Considerations for knowledge translation tool development: perspectives from French and Filipino parents (Preprint)

2021 ◽  
Author(s):  
Sarah A Elliott ◽  
Kelsey S Wright ◽  
Shannon D Scott ◽  
Lisa Hartling
Keyword(s):  
Knowledge Translation ◽  
Language Translation ◽  
First Language ◽  
Signs And Symptoms ◽  
Evidence Based ◽  
Data Sets ◽  
Structured Interviews ◽  
Cultural Adaptations ◽  
Key Stakeholders ◽  
Audio Recordings

BACKGROUND We have developed a number of evidence-based knowledge translation (KT) tools for parents of children with acute health conditions. These tools were created with parent input from, pilot-tested with, and disseminated to groups proficient in English with “westernized” cultural upbringings. It is therefore unclear if they are as useful for populations that are more diverse. To enhance the reach of our current and future KT tools, language translation and cultural adaptations may promote relevance for previously underserved knowledge users. OBJECTIVE To explore and understand considerations for cultural and linguistic adaptation of a KT tool for French and Filipino communities. METHODS A KT tool (whiteboard animation video) describing the signs and symptoms of croup was originally developed in English to provide parents with evidence-based information couched within a narrative reflecting parents’ experiences with the condition. Through feedback from key stakeholders, this KT tool was adapted (linguistics, imagery) for French and Tagalog-speaking parents and caregivers. The videos were presented to respective language speakers for usability testing and discussion. Participants were asked to view the KT tool, complete a usability survey and participate in semi-structured interviews. Audio recordings from the interviews were transcribed verbatim, translated to English, and analyzed for relevant themes using thematic analysis. RESULTS French (n=13) and Tagalog (n=13) speaking parents completed the usability survey and were interviewed. Though analyzed separately, both data sets produced similar findings with key themes relating to 1) understanding, 2) relatability, and 3) accessibility. Both French and Tagalog groups reported that the video and other KT tools were useful in their adapted forms. Participants in both groups cautioned using verbatim vocabulary and suggested that cultural competency and understanding of health language was essential for high quality translations. Parents also discussed their preference of videos with diverse visual representations of families, home environments, and healthcare workers to more broadly represent their communities. CONCLUSIONS French and Filipino parents appreciated having KT tools in their first language; however, they were also supportive of the use of English KT products. Their suggestions for improving relatability and communication of health messages are important considerations for the development and adaption of future KT products. Understanding the needs of the intended end-users is a crucial first step to produce relevant tools for health evidence dissemination.

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 Addressing the Common Pathway Underlying Hypertension and Diabetes in People Who Are Obese by Maximizing Health: The Ultimate Knowledge Translation Gap

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Elizabeth Dean ◽  
Constantina Lomi ◽  
Selma Bruno ◽  
Hamzeh Awad ◽  
Grainne O'Donoghue
Keyword(s):  
Health Care ◽  
Knowledge Translation ◽  
21St Century ◽  
Lifestyle Modification ◽  
Drug Prescription ◽  
Signs And Symptoms ◽  
Evidence Based ◽  
Major Advance ◽  
Contributing Factors ◽  
Care Community

In accordance with the WHO definition of health, this article examines the alarming discord between the epidemiology of hypertension, type 2 diabetes mellitus (T2DM), and obesity and the low profile of noninvasive (nondrug) compared with invasive (drug) interventions with respect to their prevention, reversal and management. Herein lies the ultimate knowledge translation gap and challenge in 21st century health care. Although lifestyle modification has long appeared in guidelines for medically managing these conditions, this evidence-based strategy is seldom implemented as rigorously as drug prescription. Biomedicine focuses largely on reducing signs and symptoms; the effects of the problem rather than the problem. This article highlights the evidence-based rationale supporting prioritizing the underlying causes and contributing factors for hypertension and T2DM, and, in turn, obesity. We argue that a primary focus on maximizing health could eliminate all three conditions, at best, or, at worst, minimize their severity, complications, and medication needs. To enable such knowledge translation and maximizing health outcome, the health care community needs to practice as an integrated team, and address barriers to effecting maximal health in all patients. Addressing the ultimate knowledge translation gap, by aligning the health care paradigm to 21st century needs, would constitute a major advance.

