The one-hour conversation between Dr. Marianne Farkas of Boston University's Center for Psychiatric Rehabilitation and Dr. Ian Graham was presented in . Matern Child Nutr. 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. Google Scholar also enabled access to book chapters whereas Scopus and Web of Science only indexed peer-reviewed journal articles. Kennedy CC, Ioannidis G, Giangregorio LM, Adachi JD, Thabane L, Morin SN, Crilly RG, Marr S, Josse RG, Lohfeld L, Pickard LE, King S, van der Horst M-L, Campbell G, Stroud J, Dolovich L, Sawka AM, Jain R, Nash L, Papaioannou A: An interdisciplinary knowledge translation intervention in long-term care: study protocol for the vitamin D and osteoporosis study (ViDOS) pilot cluster randomized controlled trial. Implement Sci. Sixty two of the 146 papers (43%) were classified as referenced, meaning that the framework was cited with little, if any, further explanation (see Table 2). BF, II and AB conceived the review; AB designed the study; AB undertook the searches; BF and II screened and extracted the data; BF wrote the review; and BF, II, AB and KG made comments and edited the review drafts. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. A continuum of usage, ranging from referenced to integrated, was developed to aid this process. 2009, Wiley-Blackwell BMJ Books, Chichester, UK, 83-93. We recommend using the latest version of IE11, Edge, Chrome, Firefox or For example, the creation of websites, interactive e-learning modules, training packages and a protocol were reported as part of the Action Cycle [19],[23],[24], yet they could be knowledge tools/products. J Clin Epidemiol. 10.2340/16501977-0451. The search strategy was limited to citation searching of three databases. The first component of the model is the knowledge creation funnel, which represents the production and synthesis of knowledge. The KTA Framework is composed of two distinct, but related components: (i) Knowledge Creation, and (ii) the Action Cycle. looked at 10 behaviour change interventions where explicit use of theory was absent, and mapped these strategies to domains of the Theoretical Domains Framework. to the This review is designed to address this knowledge gap. Understanding effects in reviews of implementation interventions using the Theoretical Domains Framework. For an overview of other determinant frameworks that are useful in this phase, see the determinant frameworks section of Nilsens paper [7]. Difficulties applying the exclusion criteria were discussed to ensure the inclusion/exclusion criteria were applied consistently. 2010, 5: 92-10.1186/1748-5908-5-92. 61656, Rockford, Worldviews Evid Based Nurs. It sets out the key It would be interesting to review the conceptual papers we excluded to explore how they were influenced by the framework and informed the development of conceptual frameworks more generally. Program planning for health education and promotion. Data collection Step KTA 3.A - Center on Knowledge Translation for Technology Transfer Most of the theories were interdisciplinary or from nursing and were published between 1983 and 2006 [11]. In these studies, the KTA Framework appeared to provide a practical yet flexible guide to getting research findings into practice, allowing it to be applied in idiosyncratic ways. Further information about how the different studies applied the phases within the Action Cycle are shown in Table 6. Also, this conceptual framework may appeal because of a lack of jargon and a simple diagram depicts the knowledge translation process. 2010, 29: 1-8. The findings informed their conceptual framework, which was intended to address the need for conceptual clarity in the KTA field and to offer a framework to help elucidate what we believe to be the key elements of the KTA process [1] (p. 14). The index citation for the source paper for the KTA Framework Lost in knowledge translation: time for a map? by Graham and colleagues [1] was identified on each of three databases that offered functionality for citation searching. Safari. Action includes identifying and appraising the problem and the known research, identifying barriers and successes, planning and executing, and finally monitoring, evaluating, and adjusting. The KTA process has two components: (1) knowledge creation and (2) action. review papers, conceptual or descriptive papers and those describing a single knowledge translation strategy or not topically relevant), we excluded against a single criterion, even when multiple criteria applied, as practical considerations rendered it unnecessary to exhaustively document all possible reasons for exclusion for each paper. The K2A framework describes and depicts the high-level processes necessary to move from discovery into action by using translation of evidence-based programs, practices, or policiesbroadly defined to include evidence-based communications, campaigns, guidelines, and other interventions and tools. Secondly, multifaceted strategies are more likely to be successful than a single strategy [27],[46],[47], as they target different barriers [40], which reflects our interest in the real-world use of the KTA Framework, where it is probably impossible to control and isolate one strategy [48]. Implement Sci. 10.1007/s10865-010-9260-1. It focuses on two main areas of activity: knowledge creation and knowledge tailoring . The knowledge to action cycle begins with the identification of a problem (usually a gap in care provision). 