2010, Dissertation for Masters of Science, School of Nursing, Queens University, Ontario, Canada. CIHR also provides a practical guide to designing a KT intervention for health researchers, with relevant examples of its application. Next, 911 records were excluded at the sift stage. 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. 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. 10.2522/ptj.20070056. It may be useful for them to consider the extent to which they wish to follow or be guided by a conceptual framework before embarking on a knowledge translation project, especially regarding outcome measures because .the focus of knowledge into action is ultimately to enhance health status [1 p. 18]. The authors attribution of use was variable, with most merely referencing the framework or describing how it was used to inform or structure projects. 10.1016/j.amepre.2012.05.024. Action model learning - Wikipedia Graham ID, Tetroe J: Some theoretical underpinnings of knowledge translation. Terms and Conditions, Knowledge-to-action cycle | BMJ Evidence-Based Medicine In the COM-B model behavior is a result of an interaction between three components, which includes: Capability, which can be psychological (knowledge) or physical (skills); Opportunity can be social (societal influences) or physical (environment); motivation can be automatic (emotion) or reflective (beliefs, intentions) [ 16, 17 ]. This study also reinforces the importance of reporting standards [8],[36], such as the new TIDieR checklist [37] to facilitate more explicit reporting of implementation studies and their subsequent inclusion in systematic reviews. the secondary menu, the site search form or go 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. Once an understanding of the potential barriers and facilitators to adoption has been achieved, the next phase involves planning and carrying out interventions to bring about the intended change. Google Scholar. This scheme may be useful for similar studies examining theory use. Tugwell PS, Santesso NA, OConnor AM, Wilson AJ: Knowledge translation for effective consumers. The source paper was cited four times more frequently than the next highest cited article from the same journal published in the same year. Nine were published in peer-reviewed journals with the exception being a Master of Science degree dissertation [19]. 2013, 13: 118-10.1186/1471-2288-13-118. The impact of a strategy should be assessed using explicit, rigorous qualitative and quantitative methods, beginning with formulation of a defined question of interest. Further, the time frame of the citation searches only captures work up to a certain point (from the date of publication of the source paper to July 2013). Rather, papers typically stated aims and objectives, which often related to closing evidence/knowledge-practice gaps. Notably, the KTA Framework assumes a systems perspective and situates knowledge producers and users within a system of knowledge that is responsive, adaptive, and unpredictable. We acknowledge that faced with the same task, another review team might choose to include papers reporting a single knowledge translation strategy. Knowledge becomes more refined as it moves through these three steps. Article Seven described using both the Knowledge Creation and the Action Cycle components [18],[20]-[24],[27]. 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. 1992). Rycroft-Malone J: The PARIHS framework: a framework for guiding the implementation of evidence based practice. looked at 10 behaviour change interventions where explicit use of theory was absent, and mapped these strategies to domains of the Theoretical Domains Framework. Our review, and similar studies [39],[40],[43]-[45], consistently comments on the limited, haphazard use of theory, even though theories can be applied in many different ways [41]. Data for each phase were then synthesised across studies to help understand how the framework had been used in practice. Ian D. Graham PhD, Ian D. Graham PhD. We did not include the many papers about clinical practice guidelines for two interrelated reasons. Tailoring knowledge was described in three studies [18],[20],[26]. BMJ Qual Saf. 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. In practice, the implications of this decision were minimal as many Google Scholar records either duplicated full bibliographic records already identified from Web of Science or Scopus or contained at least sufficient detail in the title or in the limited text displayed (text fragment), to indicate whether the paper merited further consideration. Non-stop action: The best choice for iCaf, configure-to-order gaming systems and quality-driven businesses; Non-stop durability: . Matern Child Nutr. Any differences were discussed and resolved by consensus. This can be achieved through observation (e.g. Using the knowledge to action process model to incite clinic - LWW BMJ. Adapted from Graham 2006 (https://pubmed.ncbi.nlm.nih.gov/16557505/) by Crockett 2017 (https://medium.com/knowledgenudge/kt-101-the-knowledge-to-action-framework-7fbe399723e8). 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. Two studies reported using all phases of Knowledge Creation [20],[26] (see Table 4). As knowledge moves through the funnel, it is refined and summarized to be more useful for end-users. 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]. Action phases may be carried out sequentially or simultaneously; knowledge phases may impact on the action phases. 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]. Action Cycle within the KTA Model The second step involves adapting the validated knowledge to the local context. Reprinted with permission from John Wiley and Sons. J Contin Educ Health Prof. 2010, 30: 167-71. Can J Cardiol. Citation searching seeks to optimise sensitivity and specificity when seeking to identify reports of practical applications of a model or framework. 