Knowledge Translation
The term knowledge translation (KT) is increasing in importance and use in the fields of public health, medicine, and rehabilitation research (Brandt & Pope, 1997; CIHR, 2004; Davis et al., 2003; Glasgow, Lichtenstein, & Marcus, 2003; Jacobson, Butterill, & Goering, 2003; Tingus, Berland, Myklebust, & Sherwood, 2004).
KT is a relatively new term that is used to describe a relatively old problem—the underutilization of evidence-based research in systems of care. Underutilization of evidence-based research is often described as a gap between "what is known" and "what is currently done" in practice settings (Davis et al., 2003; Grol, 2000; Grol & Grimshaw, 2003).
KT has also emerged as an important concept for the National Institute on Disability and Rehabilitation Research (NIDRR). NIDRR has remarked that KT plays an important role in enhancing the lives of individuals with disabilities, as science-based knowledge, technologies, and applications must be translated in order to inform disability and rehabilitation policy and improve practice (Tingus et al., 2004).
References
Brandt, E., & Pope, A. M. (Eds.). (1997). Enabling America: Assessing the role of rehabilitation science and engineering. Washington, DC: National Academy Press.
CIHR. (2004). Knowledge translation strategy 2004 —2009: Innovation in action. Ottawa, ON: Canadian Institutes of Health Research.
Davis, D., Evans, M., Jadad, A., Perrier, L., Rath, D., Ryan, D., et al. (2003). The case for knowledge translation: Shortening the journey from evidence to effect. British Medical Journal, 327(7405), 33—35.
Glasgow, R. E., Lichtenstein, E., & Marcus, A. C. (2003).
Grol, R. (2000). Twenty years of implementation research. Family Practice, 17, S32 —S35.
Grol, R., & Grimshaw, J. (2003). From best evidence to best practice: Effective implementation of change in patients' care. Lancet, 362(9391), 1225 —1230.
Jacobson, N., Butterill, D., & Goering, P. (2003). Development of a framework for knowledge translation: Understanding user context. Journal of Health Services Research & Policy, 8(2), 94 —99.
Tingus, S. J., Berland, B. J., Myklebust, J., Sherwood, A. (2004, August). NIDRR long-range planning update for KDU. Paper presented at the Knowledge Dissemination and Utilization Projects Meeting: Translating Disability Research into Practice, Pentagon City, VA.
Adapted from NCDDR's FOCUS: Technical Brief Number 10, What is Knowledge Translation?
What is the KT Planning Process?
There are planning models that self-identify as KT approaches (CIHR, 2004; Jacobson et al., 2003) and several more that are frequently cited in reference to KT, such as the Ottawa Model of Research Use (Logan & Graham, 1998) or the Lavis framework (Lavis, Robertson, Woodside, Mcleod, & Abelson, 2003). In addition, numerous authors, particularly in medical and health-care literature, have described the KT process as consisting of multiple stages designed to identify research gaps and plan for evidence-based implementation (Backer, 2000; Glasgow et al., 2003; Little & Houston, 2003; Roy, 1999). These models vary in their descriptions and emphasis; however, most authors agree that KT is a complex and lengthy process, and one that requires innovative and dedicated action on the part of knowledgeable strategic planners and change agents (Brandt & Pope, 1997). Table 1 summarizes several KT planning models.
