(2010). Theories and Models of Knowledge to Action. 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). In other cases, we made an initial judgement, based on the abstract or a Google text fragment, that the paper was not about an empirical, real-life, knowledge translation or implementation project. Translation - Moving the best evidence into professional practice. The uptake of EBP is a complex process that can be facilitated by the use of the Knowledge to Action Process model. Studies were published between 2007 and 2013. ASUS Corporate Stable Model (CSM) is a commercial program designed to provide stable and reliable motherboards. Box. Several strategies were used to counter this risk. 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. Three studies illustrated each phase of the Action Cycle or explained their reasons for not doing so [18],[23],[25]. For an overview of other determinant frameworks that are useful in this phase, see the determinant frameworks section of Nilsens paper [7]. 10.1111/j.1752-7325.2011.00223.x. Knowledge-to-Action Framework | CEBI J Adv Nurs. The KTA Framework was enacted in a variety of ways, from informing to full integration, showing flexibility of use and that it can fit local circumstances and need. Papers could be scrutinised according to how their aims and objectives had been operationalised. 10.1177/1077558711430690. Implement Sci. The KTA Framework comprises two distinct but related components: (i) Knowledge Creation (represented by the funnel) surrounded by (ii) the Action Cycle (Figure 1). 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]. Adapted from Graham 2006 (https://pubmed.ncbi.nlm.nih.gov/16557505/) by Crockett 2017 (https://medium.com/knowledgenudge/kt-101-the-knowledge-to-action-framework-7fbe399723e8). 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. Data collection PDF SYSTEMATIC REVIEW Open Access Using the Knowledge to Action Framework Referred to as first generation knowledge and vastly out of scale (considering that the body of new, original knowledge in healthcare is enormous part of the reason we need KT), knowledge inquiry refers to primary studies and represents the majority of research that is conducted. In these studies, the KTA Framework appeared to provide a practical yet flexible guide to getting research findings into practice, allowing it to be applied in idiosyncratic ways. This illustrates the adaptability of the conceptual framework to different health care settings and topics. Too many KT strategies use the traditional ISLAGIATT (It Seemed Like A Good Idea At The Time)* approach, and result in uninformed interventions that are often too broad and too ambitious. The action cycle is iterative and includes the deliberate application of knowledge to cause change in behaviours and/or attitudes. The result set was reduced to 1,057 records following removal of duplicate and non-English language records. 60607, Chicago, Thirty nine (27%) were categorised as informed because the KTA Framework had influenced the project in a non-specified way without citing examples of how it had been applied. Implement Sci. The Knowledge-to-Action Framework | by Leah Crockett - Medium 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. This may reflect a publication bias, between reporting process and outcomes. This framework was developed in Canada by Graham et al. Action includes identifying and appraising the problem and the known research, identifying barriers and successes, planning and executing, and finally monitoring, evaluating, and adjusting. Quality assessment of the integrated studies proved problematic given that many papers did not report research questions, traditional research designs or recruitment and selection of participants as required by the criteria [16]. However, our review focused primarily on examining how a conceptual framework had been used in practice. It is important to note that Graham and colleagues have continued to publish on applications of the framework and the multiple factors to be considered [29]. Phys Ther. Most studies created a range of products, either as part of Knowledge Creation [18],[20],[21],[26] or the Action Cycle [21],[23],[24]. The Journal of Continuing Education in the Health Professions 2006, 26, p. 19. We did not follow up references (including book chapters) or contact authors of included or excluded studies. A secondary concern was theory fidelity [13], which relates to how this conceptual framework was being used in practice, specifically whether the KTA Framework was articulated in a way that was true to the source paper [1]. Health professionals across the globe share the challenges of translating the best available evidence into actual health interventions in a timely way to provide the most effective care and service. looked at 10 behaviour change interventions where explicit use of theory was absent, and mapped these strategies to domains of the Theoretical Domains Framework. Becky Field. Only one study [26] reported using decision support tools as a knowledge translation strategy, although it is possible others did not report all the details of strategies they used to promote the adoption of their interventions. There are a number of factors that can hinder or enhance the uptake of knowledge, including issues relating to the knowledge itself, factors relating to those who will be using the knowledge, and the context where the knowledge is to be used. Journal of Continuing Education in the Health Professions, 30, 167-171. doi:10 This is typically the recommended starting point for implementation and involves identifying a problem that needs attention. 