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Gallant SM, Cassidy C, Al-Rassi J, Moody E, Shin HD, Best S, Steenbeek A. Integrated knowledge translation guidelines for trainees in health research: an environmental scan. Health Res Policy Syst 2023; 21:74. [PMID: 37452332 PMCID: PMC10349463 DOI: 10.1186/s12961-023-01024-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 06/23/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Collaborative health research, such as integrated knowledge translation (IKT), requires researchers to have specific knowledge and skills in working in partnership with knowledge users. Graduate students are often not provided with the opportunity to learn skills in how to establish collaborative relationships with knowledge users in the health system or communities, despite its importance in research. The objective of this environmental scan is to identify available guidelines for graduate trainees to use an IKT approach in their research. METHODS We conducted an environmental scan with three separate systematic searches to identify guidelines available to support graduate students in engaging in an IKT approach to research: (i) a customized Google search; (ii) a targeted Canadian university website search; and (iii) emails to administrators of graduate studies programmes asking for available guidelines and documents designed for graduate students. Data were extracted using a standardized data extraction tool and analysed using a directed content analysis approach. Due to the minimal results included based on the a priori eligibility criteria, we returned to the excluded records to further review the current state of the environment on trainee support for IKT research. RESULTS Our search strategy yielded 22 900 items, and after a two-step screening process with strict inclusion criteria three documents met the eligibility criteria. All three documents highlighted the need for an IKT plan for knowledge user involvement throughout the research process. Furthermore, documents emphasized the need for tangible steps to guide graduate students to engage in effective communication with knowledge users. Due to the lack of documents retrieved, we conducted a post hoc content analysis of relevant IKT documents excluded and identified five themes demonstrating increased education and engagement in an IKT approach at an interpersonal and organizational level. CONCLUSION We identified three documents providing guidance to trainees using a collaborative approach in their health research. This scan highlighted two key findings including the importance of supporting trainees to engage knowledge users in research and preparing an IKT plan alongside a research plan. Further research is needed to co-design guidelines to support graduate students and trainees in engaging in an IKT approach.
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Affiliation(s)
- Sarah Madeline Gallant
- School of Nursing, Dalhousie University, Halifax, NS, Canada.
- The Strengthening Transitions in Care Lab, IWK Health, Halifax, NS, Canada.
| | - Christine Cassidy
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- The Strengthening Transitions in Care Lab, IWK Health, Halifax, NS, Canada
| | - Joyce Al-Rassi
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Elaine Moody
- School of Nursing, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - Hwayeon Danielle Shin
- Management, and Evaluation, Institute of Health Policy, University of Toronto, Toronto, ON, Canada
- Centre for Complex Care Interventions, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
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Williams S, Fernandes G. Cutting Edge Research? Realistic Expectations of Priorities, Scope and Engagement Comment on "'We're Not Providing the Best Care If We Are Not on the Cutting Edge of Research': A Research Impact Evaluation at a Regional Australian Hospital and Health Service". Int J Health Policy Manag 2023; 12:7792. [PMID: 37579376 PMCID: PMC10461889 DOI: 10.34172/ijhpm.2023.7792] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 05/07/2023] [Indexed: 08/16/2023] Open
Abstract
While research is linked with informed decision-making and improved healthcare delivery and patient outcomes, the process of generating and translating research evidence in practice and capturing its impact can often be challenging. Based on document and database reviews and interviews in a regional Australian health system, Brown et al discuss the challenges of assessing the impact of research investments over a ten-year period. This commentary explores three inter-related lessons from this article for developing and sustaining a research culture and supporting translation in a health system: (i) achieving a shared definition and expectation of research; (ii) the importance of stakeholder engagement particularly for research prioritisation; and (iii) enabling research across a system. In doing so, it highlights the role and value of engaging knowledge generators and end-users from clinical, management and community domains not only in research development but most importantly in research prioritisation.
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Affiliation(s)
- Siân Williams
- Healthcare Consultant, London, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
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3
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Ernstmann N, Kuske S, Holmberg C, Wensing M, Reuschenbach B, Büscher A, Neugebauer E, Karbach U, Bethge M, Ansmann L, Pfaff H. [Recommendations for a Core Curriculum for Master's Degree Programs in Health Services Research]. DAS GESUNDHEITSWESEN 2023; 85:133-138. [PMID: 36543257 PMCID: PMC9931451 DOI: 10.1055/a-1981-1643] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The aim of the present study was to develop recommendations for a core curriculum for master's degree programs in health services research. For this purpose, a standardized online survey of university lecturers was conducted in the first step. In the second step, the curricula of the existing study programs were analyzed. In the third step, a literature search was conducted. In the last step, the resulting recommendations were discussed in a panel of experts. The final recommendations comprise 13 topics on five guiding questions with 26 subtopics. The main topics come from the areas of basic sciences in the context of health services research, the health care system and health policy, the (empirical) health services research process, and knowledge transfer. The present recommendations will serve as a basis for discussion and as a starting point. The development of recommendations should be seen as an ongoing process, as the core competencies of health services researchers will have to be continuously adapted to new research topics, new research methods and regulations.
