Step KTA 3.A

Use initial need assessment, valuability assessments, and value proposition to match the discovery to the knowledge gap.

Primary findings

Secondary findings

Primary findings

Barriers

Failure of a research network (or project) to clearly articulate and broadly communicate its goals and objectives can impede its progress. It can also cloud stakeholder’s abilities to evaluate network (project) outcomes.
Lessons from a health research network evaluation
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When executives deliberate about the value of applying research in their organization, one of the factors they often consider is the “replicability” of the research findings, especially in their setting. Researchers should clearly communicate “replicability.”
Lessons from a health research network evaluation.
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When organizational executives deliberate about the value of applying research in their organization, one of the factors they often consider is the “scalability” of the research findings. Researchers should clearly communicate “scalability.”
Lessons from a health research network evaluation.
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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. Knowledge producers should clearly communicate, in simple terms, how knowledge users can assess the validity of the new knowledge. One solution is to provide easy-to-use synthesis, assessment, learning and application tools.
Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
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Carriers

Knowledge translation literacy — Establishing relevant research questions — Researchers tend to begin by observing a broad or abstract problem and then narrowing down to a very specific question that can be answered with confidence following a scientific method. In our experience, practitioners may take the inverse approach. They encounter a very specific or practical problem, and, in the course of framing research questions, their inquiry broadens and they see a whole family of interconnected issues that impinge on the question that also need to be addressed. In both cases, the process of defining the problem and the question are learning exercises. But the processes seem to move in opposite directions, and it can be challenging to execute a delimited project that makes sense and is meaningful to everyone. Involving stakeholders can help to isolate and hone the research question. They can be helpful in identifying policy nuances, complexities, contradictions, and systemic links that needed to be taken into account for the study to be comprehensive.
Literature review and experience.
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Researchers can benefit from establishing ongoing partnerships with key knowledge users (stakeholder groups). As a researcher gets to know a stakeholder group, there is the potential to develop a trusting relationship, which can lead to greater openness and opportunities to better understand the issues that drive the stakeholder group and the kinds of important questions that remain unanswered and remain open to research.
Lessons learned from close researcher-stakeholder partnerships.
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Researchers should carefully define and communicate to stakeholders what they mean by “moving research into practice.” The starting point of the spectrum is research findings that are specific to a unique set of circumstances. The endpoint of the spectrum is research findings that can be generalized across an entire system. Correctly setting stakeholder expectations is crucial.
Lessons from a health research network evaluation.
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The inclusion of a policy entrepreneur on a research project can enhance: policy-related research focus, policy stakeholder understanding of the project and engagement in related activities, and the relevance, transferability and use of research findings by policy stakeholders.
Project-based learnings.
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Models

As part of the evaluation planning associated with a research project, the researchers should consider the context of the knowledge translation process. Useful questions to ask include, what is the issue being translated? what stage of knowledge translation is currently the focus? who are the key actors? what are characteristics of the setting?
Literature review.
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Knowledge Translation — A wide range of models contribute insights for increasing awareness, interest and use of knowledge generated through research activity, among targeted stakeholder groups. Categories of such models include: 1) Organizational Innovation; 2) Social Science Research Utilization; 3) Nursing Research Utilization; 4) Health Promotion.
Literature review, synthesis and author expertise.
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Methods