2010, 33: 259-263. 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]. 2014, 9: 2-10.1186/1748-5908-9-2. Adapting to local context is a critical step in the process. Implement Sci. 2007, 14: 936-941. Harrison, S.E. Knowledge-related barriers [32] were the most common, indicating the appropriateness of using educational strategies to address such barriers. Taylor MJ, McNicholas C, Nicolay C, Darzi A, Bell D, Reed JE: Systematic review of the application of the plan-do-study-act method to improve quality in healthcare. CIHR also provides a practical guide to designing a KT intervention for health researchers, with relevant examples of its application. 60607, Chicago, This study is a citation analysis and systematic review. Initial screening out by title and abstract on the basis of partial information from Google Scholar may also have excluded relevant studies. These include things like clinical practice guidelines, decision aids and videos. A taxonomy categorising the continuum of usage was developed. Limitations of English language and year of publication 2006-June 2013 were set. 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]. 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). 2010, Dissertation for Masters of Science, School of Nursing, Queens University, Ontario, Canada. Ilott I, Gerrish K, Booth A, Field B: Testing the consolidated framework for implementation research on health care innovations from South Yorkshire. 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). 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]. Eight of the ten studies were conducted in Canada, one in the Democratic Republic of Congo [17] and one in Denmark [18]. Leah Crockett is a doctoral student in the Department of Community Health Sciences at the University of Manitoba. Generally, it was difficult to ascertain whether the methods used captured, and indeed subsequently addressed, the full range of barriers. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. 2012, 43: 337-50. The KTA process has two components: Knowledge Creation and Action. 10.1111/j.1553-2712.2007.tb02369.x. Ian D. Graham PhD, Ian D. Graham PhD. Nine were published in peer-reviewed journals with the exception being a Master of Science degree dissertation [19]. Action Cycle within the KTA Model The second step involves adapting the validated knowledge to the local context. We focus on all things knowledge translation (KT) and patient engagement (PE), from a health research and healthcare perspective. Armstrong R, Waters E, Dobbins M, Anderson L, Moore L, Petticrew M, Clark R, Pettman TL, Burns C, Moodie M, Conning R, Swinburn B. Kitson A, Powell K, Hoon E, Newbury J, Wilson A, Beilby J. LaRocca R, Yost J, Dobbins M, Ciliska D, Butt M. Kothari AR, Bickford JJ, Edwards N, Dobbins MJ, Meyer M. National Collaborating Centre for Methods and Tools (2010). 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. The knowledge to action (KTA) is a process model that helps you select implementation strategies. 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]. Today well highlight one of the most highly cited conceptual frameworks in Canada the Knowledge-to-Action (KTA) Framework. 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. 2013, 69: 194-204. 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). Only ten studies reported and gave supportive examples of incorporating the KTA Framework in an integrated way. The action cycle includes a range of activities needed for knowledge implementation. Citation searches were limited to the period from 2006 (the date of publication of the source paper) to July 2013. 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]. 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). Health professionals across the globe share the challenges of translating the best available evidence into actual health interventions in a timely way to provide the most effective care and service. The knowledge to action cycle is one framework for knowledge translation that integrates policy makers throughout the research cycle. Citation searching seeks to optimise sensitivity and specificity when seeking to identify reports of practical applications of a model or framework. The first phase explores the creation of knowledge tools or products, such as an intervention or a clinical guideline . Davidoff F, Batalden P, Stevens D, Ogrinc G, Mooney SE: Publication guidelines for quality improvement studies in health care: evolution of the SQUIRE project. Preventing Chronic Disease: March 2011: 10_0012 Lost in knowledge Translation: time for a map? 2012, 28: 258-61. 