Public Health Knowledge Utilization and Exchange
by
Erica Di Ruggiero, Sarah Viehbeck, Devon Greyson
  • LAST REVIEWED: 11 September 2017
  • 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.

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    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.

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    • 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: 10.1111/1540-6210.00279Save Citation »Export Citation »E-mail Citation »

      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.

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      • 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.t01-1-00052Save Citation »Export Citation »E-mail Citation »

        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.

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        • 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.

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          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.

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          • 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.xSave Citation »Export Citation »E-mail Citation »

            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.

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            • 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: 10.1155/2015/191856Save Citation »Export Citation »E-mail Citation »

              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.

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              • 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: 10.1332/1744264054851612Save Citation »Export Citation »E-mail Citation »

                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.

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                Textbooks and Glossaries

                This section includes texts that outline theoretical approaches, design, and implementation considerations related to knowledge dissemination and utilization, such as those in Rogers 2003 and Brownson, et al. 2012. Lemieux-Charles and Champagne 2004 summarizes the multidisciplinary evidence on effective knowledge translation strategies, while other works by organizations, such as Institute of Health Economics 2008, reflect on the potential generalizability of this evidence base to other contexts. Contributors such as in Rabin, et al. 2008 define key concepts in dissemination and implementation research, with relevance to public health, health care, global health policy and practice, or a combination of these. More-applied works in Bennett and Jessani 2011 and others are also featured and include practical tools and strategies to support efforts aiming to bridge the gap among research, policy, practice, and people, whereas Brownson, et al. 2011 reflects on the incentives and other strategies needed to promote evidence-based practice in public health, and Parkhurst 2017 critically analyzes evidence-based policymaking.

                • Bennett, Gavin, and Nasreen Jessani. 2011. The knowledge translation toolkit: Bridging the know-do gap; A resource for researchers. Thousand Oaks, CA: SAGE.

                  DOI: 10.4135/9789351507765Save Citation »Export Citation »E-mail Citation »

                  Produced by Canada’s International Development Research Centre (IDRC), this comprehensive guide to knowledge translation offers tools, theories, strategies, and illustrative examples to help enhanced efforts to bridge the gap among research, policy, practice, and people. It addresses such topics as context mapping for understanding dynamic policy environments, the role of media in the research process, and evaluation approaches for measuring success.

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                  • Brownson, Ross C., Elizabeth A. Baker, Terry L. Left, Kathleen N. Gillespie, and William R. True. 2011. Evidence-based public health. 2d ed. Oxford and New York: Oxford Univ. Press.

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                    Reflects on the evidence base for public health programs and policies that aim to address health, health disparities, and social inequalities. The authors highlight analytic tools for evaluating evidence, including economic evaluation, health impact assessment, expert guidelines, and the need for incentives to encourage practitioners to increase and make better use of evidence in public health.

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                    • Brownson, Ross C., Graham A. Colditz, and Enola K. Proctor. 2012. Dissemination and implementation research in health: Translating science to practice. Oxford: Oxford Univ. Press.

                      DOI: 10.1093/acprof:oso/9780199751877.001.0001Save Citation »Export Citation »E-mail Citation »

                      This anthology is the first academic textbook on the topic of research dissemination and implementation beyond the clinical setting. Sections span theoretical approaches, design and implementation, and population-specific issues germane to public health research dissemination and utilization.

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                      • Institute of Health Economics. 2008. Effective dissemination of findings from research. Edmonton, AB: Institute of Health Economics.

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                        Summarizes essays on effective dissemination of research findings. Key concepts and evidence on the effectiveness of knowledge translation strategies for health professionals and policymakers are described. Using evidence from Canadian and Swedish programs, the authors reflect on issues such as the generalizability of findings to other contexts, the role of brokers in facilitating national scale-up and dissemination, and program sustainability.

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                        • Lemieux-Charles, Louise, and François Champagne. 2004. Using knowledge and evidence in health care: Multidisciplinary perspectives. Toronto: Univ. of Toronto Press.

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                          This Canadian text is focused on knowledge utilization in health care. Taking a multidisciplinary perspective, the authors draw on sociology, informatics, and political science, as well as public health, medicine, and allied health disciplines, to discuss evidence-based decision making.

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                          • Parkhurst, Justin. 2017. The politics of evidence: From evidence-based policy to the good governance of evidence. Routledge Studies in Governance and Public Policy. Abingdon, UK: Routledge.

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                            Provides a critical analysis of evidence-based policymaking, using case examples (e.g., Exxon, sudden infant death syndrome). The book addresses how biases change the way research is used by policymakers, calling for greater attention to the governance of evidence use. The author discusses issues arising with a lack of legitimacy in assessing research, while sharing lessons we can learn from when dealing with these issues.

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                            • Rabin, Borsika A., Ross C. Brownson, Debra Haire-Joshu, Matthew W. Kreuter, and Nancy L. Weaver. 2008. A glossary for dissemination and implementation research in health. Journal of Public Health Management & Practice 14.2: 117–123.

                              DOI: 10.1097/01.PHH.0000311888.06252.bbSave Citation »Export Citation »E-mail Citation »

                              Pulls from diverse areas of research to create a glossary of terms related to dissemination and implementation research. In so doing, the authors hope to standardize terminology of a developing field of study as they suggest that a common language is critical for a field to “prosper and thrive.” Over a hundred terms are included and range from foundational concepts to measurement and evaluation of dissemination and implementation research.

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                              • Rogers, Everett M. 2003. Diffusion of innovations. 5th ed. New York: Free Press.

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                                First published in 1962, this is an updated version of the classic text on diffusion of innovations (that is, practices and technologies). Originally grounded in a study of farmers’ uptake of hybrid seed, Rogers’s theory on the diffusion of innovations has been applied widely in and beyond health and encompasses both incidental spread and deliberate dissemination efforts. The typology of adopters from innovators to laggards has been extensively used to characterize stages of diffusion.

