Chapter 7: Knowledge Translation
Last updated: March 1, 2023
7 Knowledge Translation
Knowledge Translation (KT; also called knowledge mobilisation, amongst other terms) can include dissemination and/or implementation of evidence. Integrated KT involves partnering with knowledge users in work from conception of research (including guideline development) through to its conduct and dissemination. The Task Force uses an integrated KT approach whereby relevant knowledge users (e.g., primary care clinicians, patients/public partners) are engaged throughout the guideline development process.
The Task Force Knowledge Translation Working Group (see section 1.6.2.3) develops partnerships and strategies aimed at advancing and supporting the dissemination and uptake of Task Force guidelines and other knowledge products into clinical primary care practice. The KT Team executes the work approved by the KT Working Group and works closely with the Communications team on matters related to public relations.
Approaches to engagement and co-creation are mentioned throughout the manual (e.g., see section 6.3 for more detail on stakeholder engagement). Methods for new initiatives such as the Task Force Public Advisors Network and Clinical Prevention Leaders Network will be added to the manual following completion of the pilot phase. This chapter provides more detail on diffusion, dissemination and implementation strategies, development of KT tools and evaluation of KT activities.
7.1 Diffusion, Dissemination, and Implementation
The Task Force KT strategies include a combination of different methods of diffusion, dissemination, and implementation. Diffusion focuses on passive strategies, such as publication of guidelines in peer-reviewed publications and newsletters, with targeting of open access journals. The Task Force website also serves as passive diffusion. Dissemination involves activities that tailor the message and medium to a particular audience, such as the creation of decision support tools, infographics, and mass media communications, including social media. Implementation moves research into decision-making when the strength of the evidence is sufficient, such as enabling local opinion leaders to support the application of Task Force guidelines.
For each of these approaches, the Task Force considers the following questions:
- Who are the end-users (or knowledge users) of the guideline and who will be interested in its results?
- What are the key messages for each of the relevant end-user groups?
- Who are the principal target audiences, organizations, and groups for each of these messages?
- What are the barriers and facilitators to uptake of the guideline for each of these end-user groups?
- What KT strategy will be used to address these barriers and/or facilitators to the uptake of the guideline?
Considering the above questions, the KT Working Group then uses a multi-pronged, tailored approach to disseminate information to knowledge users that is evidence-based and theory informed. Diffusion and dissemination strategies include the following:
- In conjunction with the Communications team, sharing communication about Task Force activities (e.g., new guidelines and KT tools, other Task Force publications and products, new Task Force projects) through a dedicated website, E-newsletters, and social media campaigns;
- Engaging a wide audience through a comprehensive public communications campaign with the release of each guideline, which includes, but is not limited to, developing press releases, media materials, social media plans, and media training for Task Force members;
- Coordinating media planning with stakeholders around guideline release;
- Engaging knowledge users and developing strategic partnerships through ongoing communications with knowledge users, seeking out and responding to their feedback on guidelines and related materials, and engaging key audiences (e.g., primary care providers, patients/public partners) in KT tool development through co-creation (in some instances) and usability testing (usability testing process further described below);
- Co-developing KT tools with primary care providers, the general public, and policy-makers;
- Publishing guidelines and methods (including of KT methods and evaluation results) in peer-reviewed journals;
- Presenting guidelines, methods and KT tools at major scientific meetings;
- Seeking out endorsement or other forms of support from relevant organizations for new guidelines (see section 6.3.3.4);
- Providing webinars to knowledge users close to the release of new guidelines;
- Sending copies of newly released guidelines and KT tools to knowledge users;
- Developing and testing approaches to facilitate dissemination and implementation of guidelines through use of opinion leaders and educationally influential individuals (e.g., pilot of Clinical Prevention Leader Network).
While widespread guideline implementation is not the primary focus of the KT Working Group, the development of KT tools supports guideline implementation. Pilot initiatives, such as the Clinical Prevention Leader Network are also being tested to support implementation.
7.2 Development of KT Tools
A wide array of KT tools are developed by the Task Force and KT Team to assist primary care providers in deepening their understanding of the Task Force guidelines and methodology and to facilitate their integration into clinical practice. The development process is based on the knowledge-to-action framework (1), and uses co-design principles with primary care clinicians and patients. The resulting tools incorporate the emerging best practices for KT. The protocol for the development of KT Tools is provided in the Appendix. These tools may include but are not limited to:
- Algorithms,
- Harms and benefits posters,
- Clinician and patient frequently asked questions (FAQ) sheets,
- 1000-person diagrams,
- Decision-aids.
KT tools are available on the Task Force website (https://canadiantaskforce.ca/tools-resources/).
7.3 Evaluation of KT Activities
The KT Team leads an annual evaluation of Task Force activities, as outlined in Table 1, to assess the impact of dissemination activities and the uptake of guidelines by stakeholders, and to ensure that all KT activities are consistently aligned with key objectives. The Task Force will consider the following:
- Are the KT strategies selected having a sustained effect on the dissemination and uptake of the Task Force guidelines?
- How can the Task Force optimize sustainability?
- How can previous successful strategies be leveraged for future guidelines?
The annual evaluations use the RE-AIM evaluation framework (2,3) to guide design and analysis of data. This framework accounts for reach, effectiveness, adoption, implementation, and maintenance of guidelines, KT tools and other Task Force products. Data are collected through document reviews, collection of metrics (on publications, presentations, website usage, etc.), and surveys and interviews with primary care providers in English and French. These activities are described further in Table 1.
The results of the annual evaluation are reviewed by the Task Force members, and if necessary, adjustments made to the KT strategy. The annual evaluation report is posted on the Task Force website (https://canadiantaskforce.ca/get-involved/annual-evaluation/).
Table 1. Summary of activities to evaluate knowledge translation (KT)
| Objective | Outcome | Measurement method/Data source | Timeline |
|---|---|---|---|
| To determine if statements of the Task Force’s objectives are aligned with its implementation efforts | Alignment | Document review | Completed once, before beginning the evaluation |
| To determine the reach of KT activities aimed at disseminating guidelines to the primary knowledge users (primary care providers) | Reach | Publications Presentations Stakeholder dissemination Website usage measures Media hits | Annually, for all guideline topics |
| To determine primary care providers level of awareness and knowledge of key recommendations, the current source(s) of information they use to guide their practice (in the context of the guideline topic), and their general perceptions of the guideline, the Task Force, and KT processes used | Awareness of:
| Surveys/interviews | |
| Knowledge of guideline recommendations | Surveys/interviews | ||
| Agreement with guidelines | Surveys/interviews | ||
| To determine the outcomes of more active KT activities aimed at increasing use and uptake of guideline knowledge by primary care providers and their patients, where these activities include dissemination of KT tools for primary care providers (e.g., algorithms, summaries, and clinical decision support tools) and patients (e.g., summaries, FAQ sheets, and decision aids) | Self-reported actual and planned practice change | Surveys/interviews | Annually, for selected guideline topics for which evaluation of KT tools is feasible and appropriate or where KT activities represent major changes to previous practice |
References
- Graham ID, Logan J, Harrison MB, Straus SE, Tetroe J, Caswell W, et al. Lost in knowledge translation: time for a map? J Contin Educ Health Prof. 2006;26(1):13–24.
- Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999 Sep;89(9):1322–7.
- RE-AIM. RE-AIM [Internet]. [cited 2023 Feb 16]. Available from: https://re-aim.org/
Appendix
Appendix: Protocol for Development of Knowledge Translation (KT) Tools