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. to the For example, Eccles et al. administrative databases) and/or active measurement (e.g. Papers could be scrutinised according to how their aims and objectives had been operationalised. Also, this conceptual framework may appeal because of a lack of jargon and a simple diagram depicts the knowledge translation process. None reported using every phase of the KTA Framework. 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. Conceptual frameworks provide a frame of reference for organising thinking, a guide for action and interpretation. 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 ]. Graham ID, Tetroe J: Some theoretical underpinnings of knowledge translation. 60612, One Illini Drive J Contin Educ Health Prof. 2008, 28: 117-122. Building a conceptual model Forms of knowledge Research evidence Clinician knowledge, skills, experience We acknowledge that there are multiple choices available when conducting citation searches. The Knowledge to Action (KTA) framework is an effective approach in the implementation science literature to methodically guide the translation of evidence-based research findings into practice, putting knowledge into practical use. It includes the production, synthesis and interpretation of knowledge. looked at 10 behaviour change interventions where explicit use of theory was absent, and mapped these strategies to domains of the Theoretical Domains Framework. contextualize the Evidence Based Review of Stroke Rehabilitation and Rehabilitation Knowledge to Action Project within the KTA model and (2) show how this process led . Action is the deeds or decisions made based on knowledge and information. This study sought to identify and describe available full-spectrum KT TMFs to subsequently guide users. The result set was reduced to 1,057 records following removal of duplicate and non-English language records. 10.1016/j.jclinepi.2004.09.002. 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). The first component of the model is the knowledge creation funnel, which represents the production and synthesis of knowledge. ASUS Corporate Stable Model (CSM) is a commercial program designed to provide stable and reliable motherboards. For example, in the context of clinical practice guidelines (CPGs), adapting existing national guidelines (which may lack applicability and how organizations need to change to adopt guidelines) to fit local circumstances serves not only to increase the relevance and applicability of guidelines, but also gives end-users a sense of ownership to help promote implementation. Nilsens paper provides an overview of evaluation frameworks to guide evaluation of implementation strategies [7]. None described applying every phase of the KTA Framework. The K2A framework describes and depicts the high-level processes necessary to move from discovery into action by using translation of evidence-based programs, practices, or policiesbroadly defined to include evidence-based communications, campaigns, guidelines, and other interventions and tools. Throughout each of these stages, researchers can take an integrated approach, tailoring their activities (be they developing research questions, messages or dissemination strategies) to that of the end-users. Russell and colleagues [25] describe use of a knowledge broker, an example of a linkage and exchange-type strategy. Retrieved from 10.2522/ptj.20070056. Any differences were discussed and resolved by consensus. Ullrich PM, Sahay A, Stetler CB: Use of implementation theory: a focus on PARIHS. Seventeen studies (12%) were noted as adapted or combined where the KTA Framework had either been modified or blended with another conceptual framework. Claude KM, Juvenal KL, Hawkes M: Applying a knowledge-to-action framework for primary prevention of spina bifida in tropical Africa. When thinking about program planning and implementation, there are several important concepts that need to be considered. Keyser SE: The Implementation of a Delirium Knowledge Translation Project for Families of the Elderly. For an overview of other determinant frameworks that are useful in this phase, see the determinant frameworks section of Nilsens paper [7]. Knowledge Creation includes knowledge inquiry, knowledge synthesis, and knowledge tools/products. the main menu, IL Further details can be found at J Nurs Care Qual. This citation analysis and systematic review investigated the practical application of a well-established conceptual frameworkthe KTA Framework [1]. The Knowledge-to-Action Framework | by Leah Crockett | KnowledgeNudge | Medium Sign up 500 Apologies, but something went wrong on our end. Three studies illustrated each phase of the Action Cycle or explained their reasons for not doing so [18],[23],[25]. 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]. 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]. Article For an example of how these might be developed, check out our earlier post. From Graham I, Logan J, Harrison M, Strauss S, Tetroe J, Caswell W, Robinson N: Lost in knowledge translation: time for a map? Knowledge Translation in Health Care: Moving from Evidence to Practice. 10.1002/chp.20077. Potential benefits from applying a conceptual framework include making the process of knowledge translation more systematic, with greater likelihood of changed practice and spread of evidence [4],[6]-[9]. Knowledge synthesis is essential when considering an initiatives potential for widespread implementation and collates existing knowledge using rigorous methodologies. Health Psychol. Guide to Evidence Based Practice and Knowledge Translation for Public Health Nursing. Each article was scrutinised and mapped against the corresponding phases within the Knowledge Creation and Action Cycle components of the framework. 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. It was cited 470 unique times across all databases. California Privacy Statement, 2007, 87: 1728-38. 