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                                Journals

                                Many public health journals carry articles on dissemination and knowledge utilization, but it is not their exclusive focus. Some have sections that encourage these kinds of submissions (e.g., American Journal of Public Health) or provide voice to practice in an effort to bridge the research to practice gap (e.g., Journal of Public Health Management & Practice). The focus of the featured journals strongly reflects the era in which they were founded: Science Communication, for instance, was founded in 1979 (as Knowledge): it is based in interdisciplinary social science research and contains some of the seminal works in research dissemination to influence policy. Implementation Science¸ a more recent journal launched in 2006, promotes health-care research on how knowledge is taken up in clinical, organizational, and policy contexts. Consistent with the broader move toward open-access publishing, new entrants into this field are more freely available online, often have copyright licenses allowing for liberal reuse of published material, and may have no paper “print” version. The peer-reviewed journals included here were selected on the basis of their interdisciplinary nature and orientation toward knowledge being put into policy and practice. As a result, they include public health journals such as the International Journal of Public Health and the Journal of Epidemiology & Community Health with targeted mandates or sections on dissemination and knowledge utilization in practice/policy and also nonpublic health journals where public health content is featured alongside other fields, including Evidence & Policy, Health Research and Policy Systems, and Milbank Quarterly.

                                • American Journal of Public Health.

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                                  The American Public Health Association’s journal publishes original research on methods, and program evaluation in public health. Its dedicated section “Field Action Reports” features practice-based initiatives that have the potential to advance public health. Articles are available through subscription or purchase online but are not fully open access. The online version is the official version due to enhanced interactive features.

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                                  • Evidence & Policy.

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                                    Published by Policy Press since 2005, this journal focuses on the relationship between research evidence and public policy. Articles span many disciplines and topics and many different concerns of research, policymakers, and practitioners and have a common thread on knowledge use and exchange. Selected articles are freely available online.

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                                    • Health Research and Policy Systems.

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                                      This open-access journal is published in collaboration with the World Health Organization, with a focus on evidence-based health policy and the organization of health research systems, including how to build health research capacity, agenda setting, and how research can benefit decision making to improve health and health equity, especially in developing countries. The journal provides space for discussion and analysis of issues of interest to decision makers, practitioners, and research-funding agencies globally.

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                                      • Implementation Science.

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                                        Published by BioMed Central since 2006, this open-access journal features research on all elements of knowledge translation. It publishes articles relating to intervention development, evaluation of the processes through which implementation is achieved, and the role of theory in relation to implementation research and knowledge dissemination in multiple domains, including health care, clinical, organizational, and policy contexts.

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                                        • International Journal of Public Health.

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                                          Funded by the Swiss School of Public Health, this journal publishes articles related to global public health research and practice, specifically focusing on different countries and cultures, with the goal of raising awareness of international public health problems and solutions. It encourages submissions to the section “Knowledge Synthesis, Translation, and Exchange.”(see editorial Potvin and Abel [2011] describing this section of the journal).

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                                          • Journal of Epidemiology & Community Health.

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                                            This journal is part of the BMJ suite of publications and is the official journal of the Society for Social Medicine. It publishes articles featuring original research and reviews on topics such as “methodological and theoretical issues with emphasis on studies using multidisciplinary or integrative approaches.” The journal also contains a section on evidence-based public health policy and practice to feature work from the frontline of public health study.

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                                            • Journal of Public Health Management & Practice.

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                                              Focuses primarily on the practice of public health; specifically, the design, implementation, and evaluation of public health programs, organizations, and systems. It has included articles on issues such as “bridging the research to practice gap” and contains a section on “Practice Brief Reports” to encourage submissions from frontline public health sources.

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                                              • Milbank Quarterly.

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                                                Published on behalf of the Milbank Memorial Fund by John Wiley, this journal has been in circulation since 1923. It is a multidisciplinary journal featuring original research, policy reviews, and analysis by academics, clinicians, and policymakers. This journal offers in-depth assessments of economic, social, legal, historical, and ethical dimensions of health and health-care policy and has included critical reviews and commentaries related to dissemination, knowledge translation, and exchange.

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                                                • Science Communication.

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                                                  Formerly known as Knowledge and Knowledge: Creation, Diffusion, Utilization, this interdisciplinary social science journal addresses topics in science knowledge and its diffusion. It includes theoretical and empirical works, including some of the key social science articles on the use and nonuse of research in public policy from 1979 to date.

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                                                  Web Resources

                                                  While several websites contain information on knowledge translation and related topics, there is a select set that focuses significantly on the domain of population and public health, account for the complex nature of population and public health evidence, and the promotion of better utilization of research in this field. The Centre for Reviews and Dissemination: University of York, the Cochrane Public Health Group, and McMaster University’s Health Evidence websites all serve as clearinghouses for systematic reviews and knowledge syntheses of relevance to clinical and public health research. The Evidence-Informed Policy Network website includes a range of resources of relevance to knowledge utilization in low- and middle-income countries, and the National Collaborating Centre for Methods and Tools (Registry of Methods and Tools) promotes resources to enhance evidence-informed public health practice.

                                                  • Bennett, Gavin, and Nasreen Jessani, eds. The Knowledge Translation Toolkit: Bridging the Know-Do Gap; A Resource for Researchers. Thousand Oaks, CA: SAGE.

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                                                    Building on research on knowledge translation skills and principles, the Knowledge Translation Toolkit aims at building capacity for developing country researchers to bridge the “know-do gap.” It features tools and theories such as context mapping, and evaluation strategies, practical examples and resources.

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                                                    • Centre for Reviews and Dissemination: University of York.