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. Inevitably, decisions about including or excluding studies were reliant on subjective judgements about whether the KTA Framework had been reported in an integrated way, or not. Knowledge synthesis is essential when considering an initiatives potential for widespread implementation and collates existing knowledge using rigorous methodologies. Regardless of the approach, its critical to ensure that interventions are tailored to address the specific issue, audience and context to enhance uptake. Article 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. Social support interventions. BMJ Qual Saf. Discovery: The original biomedical, behavioral, or epidemiologic factor that stimulated development of an intervention (1).. Efficacy: The extent to which the intended effect or benefits were achieved under optimal conditions (2).. The KTA could also be used as a literacy device to structure reporting of the framework. Assessing the public health impact of health promotion initiatives. Translating Evidence Into Practice Through Knowledge Impleme - LWW 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]. Overview of the Knowledge to Action Cycle. (2013), "The effectiveness of knowledge translation strategies used in public health: a systematic review" (2012), "Uncovering Tacit Knowledge: A Pilot Study to Broaden the Concept of Knowledge in Knowledge Translation" (2011), "Assessing the public health impact of health promotion initiatives" (2010), Agency for Healthcare Research and Quality (AHRQ) - Translating Research into Practice, Canadian Institute for Health Research (CIHR) - Knowledge Translation & Commercialization, Center on Knowledge Translation for Disability and Rehabilitation Reseach (KTDRR) - KT Library, Cochrane Public Health Group - Knowledge Translation, McMaster University - Collaborations for Health (CfH) - Knowledge Translation, National Collaborating Centre for Methods and Tools - Knowledge Translation Methods and Tools for Public Health, University of Alberta - Knowledge Utilization Studies Program, Develop a PLAN - determine key stakeholders, expertise & support, Measure/collect data - baseline, process, outcomes, expenses, Implement - DO - pilot roll-out, educate, support, navigate, Manage & Adjust - ACT - Adapt, Adopt or Abandon based on evidence, Sustain & Grow - Share the results, get feedback, embed in standards or policies, spread more broadly. Armstrong R, Waters E, Dobbins M, Anderson L, Moore L, Petticrew M, Clark R, Pettman TL, Burns C, Moodie M, Conning R, Swinburn B. Kitson A, Powell K, Hoon E, Newbury J, Wilson A, Beilby J. LaRocca R, Yost J, Dobbins M, Ciliska D, Butt M. Kothari AR, Bickford JJ, Edwards N, Dobbins MJ, Meyer M. National Collaborating Centre for Methods and Tools (2010). The full text of the 146 papers was examined to establish the extent to which the use of the KTA Framework was attributed by the authors. Helfrich CD, Damschroder LJ, Hagedorn HJ, Daggett GS, Sahay A, Ritchie M, Damush T, Guihan M, Ullrich PM, Stetler CB: A critical synthesis of literature on the promoting action on research implementation in health services (PARIHS) framework. Knowledge-to-action cycle | BMJ Evidence-Based Medicine School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK, You can also search for this author in Knowledge creation has three phases: (1) knowledge inquiry, (2) knowledge synthesis, and (3) knowledge tools and products. CIHR also provides a practical guide to designing a KT intervention for health researchers, with relevant examples of its application. Petzold, A., Korner-Bitensky, N., & Menon, A. (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. Springer Nature. Others argue that the effectiveness and generalisability of implementation studies are hindered by weak theoretical underpinnings [40],[43],[44]. J Contin Educ Health Prof. 2006, 26: 13-24. The lead author (BF) contributed to this study while undertaking the National Institute for Health Research/Health Education England Clinical Academic Training Programme Master in Clinical Research scheme. The search results are illustrated in Figure 2, the PRISMA flow chart. 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. Knowledge becomes more refined as it moves through these three steps. Jacqueline Tetroe MA, Furthermore, knowledge can inform each phase of the action cycle and the knowledge funnel can rotate to feed into different phases. The KTA Framework is one of many frameworks, models, and theories that provides KT researchers with a practical yet systematic method of implementation. Initial screening out by title and abstract on the basis of partial information from Google Scholar may also have excluded relevant studies. Seven described using both the Knowledge Creation and the Action Cycle components [18],[20]-[24],[27]. the secondary menu, the site search form or go 2010, 5: 82-10.1186/1748-5908-5-82. Citation searching was further indicated in this review given that our scoping search, using the databases MEDLINE and CINAHL, had previously identified few abstracts reporting explicitly the use of the KTA Framework in practice. 10.1046/j.1365-2648.2002.02150.x. By using this website, you agree to our Implementation Sci 9, 172 (2014). How have you used the KTA Framework in your own work? Leah Crockett is a doctoral student in the Department of Community Health Sciences at the University of Manitoba. review papers, conceptual or descriptive papers and those describing a single knowledge translation strategy or not topically relevant), we excluded against a single criterion, even when multiple criteria applied, as practical considerations rendered it unnecessary to exhaustively document all possible reasons for exclusion for each paper. The KTA Framework consists of two components: (1) Knowledge Creation Knowledge creation is represented by the funnel in the centre of the image above. Knowledge Creation includes knowledge inquiry, knowledge synthesis, and knowledge tools/products. All these described the Action Cycle and seven referred to Knowledge Creation, articulating the KTA Framework in a way that was true to the source paper [1]. In contrast, they wanted to evaluate the impact of their intervention on peoples ability to understand their choices and make informed decisions about treatment. 