1. Jaleh Gholami Eshlaghi MD. MPH. PhD Candidate in Epidemiology

2. آشنایی با اصول کلی که در هنگام انتقال دانش باید در نظر گرفت آشنایی با برخی از روش های انتقال دانش برای گروه های متفاوت مخاطبین آشنایی با روش های موثر انتقال دانش توجه به اثربخشی روش های انتقال هنگام تدوین استراتژی انتقال اهداف آموزشی این بخش

3. Message (WHAT?) Target Audience ( To WHOM?) Messenger (BY WHOM?) Evaluation (with what EFFECT should it be transferred?) Knowledge transfer process and support system (HOW?) Review Level of Evidence Barriers

4.  Consider the audience: –the problems audiences face, –the message that is valuable to him/her –the level of detail they need, –the style of thinking they use –the messenger they can trust –the language they are comfortable with What should be considered?

5. مرور نظام مند و متاآناليز كارازمايي هاي باليني شاهد دار تصادفي شده نشان مي دهد كه ميزان خطر نسبي شكستگي ران براي مصرف ويتامين D به تنهايي 1.1 ( با حدود اطمينان 95% 0.89-1.36) مي باشد در حالي خطر نسبي شكستگي ران در صورت مصرف ويتامين D و مكمل كلسيم برابر با 0.82 ( با حدود اطمينان 95% 0.71, 0.94 ) مي باشد. ويتامين D در صورت مصرف مكمل كلسيم باعث كاهش خطر شكستگي ران مي شود در صورتي كه مصرف ويتامين D ‌ به تنهايي اين تاثير را ندارد. Example

6. Evidence based medicine should be complemented by evidence based implementation. Richard Grol

7. Health care Professionals Patients Policy makers and managers strategies focusing:

9. –Printed Educational material (Clinical Practice Guideline, audio-visual materials, and electronic publications) –Educational Meeting Didactic meeting (Lectures, Conferences) Interactive Educational Meeting (workshop) –Educational Outreach (Prescribing behavior) –Local opinion leaders (Educationally influential providers) –Audit and feedback (Any summary of Clinical performance) –Reminders (Patient or encounter specific information) strategies focusing on professionals

10. Evidence-based clinical practice guidelines are knowledge tools defined as systematically developed statements that help clinicians and patients make decisions about appropriate health care for specific clinical circumstances. Clinical Practice Guideline

14. How are clinical practice guidelines developed? Establish multidisciplinary guideline team Identify clinical question that explicitly defines the patients, intervention/exposure, comparisons (if relevant), outcomes of interest and setting Conduct a systematic review of evidence Appraise and interpret evidence and come to consensus on its meaning Draft guideline recommendations that align with evidentiary base Complete an external review of draft report among intended users and key stakeholders Revise the guidelines in response to external review Read the final guideline report for distribution and dissemination Prepare implementation strategy Appraisal of Guidelines Research and Evaluation (AGREE)

15. Opinion leadership is the degree to which an individual is able to influence other individuals’ attitudes or overt behavior informally in a desired way with relative frequency. Local opinion leaders

16. This informal leadership is not a function of the individual’s formal position or status in the system, it is earned and maintained by the individual’s –Technical competence, –social accessibility, and –conformity to the systems norms. opinion leaders have more: –external communication, –higher social status, –innovative Local opinion leaders

17. High level of knowledge Communication skills Taking into account stakeholders Professional ethics Local opinion leaders characteristics in Iran

19. –Printed Educational material (Clinical Practice Guideline, audio-visual materials, and electronic publications) –Educational Meeting Didactic meeting (Lectures, Conferences) Interactive Educational Meeting (workshop) –Educational Outreach (Prescribing behavior) –Local opinion leaders (Educationally influential providers) –Audit and feedback (Any summary of Clinical performance) –Reminders (Patient or encounter specific information) Effectiveness of professional behavior change strategies

20. Patient decision aids Interactive Health Communication Applications (Information packages for patients that combine health information with at least one of social support, decision support, or behavior change support) Interventions to enhance medication adherence (Instruction, telephone monitoring and counseling, Reminders, special ‘reminder’ pill packaging, …) strategies focusing on patients

21. What are patient decision aids? Patient decision aids translate evidence into patient-friendly tools to inform patients about their options, help them clarify the value they place on benefits versus harms, and guide them in the process of decision making. Formats for decision aids are: paper-based booklets, video/DVDs, decision boards, and internet-based materials