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                                                      The Centre for Reviews and Dissemination (CRD), publicly funded by multiple UK health institutions, generates and disseminates research on health and social care interventions. The CRD website has searchable research databases of systematic reviews, economic evaluations, health technology assessments, and Cochrane reviews and protocols. Additionally, they provide guidance on methods for conducting systematic reviews in health- and literature-searching resources.

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                                                      • Cochrane Public Health Group. Cochrane Collaboration.

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                                                        The Cochrane Collaboration coordinates and publishes systematic reviews and reviewing resources and is a key player in the evidence-based medicine movement. Formerly known as the Cochrane Health Promotion and Public Health field, the public health subject node for the collaboration is based in Australia. Its website provides access to and support for reviews dealing with public health research utilization, as well as support for conducting public health knowledge translation.

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                                                        • Evidence-Informed Policy Network. World Health Organization.

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                                                          The Evidence-Informed Policy Network (EVIPNet) focuses on promoting use of health research in policy in low- and middle-income countries in order to improve public health. The website contains resources to support finding and use of evidence, capacity-building initiatives, web pages of regional EVIP teams, and a searchable database of various types of evidence and decision support tools.

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                                                          • Health Evidence. McMaster University.

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                                                            Health Evidence hosts a searchable database of quality-screened systematic reviews in public health. The database includes published summaries of the reviews, where available, and also other tools to promote research uptake. Full site access requires free registration.

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                                                            • Registry of Methods and Tools. National Collaborating Centre for Methods and Tools.

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                                                              This Canadian center supports knowledge translation for public health. It provides access to multiple resources on research methods, including this registry of methods and tools, aimed at different audiences (public health practitioners, evaluators, knowledge brokers, decision makers, researchers). See “The Registry of Knowledge Translation Methods and Tools: A Resource to Support Evidence-Informed Public Health” by Leslea Peirson, Cristina Catallo, and Sunita Chera in International Journal of Public Health 58.4 (2013): 493–500 for an evaluation of this resource.

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                                                              History

                                                              The dissemination of research knowledge has its roots both in communications and management science. Diffusion theory (see Rogers 2003, cited under Textbooks and Glossaries) is key to most modern understandings of dissemination. Late 1970s and early 1980s social science research on public policy and administration by the authors of Weiss 1979, Weiss 1980, Dunn 1980, and Beyer and Trice 1982 brought focus to the “know-do” gap between research and practice and began to characterize the differences between research and policy “communities” and other decision-making contexts. In the 1990s and first decade of the 21st century, as evidence-based medicine grew in prominence and influenced allied fields such as evidence-informed health policy, scholars such as in Lomas 1997; Lomas 2000; Lavis, et al. 2003; and Greenhalgh, et al. 2004 (the last two cited under General Overviews) began writing about knowledge dissemination with relevance to the health services and public health domains in addition to clinical practice.

                                                              • Beyer, Janice M., and Harrison M. Trice. 1982. The utilization process: A conceptual framework and synthesis of empirical findings. Administrative Science Quarterly 27.4: 591–622.

                                                                DOI: 10.2307/2392533Save Citation »Export Citation »E-mail Citation »

                                                                This synthesis of public administration literature on research utilization aims to support researchers in better using their own research and improving research on its utilization. Noting a prior focus on the characteristics of research rather than on organizational or cultural enablers and barriers, the authors model ways that behavioral processes in research utilization might unfold, and they discuss different levels of utilization.

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                                                                • Dunn, William.1980. The two-communities metaphor and models of knowledge use. Science Communication 1.4: 515–537.

                                                                  DOI: 10.1177/107554708000100403Save Citation »Export Citation »E-mail Citation »

                                                                  Drawing from the literature on organizational social science research utilization, Dunn proposes the use of a “two-communities metaphor” to explain the use (and nonuse) of research in public policy, by contrasting researchers and policymakers as inhabiting separate social spaces with different values, languages, worldviews, and thus understandings of knowledge. Since Dunn’s contribution, this concept has been a recurring thread throughout much of the knowledge translation literature.

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                                                                  • Lomas, John. 1997. Improving research and dissemination and uptake in the health sector: Beyond the sound of one hand clapping. McMaster University Centre for Health Economics and Policy Analysis Policy Commentary C97-1.

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                                                                    Lomas echoes Dunn’s “two-communities” metaphor nearly two decades later in his widely cited “one hand clapping” speech/commentary (see Dunn 1980), suggesting ways researchers may bridge the gap between research and practice. Lomas extends Dunn’s argument by speaking to the structures needed to facilitate research uptake, including greater emphasis on applied research and ongoing communication processes.

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                                                                    • Lomas, Jonathan. 2000. Connecting research and policy. Isuma: Canadian Journal of Policy Research 1.1: 140–144.

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                                                                      Written from the Canadian Health Services Research Foundation’s perspective, this article busts some myths in knowledge translation, including “decision making is not an event” and “research is not a retail store.” It also tackles the complex web of influences on decision making, thorny issues related to ideology, and implications of “typical” research and policy processes on linking research to policy.

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                                                                      • Weiss, Carol H. 1979. The many meanings of research utilization. Public Administration Review 39.5: 426–431.

                                                                        DOI: 10.2307/3109916Save Citation »Export Citation »E-mail Citation »

                                                                        Weiss, a pioneer in the field of social sciences research utilization, notes an increased concern from social scientists over “making their research useful for public policy” and uncertainty about its actual use. She advances different models for research utilization in policy. This is key reading for students and researchers interested in understanding how research can be used and to what end.

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                                                                        • Weiss, Carol H. 1980. Knowledge creep and decision accretion. Science Communication 1.3: 381–404.