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Affiliation(s)
- Nicole Ernstmann
- Forschungsstelle für Gesundheitskommunikation und Versorgungsforschung (CHSR), Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Bonn, Bonn, Germany
- Lehrstuhl für Versorgungsforschung, Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Universität zu Köln, Köln, Germany
| | - Silke Kuske
- Pflegewissenschaft und Versorgungsforschung, Fliedner Fachhochschule Düsseldorf, Düsseldorf, Germany
| | - Christine Holmberg
- Institut für Sozialmedizin und Epidemiologie, Medizinische Hochschule Brandenburg Theodor Fontane, Brandenburg an der Havel, Germany
| | - Michel Wensing
- Abteilung Allgemeinmedizin und Versorgungsforschung, UniversitatsKlinikum Heidelberg, Heidelberg, Germany
| | - Bernd Reuschenbach
- Fakultät für Gesundheit und Pflege, Katholische Stiftungshochschule München, München, Germany
| | - Andreas Büscher
- Fakultät Wirtschafts- und Sozialwissenschaftten, Deutsches Netzwerk für Qualitätssicherung in der Pflege (DNQP), Hochschule Osnabruck, Osnabruck, Germany
| | - Edmund Neugebauer
- Campus Neuruppin, Medizinische Hochschule Brandenburg (MHB), Neuruppin, Germany
| | - Ute Karbach
- Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Universität zu Köln, Köln, Germany
| | - Matthias Bethge
- Institut für Sozialmedizin und Epidemiologie, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
| | - Lena Ansmann
- Department für Versorgungsforschung, Abteilung Organisationsbezogene Versorgungsforschung, Carl von Ossietzky Universitat Oldenburg, Oldenburg, Germany
| | - Holger Pfaff
- Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Universität zu Köln, Köln, Germany
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4
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Brown A, Edelman A, Pain T, Larkins S, Harvey G. "We're Not Providing the Best Care If We Are Not on the Cutting Edge of Research": A Research Impact Evaluation at a Regional Australian Hospital and Health Service. Int J Health Policy Manag 2022; 11:3000-3011. [PMID: 35643418 PMCID: PMC10105178 DOI: 10.34172/ijhpm.2022.6529] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 05/10/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Research is central to high functioning health services alongside clinical care and health professional training. The impact of embedded research includes delivery of high-quality care and improved patient outcomes. Evaluations of research impact help health service leadership ensure investments lead to the greatest healthcare benefits for patients. This study aimed to retrospectively evaluate the impact of research investment from 2008 to 2018 at Townsville Hospital and Health Service (THHS), a regional Hospital and Health Service (HHS) in Queensland, Australia. The evaluation also sought to identify contextual conditions that enable or hinder intended impacts. METHODS A mixed-methods realist-informed evaluation was conducted using documentation, interviews with 15 staff and available databases to identify and measure research investments, impacts and contextual conditions influencing impact outcomes. RESULTS Between 2008 and 2018, THHS increased resources for research by funding research projects, employing research personnel, building research-enabling facilities, hosting research events, and providing research education and training. Clinical practice, policy and workforce impacts were successful in isolated pockets, championed by individual researchers and facilitated by their policy and community-of-practice networks. However, there was little organisational-level support for continuity of research and implementation into practice and policy. Availability of research supports varied geographically across THHS, and across disciplines. CONCLUSION Definitive steps in the development of THHS as a credible and productive research centre and leading hospital research centre in Northern Australia are evident. Continuing investments should address support for the research continuum through to translation and establish ongoing, systematic processes for evaluating research investment and impact.
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Affiliation(s)
- Amy Brown
- Townsville Hospital and Health Service, Townsville, QLD, Australia
| | - Alexandra Edelman
- Townsville Hospital and Health Service, Townsville, QLD, Australia
- James Cook University, Townsville, QLD, Australia
| | - Tilley Pain
- Townsville Hospital and Health Service, Townsville, QLD, Australia
- James Cook University, Townsville, QLD, Australia
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Abu-Odah H, Said NB, Nair SC, Allsop MJ, Currow DC, Salah MS, Hamad BA, Elessi K, Alkhatib A, ElMokhallalati Y, Bayuo J, AlKhaldi M. Identifying barriers and facilitators of translating research evidence into clinical practice: A systematic review of reviews. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3265-e3276. [PMID: 35775332 DOI: 10.1111/hsc.13898] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 05/06/2022] [Accepted: 06/18/2022] [Indexed: 06/15/2023]
Abstract
Translating research into clinical practice is a global priority because of its potential impact on health services delivery and outcomes. Despite the ever-increasing depth and breadth of health research, most areas across the globe seem to be slow to translate relevant research evidence into clinical practice. Thus, this review sought to synthesise existing literature to elucidate the barriers and facilitators to the translation of health research into clinical practice. A systematic review of reviews approach was utilised. Review studies were identified across PubMed, Scopus, Embase, CINAHL and Web of Science databases, from their inception to 15 March 2021. Searching was updated on 30 March 2022. All retrieved articles were screened by two authors; reviews meeting the inclusion criteria were retained. Based on the review type, two validated tools were employed to ascertain their quality: A Measurement Tool to Assess Systematic Reviews-2 and International Narrative Systematic assessment. The framework synthesis method was adopted to guide the analysis and narrative synthesis of data from selected articles. Ten reviews met the inclusion criteria. The study revealed that the translation of new evidence was limited predominantly by individual-level issues and less frequently by organisational factors. Inadequate knowledge and skills of individuals to conduct, organise, utilise and appraise research literature were the primary individual-level barriers. Limited access to research evidence and lack of equipment were the key organisational challenges. To circumvent these barriers, it is critical to establish collaborations and partnerships between policy makers and health professionals at all levels and stages of the research process. The study concluded that recognising barriers and facilitators could help set key priorities that aid in translating and integrating research evidence into practice. Effective stakeholder collaboration and co-operation should improve the translation of research findings into clinical practice.
