Integrated knowledge translation to advance noncommunicable disease policy and practice in South Africa: application of the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework

Abstract Background In response to the “know–do” gap, several initiatives have been implemented to enhance evidence-informed decision-making (EIDM). These include individual training, organizational culture change management, and legislative changes. The importance of relationships and stakeholder engagement in EIDM has led to an evolution of models and approaches including integrated knowledge translation (IKT). IKT has emerged as a key strategy for ensuring that engagement is equitable, demand-driven, and responsive. As a result, the African-German Collaboration for Evidence-Based Healthcare and Public Health in Africa (CEBHA+) incorporated an IKT approach to influence noncommunicable diseases (NCD) policy and practice. We documented the phased process of developing, implementing, and monitoring the IKT approach in South Africa; and explored the appropriateness of using the exploration, preparation, implementation, and sustainment (EPIS) framework for this purpose. Methods We mapped the South Africa IKT approach onto the EPIS framework using a framework analysis approach. Notes of team meetings, stakeholder matrices, and engagement strategies were analysed and purposefully plotted against the four phases of the framework in order to populate the different constructs. We discussed and finalized the analysis in a series of online iterations until consensus was reached. Results The mapping exercise revealed an IKT approach that was much more iterative, dynamic, and engaging than initially thought. Several constructs (phase-agnostic) remained important and stable across EPIS phases: stable and supportive funding; committed and competent leadership; skilled and dedicated IKT champions; diverse and established personal networks; a conducive and enabling policy environment; and boundary-spanning intermediaries. Constructs such as “innovations” constantly evolved and adapted to the changing inner and outer contexts (phase-specific). Conclusions Using the EPIS framework to interrogate, reflect on, and document our IKT experiences proved extremely relevant and useful. Phase-agnostic constructs proved critical to ensure resilience and agility of NCD deliberations and policies in the face of highly dynamic and changing local contexts, particularly in view of the current coronavirus disease 2019 (COVID-19) pandemic. Bridging IKT with a framework from implementation science helps to reflect on this process and can guide the development and planning of similar interventions and strategies.

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Improving research impact: lessons from the infrastructure engagement excellence standards

Evidence & Policy A Journal of Research Debate and Practice ◽

10.1332/174426421x16225315303512 ◽

2021 ◽

Author(s):

Kirsty Jones ◽

Sara Bice

Keyword(s):

Knowledge Translation ◽

Implementation Science ◽

Research Impact ◽

Integrated Knowledge Translation ◽

Practical Implementation ◽

Translation Theory ◽

Policy And Practice ◽

Research Implementation ◽

Research Findings ◽

Integrated Knowledge

Background: The gap between research and practical implementation remains a major challenge for policymakers. Research co-creation, involving researchers co-designing and co-producing research with industry, government and civil society, can support improved end user uptake and better research implementation.Aims and objectives: This Practice Paper introduces a process of research co-creation based in implementation science and integrated knowledge translation theories. It details the development of the Infrastructure Engagement Excellence Standards (IEE), a framework of 10 Standards defining the qualities of community engagement for optimal infrastructure planning and delivery. The paper details a research co-creation process applicable across a variety of industries and policy settings.Key conclusions: The Practice Paper introduces a theory-based method for research co-production and discusses strengths and weaknesses of the co-creation approach used to develop the IEE Standards. Implementation science and integrated knowledge translation theory offer important insights to support more successful research co-design and co-production. Research that incorporates these theories is better positioned to achieve implementation. The creation of the IEE Standards offers one helpful example of how researchers, policymakers and practitioners can begin to close the research-implementation gap. Key messages <ul><li>Research co-creation, using implementation science and integrated knowledge translation, supports uptake of research outcomes;</li> <li>Co-design creates ownership and understanding of research findings among participants;</li> <li>Ownership of research findings improves research use, to inform policy and practice;</li> <li>Involving end users in all research stages makes results more applicable and meets practice needs.</li></ul>

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Initiation is recognized as a fundamental early phase of integrated knowledge translation (IKT): qualitative interviews with researchers and research users in IKT partnerships