                                                                          DOI: 10.1177/107554708000100303Save Citation »Export Citation »E-mail Citation »

                                                                          Following up on her 1979 article, Weiss interrogates the “messiness” of research utilization in policymaking, using data from interviews with mental health agency officials. In another seminal piece, Weiss states the rarity of instrumental knowledge utilization in policy decisions and suggests instead that research “creeps” into policy decisions. She also asserts that policy decision making is seldom a single, discrete event, but rather a process of “accretion” through deliberation.

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                                                                          Models and Frameworks

                                                                          This section highlights models and frameworks to further understand how knowledge is conceptualized, integrated, and used in public health decision making and the related influences on knowledge translation processes. It includes a review of foundational concepts and models that link knowledge to action such as those proposed in Armstrong, et al. 2006; Graham, et al. 2009; Best and Holmes 2010; and Willis, et al. 2017, and assesses their usefulness in promoting health equity, such as in Davison, et al. 2015. Frameworks, models, and strategies in Bowen and Zwi 2005; Kalmuss and Armstrong 2008; Ogilvie, et al. 2009; Evans and Scarbrough 2014; Salsberg, et al. 2015 (cited under General Overviews); and Jenkins, et al. 2016 are also featured with direct applicability to public health policy and practice.

                                                                          • Armstrong, Rebecca, Elizabeth Waters, Helen Roberts, Sandy Oliver, and Jennie Popay. 2006. The role and theoretical evolution of knowledge translation and exchange in public health. Journal of Public Health 28.4: 384–389.

                                                                            DOI: 10.1093/pubmed/fdl072Save Citation »Export Citation »E-mail Citation »

                                                                            Discusses foundational concepts in knowledge translation and exchange as related to public health. The authors focus on knowledge translation: in particular, the application of knowledge and, ideally, the acceleration of the knowledge cycle. They describe theoretical perspectives as well as innovations in knowledge translation research from several countries and highlight frameworks that may guide understanding of the relationships between knowledge and action.

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                                                                            • Best, Allan, and Bev Holmes. 2010. Systems thinking, knowledge and action: Towards better models and methods. Evidence & Policy 6.2: 145–159.

                                                                              DOI: 10.1332/174426410X502284Save Citation »Export Citation »E-mail Citation »

                                                                              Best and Holmes outline three approaches to knowledge to action (KTA)—linear, relationships, and systems models—but argue for a systems thinking approach. Their KTA model includes four interconnected components: knowledge on effective multilevel interventions, collaborative and accountable leadership, networks, and strategic communications to facilitate action. They call for greater collaboration across disciplines and sectors to evaluate the KTA process.

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                                                                              • Bowen, Shelley, and Anthony B. Zwi. 2005. Pathways to “evidence-informed” policy and practice: A framework for action. PLoS Medicine 2.7: 600–605.

                                                                                DOI: 10.1371/journal.pmed.0020166Save Citation »Export Citation »E-mail Citation »

                                                                                Using diffusion-of-innovations theory and case studies, Bowen and Zwi outline a pathway to evidence-informed policy and practice to help researchers and policymakers understand various influences affecting research use in policy. The authors’ framework calls for greater attention in research and planning to the source of evidence: how evidence is adopted, adapted, and used, and capacity for policy implementation.

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                                                                                • Davison, Colleen M., Sume Ndumbe-Eyoh, and Connie Clement. 2015. Critical examination of knowledge to action models and implications for promoting health equity. International Journal for Equity in Health 14:49.

                                                                                  DOI: 10.1186/s12939-015-0178-7Save Citation »Export Citation »E-mail Citation »

                                                                                  Assesses the usefulness of KTA models in promoting health equity, using six categories (e.g., explicit focus on equity or related value, explicit focus on interactions across sectors, context emphasized). The highest-ranking KTA model explicitly supported inclusive conceptualization of knowledge, prioritized diverse stakeholder engagement, and social change frameworks in brokering change within power differentials. The authors find multisectoral approaches are largely missing from such models.

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                                                                                  • Evans, Sarah, and Harry Scarbrough. 2014. Supporting knowledge translation through collaborative translational research initiatives: “Bridging” versus “blurring” boundary-spanning approaches in the UK CLAHRC initiative. Social Science & Medicine 106 (April):119–127.

                                                                                    DOI: 10.1016/j.socscimed.2014.01.025Save Citation »Export Citation »E-mail Citation »

                                                                                    Reviews boundary-spanning techniques in collaborative health-care systems in the United Kingdom to determine the impact of policy-driven strategies aimed at encouraging collaboration. The study identifies six types of boundary-spanning activity common both to bridging and blurring structures, while discussing key differences in knowledge dissemination systems: bridging creates common resources used by distinct teams for idea sharing, whereas blurring creates a flow of collaborative ideas through integration.

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                                                                                    • Graham, Ian D., Jo Logan, Margaret B. Harrison, et al. 2009. Lost in knowledge translation: Time for a map? Journal of Continuing Education in the Health Professions 26.1: 13–24.

                                                                                      DOI: 10.1002/chp.47Save Citation »Export Citation »E-mail Citation »

                                                                                      Proposes a model for moving research knowledge into various types of action (clinical, population, and public health, etc.). The review portion defines and discusses regional and disciplinary variation in the use of terms such as knowledge translation, research utilization, dissemination, and implementation. The authors also propose and explain the “knowledge-to-action cycle” model of knowledge creation and application, used by the Canadian Institutes of Health Research.

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                                                                                      • Jenkins, Emily K., Anita Kothari, Vicky Bungay, Joy L. Johnson, and John L. Oliffe. 2016. Strengthening population health interventions: Developing the CollaboraKTion Framework for Community Based Knowledge Translation. Health Research Policy and Systems 14:65.

                                                                                        DOI: 10.1186/s12961-016-0138-8Save Citation »Export Citation »E-mail Citation »

                                                                                        Addresses gaps between the implementation of KT science in care environments and community settings. Researchers concluded that the community-based knowledge translation (CBKT) framework involves (1) contacting and connecting, (2) deepening understandings, (3) adapting and applying the knowledge base, (4) supporting and evaluating continued action, and (5) transitioning and embedding. Findings point to the overlapping relationship between communities and researchers in CBKTs, and adaptability of CBKT frameworks within communities in lieu of one-size-fits-all models.

