scholarly journals Characteristics of knowledge translation theories, models and frameworks for health technology reassessment: expert perspectives through a qualitative exploration

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rosmin Esmail ◽  
Fiona M. Clement ◽  
Jayna Holroyd-Leduc ◽  
Daniel J. Niven ◽  
Heather M. Hanson
Keyword(s):  
Knowledge Translation ◽  
Technology Implementation ◽  
Health Technology ◽  
Theory Model ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Patient Centered ◽  
Research Knowledge ◽  
Knowledge To Action ◽  
Health Technology Reassessment

Abstract Background Health Technology Reassessment (HTR) is a process that systematically assesses technologies that are currently used in the health care system. The process results in four outputs: increase use or decrease use, no change, or de-adoption of a technology. Implementation of these outputs remains a challenge. The Knowledge Translation (KT) field enables to transfer/translate knowledge into practice. KT could help with implementation of HTR outputs. This study sought to identify which characteristics of KT theories, models, and frameworks could be useful, specifically for decreased use or de-adoption of a technology. Methods A qualitative descriptive approach was used to ascertain the perspectives of international KT and HTR experts on the characteristics of KT theories, models, and frameworks for decreased use or de-adoption of a technology. One-to-one semi-structured interviews were conducted from September to December 2019. Interviews were audio recorded and transcribed verbatim. Themes and sub-themes were deduced from the data through framework analysis using five distinctive steps: familiarization, identifying an analytic framework, indexing, charting, mapping and interpretation. Themes and sub-themes were also mapped to existing KT theories, models, and frameworks. Results Thirteen experts from Canada, United States, United Kingdom, Australia, Germany, Spain, and Sweden participated in the study. Three themes emerged that illustrated the ideal traits: principles that were foundational for HTR, levers of change, and steps for knowledge to action. Principles included evidence-based, high usability, patient-centered, and ability to apply to the micro, meso, macro levels. Levers of change were characterized as positive, neutral, or negative influences for changing behaviour for HTR. Steps for knowledge to action included: build the case for HTR, adapt research knowledge, assess context, select interventions, and assess impact. Of the KT theories, models, and frameworks that were mapped, the Consolidated Framework for Implementation Research had most of the characteristics, except ability to apply to micro, meso, macro levels. Conclusions Characteristics that need to be considered within a KT theory, model, and framework for implementing HTR outputs have been identified. Consideration of these characteristics may guide users to select relevant KT theories, models, and frameworks to apply to HTR projects.

PP100 Characteristics To Consider In A Knowledge Translation Theory, Model Or Framework For Health Technology Reassessment

2021 ◽  
Vol 37 (S1) ◽  
pp. 18-19
Author(s):  
Rosmin Esmail ◽  
Heather M. Hanson ◽  
Jayna Holroyd-Leduc ◽  
Daniel J. Niven ◽  
Fiona M. Clement
Keyword(s):  
Knowledge Translation ◽  
Health Technology ◽  
Theory Model ◽  
Evidence Based ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Patient Centered ◽  
Research Knowledge ◽  
Knowledge To Action ◽  
Health Technology Reassessment

IntroductionHealth technology reassessment (HTR) is a structured evidence-based assessment of an existing technology in comparison to its alternatives. The process results in the following four outputs: (i) increased use; (ii) decreased use; (iii) no change; or (iv) de-adoption. However, implementing these outputs remains a challenge. Knowledge translation (KT) can be applied to implement findings from the HTR process. This study sought to identify which characteristics of KT theories, models, and frameworks (TMFs) could be useful, specifically for decreasing the use of or de-adopting a technology.MethodsA qualitative descriptive approach was used to ascertain the perspectives of international KT and HTR experts on the characteristics of KT TMFs for decreasing the use of or de-adopting a technology. One-to-one semi-structured interviews were conducted. Interviews were audio recorded and transcribed verbatim. Themes and sub-themes were deduced from the data through framework analysis using the following five distinctive steps: familiarization; identifying an analytic framework; indexing; charting; and mapping and interpretation. Themes and sub-themes were also mapped to existing KT TMFs.ResultsThirteen experts participated. The following three themes emerged as ideal characteristics of a KT TMF: (i) principles foundational for HTR: evidence-based, high usability, patient-centered, and ability to apply to micro, meso, and macro levels; (ii) levers of change: characterized as positive, neutral, or negative influences for changing behavior; and (iii) steps for knowledge to action: build the case for HTR, adapt research knowledge, assess context, select, tailor, and implement interventions, and assess impact. The Consolidated Framework for Implementation Research had the greatest number of ideal characteristics.ConclusionsApplication of KT TMFs to the HTR process has not been clearly established. This is the first study to provide an understanding of characteristics within KT TMFs that could be considered by users undertaking projects to decrease or de-adopt technologies. Characteristics to be considered within a KT TMF for implementing HTR outputs were identified. Consideration of these characteristics may guide users in choosing which KT TMF(s) to use when undertaking HTR projects.