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Affiliation(s)
- Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Nizar B Said
- Department of Nursing and Midwifery, An Najah National University, Nablus, Palestine
| | - Satish Chandrasekhar Nair
- Johns Hopkins Medicine Tawam Hospital, College of Medicine UAE University, Al Ain, United Arab Emirates
| | - Matthew J Allsop
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - David C Currow
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Motasem Said Salah
- Nursing Consultant for Minster of Health, Ministry of Health, Gaza, Palestine
- Nursing and Health Sciences Department, University College of Applied Sciences (UCAS), Gaza, Palestine
| | - Bassam Abu Hamad
- School of Public Health, Al-Quds University, Jerusalem, Palestine
| | - Khamis Elessi
- Faculty of Medicine, Evidence-Based Medicine Unit, Islamic University, Gaza City, Palestine
| | - Ali Alkhatib
- Nursing and Health Sciences Department, University College of Applied Sciences (UCAS), Gaza, Palestine
| | - Yousuf ElMokhallalati
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Mohammed AlKhaldi
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Department of Medicine, McGill University Health Center (MUHC), Montreal, Canada
- Canadian Institutes of Health Research (CIHR), Health System Impact Fellowship, Ottawa, Canada
- Department of Environmental Health Sciences, Canadian University Dubai, Dubai, United Arab Emirates
- University of Basel, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Council on Health Research for Development (COHRED), Geneve, Switzerland
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6
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Gilchrist L, Jamieson SK, Zeki R, Ward S, Chang S, Sullivan E. Understanding health and social service accessibility for young people with problematic substance use exiting prison in Australia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4735-e4744. [PMID: 35762623 PMCID: PMC10947141 DOI: 10.1111/hsc.13880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 02/14/2022] [Accepted: 05/27/2022] [Indexed: 06/15/2023]
Abstract
Incarcerated young people (aged 18-24) with a history of problematic substance use are a particularly vulnerable group, with a higher risk of mortality and return to custody compared to their older counterparts. Yet, there is limited research investigating service accessibility for this population. This study aimed to address this gap by investigating the characteristics of young people exiting prison on the 'Connections Program' (Connections) and their access to support services. Connections is a transitional program with a remit to link people with problematic substance use exiting prison in New South Wales, Australia, to health and social services in the community. We used an explanatory sequential mixed methods approach including (1) a retrospective cohort study of young people on Connections (n = 359), utilising self-reported data collected in a routine pre-release questionnaire from January 2008 to February 2015 and (2) a qualitative survey with Connections caseworkers (n = 10). In stage one, descriptive statistics were calculated to produce a profile of sociodemographic and health characteristics of young people with problematic substance use exiting prison. In stage two, qualitative data were thematically analysed to explore the accessibility of services to meet young people's needs from the perspective of caseworkers. The study found young people experienced substantially poorer mental health than the general population, and the vast majority had received treatment for a mental health issue (96.5%). Illicit substance use prior to incarceration was common (91.5%). Caseworkers reported substantial barriers to service accessibility in the community related to intersecting social disadvantage and co-occurring mental distress and substance use. Caseworkers have front-line knowledge of how gaps and barriers in services impact transition from prison and identified longer-term case coordination, inter-agency collaboration and holistic care as vital strategies to support young people in transition from prison to community.
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Affiliation(s)
- Lauren Gilchrist
- The Australian Centre for Public and Population Health Research, Faculty of HealthUniversity of Technology SydneySydneyNew South WalesAustralia
| | - Sacha Kendall Jamieson
- The Australian Centre for Public and Population Health Research, Faculty of HealthUniversity of Technology SydneySydneyNew South WalesAustralia
- Sydney School of Education and Social Work, Faculty of Arts and Social SciencesThe University of SydneySydneyNew South WalesAustralia
| | - Reem Zeki
- College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Justice Health and Forensic Mental Health NetworkMatravilleNew South WalesAustralia
| | - Stephen Ward
- Justice Health and Forensic Mental Health NetworkMatravilleNew South WalesAustralia
| | - Sungwon Chang
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of HealthUniversity of Technology SydneyBroadwayNew South WalesAustralia
| | - Elizabeth Sullivan
- The Australian Centre for Public and Population Health Research, Faculty of HealthUniversity of Technology SydneySydneyNew South WalesAustralia
- College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Justice Health and Forensic Mental Health NetworkMatravilleNew South WalesAustralia
- Hunter Medical Research InstituteNew LambtonNew South WalesAustralia
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7
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Prathivadi P, Buckingham P, Chakraborty S, Hawes L, Saha SK, Barton C, Mazza D, Russell G, Sturgiss E. Implementation science: an introduction for primary care. Fam Pract 2022; 39:219-221. [PMID: 34694348 DOI: 10.1093/fampra/cmab125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Pallavi Prathivadi
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Philippa Buckingham
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Samantha Chakraborty
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lesley Hawes
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,National Centre for Antimicrobial Stewardship, Doherty Institute, Melbourne, Australia
| | - Sajal K Saha
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,National Centre for Antimicrobial Stewardship, Doherty Institute, Melbourne, Australia.,Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Christopher Barton
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Danielle Mazza
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,National Centre for Antimicrobial Stewardship, Doherty Institute, Melbourne, Australia
| | - Grant Russell
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Elizabeth Sturgiss
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia
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Popp J, Carl J, Grüne E, Pfeifer K. Introducing the Practice Dive Approach: an extension of co-creation in physical activity promotion and health promotion. Health Promot Int 2021; 36:ii53-ii64. [PMID: 34905611 PMCID: PMC8672929 DOI: 10.1093/heapro/daab160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Recently, there has been increasing interest in co-creation utilized for physical
activity (PA) promotion and health promotion. Co-creation involves researchers
and non-academic stakeholders conjointly developing and implementing
interventions. In addition to the frequently reported benefits of co-creation,
critical voices highlight the associated challenges (e.g. different interests
that inhibit interaction). So far, research has not identified concrete
solutions to these challenges and the limitations of co-creation. This article
aims to introduce the Practice Dive Approach as a potential way to strengthen
cooperation between researchers and non-academic stakeholders. We build on
real-life experiences from a German research project, in which researchers moved
into practice to familiarize themselves with the settings and end-users. After
conducting a literature search on related concepts in PA/health promotion, we
developed a comprehensive approach to fostering multi-sectoral cooperation. The
introduced Practice Dive Approach assumes that a significant contribution to
better cooperation among co-creators is the temporal immersion of researchers in
their setting of interest, which has the potential to improve the success of
co-creation in the PA/health promotion field. A four-level typology
characterizes the intensity of researcher interactions with the setting and the
non-academic stakeholders. Potential beneficial effects for both researchers and
non-academic stakeholders can be hypothesized (e.g. familiarity with the setting
structures and increased understanding of the end-users), while simultaneously,
some challenges need to be considered. Future research should aim to validate
the concept and its postulated effects. Collaboration among researchers and non-academic stakeholders is increasingly
used to promote physical activity and health. For example, people involved in
such collaborations jointly develop new interventions. Potential challenges
include different interests or work routines that can complicate cooperation.