scholarly journals Conservation Debates: People’s Perceptions and Values towards a Privately Protected Area in Southern Ecuador

Land ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 233
Author(s):  
Verónica Iñiguez-Gallardo ◽  
Fabián Reyes-Bueno ◽  
Olga Peñaranda
Keyword(s):  
Protected Areas ◽  
Land Tenure ◽  
Protected Area ◽  
Planning Process ◽  
Social Needs ◽  
Structured Interviews ◽  
Key Stakeholders ◽  
Southern Ecuador ◽  
Negative Perceptions ◽  
Land Tenure System

The perceptions and values that local communities have towards protected areas are of great value for the improvement of these territories’ management. Such perceptions and values are often absent in the conservation planning process, particularly in those privately protected areas that are established in areas where the land tenure system is based not only on ownership but also on customary uses. Drawing on qualitative and quantitative data obtained through semi-structured interviews with key stakeholders and members of communities surrounding a privately protected area in southern Ecuador, we identify that the level of collaboration with the managers, the distance to the protected area, the percentage of untitled land, and the dependence on the resources (customary uses) are among the variables affecting these perceptions and values. Positive perceptions towards protected areas and naturalistic values are developed among those who collaborate with the protected area managers, whereas negative perceptions, and a mix of naturalistic and biospheric values are developed among those who have a sense of a lack of attention to social needs although supporting nature conservation at the same time. The evidence presented shows the importance of matching local peoples’ expectations with conservation goals during the establishment of a protected area.

Asking the Hard Questions: Psychologists’ Discomfort With Inquiring About Sexual Abuse Histories

2021 ◽  
pp. 107780122110145
Author(s):  
Belinda Nixon ◽  
Elly Quinlan
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Mental Health Professionals ◽  
Thematic Analysis ◽  
Health Professionals ◽  
Early Career ◽  
Evidence Based ◽  
Structured Interviews ◽  
Early Career Psychologists ◽  
University Training

The literature on sexual abuse indicates low rates of inquiry by mental health professionals. This study explores early career psychologists’ experiences of inquiry into their clients’ sexual abuse histories. Twelve Australian psychologists participated in semi-structured interviews with transcripts analyzed using thematic analysis. The vast majority of participants reported that they did not routinely inquire about sexual abuse with barriers including not knowing what to do, discomfort, stigma, and fear of negative outcomes. Participants asserted that their university training in sexual abuse inquiry was inadequate. Findings emphasize the need for the development of an evidence-based framework for sexual abuse training.

scholarly journals Which triggers could support timely identification of primary antibody deficiency? A qualitative study using the patient perspective

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lisanne M. A. Janssen ◽  
Kim van den Akker ◽  
Mohamed A. Boussihmad ◽  
Esther de Vries
Keyword(s):  
Respiratory Infections ◽  
Diagnostic Delay ◽  
Signs And Symptoms ◽  
Negative Influence ◽  
Primary Antibody ◽  
Emotional Impact ◽  
Structured Interviews ◽  
Timely Treatment ◽  
The Way

Abstract Background Patients with predominantly (primary) antibody deficiencies (PADs) commonly develop recurrent respiratory infections which can lead to bronchiectasis, long-term morbidity and increased mortality. Recognizing symptoms and making a diagnosis is vital to enable timely treatment. Studies on disease presentation have mainly been conducted using medical files rather than direct contact with PAD patients. Our study aims to analyze how patients appraised their symptoms and which factors were involved in a decision to seek medical care. Methods 14 PAD-patients (11 women; median 44, range 16-68 years) were analyzed using semi-structured interviews until saturation of key emergent themes was achieved. Results Being always ill featured in all participant stories. Often from childhood onwards periods of illness were felt to be too numerous, too bad, too long-lasting, or antibiotics were always needed to get better. Recurrent or persistent respiratory infections were the main triggers for patients to seek care. All participants developed an extreme fatigue, described as a feeling of physical and mental exhaustion and thus an extreme burden on daily life that was not solved by taking rest. Despite this, participants tended to normalize their symptoms and carry on with usual activities. Non-immunologists, as well as patients, misattributed the presenting signs and symptoms to common, self-limiting illnesses or other ‘innocent’ explanations. Participants in a way understood the long diagnostic delay. They know that the disease is rare and that doctors have to cover a broad medical area. But they were more critical about the way the doctors communicate with them. They feel that doctors often don’t listen very well to their patients. The participants’ symptoms as well as the interpretation of these symptoms by their social environment and doctors had a major emotional impact on the participants and a negative influence on their future perspectives. Conclusions To timely identify PAD, ‘pattern recognition’ should not only focus on the medical ‘red flags’, but also on less differentiating symptoms, such as ‘being always ill’ and ‘worn out’ and the way patients cope with these problems. And, most important, making time to really listen to the patient remains the key.

