Public Health Knowledge Translation and Exchange
by
Graham Colditz
  • LAST REVIEWED: 05 May 2017
  • LAST MODIFIED: 22 April 2013
  • DOI: 10.1093/obo/9780199756797-0025

Introduction

“Words, whether credible or not, rarely flow automatically into action” (Lomas 1991, cited under Models for Understanding). The gap between research findings and their broader use has increasingly drawn attention to the dissemination and uptake of best practices to improve population health. One may consider an active approach of spreading evidence-based interventions to the target audience via determined channels using planned strategies. On the other hand dissemination has also been defined as a push-pull process. Those who adopt innovations must want them or be receptive (pull), while there is systematic effort to help adopters implement innovations (push). The intent of dissemination research is to spread knowledge and the associated interventions, building understanding of approaches to increased effectiveness of dissemination efforts. In understanding these approaches, numerous studies have shown that dissemination of evidence-based interventions using passive methods (e.g., publication of consensus statements in professional journals, mass mailings) has been ineffective, resulting in only small changes in the uptake of a new practice. Implementation research is active and supports movement of effective evidence-based health care and prevention strategies or programs from the research knowledge base into routine use. A number of different terms are used: for example, The Canadian Institutes of Health Research uses the following definition for knowledge translation: “synthesis, dissemination, exchange and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system.” Dissemination is defined in NIH program announcements as “the targeted distribution of information and intervention materials to a specific public health or clinical practice audience.” Implementation research is defined as the use of strategies to adopt and integrate evidence-based health interventions and change practice patterns within specific clinical and public health settings. Speeding implementation research and diffusion of research into practice remains an emerging field in population health. While the translation of evidence-based interventions into practice to improve population health outcomes is a common theme of government agencies, the process for distribution of scientific findings, materials, and associated resources to support interventions is less developed. Interventions for population health occur at multiple levels, through services by health care providers, through policy and regulatory changes that modify access, incentives, or health systems and through individual- and community-level changes in behavior.

General Overviews

The overall concept for implementation of evidence-based interventions suggests that once an intervention is shown to work (or a body of evidence supports this contention), then implementation follows logically. Models suggest, however, that adaptation of interventions is necessary to meet the needs of the end-users. Accordingly, subsequent evaluation must also address the process of implementation as well as more robust measures of change in population health.

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