According to the researcher’s guide to planning for knowledge translation there are five essential elements of knowledge translation, including: the problem (the problem or issue to be addressed by the research/knowledge), context (the circumstances surrounding the user and researcher), knowledge (properties of the pre-existing knowledge/evidence about the problem or the generation of new knowledge/evidence), intervention (specific activities designed to translate knowledge/research into action), and use (ways in which the knowledge/research is or might be used). For each element, a series of questions is provided. Each question encourages the researcher to think broadly and deeply about the knowledge translation implications. Elements and related questions are evidence-based, which adds to their credibility.
Knowledge translation guidance for researchers.
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Action Cycle within KTA Model — The action cycle takes a planned action approach which is a deliberate effort to change behaviors within social systems. The first step is to identify a problem or issue deserving attention and searching for knowledge that addresses the need. Any found knowledge — or newly generated knowledge — is critically appraised to determine its validity and usefulness for the problem.
Summary of the Knowledge To Action Model and its application to knowledge translation.
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Identify a problem that needs addressing; Identify the need for change; Identify change agents (i.e., the appropriate actors to bring about the change); Identify target audience; Assess barriers to using the knowledge; Review evidence and literature or develop or adapt innovation; Select and tailor interventions to promote the use of the knowledge; Link to appropriate individuals or groups who have vested interests in the project; Implement; Evaluate; Develop a plan to evaluate use of the knowledge; Pilot test; Evaluate process; Evaluate outcomes; Maintain change or sustain ongoing knowledge use.
Results from a knowledge synthesis
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Initiate “knowledge awareness” by identifying the appropriate or valuable knowledge.
Literature review.
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Knowledge Translation — the primary purpose of KT is to address the gap between the base of knowledge from research along with related knowledge syntheses, and the implementation of this knowledge by key stakeholders. To address the gap between what is known and what is used.
Summary of the Knowledge To Action Model and its application to knowledge translation.
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Knowledge brokering — the closer the knowledge brokering service matches the knowledge users’ needs and environment, the more likely the brokering services will be used. One way to facilitate this alignment is to conduct an in-depth needs assessment with potential participants. This approach is helpful in building relationships between the broker and potential users — which facilitates trust and sustainable engagement. This approach also enables the broker to better understand the life cycle of the users’ project and to adapt service offerings to changing needs.
Description of knowledge broker roles.
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When intending to implement change, one also needs to consider the impact of the following factors to fully understand what is involved in completing each of the steps: 1) nature of the evidence or knowledge, 2) attributes of change or innovation, 3) who the audience is, 4) organizational context and culture in which the change is to take place, 5) the organizational resources and support for the proposed change, and 6) implementation-related factors.
Results from knowledge synthesis
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When using the Knowledge to Action Process model to effect an evidence-based change (e.g., in a clinical practice), one approach that can be taken to identifying a problem (phase 1 of the model) with a practice is to formally study actual cases (e.g., by conducting chart audits).
Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
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When using the Knowledge to Action Process model to effect an evidence-based change (e.g., in a clinical practice), one approach that can be taken to identifying a problem (phase 1 of the model) with a practice is to formally survey knowledge users (clinicians) about their use of research knowledge in their practice.
Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
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When using the Knowledge to Action Process model to effect an evidence-based change (e.g., in a clinical practice), one approach that can be taken to identifying a problem (phase 1 of the model) with a practice is to conduct focus groups with knowledge producers (researchers) and knowledge users (clinicians) to explore why there are gaps between the availability of research evidence and its application in a clinical setting.
Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
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Tips

