Knowledge Translation
Using Evidence for Better Decisions
Alberta Innovates – Health Solutions
Presentation at University of
Lethbridge, June 2012
Transforming health and wellbeing through research and innovation
Funded by the Government of Alberta
Aspiring – good for pain. How do you know?
common knowledge
good credible research
plain language
experience
lots of research
recommended
by someone you
trust
Knowledge Translation?
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Knowledge mobilization
Evidence-based practice
Research transfer
Dissemination
Diffusion of innovation
Knowledge to action
Knowledge utilization
Technology transfer
Implementation science
Linkage and exchange
CIHR Definition
Knowledge translation (KT) 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.
This process takes place within a complex system
of interactions between researchers and knowledge users
which may vary in intensity, complexity and level of
engagement depending on the nature of the research
and the findings as well as the needs of the particular
knowledge user.
Other definitions
• Knowledge transfer is a deliberate process of information exchange
between producers and potential users of research that supports
evidence-informed decision making and decision-maker informed
research, ultimately for the betterment of peoples’ lives. AIHS
• Knowledge transfer and exchange is collaborative problem-solving
between researchers and decision makers. Knowledge transfer and
exchange occurs through "linkage and exchange" - the interaction,
collaboration, and exchange of ideas at every stage of the research
process. CHSRF
• Knowledge transfer is about transferring good ideas, research
results and skills between universities, other research organizations,
business and the wider community to enable innovative new
products and services to be developed. UK Office of Science and
Technology
• Research use. SHRF
Transmission and Reception
A letter:
(1)
(2)
(3)
(4)
(5)
receiving it
receiving and reading it
receiving, reading, and understanding it
receiving, reading, understanding, and appreciating it;
receiving, reading, understanding, appreciating, and
making it the basis of a decision
(6) receiving, reading, understanding, appreciating,
making it the basis of a decision, and taking an action
(or refusing to act) in line with the decision reached.
Canadian Institutes of Health Research KT
model
Graham et al. (2006). Lost in knowledge translation: time for a map? The Journal of Continuing Education in the Health
Professions, 26(1): 13-24
Knowledge to Policy and Practice
Question
Evaluate
Databases,
Research
results
Knowledge
needs
Knowledge
Impact
Knowledge
Generation
Influence
decisions,
change
practice
Linkage and
Exchange
Body of
knowledge
Social Capital
Knowledge
Implementation
Knowledge
KT Strategies,
Synthesis
dissemination
Knowledge
Movement
KT Strategies in General
The KT Plan
1. Goals/objectives
2. Audience
3. Strategy and tactics (how and when
to engage audiences)
4. Main messages
5. Resources
6. Evaluation
Goals/Objectives
• What is it you wish to accomplish?
– Raise awareness
– Change behaviour
– Market a new widget
• What do you want people to do?
Audience?
Who will help you reach your goals?
Who needs to hear your messages?
What do you know them?
Are they ready to hear what you have to
say? What are the barriers?
• What is the best way to reach your
audience(s)?
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Audience?
Who will help you reach your goals?
Who needs to hear your messages?
What do you know about your audience?
Are they ready to hear what you have to
say? What are the barriers?
• What is the best way to
approach this audience?
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Some Barriers
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Cultural differences
Language
Time commitments and constraints
Context
Resources
Concerns about quality of research
Competing agendas
Academic incentives/reward structure
Relationship building issues
Staff turnover
Lack of skills
Power imbalance
Perspectives
Public Policy
Administration
Clinical
 Do we fund heart
transplant?
 Where do we locate
heart transplant?
 Who should receive
heart transplants?
The timeline for a research
project is often longer than
the career path of the average
decision maker.
• http://www.dobugsneeddrugs.org/
Exercise
• http://www.dobugsneeddrugs.org/
Strategies
• Format, style, and timeliness by themselves will
not lead to utilization.
• One size-fits-all communication strategies are
rarely successful.
