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1 1 © Fraser Health Authority, 2007 The Fraser Health Authority (“FH”) authorizes the use, reproduction and/or modification of this publication for purposes other than commercial redistribution. In consideration for this authorization, the user agrees that any unmodified reproduction of this publication shall retain all copyright and proprietary notices. If the user modifies the content of this publication, all FH copyright notices shall be removed, however FH shall be acknowledged as the author of the source publication. Reproduction or storage of this publication in any form by any means for the purpose of commercial redistribution is strictly prohibited. This publication is intended to provide general information only, and should not be relied on as providing specific healthcare, legal or other professional advice. The Fraser Health Authority, and every person involved in the creation of this publication, disclaims any warranty, express or implied, as to its accuracy, completeness or currency, and disclaims all liability in respect of any actions, including the results of any actions, taken or not taken in reliance on the information contained herein. Knowledge Transfer and Exchange (KTE) Terminology and Steps in Planning Dissemination
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© Fraser Health Authority, 2007

The Fraser Health Authority (“FH”) authorizes the use, reproduction and/or modification of this publication for purposes other than commercial redistribution. In consideration for this authorization, the user agrees that any unmodified reproduction of this publication shall retain all copyright and proprietary notices. If the user modifies the content of this publication, all FH copyright notices shall be removed, however FH shall be acknowledged as the author of the source publication.

Reproduction or storage of this publication in any form by any means for the purpose of commercial redistribution is strictly prohibited.

This publication is intended to provide general information only, and should not be relied on as providing specific healthcare, legal or other professional advice. The Fraser Health Authority, and every person involved in the creation of this publication, disclaims any warranty, express or implied, as to its accuracy, completeness or currency, and disclaims all liability in respect of any actions, including the results of any actions, taken or not taken in reliance on the information contained herein.

Knowledge Transfer and Exchange (KTE)

Terminology and Steps in Planning Dissemination

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Beware!Be aware of the fact that the science of KTE has a deluge of terminology which is often used interchangeably (and often incorrectly !)

terms actually all have a specific meaning and action(s) associated

In this presentation, you will be introduced to the same terminology from two (or more) perspectives:

1) the academic research perspective –CIHR / CHSRF2) the continuing health education perspective-CACHE

The key is to remember the source and its objective

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Knowled

ge

Tran

sfer

?

Knowledge Synthesis??

Knowledge

Exchange?

Knowledge to Action ?

Knowledge Dissemination?

KT

KSTE

Knowledge Utilization

Terminology?

Dissemination Utilization

Actionable

MessageKTE KSE

Knowledge Sharing

diffusion

Push / Pull

Linkage & Exchange

Knowledge Translation

Knowledge

Mobilization

Knowledge management

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What is most important?

To understand:

That KTE is an iterative process that takes timeHow the KTE process worksThat a range of stakeholders need to be involvedEffective strategies for KTEUseful frameworks for facilitating the use of best evidence in practice or decision making

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Terminology- Knowledge Creation/Generation

Creation of “evidence-based”knowledge through scientific research/study or evaluation

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Terminology- Knowledge Translation

“The exchange, synthesis & ethically-sound application of knowledge---within a complex system of interactions among researchers & users----to accelerate the capture of benefits of research for Canadians through improved health, more effective services & products, and a strengthened health care system”

• Canadian Institutes of Health Research (CIHR-2000)

“The purpose is to bridge the gap between what we know (evidence) with what we actually do; any KT strategy takes into account that translation and learning occurs in a complex social system, thus, it requires a learner-centered approach”

• Canadian Association of Continuing Health Education (CACHE)

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Terminology- Knowledge Synthesis

The importance of understanding how the results from a single research study mesh with the larger body of knowledge / research on the topic

Conducted by completing a synthesis of the global literature on the topicAllows determination of the effectiveness of interventions or practices

Canadian Institutes of Health Research (CIHR-2000)

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Terminology- Knowledge Exchange

The interactions between the research user and the research producer that result in mutual learning

• Canadian Institutes of Health Research (CIHR-2000)

Emphasizes a collaborative approach that spans knowledge creation to its implementation.