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                                                                                        • Kalmuss, Debra, and Bruce Armstrong. 2008. Service-based research: Linking public health research and practice to improve the quality of public health programs. Journal of Public Health Management & Practice 14.1: 62–65.

                                                                                          DOI: 10.1097/01.PHH.0000303415.96979.0fSave Citation »Export Citation »E-mail Citation »

                                                                                          The authors propose a “service-based research” model to support academic/practitioner collaborations through evidence. They argue that practitioners must have a central role in formulating research questions, selecting a study design and data collection methods that balance rigor and feasibility considerations, and in the translation process to enhance relevance to public health practice. They reflect on the challenges of service-based research.

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                                                                                          • Ogilvie, David, Peter Craig, Simon Griffin, Sally Macintyre, and Nicholas J. Wareham. 2009. A translational framework for public health research. BMC Public Health 9:116.

                                                                                            DOI: 10.1186/1471-2458-9-116Save Citation »Export Citation »E-mail Citation »

                                                                                            Outlines a framework that extends beyond translational medicine models and individual-level health perspectives that do not account for the multilevel complexity of real-world public health. The authors propose an interdisciplinary research agenda to populate the framework, including to describe the framework’s elements and points of intersection, to review the evidence on intervention effectiveness, and to understand the processes of translation.

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                                                                                            • Rychetnik, Lucie, Adrian Bauman, Rachel Laws, et al. 2012. Translating research for evidence-based public health: Key concepts and future directions. Journal of Epidemiology & Community Health 66.12: 1187–1192.

                                                                                              DOI: 10.1136/jech-2011-200038Save Citation »Export Citation »E-mail Citation »

                                                                                              The authors describe frameworks for translating public health research into practice. They examine four related but distinct “translation processes” that can support evidence-informed public health practice. They present an integrated framework to help decision makers map evidence for a given intervention, including what type or types of evaluations exist and which of this evidence (if any) informed current policy and practice.

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                                                                                              • Willis, Cameron, Barbara Riley, Mary Lewis, Lisa Stockton, and Jennifer Yessis. 2017. Guidance for organisational strategy on knowledge to action from conceptual frameworks and practice. Evidence & Policy 13.2: 317–341.

                                                                                                DOI: 10.1332/174426416X14609194878495Save Citation »Export Citation »E-mail Citation »

                                                                                                This study combined findings from a review of thirteen KTA frameworks with organizational case studies. The results included insights and considerations for KTA practices, including alignment between knowledge production and action, fostering connections among relevant stakeholders, the role of context, and diverse active components of the strategies/approaches.

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                                                                                                Theories

                                                                                                This section includes references to foundational theories in knowledge dissemination and utilization and reflects on their relevance to the fields of public health and evaluation. Green, et al. 2009 presents a comprehensive overview of relevant theories and calls for greater attention, along with other studies such as Riley, et al. 2012, on systems thinking. Ottoson 2009 explores knowledge-to-action theories with particular relevance to the practice of evaluation, whereas Willis, et al. 2016 outlines the main mechanisms for scaling-up complex interventions.

                                                                                                • Green, Lawrence W., Judith M. Ottoson, César García, and Robert A. Hiatt. 2009. Diffusion theory and knowledge dissemination, utilization, and integration in public health. Annual Review of Public Health 30:151–174.

                                                                                                  DOI: 10.1146/annurev.publhealth.031308.100049Save Citation »Export Citation »E-mail Citation »

                                                                                                  The authors contrast literatures and theories on dissemination, diffusion, implementation, and knowledge utilization. They call for greater attention to the role of context, external validity through “practice-based” evidence, and changes to systematic review structures to consider the heterogeneity in evidence for public health interventions. Systems thinking and social network theory represent the next frontier for understanding mechanisms for linking evidence and practice.

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                                                                                                  • Ottoson, Judith M. 2009. Knowledge-for-action theories in evaluation: Knowledge utilization, diffusion, implementation, transfer, and translation. In Special issue: Knowledge utilization, diffusion, implementation, transfer, and translation: Implications for evaluation. Edited by Judith M. Ottoson and Penelope Hawe. New Directions for Evaluation 124 (Winter): 7–20.

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                                                                                                    This is the lead paper for a special issue dedicated to exploring the implications of knowledge translation–relevant concepts and theories for the field of evaluation. Ottoson describes, compares, and contrasts key theories and provides coherence for areas of inquiry in the rest of the special issue. By design, the paper explores the distinctions and complementarities of relevant theories and remains mindful of their practical utility for evaluation practice.

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                                                                                                    • Riley, Barbara, Cameron D. Norman, and Allan Best. 2012. Knowledge integration in public health: A rapid review using systems thinking. Evidence & Policy 8.4: 417–431.

                                                                                                      DOI: 10.1332/174426412X660089Save Citation »Export Citation »E-mail Citation »

                                                                                                      Riley and colleagues examine critical success factors for knowledge integration and key gaps through a complex adaptive systems lens. Findings in five related topic areas/concepts and a list of “evidence statements” are presented. Although little public health–specific evidence is included, the authors note direct applicability of findings for complex public health systems.

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                                                                                                      • Willis, Cameron D., Barbara L. Riley, Lisa Stockton, et al. 2016. Scaling up complex interventions: Insights from a realist synthesis. Health Research Policy and Systems 14:88.