This article aims to introduce the Practice Dive Approach as a potential way to
improve cooperation between researchers and non-academic stakeholders. We
developed the approach based on observations from a German research project and
a literature search on related concepts. This approach assumes that the temporal
involvement of researchers in their setting of interest can strengthen
research-practice cooperation and improve its success. We describe different
types of a Practice Dive and the requirements for conducting Practice Dive
activities. Furthermore, we present the potential effects of a Practice Dive for
the researchers and the non-academic stakeholders, such as increased familiarity
between both groups. However, some challenges need to be considered when
applying the Practice Dive Approach. Future research should test this approach
and its potential effects.
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Affiliation(s)
- Johanna Popp
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Gebbertstraße 123b, Erlangen 91058, Germany
| | - Johannes Carl
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Gebbertstraße 123b, Erlangen 91058, Germany
| | - Eva Grüne
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Gebbertstraße 123b, Erlangen 91058, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Gebbertstraße 123b, Erlangen 91058, Germany
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Cassidy CE, Shin HD, Ramage E, Conway A, Mrklas K, Laur C, Beck A, Varin MD, Steinwender S, Nguyen T, Langley J, Dorey R, Donnelly L, Ormel I. Trainee-led research using an integrated knowledge translation or other research partnership approaches: a scoping reviews. Health Res Policy Syst 2021; 19:135. [PMID: 34727926 PMCID: PMC8561363 DOI: 10.1186/s12961-021-00784-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/12/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND There are increasing expectations for researchers and knowledge users in the health system to use a research partnership approach, such as integrated knowledge translation, to increase the relevance and use of research findings in health practice, programmes and policies. However, little is known about how health research trainees engage in research partnership approaches such as IKT. In response, the purpose of this scoping review was to map and characterize the evidence related to using an IKT or other research partnership approach from the perspective of health research trainees in thesis and/or postdoctoral work. METHODS We conducted this scoping review following the Joanna Briggs Institute methodology and Arksey and O'Malley's framework. We searched the following databases in June 2020: MEDLINE, Embase, CINAHL and PsycINFO. We also searched sources of unpublished studies and grey literature. We reported our findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. RESULTS We included 74 records that described trainees' experiences using an IKT or other research partnership approach to health research. The majority of studies involved collaboration with knowledge users in the research question development, recruitment and data collection stages of the research process. Intersecting barriers to IKT or other research partnerships at the individual, interpersonal and organizational levels were reported, including lack of skills in partnership research, competing priorities and trainees' "outsider" status. We also identified studies that evaluated their IKT approach and reported impacts on partnership formation, such as valuing different perspectives, and enhanced relevance of research. CONCLUSION Our review provides insights for trainees interested in IKT or other research partnership approaches and offers guidance on how to apply an IKT approach to their research. The review findings can serve as a basis for future reviews and primary research focused on IKT principles, strategies and evaluation. The findings can also inform IKT training efforts such as guideline development and academic programme development.
