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Knowledge to Action Model

Amy Seitz Cooley, MS, RN, ACNS-BC York College of Pennsylvania

Presentation Objectives:

•  Discuss the purpose of the model •  Describe the model and

associated concepts and steps •  Identify the model’s use in practice

Authors of the Model Dr. Ian Graham and colleagues from the University of Ottawa

•  Designed for use by wide range of knowledge…not just clinicians

•  Canadian Institutes of Health Research (CIHR)

(White, 2012)

Purpose of the KTA model

•  To provide a framework to help elucidate the key actions in the Knowledge to Action (KTA) process

•  Conceptual map to help knowledge producers and users navigate through the complex iterative and organic process of knowledge translation

Graham et al., 2006

So Many Terms!!!

Knowledge Knowledge Transfer

Research Utilization

Implementation Research

Diffusion and Dissemination

Knowledge Exchange

•  Preferred term of the Canadian Health Services Research Foundation

•  Key assumption: – Researchers and decision makers

separate groups with distinct cultures and perspectives of research and knowledge

•  Hope is to bring researchers and decision makers together to collaborate through the KTA process

Graham et al., 2006

KTA MODEL

Graham et al., 2006

Steps of KTA: Two Concepts

Knowledge Creation •  Knowledge “funnel” •  Major types of

knowledge or research

•  Becomes more distilled and refined as it moves through funnel—more usable to stakeholders

Graham et al., 2006

Steps of KTA: Two Concepts

Action •  Cycle leading to

application of the knowledge—knowledge implementation

•  Dynamic phases—influence each other and can be influenced by knowledge creation phases

•  Derived from planned action theories

•  Cycle starts here Graham et al., 2006

Uses in Practice

•  Alzheimer’s Research & Therapy: physicians (Cook and Rockwood, 2013)

•  Dementia KT Learning Center (dementiakt.ca/dkt)

•  Canadian Hypertension Education: public

health-general public, professionals and policy makers (Hua et al., 2012)

•  Community Education re: delirium: families of older adults (Keyser, 2010)

Uses in Practice

•  Rehabilitation setting: children with CP—evidence based pediatric measurement tool: physiotherapists (Russell et al., 2010)

•  Nursing Education: Integrating patient decision support within the undergraduate nursing curriculum: Academic stakeholders (Stacey et al., 2009)

•  Clinical/Academic Mentor scheme for clinician scientist: Mentor stakeholders (Straus et al., 2008)

Uses in Practice

•  Osteoarthritis: Healthcare consumers including patients and clinicians (Tugwell et al, 2007)

•  Stroke care: – Evidence based treatment of dysphagia post

stroke: speech and language pathologists (Molfenter et al., 2009)

– Unilateral spatial neglect: Occupational therapists (Petzold et al., 2010)

•  Fall Prevention Research: CIHR (Tetroe, Graham, & Scott, 2011)

Uses in Practice •  Pharmaceuticals: EpiQ Quality and Values

through outcomes (www.epi-q.com) •  Collaborations for leadership in applied

health research and care (CLAHRC): stakeholders in academics and health services (Rycroft-Malone, et al., 2011)

Questions… •  How could this model be used to with

your EBP project? •  What part of this model resonates with

your beliefs or experiences with translating evidence into practice?

•  What commonalities do you see this model has with other models?

References Bjork, I. T., Nielsen, C. M., Brynildsen, G., Frederiksen, A. M. S., Larsen, K., Rierson, I.

A.,...Stenholt, B. (2013). From theoretical model to practical use: an example of knowledge translation. Journal of Advanced Nursing, 6, 2336-2347. doi: 10.1111/jan.12091

Claude, K. M., Juvenal, K. L., & Hawkes, M. (2012). Applying a knowledge-to-action framework for primary prevention of spina bifida in tropical Africa. Maternal Child Nurtrition, 8, 174-184.