                                                                                                        DOI: 10.1186/s12961-016-0158-4Save Citation »Export Citation »E-mail Citation »

                                                                                                        Researchers reviewed how and under what conditions public health interventions can be scaled up to benefit more people and populations. The authors found four main mechanisms, including awareness, commitment, confidence, and trust. Applying specific actions, such as conducting evaluations, to one of two scaling-up strategies (i.e., renewing and regenerating and documenting success) set off the mechanisms, resulting in various possible outcomes resulting from scaling up.

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                                                                                                        Debates

                                                                                                        This section examines areas requiring debate and reflection to advance the field of knowledge translation (KT) and related concepts. While Reimer-Kirkham, et al. 2009 and Davies, et al. 2008 reflect on current traditions of inquiry in the field and the need for greater precision in the current terminology used, other studies such as Greenhalgh and Wieringa 2011 and Kothari and Wathen 2013 argue for broadening how the field is conceptualized and more-critical examination of the benefits and challenges associated with integrated models of KT. They call for new theoretical approaches grounded in organizational level and systems thinking.

                                                                                                        • Davies, Huw, Sandra Nutley, and Isabel Walter. 2008. Why “knowledge transfer” is misconceived for applied social research. Journal of Health Services Research and Policy 13.3: 188–190.

                                                                                                          DOI: 10.1258/jhsrp.2008.008055Save Citation »Export Citation »E-mail Citation »

                                                                                                          Davies and colleagues argue for more-precise terminology in describing applied social research by exposing how terms such as knowledge transfer can be misinterpreted and misused. They challenge the notion that objective and stable knowledge can be created for the purposes of transfer and translation. They conclude by proposing “knowledge interaction” as a better term to describe the “messy engagement” between diverse social actors, with different ways and sources of knowledge.

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                                                                                                          • Greenhalgh, Trisha, and Sietse Wieringa. 2011. Is it time to drop the “knowledge translation” metaphor? A critical literature review. Journal of the Royal Society of Medicine 104.12: 501–509.

                                                                                                            DOI: 10.1258/jrsm.2011.110285Save Citation »Export Citation »E-mail Citation »

                                                                                                            This interdisciplinary review of KT literature aims to broaden conceptualizations of KT beyond its use in medicine. The authors address what is knowledge, how it is generated, the role of judgment in knowledge use, and the place of knowledge in organization, management, and policymaking. Although grounded in medicine and clinical practice, much of the review could hold relevance for public health.

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                                                                                                            • Kothari, Anita, and C. Nadine Wathen. 2013. A critical second look at integrated knowledge translation. Health Policy 109.2: 187–191.

                                                                                                              DOI: 10.1016/j.healthpol.2012.11.004Save Citation »Export Citation »E-mail Citation »

                                                                                                              Reviews the benefits and issues with the integrated knowledge translation (IKT) model. Benefits included more-relevant research questions, more-adaptable findings, increased value of other researchers’ perspective, and creation of more-tangible information about the research. Issues included difficulties incentivizing IKT, and the potential for limiting future collaboration should research findings not result in any major changes in the field.

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                                                                                                              • Reimer-Kirkham, Sheryl, Colleen Varcoe, Annette J. Browne, M. Judith Lynam, Koushambhi Basu, and Heather McDonald. 2009. Critical inquiry and knowledge translation: Exploring compatibilities and tensions. Nursing Philosophy 10.3: 152–166.

                                                                                                                DOI: 10.1111/j.1466-769X.2009.00405.xSave Citation »Export Citation »E-mail Citation »

                                                                                                                Reviews and discusses traditions of critical inquiry in relation to the emerging field of KT. Issues include the definition and authority of “knowledge,” pressure to be concrete and “package” knowledge for easy consumption, and the potential for KT activities to address or replicate social hierarchies and disparities.

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                                                                                                                Individual, Organizational, and System Capacities

                                                                                                                Capacity development to support knowledge utilization and exchange can occur at individual, organizational, and system levels. The section Individual Level outlines evidence from a variety of studies that examine individual-level capacities, and those required to facilitate effective use of evidence are discussed in Organizational and System Levels.

                                                                                                                Individual Level

                                                                                                                There are many examples of interventions aimed at increasing the use of evidence by individual practitioners and policymakers, but the articles in this section do not address this topic. Instead, this section features Estabrooks, et al. 2008, which identifies the role of incentives to engage in knowledge dissemination–related activities. Whereas Kansagra and Farley 2011 highlights the need for new research methods to understand knowledge dissemination and utilization, Elueze 2015 calls for more empirical research to assess the comparative effectiveness of knowledge-brokering approaches. And Lorenc, et al. 2014 examines decision makers’ use of research in policy.

                                                                                                                • Elueze, Isioma N. 2015. Evaluating the effectiveness of knowledge brokering in health research: A systematised review with some bibliometric information. Health Information and Libraries Journal 32.3: 168–181.

                                                                                                                  DOI: 10.1111/hir.12097Save Citation »Export Citation »E-mail Citation »

                                                                                                                  Analyzes how effective knowledge brokering (KB) is for promoting evidence-based decision making, and collaboration among researchers, practitioners, and policymakers in health research. While KB was found to be an effective strategy to communicate health research knowledge, the author calls for more research comparing the effectiveness of different KB approaches and a greater articulation of the roles played by library science professionals in KB.

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                                                                                                                  • Estabrooks, Carole A., Peter Norton, Judy M. Birdsell, Mandi S. Newton, Adeniyi J. Adewale, and Richard Thornley. 2008. Knowledge translation and research careers: Mode I and Mode II activity among health researchers. Research Policy 37.6–7: 1066–1078.

                                                                                                                    DOI: 10.1016/j.respol.2008.04.006Save Citation »Export Citation »E-mail Citation »

                                                                                                                    The authors report cross-sectional results that point to differences in knowledge translation (KT) activities between applied and basic researchers. They note a significant increase for clinical, health services, and population health researchers to engage more in Mode II (problem-solving) rather than Mode I (curiosity-driven) forms. They reflect on the implications, including how to achieve better balance between different forms of knowledge production.