BMC Health Services Research ◽

10.1186/s12913-019-4573-4 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Maria Maddalena Zych ◽

Whitney B. Berta ◽

Anna R. Gagliardi

Keyword(s):

Knowledge Translation ◽

Web Sites ◽

Early Phase ◽

Qualitative Interviews ◽

Effective Means ◽

Integrated Knowledge Translation ◽

Policy And Practice ◽

Research Activities ◽

Research User ◽

Integrated Knowledge

Abstract Background Health care researcher-research user partnerships, referred to as integrated knowledge translation (IKT), have been adopted on an international basis, and are an effective means of co-generating and implementing evidence into policy and practice. Prior research suggests that an initiation period is essential for establishing functional partnerships. To characterize IKT initiation and describe determinants of IKT initiation success, this study explored IKT initiation processes, enablers, and barriers among researchers and research users involved in IKT partnerships. Methods A descriptive qualitative approach was used compliant with COREQ standards. Canadian researchers and research users in research collaborations were identified on publicly-available directories and web sites, and referred by those interviewed. They were asked to describe how partnerships were initiated, influencing factors, the length of initiation, and interventions needed to support initiation. Sampling was concurrent with data collection and analysis to achieve thematic saturation. Data were analyzed using constant comparative technique by all members of the research team. Results In total, 22 individuals from 6 provinces were interviewed (9 researchers, 11 research users, 2 connectors). They confirmed that IKT initiation is a distinct early phase of partnerships. The period ranged from 6 months to 2 years for 75.0% of participants in pre-existing partnerships, to 6 years for newly-formed partnerships. High-level themes were: Newly identifying and securing partners is an intensive process; Processes and activities take place over a protracted period through multiple interactions; Identifying and engaging committed partners is reliant on funding; and Partnership building is challenged by maintaining continuity and enthusiasm. Participants underscored the need for an IKT partner matching forum, IKT initiation toolkit, and funding for non-research activities required during IKT initiation to establish functional researcher-research user partnerships. Themes were largely similar regardless of participant years of experience with IKT or being involved in a new versus pre-existing partnership. Conclusions IKT initiation is a recognized and important early phase of IKT that establishes functional partnerships, and once established, ongoing partnership for subsequent projects is likely. Further research is needed to develop and evaluate approaches recommended by participants for stimulating IKT initiation.

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Integrated Knowledge Translation in Non-Communicable Disease Research in Sub-Saharan Africa: A Comparison of Systematic and Ad Hoc Stakeholder Engagement

Frontiers in Tropical Diseases ◽

10.3389/fitd.2021.753192 ◽

2021 ◽

Vol 2 ◽

Author(s):

Talitha L. Mpando ◽

Kerstin Sell ◽

Peter Delobelle ◽

Jimmy Osuret ◽

Jean Berchmans Niyibizi ◽

...

Keyword(s):