scholarly journals Characteristics of Knowledge Translation Theories, Models and Frameworks for Health Technology Reassessment: Expert Perspectives Through a Qualitative Exploration

2020 ◽  
Author(s):  
Rosmin Esmail ◽  
Fiona M Clement ◽  
Jayna Holroyd-Leduc ◽  
Daniel J Niven ◽  
Heather M Hanson
Keyword(s):  
Knowledge Translation ◽  
Technology Implementation ◽  
Health Technology ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Patient Centered ◽  
Research Knowledge ◽  
Knowledge To Action ◽  
Health Technology Reassessment ◽  
Decrease Use

Abstract Background: Health Technology Reassessment (HTR) is a process that systematically assesses technologies that are currently used in the health care system. The process results in four outputs: increase use or decrease use, no change, or de-adoption of a technology. Implementation of these outputs remains a challenge. The Knowledge Translation (KT) field enables knowledge into practice. KT could help with implementation of HTR outputs. This study sought to identify which characteristics of KT theories, models, and frameworks (TMFs) could be useful, specifically for decrease use or de-adoption of a technology.Methods: A qualitative descriptive approach was used to ascertain the perspectives of international KT and HTR experts on the characteristics of KT TMFs for decrease use or de-adoption of a technology. One-to-one semi-structured interviews were conducted from September to December 2019. Interviews were audio recorded and transcribed verbatim. Themes and sub-themes were deduced from the data through framework analysis using five distinctive steps: familiarization, identifying an analytic framework, indexing, charting, mapping and interpretation. Themes and sub-themes were also mapped to existing KT TMFs.Results: Thirteen individuals from Canada, United States, United Kingdom, Australia, Germany, Spain, and Sweden participated in the study. Three themes emerged that illustrated the ideal traits of a KT TMF: principles that were foundational for HTR, levers of change, and steps for knowledge to action. Principles included evidence-based, high usability, patient-centered, and ability to apply to the micro, meso, macro levels. Levers of change were characterized as positive, neutral, or negative influences for changing behaviour for HTR. Steps for knowledge to action included: build the case for HTR, adapt research knowledge, assess context, select, tailor and implement interventions, and assess impact. Of the KT TMFs that were mapped, the Consolidated Framework for Implementation Research had most of the characteristics, except ability to apply to micro, meso, macro levels. Conclusions: Application of KT TMFs to HTR has not been clearly understood. Characteristics that need to be considered within a KT TMF for implementing HTR outputs have been identified. Consideration of these characteristics within KT TMFs may guide users undertaking HTR projects.

scholarly journals Identification of knowledge translation theories, models or frameworks suitable for health technology reassessment: a survey of international experts

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e042251
Author(s):  
Rosmin Esmail ◽  
Heather M Hanson ◽  
Jayna Holroyd-Leduc ◽  
Daniel J Niven ◽  
Fiona M Clement
Keyword(s):  
Knowledge Translation ◽  
Health Technology ◽  
Ease Of Use ◽  
Cross Sectional Survey ◽  
Full Spectrum ◽  
Cross Sectional ◽  
Knowledge To Action ◽  
Purposeful Sampling ◽  
International Experts ◽  
Health Technology Reassessment