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                                                                                                                    • Kansagra, Susan M., and Thomas A. Farley. 2011. Public health research: Lost in translation or speaking the wrong language? American Journal of Public Health 101.12: 2203–2206.

                                                                                                                      DOI: 10.2105/AJPH.2011.300302Save Citation »Export Citation »E-mail Citation »

                                                                                                                      Outlines the need for increased use of evidence in public health decisions and the particular urgency for evidence on population-level health interventions. This is one of the few papers in this article arguing for new methods and research to generate the range of evidence that is needed in this field and to have a greater impact on public health action.

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                                                                                                                      • Lorenc, Theo, Elizabeth F. Tyner, Mark Petticrew, et al. 2014. Cultures of evidence across policy sectors: Systematic review of qualitative evidence. European Journal of Public Health 24.6: 1041–1047.

                                                                                                                        DOI: 10.1093/eurpub/cku038Save Citation »Export Citation »E-mail Citation »

                                                                                                                        Synthesizes various qualitative research studies about local decision makers’ use and perception of research in policy sectors about the built environment. The authors found that factors including credibility of the evidence, organizational support, relevancy to practice, feasibility of political support, and legislative constraints all played a role in influencing local decision makers’ views of evidence. Evidence was also occasionally used to support legitimacy of decisions made.

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                                                                                                                        Organizational and System Levels

                                                                                                                        In order to maximize evidence-informed decision making in population and public health, knowledge dissemination and utilization studies need to place greater emphasis on organizational and system levels. This section includes citations that address these levels, including enabling structures and barriers that facilitate or impede the use of evidence in policy and practice in multiple sectors. For example, Kiefer, et al. 2005; Bosch-Capblanch, et al. 2012; and Armstrong, et al. 2007 examine knowledge synthesis activities, including centers for knowledge synthesis, systematic reviews, guidelines, and what opportunities those mechanisms present to enable the use of research in practice/policy, whereas Frank, et al. 2012 and Kothari, et al. 2016 examine knowledge brokering and knowledge use at organizational and network levels. Glasgow, et al. 2012 and Tetroe, et al. 2008 examine the issues from the perspectives of health research–funding agencies. Lavis, et al. 2006 looks at funding agencies as one component of other country-level efforts to bridge research and action, and Newton and Scott-Findlay 2007 delves into the Canadian context specifically to study the perspectives of stakeholders in the KT agenda. As a set, the papers make the case for greater attention to interventions aimed at the organizational and system levels to support knowledge utilization and exchange.

                                                                                                                        • Armstrong, Rebecca, Elizabeth Waters, Belinda Crockett, and Helen Keleher. 2007. The nature of evidence resources and knowledge translation for health promotion practitioners. Health Promotion International 22.3: 254–260.

                                                                                                                          DOI: 10.1093/heapro/dam017Save Citation »Export Citation »E-mail Citation »

                                                                                                                          Summarizes findings from an assessment of how evidence-based health promotion resources were perceived and used by health promotion practitioners. Results point to practitioners’ need for fast and easy access to evidence-based resources, their preferred formats (e.g., case studies) supported by structured dissemination strategies (e.g., training, access to knowledge broker) and a network of experts and change agents.

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                                                                                                                          • Bosch-Capblanch, Xavier, John N. Lavis, Simon Lewin, et al. 2012. Guidance for evidence-informed policies about health systems: Rationale for and challenges of guidance development. PLoS Medicine 9.3: e1001185.

                                                                                                                            DOI: 10.1371/journal.pmed.1001185Save Citation »Export Citation »E-mail Citation »

                                                                                                                            Part of a series that provides guidance to inform health system policy and delivery of clinical and public health interventions. The authors call for rigorous and transparent knowledge generation approaches and related evidence-informed guidance that account for contextual influences and their effects on intervention effectiveness, with particular attention to the impacts on disadvantaged populations.

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                                                                                                                            • Frank, John, Helen Frost, Rosemary Geddes, et al. 2012. Experiences of knowledge brokering for evidence-informed public health policy and practice: Three years of the Scottish Collaboration for Public Health Research and Policy. In Special issue: Public health science. The Lancet 380.9856: S39.

                                                                                                                              DOI: 10.1016/S0140-6736(13)60395-5Save Citation »Export Citation »E-mail Citation »

                                                                                                                              Examines the knowledge-brokering role of the Scottish Collaboration in identifying public health interventions that equitably address major health priorities and build capacity for collaborative-intervention research. Essential to the collaboration are knowledge brokers, who facilitate knowledge exchange through linking decision makers, researchers, and health-care professionals. Identifies the importance of nurturing relationships between academics and policymakers, and facilitating their involvement in planning and development.

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                                                                                                                              • Glasgow, Russell E., Cynthia Vinson, David Chambers, Muin J. Khoury, Robert M. Kaplan, and Christine Hunter. 2012. National Institutes of Health approaches to dissemination and implementation science: Current and future directions. American Journal of Public Health 102.7: 1274–1281.

                                                                                                                                DOI: 10.2105/AJPH.2012.300755Save Citation »Export Citation »E-mail Citation »

                                                                                                                                Summarizes the National Institutes of Health’s investments and future directions in the science of dissemination and implementation. The authors call for greater rigor through methods and tools development in implementation science, enhanced interdisciplinary research-practice collaborations, and more focus on scale-up and sustainability of interventions to realize better returns on research investments.

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                                                                                                                                • Kiefer, Lori, John Frank, Erica Di Ruggiero, et al. 2005. Fostering evidence-based decision-making in Canada: Examining the need for a Canadian population and public health evidence centre and research network. Canadian Journal of Public Health 96.3: I1–I20.

