knowledge to action model knowledge to action model
This is noteworthy given Canadian research may be published in French language journals. J Adv Nurs. PubMed Central In contrast, they wanted to evaluate the impact of their intervention on peoples ability to understand their choices and make informed decisions about treatment. 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. 2010, 5: 92-10.1186/1748-5908-5-92. volume9, Articlenumber:172 (2014) Action model learning (sometimes abbreviated action learning) is an area of machine learning concerned with creation and modification of software agent 's knowledge about effects and preconditions of the actions that can be executed within its environment. The search results are illustrated in Figure 2, the PRISMA flow chart. McCormack B, Kitson A, Harvey G, Rycroft-Malone J, Titchen A, Seers K: Getting evidence into practice: the meaning of context. Development of a theory coding scheme. This review sought to answer two questions: 'Is the This may explain the varying degrees to which the framework was used. 10.2522/ptj.20070056. Exploring the impact of the KTA Framework, and other conceptual frameworks, on patients and the public in terms of health improvement and outcomes would also be worthwhile, as would exploring their involvement in the application of the framework, not just as recipients of services but as key stakeholders in each phase. 10.1037/a0016939. Judging between informed and directed was difficult, suggesting further refinement of the categories is required. This illustrates the adaptability of the conceptual framework to different health care settings and topics. The Knowledge to Action (KTA) framework is an effective approach in the implementation science literature to methodically guide the translation of evidence-based research findings into practice, putting knowledge into practical use. In summary, KTA is applying knowledge to real life situations. A total of 1,057 titles and abstracts were screened. The databases were Scopus, Web of Science and Google Scholar. The following analysis focuses on results relating to these ten integrated studies. Program planning for health education and promotion. And if so, how?. Citations were excluded where there was insufficient information to make a judgment about inclusion/exclusion criteria. The importance of organisational or external factors and the ability to influence them is well recognised [1],[3],[33]-[35]. The Knowledge to Action KTF The Knowledge to Action (KTA)4 is an overarching framework that includes both knowledge creation and implementation. Several strategies were used to counter this risk. Knowing your audience and assessing the value, usefulness and appropriateness of the particular knowledge is critical to its uptake and sustained use. So in terms of doing theory-informed KT, as the saying goes if you dont have time to do it right, when will you have time to do it over?, *ISLAGIATT: Attributed to Dr. Martin P. Eccles. 2012, 9: 1-10.1111/j.1741-6787.2011.00240.x. 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. Rycroft-Malone J, Harvey G, Kitson A, McCormack B, Seers K, Titchen A: Getting evidence into practice: ingredients for change. https://doi.org/10.1186/s13012-014-0172-2, DOI: https://doi.org/10.1186/s13012-014-0172-2. 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. It is one of the most frequently cited conceptual frameworks for knowledge translation. statement and the content of this page, Field, B., Booth, A., Ilott, I. et al. 61107, 102 Medical Sciences Building, 506 S. Mathews, Urbana, When the framework was integral to knowledge translation, it guided action in idiosyncratic ways and there was theory fidelity. Glossary for Knowledge to Action Framework; Research Phase. Furthermore, knowledge can inform each phase of the action cycle and the knowledge funnel can rotate to feed into different phases. As such, the process of moving evidence to action is iterative, dynamic, and complex. the site home page. This may reflect a publication bias, between reporting process and outcomes. Article Russell and colleagues [25] describe use of a knowledge broker, an example of a linkage and exchange-type strategy. 2010, Dissertation for Masters of Science, School of Nursing, Queens University, Ontario, Canada. In addition, this suggests conceptual frameworks do not have to be mutually exclusive. Michie S, Prestwich A: Are interventions theory-based? The KTA Framework was adapted to different health service settings and resources, indicating a good fit for the diversity of real-world health care. Finfgeld-Connett D, Johnson ED: Literature search strategies for conducting knowledge-building and theory-generating qualitative systematic reviews. 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. J Rehabil Med. Two researchers (BF and II) conducted an initial assessment of the full-text articles. For example, in the context of clinical practice guidelines (CPGs), adapting existing national guidelines (which may lack applicability and how organizations need to change to adopt guidelines) to fit local circumstances serves not only to increase the relevance and applicability of guidelines, but also gives end-users a sense of ownership to help promote implementation. In ten studies, the KTA Framework was integral to the design, delivery and evaluation of the implementation activities. Potential benefits from applying a conceptual framework include making the process of knowledge translation more systematic, with greater likelihood of changed practice and spread of evidence [4],[6]-[9]. Translation - Moving the best evidence into professional practice. Monitoring the use of knowledge is critical in understanding how and to what extent the KT strategy has had an impact on outcomes (the next phase in the action cycle). Also, this conceptual framework may appeal because of a lack of jargon and a simple diagram depicts the knowledge translation process. 