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). Claude and colleagues [17] stated that these phases were beyond the scope of their project. As knowledge moves through the funnel, it is refined and summarized to be more useful for end-users. J Contin Educ Health Prof. 2006, 26: 13-24. Nine were published in peer-reviewed journals with the exception being a Master of Science degree dissertation [19]. Field, B., Booth, A., Ilott, I. et al. 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. 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. Becky Field. (2006) proposed the knowledge-to-action (KTA) process conceptual framework that could be useful for facilitating the use of research knowledge by several stakeholders, such as practitioners, policymakers, patients, and the public. Given the incomplete abstracts obtained via Google Scholar, a rule-out strategy was employed. We sought to identify all reported citations of a particular reference irrespective of the context within which that reference had been used. Program planning for health education and promotion. 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. Interest in using systematic literature reviews to investigate theories, models and conceptual frameworks has increased in recent years [7],[39]. 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. 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. 2010, 33: 259-263. Regardless of the approach, its critical to ensure that interventions are tailored to address the specific issue, audience and context to enhance uptake. J Adv Nurs. Worldviews Evid Based Nurs. We found that the framework is being used in practice, to varying degrees of completeness, and with theory fidelity when reported as integral to the implementation effort. 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. PubMed 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). Several conceptual frameworks are pertinent for implementation scientists, including Promoting Action on Research Implementation in Health Services (PARIHS) [5],[10] the Consolidated Framework for Implementation Research (CFIR) [3] as well as the KTA Framework [1]. A taxonomy categorising the continuum of usage was developed. 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. However, the method is replicable and could be repeated to update the review in future. A notable feature of the KTA Framework is the development of knowledge tools or products as part of Knowledge Creation. When the framework was integral to knowledge translation, it guided action in idiosyncratic ways and there was theory fidelity. This was necessary given the limited resources available to support the review process. 2nd ed. (Dignan, M.B & Carr, P.A. Davidoff F, Batalden P, Stevens D, Ogrinc G, Mooney SE: Publication guidelines for quality improvement studies in health care: evolution of the SQUIRE project. CDC Knowledge to Action Framework [PDF - 33 KB] An Organizing Framework for Translation in Public Health: The Knowledge to Action Framework Applying the Knowledge to Action (K2A) Framework: Questions to Guide Planning Tool [PDF - 3.57 MB] Glossary of Terms [DOC -17 KB] Page last reviewed: April 28, 2021 An exception was the study by Russell and colleagues [25] who reported using a questionnaire to assess a range of potential barriers and facilitators. Exploring the impact of the KTA Framework, and other conceptual frameworks, on patients and the public in terms of health improvement and outcomes would also be worthwhile, as would exploring their involvement in the application of the framework, not just as recipients of services but as key stakeholders in each phase. 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. Can J Speech-Language Pathol Audiol. Knowledge Translation in Health Care: Moving from Evidence to Practice. Several strategies were used to counter this risk. Lost in knowledge Translation: time for a map? CLAHRC YH would also like to acknowledge the participation and resources of our partner organisations. Questionnaires, interviews, workshops, focus groups and needs assessment were used to identify barriers to change. 2009, 4: Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N: Changing the behavior of healthcare professionals: the use of theory in promoting the uptake of research findings. Knowledge translation strategies can include elements such as linkage and exchange, audit and feedback, informatics and patient-mediated and organisational interventions [29]. Nine of the studies reported assessing barriers to change [17]-[19],[21]-[26]. All undertook the first phase of identifying the problem. volume9, Articlenumber:172 (2014) 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. Google Scholar. BMC Med Res Methodol. This review is designed to address this knowledge gap. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The framework has two components: Knowledge Creation and an Action Cycle, each of which comprises multiple phases. Implement Sci. Although the terms conceptual frameworks, theories and models are often used interchangeably, conceptual frameworks are broad and descriptive, whereas theories and models are more specific and amenable to hypothesis testing [6]. Search for more papers by this author. For example, difficulties in applying exclusion/inclusion criteria were discussed by the team and all subsequent decisions were then resolved by consensus. Knowledge-related barriers [32] were the most common, indicating the appropriateness of using educational strategies to address such barriers. It also involves comparing what is known about a problem and what current practice is and whether there is a gap that needs to be addressed. Primary studies, exploring the direct experience and perceptions of different stakeholders in implementation projects, which have been guided by conceptual frameworks, or theories, would add to our understanding of the utility and impact of these tools. Jacqueline Tetroe MA, This involved checking whether the four elements were described. 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. A prospective design would strengthen research studies. This MCHRI framework for impact has been adapted form multiple sources and from internal learnings and is underpinned by the Canadian knowledge to action process. 