ObjectiveHealth technology reassessment (HTR) is a field focused on managing a technology throughout its life cycle for optimal use. The process results in one of four possible recommendations: increase use, decrease use, no change or complete withdrawal of the technology. However, implementation of these recommendations has been challenging. This paper explores knowledge translation (KT) theories, models and frameworks (TMFs) and their suitability for implementation of HTR recommendations.DesignCross-sectional survey.ParticipantsPurposeful sampling of international KT and HTR experts was administered between January and March 2019.MethodsSixteen full-spectrum KT TMFs were rated by the experts as ‘yes’, ‘partially yes’ or ‘no’ on six criteria: familiarity, logical consistency/plausibility, degree of specificity, accessibility, ease of use and HTR suitability. Consensus was determined as a rating of ≥70% responding ‘yes’. Descriptive statistics and manifest content analysis were conducted on open-ended comments.ResultsEleven HTR and 11 KT experts from Canada, USA, UK, Australia, Germany, Spain, Italy and Sweden participated. Of the 16 KT TMFs, none received ≥70% rating. When ratings of ‘yes’ and ‘partially yes’ were combined, the Consolidated Framework for Implementation Research was considered the most suitable KT TMF by both KT and HTR experts (86%). One additional KT TMF was selected by KT experts: Knowledge to Action framework. HTR experts selected two additional KT TMFs: Co-KT framework and Plan-Do-Study-Act cycle. Experts identified three key characteristics of a KT TMF that may be important to consider: practicality, guidance on implementation and KT TMF adaptability.ConclusionsDespite not reaching an overall ≥70% rating on any of the KT TMFs, experts identified four KT TMFs suitable for HTR. Users may apply these KT TMFs in the implementation of HTR recommendations. In addition, KT TMF characteristics relevant to the field of HTR need to be explored further.

scholarly journals Knowledge Translation Improvement Strategies in Universities of Medical Sciences in Iran: A Qualitative Study

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Sogand Tourani ◽  
Narges Rafiei ◽  
Shahnaz Rimaz ◽  
Seyed Kazem Malakouti ◽  
Alireza Heidari
Keyword(s):  
Qualitative Study ◽  
Knowledge Translation ◽  
Knowledge Production ◽  
Data Organization ◽  
Health Plans ◽  
Medical Sciences ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Improvement Strategies

BACKGROUND፡ Recently, one of the challenges in the health system of the country is the need for research contributing to policy-making. Therefore, it is crucial to develop activities in the field of knowledge Translation (KT). This study aimed to propose KT improvement strategies in universities of medical sciences in Iran.METHODS: In this qualitative study, 18 semi-structured interviews were conducted with key informants from the medical universities in Iran during January-July 2018. The transcribed documents were analyzed using the Gale framework analysis approach. Data organization was carried out using MAXQDA version 10 software.RESULTS: According to framework analysis, six KT improvement strategies were identified including improving the abilities and skills of researchers, improving the processes and quality of knowledge production, revising policies and laws, mproving the prerequisites, culture-building, and promoting the, use of evidence.CONCLUSION: Given the challenges and strategies outlined in this study, it seems that the mechanism of KT and its effects on improving health plans for policymakers and researchers has not been elucidated yet. Therefore, considerable changes in prerequisites, knowledge production processes, academic procedures, policies and laws are necessary for implementing KT in universities of medical sciences in Iran. 

scholarly journals Knowledge translation and health technology reassessment: identifying synergy

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Rosmin Esmail ◽  
Heather Hanson ◽  
Jayna Holroyd-Leduc ◽  
Daniel J. Niven ◽  
Fiona Clement
Keyword(s):  
Knowledge Translation ◽  
Health Technology ◽  
Health Technology Reassessment

scholarly journals Incorporating Self-Management in Prosthetic Rehabilitation: Case Report of an Integrated Knowledge-to-Action Process

2015 ◽  
Vol 95 (4) ◽  
pp. 640-647 ◽  
Author(s):  
Sacha van Twillert ◽  
Klaas Postema ◽  
Jan H.B. Geertzen ◽  
Ant T. Lettinga
Keyword(s):  
Knowledge Translation ◽  
Practical Knowledge ◽  
Self Management ◽  
Specific Training ◽  
Prosthetic Rehabilitation ◽  
Research Knowledge ◽  
Translation Process ◽  
Knowledge To Action ◽  
Context Specific ◽  
And Task