• Be persistent and repetitious.
• Who provides the information is as important as
what the information actually is.
• Readiness for change/readiness for knowledge
use is an important consideration.
• Involve your audience in developing, discussing,
and delivering messages.
Strategies
• Format, style, and timeliness by themselves will
not lead to utilization
• One size-fits-all communication strategies are
rarely successful
• Persistent and repetitious
• Who provides the information is as important as
what the information actually is.
• Readiness for change / readiness for knowledge
use is an important consideration
• Involve your audience in developing, discussing,
and delivering messages.
Four Factor Model of KT for Practice Change
Research
Evidence
Facilitation
Implementation of EBP
Context
Readiness
Change
Preferences
CIHR Emerging Team on KT for Child and Youth Mental Health (2009-2012) Melanie Barwick (SickKids), Chuck Cunningham (McMaster), Bruce
Ferguson (SickKids), Rhonda Martinussen (OISE), Rosemary Tannock (OISE/SickKids), Peter Chaban (SickKids), Dean Fergusson (Ontario Institute
for Health Research)
Strategies
• Format, style, and timeliness by themselves
will not lead to utilization
• One size-fits-all communication strategies are
rarely successful
• Persistent and repetitious
• Who provides the information is as important
as what the information actually is.
• Readiness for change/readiness for
knowledge use is important.
• Involve your audience in your strategy.
End of grant versus integrated KT
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collaborative, participatory, action-oriented,
community-based research, co-production of
knowledge, mode 2 research
involves engaging and integrating knowledge users in
the research process
knowledge users can be:
– policy-makers in government
– decision-makers from business
– researchers from different disciplines, teams,
countries
– community leaders
– industry
– public
More on iKT
Knowledge users and researchers work together to:
 shape the research questions
 decide on the methodology
 help with data collection, tools development, selection
of outcome measures
 interpret the study findings and craft messaging
around them
 move the research results into practice.
 widespread dissemination and application
Specific Strategies
Knowledge broker
Champions
Opinion leaders
Academic Detailing
Media
Written docs – policy briefs,
plain language summaries,
1-3-25
• Practice guidelines
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Audit and feedback
Educational material
Web sites
Social media
Decision support tools
Networks
COPs
Small group discussions
• http://www.youtube.com/watch?v=Ha2JcEdzLis&l
ist=PL07888926122D7FFB&feature=plcp
• http://www.youtube.com/watch?v=lkPv72O9ums
&feature=BFa&list=PL07888926122D7FFB
Evidence
 CurrentState of 
MOSTLY EFFECTIVE
MIXED EFFECTIVENESS
LIMITED EFFECTIVENESS
Participatory research
Conferences, courses
Total quality management
NOT SYSTEMATICALLY REVIEWED
AS YET
Interactive small groups
Opinion leaders
Educational outreach
Champions
Continuous quality
improvement
Patent license
Reminders
Educational materials
Didactic meetings
Social marketing
Computerized decision
support
Patient-mediated
interventions
Use of computers in practice
Performance feedback
Multi-disciplinary
collaboration
Educational strategies –
dependent on combination of
strategies
Mass media campaign
Financial intervention /
incentive
Combined interventions
Substitution of Tasks
Grol, R. & Grimshaw, J. 2003, The Lancet, 362.
Press release
Arts-based KT
• http://www.thefuntheory.com/
Messages
 Message(s) must be audience-specific.
 Adapt knowledge, tailor your main messages to your
audiences.
 Give people the information they need, not what you
think they need.
 Listen to your audience – what issues are important
to them?
 What do the results mean?
 What was the answer to your research question?
 Interesting or exciting?
 New versus confirming other studies?
The key questions
• What?
• So what?
• Now what?
