Neither did we seek out grey literature or search specific thesis/dissertation databases. Included articles were re-examined and re-coded according to this more detailed classification. 2014, 348: g1687-10.1136/bmj.g1687. 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. Initial screening out by title and abstract on the basis of partial information from Google Scholar may also have excluded relevant studies. McCormack B, Kitson A, Harvey G, Rycroft-Malone J, Titchen A, Seers K: Getting evidence into practice: the meaning of context. J Contin Educ Health Prof. 2008, 28: 117-122. For example, if a strategy has the goal of improving social networking, and the barrier is weak ties between end-users, the social support theory [8] may be used to design an intervention that involves the use of change agents to transfer information [2]. Within KTA, knowledge creation - or the production of knowledge - is composed of three phases: knowledge inquiry (first-generation knowledge), knowledge synthesis (second-generation knowledge), and creation of knowledge tools and/or products (third-generation knowledge). Understanding if and how these theoretical tools add value to implementation endeavours and outcomes merits further research. By using this website, you agree to our None reported using every phase of the KTA Framework. II is an occupational therapist. And if so, how?. This article presents independent research by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Yorkshire and Humber (NIHR CLAHRC YH). A notable feature of the KTA Framework is the development of knowledge tools or products as part of Knowledge Creation. The Knowledge-to-Action (KTA) framework provides a logical structure and process to plan IS projects. School of Nursing, University of Ottawa, Ottawa, ON, Canada. 10.1111/j.1740-8709.2010.00271.x. Our experience certainly confirms that this search method circumvents the problems of variation in terminology typically encountered in topic-based searches of bibliographic databases. Two were concerned with public health or health promotion [17],[20]; three focused on clinical academic or nurse education [18],[21],[22]. 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). Action Cycle within the KTA Model The second step involves adapting the validated knowledge to the local context. The KTA could also be used as a literacy device to structure reporting of the framework. 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. 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. Our findings support this proposal. All citations identified were screened by title and available information according to agreed criteria. 61801, 2016 The Board of Trustees of the University of Illinois. Rycroft-Malone J: Implementing evidence-based practice in the reality of clinical practice. However, there are multiple KT TMFs and little guidance on which to select. Journal of Continuing Education in the Health Professions, 30, 167-171. doi:10 As part of this programme, the first author (BF) undertook a knowledge translation project that sought to identify examples of the use of the KTA Framework in practice. Straus S, Tetroe J, Graham ID: Knowledge Translation in Health Care. 2010, 29: 1-8. 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. Action is the deeds or decisions made based on knowledge and information. Health Psychol. Action phases may be carried out sequentially or simultaneously; knowledge phases may impact on the action phases. 60607, Chicago, The KTA Framework was adapted to different health service settings and resources, indicating a good fit for the diversity of real-world health care. AB is a member of the editorial board of Implementation Science. Implement Sci. 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. As such, the process of moving evidence to action is iterative, dynamic, and complex. PubMed Single studies at this stage are not ready to be translated into practice on a broad scale, but are necessary to inform future research and feed into the larger evidence base. Use at a lighter level through adapting or combining with other conceptual frameworks could be considered a strength, in that the KTA Framework offers the flexibility to be combined with other frameworks, being responsive to facilitating practitioner preferences and context-specific needs. Cookies policy. References to non-English language articles were removed. Knowledge to Action Model. Nine were published in peer-reviewed journals with the exception being a Master of Science degree dissertation [19]. 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. The MCHRI framework includes 6 Key Steps summarised below: Steps 1 & 2 - Formative Research: engage stakeholders to identify problem from all perspectives, to scope and prioritise . One hundred and forty-six studies described usage to varying degrees, ranging from referenced to integrated. 2013, 23 (4): 290-298. We did not include the many papers about clinical practice guidelines for two interrelated reasons. 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]. Limitations of English language and year of publication 2006-June 2013 were set. BMC Med Res Methodol. 2013, 19: 915-24. 2012, 7: 50-10.1186/1748-5908-7-50. The following analysis focuses on results relating to these ten integrated studies. Finfgeld-Connett D, Johnson ED: Literature search strategies for conducting knowledge-building and theory-generating qualitative systematic reviews. Celebrate the work you have accomplished. questionnaires). BMJ. Philadelphia: Lea & Febiger. J Adv Nurs. the site home page. Crosby R, Noar SM: Theory development in health promotion: are we there yet?. IL These goals are to increase (a) the use of evidence-based research and (b) the understanding and use of KT principles. research findings not being translated. 10.7748/ns2002.05.16.37.38.c3201. Overlaying the Consolidated Framework for Implementation Research (CFIR) on the KTA framework offers a comprehensive methodology to identify barriers and facilitators and evaluation of the project. 2009, 6: Paper 10-10.2202/1548-923X.1741. Our study had several limitations. Ian D. Graham PhD, Ian D. Graham PhD. Damschroder LJ, Aron DC, Keith , Rosalind E, Kirsh SR, Alexander JA, Lowery JC: Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. A few free articles for further reading Chicago, Russell DJ, Rivard LM, Walter SD, Rosenbaum PL, Roxborough L, Cameron D, Darrah J, Bartlett DJ, Hanna SE, Avery LM: Using knowledge brokers to facilitate the uptake of pediatric measurement tools into clinical practice: a before-after intervention study. 