• Canadian Association of Continuing Health Education(CACHE-)

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Lavis, Lomas et al (2006). Bulletin Lavis, Lomas et al (2006). Bulletin of the WHO.of the WHO. 99

The Push Model

Push

the researcher is the catalyst for change• packages tools (syntheses, policy briefs, videos) in

order to make research more accessible for decision-makers & other research users

Decision-maker is the target of information in the push model, but may be involved in the research also

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Lavis, Lomas et al (2006). Bulletin Lavis, Lomas et al (2006). Bulletin of the WHO.of the WHO. 1010

The Pull Model

Pull

Focus is on the decision-maker’s desire for informationThey may be looking for new evidence that will change programs/servicesThey may be learning how to critically appraise the evidence or learning how to use the evidence in decision-making

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Lavis, Lomas et al (2006). Bulletin Lavis, Lomas et al (2006). Bulletin of the WHO.of the WHO. 1111

Linkage and Exchange ModelResearchers and research-users collaborate for mutual benefit

May be a short or long-term collaboration and may occur at any point in the research / policy processMay include priority setting exercises, collaborative research projects, or projects with a developmental product at the end eg. database

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Terminology- Knowledge Transfer

“A systematic approach to capturing, collecting & sharing tacit knowledge in order for it to become explicit knowledge”

Government of Alberta

KT is about transferring good ideas, research results & skills between universities, other research organizations, business & the widercommunity to enable innovative new products and services to be developedUK Office of Science and Technology

“Successful knowledge transfer involves much more than a one way, linear diffusion of knowledge & skills from a university to industry; it depends on access to people, information and infrastructure”

UK Particle Physics & Astronomy Research Council

Refers to the process of having all forms of knowledge used by stakeholders; has been criticized for implying a unidirectional process.

Canadian Association of Continuing Health Education (CACHE)

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Terminology-Diffusion and Dissemination

Diffusion: The process by which an innovation is communicated through certain channels over time among members of a social system

• Rogers (1995 -5th ed.)

Dissemination: targets a specific audience and (inter) actively uses specific styles and levels / types of communication (small groupdiscussion, one-one meetings, didactic pres) of information to improve knowledge or skills or elicit change

The spreading of knowledge or research eg in journals or at conferences

Concerns the transmitting of knowledge, but does not emphasize the development of knowledge, nor the context of the receiver of knowledge.

• Canadian Association of Continuing Health Education (CACHE)

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Terminology

Research UtilizationThe process by which specific research-based knowledge is implemented in practice

• Estabrooks et al, 2003

ImplementationThe execution of the adoption decision where the research or decision is put into practice

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Terminology

Adoption and Uptake: To implement and sustain the innovation or program over time as a regular ingredient of practice/policy

Evaluation:Measure how successful knowledge exchange activities are based on a pre-determined set of outcomes or indicators

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Knowledge Transfer and Exchange (KTE)

WHAT IS THE GOAL OF KTE?:To produce and disseminate information that is useful for intended end-users (managers, decision makers, policymakers)

The style, format, content, and process of reporting information influences the ability for the information to be used

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Dissemination ActivitiesDissemination Activities--when and who?when and who?

What is the preferred order of these dissemination What is the preferred order of these dissemination activities and why?activities and why?

Who will take the lead on each of these?Who will take the lead on each of these?

Suggest: Each committee member responsible for at Suggest: Each committee member responsible for at least one dissemination activity with reportleast one dissemination activity with report--back at back at next meeting to groupnext meeting to group

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Steps in Planning Dissemination

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Consider the goal…..

What is the goal of disseminating?

A single change in a program?

A change in practice?

A change in culture?

Are there both short-term & long-term goals

to consider?

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Consider the context….

In creating a plan, we will need to consider the context or the environment that it is being completed within

• political, organizational, social, cultural context?

• utility?• relevance?

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Grol and Grimshaw (2003)Grol and Grimshaw (2003) 21212121

Consider the Barriers…..Potential barriers exist- examples :

The practice environment / organizational context

• Financial disincentives (lack of re-imbursement)

• Lack of time

• Risk of formal complaint

The social context

• Usual Routines

• Opinion leaders do not agree with the evidence

• Obsolete knowledge

Professional Context aka knowledge and attitudes

• Clinical uncertainty

• Self confidence in skills

• Need to do something

• Inability to appraise the evidence

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Who is your target audience?

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Who is your Target Audience?

Who are the people who can use these findings/results?• Primary Audience?• Secondary Audience?

Target audiences should be identified and engaged early in the process to

build their interest and give them a sense of ownership in the program

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Developing key messages……

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Develop Key Messages ….

identify the most important, and locally relevant

findings, results, information

What does it mean? why it is important? How does it fit

into the local context?