Cook, C., & Rockwood, K. (2013). Knowledge translation: an overview and recommendations in relation to the fourth Canadian consensus conference on the diagnosis and treatment of dementia. Alzheimer's Research & Therapy, 5(5), 1-7. doi:10.1186/alzrt202

Field, B., Booth, A., Ilott, I., & Gerrish, K. (2014). Using the knowledge to action framework in practice: a citation analysis and systematic review. Implementation Science, 9(172), 1-14. doi:doi:10.1186/s13012-014-0172-2

Graham, I. D., Logan, J., Harrison, M. B., Straus, S. E., Tetroe, J. .., Caswell, W., & Robinson, N. (2006). Lost in knowledge translation: Time for a map? The Journal of Continuing Education in the Health Professions, 26, 13-24. doi: 10.1002/chp.47

References

Graham, I. D., Tetroe, J., & The KT Theories Research Group. (2007). Some theoretical underpinings of knowledge translation. Academic Emergency Medicine, 14, 936-941. doi:10.1097/j.aem. 2007.07.004

Hua, D., Carter, S., Bellerive, J., Allu, S. O., Reid, D., Tremblay, G.,...Tobe, S. W. (2012). Bridging the gap: Innovative knowledge translation and the Canadian hypertension education group. Canadian Journal of Cardiology, 28, 258-261. doi:10.1016/j.cjca.2012.03.001

Keyser, S. E. (2010). The implementation of a delirium knowledge translation product for families of the elderly (Doctoral dissertation, Queen's University School of Nursing, Ontario, Canada). Retrieved from https:// qspace.library.queensu.ca

Molfenter, S., Ammoury, A., Yeates, E., & Steele, C. (2009). Decreasing the knowledge to action gap through research-clinical partnerships in speech- language pathology. Canadian Journal of Speech-Language Pathology Audiology, 33, 82-88. Retrieved from http://hdl.handle.net/1807/17677

References Petzold, A., Korner-Bitensky, N., & Menon, A. (2010). Using the knowledge to action

process model to incite clinical change. Journal of Continuing Education in the Health Professions, 30, 167-171. doi:10.1002/chp.20077

Russell, D. J., Rivard, L. M., Walter, S. D., Rosenbaum, P. L., Roxborough, L., Cameron, D.,...Avery, L. M. (2010). Using knowledge brokers to facilitate the uptake of pediatric measurement tools into clinical practice: A before-after intervention study. Implementation Science, 5(92), . doi:10.1186/1748-5908-5-92

Rycroft-Malone, J., Wilkinson, J. E., Burton, C. R., Andrews, G., Ariss, S., Baker, R.,...Thompson, C. (2011). Implementing health research through academic and clinical partnerships: a realistic evaluation of the Collaborations for Leadership in Applied Health Research and Care (CLAHRC). Implementation Science, 6(74), 1-12. doi:doi:10.1186/1748-5908-6-74

Stacey, D., Higuchi, K. A. S., Menard, P., Davies, B., Graham, I. D., & O'Connor, A. M. (2009). Integrating patient decision support in an undergraduate nursing curriculum: An implementation project. International Journal of Nursing Education Scholarship, 6(1), 1-16. doi:10.2202/1548-923X.1741

Straus, S. E., Graham, I. D., Taylor, M., & Lockyer, J. (2008). Development of a mentorship strategy: A knowledge translation case study. Journal of Continuing Education in the Health Professions, 28, 117-122. doi:10.1002/chp. 179

References Tetroe, J., Graham, I. D., & Scott, V. (2011). What does it mean to transform

knowledge into action in falls prevention research? Perspectives from the Canadian Institutes of Health Research. Journal of Safety Research, 42, 423-426. doi:1o.1016/j.jsr.2011.08.005

Tugwell, P. S., Santesso, N. A., O'Connor, A. M., & Wilson, A. J. (2007). Knowledge translation for effective consumers. Physical Therapy: Journal of the Amercan Physical Therapy Association, 87, 1728-1738.

White, K. M. (2012). The science of translation and major frameworks. In K. M. White & S. Dudley-Brown (Eds.), Translation of evidence into nursing and health care practice (pp. 23-49). New York: Springer Publishing Company.