1 KNOWLEDGE TO ACTION: ACTION TO RESEARCH Katharina Kovacs Burns, MSc, MHSA, PhD Conference on Moving Palliative & End-of-Life Care Forward Edmonton, Alberta May 18,2010

2 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

3 DEFINITIONS - KT CIHR’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).

4 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

5 Researcher – Knowledge User Interaction/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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7 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

8 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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10 Decision Tree for Using Research Evidence (Buffett, Ciliska & Thomas, 2007)

11 PUSH – PULL FACTORS WHO, 2004

12 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 utilization Process. Goals Inputs Processes Outcomes Quality of Results Importance of results Pattern Rationale State of utilizers Type Level Timing

13 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

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

15 Knowledge to Action Process (Graham, 2006)

16 CIHR Model of KT (CIHR, 2007)

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20 CONTACT INFORMATION Katharina Kovacs Burns Associate Director Health Sciences Council 300 Campus Tower 8625 – 112 Street Edmonton, AB T6R 1K8 Ph