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. This inner component of the model is broken down into 3 phases: (1) knowledge inquiry, (2) knowledge synthesis, and (3) the creation of knowledge tools and products. 2nd ed. Most of the theories were interdisciplinary or from nursing and were published between 1983 and 2006 [11]. Box. Part of 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]. Rycroft-Malone J: Implementing evidence-based practice in the reality of clinical practice. KG is a professor of nursing research at the University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust where she leads the Translating Knowledge into Action theme of NIHR CLAHRC for Yorkshire and Humber. Hua D, Carter S, Bellerive J, Allu SO, Reid D, Tremblay G, Lindsay P, Tobe SW: Bridging the gap: innovative knowledge translation and the Canadian hypertension education program. Most studies created a range of products, either as part of Knowledge Creation [18],[20],[21],[26] or the Action Cycle [21],[23],[24]. The final list of integrated studies was agreed by two authors (BF and II), and the synthesis was discussed in detail by the team. The search strategy was limited to citation searching of three databases. Change may occur at more than one level, and for more than one intended end-user, and may require multiple methods of monitoring knowledge use. 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. 10.1111/j.1365-2648.2012.06037.x. Next, 911 records were excluded at the sift stage. McLean R, Tucker J: Evaluation of CIHRs Knowledge Translation Funding ProgramCIHR.[http://www.cihr-irsc.gc.ca/e/47332.html#a2.1]. This article is published under license to BioMed Central Ltd. This scheme may be useful for similar studies examining theory use. Data for each phase were then synthesised across studies to help understand how the framework had been used in practice. 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. IL 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. Springer Nature. 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. 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. As knowledge moves through the funnel, it is refined and summarized to be more useful for end-users. 2009, 6: Paper 10-10.2202/1548-923X.1741. Knowledge-related barriers [32] were the most common, indicating the appropriateness of using educational strategies to address such barriers. Based on knowledge to action, there were 3 phases to the study implementation: problem identification (lack of routine checklist use in Cameroonian hospitals), multifaceted implementation strategy (3-day multidisciplinary training course, coaching, facilitated leadership engagement, and support networks), and outcome evaluation 4 months Bartholomew LK, Mullen PD: Five roles for using theory and evidence in the design and testing of behaviour change interventions. Ian D. Graham PhD, Ian D. Graham PhD. 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. 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 2010, 29: 1-8. Lost in knowledge Translation: time for a map? The taxonomy enabled us to refine the inclusion criteria to identify studies that reported explicit application of the KTA Framework. Search for more papers by this author. 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 2002, 16: 38-43. The target audience included the public and patients, the families of older adults, health professionals, occupational therapists, speech and language therapists, physiotherapists and educationalists/academics within universities. Associated knowledge tools included summaries of evidence targeted at specific audiences, continuing health care education modules, information posted on websites and decision aids. Citation searching for the original reference by Graham and colleagues [1] optimised the sensitivity and specificity of the search strategy. Nilsens paper provides an overview of evaluation frameworks to guide evaluation of implementation strategies [7]. Jacqueline Tetroe MA, Estabrooks and colleagues [28] comment that the Canadian research funding organisation had adopted the KTA Framework to guide knowledge translation, deploying specific grant mechanisms to ensure involvement of knowledge users with researchers throughout the research process (p. 2). All citations identified were screened by title and available information according to agreed criteria. 2013, 13: 118-10.1186/1471-2288-13-118. The knowledge to action (KTA) is a process model that helps you select implementation strategies. 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. 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. However, the method is replicable and could be repeated to update the review in future. 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. Do they work? Retrieved from http://www.nccmt.ca/registry/view/eng/70.html. The full text of the 146 papers was examined to establish the extent to which the use of the KTA Framework was attributed by the authors. A few authors have attempted this, such as McEvoy and colleagues [43] who examined benefits reported by authors using the Normalization Process Theory. [http://www.rcn.org.uk/__data/assets/pdf_file/0014/512600/2013_RCN_research_W06.pdf]. Authors identified many barriers relating to environmental factors [32] such as lack of time and/or resources. 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. The lead author (BF) contributed to this study while undertaking the National Institute for Health Research/Health Education England Clinical Academic Training Programme Master in Clinical Research scheme. Duplicates between records from the databases were identified and the most complete record was retained for the subsequent sift process. 