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Affiliation(s)
| | | | - Emily Ramage
- School of Health Sciences, University of Newcastle, Callaghan, Australia
| | - Aislinn Conway
- Better Outcomes and Registry Network (BORN), Ottawa, ON Canada
| | - Kelly Mrklas
- Alberta Health Services Foothills Medical Centre, Calgary, AB Canada
| | - Celia Laur
- Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, Canada
| | - Amy Beck
- Faculty of Nursing, University of Calgary, Calgary, AB Canada
| | | | | | - Tram Nguyen
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON Canada
| | - Jodi Langley
- School of Health and Human Performance, Dalhousie University, Halifax, NS Canada
| | | | | | - Ilja Ormel
- Department of Family Medicine, McGill University, Montreal, QC Canada
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10
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Desveaux L, Budhwani S, Stamenova V, Bhattacharyya O, Shaw J, Bhatia RS. Closing the Virtual Gap in Health Care: A Series of Case Studies Illustrating the Impact of Embedding Evaluation Alongside System Initiatives. J Med Internet Res 2021; 23:e25797. [PMID: 34477560 PMCID: PMC8449303 DOI: 10.2196/25797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 05/20/2021] [Accepted: 07/29/2021] [Indexed: 11/13/2022] Open
Abstract
Early decisions relating to the implementation of virtual care relied on necessity and clinical judgement, but there is a growing need for the generation of evidence to inform policy and practice designs. The need for stronger partnerships between researchers and decision-makers is well recognized, but how these partnerships can be structured and how research can be embedded alongside existing virtual care initiatives remain unclear. We present a series of case studies that illustrate how embedded research can inform policy decisions related to the implementation of virtual care, where decisions are either to (1) discontinue (red light), (2) redesign (yellow light), or (3) scale up existing initiatives (green light). Data were collected through document review and informal interviews with key study personnel. Case 1 involved an evaluation of a mobile diabetes platform that demonstrated a mismatch between the setting and the technology (decision outcome: discontinue). Case 2 involved an evaluation of a mental health support platform that suggested evidence-based modifications to the delivery model (decision outcome: redesign). Case 3 involved an evaluation of video visits that generated evidence to inform the ideal model of implementation at scale (decision outcome: scale up). In this paper, we highlight the characteristics of the partnership and the process that enabled success and use the cases to illustrate how these characteristics were operationalized. Structured communication included monthly check-ins and iterative report development. We also outline key characteristics of the partnership (ie, trust and shared purpose) and the process (ie, timeliness, tailored reporting, and adaptability) that drove the uptake of evidence in decision-making. Across each case, the evaluation was designed to address policy questions articulated by our partners. Furthermore, structured communication provided opportunities for knowledge mobilization. Structured communication was operationalized through monthly meetings as well as the delivery of interim and final reports. These case studies demonstrate the importance of partnering with health system decision-makers to generate and mobilize scientific evidence. Embedded research partnerships founded on a shared purpose of system service provided an effective strategy to bridge the oft-cited gap between science and policy. Structured communication provided a mechanism for collaborative problem-solving and real-time feedback, and it helped contextualize emerging insights.
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Affiliation(s)
- Laura Desveaux
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Suman Budhwani
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
| | - Vess Stamenova
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
| | - Onil Bhattacharyya
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
| | - James Shaw
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Joint Centre for Bioethics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - R Sacha Bhatia
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
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11
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Spaak M, Cipriano M, Alla F, Benamouzig D. Health services research in France: bridging the gap between academia and policymaking. Eur J Public Health 2021; 31:87-92. [PMID: 33249454 DOI: 10.1093/eurpub/ckaa199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND -We aimed to identify the knowledge producers, the knowledge that they produce and the main areas of interest for health services research (HSR) in France, which is one of the priorities for public health research planning. METHODS -A two-phase approach comprising a bibliometric analysis and semi-structured interviews with 20 researchers and 13 staff members of public health bodies was used. RESULTS -In France today, interdisciplinary research teams are being organized in the main cities despite a lack of critical mass. The interviews showed that the term 'health services research' is vague with fuzzy boundaries between research, scientific expertise and evaluation. A keyword cluster analysis showed that French HSR is more hospital-centric compared to those countries that publish most frequently. The analysis also revealed a lack of research on methodological aspects. CONCLUSIONS -We analyzed the structure of HSR in France and the specificity of the French publications in this field, compared with other countries. The results indicate the obstacles faced by researchers and decision-makers and offer insight into how these barriers may be removed.
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Affiliation(s)
- Marine Spaak
- Iresp, Inserm, Paris, France.,Fédération Addiction, Paris, France
| | | | - François Alla
- Research Centre "Bordeaux Population Health" (Unit U1219), Inserm, Université de Bordeaux, Bordeaux, France
| | - Daniel Benamouzig
- Sciences Po, Centre de Sociologie des Organisations et Chaire santé, CNRS, Paris, France
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12
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Kitzman H, DaGraca B, Mamun A, Collinsworth A, Halloran K, Masica A. Embedded Health Systems Science as a driver of care improvement within an integrated delivery organization. HEALTHCARE-THE JOURNAL OF DELIVERY SCIENCE AND INNOVATION 2021; 8 Suppl 1:100497. [PMID: 34175103 DOI: 10.1016/j.hjdsi.2020.100497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 10/23/2020] [Accepted: 11/03/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Embedded Health Systems Science (HSS) has the potential to reduce gaps between research and delivery of evidence-based medicine. Models are needed to guide the development of embedded HSS in health care delivery organizations particularly with the rise of value-based care. METHODS The development of HSS infrastructure at a large nonprofit health care delivery organization is described, along with an embedded HSS diabetes study to illustrate the integration of program specific data, electronic health records, and health care system data infrastructure. To compare diabetes outcomes across four evidenced-based programs, a control group was developed from EHR data using propensity score matching. Mixed effect adjusted models were used to estimate reductions in hemoglobin A1c (HbA1c) and body weight. RESULTS Adjusted analyses using an EHR derived comparison group demonstrated significantly different findings than unadjusted pre to post analyses. The embedded HSS study indicates that appropriate statistical methods, staff with required expertise, and integration with health system data infrastructure are needed to develop timely and rigorous HSS outcomes that effectively improve patient care. CONCLUSIONS Embedded HSS has the potential to inform value-based care models and contribute to evidence-based medicine approaches that improve patient care. Although developing system wide integrated data structures and staff with the appropriate skills requires substantial effort, the outcome is more reliable evaluations that lead to higher quality and higher value care. IMPLICATIONS Health care delivery organizations can improve patient care by dedicating resources to embed HSS into its routine operations.