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. The knowledge to action cycle begins with the identification of a problem (usually a gap in care provision). volume9, Articlenumber:172 (2014) Importantly, these integrated studies included examples to illustrate how the KTA Framework had been used as a guide. Musk threatens to sue Microsoft over Twitter data being used in A.I. - CNBC 10.1002/chp.47. The KTA Framework is a framework for guiding the process of KT, adopted by the Canadian Institutes of Health Research (CIHR) and other organizations worldwide. Tabak RG, Khoong EC, Chambers DA, Brownson RC: Bridging research and practice: models for dissemination and implementation research. No existing systematic review was found on this subject. Translating Knowledge into Action to Prevent Type 2 Diabetes: Medicare 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]. A notable feature of the KTA Framework is the development of knowledge tools or products as part of Knowledge Creation. A taxonomy categorising the continuum of usage was developed. 2013, 13: 118-10.1186/1471-2288-13-118. Education was the most frequently employed strategy albeit in a variety of forms. 10.1016/j.jclinepi.2004.09.002. Philadelphia: Lea & Febiger. 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]. The Knowledge to Action KTF The Knowledge to Action (KTA)4 is an overarching framework that includes both knowledge creation and implementation. The KTA process has two components: Knowledge Creation and Action. A prospective design would strengthen research studies. Program implementation involves the activities of putting the program into place, from gaining acceptance for the program to making revisions when the program is not working as planned - (Ervin, N. Advanced community health nursing practice: Population focused care. The source paper was cited four times more frequently than the next highest cited article from the same journal published in the same year. Understanding effects in reviews of implementation interventions using the Theoretical Domains Framework. The Knowledge to Action (KTA) Framework was developed in Canada by Graham and colleagues in the 2000s, following a review of 31 planned action theories. 10.1016/j.amepre.2012.05.024. 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]. Interest in using systematic literature reviews to investigate theories, models and conceptual frameworks has increased in recent years [7],[39]. 10.2340/16501977-0451. Privacy Finding Health Statistics: Going Beyond the Literature, Learning, Leadership, and Professionalism, NExT Online Course for Public Health Nursing, Program planning for health education and promotion, Special Collections & University Archives, Nursing Experts: Translating the Evidence - Public Health Nursing, The Canadian Institute of Health Research, https://pubmed.ncbi.nlm.nih.gov/16557505/, https://medium.com/knowledgenudge/kt-101-the-knowledge-to-action-framework-7fbe399723e8, "Knowledge translation strategies to improve the use of evidence in public health decision making in local government: intervention design and implementation plan" (2013), "Knowledge translation within a population health study: how do you do it?" Measuring this practice gap can include the use of administrative data, questionnaires, or conducting chart audits, to name a few. Implement Sci. Ilott I, Gerrish K, Bray K, Laker S: Tackling the implementation challenge: bridging thegapbetweenresearchandpractice. All undertook the first phase of identifying the problem. 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. Implement Sci. The Knowledge to Action (KTA) Framework was developed in Canada by Graham and colleagues in the 2000s, following a review of 31 planned action theories. 2014, 9: 54-10.1186/1748-5908-9-54. Article Evaluating outcomes is an area of KT that requires more attention and involves evaluating whether application of the knowledge is actually impacting the desired outcome be it patient or practitioner behaviour, health outcomes, or system-level changes. The framework has two components: Knowledge Creation and an Action Cycle, each of which comprises multiple phases. Nine were published in peer-reviewed journals with the exception being a Master of Science degree dissertation [19]. Theories and Models of Knowledge to Action - Knowledge Translation in Google Scholar. 10.1002/chp.179. Rycroft-Malone J: Implementing evidence-based practice in the reality of clinical practice. The "Knowledge to Action" Cycle: A Conversation with Dr. Ian Graham Most studies illustrate how knowledge was adapted to the local context. 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 quality of reporting was assessed using criteria adapted from Carroll and colleagues [16]. Citation searches were limited to the period from 2006 (the date of publication of the source paper) to July 2013. 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]. 2009, 41: 1024-1032. 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]. 10.1007/s10865-010-9260-1. Change may occur at more than one level, and for more than one intended end-user, and may require multiple methods of monitoring knowledge use. This study is a citation analysis and systematic review. In the context of healthcare, the Theoretical Domains Framework (which we break down in another post) is one example of a comprehensive, validated, and integrative model for assessing barriers to change that can be used to inform the development of strategies for changing attitudes and behaviours [5, 6]. They and we resorted to a simple taxonomy to describe the level and type of usage based on explicit reporting. One hundred and forty-six studies described usage to varying degrees, ranging from referenced to integrated. PDF Introduction to Knowledge into Action - The Centre for Evidence-Based 2010, 29: 1-8. Our review, and similar studies [39],[40],[43]-[45], consistently comments on the limited, haphazard use of theory, even though theories can be applied in many different ways [41]. Sixty two of the 146 papers (43%) were classified as referenced, meaning that the framework was cited with little, if any, further explanation (see Table 2). IL These were the question and study design, recruitment and selection and methods of data collection and analysis. This scheme may be useful for similar studies examining theory use.