10.1111/j.1553-2712.2007.tb02369.x. 2013, 19: 915-24. Cite this article, Conceptual frameworks are recommended as a way of applying theory to enhance implementation efforts. 60607, Chicago, The views and opinions expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. It is important to note that Graham and colleagues have continued to publish on applications of the framework and the multiple factors to be considered [29]. 10.1016/j.cjca.2012.03.011. Building a conceptual model Forms of knowledge Research evidence Clinician knowledge, skills, experience This is a limitation of using Google Scholar for citation searches. Conceptual frameworks provide a frame of reference for organising thinking, a guide for action and interpretation. 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). Kitson AL, Rycroft-Malone J, Harvey G, McCormack B, Seers K, Titchen A: Evaluating the successful implementation of evidence into practice using the PARiHS framework: theoretical and practical challenges. The result set was reduced to 1,057 records following removal of duplicate and non-English language records. 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]. However, adaptation of guidelines also runs the risk of deviating from the original evidence base to address this, a systematic approach to guideline adoption has been developed by a Canadian collaboration called ADAPTE [4]. 2009, 338: a3152-10.1136/bmj.a3152. Skip to This review seeks to answer two questions: Is the KTA Framework being used in practice? and If so, how is the KTA Framework being used in practice? We were interested in the real-life application of this conceptual framework to real-world implementation challenges. The least reported phase, or the phase carried out least often, was sustain knowledge use. In the absence of formal comparisons of citation search techniques, we decided to operationalise citation searching using Google Scholar. 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]. Our experience certainly confirms that this search method circumvents the problems of variation in terminology typically encountered in topic-based searches of bibliographic databases. Leah Crockett is a doctoral student in the Department of Community Health Sciences at the University of Manitoba. We acknowledge that faced with the same task, another review team might choose to include papers reporting a single knowledge translation strategy. questionnaires). 2014, 9: 2-10.1186/1748-5908-9-2. Petzold, A., Korner-Bitensky, N., & Menon, A. Estabrooks CA, Teare GF, Norton PG: Should we feed back research results in the midst of a study?. McEvoy R, Ballini L, Maltoni S, O Donnell CA, Mair FS, Macfarlane A: A qualitative systematic review of studies using the normalization process theory to research implementation processes. 2004, 19: 297-304. This framework was developed in Canada by Graham et al. II is an occupational therapist. Any differences were discussed and resolved by consensus. Implement Sci. We focus on all things knowledge translation (KT) and patient engagement (PE), from a health research and healthcare perspective. This is typically the recommended starting point for implementation and involves identifying a problem that needs attention. One hundred and forty-six studies described usage to varying degrees, ranging from referenced to integrated. Google Scholar. The Knowledge to Action Framework [1] (the KTA Framework) is a conceptual framework intended to help those concerned with knowledge translation deliver sustainable, evidence-based interventions. Further details can be found at www.clahrc-yh.nihr.ac.uk. Terms and Conditions, 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). Graham et al. (2013), "The effectiveness of knowledge translation strategies used in public health: a systematic review" (2012), "Uncovering Tacit Knowledge: A Pilot Study to Broaden the Concept of Knowledge in Knowledge Translation" (2011), "Assessing the public health impact of health promotion initiatives" (2010), Agency for Healthcare Research and Quality (AHRQ) - Translating Research into Practice, Canadian Institute for Health Research (CIHR) - Knowledge Translation & Commercialization, Center on Knowledge Translation for Disability and Rehabilitation Reseach (KTDRR) - KT Library, Cochrane Public Health Group - Knowledge Translation, McMaster University - Collaborations for Health (CfH) - Knowledge Translation, National Collaborating Centre for Methods and Tools - Knowledge Translation Methods and Tools for Public Health, University of Alberta - Knowledge Utilization Studies Program, Develop a PLAN - determine key stakeholders, expertise & support, Measure/collect data - baseline, process, outcomes, expenses, Implement - DO - pilot roll-out, educate, support, navigate, Manage & Adjust - ACT - Adapt, Adopt or Abandon based on evidence, Sustain & Grow - Share the results, get feedback, embed in standards or policies, spread more broadly. These were the question and study design, recruitment and selection and methods of data collection and analysis. Davies P, Walker AE, Grimshaw JM: A systematic review of the use of theory in the design of guideline dissemination and implementation strategies and interpretation of the results of rigorous evaluations. All ten studies reported applying the Action Cycle, describing at least five of the seven possible phases (see Table 5). 2009, Wiley-Blackwell BMJ Books, Oxford, 94-113. Action phases may be carried out sequentially or simultaneously; knowledge phases may impact on the action phases. 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. It is possible some potentially relevant studies were excluded during the initial sift stage. However, it is worth noting that clinical guidelines could be categorised as knowledge tools/products and/or implementation strategies depending on if, and how, the guideline features in the framework. A prospective design would strengthen research studies. 