2008, 3: 1-10.1186/1748-5908-3-1. Share your thoughts in the comments section below, or by tweeting at us at @KnowledgeNudge. Today well highlight one of the most highly cited conceptual frameworks in Canada the Knowledge-to-Action (KTA) Framework. Can J Speech-Language Pathol Audiol. Straus S, Graham I: Development of a mentorship strategy: a knowledge translation case study. Theories and Models of Knowledge to Action. This citation analysis and systematic review investigated the practical application of a well-established conceptual frameworkthe KTA Framework [1]. 2011, 71 (Suppl 1): S20-S33. 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. This review sought to answer two questions: Is the KTA Framework used in practice? Methods Google Scholar. 2012, 69: 123-157. It includes the production, synthesis and interpretation of knowledge. 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]. Field, B., Booth, A., Ilott, I. et al. Involvement of stakeholders, and tailoring knowledge to the needs of people who are going to use it, is crucial. -[http://www.cihr-irsc.gc.ca/e/39033.html]. Authors identified many barriers relating to environmental factors [32] such as lack of time and/or resources. Four of the ten studies [17],[19],[21],[23] reported gaining ethical approval, suggesting that these had been independently characterised as research. When using the Knowledge to Action Process model to effect an evidence-based change (e.g., in a clinical practice), one of the factors that knowledge users (e.g., clinicians) may site as an impediment is an absence of the evidence appraisal and statistical analysis skills that are required in the knowledge inquiry phase. 2013, 19: 915-24. AB is Reader in Evidence Based Information Practice at the School of Health and Related Research (ScHARR), University of Sheffield, where he leads on systematic review and evidence synthesis activities. 2010, 5: 92-10.1186/1748-5908-5-92. Building a conceptual model Forms of knowledge Research evidence Clinician knowledge, skills, experience This study sought to identify and describe available full-spectrum KT TMFs to subsequently guide users. Action phases may be carried out sequentially or simultaneously; knowledge phases may impact on the action phases. 2005, 58: 107-12. 2013, 69: 2336-47. Action Cycle within the KTA Model The second step involves adapting the validated knowledge to the local context. We have chosen to report the aggregate number of excluded papers on the PRISMA flow diagram (Figure 2). The KTA process has two components: Knowledge Creation and Action. 2010, Wiley Blackwell, Chichester, UK. 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. 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). No existing systematic review was found on this subject. "The KT Library is designed to provide information to NIDRR grantees and interested members of the public about a wide spectrum of knowledge translation and evidence-based resources.". Implent Sci. In contrast, they wanted to evaluate the impact of their intervention on peoples ability to understand their choices and make informed decisions about treatment. 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]. From 2008 to 2013, she led the Translating Knowledge into Action theme of NIHR CLAHRC SY. Box. This study is a citation analysis and systematic review. Reprinted with permission from John Wiley and Sons. 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 ]. A strategy informed by theory is also much more likely to be effective in changing behaviours and attitudes. As knowledge moves through the funnel, it is refined and summarized to be more useful for end-users. Two researchers (BF and II) conducted an initial assessment of the full-text articles. Rycroft-Malone J, Harvey G, Kitson A, McCormack B, Seers K, Titchen A: Getting evidence into practice: ingredients for change. Unfortunately, an implemented change is not usually self-sustaining and requires ongoing monitoring and effort. The Knowledge-to-Action Framework | by Leah Crockett | KnowledgeNudge | Medium Sign up 500 Apologies, but something went wrong on our end. The Journal of Continuing Education in the Health Professions 2006, 26, p. 19. Based on knowledge to action, there were 3 phases to the study implementation: problem identification (lack of routine checklist use in Cameroonian hospitals), multifaceted implementation strategy (3-day multidisciplinary training course, coaching, facilitated leadership engagement, and support networks), and outcome evaluation 4 months 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. 10.1111/wvn.12016. Provided by the Springer Nature SharedIt content-sharing initiative. Due to overlapping categories (e.g. All authors read and approved the final manuscript. Part of As weve discussed in a previous post, there are many theories, models and frameworks used in the field of knowledge translation (KT). Next, 911 records were excluded at the sift stage. Further, the time frame of the citation searches only captures work up to a certain point (from the date of publication of the source paper to July 2013). [http://www.rcn.org.uk/__data/assets/pdf_file/0014/512600/2013_RCN_research_W06.pdf]. Most studies (8/10) were conducted in Canada where the KTA Framework originated. A taxonomy categorising the continuum of usage was developed. Thomas A, Menon A, Boruff J, Rodriguez AM, Ahmed S: Applications of social constructivist learning theories in knowledge translation for healthcare professionals: a scoping review. Jacqueline Tetroe MA, The index citation for the source paper for the KTA Framework Lost in knowledge translation: time for a map? by Graham and colleagues [1] was identified on each of three databases that offered functionality for citation searching. Harrison, S.E. It is one of the most frequently cited conceptual frameworks for knowledge translation. Davies P, Walker AE, Grimshaw JM: A systematic review of the use of theory in the design of guideline dissemination and implementation strategies and interpretation of the results of rigorous evaluations. 