scholarly journals “What is the actual goal of the pathway?”: examining emergency department physician and nurse perspectives on the implementation of a pediatric concussion pathway using the theoretical domains framework

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anh Ly ◽  
Roger Zemek ◽  
Bruce Wright ◽  
Jennifer Zwicker ◽  
Kathryn Schneider ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Clinical Pathways ◽  
Theoretical Domains Framework ◽  
Local Context ◽  
Emergency Department Physician ◽  
Evidence Based ◽  
Care Providers ◽  
Structured Interviews ◽  
Pediatric Concussion

Abstract Background Multiple evidence-based clinical practice guidelines (CPGs) exist to guide the management of concussion in children, but few have been translated into clinical pathways (CP), which operationalize guidelines into accessible and actionable algorithms that can be more readily implemented by health care providers. This study aimed to identify the clinical behaviours, attitudinal factors, and environmental contexts that potentially influence the implementation of a clinical pathway for pediatric concussion. Methods Semi-structured interviews were conducted from October 2017 to January 2018 with 42 emergency department clinicians (17 physicians, 25 nurses) at five urban emergency departments in Alberta, Canada. A Theoretical Domains Framework (TDF)-informed interview guide contained open-ended questions intended to gather feedback on the proposed pathway developed for the study, as well as factors that could potentially influence its implementation. Results The original 14 domains of the TDF were collapsed into 6 clusters based on significant overlap between domains in the issues discussed by clinicians: 1) knowledge, skills, and practice; 2) professional roles and identity; 3) attitudes, beliefs, and motivations; 4) goals and priorities; 5) local context and resources; and 6) engagement and collaboration. The 6 clusters identified in the interviews each reflect 2–4 predominant topics that can be condensed into six overarching themes regarding clinicians’ views on the implementation of a concussion CP: 1) standardization in the midst of evolving research; 2) clarifying and communicating goals; 3) knowledge dissemination and alignment of information; 4) a team-oriented approach; 5) site engagement; and 6) streamlining clinical processes. Conclusion Application of a comprehensive, evidence-based, and theory-driven framework in conjunction with an inductive thematic analysis approach enabled six themes to emerge as to how to successfullly implement a concussion CP.

Recognition and management of neonatal sepsis

2021 ◽  
Vol 30 (7) ◽  
pp. 410-415
Author(s):  
Luke William Crocker ◽  
Ayesha White ◽  
Paul Anthony Heaton ◽  
Débora Pascoal Horta ◽  
Siba Prosad Paul
Keyword(s):  
Neonatal Sepsis ◽  
Early Recognition ◽  
Signs And Symptoms ◽  
Evidence Based ◽  
Suspected Sepsis ◽  
Serious Illness ◽  
Prompt Treatment ◽  
Serious Infection ◽  
Common Causes ◽  
Red Flag

Neonatal sepsis results from acute bacterial or viral infection occurring in the first 28 days of life. It causes significant morbidity and mortality, although the outcome can be improved by early recognition and prompt treatment by health professionals. This article describes the most common causes of sepsis, and explains why neonates are particularly vulnerable to infection. It highlights the non-specific way in which an infant with a serious infection may present, indicating the crucial features to elicit during history taking and examination, and emphasising the ‘red-flag’ signs and symptoms that should increase suspicion of a serious illness. The authors have adapted National Institute for Health and Care Excellence guidelines to produce an evidence-based approach to the management of an infant with suspected sepsis, and describe the roles of nurses in ensuring effective treatment and best outcomes for these babies.

scholarly journals Anxiety in autistic individuals who speak few or no words: A qualitative study of parental experience and anxiety management

