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]. Each article was scrutinised and mapped against the corresponding phases within the Knowledge Creation and Action Cycle components of the framework. A notable feature of the KTA Framework is the development of knowledge tools or products as part of Knowledge Creation. Only four studies detailed Knowledge Creation, yet existing knowledge was utilised in the other studies to identify knowledge-practice gaps, or as part of the Action Cycle. In the COM-B model behavior is a result of an interaction between three components, which includes: Capability, which can be psychological (knowledge) or physical (skills); Opportunity can be social (societal influences) or physical (environment); motivation can be automatic (emotion) or reflective (beliefs, intentions) [ 16, 17 ]. Upper Saddle River, NJ: Prentice Hall. 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. 10.1046/j.1365-2648.2002.02150.x. "Knowledge translation is defined as a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system.. All undertook the first phase of identifying the problem. Each implementation study was very different (see Table 3). EX-B760M-V5-CSMMotherboardsASUS Global Papers were excluded if they were not empirical real-life applications of the KTA Framework; if they were literature reviews; if they were only conceptual or descriptive papers (including discussion, commentaries or protocols); if they described a single knowledge translation strategy, such as a clinical practice guideline; or if they were not topically relevant. Work Group on Translation Tools | CDC 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. 2014, 11: 26-34. Action Cycle within the KTA Model The second step involves adapting the validated knowledge to the local context. Included articles were re-examined and re-coded according to this more detailed classification. Provided by the Springer Nature SharedIt content-sharing initiative. (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. The KTA Framework is one of many frameworks, models, and theories that provides KT researchers with a practical yet systematic method of implementation. McCormack B, Kitson A, Harvey G, Rycroft-Malone J, Titchen A, Seers K: Getting evidence into practice: the meaning of context. As knowledge moves through the funnel, it is refined and summarized to be more useful for end-users. The authors declare that they have no competing interests. The quality of reporting was assessed using criteria adapted from Carroll and colleagues [16]. Skip to Claude KM, Juvenal KL, Hawkes M: Applying a knowledge-to-action framework for primary prevention of spina bifida in tropical Africa. Seven described using both the Knowledge Creation and the Action Cycle components [18],[20]-[24],[27]. One hundred and forty-six studies described usage to varying degrees, ranging from referenced to integrated. Article PubMed Discovery: The original biomedical, behavioral, or epidemiologic factor that stimulated development of an intervention (1).. Efficacy: The extent to which the intended effect or benefits were achieved under optimal conditions (2).. However, there are multiple KT TMFs and little guidance on which to select. Download scientific diagram | Knowledge-to-Action Model (Adapted from I.D. 10.1016/j.amepre.2012.05.024. Why use theory to guide the process of moving evidence into action? 10.1002/chp.179. Finally, knowledge tools and products, considered third generation knowledge, are the most refined form of knowledge, based on earlier stages of the funnel. In ten studies, the KTA Framework was integral to the design, delivery and evaluation of the implementation activities. Implement Sci. School of Nursing, University of Ottawa, Ottawa, ON, Canada. administrative databases) and/or active measurement (e.g. Finfgeld-Connett D, Johnson ED: Literature search strategies for conducting knowledge-building and theory-generating qualitative systematic reviews. As knowledge moves through three stages (inquiry, synthesis, tools/products), it becomes more user-friendly. statement and Rycroft-Malone J, Harvey G, Kitson A, McCormack B, Seers K, Titchen A: Getting evidence into practice: ingredients for change. Graham, J. Logan, M.B. The KTA Framework comprises two distinct but related components: (i) Knowledge Creation (represented by the funnel) surrounded by (ii) the Action Cycle (Figure 1). . Search for more papers by this author. 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. We did not assess the research rigour of the individual knowledge translation projects. Citation searching for the original reference by Graham and colleagues [1] optimised the sensitivity and specificity of the search strategy. 2011, 71 (Suppl 1): S20-S33. However, supplementary hypertext links could be followed up from Google Scholar to either an abstract or, optimally, to the full text. Data extraction and presenting results according to the phases were also challenging, given that the framework is dynamic, and can be non-sequential with overlap between phases [1]. Most of the theories were interdisciplinary or from nursing and were published between 1983 and 2006 [11]. 10.1002/chp.20077. Celebrate the work you have accomplished. Bartholomew and Mullen [42] suggest that the prevailing wisdom in the field of health-related behaviour change is that well-designed and effective interventions are guided by theory (p. S20). Refresh the page, check Medium 's site status, or find. 