2012, 43: 337-50. The purpose of translation is to provide the best outcomes and value, and lower risks to our patient population. Understanding if and how these theoretical tools add value to implementation endeavours and outcomes merits further research. Important considerations for choosing a KT strategy (or strategies) include a clearly defined goal or objective for each strategy, an understanding of how the strategy overcomes one or more barriers to behaviour or attitude change, and the use of theory to inform selection and implementation. Any differences were discussed and resolved by consensus. However, citation figures do not reflect how this conceptual framework has actually been applied in practice. 2010, Dissertation for Masters of Science, School of Nursing, Queens University, Ontario, Canada. (2010). A notable feature of the KTA Framework is the development of knowledge tools or products as part of Knowledge Creation. The views and opinions expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. 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. 2nd ed. This reinforces the importance of theory fidelity and that authors refer to established taxonomies or reporting standards [36],[37],[40],[41] so we can understand how conceptual frameworks, theories and models are really used to guide practice or inform research. Hua D, Carter S, Bellerive J, Allu SO, Reid D, Tremblay G, Lindsay P, Tobe SW: Bridging the gap: innovative knowledge translation and the Canadian hypertension education program. Using the Knowledge to Action Framework in practice: a citation analysis and systematic review. Upper Saddle River, NJ: Prentice Hall. They reviewed 31 planned action theories about the process of change. In summary, KTA is applying knowledge to real life situations. 2007, 14: 936-941. Three studies illustrated each phase of the Action Cycle or explained their reasons for not doing so [18],[23],[25]. The Knowledge to Action KTF The Knowledge to Action (KTA)4 is an overarching framework that includes both knowledge creation and implementation. Glossary for Knowledge to Action Framework; Research Phase. Edited by: Straus S, Tetroe J, Graham I. Bartholomew and Mullen [42] suggest that the prevailing wisdom in the field of health-related behaviour change is that well-designed and effective interventions are guided by theory (p. S20). As the process of KT is iterative, not only can (i) inform (ii), but components of the action cycle also feed back to inform knowledge creation [2, 3]. 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. Measuring this practice gap can include the use of administrative data, questionnaires, or conducting chart audits, to name a few. 10.2522/ptj.20070056. Nurs Stand. Stacey D, Higuchi K, Menard P: Integrating patient decision support in an undergraduate nursing curriculum: an implementation project. Knowledge creation has three phases: (1) knowledge inquiry, (2) knowledge synthesis, and (3) knowledge tools and products. One can also move between the knowledge creation phase and the action cycle, in an iterative fashion. We acknowledge that faced with the same task, another review team might choose to include papers reporting a single knowledge translation strategy. 10.1037/a0016939. Knowledge Translation in Health Care: Moving from Evidence to Practice. 10.1007/s10865-010-9260-1. BF is a researcher at the School of Health and Related Research (ScHARR), University of Sheffield, and also an occupational therapist. 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 production of knowledge tools and products uses synthesized knowledge to present evidence in concise and user-friendly formats tailored to meet end-user informational needs. Conventional views support the use of theories, models and conceptual frameworks to underpin the process of change, yet in practice, their application seems more limited [40],[43]-[45]. However, none of these knowledge translation strategies, designed to target different barriers, featured in the included studies, with one exception. Development of a theory coding scheme. 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]. Springer Nature. This frequency of use in Canada could be explained by the influence of national Canadian networks and dissemination activities. This may explain the varying degrees to which the framework was used. 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]. In real-world practices of the Data-Information-Knowledge-Action model, data are collected surrounding a problem to be addressed, then the data are interpreted to identify competing explanations for the problem, as well as uncertainties of the explanations. The KTA Framework is being used in practice with varying degrees of completeness. Understanding the barriers to knowledge uptake and implementation strategies, as well as facilitators of change, are critical to effective knowledge translation activities. Our experience certainly confirms that this search method circumvents the problems of variation in terminology typically encountered in topic-based searches of bibliographic databases. Ullrich PM, Sahay A, Stetler CB: Use of implementation theory: a focus on PARIHS. 