Autism ◽  
2020 ◽  
pp. 136236132096236
Author(s):  
Joanne Tarver ◽  
Effie Pearson ◽  
Georgina Edwards ◽  
Aryana Shirazi ◽  
Liana Potter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intellectual Disability ◽  
Language Use ◽  
Management Strategies ◽  
Assessment Tools ◽  
Evidence Based ◽  
Structured Interviews ◽  
Verbal Language ◽  
Parental Recognition

Anxiety is a common co-occurring condition in autism and impacts quality of life of autistic individuals and their families; autistic individuals who speak few or no words represent an under-researched group. This qualitative study aimed to understand more about parental recognition and management of anxiety in autistic individuals who speak few or no words. Semi-structured interviews were conducted with parents/carers of 17 autistic individuals (mage = 14.29) recruited from an existing participant database and social media adverts. Using thematic analysis, 15 themes were placed under three a-priori grand themes: parental recognition of anxiety; parental management of anxiety; and anxiety impact on the autistic individual and their family. Due to reduced verbal language use and overlap with other behaviours, parents described difficulties recognising anxiety in their child. However, they also described use of a number of management strategies, including some which overlap with components of evidence-based interventions for emotional and behavioural problems in autistic individuals (e.g. exposure/sensory calming). Despite this, parents reported that anxiety continues to have significant impact on quality of life. The findings of this study can help to inform the development of targeted intervention and assessment measures for anxiety in autistic individuals who speak few or no words. Lay abstract Anxiety is a common condition in autistic individuals, including those who also have an intellectual disability. Despite this, autistic individuals who have severe to profound intellectual disability, or use few or no words, are often excluded from autism research. There are also very few assessment tools and interventions with known effectiveness for autistic individuals with intellectual disability. In this study, we aimed to learn more about parent/carers experiences of recognising and managing anxiety in autistic individuals who use few or no words. We conducted semi-structured interviews with parents and carers to address three research questions: (1) what techniques and management strategies do parents describe for anxiety-related behaviour in their child; (2) how do communication difficulties impact parental understanding and management of anxiety provoking situations and behaviours; (3) what is the impact of anxiety-related behaviours on the quality of life of autistic individuals and their families? During the interviews, parents described difficulties recognising anxiety in their child, mostly due to reduced verbal language use and anxiety behaviours overlapping with other behaviours (e.g. autism characteristics). However, parents also described use of a number of management strategies, including some which overlap with components of evidence-based interventions for emotional and behavioural problems in autistic individuals (e.g. exposure/sensory calming). Despite this, parents reported that anxiety continues to have significant impact on quality of life. We will use the findings of this study to inform future research to develop assessment tools and interventions for anxiety in autistic individuals who use few or no words.

Language and identity in East Timor

2008 ◽  
Vol 32 (2) ◽  
pp. 153-180 ◽  
Author(s):  
Kerry Taylor-Leech
Keyword(s):  
Language Policy ◽  
Policy Development ◽  
East Timor ◽  
Language And Identity ◽  
Data Sets ◽  
Structured Interviews ◽  
Student Focus ◽  
Research Findings ◽  
Official Languages

Language choice in the newly independent Republic of East Timor can be usefully examined in the wider context of language policy in multilingual states. The present article reports on ethnographic research investigating official and popular discourses of language and identity in East Timor and the role of past and present language policies and practices in shaping national and social identity. It focuses on the discursive reconstruction of identity through five official instruments of language policy development. Hostile discourses in the Australian and Indonesian press towards the choice of Portuguese (the former colonial language) and Tetum (the endogenous lingua franca) as official languages provided the context for the investigation. A persistent theme in these discourses is that English and/or Indonesian would be preferable choices. The article puts these discourses into perspective by presenting findings from two data sets: (i) the 2004 National Census and (ii) analysis of the discourses of 78 participants in semi-structured interviews and student focus groups. The census shows clear signs of the revival of Portuguese and the reinvigoration of Tetum. It also shows how diverse linguistic identities have become in East Timor. The research findings show that there is less hostility to official language policy than claimed in the Australian and Indonesian press. However, the findings also emphasise the urgent need to reconstruct an inclusive, plurilingual national identity that can encompass diversity.

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