Background In improvement of clinical practice, unidirectional approaches of translating evidence into clinical practice have been pinpointed as main obstacles. The concept of engaged scholarship has been introduced to guide knowledge-to-action (KTA) processes, in which research knowledge and practical knowledge derived from therapists, patients, and organizational structures mutually inform each other. Accordingly, KTA experts should engage end-users earlier in knowledge translation and work in concert with them on both knowledge creation and knowledge implementation. Purpose The purposes of this case report are: (1) to provide an illustrative example of an evidence-informed improvement process in prosthetic rehabilitation in a local setting and (2) to articulate the bidirectional translation work incorporated into an integrated KTA process. Case Description A KTA expert translated research knowledge on self-management and task- and context-specific training into a functional prosthetic training program for patients with a lower limb amputation. Therapists contributed as co-creators to the translation process with practical knowledge of the specificities of the target group and local organizational context. The KTA expert moved the co-created knowledge into action in iterative and interactive steps with local therapists, patients, and managers. Outcome This bidirectional KTA translation process led to shared ownership of the functional prosthetic training program, in which self-management and task- and context-specific training principles and practices were integrated. Discussion Bidirectional knowledge translation builds on explicating and integrating the different knowledge practices of researchers, therapists, and their patients. Knowledge-to-action experts and end-users have their own roles and activities in such knowledge translation processes. Appreciating these different roles in genuine partnerships and acknowledging the distinct but equally valued knowledge practices can help in effectively translating evidence into action.

scholarly journals The psychosocial response to a terrorist attack at Manchester Arena, 2017: a process evaluation

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Daniel Hind ◽  
Kate Allsopp ◽  
Prathiba Chitsabesan ◽  
Paul French
Keyword(s):  
Young People ◽  
Process Evaluation ◽  
Terrorist Attack ◽  
Health Sector ◽  
Routine Data ◽  
Recovery Phase ◽  
Normalisation Process Theory ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Response Phase

Abstract Background A 2017 terrorist attack in Manchester, UK, affected large numbers of adults and young people. During the response phase (first seven weeks), a multi-sector collaborative co-ordinated a decentralised response. In the subsequent recovery phase they implemented a centralised assertive outreach programme, ‘The Resilience Hub’, to screen and refer those affected. We present a process evaluation conducted after 1 year. Methods Case study, involving a logic modelling approach, aggregate routine data, and semi-structured interviews topic guides based on the Inter-Agency Collaboration Framework and May’s Normalisation Process Theory. Leaders from health, education and voluntary sectors (n = 21) and frontline Resilience Hub workers (n = 6) were sampled for maximum variation or theoretically, then consented and interviewed. Framework analysis of transcripts was undertaken by two researchers. Results Devolved government, a collaborative culture, and existing clinical networks meant that, in the response phase, a collaboration was quickly established between health and education. All but one leader evaluated the response positively, although they were not involved in pre-disaster statutory planning. However, despite overwhelming positive feedback there were clear difficulties. (1) Some voluntary sector colleagues felt that it took some time for them to be involved. (2) Other VCSE organisations were accused of inappropriate, harmful use of early intervention. (3) The health sector were accused of overlooking those below the threshold for clinical treatment. (4) There was a perception that there were barriers to information sharing across organisations, which was particularly evident in relation to attempts to outreach to first responders and other professionals who may have been affected by the incident. (5) Hub workers encountered barriers to referring people who live outside of Greater Manchester. After 1 year of the recovery phase, 877 children and young people and 2375 adults had completed screening via the Resilience Hub, 79% of whom lived outside Greater Manchester. Conclusions The psychosocial response to terrorist attacks and other contingencies should be planned and practiced before the event, including reviews of communications, protocols, data sharing procedures and workforce capacity. Further research is needed to understand how the health and voluntary sectors can best collaborate in the wake of future incidents.

scholarly journals Theory-based approach to developing an implementation plan to support the adoption of a patient decision aid for Down syndrome prenatal screening