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. Only ten studies reported and gave supportive examples of incorporating the KTA Framework in an integrated way. School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK, You can also search for this author in Offering up to 36-month product lifecycle support and 6-month end-of-life notice to allow . J Adv Nurs. This was necessary given the limited resources available to support the review process. Implement Sci. In addition, this suggests conceptual frameworks do not have to be mutually exclusive. Below are the links to the authors original submitted files for images. Implement Sci. Several strategies were used to counter this risk. 2009, Wiley-Blackwell BMJ Books, Oxford, 94-113. The Knowledge to Action KTF The Knowledge to Action (KTA)4 is an overarching framework that includes both knowledge creation and implementation. 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. Unfortunately, an implemented change is not usually self-sustaining and requires ongoing monitoring and effort. Citation searching was further indicated in this review given that our scoping search, using the databases MEDLINE and CINAHL, had previously identified few abstracts reporting explicitly the use of the KTA Framework in practice. Some indication of the impact of this article can be gained from constructing a normalised citation count for comparison purposes. The prevalence of the Action Cycle may simply reflect the cyclical nature of the change process evident in other common, quality improvement tools such as the Plan, Do, Study, Act cycle [30]. 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. Making sense of implementation theories, models and frameworks. Using the Knowledge to Action Process Model to Incite - ResearchGate Springer Nature. Guideline adaptation: an approach to enhance efficiency in guideline development and improve utilisation, Validation of the theoretical domains framework for use in behaviour change and implementation research, Theoretical domains framework to assess barriers to change for planning health care quality interventions: a systematic literature review. to the In contrast, they wanted to evaluate the impact of their intervention on peoples ability to understand their choices and make informed decisions about treatment. Secondly, multifaceted strategies are more likely to be successful than a single strategy [27],[46],[47], as they target different barriers [40], which reflects our interest in the real-world use of the KTA Framework, where it is probably impossible to control and isolate one strategy [48]. All ten studies reported using the Action Cycle. We thank Jennifer Read who provided BF with academic supervision for her MSc dissertation. We chose citation searching as our preferred method to identify reports of practical applications of a model or framework [14],[15]. 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]. Data collection Knowledge Translation: Introduction to Models, Strategies, and - KTDRR It is frequently cited, with usage ranging from simple attribution via a reference, through informing planning, to making an intellectual contribution. Translation - Moving the best evidence into professional practice. 10.2340/16501977-0451. The KTA Framework is composed of two distinct, but related components: (i) Knowledge Creation, and (ii) the Action Cycle. PDF Introduction to Knowledge into Action - The Centre for Evidence-Based Knowledge becomes more refined as it moves through these three steps. BMJ. 2012, 8: 174-84. 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). Three studies illustrated each phase of the Action Cycle or explained their reasons for not doing so [18],[23],[25]. Edited by: Straus S, Tetroe J, Graham I. The Knowledge to Action (KTA) Framework was developed in Canada by Graham and colleagues in the 2000s, following a review of 31 planned action theories. Field, B., Booth, A., Ilott, I. et al. 61656, Rockford, Sixty two of the 146 papers (43%) were classified as referenced, meaning that the framework was cited with little, if any, further explanation (see Table 2). The KTA Framework is being used in practice with varying degrees of completeness. Initial screening out by title and abstract on the basis of partial information from Google Scholar may also have excluded relevant studies. 2010, 5: 14-10.1186/1748-5908-5-14. Implement Sci. Each study applied the framework in an idiosyncratic way. This study is a citation analysis and systematic review. We did not follow up references (including book chapters) or contact authors of included or excluded studies. 2013, 69: 2336-47. The KTA could also be used as a literacy device to structure reporting of the framework. Philadelphia: Lea & Febiger. Tailoring knowledge was described in three studies [18],[20],[26]. These include things like clinical practice guidelines, decision aids and videos. How Much Knowledge Is Necessary for Action? | SpringerLink Future research could examine the studies which we categorised as using the KTA Framework to a lesser degree, perhaps for conceptual or persuasive reasons rather than instrumentally. Cite this article, Conceptual frameworks are recommended as a way of applying theory to enhance implementation efforts. This involved checking whether the four elements were described. 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. We did not include the many papers about clinical practice guidelines for two interrelated reasons. This review sought to answer two questions: 'Is the By using this website, you agree to our 2010, 29: 1-8. Our findings support this proposal. Do they work? 2012, 43: 337-50. the main menu, 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. Implent Sci. Given the incomplete abstracts obtained via Google Scholar, a rule-out strategy was employed. PubMedGoogle Scholar. Overview of the Knowledge to Action Cycle. This may be an artefact of reporting: few studies justify or explain their theoretical stance; even fewer do so using the appropriate constructs or with theory fidelity. The Action Cycle outlines a process, representing the activities needed for knowledge to be applied in practice; knowledge is adapted to the local context, and barriers and facilitators to its use are explicitly assessed. Next, 911 records were excluded at the sift stage. It focuses on two main areas of activity: knowledge creation and knowledge tailoring . 