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KNOWLEDGE TO ACTION:

ACTION TO RESEARCHKatharina Kovacs Burns, MSc, MHSA, PhD

Conference on

Moving Palliative & End-of-Life Care Forward

Edmonton, Alberta

May 18,2010

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TERMINOLOGY Knowledge Translation Knowledge Exchange Knowledge Utilization/

Implementation Knowledge Transfer Knowledge Mobilization Knowledge Management Knowledge Cycle Knowledge Diffusion Knowledge To Action

Knowledge Dissemination

Knowledge Communication

Evidence-based Practice Research

Implementation Practice Impact Research/Practice

Linkage Translational Research

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DEFINITIONS - KTCIHR’s definition:

The exchange, synthesis & ethically-sound application of knowledge – within a complex system of interactions among researchers and users – to accelerate the capture of the benefits of research for Canadians through improved health, more effective services & products, & a strengthened health care system (2005).

Graham’s definition:

A dynamic & tentative process that includes the synthesis, dissemination, exchange and ethically sound application of knowledge to improve the health of Canadians, provide more effective health services & products & strengthen the healthcare system (2006).

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CHARACTERISTICS OF KT All steps between knowledge creation & its application Multidirectional communications Interactive process Ongoing collaborations among relevant parties Multiple activities Nonlinear process Use of research-generated knowledge & other

knowledge Diverse knowledge-user groups User and context-specific Impact-oriented An interdisciplinary process

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Researcher – Knowledge UserInteraction/Collaboration

Who are the knowledge users? Researchers within & across disciplines Policy makers, planners, managers Health care providers, professionals General public, patients, families, others Voluntary sector, NGOs Private sector, manufacturers Institutions Others?

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TYPES OF KNOWLEDGE USE(1) Instrumental Use – applying research

results in specific & direct ways

e.g. linked to decision-making

(2) Conceptual Use – using research results for general enlightenment

e.g. changing thinking or attitudes

(3) Symbolic Use - using research to legitimatize and sustain predetermined positions

e.g. political/advocacy tool

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BARRIERS TO KT (Ciliska, 2009)

Time Inability to access

research Inability to understand

the language of research

Lack of critical appraisal skills

Lack of confidence in making change based on research evidence

Lack of sense of control over practice

Culture – resistance to change, decisions based on history

Lack of organization valuing or supporting evidence-based practice

Lack of consensus on what constitutes evidence

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Decision Tree for Using Research Evidence (Buffett, Ciliska &

Thomas, 2007)

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PUSH – PULL FACTORS

WHO, 2004

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EVALUATING/MEASURING KT Patient level

Health practitioner level Organizational or process level

(Conner’s Conceptual model for research utilization evaluation – 1980)

Components of

an evaluation project

Aspects of the

utilizationProcess.

Goals Inputs

Processes

Outcomes

•QualityofResults

•Importanceof results

•Pattern

•Rationale

•State ofutilizers

•Type

•Level

•Timing

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KT MODELS Coordinated Implementation Model (1993) Stetler Model of Research Utilization (2001) Understanding User-Context Framework

(2003) Ottawa Model of Research Use (2004) Knowledge to Action Process (2006) CIHR Model of KT (2007) Others

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Ottawa Model of Research Use (Graham & Logan, 2004)

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Knowledge to Action Process (Graham, 2006)

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CIHR Model of KT (CIHR, 2007)

17www.learning.cihr-ir.gc.ca/mod/resource/view

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CONTACT INFORMATIONKatharina Kovacs Burns

Associate DirectorHealth Sciences Council

300 Campus Tower8625 – 112 Street

Edmonton, ABT6R 1K8

Ph. 780-492-7766Email: kathy.kovacsburns@ualberta.ca