| Authors(s) | Key characteristics |
|---|---|
| CIHR. (2004). Knowledge Translation Strategy 2004—2009: Innovation in Action. Ottawa, ON: Canadian Institutes of Health Research. http://www.cihr-irsc.gc.ca/e/26574.html | CIHR conceptualizes KT as an acceleration of the Knowledge Cycle Model, which consists of seven bilateral stages. There is recognition in the CIHR definition that KT stages must consider coordinated communication, marketing, and training to facilitate KT. The seven stages are the following:
|
| Logan, J., & Graham, I. D. (1998). Toward a comprehensive interdisciplinary model of health care research use. Science Communication, 20(2), 227—246. | The Ottawa Model of Research Use (OMRU) is a logic model approach for planning dissemination and knowledge utilization and for managing results. It features six primary elements and requires attention to a continuous assessment, monitoring, and evaluation process. The six elements are the following:
|
| Research implementation model. Various authors | Numerous authors have described research implementation as a process consisting of multiple stages designed to reduce the gap between research evidence and practice (Grol, 2000). These models are described using a circular process, a continuous improvement approach (National Cancer Institute, 2002), and an iterative process (Caburnay, Kreuter, & Donlin, 2001; Demakis, McQueen, Kizer, & Feussner, 2000). In general, this model includes six stages for research implementation summarized as follows:
|
| Lavis, J. N., Robertson, D., Woodside, J. M., Mcleod, C. B., & Abelson, J. (2003). How can research organizations more effectively transfer research knowledge to decision makers? Milbank Quarterly, 81(2), 221—248. Lavis, J. N., Ross, S. E., Hurley, J. E., Hohenadel, J. M., Stoddart, G. L., Woodward, C. A., et al. (2002). Examining the role of health services research in public policymaking. Milbank Quarterly, 80(1), 125—154. |
Though describing his research as knowledge transfer, Lavis' (2003) research is often cited in reference to KT strategies. He notes the following five key determinants that should guide planners:
|
| Jacobson, N., Butterill, D., & Goering, P. (2003). Development of a framework for knowledge translation: Understanding user context. Journal of Health Services Research & Policy, 8(2), 94—99. | Similar to Lavis but specifically invoking the phrase "KT model," Jacobson presents a series of questions for researchers and planners to consider. She notes the following six key domains in a framework for audience-centered knowledge translation:
|
Summary: KT and the NCDDR
Knowledge translation (KT) is a relatively new term that is increasing in importance and use. KT involves more than distribution of practical scientific information and reliance on academic publication as a primary mechanism for disseminating results. KT implies an interactive and engaged process between the research and systems of care (i.e., teams, populations, policymakers, and consumers) (Jacobson et al., 2003). Also, there are several planning models that discuss the KT process and KT strategies. However, there is a need to refine the definition of KT to reflect the disability and rehabilitation research and development priorities supported by NIDRR. In refining this concept, the National Center for the Dissemination of Disability Research (NCDDR) suggests that KT is multi-dimensional and should reflect the context in which end-users of high-quality information will make decisions, solve problems, or use knowledge as practitioners, educators, or consumers in their everyday life (Stetler, 1994). To embrace this wider view, the NCDDR suggests the following as a working definition for KT:
The collaborative and systematic review, assessment, identification, aggregation, and practical application of high-quality disability and rehabilitation research by key stakeholders (i.e., consumers, researchers, practitioners, and policymakers) for the purpose of improving the lives of individuals with disabilities.
In this working definition, KT involves the reporting, quality assessment, and adaptation of research and development knowledge into an understandable and contextually relevant form that reflects the NIDRR research and development priorities and that will be utilized by and benefit practitioners and consumers. As the ongoing discussion about KT continues, the NCDDR will refine this definition and propose KT-related roles and strategies of interest to NIDRR grantees.
References
Backer, T. E. (2000). The failure of success: Challenges of disseminating effective substance abuse prevention programs. Journal of Community Psychology, 28(3), 363—373.
Brandt, E., & Pope, A. M. (Eds.). (1997). Enabling America: Assessing the role of rehabilitation science and engineering. Washington, DC: National Academy Press.
Caburnay, C. A., Kreuter, M. W., & Donlin, M. J. (2001). Disseminating effective health promotion programs from prevention research to community organizations. Journal of Public Health Management & Practice, 7(2), 81—89.
CIHR. (2004). Knowledge translation strategy 2004—2009: Innovation in action. Ottawa, ON: Canadian Institutes of Health Research.
Demakis, J. G., McQueen, L., Kizer, K. W., & Feussner, J. R. (2000). Quality enhancement research initiative (QUERI): A collaboration between research and clinical practice. Medical Care, 38(6 Supplement 1), I17—25.
Glasgow, R. E., Lichtenstein, E., & Marcus, A. C. (2003). Why don't we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93(8), 1261—1267.
Grol, R. (2000). Twenty years of implementation research. Family Practice, 17, S32—S35.
Jacobson, N., Butterill, D., & Goering, P. (2003). Development of a framework for knowledge translation: Understanding user context. Journal of Health Services Research & Policy, 8(2), 94—99.
Lavis, J. N., Robertson, D., Woodside, J. M., Mcleod, C. B., & Abelson, J. (2003). How can research organizations more effectively transfer research knowledge to decision makers? Milbank Quarterly, 81(2), 221—248.
Lavis, J. N., Ross, S. E., Hurley, J. E., Hohenadel, J. M., Stoddart, G. L., Woodward, C. A., et al. (2002). Examining the role of health services research in public policymaking. Milbank Quarterly, 80(1), 125—154.