Plain Language
• Know your
reader/listener
• Short sentences
• Active voice
• One idea per sentence
• Subject-verb-predicate
• Bullets
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Same terms
Nouns instead of verbs
Jargon
Acronyms
Subordinate clause
deletions
• When you apply for a grant, you must send us a description of
your experience in the area covered by the grant, copies of
any material you have published relevant to the area of the
grant, and a detailed account of how you intend to spend the
grant funds.
versus
• When applying for a grant, you must send:
o a description of your experience relevant to the grant,
o copies of your publications relevant to the grant,
o a detailed account of how you intend to spend the grant
funds.
Effect of colour (of attire) on
poster popularity
Stickiness
6 Principles of Sticky Ideas – Chip & Dan Heath
1. Simplicity – Isolate your core message and convey it
succinctly
2. Unexpectedness – Surprise and intrigue with leaps of
thought
3. Concreteness – Make it real and recognizable
4. Credibility – Use details that symbolize and support your
core idea
5. Emotions – Evoke feelings about what matters
6. Stories – Connect the dots
KT Planning Templates
Your Research Partners
Partner Engagement
KT Expertise on Your Team
Main Messages, Audience, Goals
Methods, Process, Impact
Partners, Resources, Budget
14. Describe how you will implement your KT strategy.
Implementation is the process involved with applying
your strategies, and ensures that the knowledge you
are transferring is done with fidelity and maintains
quality.
AIHS KT Plan Template
Objective(s)
Objectives are what you hope the impact of your research will be. KT objectives should be
clear, concise, measureable and appropriate to the expected research results.
Questions for the team to consider:
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What do you want to accomplish? What do you want people to do with the research results?
What will the impact be if you succeed? Will you be adding to a body of knowledge that will
inform continuing research? Will you raise awareness within a specific audience? Change
practice or service delivery? Inform policy decisions? Market a new medical device?
KT objectives for this project:
#1
#2
#3
Key Audiences
Key audiences are those individuals and groups who are essential to you reaching your
objectives.
Questions to consider:
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Who are the audiences, specifically that you need to engage to realize your KT objectives
(above)?
What do you know about these audiences and how they make decisions?
What is their knowledge base and are there gaps between what they know and what they
do?
What are the barriers and facilitators to KT with these audiences?
Key audiences for this project:
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Strategies and Tactics
This section of the plan will outline how you plan to reach and influence your key audiences. Strategies are the
broader initiatives and tactics are the specifics within those.
Questions to consider:
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How will you engage your key audiences? Will you integrate them into the project or engage them after the
project is complete? If integrated, how will you do that – developing the research question together, vetting
early results, active player in disseminating/transferring results, business development?
How will you place your results in context of other research in this subject area?
What tools or methods will you use to involve or engage your audiences? Targeted face-to-face presentations,
knowledge brokers, use of opinion leaders, chart audit and feedback, focus groups, mass media, conference
presentation, business plan, etc?
Who will do the KT work and how much will that cost?
Are your strategies and tactics reasonable, appropriate and feasible for the research results you hope to
generate?
What are the key messages from your results? Why are the results relevant to the audiences? What do you
want the audiences to do with the results you are presenting?
Have you made progress already in your KT strategies? These activities should be noted.
Proposed strategies and tactics (including responsibility, timing, budget):
Evaluation
The evaluation will address how you intend to measure uptake and impact and will be
matched against your stated objectives.
Questions to consider:
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Do you expect to have an impact in any of the following and what do you think that
impact will be:
advancing knowledge in your field of study or in the field of KT;
capacity building including building the capacity of end users to use research;
informing decision making;
improving health, the economy or society.
What metrics will you use to measure your impact?
How will you measure sustained knowledge use?
Proposed evaluation plan:
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Evaluation
• Metrics to consider:
– Increases knowledge
– Increases capacity
– Influences decisions
– Changes practice or policy
– Effects health or health system outcomes
Resources
• http://www.aihealthsolutions.ca/rtna/
• http://www.cihr.ca/e/29418.html
– 7 modules
– 4 casebooks
– Grants
• http://ktclearinghouse.ca/
• http://www.melaniebarwick.com