10.1016/j.amepre.2012.05.024. Only 10 of 146 papers reported direct use, with examples demonstrating that the framework was integral to their study. Offering up to 36-month product lifecycle support and 6-month end-of-life notice to allow . Worldviews Evid Based Nurs. 2012, 69: 123-157. We did not follow up references (including book chapters) or contact authors of included or excluded studies. Implement Sci. Assessment of barriers can be done quantitatively and qualitatively using a variety of conceptual models and instruments. 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). Acad Emerg Med. 2009, Wiley-Blackwell BMJ Books, Chichester, UK, 83-93. 2014, 9: 2-10.1186/1748-5908-9-2. 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. 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]. 2012, 8: 174-84. It was cited 470 unique times across the three databases, indicating the bibliometric impact of the source paper. 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). 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. Tailoring knowledge was described in three studies [18],[20],[26]. Springer Nature. Hamilton, ON: McMaster University. Copyright 2015 Wiley Periodicals, Inc., A Wiley Company Can J Speech-Language Pathol Audiol. The knowledge to action (KTA) process proposed by Graham et al (2006) is a framework to facilitate the development and application of research evidence into clinical practice. Knowledge to Action Framework. Canadian Journal of Speech-Language Pathology . They and we resorted to a simple taxonomy to describe the level and type of usage based on explicit reporting. Petzold, A., Korner-Bitensky, N., & Menon, A. Correspondence to Such work may require additional funding for longer term monitoring or strategies to sustain knowledge use over time. These were the question and study design, recruitment and selection and methods of data collection and analysis. Michie S, Prestwich A: Are interventions theory-based? Davies and colleagues [40] note that less than 6% of 235 studies, albeit published before 1998, explicitly used theories of behaviour or behaviour change. The Knowledge to Action Framework. 2012, 28: 258-61. BF is a researcher at the School of Health and Related Research (ScHARR), University of Sheffield, and also an occupational therapist. Rather, papers typically stated aims and objectives, which often related to closing evidence/knowledge-practice gaps. Harrison, S.E. 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. Privacy Bartholomew LK, Mullen PD: Five roles for using theory and evidence in the design and testing of behaviour change interventions. 2010, 5: 14-10.1186/1748-5908-5-14. Nilsens paper provides an overview of evaluation frameworks to guide evaluation of implementation strategies [7]. CIHR also provides a practical guide to designing a KT intervention for health researchers, with relevant examples of its application. Moving from Evidence to Practice. Article Developed by Ian Graham and colleagues [1], the KTA Framework is based on the commonalities of over 30 planned-action theories (which make up the action cycle) with the addition of a knowledge creation component. 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]. 2009, 41: 1024-1032. 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. The authors attribution of use was variable, with most merely referencing the framework or describing how it was used to inform or structure projects. Google Scholar. This was necessary given the limited resources available to support the review process. When thinking about program planning and implementation, there are several important concepts that need to be considered. 10.1111/wvn.12016. Rycroft-Malone J, Bucknall T: Models and Frameworks for Implementing Evidence-Based Practice. 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. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. 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 study was funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for South Yorkshire and Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Yorkshire and Humber. Once an understanding of the potential barriers and facilitators to adoption has been achieved, the next phase involves planning and carrying out interventions to bring about the intended change. It would be interesting to review the conceptual papers we excluded to explore how they were influenced by the framework and informed the development of conceptual frameworks more generally. Edited by: Straus S, Tetroe J, Graham I. 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. looked at 10 behaviour change interventions where explicit use of theory was absent, and mapped these strategies to domains of the Theoretical Domains Framework. the content of this page, Seventeen studies (12%) were noted as adapted or combined where the KTA Framework had either been modified or blended with another conceptual framework. 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]. Studies were published between 2007 and 2013. All authors read and approved the final manuscript. Most of the theories were interdisciplinary or from nursing and were published between 1983 and 2006 [11]. Provided by the Springer Nature SharedIt content-sharing initiative. 2010, 33: 259-263. Further, the time frame of the citation searches only captures work up to a certain point (from the date of publication of the source paper to July 2013). There was substantial variation in the setting and target audience for each documented change, the methods used to apply the KTA Framework and the terminology employed to report the phases within Knowledge Creation and the Action Cycle. J Contin Educ Health Prof. 2006, 26: 13-24. We initially included 146 studies that reported using the KTA Framework. Cite this article, Conceptual frameworks are recommended as a way of applying theory to enhance implementation efforts. knowledge to action gap through research-clinical partnerships in speech-language pathology. A taxonomy categorising the continuum of usage was developed. 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]. As the process of KT is iterative, not only can (i) inform (ii), but components of the action cycle also feed back to inform knowledge creation [2, 3]. For example, difficulties in applying exclusion/inclusion criteria were discussed by the team and all subsequent decisions were then resolved by consensus. Most studies illustrate how knowledge was adapted to the local context. Today well highlight one of the most highly cited conceptual frameworks in Canada the Knowledge-to-Action (KTA) Framework. Each component involves several phases which overlap and can be iterative; Graham and colleagues [1] describe the phases as dynamiccan influence each other (p. 20). The KTA Framework consists of two components: (1) Knowledge Creation Knowledge creation is represented by the funnel in the centre of the image above.
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