Consider: How is this information potentially useful to

your target audience?

develop clear, simple, action-oriented messages

the tone, content, and language of a key message needs

to be appropriate for its intended audience

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Tips on tailoring the messages

Messages should be tailored to each audience

based on what is relevant and of interest to them

Consider your specific target audience- how would

you tailor your message so that it becomes what

the audience wants to hear?

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Identifying Spokespeople

Need to identify credible / influentialspokespeople to spread messages in order to spread the message and increase uptake:

Champions / messengers should be people or organizations that are credible and influential within each target audience

Aim to engage them early in the process

WHO are these spokespeople? What makes them credible?

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Dissemination Activities-what?

What activities will be undertaken for dissemination of the key messages to each of the target audiences?

What is appropriate and effective?

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Grol and Grimshaw (2003)Grol and Grimshaw (2003) 2929

What are successful techniques ? What are successful techniques ? ‘‘Mostly effective to effectiveMostly effective to effective’’

MultiMulti--professional collaborationprofessional collaborationInteractive small group meetingsInteractive small group meetingsRegular remindersRegular remindersEducational outreach visitsEducational outreach visitsComputerized decision supportComputerized decision supportMass media campaignsMass media campaigns

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Grol and Grimshaw (2003)Grol and Grimshaw (2003) 3030

What are successful techniques ? What are successful techniques ? ‘‘Mixed effectsMixed effects’’

Educational MaterialsEducational MaterialsConferencesConferencesUse of opinion leadersUse of opinion leadersEducation with different educational Education with different educational strategiesstrategiesFeedback on performanceFeedback on performanceContinuous quality improvementContinuous quality improvement

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Dissemination Activities

Aim for INTERACTION!!

Face-to-face meetingsSmall groups All party involvement

Aim for two-way dialogue---avoid one way flow of information

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Other considerations for dissemination..

While planning, don’t forget: COSTS

print or web-based support materials: cost of design,

layout, translation if required

travel costs: whose budget? how much is required?

venue, equipment, technicians, catering costs

resources for future activities (meetings) and actions

that pertain to messages (eg new initiatives)

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Note to self:

What is the timeline for dissemination?

Remember:Dissemination is an iterative process of several months / meetings, not a one-off taskMeetings will provide an opportunity to assess progress, adjust and fine-tune activities as required

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Time to spread the message……..

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Who else needs to know?

Raise awareness internally- who else needs to know?What will they do with the information?

Managers, Directors, Executive, Front Line staffOthers?

Externally-Raising public awarenessDevelop and distribute public reportsMedia releases, interviewsGovernmentOrganise public forumsOther ideas?

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External Communication Strategy

Is one required?Who needs to know? What do they need to know and why?For media releases to the public, use plain language and tell a story that will generate human interestConsider informing other groups e.g. rotary clubs, chamber of commerceEnlist outsiders (public, media and externals) to assist in spreading the messages

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Useful KTEResources-practical examples

From CIHR, the KT Casebook titledMoving Population and Public Health Knowledge Into Action –A casebook of Knowledge Translation stories

From CIHR, the KT Casebook titledEvidence in Action. Acting on Evidence. A casebook of health services and policy research knowledge translation stories

http://www.cihr-irsc.gc.ca/e/30739.html

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Useful KTE ResourcesCanadian Association of Continuing Health Educationhttp://www.cachecanada.org

Institute of Health Economics Report (2008). Effective Dissemination of Findings from Research. www.ihe.ca

Canadian Health Services Research Foundation: www.chsrf.ca

Molapo, D (2007). Knowledge dissemination: Determining impact. IFLA Conference, Knowledge Management Workshop, Howard College Campus, University of KwaZulu-Natal, Durban.http://researchspace.csir.co.za/dspace/bitstream/10204/1255/1/Molapo_2007.pdf

Developing an Effective Dissemination Plan (2001).http://www.researchutilization.org/matrix/resources/dedp/#ten

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Useful KTE Resources: Canadian Health Services Research Foundation http:// www.chsrf.ca

The Foundation's Communication Notes:

Developing a Dissemination PlanReader-Friendly Writing - 1:3:25 How to Give a Research Presentation to Decision MakersDealing With the MediaSelf-Editing: Putting Your Readers FirstDesigning a Great PosterCommunications Primer


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