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Affiliation(s)
- Heather Kitzman
- Baylor Scott and White Health and Wellness Center, Baylor Scott and White Health, Dallas, TX, USA.
| | - Briget DaGraca
- Center for Clinical Effectiveness, Baylor Scott and White Health, Dallas, TX, USA
| | - Abdullah Mamun
- Baylor Scott and White Health and Wellness Center, Baylor Scott and White Health, Dallas, TX, USA
| | - Ashley Collinsworth
- Center for Clinical Effectiveness, Baylor Scott and White Health, Dallas, TX, USA
| | - Kenneth Halloran
- Baylor Scott and White Health and Wellness Center, Baylor Scott and White Health, Dallas, TX, USA
| | - Andrew Masica
- Center for Clinical Effectiveness, Baylor Scott and White Health, Dallas, TX, USA; Texas Health Resources, Arlington, TX, USA
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13
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Cassidy CE, Beck AJ, Conway A, Demery Varin M, Laur C, Lewis KB, Ramage ER, Nguyen T, Steinwender S, Ormel I, Stratton L, Shin HD. Using an integrated knowledge translation or other research partnership approach in trainee-led research: a scoping review protocol. BMJ Open 2021; 11:e043756. [PMID: 34035094 PMCID: PMC8154946 DOI: 10.1136/bmjopen-2020-043756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Collaborative research approaches, such as co-production, co-design, engaged scholarship and integrated knowledge translation (IKT), aim to bridge the evidence to practice and policy gap. There are multiple benefits of collaborative research approaches, but studies report many challenges with establishing and maintaining research partnerships. Researchers often do not have the opportunity to learn how to build collaborative relationships, and most graduate students do not receive formal training in research partnerships. We are unlikely to make meaningful progress in strengthening graduate and postgraduate training on working collaboratively with the health system until we have a better understanding of how students are currently engaging in research partnership approaches. In response, this scoping review aims to map and characterise the evidence related to using an IKT or other research partnership approach from the perspective of health research trainees. METHODS AND ANALYSIS We will employ methods described by the Joanna Briggs Institute and Arksey and O'Malley's framework for conducting scoping reviews. The reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews checklist. We will include both published and unpublished grey literature and search the following databases: MEDLINE, Embase, CINAHL, PsycINFO, ProQuest Dissertations & Theses Global databases, Google Scholar and websites from professional bodies and other organisations. Two reviewers will independently screen the articles and extract data using a standardised data collection form. We will narratively describe quantitative data and conduct a thematic analysis of qualitative data. We will map the IKT and other research partnership activities onto the Knowledge to Action cycle and IAP2 Levels of Engagement Framework. ETHICS AND DISSEMINATION No ethical approval is required for this study. We will share the results in a peer-reviewed, open access publication, conference presentation and stakeholder communications.
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Affiliation(s)
| | - Amy Jane Beck
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | | | - Melissa Demery Varin
- School of Nursing, University of Ottawa Faculty of Health Sciences, Ottawa, Ontario, Canada
| | - Celia Laur
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada
| | - Krystina B Lewis
- School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
- University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Emily R Ramage
- School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Tram Nguyen
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Sandy Steinwender
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Ilja Ormel
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Lillian Stratton
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
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14
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Cassidy CE, Bowen S, Fontaine G, Côté-Boileau É, Botting I. How to Work Collaboratively Within the Health System: Workshop Summary and Facilitator Reflection. Int J Health Policy Manag 2020; 9:233-239. [PMID: 32613791 PMCID: PMC7382904 DOI: 10.15171/ijhpm.2019.131] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 11/27/2019] [Indexed: 11/09/2022] Open
Abstract
Effectiveness in health services research requires development of specific knowledge and skills for working in partnership with health system decision-makers. In an initial effort to frame capacity-building activities for researchers, we designed a workshop on working collaboratively within the health system. The workshop, based on recent research exploring health system experience and perspectives on research collaborations, was trialed at the annual Canadian Health Services and Policy Research (CAHSPR) conference in May 2019. Participants reported positive evaluations of the workshop. However, further efforts should target health services researchers that may not be as motivated to develop skills in collaborative research. Additional attention to equipping researchers with the skills needed to work in partnerships is recommended, including approaches and materials that avoid oversimplification of complex challenges.
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Affiliation(s)
- Christine E Cassidy
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Sarah Bowen
- Applied Research and Evaluation Consultant, Halifax, NS, Canada
| | - Guillaume Fontaine
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada.,Montreal Heart Institute Research Center, Montreal, QC, Canada
| | - Élizabeth Côté-Boileau
- Faculty of Medicine and Health Sciences Research, University of Sherbrooke, Sherbrooke, QC, Canada.,Charles-Le Moyne - Saguenay-Lac-Saint-Jean Research Center on Health Innovations, Longueuil, QC, Canada
| | - Ingrid Botting
- Health Services Integration, Winnipeg Regional Health Authority, Winnipeg, MB, Canada
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15
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Eljiz K, Greenfield D, Taylor R. The Embedded Health Management Academic: A Boundary Spanning Role for Enabling Knowledge Translation Comment on "CIHR Health System Impact Fellows: Reflections on 'Driving Change' Within the Health System". Int J Health Policy Manag 2020; 9:170-174. [PMID: 32331497 PMCID: PMC7182145 DOI: 10.15171/ijhpm.2019.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 10/30/2019] [Indexed: 12/21/2022] Open
Abstract
Healthcare organisations are looking at strategies and activities to improve patient outcomes, beyond clinical interventions. Increasingly, health organisations are investing significant resources in leadership, management and team work training to optimise professional collaboration, shared decision-making and, by extension, high quality services. Embedded clinical academics are a norm in, and considered a strength of, healthcare organisations and universities. Their role contributes, formally and informally, to clinical teaching, knowledge sharing and research. An equivalent, but significantly less common role, addressing the management of healthcare organisations, is the embedded health management academic (EHMA). A stimulus encouraging this intertwined embedded academic role, in both clinical and managerial fields, is the demand for the translation of knowledge between academic and industry contexts. In this essay, we describe the EHMA role, its value, impact and potential for enabling healthcare organisation improvement. Focusing on the business of healthcare, the EHMA is a conduit between sectors, stakeholders and activities, enabling different organisations and experts to co-create, share and embed knowledge. The value and impact achieved is significant and ongoing, through the nurturing of an evidence-based management culture that promotes ongoing continuous improvement and research activities.
