1. Canadian Dementia Knowledge Translation Network Cynthia Giles, Senior Project Manager cynthia.giles@cdktn.ca cynthia.giles@cdktn.ca Knowledge Translation 101 Conducting KT for different research themes and projects Geriatric Medicine Research Cheryl Cook, Research Associate cheryl.cook@cdha.nshealth.ca

2. Outline 1.Canadian Dementia Knowledge Translation Network 2.What is Knowledge Translation ? 3.Knowledge to Action Cycle 4.Types of Knowledge Translation 5.What is Knowledge Synthesis? 6.After Translation is Dissemination 7.Don’t forget EVALUATION

3. Translation, Transfer & Brokering

4. Canadian Dementia Knowledge Translation Network 1.Education and Training in Knowledge Translation 2.Resource and Knowledge Exchange 3.Patient/Care Partner Centred Knowledge Translation

5. Dementia Knowledge Broker A platform to find and share knowledge and resources, in order to help those affected by Alzheimer's disease and related dementias. http://www.dementiaknowledgebroker.ca

6. So What is Knowledge Translation?

7. Canadian Institute of Health Research Defines KT as…. “ Knowledge translation is the exchange, synthesis and 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 and products, and a strengthened health care system.” (CIHR)

8. The Elevator Pitch: "...methods for closing the gaps from knowledge to practice." (Straus et al, CMAJ 2009; 181:165-8)

9. That’s simple. It may seem simple, but people sometimes lose sight of the most fundamental part: You must be translating knowledge and there must be a practical use for that knowledge.

10. 8 things you should know about good KT. KT involves every step from the creation of new knowledge to producing beneficial products, services and tools for the public. KT is a loop; the end leads back to the beginning.

11. 8 things you should know about good KT. KT is interdisciplinary and is a collaboration between all involved parties. KT can involve health care providers, the general public, the government, NGO’s/the voluntary sector, and the private sector. KT includes many different activities.

12. 8 things you should know about good KT. KT focuses on research-generated knowledge, but may incorporate other types of knowledge with this. KT is user and context specific. KT is impact-oriented. adapted from Sudsawad 2007

13. The Knowledge to Action Cycle (CIHR)

14. Knowledge creation 1.Knowledge inquiry. 2.Knowledge synthesis. 3.Knowledge tools, products. These three are typically represented as a funnel, with inquiry, the largest part, at the top. This is narrowed by the synthesis of information, and then further narrowed into the products/tools. The needs of the knowledge users can be incorporated into every stage in the funnel, allowing for modification of the work.

15. Knowledge Application (the action cycle) Identify the problem as well as the knowledge needed to address this. Adapt the knowledge to the local context. Assess barriers and facilitators related to the knowledge to be adopted, the potential adopters, and the context in which the knowledge will be used.

16. Knowledge Application (the action cycle) Develop and execute the plan and any strategies to promote awareness and use of the knowledge. Monitor knowledge use to determine effectiveness of the plan in order to adjust them if necessary Evaluate the impact of using the knowledge to determine if it has effected the desired outcomes. Make a plan to sustain the use of the knowledge over time.

17. Don’t we already use evidence? The evidence says we are not using evidence. Of eight policy making processes studied in Canada, only four were using evidence in at least one stage of their process. Lavis et al, 2002

18. Types of KT

19. Researchers and knowledge users work together to identify research questions, decide on methodology, interpret findings, and disseminate findings. IKT aims to produce research results that are highly relevant and likely to be used by knowledge users to improve health and the health system. CIHR http://www.cihr-irsc.gc.ca/e/38654.html Integrated KT:

20. The researcher develops and implements a plan for making knowledge users aware of the findings from a research project once available. End of grant KT: CIHR http://www.cihr-irsc.gc.ca/e/38654.html

21. Knowledge Synthesis

22. Knowledge Synthesis (KS) Making decisions based on the results of one study means your decisions are only as good as that study. “… 'the contextualization and integration of research findings of individual research studies within the larger body of knowledge on the topic.” CIHR http://www.cihr- irsc.gc.ca/e/39033.htm

23. Knowledge Synthesis (KS) In general syntheses involve the following steps: Stating the objectives of the research Defining eligibility criteria for studies to be included; Identifying (all) potentially eligible studies; Applying eligibility criteria; Assembling the most complete data set feasible Analyzing this data set, using statistical synthesis and sensitivity analyses, if appropriate and possible; and Preparing a structured report of the research. Chalmers I. The Annals of the American Academy of Political and Social Science 2003;589:22-40

24. Aaaah…..Dissemination!

25. There are Three ways to get your research ‘out there’ 1.Diffusion 2.Dissemination 3.Implementation (Application) Lomas J. Ann NY Acad Sci. 1993, 703:226-37

26. Diffusion Passive Generally unplanned and uncontrolled Examples: Publishing a paper in an academic journal, going to a conference with a poster.

27. Dissemination You target and tailor what you are communicating to the specific audience you are trying to reach. This approach can be more or less active. Less active: You have completed research and you translate the results into brochures, videos etc. for the public. More active: tailoring a small workshop to disseminate results, get feedback etc.