10.1007/s10865-010-9260-1. 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. 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. Action Cycle within the KTA Model The second step involves adapting the validated knowledge to the local context. Disconnect between Knowledge and Action Gap between what we know and what we do Under-use of effective treatments -5-50 years to change practice . In other cases, we made an initial judgement, based on the abstract or a Google text fragment, that the paper was not about an empirical, real-life, knowledge translation or implementation project. A few free articles for further reading Chicago, 10.1016/j.jclinepi.2004.09.002. Firstly, there is a risk of bias and subsequent error given the lead author conducted most of the initial screening, all data extraction and synthesis. The framework has two components: Knowledge Creation and an Action Cycle, each of which comprises multiple phases. Closer examination revealed that usage varied considerably, ranging from simple attribution via a reference through to being integral to most aspects of the implementation work. 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. Only one study [26] reported using decision support tools as a knowledge translation strategy, although it is possible others did not report all the details of strategies they used to promote the adoption of their interventions. The one-hour conversation between Dr. Marianne Farkas of Boston University's Center for Psychiatric Rehabilitation and Dr. Ian Graham was presented in . II provided BF with clinical supervision for her MSc dissertation. This study sought to identify and describe available full-spectrum KT TMFs to subsequently guide users. Perhaps more significantly, the KTA Framework is associated with the Canadian Institutes of Health Research [27]. One can also move between the knowledge creation phase and the action cycle, in an iterative fashion. IL Graham I, Logan J, Harrison M, Straus S, Tetroe J, Caswell W, Robinson N: Lost in knowledge translation: time for a map?. 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. Knowledge becomes more refined as it moves through these three steps. Most studies (8/10) were conducted in Canada where the KTA Framework originated. Non-English language studies were excluded, reducing access to examples of applying the KTA Framework published in other languages. 2010, Wiley Blackwell, Chichester, UK. looked at 10 behaviour change interventions where explicit use of theory was absent, and mapped these strategies to domains of the Theoretical Domains Framework. 2013, Wiley-Blackwell BMJ Books, Oxford, 2, Book A strategy informed by theory is also much more likely to be effective in changing behaviours and attitudes. 10.1111/j.1740-8709.2010.00271.x. This reflected our focus on whether the KTA Framework is used in practice and, if so, how it is applied. Download scientific diagram | Knowledge-to-Action Model (Adapted from I.D. Claude and colleagues [17] stated that these phases were beyond the scope of their project. J Behav Med. Over time, barriers to knowledge use may change from those initially identified, so sustaining knowledge use includes an ongoing feedback loop that cycles back through the action phases. Correspondence to 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. 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]. We recognise that assimilation and utilisation of an influential framework is a continuous process and that we have employed essentially a cross-sectional method to survey the literature. For an overview of other determinant frameworks that are useful in this phase, see the determinant frameworks section of Nilsens paper [7]. Studies were published between 2007 and 2013. Google Scholar. A further eighteen (12%) were categorised as directed because the KTA Framework influenced the project design or helped to plan, structure or conceptualise what was done, but with no examples given. Implement Sci. Non-stop action: The best choice for iCaf, configure-to-order gaming systems and quality-driven businesses; Non-stop durability: . 61801, 2016 The Board of Trustees of the University of Illinois. Methods Graham ID, Tetroe J: Some theoretical underpinnings of knowledge translation. Key factors present in sustaining knowledge use can include perceived benefits and risks, relevance, leadership, policy integration, resources and politics. CLAHRC YH would also like to acknowledge the participation and resources of our partner organisations. By using this website, you agree to our The Knowledge-to-Action Framework | by Leah Crockett | KnowledgeNudge | Medium Sign up 500 Apologies, but something went wrong on our end. Action is the deeds or decisions made based on knowledge and information. The Action Cycle was reported in all the integrated examples, illustrating theory fidelity in this specific subset of studies. Some indication of the impact of this article can be gained from constructing a normalised citation count for comparison purposes. 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). We further identified a need to use taxonomies when analysing or evaluating knowledge translation strategies [33],[34]. These goals are to increase (a) the use of evidence-based research and (b) the understanding and use of KT principles. Assessment of barriers can be done quantitatively and qualitatively using a variety of conceptual models and instruments. Knowledge to Action Model. This frequency of use in Canada could be explained by the influence of national Canadian networks and dissemination activities. No existing systematic review was found on this subject. Acad Emerg Med. The source paper was cited four times more frequently than the next highest cited article from the same journal published in the same year. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article.