2009, Wiley-Blackwell BMJ Books, Chichester, UK, 83-93. For an example of how these might be developed, check out our earlier post. Citation searching was further indicated in this review given that our scoping search, using the databases MEDLINE and CINAHL, had previously identified few abstracts reporting explicitly the use of the KTA Framework in practice. Further information about how the different studies applied the phases within the Action Cycle are shown in Table 6. Provided by the Springer Nature SharedIt content-sharing initiative. 10.1111/j.1553-2712.2007.tb02369.x. Importantly, these integrated studies included examples to illustrate how the KTA Framework had been used as a guide. 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. The KTA Framework comprises two distinct but related components: (i) Knowledge Creation (represented by the funnel) surrounded by (ii) the Action Cycle (Figure 1). Action is the deeds or decisions made based on knowledge and information. All authors read and approved the final manuscript. Due to overlapping categories (e.g. 10.1111/wvn.12016. PO Box 1649, Peoria, 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. This flexibility was intended, as Graham and colleagues [1] state the framework can also accommodate different phases being accomplished by different stakeholders and groups (working independently of each other) at different points in time (p. 18). Once a KT strategy has been delivered, the use of knowledge should be monitored which may be instrumental (behaviour), conceptual (attitude/perception), or as a persuasive tool for pushing change(knowledge as ammunition). Evaluating outcomes is an area of KT that requires more attention and involves evaluating whether application of the knowledge is actually impacting the desired outcome be it patient or practitioner behaviour, health outcomes, or system-level changes. As such, the process of moving evidence to action is iterative, dynamic, and complex. Knowledge to Action Framework. Manage cookies/Do not sell my data we use in the preference centre. The first phase explores the creation of knowledge tools or products, such as an intervention or a clinical guideline . Tabak RG, Khoong EC, Chambers DA, Brownson RC: Bridging research and practice: models for dissemination and implementation research. By using this website, you agree to our Booth A, Harris J, Croot E, Springett J, Campbell F, Wilkins E: Towards a methodology for cluster searching to provide conceptual and contextual richness for systematic reviews of complex interventions: case study (CLUSTER). Understanding effects in reviews of implementation interventions using the Theoretical Domains Framework. How Much Knowledge Is Necessary for Action? | SpringerLink Interestingly, a recent evaluation of the Canadian Institutes of Health Research (CIHR) Knowledge Translation Funding Program [38] presented results relating to knowledge translation products, academic outputs and capacity building together, giving the appearance, in our interpretation, that these different dimensions may be regarded as equally important. J Adv Nurs. 2012, 28: 258-61. Difficulties applying the exclusion criteria were discussed to ensure the inclusion/exclusion criteria were applied consistently. 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. 1, EPOC Taxonomy of Professional and OrganisationalInterventions.[https://epoc.cochrane.org/sites/epoc.cochrane.org/files/uploads/EPOC%20Taxonomy%20of%20Interventions%202002.pdf]. 2013, 19: 915-24. Knowledge translation has been defined as a process that includes synthesis, dissemination, exchange and ethically sound application of knowledge to improvehealthprovide more effective health services and products and strengthen the health care system [2]. 2007, 14: 936-941. Judging between informed and directed was difficult, suggesting further refinement of the categories is required. It is one of the most frequently cited conceptual frameworks for knowledge translation. It was cited 470 unique times across all databases. 2011, 11: 29-10.1186/1471-2288-11-29. Only ten studies were integrated, signifying that the KTA Framework was integral to the design, delivery and evaluation of the implementation activities. 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. Implementation researchers and health professionals can learn from this flexibility. 1, Lgar F: Assessing barriers and facilitators to knowledge use. This frequency of use in Canada could be explained by the influence of national Canadian networks and dissemination activities. This is noteworthy given Canadian research may be published in French language journals. 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. Jacqueline Tetroe MA, When thinking about program planning and implementation, there are several important concepts that need to be considered. Privacy 2012, 7: 50-10.1186/1748-5908-7-50. Michie S, Prestwich A: Are interventions theory-based? For example, Eccles et al. Data collection Step KTA 3.B - Center on Knowledge Translation for Technology Transfer This review sought to answer two questions: 'Is the Understanding the barriers to knowledge uptake and implementation strategies, as well as facilitators of change, are critical to effective knowledge translation activities. A citation search of three databases tracking the source paper Lost in knowledge translation: time for a map? identified 1,787 records between 2006 and July 2013. J Public Health Dent. A total of 1,057 titles and abstracts were screened. The framework has two components: Knowledge Creation and an Action Cycle, each of which comprises multiple phases. Musk threatens to sue Microsoft over Twitter data being used in A.I. - CNBC The issues around the keywords knowledge and actionwhich constitute the title of a book by Frey, Mandl, and von Rosenstiel ()are captured by the following four main aspects, which generate corresponding questions.. 