Little, M. E., & Houston, D. (2003). Research into practice through professional development. Remedial and Special Education, 24(2), 75—87.
Logan, J., & Graham, I. D. (1998). Toward a comprehensive interdisciplinary model of health care research use. Science Communication, 20(2), 227—246.
National Cancer Institute. (2002). Making health communication programs work. Bethesda, MD: U.S. Department of Health and Human Services, Public Health Service, NIH Publication No. 89-1493.
Roy, C. (1999). State of the art: Dissemination and utilization of nursing literature in practice. Biological Research for Nursing, 1(2), 147—155.
Stetler, C. B. (1994). Refinement of the Stetler/Marram model for application of research findings to practice. Nursing Outlook, 42, 15—25.
Adapted from NCDDR's FOCUS: Technical Brief Number 10, What is Knowledge Translation?
Selected Resources on Knowledge Translation
Canadian Institutes of Health Research
Knowledge Translation (KT)
http://www.cihr-irsc.gc.ca/e/26574.html
Overview of Knowledge Translation
http://www.cihr-irsc.gc.ca/e/7518.html
Knowledge Translation Resource Materials
http://www.cihr-irsc.gc.ca/e/8537.html
Knowledge Utilization (KU-UC) Database
HSRF/CIHR Chair on Knowledge Transfer and Innovation, Laval University
http://kuuc.chair.ulaval.ca/english/index.php
The KU-UC Database contains documents on knowledge transfer, innovation, and policy and management of health services, and is located at the bottom of this page.
Institute for Work & Health
Knowledge Transfer & Exchange
http://www.iwh.on.ca/kte/kte.php
A conversation about knowledge transfer
http://www.iwh.on.ca/kte/kte_profile.php
Knowledge Translation Program
Faculty of Medicine, University of Toronto
http://www.ktp.utoronto.ca/
About Knowledge Translation > Tools
A list of tools and strategies commonly used in knowledge translation.
http://www.ktp.utoronto.ca/whatisktp/tools/
Knowledge Translation
References recommended by participants of a retreat held at University of Toronto, June 2003.
http://www.cme.utoronto.ca/rdrb/bibkt.asp
National Institute of Environmental Health Sciences (NIEHS)
Translational Research
http://www.niehs.nih.gov/translat/home.htm
National Cancer Institute Center for Cancer Research (NCI-CCR)
Translational Research Initiative
http://ccr.cancer.gov/initiatives/TRI/
National Center for Complementary and Alternative Medicine (NCCAM)
Regional Translational Research Centers (RTRCs)
http://nccam.nih.gov/rtrc/
Examples of Centers with a KT Focus
In an effort to advance KT, several academic programs and international organizations have established centers that conduct KT-related research, development, and dissemination activities, including the following:
Agency for Healthcare Research and Quality (AHRQ) Translating Research Into Practice (TRIP) Program
An initiative focusing on implementation techniques and factors associated with successfully translating research findings into diverse applied settings (http://www.ahrq.gov/research/trip2fac.htm
Campbell Collaboration (C2)
An international organization that conducts systematic reviews of education, social welfare, and social science research http://www.campbellcollaboration.org
Canadian Institute for Health Research (CIHR)
The major federal agency responsible for funding health research in Canada that has established charges for KT research, development, and dissemination http://www.cihr-irsc.gc.ca/e/29529.html
Cochrane Collaboration
An international organization that conducts systematic reviews of health and medical research http://www.cochrane.org
Knowledge Translation Program (KTP) at the University of Toronto, Canada
A multidisciplinary academic program developed to address the gap between research evidence and clinical practice and the need to focus on the processes through which knowledge is effectively translated into changed practices http://www.ktp.utoronto.ca/aboutTheKTP/mission/
Knowledge Utilization Studies Program at the University of Alberta, Canada
A health research program focusing on nursing, the social sciences, and research utilization in the nursing profession http://www.nursing.ualberta.ca/kusp/
National Health Service (NHS) Centre for Reviews and Dissemination at the University of York
An organization that conducts systematic reviews of research and disseminates research-based information about the effects of interventions used in health and social care in the United Kingdom http://www.york.ac.uk/inst/crd/welcome.htm
What Works Clearinghouse (WWC)
A clearinghouse established by the U.S. Department of Education's (ED's) Institute of Education Sciences to provide educators, policymakers, and the public with a central, independent, and trusted source of scientific evidence of what works in education http://w-w-c.org
Adapted from NCDDR's FOCUS: Technical Brief Number 10, What is Knowledge Translation?