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. The KTA Framework was adapted to different health service settings and resources, indicating a good fit for the diversity of real-world health care. Furthermore, knowledge can inform each phase of the action cycle and the knowledge funnel can rotate to feed into different phases. Citations were excluded where there was insufficient information to make a judgment about inclusion/exclusion criteria. The inclusion criteria were based on an affirmative answer to two questions Does the paper describe a KT project? and Is the KTA Framework a fundamental guide to this project? The initial sift phase was carried out by one researcher (BF), with another researcher coding a proportion of these (II). PDF Knowledge Translation Frameworks: What Are They, How and When to - Hse Crosby R, Noar SM: Theory development in health promotion: are we there yet?. Knowledge Translation in Health Care: Moving from Evidence to Practice. However, the method is replicable and could be repeated to update the review in future. Google Scholar. Int J Nurs Educ Scholarsh. Too many KT strategies use the traditional ISLAGIATT (It Seemed Like A Good Idea At The Time)* approach, and result in uninformed interventions that are often too broad and too ambitious. Within KTA, knowledge creation - or the production of knowledge - is composed of three phases: knowledge inquiry (first-generation knowledge), knowledge synthesis (second-generation knowledge), and creation of knowledge tools and/or products (third-generation knowledge). One hundred and forty-six studies described usage to varying degrees, ranging from referenced to integrated. This was necessary given the limited resources available to support the review process. Rycroft-Malone J, Bucknall T: Models and Frameworks for Implementing Evidence-Based Practice. Molfenter S, Ammoury A, Yeates E, Steele C: Decreasing the knowledge to action gap through research-clinical partnerships in speech-language pathology. Knowledge syntheses take the form of studies that fall into the categories of systematic reviews, scoping reviews, and meta-analyses, just to name a few. 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. From the perspective of the psychology of knowledge (e.g., Strube & Wender, 1993), knowledge is a competence for action, a . Some indication of the impact of this article can be gained from constructing a normalised citation count for comparison purposes. In contrast, they wanted to evaluate the impact of their intervention on peoples ability to understand their choices and make informed decisions about treatment. Davies and colleagues [40] note that less than 6% of 235 studies, albeit published before 1998, explicitly used theories of behaviour or behaviour change. Effectiveness: The extent to which the intended effect or benefits that were achieved under optimal . Summary of the Knowledge To Action Model and its application to . Work Group on Translation Tools | CDC 2013, 13: 118-10.1186/1471-2288-13-118. Google Scholar. We have chosen to report the aggregate number of excluded papers on the PRISMA flow diagram (Figure 2). Tugwell PS, Santesso NA, OConnor AM, Wilson AJ: Knowledge translation for effective consumers. Citation searching for the original reference by Graham and colleagues [1] optimised the sensitivity and specificity of the search strategy. 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. BMJ. 10.1002/chp.47. Action model learning - Wikipedia 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. As knowledge moves through three stages (inquiry, synthesis, tools/products), it becomes more user-friendly. 10.1111/wvn.12016. 2012, 8: 174-84. It may also be a reflection of the challenges for defining and reporting outcomes for knowledge translation projects. On this basis, all ten studies were judged as having described their projects clearly. Knowledge Translation in Health Care: Moving from Evidence to Practice. Cookies policy. Making sense of implementation theories, models and frameworks Moving from Evidence to Practice. 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. 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. What is Knowledge Translation? | School of Physical & Occupational Knowledge becomes more refined as it moves through these three steps. 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]. Involvement of stakeholders, and tailoring knowledge to the needs of people who are going to use it, is crucial. 61801, 2016 The Board of Trustees of the University of Illinois. McLean R, Tucker J: Evaluation of CIHRs Knowledge Translation Funding ProgramCIHR.[http://www.cihr-irsc.gc.ca/e/47332.html#a2.1]. The Journal of Continuing Education in the Health Professions 2006, 26, p. 19. Am J Prev Med. Manage cookies/Do not sell my data we use in the preference centre. Finfgeld-Connett D, Johnson ED: Literature search strategies for conducting knowledge-building and theory-generating qualitative systematic reviews. 10.7748/ns2002.05.16.37.38.c3201. Although there may be some small variation in the actual sets of references retrieved by different citation searches, we have no reason to believe that we have systematically under- or over-represented particular types of studies in our sample. Important considerations for choosing a KT strategy (or strategies) include a clearly defined goal or objective for each strategy, an understanding of how the strategy overcomes one or more barriers to behaviour or attitude change, and the use of theory to inform selection and implementation. All ten studies reported applying the Action Cycle, describing at least five of the seven possible phases (see Table 5). 