1. 2010, Wiley Blackwell, Chichester, UK. Initial screening out by title and abstract on the basis of partial information from Google Scholar may also have excluded relevant studies. 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. Education was the most frequently employed strategy albeit in a variety of forms. The Knowledge-to-Action Process The Coordinated Implementation Model The Stetler Model of Research Utilization Conner's conceptual model for research-utilization evaluation Publication Date: August 2007 Copyright 2007 The Board of Regents of The University of Wisconsin System. One of the things that makes the KTA unique is that it begins with research evidence, the need to synthesize and translate that evidence - these are represented by the funnel in the middle of the cycle. Petzold A, Korner-Bitensky N, Menon A: Using the knowledge to action process model to incite clinical change. Conventional views support the use of theories, models and conceptual frameworks to underpin the process of change, yet in practice, their application seems more limited [40],[43]-[45]. 2023 BioMed Central Ltd unless otherwise stated. This MCHRI framework for impact has been adapted form multiple sources and from internal learnings and is underpinned by the Canadian knowledge to action process. This may explain the varying degrees to which the framework was used. Measuring this practice gap can include the use of administrative data, questionnaires, or conducting chart audits, to name a few. Applying the Knowledge-to-Action Framework to Engage Stakeholders and Solve Shared Challenges with Person-Centered Advance Care Planning in Long-Term Care Homes Authors George A Heckman 1 2 , Veronique Boscart 1 3 , Patrick Quail 4 , Heather Keller 1 5 , Clare Ramsey 6 , Vanessa Vucea 2 , Seema King 7 , Ikdip Bains 2 , Nora Choi 6 , Allan Garland 6 The citation search for the original source paper [1] yielded 1,787 records. Retrieved from http://www.nccmt.ca/registry/view/eng/70.html. Leah Crockett is a doctoral student in the Department of Community Health Sciences at the University of Manitoba. 2012, 9: 1-10.1111/j.1741-6787.2011.00240.x. Five studies applied one or more phases [18],[20],[22],[24],[26]. 2009, Wiley-Blackwell BMJ Books, Oxford, 94-113. Using the framework itself as a device through which to examine how it had been used seemed an appropriate and pragmatic approach for our purposes. AB is a member of the editorial board of Implementation Science. Graham I, Logan J, Harrison M, Straus S, Tetroe J, Caswell W, Robinson N: Lost in knowledge translation: time for a map?. Our findings support this proposal. Assessment of barriers can be done quantitatively and qualitatively using a variety of conceptual models and instruments. PRISMA flow diagram of citation analysis and systematic literature review. Studies were published between 2007 and 2013. Given the incomplete abstracts obtained via Google Scholar, a rule-out strategy was employed. Implementation Sci 9, 172 (2014). Several conceptual frameworks are pertinent for implementation scientists, including Promoting Action on Research Implementation in Health Services (PARIHS) [5],[10] the Consolidated Framework for Implementation Research (CFIR) [3] as well as the KTA Framework [1]. Petzold, A., Korner-Bitensky, N., & Menon, A. Most studies created a range of products, either as part of Knowledge Creation [18],[20],[21],[26] or the Action Cycle [21],[23],[24]. What is Knowledge Translation? | School of Physical & Occupational 2009, 4: Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N: Changing the behavior of healthcare professionals: the use of theory in promoting the uptake of research findings. Included articles were re-examined and re-coded according to this more detailed classification. Our experience certainly confirms that this search method circumvents the problems of variation in terminology typically encountered in topic-based searches of bibliographic databases. Knowledge Translation - KTDRR We acknowledge that there are multiple choices available when conducting citation searches. A secondary concern was theory fidelity [13], which relates to how this conceptual framework was being used in practice, specifically whether the KTA Framework was articulated in a way that was true to the source paper [1]. IL -[http://www.cihr-irsc.gc.ca/e/39033.html]. The action cycle includes a range of activities needed for knowledge implementation. Knowledge-to-Action Model (Adapted from I.D. Graham, J. Logan, M.B The KTA could also be used as a literacy device to structure reporting of the framework. This is typically the recommended starting point for implementation and involves identifying a problem that needs attention. Search for more papers by this author. 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. BMC Med Res Methodol. Straus S, Tetroe J, Graham ID: Knowledge Translation in Health Care. This involves valuing the utility of the knowledge to the problem, setting and circumstances, as well as tailoring the knowledge to the specific situation. A prospective design would strengthen research studies. It sets out the key 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. From 2008 to 2013, she led the Translating Knowledge into Action theme of NIHR CLAHRC SY. Each implementation study was very different (see Table 3). Eight of the ten studies were conducted in Canada, one in the Democratic Republic of Congo [17] and one in Denmark [18]. 