22. Ottawa Hospital Research Institute (OHRI)

23. presentation of outcome probabilities

24. Ottawa PDA format

25. clarify patients’ values for outcomes

27. How do we determine the quality of patient decision aids?

28. IPDAS Criteria

29. Patient decision aids Interactive Health Communication Applications (Information packages for patients that combine health information with at least one of social support, decision support, or behavior change support) Interventions to enhance medication adherence (Instruction, telephone monitoring and counseling, Reminders, special ‘reminder’ pill packaging, …) Effectiveness of knowledge translation strategies focusing on patients

30. Do patient decision aids work? PDAs improve: patients’ participation in decision making, knowledge of options, agreement between patients’ values and the subsequent treatment or screening decisions. realistic expectations of the chances of benefits, harms, and side effects More use of conservative options, without apparent adverse effects on health outcomes or anxiety.

31. Reader Friendly Writing (1:3:25) Policy brief strategies focusing on professionals

33. 1:3:25 1: Main message 3: 3: Executive Summary 25: The Report “Reader Friendly Writing” Writing for health policy makers, planners and managers ( Canadian Health Service Research Foundation)

34. This part is one page of main message bullets. They are the heart of your report, the lessons decision makers can take from your research. Set aside your text and focus on expressing clear conclusions based on what you've learned. Consider your audience - who are they, and what do they most need to know about what you've learned? tell decision makers what implications your work has for theirs. if you're really not ready to draw more conclusions, don't just fall back on "more research is needed." Use your main messages to define the questions that still need to be asked. Main Messages

35. The three in 1:3:25 is the executive summary. An executive summary is not an academic abstract; it's much more like a newspaper story, where the most interesting stuff goes at the top, followed by the background and context and less important information further down. This is not the place for more than a line or two about your approach, methods and other technical details. Executive Summary

36. Context Implications Approach Results Additional Resources Further Research References and Bibliography appendix The Report

37. 3 صفحه : خلاصه اجرايي نكات داراي اهميت بيشتر در ابتداي متن و نكات كم اهميت تر در ادامه نگارش با زبان شفاف و روشن ولي غيرعاميانه به گونه اي كه فرد ناآشنا به پژوهش آن را كاملا درك نمايد اشاره به موضوع مورد بررسي و پاسخ هاي بدست آمده يافته هاي طرح به صورت فشرده روش اجرا و جزئيات تكنيكي در حد 2-1 سطر

38. 25 صفحه : گزارش 1. زمينه و سابقه Context: سوال پژوهش، پژوهش هاي قبلي و سهم اين پژوهش در پاسخ به سوال 2. مفاهيم Implications: مفهوم يافته ها براي مدير يا سياست گذار، ذكر گستره تعميم نتايج، تفكيك پيام ها 3. رويكرد Approach: طراحي مطالعه، روش ها، منبع داده ها، جزئيات نمونه گيري، تكنيك هاي آناليز و... 4. نتايج Results: نگارش نتايج به صورت خلاصه و پررنگ نمودن پيام ها، استفاده از جداول و نمودارها 5. منابع اضافي Additional Resources: ساير منابع كه براي سياست گذار مي تواند مفيد باشد 6. پژوهش هاي بيشتر Further Research: فهرست نمودن شكاف هاي موجود، طرح پرسش هاي مشخص 7. مراجع و كتابشناسي References and Bibliography: مشخص نمودن مواردي كه مفيدتر است 8. پيوست : يافته هايي كه مستقيما به نتيجه گيري ارتباط ندارند، مواد و روش هاي تكنيكي، مراجعي کامل

39. Policy briefs are a relatively new approach to packaging research evidence for policymakers. Policy Brief

41. Title Key messages –What is the problem? –What do we know (and not know) about viable options to address the problem? –What implementation considerations need to be borne in mind? Report –Introduction that describes the issue and the context in which it will be addressed –Definition of the problem –Options for addressing the problem, with each one assessed in a table (an example is shown below) Possible outline of a policy brief

45. In contrast to the substantial evidence base on the effectiveness of knowledge translation strategies targeting health care professionals and patients, we are not aware of any experimental studies evaluating the effects of knowledge translation research that focused on policy makers or senior health service managers. Effectiveness of knowledge translation strategies focusing on policy makers and senior health service managers

46.  Mass media  Continuous medical education  Structural modification and support  Financial incentives  Changing rules and regulations  … Other strategies

47. Thank you