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Affiliation(s)
- Kathy Eljiz
- Australian Institute of Health Service Management (AIHSM), University of Tasmania, Sydney, NSW, Australia
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16
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Frost J, Britten N. Learning from a Feasibility Trial of a Simple Intervention: Is Research a Barrier to Service Delivery, or is Service Delivery a Barrier to Research? Healthcare (Basel) 2020; 8:E53. [PMID: 32138337 PMCID: PMC7151079 DOI: 10.3390/healthcare8010053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 02/27/2020] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Applied health services research (AHSR) relies upon coordination across multiple organizational boundaries. Our aim was to understand how competing organizational and professional goals enhance or impede the conduct of high quality AHSR. (2) Methods: A qualitative study was conducted in two local health care systems in the UK, linked to a feasibility trial of a clinic-based intervention in secondary care. Data collection involved 24 semi-structured interviews with research managers, clinical research staff, health professionals, and patients. (3) Results: This study required a dynamic network of interactions between heterogeneous health and social care stakeholders, each characterized by differing ways of organizing activities which constitute their core functions; cultures of collaboration and interaction and understanding of what research involves and how it contributes to patient care. These interrelated factors compounded the occupational and organizational boundaries that hindered communication and coordination. (4) Conclusions: Despite the strategic development of multiple organizations to foster inter-professional collaboration, the competing goals of research and clinical practice can impede the conduct of high quality AHSR. To remedy this requires the alignment and streamlining of organizational goals, so that all agencies involved in AHSR develop a shared understanding and mutual respect for the progress of evidence-based medicine and the complex and often nuanced environments in which it is created and practiced.
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Affiliation(s)
- Julia Frost
- St Luke’s Campus, University of Exeter Medical School, Exeter EX1 2LU, UK;
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17
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Turner S, Sharp CA, Sheringham J, Leamon S, Fulop NJ. Translating academic research into guidance to support healthcare improvement: how should guidance development be reported? BMC Health Serv Res 2019; 19:1000. [PMID: 31881964 PMCID: PMC6935180 DOI: 10.1186/s12913-019-4792-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 11/29/2019] [Indexed: 11/15/2022] Open
Abstract
Background There is interest internationally in improving the uptake of research evidence to inform health care quality and safety. This article focusses on guidance development from research studies as one method for improving research uptake. While we recognise that implementation strategies on the ´demand´ side for encouraging the uptake of research are important, e.g. knowledge brokers and university-practice collaborations, this article focusses on the ´production´ aspect of how guidance development is reported and the consequent influence this may have on end-users´ receptivity to evidence, in addition to other demand-side processes. Main text The article considers the following question: how is guidance developed and what are the implications for reporting? We address this question by reviewing examples of guidance development reporting from applied health research studies, then describe how we produced guidance for a national study of evidence use in decision-making on adopting innovations. The starting point for reflecting on our experiences is a vignette of the guidance ´launch´ event at a national conference. Conclusions Implications for reporting guidance development and supporting improvement are discussed. These include the need to (a) produce reporting standards for the production of guidance to match reporting standards for other research methods, (b) acknowledge the ´informal´ or emergent aspects of producing guidance and its role within a wider knowledge mobilization strategy, (c) consider guidance development from projects as part of a wider knowledge mobilization strategy, and (d) encourage a receptive environment for guidance development and use, including researcher training, durable funding to support impact, and closer relations between research and practice.
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Affiliation(s)
- Simon Turner
- School of Management, University of Los Andes, Edificio Santo Domingo, Cl. 21 #1 20, Bogotá, Colombia.
| | - Charlotte A Sharp
- Centre for Primary Care and Health Services Research, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Jessica Sheringham
- Department of Applied Health Research, University College London, Gower Street, London, WC1E 6BT, UK
| | - Shaun Leamon
- The Health Foundation, 8 Salisbury Square, London, EC4Y 8AP, UK
| | - Naomi J Fulop
- Department of Applied Health Research, University College London, Gower Street, London, WC1E 6BT, UK
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18
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Hensel JM, Shaw J, Ivers NM, Desveaux L, Vigod SN, Cohen A, Onabajo N, Agarwal P, Mukerji G, Yang R, Nguyen M, Bouck Z, Wong I, Jeffs L, Jamieson T, Bhatia RS. A Web-Based Mental Health Platform for Individuals Seeking Specialized Mental Health Care Services: Multicenter Pragmatic Randomized Controlled Trial. J Med Internet Res 2019; 21:e10838. [PMID: 31165710 PMCID: PMC6684216 DOI: 10.2196/10838] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 04/26/2019] [Accepted: 04/26/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Web-based self-directed mental health applications are rapidly emerging to address health service gaps and unmet needs for information and support. OBJECTIVE The aim of this study was to determine if a multicomponent, moderated Web-based mental health application could benefit individuals with mental health symptoms severe enough to warrant specialized mental health care. METHODS A multicenter, pragmatic randomized controlled trial was conducted across several outpatient mental health programs affiliated with 3 hospital programs in Ontario, Canada. Individuals referred to or receiving treatment, aged 16 years or older, with access to the internet and an email address, and having the ability to navigate a Web-based mental health application were eligible. A total of 812 participants were randomized 2:1 to receive immediate (immediate treatment group, ITG) or delayed (delayed treatment group, DTG) access for 3 months to the Big White Wall (BWW), a multicomponent Web-based mental health intervention based in the United Kingdom and New Zealand. The primary outcome was the total score on the Recovery Assessment Scale, revised (RAS-r) which measures mental health recovery. Secondary outcomes were total scores on the Patient Health Questionnaire-9 item (PHQ-9), the Generalized Anxiety Disorder Questionnaire-7 item (GAD-7), the EuroQOL 5-dimension quality of life questionnaire (EQ-5D-5L), and the Community Integration Questionnaire. An exploratory analysis examined the association between actual BWW use (categorized into quartiles) and outcomes among study completers. RESULTS Intervention participants achieved small, statistically significant increases in adjusted RAS-r score (4.97 points, 95% CI 2.90 to 7.05), and decreases in PHQ-9 score (-1.83 points, 95% CI -2.85 to -0.82) and GAD-7 score (-1.55 points, 95% CI -2.42 to -0.70). Follow-up was achieved for 55% (446/812) at 3 months, 48% (260/542) of ITG participants and 69% (186/270) of DTG participants. Only 58% (312/542) of ITG participants logged on more than once. Some higher BWW user groups had significantly greater improvements in PHQ-9 and GAD-7 relative to the lowest use group. CONCLUSIONS The Web-based application may be beneficial; however, many participants did not engage in an ongoing way. This has implications for patient selection and engagement as well as delivery and funding structures for similar Web-based interventions. TRIAL REGISTRATION ClinicalTrials.gov NCT02896894; https://clinicaltrials.gov/ct2/show/NCT02896894 (Archived by WebCite at http://www.webcitation.org/78LIpnuRO).
