Building theories of knowledge translation interventions: Use the entire menu of constructs

Abstract

BackgroundIn the ongoing effort to develop and advance the science of knowledge translation (KT), an important question has emerged around how theory should inform the development of KT interventions.DiscussionEfforts to employ theory to better understand and improve KT interventions have until recently mostly involved examining whether existing theories can be usefully applied to the KT context in question. In contrast to this general theory application approach, we propose a ‘menu of constructs’ approach, where individual constructs from any number of theories may be used to construct a new theory. By considering the entire menu of available constructs, rather than limiting choice to the broader level of theories, we can leverage knowledge from theories that would never on their own provide a complete picture of a KT intervention, but that nevertheless describe components or mechanisms relevant to it. We can also avoid being forced to adopt every construct from a particular theory in a one-size-fits-all manner, and instead tailor theory application efforts to the specifics of the situation. Using audit and feedback as an example KT intervention strategy, we describe a variety of constructs (two modes of reasoning, cognitive dissonance, feed forward, desirable difficulties and cognitive load, communities of practice, and adaptive expertise) from cognitive and educational psychology that make concrete suggestions about ways to improve this class of intervention.SummaryThe ‘menu of constructs’ notion suggests an approach whereby a wider range of theoretical constructs, including constructs from cognitive theories with scope that makes the immediate application to the new context challenging, may be employed to facilitate development of more effective KT interventions.

A systematic review of the use of theory in randomized controlled trials of audit and feedback

“…Brehaut and Eva have advocated for a ‘menu of constructs’ approach in which the application of theory becomes a process of choosing relevant individual constructs from any number of theories to inform implementation efforts [4]. Michie and colleagues developed a framework that summarized a set of 33 mutually agreed upon theories that were used to inform a core set of 128 constructs critical for behavior change [65].…”

“…The term ‘Audit and feedback’ has been used generally to refer to a heterogeneous group of interventions that provide feedback on existing practice to healthcare providers. A&F can be defined as a summary of clinical performance (audit) over a specific period of time, and the provision of that summary (feedback) to individual practitioners, teams, or healthcare organizations [4]. …”

The enhanced knowledge translation and exchange framework for road safety: a brief report on its development and potential impacts

“…Such efforts should leverage insights from cognitive psychology and organisational theories of change to increase receptivity and support. As has been previously noted,18 the shrewd application of implementation science theories, and their individual constructs, to support the application of KTE interventions in different contexts is recommended.…”

Toward an Information Infrastructure for Global Health Improvement

“…K2P services enable the system to represent knowledge in machine-executable forms so it can be rapidly updated as the system learns, it rapidly generates advice to inform decisions, and it tailors the advice to the needs and characteristics of the recipients [53]. Methods drawn from the behavioral and implementation sciences to promote practice change complete the services necessary to support K2P [57,58].…”