Knowledge Utilization and Exchange

by

Erica Di Ruggiero, Sarah Viehbeck, Devon Greyson

• LAST REVIEWED: 11 January 2018
• LAST MODIFIED: 11 January 2018
• DOI: 10.1093/obo/9780199756797-0106

Introduction

Knowledge on population and public health relates to the social, cultural, economic, and environmental determinants of health and to policy and program interventions operating at multiple levels within and outside health. The nature of this knowledge extends well beyond behavioral interventions to include knowledge about the impacts of social-structural policy levers that influence health or health equity at a population level. This added complexity creates challenges for researchers and policymakers seeking to understand the processes of knowledge dissemination and utilization and to effectively integrate research with policy and practice. As applied to population and public health, there is, however, a relatively limited scholarship in comparison to the study of knowledge dissemination and utilization in individual clinical practice or on health-care policies and systems. While multiple reviews call for greater theoretical and methodological developments to understand the role of organization- and system-level influences on knowledge utilization, empirical research remains more focused on individual-level solutions to knowledge use. If we want to further maximize evidence-informed decision making in population and public health, studies need to further emphasize organizational and system-level barriers and enablers to change and consider ethical implications. Research on knowledge translation, which includes (but is not limited to) knowledge dissemination and utilization, comprises concepts, theories, models, frameworks, and more-applied work on tools, approaches, and “best practices” for disseminating and integrating knowledge with policy and practice. Since early calls for more coordinated and rigorous studies of knowledge utilization, the field of knowledge translation has steadily grown. Authors have mapped the intellectual structure of the field, including the most-influential concepts and authors that have shaped understanding of diffusion and knowledge utilization. The concepts outlined in this article demonstrate the shifting language of the field over time. This article is organized both according to publication format (e.g., journals, websites) and content areas (e.g., history, theories), and several publications could have been listed in more than one section. It is limited to only English sources, which therefore excludes some important scholarship in French and possibly other languages. Previous Oxford Bibliographies articles on related topics provide an overview of key definitions in this field, as do other articles featured in herein. While this field has experienced a burst in popularity and it has perhaps become somewhat crowded, this increase is commensurate with parallel movements toward evidence-informed decision making and increasing pressures on researchers and research funders to demonstrate the health, social, economic, and health-system returns on investment in health research and to evaluate the performance and impact of knowledge translation and exchange funding programs. The authors acknowledge the contribution of Alannah Brown, MPH student at the University of Edinburgh, for her assistance with references and formatting, and Kyle Jayasingam and Simrit Khabra, students at the University of Toronto, for their assistance with references included in the updated version. Sarah Viehbeck gratefully acknowledges the support received from the Population Health Improvement Research Network through an Emerging Researcher Award.

General Overviews

Beginning in the early 21st century, a number of overviews of relevance to knowledge translation and exchange, including dissemination and utilization, have been published. These include systematic reviews, which examine key issues, opportunities, and barriers to enhanced dissemination and use of research in policy and practice, commentaries and debates, and empirical studies. Though many are specific to the area of population and public health, Landry, et al. 2003 and Mitton, et al. 2007 go beyond to explore perceptions of health policymakers more generally, and Lavis, et al. 2003 underscores the role of research-funding agencies. Several, including Greenhalgh, et al. 2004; Walter, et al. 2005; Macoubrie and Harrison 2013; and Greenhalgh and Wieringa 2011 (cited under Debates), draw on interdisciplinary or multisectoral literatures and raise issues for further debate. The breadth and depth of articles reflect a growing field of study, and the syntheses underscore the value of bringing a range of disciplinary perspectives to bear to understand dissemination and knowledge utilization in a population and public health context. The selected citations are likely to be valuable for researchers and decision makers alike, as well as to students trying to understand the key issues and remaining research gaps in this field.