Develop a strong Knowledge Management system within a complete New Product Development Strategy and the New Product Development Performance will be more effective.
Survey. T-Tests and Multiple regressions were performed on each component of Knowledge Management and New Product Development Strategy to New Product Development Performance. All results were found to be significant and positive.
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In cases where new research findings conflict with a stakeholder’s existing values, if research is framed as a process of argument or debate to help create legitimate concern and help set an appropriate agenda (and not as a product to be used solely for problem-solving), as part of the process, stakeholders may adjust their values to be in alignment with the research results and not interpret the finding to be a threat, but see them as constructive and valuable.
Literature review and single case study.
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In the government policy making process, it is important to remember that research evidence often competes with other forms of evidence (e.g., budgetary constraints and the legal code) and with values (e.g., public opinion about the role of government versus the market). The receptivity of a policy proposal can be influenced by how it aligns with (or is given visibility by) other institutional arrangements (e.g., jurisdictional authorities, past policies and practices, etc.) and interests (e.g., elected officials’ commitments, civil servants’ authorities, advisory bodies, etc.).
Literature review and direct experience.
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Knowledge translation efforts should be mindful of the project valuation metrics internally used by transfer partners. For example, one company accepts projects based on a review of strategic fit, ability to increase revenue, ability to increase market share, degree of product differentiation, and technological advancement.
Survey of 105 U.S. companies
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Knowledge translators should adopt conceptualizations of knowledge, evidence, and KT as human processes fraught with all of the challenges of human subjectivity, dynamic interaction, and change within a complex context.
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Research design: Where possible, involve an international, interdisciplinary team of experts and professionals in the design of the research program and its related content. Active and regular researcher interaction with political and policy decision-makers is highly recommended.
Applying integrated KT in Mental Health research.
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Research funders should consider funding large-scale systematic push efforts. Using this approach, there could be a greater chance that the research being pushed by researchers could be matched with the needs of public policymakers (or trigger the opening of policy windows in the policy making process).
Literature review and direct experience.
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Researchers (and research networks) can enhance stakeholder receptivity to the application of research findings by establishing stakeholder advocates — members of the stakeholder community that are recognized as leaders and respected by their peers.
Lessons from a health research network evaluation.
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Researchers are usually required to obtain advance approval from independent ethics boards prior to engaging in research that involves human subjects. Knowledge users (stakeholder groups) are often unfamiliar with requirements associated with informed consent, anonymity, confidentiality, data access and data management. Ensure these requirements and their implications for participation, process and practice are understood at the beginning of the project.
Lessons learned from close researcher-stakeholder partnerships.
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Researchers can benefit from establishing ongoing partnerships with key knowledge users (stakeholder groups). Each stakeholder group brings a unique and informed perspective that can positively influence research design and knowledge translation strategy.
Lessons learned from close researcher-stakeholder partnerships.
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Researchers should not assume that practitioners will see any direct connection between academic research and the practices of their organization. Researchers should take the time to help practitioners make the connection.
Case study.
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Stakeholder engagement strategies must be tailored to each stakeholder group. Strategies to engage strategic direction-setters will be different from strategies required to engage perception-influencers and/or adopters.
Literature review and case example.
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The inherently complex nature of knowledge translation implies that, to be comprehensive, there would need to be an equally complex set of knowledge translation guidelines. This is not practical for design or practice, as it could involve a significant number of permutations and combinations and could easily overwhelm a researcher — especially a novice one. One alternative is to provide a simple template that explains the essential knowledge translation guideline categories (e.g. problem statement, research context, knowledge objectives, possible research interventions, and potential knowledge uses) and associates sample questions and hypothetical examples with each category to reinforce deliberation, understanding and application.
Knowledge translation guidance for researchers.
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There is a huge gap to bridge between the kind of questions that policy makers would like to have answered, and the kind of answers that researchers can typically provide. For example, policy makers rarely transmit clear messages on their knowledge needs to inform a feasible and timely solution to a problem within their context. While researchers produce scientific evidence that is not always tailor-made for applications in specific contexts, while also being careful to qualify their findings and set the limitations of their interpretation.
Comparative analysis of policy-related research results and the expectations of policy-makers regarding information useful for application in their decisions.
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When a client (stakeholder) is involved in the knowledge translation process, the practitioner may solicit, validate and integrate client-supplied knowledge (about the client’s situation and environment) into the overall knowledge translation process.
Application of Graham’s Knowledge-to-Action Process model in occupational therapy.
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When knowledge translation process involves collaboration with the client (stakeholder), interactions with the client can shape the knowledge translation process before research is even accessed.
Application of Graham’s Knowledge-to-Action Process model in occupational therapy.
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Secondary findings

Carriers

A research project-based policy entrepreneur can be a central force for coordinating and promoting collective policy learning.
Source: Stone (2001a). In: Williams, A., Holden, B., Krebs, P., Muhajarine, N., Waygood, K.,Randall, J. & Spence, C. (2008)

According to policy scientists, involving the target users of research information from the start of the process — such as policymakers and healthcare providers — would favor the eventual uptake and use of research results.
Source: C. Weis (1979). In: van Kammen, J., Jansen, C.W., Bonsel, G.J., Kremer, J.A.M., Evers, J.L.H., & Wladimiroff, J.W. (2006)

