Structural barriers to knowledge transfer and exchange among men and women in low-, middle- and high-income countries: an international cross-sectional study with vaccine researchers in 44 countries

Background Globally, women constitute 30% of researchers. Despite an increasing proportion of women in research, they are still less likely to have international collaborations. Literature on barriers to knowledge transfer and exchange (KTE) between men and women remains limited. This study aimed to assess perceived gender barriers to KTE activities in vaccination-related research in low-, middle- and high-income countries. Methods This was a cross-sectional data assessment from a self-administered questionnaire distributed to researchers in the field of vaccination research. The administered questionnaire was developed and validated by WHO and McMaster University. Descriptive statistics were carried out. Structural factors of KTE were assessed using 12 statements measured with a five-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). An index ranging from 12 to 60 points was created to assess structural factors of KTE, with higher score indicating fewer perceived barriers. Multivariable linear regression modelling was applied to examine the association between KTE barriers and gender. Results A total of 158 researchers were included in the analysis. Regardless of gender and country of affiliation, researchers experienced challenges with respect to KTE activities; particularly factors related to the availability of human and financial resources and level of technical expertise among their target audience. We were also able to identify perceived facilitators among men and women, such as the presence of structures that link researchers and target audiences, the investment of target audiences in KTE efforts and the presence of stable contacts among target audiences. Our linear regression analysis showed that women perceived more barriers than men (R2 = 0.014; B = −1.069; 95% CI −4.035; 1.897). Conclusions Men and women shared common perspectives on barriers to KTE. KTE activities could be strengthened by improving structural efforts to reduce gender differences and increase collaborations between researchers and their target audience.

To Cohere and Act as One: IAU—The Global Voice of Higher Education

Knowledge and knowledge development have always been essential for the survival and continuing development of humankind. As part of the human condition, people have always adapted to the particularities of local environments which in turn are influenced by global conditions and changes, such as climate change, disease, and armed conflict, among others. Knowledge has, throughout human history, been shared and transferred, and with time ever more extensively across regions and national borders. The basic idea that knowledge has no borders has always been and needs to continue to be a guiding light for higher education (HE). International mobility is part of this knowledge transfer and exchange as it augments our understanding of cultural, structural, and financial differences in the world, which must be considered collectively as our shared global responsibility for sustainable social development. These, as well as other perspectives, will be addressed in the following lines.

Gender Barriers to Knowledge Transfer and Exchange Among Vaccine Researchers in Low-, Middle- and High-Income Countries – An International Cross-Sectional Study in 44 Countries

Background: Globally, women constitute 30% of researchers. Despite an increasing proportion of women in research, they are still less likely to have international collaborations. Literature on barriers to knowledge transfer and exchange (KTE) between men and women, remain limited. This study aimed to elucidate perceived gender barriers to KTE activities in vaccination related research in low, middle- and high-income countries. Methods: This was a cross-sectional data from a self-administered questionnaire distributed to researchers in the field of vaccination research. Structural factors to KTE were assessed using 12 statements measured with 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). An index ranging from 12 to 60 points was created to assess structural factors to KTE, with higher score indicating higher perceived barriers. Linear regression modelling was applied to examine the association between KTE barriers and gender. Results: Regardless of gender, researchers experienced challenges with respect to KTE activities, particularly factors related to the availability of human and financial resources, and level of technical expertise among their target audience. We were also able to identify perceived facilitators among men and women, such as the presence of structures that link researchers and target audiences, the investment of target audiences in KTE efforts and the presence of stable contacts among target audience. Our linear regression analysis showed that women have a reduction of 1.069 in their scores in comparison with men (R2=0.014; B=-1.069; 95%CI -4.035;1.897). Conclusions: Men and women shared common perspectives on barriers to KTE. KTE activities could be strengthened by improving structural efforts to reduce gender differences and increase collaborations between researchers and their target audience.

How to build the partnership between researchers and field actors?

In health promotion, the partnership between researchers and practitioners (field actors) is necessary for multiple reasons: to build intervention research together, to share our knowledge and experience, to produce new knowledge and experience, and to improve the quality of interventions, decisions... and research. In order to build this partnership and to achieve these goals, two dimensions were explored during several mixed workshops (researchers and field actors) organized in Brittany (France): their reciprocal perceptions, and what they can mutually bring to each other. During the first workshop, a facilitation technique called “the figure,” (which health educators use when they need to underscore the perceptions of a group of professionals about a specific population) shed light on mutual misconceptions and helped rectify them. During the following workshops, both groups identified their common assets, resources, difficulties and stakes. They also highlighted what they could bring to each other. Indeed, the relationship between researchers and field actors is usually considered in terms of the contributions of research to actions. However, field actors are more than simple “users” of a knowledge produced by others, they are also “producers’ of knowledge. They can contribute to define research questions, issues, hypotheses (with a social twist...); challenge the relevance and feasibility of research; promote the link and the understanding between the two separate worlds of practice and research; encourage the making of certain research protocols; facilitate experimentation; check the validity of the research projects in terms of social usefulness; make research more visible to field professionals and policy makers; and support knowledge transfer and exchange. The ways in which the partnership between researchers and health promotion actors actually enrich both categories of professionals, are detailed in this presentation. Key messages Reciprocal representations of researchers and practitioners in the field of health promotion must be highlighted to lay the foundations of their partnership. In health promotion, knowledge transfer must be understood as an exchange between researchers and field actors, the latter being experts in their domain of intervention and producers of knowledge.