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Titilayo Tatiana Agbadjé ◽  
Matthew Menear ◽  
Marie-Pierre Gagnon ◽  
France Légaré
Keyword(s):  
Prenatal Care ◽  
Knowledge Translation ◽  
Pregnant Women ◽  
Decision Aid ◽  
Prenatal Screening ◽  
Clinical Implementation ◽  
Implementation Plan ◽  
Translation Strategies ◽  
Knowledge To Action ◽  
Knowledge Translation Strategies

Abstract Background Our team has developed a decision aid to help pregnant women and their partners make informed decisions about Down syndrome prenatal screening. However, the decision aid is not yet widely available in Quebec’s prenatal care pathways. Objective We sought to identify knowledge translation strategies and develop an implementation plan to promote the use of the decision aid in prenatal care services in Quebec, Canada. Methods Guided by the Knowledge-to-Action Framework and the Theoretical Domains Framework, we performed a synthesis of our research (11 publications) on prenatal screening in Quebec and on the decision aid. Two authors independently reviewed the 11 articles, extracted information, and mapped it onto the Knowledge-to-Action framework. Using participatory action research methods, we then recruited pregnant women, health professionals, managers of three prenatal care services, and researchers to (a) identify the different clinical pathways followed by pregnant women and (b) select knowledge translation strategies for a clinical implementation plan. Then, based on all the information gathered, the authors established a consensus on strategies to include in the plan. Results Our knowledge synthesis showed that pregnant women and their partners are not sufficiently involved in the decision-making process about prenatal screening and that there are numerous barriers and facilitators of the use of the decision aid in clinical practice (e.g., low intention to use it among health providers). Using a participatory action approach, we met with five pregnant women, three managers, and six health professionals. They informed us about three of Quebec’s prenatal care pathways and helped us identify 20 knowledge translation strategies (e.g., nurse discusses decision aid with women before they meet the doctor) to include in a clinical implementation plan. The research team reached a consensus about the clinical plan and also about broader organizational strategies, such as training healthcare providers in the use of the decision aid, monitoring its impact (e.g., measure decisional conflict) and sustaining its use (e.g., engage key stakeholders in the implementation process). Conclusion Next steps are to pilot our implementation plan while further identifying global strategies that target institutional, policy, and systemic supports for implementation.

scholarly journals Development of a checklist to guide equity considerations in health technology assessment

2021 ◽  
Vol 37 ◽  
Author(s):  
Maria Benkhalti ◽  
Manuel Espinoza ◽  
Richard Cookson ◽  
Vivian Welch ◽  
Peter Tugwell ◽  
...  
Keyword(s):  
Knowledge Translation ◽  
Health Technology Assessment ◽  
Priority Setting ◽  
Technology Assessment ◽  
Literature Search ◽  
Health Inequities ◽  
Health Technology ◽  
Decision Makers ◽  
Added Value ◽  
Pilot Test

Abstract Objectives Health technology assessment (HTA) can impact health inequities by informing healthcare priority-setting decisions. This paper presents a novel checklist to guide HTA practitioners looking to include equity considerations in their work: the equity checklist for HTA (ECHTA). The list is pragmatically organized according to the generic HTA phases and can be consulted at each step. Methods A first set of items was based on the framework for equity in HTA developed by Culyer and Bombard. After rewording and reorganizing according to five HTA phases, they were complemented by elements emerging from a literature search. Consultations with method experts, decision makers, and stakeholders further refined the items. Further feedback was sought during a presentation of the tool at an international HTA conference. Lastly, the checklist was piloted through all five stages of an HTA. Results ECHTA proposes elements to be considered at each one of the five HTA phases: Scoping, Evaluation, Recommendations and Conclusions, Knowledge Translation and Implementation, and Reassessment. More than a simple checklist, the tool provides details and examples that guide the evaluators through an analysis in each phase. A pilot test is also presented, which demonstrates the ECHTA's usability and added value. Conclusions ECHTA provides guidance for HTA evaluators wishing to ensure that their conclusions do not contribute to inequalities in health. Several points to build upon the current checklist will be addressed by a working group of experts, and further feedback is welcome from evaluators who have used the tool.

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