Mass dissemination through the local media can be critical to ensuring that beneficial development takes place. The more people that are aware of the research, the greater the likelihood that the findings and their implications will be discussed, and the better the interest and support for the practical applications of the results. Engaging the media can be a key factor. For research to have the desired impact on social consciousness and policy directives, research dissemination strategies should target both decision makers, as well as the general public.
Source: Miller (1999). In: Williams, A., Holden, B., Krebs, P., Muhajarine, N., Waygood, K.,Randall, J. & Spence, C. (2008)

Ottawa Model of Research Use (OMRU) — There are six essential elements in the design of a strategy to introduce research findings into practice: 1) the practice environment; 2) the potential adopters of the evidence; 3) the evidence-based innovation; 4) research transfer strategies; 5) the evidence adoption; 6) health-related and other outcomes. The systematic assessment, monitoring and evaluation of the state of each of the six elements is required before, during and after any efforts to transfer the research findings.
Source: Logan, J et al (1999). In: Estabrooks, C.; Thompson, D.S., Lovely, J.J.E., & Hofmeyer, A. (2006)

Participation of research project-based policy entrepreneurs in public policy networks can strengthen the linkages and exchanges between researchers and policy makers.They provide awareness of research and initiatives and facilitate social learning.
Source: Reinicke (1999, 2000); Kingdon (1984). In: Williams, A., Holden, B., Krebs, P., Muhajarine, N., Waygood, K.,Randall, J. & Spence, C. (2008)

Partnering with local media providers can allow research to be tailored to meet the needs and address the concerns of the local audience. Public and political perceptions of the value and creditability of research can be higher if it is local in context and is provided by local experts who have a commitment to sustained involvement and good communication practices, which in turn can create a higher degree of trust in research findings. Using well-established and credible messengers, such as local media, not only facilitates wider dissemination, but can also reinforce the importance of working with the community, as well as target audiences, in all stages of the knowledge transfer process.
Source: Cooke (1995); Maskell (1999); Tyden (2000). In: Williams, A., Holden, B., Krebs, P., Muhajarine, N., Waygood, K.,Randall, J. & Spence, C. (2008)

Methods

Diffusion of Innovations — Four main elements influence the spread of a new idea: 1) The idea; 2) Communication channels; 3) Time; 4) A Social System. When presented with new information/ideas, individuals progress through five stages when considering use: 1) Awareness; 2) Persuasion; 3) Decision; 4) Implementation; 5) Adoption. Once adopted by some members of a social system, the idea is shared over time with other members via communication channels.
Source: Rogers, E (12003). In: Estabrooks, C.; Thompson, D.S., Lovely, J.J.E., & Hofmeyer, A. (2006)

Participatory Action Research (PAR) has been found to integrate KT with the innovation development and adoption process. Specifically, the PAR process enables participants to take an innovation and adapt it to their context, to engage in critical reflection to achieve this adaptation, and to work behind the scenes to encourage involvement and commitment.
Source: Waterman, et al. (2007). In: McWilliam, C. L., Kothari, A., Ward-Griffin, C., Forbes, D., Leipert, B. & South West Community Care Access Centre Home Care (2009)

Tips

It takes more time and effort for people to process information that is delivered through words instead of numbers. Consider this when developing implementation tools.
Source: In: Booker, M. D., Drake, A. R., & Heitger, D. L. (2007)

The sole act of rendering research results understandable by stakeholders may be of limited value. Real benefits are often derived from the application of research results that respond to a specific stakeholder need.
Source: Davis (1996); Golden-Biddle (2003). In: Bowen, S., Martens, P. & The Need to Know Team (2005)

When designing a knowledge translation communication strategy, researchers should consider clarifying the research priorities that are being addressed and the respective funding sources. Researchers should also clearly state their dissemination goals.
Source: Majdzadeh (2008); Canadian Health Services Research Foundation (2004). In: Wilson, P.M., Petticrew, M., Calnan, M. W. & Nazareth, I. (2010)