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. Thirty nine (27%) were categorised as informed because the KTA Framework had influenced the project in a non-specified way without citing examples of how it had been applied. Making sense of implementation theories, models and frameworks. A few authors have attempted this, such as McEvoy and colleagues [43] who examined benefits reported by authors using the Normalization Process Theory. A notable feature of the KTA Framework is the development of knowledge tools or products as part of Knowledge Creation. Petzold A, Korner-Bitensky N, Menon A: Using the knowledge to action process model to incite clinical change. Unfortunately, an implemented change is not usually self-sustaining and requires ongoing monitoring and effort. The action cycle is iterative and includes the deliberate application of knowledge to cause change in behaviours and/or attitudes. The papers were coded according to the taxonomy in Table 1. One can also move between the knowledge creation phase and the action cycle, in an iterative fashion. For Web of Science and Scopus citations, full abstracts were identified. Others related to specific conditions, such as stroke [23],[24], children with cerebral palsy and motor difficulties [25] and osteoarthritis [26]. It may be that when people are consulted, they identify those barriers that they feel able to influence, such as knowledge or awareness, rather than organisational barriers, which could be perceived as more problematic or more distant. 10.1046/j.1365-2648.2002.02150.x. 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. Bjrk IT, Lomborg K, Nielsen CM, Brynildsen G, Frederiksen A-MS, Larsen K, Reierson I, Sommer I, Stenholt B: From theoretical model to practical use: an example of knowledge translation. 10.1177/1077558711430690. Application of knowledge translation (KT) theories, models, and frameworks (TMFs) is one method for successfully incorporating evidence into clinical care. The "Knowledge to Action" Cycle: A Conversation with Dr. Ian Graham By using this website, you agree to our Can J Speech-Language Pathol Audiol. 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. We found that the framework is being used in practice, to varying degrees of completeness, and with theory fidelity when reported as integral to the implementation effort. The study was funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for South Yorkshire and Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Yorkshire and Humber. Importantly, these integrated studies included examples to illustrate how the KTA Framework had been used as a guide. Using the knowledge to action process model to incite clinic - LWW Graham et al. 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]. In addition, this suggests conceptual frameworks do not have to be mutually exclusive. Knowledge to Action Framework - Monash Centre for Health Research and The authors declare that they have no competing interests. It was cited 470 unique times across the three databases, indicating the bibliometric impact of the source paper. We further identified a need to use taxonomies when analysing or evaluating knowledge translation strategies [33],[34]. Using the Knowledge to Action Process Model to Incite - ResearchGate Given the incomplete abstracts obtained via Google Scholar, a rule-out strategy was employed. There was substantial variation in the setting and target audience for each documented change, the methods used to apply the KTA Framework and the terminology employed to report the phases within Knowledge Creation and the Action Cycle. Assessment of barriers can be done quantitatively and qualitatively using a variety of conceptual models and instruments. References to non-English language articles were removed. 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). Straus S, Tetroe J, Graham ID: Knowledge Translation in Health Care. 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]. 10.1016/j.cjca.2012.03.011. PO Box 1649, Peoria, PDF SYSTEMATIC REVIEW Open Access Using the Knowledge to Action Framework Between 2009 and 2013, she was a Knowledge Translation Project Lead with the NIHR CLAHRC SY. Two studies reported using all phases of Knowledge Creation [20],[26] (see Table 4). Cite this article, Conceptual frameworks are recommended as a way of applying theory to enhance implementation efforts. 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. 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. McCormack B, Kitson A, Harvey G, Rycroft-Malone J, Titchen A, Seers K: Getting evidence into practice: the meaning of context. Download scientific diagram | Knowledge-to-Action Model (Adapted from I.D. The Knowledge to Action KTF The Knowledge to Action (KTA)4 is an overarching framework that includes both knowledge creation and implementation. Health Psychol. knowledge to action gap through research-clinical partnerships in speech-language pathology. Five studies applied one or more phases [18],[20],[22],[24],[26]. 10.1016/j.jclinepi.2004.09.002. We did not assess the research rigour of the individual knowledge translation projects. 10.2522/ptj.20070056. The Action Cycle focuses on the processes needed to implement knowledge in healthcare settings including identifying problems; assessing determinants of KT; selecting, tailoring, implementing, and evaluating KT interventions; and determining strategies for ensuring sustained knowledge use.

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