 4. Ethically-sound application CIHR. http: //www. cihr-irsc. gc. ca/e/29418. html#ktap, Canadian Foundation for Healthcare Improvement. https: //www. cfhi-fcass. ca/Publications. And. Resources/Resources. And. Tools/Glossary. Knowledge. Exchange. aspx)

Elements of KT 1. Synthesis • Iterative process by which knowledge is put into

Elements of KT 1. Synthesis • Iterative process by which knowledge is put into practice 2. Dissemination • Activities consistent with ethical principles, norms, social values, legal/regulatory frameworks 3. Exchange 4. • Evaluation and monitoring of KT initiatives, processes, activities Ethically-sound application CIHR. http: //www. cihr-irsc. gc. ca/e/29418. html#ktap, Canadian Foundation for Healthcare Improvement. https: //www. cfhi-fcass. ca/Publications. And. Resources/Resources. And. Tools/Glossary. Knowledge. Exchange. aspx)

Outline • What is knowledge translation (KT) and research dissemination? • Why is KT

Outline • What is knowledge translation (KT) and research dissemination? • Why is KT important? • How do we create a KT and research dissemination plan?

Ten ingredients for implementation research proposals Proctor EK, et al. Implementation Science 2012; 7:

Ten ingredients for implementation research proposals Proctor EK, et al. Implementation Science 2012; 7: 96