South Africa ◽

Knowledge Translation ◽

Stakeholder Engagement ◽

Ad Hoc ◽

Integrated Knowledge Translation ◽

Decision Makers ◽

Sub Saharan Africa ◽

African Countries ◽

Country Specific ◽

Integrated Knowledge

BackgroundLow- and middle-income countries (LMICs) are currently experiencing an increasing prevalence of non-communicable diseases (NCDs). To address this as well as other health challenges, Integrated Knowledge Translation (IKT) approaches to build mutually beneficial relationships between researchers and decision-makers can concurrently inform research as well as enhance evidence use in policy and practice. The Collaboration for Evidence-Based Healthcare and Public Health in Africa (CEBHA+) is a research consortium which conducts research on NCDs and uses an IKT approach to facilitate the uptake of this research in five African countries: Ethiopia, Uganda, Rwanda, Malawi, and South Africa. Tailored IKT strategies were designed and implemented to plan and guide stakeholder engagement. This systematic approach contrasts with more commonly used ad hoc approaches to stakeholder engagement.MethodsIn this article, we explore the experiences of researchers engaged in the CEBHA+ IKT approach across the five African countries. Data sources included: 1) an informal document review of CEBHA+ country-specific IKT strategies, IKT team meeting minutes and activity reports, and 2) a semi-structured survey of IKT implementers to elicit country-specific experiences on actual implementation and adaptation of the IKT strategies. Results were collated and contrasted across all CEBHA+ countries with a focus on systematic versus ad hoc approaches to engagement.ResultsSouth Africa, Malawi and Ethiopia country teams indicated that their engagements benefited from a systematic IKT strategy. This was especially the case in the early stages of the project as it allowed focused and intentional engagement. However, ad hoc engagement was still required as new professional relationships developed, and contextual circumstances - including the SARS-CoV-2 pandemic - required responsive engagement with decision-makers and other stakeholders. In Rwanda and Uganda, continuous systematic engagement was found to bolster ownership of the research at both community and national levels.ConclusionPolitical and health climates are constantly shifting with a need to maintain flexibility in how IKT strategies are implemented. While strategic IKT can benefit from deliberate planning and stakeholder engagement, there is value in remaining flexible to respond to the needs of stakeholders and contextual circumstances. This paper highlights how IKT implementers in the five African CEBHA+ countries responded to this challenge.

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An Integrated Knowledge Translation Experience

Trends in Amplification ◽

10.1177/1084713811417634 ◽

2011 ◽

Vol 15 (1) ◽

pp. 34-56 ◽

Cited By ~ 5

Author(s):

Sheila T. Moodie ◽

Marlene P. Bagatto ◽

Linda T. Miller ◽

Anita Kothari ◽

Richard Seewald ◽

...

Keyword(s):

Knowledge Translation ◽

Integrated Knowledge Translation ◽

Integrated Knowledge

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Development and implementation of dementia-related integrated knowledge translation strategies in rural home care

Online Journal of Rural Nursing and Health Care ◽

10.14574/ojrnhc.v18i2.509 ◽

2018 ◽

Vol 18 (2) ◽

pp. 29-64 ◽

Cited By ~ 1

Author(s):

Melanie Bayly ◽

Catherine Blake ◽

Shelley Peacock ◽

Debra Morgan ◽

Dorothy Forbes

Keyword(s):

Knowledge Translation ◽

Home Care ◽

Integrated Knowledge Translation ◽

Translation Strategies ◽

Knowledge Translation Strategies ◽

Integrated Knowledge

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A Comparison Between Selected Noncommunicable Disease Mortality Rates Between 2010 and 2016 Among Selected Southern African Countries

International Quarterly of Community Health Education ◽

10.1177/0272684x20916588 ◽

2020 ◽

Vol 41 (2) ◽

pp. 119-123 ◽

Cited By ~ 1

Author(s):

T. J. Ellapen ◽

M. Barnard ◽

G. L. Strydom ◽

K. M. Masime ◽

Y. Paul

Keyword(s):

Diabetes Mellitus ◽

South Africa ◽

Respiratory Diseases ◽

Mortality Rates ◽

Noncommunicable Disease ◽

Noncommunicable Diseases ◽

African Countries ◽

Death Rates ◽

Chronic Respiratory Diseases ◽

Disease Mortality

Researchers have identified cancer, diabetes mellitus, cardiovascular, and respiratory diseases as being the principal pathologies of increased aged standardized death rates (ASDRs) among noncommunicable diseases (NCDs). The objective of this study was to compare the change in the ASDR of these principal NCDs between the years 2010 and 2016 in Botswana, Mozambique, Namibia, South Africa, and Zimbabwe. ASDR data were collected from the 2016 Global Health Estimate. Among the selected Southern African countries for both 2010 and 2016, the order of prevalence of NCDs linked to increased ASDR was cardiovascular diseases (both cardiac and stroke), cancer, diabetes mellitus, and chronic respiratory diseases. The percentage of the total number of NCDs linked to increased ASDR in relation to total deaths increased from 43.8% (in 2010) to 51.0% (in 2016) from ( p < .0001). The percentage of principal NCDs in relation to total ASDR increased from 33.0% (in 2010) to 38.2% (in 2016; p < .0001).

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