61107, 102 Medical Sciences Building, 506 S. Mathews, Urbana, 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. Nurs Stand. 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). Carroll C, Booth A, Cooper K: A worked example of best fit framework synthesis: a systematic review of views concerning the taking of some potential chemopreventive agents. Harrison, S.E. 2010, 5: 92-10.1186/1748-5908-5-92. Interest in using systematic literature reviews to investigate theories, models and conceptual frameworks has increased in recent years [7],[39]. Our review, and similar studies [39],[40],[43]-[45], consistently comments on the limited, haphazard use of theory, even though theories can be applied in many different ways [41]. BMC Med Res Methodol. It may also be a reflection of the challenges for defining and reporting outcomes for knowledge translation projects. BF, II and AB conceived the review; AB designed the study; AB undertook the searches; BF and II screened and extracted the data; BF wrote the review; and BF, II, AB and KG made comments and edited the review drafts. Tugwell PS, Santesso NA, OConnor AM, Wilson AJ: Knowledge translation for effective consumers. AB is Reader in Evidence Based Information Practice at the School of Health and Related Research (ScHARR), University of Sheffield, where he leads on systematic review and evidence synthesis activities. Application of knowledge translation (KT) theories, models, and frameworks (TMFs) is one method for successfully incorporating evidence into clinical care. The index citation for the source paper for the KTA Framework Lost in knowledge translation: time for a map? by Graham and colleagues [1] was identified on each of three databases that offered functionality for citation searching. Nursing Experts: Translating the Evidence - University of Illinois Chicago 2010, Wiley Blackwell, Chichester, UK. Thomas A, Menon A, Boruff J, Rodriguez AM, Ahmed S: Applications of social constructivist learning theories in knowledge translation for healthcare professionals: a scoping review. Rycroft-Malone J: The PARIHS framework: a framework for guiding the implementation of evidence based practice. This showed that the degree of usage varied from merely citing the KTA Framework to full integration into the study. The KTA Framework consists of two components: (1) Knowledge Creation Knowledge creation is represented by the funnel in the centre of the image above. Jacqueline Tetroe MA, Citation searches were limited to the period from 2006 (the date of publication of the source paper) to July 2013. Med Care Res Rev. The KTA Framework is a framework for guiding the process of KT, adopted by the Canadian Institutes of Health Research (CIHR) and other organizations worldwide. the secondary menu, the site search form or go And if so, how?. All authors read and approved the final manuscript. It may be that when people are consulted, they identify those barriers that they feel able to influence, such as knowledge or awareness, rather than organisational barriers, which could be perceived as more problematic or more distant. The relation between knowledge and action. Firstly, we were interested in the practical application of the KTA Framework and thus in identifying papers where the KTA Framework appeared to be a fundamental guide to the work reported. Rather, we focused on the application of, and theory fidelity to, the KTA Framework. 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. 2010, Dissertation for Masters of Science, School of Nursing, Queens University, Ontario, Canada. Full-text articles were obtained for any article coded for inclusion and for any articles that appeared relevant but where it was unclear whether the KTA Framework had been actually used in practice. Conceptual frameworks are recommended as a way of preparing for the multiple, dynamic and interactive factors that influence the uptake of evidence in practice [3]-[5]. The citation search yielded 1,787 records. Regardless of the approach, its critical to ensure that interventions are tailored to address the specific issue, audience and context to enhance uptake. Rather, papers typically stated aims and objectives, which often related to closing evidence/knowledge-practice gaps. Only ten studies were integrated, signifying that the KTA Framework was integral to the design, delivery and evaluation of the implementation activities. 2023 BioMed Central Ltd unless otherwise stated. Am J Prev Med. They and we resorted to a simple taxonomy to describe the level and type of usage based on explicit reporting. Notably, the KTA Framework assumes a systems perspective and situates knowledge producers and users within a system of knowledge that is responsive, adaptive, and unpredictable. 10 at the Canadian Institutes for Health Research. Implementation researchers and health professionals can learn from this flexibility. Knowledge Translation in Health Care: Moving from Evidence to Practice. Implement Sci. Similarly, we acknowledge that some readers may be interested in precise reasons for exclusions. Booth A, Harris J, Croot E, Springett J, Campbell F, Wilkins E: Towards a methodology for cluster searching to provide conceptual and contextual richness for systematic reviews of complex interventions: case study (CLUSTER). Knowledge translation strategies can include elements such as linkage and exchange, audit and feedback, informatics and patient-mediated and organisational interventions [29]. Furthermore, knowledge can inform each phase of the action cycle and the knowledge funnel can rotate to feed into different phases. Preventing Chronic Disease: March 2011: 10_0012 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]. Building a Knowledge to Action Program in Stroke Rehabilitation It may be useful for them to consider the extent to which they wish to follow or be guided by a conceptual framework before embarking on a knowledge translation project, especially regarding outcome measures because .the focus of knowledge into action is ultimately to enhance health status [1 p. 18]. 