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.


Table 1. Selected 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:
  • Research priority setting
  • Research
  • Knowledge priority setting
  • Knowledge synthesis
  • Knowledge distribution and application
  • Use
  • Evaluation of uptake
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:
  • Practice environment
  • Potential adopters of the evidence
  • Evidence-based innovation
  • Research transfer strategies
  • Evidence of adoption
  • Health-related and other outcomes
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:
  • Identification of quality information/research evidence
  • Assessment of research findings for target system
  • Program development; program/content adaptation
  • Program implementation
  • Evaluation of knowledge utilization
  • Sustainability; capacity building
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:
  • What should be transferred to decision makers (the message)?
  • To whom should research knowledge be transferred (the target audience)?
  • By whom should research knowledge be transferred (the messenger)?
  • How should research knowledge be transferred (the KT process and support system)?
  • With what effect should research knowledge be transferred (evaluation)?
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:
  • User group
  • Issue
  • Research
  • Researcher-user relationship
  • Dissemination strategy

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?