10.1002/chp.47. It is frequently cited, with usage ranging from simple attribution via a reference, through informing planning, to making an intellectual contribution. By using this website, you agree to our Interventions can be of multiple sorts: educational (passive or active strategies), professional (reminders, audit and feedback), organizational (redesign services), and patient directed (health literacy, patient decision aids) [3]. In practice, the implications of this decision were minimal as many Google Scholar records either duplicated full bibliographic records already identified from Web of Science or Scopus or contained at least sufficient detail in the title or in the limited text displayed (text fragment), to indicate whether the paper merited further consideration. Today well highlight one of the most highly cited conceptual frameworks in Canada the Knowledge-to-Action (KTA) Framework. However, the target audiences were primarily patients, the public and the nursing and allied health professions. 2012, 7: 48-10.1186/1748-5908-7-48. 2009, 6: Paper 10-10.2202/1548-923X.1741. Crosby R, Noar SM: Theory development in health promotion: are we there yet?. The least reported phase, or the phase carried out least often, was sustain knowledge use. Ilott I, Gerrish K, Bray K, Laker S: Tackling the implementation challenge: bridging thegapbetweenresearchandpractice. Do they work? 2002, 38: 94-104. Knowledge to Action Model. So-called action (or planned action) models are process models that facilitate implementation by offering practical guidance in the planning and execution of implementation endeavours and/or implementation strategies. They and we resorted to a simple taxonomy to describe the level and type of usage based on explicit reporting. It was cited 470 unique times across the three databases, indicating the bibliometric impact of the source paper. The knowledge to action (KTA) is a process model that helps you select implementation strategies. Bartholomew LK, Mullen PD: Five roles for using theory and evidence in the design and testing of behaviour change interventions. Prevailing wisdom encourages the use of theories, models and conceptual frameworks, yet their application is less evident in practice. Implement Sci. Powell BJ, McMillen C, Proctor E, Carpenter CR, Griffley RT, Bunger AC, Glass JE, York JL: A compilation of strategies for implementing clinical innovations in health and mental health. This reflects the spread of the framework across a range of settings, to different health care services and systems and larger scale and smaller projects. 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. 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]. Most studies focused on improving knowledge or awareness, supporting what we know about the preponderance of professional or educational knowledge translation strategies within interventions aiming to promote the uptake of evidence [31]. 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). The purpose of translation is to provide the best outcomes and value, and lower risks to our patient population. 2012, 69: 123-157. The KTA Framework is one of many frameworks, models, and theories that provides KT researchers with a practical yet systematic method of implementation. 2023 BioMed Central Ltd unless otherwise stated. This may explain the varying degrees to which the framework was used. Methods: We used the Knowledge to Action framework, which was developed to map how science is translated into effective health programs, to examine how the evidencebased intervention from the 2002 Diabetes Prevention Program trial was translated into the Centers for Disease Control and Prevention's largescale National Diabetes Prevention Manage cookies/Do not sell my data we use in the preference centre. Rather, we focused on the application of, and theory fidelity to, the KTA Framework. 2010, 5: 92-10.1186/1748-5908-5-92. Similarly, we acknowledge that some readers may be interested in precise reasons for exclusions. 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. We did not include the many papers about clinical practice guidelines for two interrelated reasons. Making sense of implementation theories, models and frameworks. The uptake of EBP is a complex process that can be facilitated by the use of the Knowledge to Action Process model. In ten studies, the KTA Framework was integral to the design, delivery and evaluation of the implementation activities. Safari. All ten studies reported using the Action Cycle. Only ten studies reported and gave supportive examples of incorporating the KTA Framework in an integrated way. This is a limitation of using Google Scholar for citation searches. Selecting an intervention has been described as both an art and a science, and ideally should be based on evidence of its effectiveness [2]. Provided by the Springer Nature SharedIt content-sharing initiative. Musk was a co-founder of OpenAI before leaving its board in 2018, and has complained recently of the company's move from a nonprofit model to a highly valuable business influenced by Microsoft. The importance of organisational or external factors and the ability to influence them is well recognised [1],[3],[33]-[35]. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, Altman DG, Barbour V, Macdonald H, Johnston M, Lamb SE, Dixon-Woods M, McCulloch P, Wyatt JC, Chan A-W, Michie S: Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. The framework has two components: Knowledge Creation and an Action Cycle, each of which comprises multiple phases. 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. The KTA Framework is being used in practice with varying degrees of completeness. We focus on all things knowledge translation (KT) and patient engagement (PE), from a health research and healthcare perspective. 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.
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