60612, One Illini Drive The purpose of translation is to provide the best outcomes and value, and lower risks to our patient population. The KTA Framework was enacted in a variety of ways, from informing to full integration, showing flexibility of use and that it can fit local circumstances and need. The Journal of Continuing Education in the Health Professions 2006, 26, p. 19. 2009, 41: 1024-1032. Methods An exception was the study by Russell and colleagues [25] who reported using a questionnaire to assess a range of potential barriers and facilitators. Child Health, Health Equity, Integrated Knowledge Translation, Canadian Institutes of Health Research (CIHR, https://www.ncbi.nlm.nih.gov/pubmed/16557505, practical guide to designing a KT intervention. Knowledge Translation in Health Care: Moving from Evidence to Practice. Grimshaw JM, Eccles MP, Lavis JN, Hill SJ, Squires JE: Knowledge translation of research findings. Also, this conceptual framework may appeal because of a lack of jargon and a simple diagram depicts the knowledge translation process. 10.1111/j.1553-2712.2007.tb02369.x. PubMed Central Development of a theory coding scheme. 2011, 11: 29-10.1186/1471-2288-11-29. This reinforces the importance of theory fidelity and that authors refer to established taxonomies or reporting standards [36],[37],[40],[41] so we can understand how conceptual frameworks, theories and models are really used to guide practice or inform research. 10.1016/j.jclinepi.2004.09.002. PubMed As demonstrated here, the Knowledge to Action Process model provides an excellent guide for clinicians, managers, and researchers who wish to incite change in patient care. Involvement of stakeholders, and tailoring knowledge to the needs of people who are going to use it, is crucial. J Adv Nurs. Ilott I, Gerrish K, Booth A, Field B: Testing the consolidated framework for implementation research on health care innovations from South Yorkshire. All these described the Action Cycle and seven referred to Knowledge Creation, articulating the KTA Framework in a way that was true to the source paper [1]. 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. 2004, 19: 297-304. The monitoring, outcomes or sustaining phases of the Action Cycle were less often described, although three noted their plans for doing so [18],[24],[26]. 2014, 348: g1687-10.1136/bmj.g1687. Tugwell and colleagues [26] highlight this particular challenge, commenting that most outcomes in arthritis research are about pain and function. 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. 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. The KTA Framework [1] was developed in Canada by Graham and colleagues in the 2000s in response to the confusing multiplicity of terms used to describe the process of moving knowledge into action [1]. Retrieved from http://www.nccmt.ca/registry/view/eng/70.html. Knowledge-to-action cycle | BMJ Evidence-Based Medicine The search results are illustrated in Figure 2, the PRISMA flow chart. Important considerations for choosing a KT strategy (or strategies) include a clearly defined goal or objective for each strategy, an understanding of how the strategy overcomes one or more barriers to behaviour or attitude change, and the use of theory to inform selection and implementation. Such work may require additional funding for longer term monitoring or strategies to sustain knowledge use over time. The citation search for the original source paper [1] yielded 1,787 records. A total of 146 papers were identified as attributing use of the KTA Framework. A scoping review of full-spectrum knowledge translation theories Implement Sci. Steps involved in Translating the Evidence into Practice: The Knowledge to Action (KTA) Framework is used for facilitating the use of research knowledge by several stakeholders, such as practitioners, policymakers, patients and the public. 2005, 58: 107-12. Ian D. Graham PhD, Ian D. Graham PhD. knowledge to action gap through research-clinical partnerships in speech-language pathology. Action model learning - Wikipedia 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. IL Knowledge to action framework for home health monitoring 10.1007/s10865-010-9260-1. Effectiveness: The extent to which the intended effect or benefits that were achieved under optimal . 10.1002/chp.47. Safari. 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. 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. Article In the absence of formal comparisons of citation search techniques, we decided to operationalise citation searching using Google Scholar. Moving from Evidence to Practice. 2012, 69: 123-157. 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. Education was the most frequently employed strategy albeit in a variety of forms. This can be achieved through observation (e.g. This frequency of use in Canada could be explained by the influence of national Canadian networks and dissemination activities. On this basis, all ten studies were judged as having described their projects clearly. Cookies policy. The KTA Framework [1] is being used in practice with varying degrees of completeness and theory fidelity when the conceptual framework is integrated into the implementation project.
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