KNOWLEDGE TRANSLATION:
THE WHY, WHAT, WHOM
AND HOW OF IT
Lupin Battersby
CGSM Critical Inquiries, May 2013
Introduction

A brief overview of knowledge translation
 Terminology
 Four
Questions of a KT intervention
 Theoretical frameworks

Applied examples to follow
 The
Transforming Family Film Project - Jake Pyne
 Theatre as Knowledge Translation - Lori Ross
Knowledge Translation Terminology
Historically
 Social Sciences – Diffusion1
 Medicine – Evidence Based Practice
Today
 Health Sciences – Knowledge Translation (KT);
Knowledge Transfer and Exchange (KTE)
 Other disciplines – Implementation Science;
Knowledge Mobilization; Knowledge Utilization
1Rogers,
E. M. (1962). Diffusion of innovations. New York: Free Press
Graham et al 2006
Knowledge Translation (KT)
“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.” (Canadian Institutes of Health
Research, 2009).
Canadian Institutes of Health Research. (2009). About knowledge translation. Retrieved
January 4, 2011, from http://www.cihr-irsc.gc.ca/e/29418.html
CIHR’s KT Related Terms
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Synthesis: the contextualization and integration of research
findings of individual research studies within the larger body
of knowledge on the topic.
Dissemination: involves identifying the appropriate audience
and tailoring the message and medium to the audience.
The exchange of knowledge refers to the interaction
between the knowledge user and the researcher, resulting in
mutual learning.
In end of grant KT, the researcher develops and implements
a plan for making knowledge users aware of the knowledge
that was gained during a project.
In integrated KT, stakeholders or potential research
knowledge users are engaged in the entire research
process.
Critique of KT Term

Constrains thinking and science of KT :
 Associated
with the hierarchy of evidence that identifies
randomized control trials and systematic reviews as the
ideal evidence for translation
 Problem is limited to language or tailoring
 Linear understanding of decision making process
 Implies that knowledge is research
Greenhalgh, T. (2010). What is this knowledge that we seek to "exchange"? The Millbank
Quarterly, 88(4), 492-499
Four Questions
Four questions to
understand a KT
intervention
Contandriopoulos 2012 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298020/
The four questions
1.
2.
3.
4.
Why? The nature of the problem to be addressed
What? The nature of evidence, research,
knowledge
To whom? The context being addressed
How? The framework and strategies to employ2
2Contandriopoulos,
D. (2012). Some thoughts on the field of KTE. Healthcare Policy, 7(3), 27-37
1. Why - Nature of the Problem
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Knowledge transfer problem – researchers are not
effectively transferring the knowledge or
knowledge users are not interested or willing to
implement the research
Knowledge exchange problem – are not interacting
therefore knowledge is not relevant and users are
not buying in
Knowledge production problem – superficial
engagement of knowledge users, too late in the
process, produces flawed knowledge
2. What - Nature of Knowledge,
Evidence, Research, and Use

Evidence

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Knowledge

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Episteme; Instrumental Knowledge
Techne; Tacit Knowledge
Phronesis; Personal Praxis
Research

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What evidence should be translated?
What are the sources of this evidence?
Qualitative
Quantitative
Use



Instrumental; consensual
Symbolic; contentious
Conceptual; paradigm challenging
See: Cleaver & Franks, 2008; Kothari, Bickford, Edwards, Dobbins, & Meyer, 2011; McWilliam et
al., 2009; Nutley et al., 2007; Rycroft-Malone, Seers et al., 2004; Weiss & Bucuvalas, 1980
3. Whom - Context
Contandriopoulos states “context dictates the realm of the
possible for knowledge exchange strategies aimed at
influencing policymaking or organizational behaviour”
(p. 465).
 Conceptualizations of Context – micro, meso, macro
level; culture, leadership, feedback; knowledge
user/researcher polarization & cost-sharing equilibrium
 Audience – e.g. policy, practitioners, public; individual,
collective
 Power – structural inequities; group dynamics;
organizational dynamics;
(Contandriopoulos, Lemire, Denis, & Tremblay, 2010; Best & Holmes, 2010; Van De Ven & Johnson,
2006; McCormack et al., 2002)
4. How - Frameworks and Strategies

Model
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Framework
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Representation of a theory or a set of concepts
Strategic guide based on theoretical concepts that provide a
systematic way to develop, manage and evaluate interventions
Strategy

Planned interventions to achieve goals
KT frameworks are the “best available source of advice for
someone designing or implementing a knowledge exchange
intervention…to be used as field guides to decode the
context and understand its impact on knowledge use and the
design of exchange interventions” (Contrandiopolous et al.,
2010, p. 468).
KT Frameworks: Foundations

Diffusion of Innovation (Rogers) 1950s
 Elements
of spread: Innovation, communication channels,
time and a social system

Research Development Dissemination and Utilization
Framework (Havelock) 1960s
 Collaborative
interactions and linkages, accessible
teaching & research programs

Two-Communities Metaphor (Weiss, Caplan) 1970s
 Not
a framework but a shaping force; non-use due to
cultural differences between science & policymakers
KT Frameworks: Types

Linear, science push, demand pull
 Packaging
and distribution following stages;
unidirectional dissemination

Relationship, cyclical, interaction
 Collaborative
networks of various stakeholders in
production & dissemination

Systems, dynamic multidirectional
 KT
happens in complex system with multiple forces that
mediate interactions, within a larger system
See: Landry, Amara & Lamari, 2001; Best & Holmes, 2010; Ward, House & Hamer, 2009;
Tabak et al, 2012
KT Frameworks: Current Directions

Mode 2 Science (Gibbons)
 Context-sensitive,
depth in collaborations, range of
expertise and perspectives contributed

Engaged Scholarship (Van de Ven)
 Means
to address complex problems in Mode 2
science; arbitrage for heterogeneous groups

Integrated KT (CIHR)
 Distinct
from End of Grant KT; stakeholders are
engaged in entire research process
Van De Ven, H., & Johnson, P. (2006); Gibbons, M. (2000); Bowen & Graham (2013)
A Sample of Frameworks
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Knowledge to Action (KtoA), Graham et al 2006,
Canada
Promoting Action on Research Implementation in
Health Services (PARIHS), Kitson et al 1998, UK
Participatory Action Knowledge Translation (PAKT),
McWilliams et al, 2009, Canada
Knowledge Exchange Framework, Ward et al, 2012,
UK
KtoA (Graham et al)
Graham et al, 2006; Image source http://www.cihr-irsc.gc.ca/e/39033.html
PARIHS (Kitson, Harvey, and McCormack)
(Kitson, Harvey & McCormack, 1998; Kitson et al., 2008)
Image source: http://clahrc-gm.nihr.ac.uk/heartfailure/about/
PAKT (McWilliams et al)
McWilliam et al 2009; Image source: http://www.implementationscience.com/content/4/1/26
Knowledge Exchange Framework (Ward et al)
Ward, V., Smith, S., House, A., & Hamer, S. (2012).
Strategies
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Audit and Feedback
Reminder Messages
Academic Detailing
Educational Outreach
Opinion Leaders
Interactive
Practice Tools/Decision Aids
Networking/Community of Practice
Media/Social Media
Arts-Informed KT – brings together the systematic and rigorous
qualities of scientific inquiry with the artistic and imaginative
qualities of the arts to reach out beyond academia
Barwick, M, Lockett, D, Knowledge Brokering for Pediatric Healthcare Research Team (2010)
Scientist Knowledge Translation Training Manual. Toronto: SickKids Learning Institute