Deimplementing Untested Practices in Homecare Services: A Preobservational-Postobservational Design

Introduction. With community-dwelling elders waiting to adapt their bathroom, Health and Social Services Centers in Quebec (Canada) combined human resources through cross-skilling within interdisciplinary teams. To this end, occupational therapists implemented in-house “tools” to support nonoccupational therapists in selecting bathing equipment. However, unknown psychometric properties of those in-house “tools” cast doubt on the quality of service provided to elders. Little is also known about the best processes to use to support the deimplementation of such nonevidence-based practices. This study presents the effect of a knowledge transfer and exchange intervention designed to deimplement in-house “tools” and replace them with an evidence-based tool (Algo). Methods. Censuses were conducted with the 94 Health and Social Services Centers of Quebec providing homecare services, before and after the knowledge transfer and exchange intervention (2009-2013). In 2013, the deimplementation of in-house “tools” and their replacement by Algo were measured with Knott and Wildavsky’s levels of utilization. Results. Cross-skilling within interdisciplinary teams increased between censuses (87% to 98%), as did use of in-house “tools” (67% to 81%). Algo’s uptake started during the knowledge transfer and exchange process as 25 Health and Social Services Centers achieved the first level of utilization. Nonetheless, no Health and Social Services Center deimplemented the in-house “tools” to use Algo. Conclusion. The knowledge transfer and exchange process led to the development of a scientifically sound clinical tool (Algo) and challenged the status quo in clinical settings regarding the use of nonevidence-based practices. However, the deimplementation of in-use practices has not yet been observed. This study highlights the need to act proactively on the deimplementation and implementation processes.

EMTReK: An Evidence-based Model for the Transfer & Exchange of Research Knowledge—Five Case Studies in Palliative Care

Knowledge transfer is recognized as a vital stage in evidence-informed nursing with several models available to guide the process. Although the main components commonly involve identification of messages, stakeholders, processes and contexts, the underpinning models remain largely unrefined and untested; and they need to be evaluated. We set out to explore the use of our “Evidence-based Model for Transfer & Exchange of Research Knowledge” (EMTReK) within palliative care research. Between January 2016 and May 2017, data were collected from five case studies which used the EMTReK model as a means to transfer knowledge relating to palliative care research, undertaken in Ireland. A qualitative approach was taken with thematic analysis of case documentation, semistructured interviews, and field notes from the case studies. Qualitative analysis supports the core components of EMTReK as a model of knowledge transfer and exchange in palliative care. Results focused upon identification of messages to be transferred to defined stakeholders through interactive processes that take account of context. Case study findings show how the model was interpreted and operationalized by participants and demonstrate its impact on knowledge transfer and exchange. Eight themes were drawn from the data: Credibility of the Model, Model Accessibility, Applicability to Palliative Care, A Matter of Timing, Positive Role of Facilitation, Required Resources, Enhancing Research Quality, Limitations or Areas for Further Consideration. Study participants found EMTReK to be a useful guide when making knowledge transfer plans. Success depended upon adequate facilitation and guidance. Further exploration of the model's utility is warranted.

Creating Productive Tensions: Clinicians Working with Patients as Peer Researchers in a Community-Based Participatory Research Study of the Lived Experience of HIV-Associated Neurocognitive Disorder (HAND)

About 50% of people living with HIV will develop HIV-associated neurocognitive disorder (HAND) during their lifetime, and we know that cognitive issues are a concern for people living with HIV. However, limited information exists regarding how HAND is managed and coped with, or how cognitive issues are discussed with others, including health care professionals. Following a community-based research approach, we conducted 25 interviews in 2016 aimed to (1) build the capacity of people living with HIV, (2) facilitate participant recruitment and data collection, (3) increase the validity and reliability of our data analysis results, and (4) facilitate knowledge transfer and exchange regarding HAND. After thorough training, we engaged a number of peer researchers living with HAND in the analysis and knowledge transfer and exchange (KTE) phases of the study. This engagement prompted a number of tensions between the clinicians and the peers that we learned to navigate and make productive. We conclude that it is possible to engage patients and providers only if careful attention, time and human resources are provided to navigating the emerging tensions. The outcomes of our study suggest that engaging an interdisciplinary team across multiple sites with PRAs is a valuable method for comprehensively exploring the lived experience of a complex chronic condition such as HAND.