• Greenhalgh, Trisha, Glenn Robert, Paul Bate, Olympia Kyriakidou, Fraser Macfarlane, and Richard Peacock. 2004. How to spread good ideas: A systematic review of the literature on diffusion, dissemination and sustainability of innovations in health service delivery and organisation. London: National Co-ordinating Centre for NHS Service Delivery and Organisation.

  A conceptual model (i.e., attributes of innovation and intended adopters, agents of social influence, organizational/environmental characteristics, dissemination, implementation) is derived through this systematic review. Eleven research traditions are categorized on the basis of how the spread and sustainability of innovations are conceptualized. Suggests that future research should take a “whole systems” approach and focus on interactions between model components to understand how innovations arise.

• Landry, Réjean, Moktar Lamari, and Nabil Amara. 2003. The extent and determinants of the utilization of university research in government agencies. Public Administration Review 63.2: 192–205.

  DOI: 10.1111/1540-6210.00279

  Reports the findings of a survey with Canadian government officials (“users”) to determine the nature and extent of research use by government agencies. Some of the greatest predictors of use include the extent of adaptation of research products by researchers, the intensity of the relationship between researchers and users, and the role of organizational contextual factors, which are often out of the control of users.

• Lavis, John N., Dave Robertson, Jennifer M. Woodside, Christopher B. McLeod, and Julia Abelson. 2003. How can research organizations more effectively transfer research knowledge to decision makers? Milbank Quarterly 81.2: 221–248.

  DOI: 10.1111/1468-0009.t01-1-00052

  Reports findings from a review of systematic reviews and interviews with applied-research organizations to examine conceptual knowledge translation (KT) issues related to the message, target audience, messenger, KT and communications infrastructure, and evaluation. Findings suggest that Canadian research organizations focus more on skill building for decision makers and less on impact evaluation.

• Macoubrie, Jane, and Courtney Harrison. 2013. Human services research dissemination: What works? OPRE Report 2013–09. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, US Department of Health and Human Services.

  This interdisciplinary literature review is part of the efforts of the US Department of Health and Human Services, Administration for Children and Families, to understand and identify evidence for what works to effectively disseminate knowledge in the context of complex human services environments, including public health. Dissemination is characterized as an intentional communication process that should be accompanied with channels and tactics. The review concludes with seven solutions for improved dissemination of human services research.

• Mitton, Craig, Carol E. Adair, Emily McKenzie, Scott B. Patten, and Brenda Waye Perry. 2007. Knowledge transfer and exchange: Review and synthesis of the literature. Milbank Quarterly 85.4: 729–768.

  DOI: 10.1111/j.1468-0009.2007.00506.x

  Synthesizes evidence on knowledge translation and exchange in health policy. While primarily focused on health care, findings appear relevant and transferable to public health. The authors identify facilitators and barriers at individual and organizational levels, with several related to communication, time, or timing of research relative to policy needs. The review also summarizes interactive strategies to support knowledge translation and exchange.

• Salsberg, Jon, David Parry, Pierre Pluye, Soultana Macridis, Carol P. Herbert, and Ann C. Macaulay. 2015. Successful strategies to engage research partners for translating evidence into action in community health: A critical review. Journal of Environmental and Public Health 2015:191856.

  DOI: 10.1155/2015/191856

  Examines engagement strategies for participatory research to support knowledge creation and translation in the context of funders’ increasing expectations to do so. Developing advisory committees, establishing research agreements, facilitating engagement, hiring community researchers or partners, and ongoing communication were the most-successful engagement strategies. Findings are very practical in orientation and likely to be useful to researchers and community partners alike.

• Walter, Isabel, Sandra Nutley, and Huw Davies. 2005. What works to promote evidence-based practice? A cross-sector review. Evidence & Policy 1.3: 335–363.

  DOI: 10.1332/1744264054851612

  The authors present findings from a review of the effectiveness of strategies to promote evidence-based policy and practice. They outline effective interaction approaches based on strong collaborations across research and policy/practice. Barriers that may limit interactions include time and investment to build relationships and differences in cultures of research and practice/policy. They further suggest that informal approaches (i.e., networks) hold promise.