A description of a tailored knowledge translation intervention delivered by knowledge brokers within public health departments in Canada

Abstract

Background While there is an expectation to demonstrate evidence-informed public health there is an ongoing need for capacity development. The purpose of this paper is to provide a description of a tailored knowledge translation intervention implemented by knowledge brokers (KBs), and reflections on the factors that facilitated or hindered its implementation. Methods The 22-month knowledge translation intervention, implemented by two KBs, sought to facilitate evidence-informed public health decision-making. Data on outcomes were collected using a knowledge, skills and behavioural assessment survey. In addition, the KBs maintained reflective journals noting which activities appeared successful or not, as well as factors related to the individual or the organisation that facilitated or hindered evidence-informed decision-making. Results Tailoring of the knowledge translation intervention to address the needs, preferences and structure of each organisation resulted in three unique interventions being implemented. A consistent finding across organisations was that each site needed to determine where evidence-informed decision-making ‘fit’ within pre-existing organisational processes. Components of the intervention consistent across the three organisations included one-to-one mentoring of teams through rapid evidence reviews, large group workshops and regular meetings with senior management. Components that varied included the frequency of the KB being physically onsite, the amount of time staff spent with the KB and proportion of time spent one-to-one with a KB versus in workshops. Key facilitating factors for implementation included strong leadership, influential power of champions, supportive infrastructure, committed resources and staff enthusiasm. Conclusions The results of this study illustrate the importance of working collaboratively with organisations to tailor knowledge translation interventions to best meet unique needs, preferences, organisational structures and contexts. Organisational factors such as leadership, champions and supportive infrastructure play a key role in determining the impact of the knowledge translation interventions. Future studies should explore how these factors can be fostered and/or developed within organisations. While KBs implemented the knowledge translation intervention in this study, more research is needed to understand the impact of all change agent roles including KBs, as well as how these roles can be maintained in the long-term if proven effective.

A mixed methods examination of knowledge brokers and their use of theoretical frameworks and evaluative practices

“…The literature on evaluative practices, especially programme evaluation, has proliferated in the past decade [27][28][29], and includes widely accepted guidance on developing project-appropriate logic models, outcomes and outcome indicators. Dobbins et al [30] recently found that a knowledge translation intervention delivered by KBs resulted in improvements in evidence-informed decisionmaking knowledge, skills and behaviours, suggesting that, if KB researchers develop concrete, actionable indicators and ways to measure theminformed by theories, models or frameworks and keeping in mind a wide range of stakeholder perspectivesperhaps a culture of evaluation can grow within knowledge brokering. A culture of evaluation may further define knowledge brokering roles and qualifications, which may be of use to organisations as they create knowledge brokering positions and related job descriptions.…”

Perceived Barriers and Facilitators to Using Knowledge Brokers in Canadian Rehabilitation Settings: A Qualitative Study

“…First, the need for standard evaluation tools to evaluate KBs performance; this was consistent with ndings from Newman et al [94], that have emphasized the lack of evaluation for KBs practices, and if happened, it was informal evaluation. Although the literature on program evaluation has grown substantially in the past decade [98][99][100], that has not been adapted and adopted for evaluating KBs performance and practices. Dobbins et al [101] recently suggested that KT researchers need to develop concrete and actionable indicators and tools to measure KBs practices.…”

The role of a remote knowledge broker from an academic setting using an adaptive approach to implement evidence-based practice in primary care settings: A case study of integrating mood management interventions for treatment seeking tobacco users.

“…Currently, few published studies have reported on the day-to-day practice of a KB within the context of the healthcare system (8,13,17,19,(21)(22)(23). These reports are useful in providing a framework for the daily practice of a KB in public health and primary care settings, including a description of the specific tasks performed within different clinical contexts.…”

“…These reports are useful in providing a framework for the daily practice of a KB in public health and primary care settings, including a description of the specific tasks performed within different clinical contexts. KB roles that were common across several reports (8,13,15,17,19,21,(24)(25)(26) included engagement with stakeholders through site visits and in-person communication. Although literature suggests that KT strategies involving face-to-face communication with end-users may be more successful for relationship building and promoting HCP practice change (8,17), this approach can be costly and resource intensive (18), and thus not feasible.…”

“…Perceptions from the rKB are in line with this literature and suggest that social responsiveness, including assessing tone of voice, providing affirmations, and using open-ended questions, are equally, if not more, important within remote settings in order to help build rapport and encourage discussions with HCPs, despite the lack of physical presence.The rKB found that most barriers to implementation were associated with the Inner Setting and Outer Setting domains of the CFIR constructs(47), including lack of time, resources, and patient engagement. Possessing contextual knowledge regarding the healthcare organization and being able to adapt implementation strategies to local practice settings have been recognized as important components of knowledge brokering(13,15,17,18,21,27,54,55). From the rKB's experience, understanding the contextual and operational details of the STOP program, and having previous relationships with lead implementers, was beneficial to address these perceived barriers and support the integration of tailored mood interventions into practice.…”