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Affiliation(s)
- Jennifer M Hensel
- Women's College Institute for Health Systems Solutions and Virtual Care, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada.,Women's College Research Institute, Toronto, ON, Canada
| | - James Shaw
- Women's College Institute for Health Systems Solutions and Virtual Care, Toronto, ON, Canada.,Women's College Research Institute, Toronto, ON, Canada
| | - Noah M Ivers
- Women's College Institute for Health Systems Solutions and Virtual Care, Toronto, ON, Canada.,Women's College Research Institute, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Laura Desveaux
- Women's College Institute for Health Systems Solutions and Virtual Care, Toronto, ON, Canada.,Women's College Research Institute, Toronto, ON, Canada.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Simone N Vigod
- Women's College Institute for Health Systems Solutions and Virtual Care, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Women's College Research Institute, Toronto, ON, Canada.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Ashley Cohen
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
| | - Nike Onabajo
- Women's College Institute for Health Systems Solutions and Virtual Care, Toronto, ON, Canada
| | - Payal Agarwal
- Women's College Institute for Health Systems Solutions and Virtual Care, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Geetha Mukerji
- Women's College Institute for Health Systems Solutions and Virtual Care, Toronto, ON, Canada.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Rebecca Yang
- Women's College Institute for Health Systems Solutions and Virtual Care, Toronto, ON, Canada
| | - Megan Nguyen
- Women's College Institute for Health Systems Solutions and Virtual Care, Toronto, ON, Canada
| | - Zachary Bouck
- Women's College Institute for Health Systems Solutions and Virtual Care, Toronto, ON, Canada
| | - Ivy Wong
- Women's College Institute for Health Systems Solutions and Virtual Care, Toronto, ON, Canada
| | - Lianne Jeffs
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
| | - Trevor Jamieson
- Women's College Institute for Health Systems Solutions and Virtual Care, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - R Sacha Bhatia
- Women's College Institute for Health Systems Solutions and Virtual Care, Toronto, ON, Canada.,Women's College Research Institute, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
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Edwards A, Zweigenthal V, Olivier J. Evidence map of knowledge translation strategies, outcomes, facilitators and barriers in African health systems. Health Res Policy Syst 2019; 17:16. [PMID: 30732634 PMCID: PMC6367796 DOI: 10.1186/s12961-019-0419-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 01/20/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The need for research-based knowledge to inform health policy formulation and implementation is a chronic global concern impacting health systems functioning and impeding the provision of quality healthcare for all. This paper provides a systematic overview of the literature on knowledge translation (KT) strategies employed by health system researchers and policy-makers in African countries. METHODS Evidence mapping methodology was adapted from the social and health sciences literature and used to generate a schema of KT strategies, outcomes, facilitators and barriers. Four reference databases were searched using defined criteria. Studies were screened and a searchable database containing 62 eligible studies was compiled using Microsoft Access. Frequency and thematic analysis were used to report study characteristics and to establish the final evidence map. Focus was placed on KT in policy formulation processes in order to better manage the diversity of available literature. RESULTS The KT literature in African countries is widely distributed, problematically diverse and growing. Significant disparities exist between reports on KT in different countries, and there are many settings without published evidence of local KT characteristics. Commonly reported KT strategies include policy briefs, capacity-building workshops and policy dialogues. Barriers affecting researchers and policy-makers include insufficient skills and capacity to conduct KT activities, time constraints and a lack of resources. Availability of quality locally relevant research was the most reported facilitator. Limited KT outcomes reflect persisting difficulties in outcome identification and reporting. CONCLUSION This study has identified substantial geographical gaps in knowledge and evidenced the need to boost local research capacities on KT practices in low- and middle-income countries. Evidence mapping is also shown to be a useful approach that can assist local decision-making to enhance KT in policy and practice.
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Affiliation(s)
- Amanda Edwards
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925 South Africa
| | - Virginia Zweigenthal
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925 South Africa
- Western Cape Government Health, Cape Town, South Africa
| | - Jill Olivier
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925 South Africa
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