28. Implementation The most active of all three, it “…involves systematic efforts to encourage adoption of the research findings by overcoming barriers to their use.” Gagnon, ML. J of Clin Epi 64 (2011) 25-31

29. 6 things you should know about good dissemination. 1.It should have local context. 2.It should use good quality research. 3.It should be clear. 4.It should be tailored to its audience in content and delivery. 5.It should be action oriented. 6.It needs an evaluation component. Gagnon, ML. J of Clin Epi 64 (2011) 25-31

30. Social Media – what is it? The term Social Media refers to the use of web- based and mobile technologies to turn communication into an interactive dialogue. http://en.wikipedia.org/wiki/Social_media

31. Yes, but WHAT is it? Social Media blogs FaceBook Twitter LinkedIn Flickr YouTube Etc etc Social Networking Exchanging knowledge Learning Connecting with new groups Disseminating

32. “Social Media is confusing.” Statistics are confusing. MRIs are confusing. Research is confusing. Life is confusing. Everything has the potential to be confusing until we take the time to understand it. Nothing comes with out some investment in time.

33. “Social media is for kids.” (or geeks, or people who live online, or someone else. ) Think social media isn’t reaching your target audience for KT? Think again.

34. 65% of online adults now use social media Over the last year, among internet users ages 50-64, social networking usage on a typical day grew 60% The average age of a FaceBook user in Atlantic Canada is now 55. Sources: http://pewinternet.org/Reports/2011/Social-Networking-Sites.aspx Media Badger, Atlantic Conversation III

35. Is it just for socializing? 80% of internet users have looked online for information about any of 15 health topics such as a specific disease or treatment One in three adults in the U.S. (30%) say they or someone they know has been helped by following medical advice or health information found online. That’s great, right? Pew Internet: Social Life of Health Information 2011 http://pewinternet.org/Reports/2011/Social ‐ Life ‐ of ‐ Health ‐ Info.aspx

36. “Dementia is reversible”

37. Where are you? Groups who promote the use of anecdotal evidence and junk science have some serious real estate in the social networking world. If groups who promote evidence-based knowledge and decision making don’t claim their space, someone else will. (Someone else probably already has. )

38. What can I do with Social Media? KT! It’s a handy tool in your KT toolkit. Disseminate your information to people and groups you might otherwise never reach – Increase the spread of your evidence-based work – Use Twitter to link to your blog or website – Use FaceBook to manage events, find organized groups Connect and network with other like-minded people Make good, evidence-based research more accessible to the public

39. How do you know where to start? GMR and CDKTN are working on an easy guide to Social Media as part of our work on Knowledge Translation tool for researchers that will offer: Practical steps in understanding the benefits and drawbacks to social networking. Different types of social media and what they are used for. What resources you need to begin. How to create a social media strategy for your group.

40. Evaluation!

41. Evaluation “KT promotes the uptake of evidence based practices but the methods used to promote these practices are often not evidence-based themselves.” Bhattacharyya et al, J Clin Epi 64 (2011) 32-40

42. Evaluation is hard. If you are engaged in KT, especially IKT, you have many groups and levels to consider when trying to evaluate your KT uptake. It is often as complicated as the original research itself, requiring internal and external validity checks, bias control etc. KT takes considerable time and money, thus it deserves rigorous evaluation.

43. The KT Imperative We are reminded ( and with good reason): “We must be careful to avoid the ‘knowledge translation imperative’ that all knowledge must be translated into action. Instead we need to ensure that there is a mature and valid evidence base before we expend substantial resources on implementation of this evidence.” Straus et al, J Clin Epi 64 (2011) 6-10

44. In closing… I count 4 Lessons Learned. How about you?

45. In closing… Lesson One: Involve the End-Users The people who will use the results of the research should be involved throughout the research process, starting with helping to identify the problem and refining the research question. CIHR http://www.cihr-irsc.gc.ca/e/38764.html

46. In closing… Lesson Two: Consider all Potential Stakeholders The focus of knowledge translation can and should be directed to all stakeholder audiences. Consider….everyone and anyone connected, impacted or interested in your research! CIHR http://www.cihr-irsc.gc.ca/e/38764.html

47. In closing… Lesson Three: Customize the Message Clearly focus the message for specific audience(s) of the research findings and crafting it to have resonance with them is critical. CIHR http://www.cihr-irsc.gc.ca/e/38764.html

48. In closing… Lesson Four: Evaluate and Communicate the Benefits of KT It's clear that knowledge translation can make a real difference. Evaluating the impact of your KT efforts and then communicating benefits and lessons learned will help knowledge users and other researchers better appreciate the importance of, and need for, doing knowledge translation. CIHR http://www.cihr-irsc.gc.ca/e/38764.html

49. In closing… “There remains much to be learned about how we can increase the application of research knowledge, whether it's the commercialization of scientific discoveries or changes to current health care practices and policies. However, what is certain is that as a society we will not reap the full benefits of our investments in health research unless the resulting discoveries are acted upon by other researchers, policy-makers, health care providers, patients, the public, and by the private, voluntary, and public health sectors.” CIHR http://www.cihr-irsc.gc.ca/e/38764.html

50. Acknowledgements Funding sources: CIHR Institute of Aging CIHR Knowledge Translation Branch CIHR Institute of Gender and Health CIHR Institute of Neurosciences CIHR Ethics Office Alzheimer Society of Canada Dalhousie Medical Research Foundation Fountain Innovation Fund QEII Health Sciences Foundation Mental Health and additions Ontario Ministry of Health and Long Term Care AstraZeneca Canada Inc Pfizer Inc. Principle: Prof. K. Rockwood, MD Division of Geriatric Medicine, Dalhousie University Co-Founders: Prof. H. Chertkow, MD Department of Neurology & Neurosurgery, McGill University Prof. K. Le Clair, MD Division of Geriatric Psychiatry, Queen’s University Prof. J. Keefe, PhD Canada Research Chair in Aging and Care Giving Policy Mount Saint Vincent University Prof. H. Feldman, MD Division of Neurology, University of British Columbia