2008, 3: 1-10.1186/1748-5908-3-1. The purpose of translation is to provide the best outcomes and value, and lower risks to our patient population. The first component of the model is the knowledge creation funnel, which represents the production and synthesis of knowledge. Helfrich CD, Damschroder LJ, Hagedorn HJ, Daggett GS, Sahay A, Ritchie M, Damush T, Guihan M, Ullrich PM, Stetler CB: A critical synthesis of literature on the promoting action on research implementation in health services (PARIHS) framework. Safari. Keyser SE: The Implementation of a Delirium Knowledge Translation Project for Families of the Elderly. However, none of these knowledge translation strategies, designed to target different barriers, featured in the included studies, with one exception. No existing systematic review was found on this subject. 2010, 5: 92-10.1186/1748-5908-5-92. These goals are to increase (a) the use of evidence-based research and (b) the understanding and use of KT principles. Journal of Continuing Education in the Health Professions, 30, 167-171. doi:10 The Knowledge to Action (KTA) Framework was developed in Canada by Graham and colleagues in the 2000s, following a review of 31 planned action theories. All citations identified were screened by title and available information according to agreed criteria. "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.. The KTA process has two components: Knowledge Creation and Action. Two researchers (BF and II) conducted an initial assessment of the full-text articles. statement and Some indication of the impact of this article can be gained from constructing a normalised citation count for comparison purposes. 2009, 41: 1024-1032. This showed that the degree of usage varied from merely citing the KTA Framework to full integration into the study. All ten studies reported applying the Action Cycle, describing at least five of the seven possible phases (see Table 5). Evidence-Based Decision Making 5: Knowledge Translation and the As knowledge moves through three stages (inquiry, synthesis, tools/products), it becomes more user-friendly. Box. Damschroder LJ, Aron DC, Keith , Rosalind E, Kirsh SR, Alexander JA, Lowery JC: Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. 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. 2010, 5: 82-10.1186/1748-5908-5-82. 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. IL Davies and colleagues [40] note that less than 6% of 235 studies, albeit published before 1998, explicitly used theories of behaviour or behaviour change. Selection bias is another limitation given that we aimed to identify papers reporting usage of the KTA Framework rather than considering or comparing with other conceptual frameworks. 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. The authors declare that they have no competing interests. All undertook the first phase of identifying the problem. This review sought to answer two questions: Is the KTA Framework used in practice? 2002). Work Group on Translation Tools | CDC CDC Knowledge to Action Framework [PDF - 33 KB] An Organizing Framework for Translation in Public Health: The Knowledge to Action Framework Applying the Knowledge to Action (K2A) Framework: Questions to Guide Planning Tool [PDF - 3.57 MB] Glossary of Terms [DOC -17 KB] Page last reviewed: April 28, 2021 Claude KM, Juvenal KL, Hawkes M: Applying a knowledge-to-action framework for primary prevention of spina bifida in tropical Africa. The KTA Framework is one of many frameworks, models, and theories that provides KT researchers with a practical yet systematic method of implementation. Primary studies, exploring the direct experience and perceptions of different stakeholders in implementation projects, which have been guided by conceptual frameworks, or theories, would add to our understanding of the utility and impact of these tools. Data extracted were mapped to each phase of Knowledge Creation and the Action Cycle (see Figure 1) by one researcher (BF) and then discussed with the whole team. We sought to identify all reported citations of a particular reference irrespective of the context within which that reference had been used. A total of 146 papers were identified as attributing use of the KTA Framework. IL The prevalence of the Action Cycle may simply reflect the cyclical nature of the change process evident in other common, quality improvement tools such as the Plan, Do, Study, Act cycle [30]. However, the method is replicable and could be repeated to update the review in future. Building a Knowledge to Action Program in Stroke Rehabilitation Google Scholar also enabled access to book chapters whereas Scopus and Web of Science only indexed peer-reviewed journal articles. The taxonomy enabled us to refine the inclusion criteria to identify studies that reported explicit application of the KTA Framework. Ilott I, Gerrish K, Booth A, Field B: Testing the consolidated framework for implementation research on health care innovations from South Yorkshire. 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]. One hundred and forty-six studies described usage to varying degrees, ranging from referenced to integrated. 2012, 7: 48-10.1186/1748-5908-7-48. However, because KT interventions are usually tailored to local contexts, and mapped to specific barriers/facilitators, effectiveness in one context does not guarantee success in another. Knowledge Translation in Health Care: Moving from Evidence to Practice. Article administrative databases) and/or active measurement (e.g. Conceptual frameworks provide a frame of reference for organising thinking, a guide for action and interpretation. Methods: We used the Knowledge to Action framework, which was developed to map how science is translated into effective health programs, to examine how the evidencebased intervention from the 2002 Diabetes Prevention Program trial was translated into the Centers for Disease Control and Prevention's largescale National Diabetes Prevention EX-B760M-V5-CSMMotherboardsASUS Global Step KTA 3.A - Center on Knowledge Translation for Technology Transfer