10.1111/jan.12091. 2014, 9: 54-10.1186/1748-5908-9-54. 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. PubMed 2009, Wiley-Blackwell BMJ Books, Chichester, UK, 83-93. 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. School of Nursing, University of Ottawa, Ottawa, ON, Canada. The findings informed their conceptual framework, which was intended to address the need for conceptual clarity in the KTA field and to offer a framework to help elucidate what we believe to be the key elements of the KTA process [1] (p. 14). 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. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. We thank Jennifer Read who provided BF with academic supervision for her MSc dissertation. All ten studies reported applying the Action Cycle, describing at least five of the seven possible phases (see Table 5). 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. 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. Knowing your audience and assessing the value, usefulness and appropriateness of the particular knowledge is critical to its uptake and sustained use. . 2010, 33: 259-263. However, there are multiple KT TMFs and little guidance on which to select. Most of the theories were interdisciplinary or from nursing and were published between 1983 and 2006 [11]. Offering up to 36-month product lifecycle support and 6-month end-of-life notice to allow . The databases were Scopus, Web of Science and Google Scholar. 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]. Using the knowledge to action process model to incite clinical change. The KTA Framework was enacted in different health care and academic settings with projects targeted at patients, the public, and nursing and allied health professionals. Each study demonstrates the particularity of implementation activities. 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. Use at a lighter level through adapting or combining with other conceptual frameworks could be considered a strength, in that the KTA Framework offers the flexibility to be combined with other frameworks, being responsive to facilitating practitioner preferences and context-specific needs. Davies and colleagues [40] note that less than 6% of 235 studies, albeit published before 1998, explicitly used theories of behaviour or behaviour change. The Knowledge to Action Framework. 10.1136/bmjqs-2013-001862. The KTA Framework is one of many frameworks, models, and theories that provides KT researchers with a practical yet systematic method of implementation. Taylor MJ, McNicholas C, Nicolay C, Darzi A, Bell D, Reed JE: Systematic review of the application of the plan-do-study-act method to improve quality in healthcare. These were the question and study design, recruitment and selection and methods of data collection and analysis. 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. Terms and Conditions, From the perspective of the psychology of knowledge (e.g., Strube & Wender, 1993), knowledge is a competence for action, a . This is noteworthy given Canadian research may be published in French language journals. Rather, we focused on the application of, and theory fidelity to, the KTA Framework. A few free articles for further reading Chicago, 10.1016/j.amepre.2012.05.024. 2012, 8: 174-84. 2012, 9: 1-10.1111/j.1741-6787.2011.00240.x. Implement Sci. Duplicates between records from the databases were identified and the most complete record was retained for the subsequent sift process. Adapting to local context is a critical step in the process. Their findings suggested that the more domains that were targeted, the less effective the intervention was [9]. The KTA Framework is composed of two distinct, but related components: (i) Knowledge Creation, and (ii) the Action Cycle. These goals are to increase (a) the use of evidence-based research and (b) the understanding and use of KT principles. The citation search yielded 1,787 records. the main menu, 10.1177/1077558711430690. Firstly, we were interested in the practical application of the KTA Framework and thus in identifying papers where the KTA Framework appeared to be a fundamental guide to the work reported. Do they work? 10.1111/j.1740-8709.2010.00271.x. The KTA process has two components: (1) knowledge creation and (2) action. Papers were excluded if they were not empirical real-life applications of the KTA Framework; if they were literature reviews; if they were only conceptual or descriptive papers (including discussion, commentaries or protocols); if they described a single knowledge translation strategy, such as a clinical practice guideline; or if they were not topically relevant. For Web of Science and Scopus citations, full abstracts were identified. Notably, the KTA Framework assumes a systems perspective and situates knowledge producers and users within a system of knowledge that is responsive, adaptive, and unpredictable. The Action Cycle was reported in all the integrated examples, illustrating theory fidelity in this specific subset of studies.

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