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                                                                                                                                  Deals with issues about the complex evidence base in population and public health, and related knowledge transfer, exchange, utilization, and evaluation activities. The authors call for structural changes in the Canadian context: a center for synthesizing evidence and fostering knowledge exchange and a research/practice network to identify gaps and continually improve methods for conducting and using evidence in program planning and policy.

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                                                                                                                                  • Kothari, Anita, Charmaine McPherson, Dana Gore, Benita Cohen, Marjorie MacDonald, and Shannon L. Sibbald. 2016. A multiple case study of intersectoral public health networks: Experiences and benefits of using research. Health Research Policy and Systems 14:11.

                                                                                                                                    DOI: 10.1186/s12961016-0082-7Save Citation »Export Citation »E-mail Citation »

                                                                                                                                    Analyzes the benefits of research and knowledge on the basis of experiences of four public health networks. All networks integrated different types of research (e.g., scientific articles) and knowledge (e.g., anecdotal community knowledge). Both research and knowledge were important in creating the function of a network, benefiting individuals and the network as a whole. Findings help shed light on how collaborative processes of using knowledge, structure (network), and outcomes (benefits) are related.

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                                                                                                                                    • Lavis, John N., Jonathan Lomas, Maimunah Hamid, and Nelson K. Sewankambo. 2006. Assessing country-level efforts to link research to action. Bulletin of the World Health Organization 84.8: 620–628.

                                                                                                                                      DOI: 10.2471/BLT.06.030312Save Citation »Export Citation »E-mail Citation »

                                                                                                                                      Presents a framework for assessing country-level research dissemination and implementation efforts. Elements of the framework include general research climate, research prioritization and production processes, activities to link research and action, and evaluation.

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                                                                                                                                      • Newton, Mandi S., and Shannon Scott-Findlay. 2007. Taking stock of current societal, political and academic stakeholders in the Canadian healthcare knowledge translation agenda. Implementation Science 2.32.

                                                                                                                                        DOI: 10.1186/1748-5908-2-32Save Citation »Export Citation »E-mail Citation »

                                                                                                                                        Discusses different interests thought to influence KT in health care. Recommends areas for advancement and debate: recognition that KT is an ethically bound process to be based on the best evidence, transparency and accountability at multiple levels, and organizational research on features of academic and policymaking institutions and how they influence discovery and translation of health research.

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                                                                                                                                        • Tachameni Ngamo, Salomon, Karine Souffez, Catherine Lord, and Christian Dagenais. 2016. Do knowledge translation (KT) plans help to structure KT practices? Health Research Policy and Systems 14:46.

                                                                                                                                          DOI: 10.1186/s12961-016-0118-zSave Citation »Export Citation »E-mail Citation »

                                                                                                                                          This paper used a mixed-methods case study to assess the effectiveness and areas of improvement for KT plans for projects at a public health institute. KT plans were recommended (with caution) as a structured and deliberate mechanism for enabling reflexive practice. Eight dimensions were recommended for inclusion (e.g., KT partners, KT strategies); however, their relative importance was not determined.

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                                                                                                                                          • Tetroe, Jacqueline, Ian Graham, Robbie Foy, et al. 2008. Health research funding agencies’ support and promotion of knowledge translation: An international study. Milbank Quarterly 86.1: 123–153.

                                                                                                                                            DOI: 10.1111/j.1468-0009.2007.00515.xSave Citation »Export Citation »E-mail Citation »

                                                                                                                                            The authors present findings from interviews with health research funders to determine their support and promotion of KT. Variations in how knowledge translation is conceptualized and operationalized are reported. The authors highlight areas of more-frequent investments including knowledge syntheses and “push” strategies (dissemination of findings), compared to more limited use of “linkage,” “pull” strategies, and evaluation of KT strategies.

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                                                                                                                                            Ethics and Knowledge Dissemination

                                                                                                                                            This section presents a selection of papers such as Trevor-Deutsch, et al. 2009 and Walton 2012 that both analyze and call for greater attention to ethical issues related to the dissemination of public health knowledge. Among the issues emerging here are those surfaced in Kuhlau, et al. 2013 about public access to research results and the risks and merits of making publicly available “dual-use” information that might be used either to the benefit or detriment of public health. According to Willinsky and Alperin 2011, access concerns have led some research funders to require free, online access (“open access”) to articles or data created from the research they fund; however, most have linked this requirement to accountability rather than ethical concerns. Within public health and health policy, and particularly the global health community, subscription-only access to publications carries the potential to restrict dissemination to more-affluent networks and jurisdictions. Closely related to, and intertwined with, the more general inquiry into ethics and knowledge dissemination draws attention to the importance of cultural values and traditions—such as indigenous approaches to knowledge—in informing dissemination strategies (Reimer-Kirkham, et al. 2009, cited under Debates). Those issues are not fully explored here and merit future discussion.

                                                                                                                                            • Kuhlau, Frida, Anna T. Höglund, Stefan Eriksson, and Kathinka Evers. 2013. The ethics of disseminating dual-use knowledge. Research Ethics 9.1: 6–19.

                                                                                                                                              DOI: 10.1177/1747016113478517Save Citation »Export Citation »E-mail Citation »

                                                                                                                                              Discusses a 2011 case in which major scientific journals were asked not to publish specific information about research on the H5N1 influenza virus. The authors argue that there may be cases where it is justifiable to constrain knowledge dissemination, and they discuss ethical issues associated with balancing public health benefits with the risks of possible malicious use of this information. They also raise issues related to academic freedom of researchers and the public right to research and propose preliminary guidelines for when constraints on publication might be justified.

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                                                                                                                                              • Trevor-Deutsch, Burleigh, Kristiann Allen, and Vardit Ravitsky. 2009. Appendix 3: Ethics in knowledge translation. In Knowledge translation in health care: Moving from evidence to practice. Edited by Sharon E. Straus, Jacqueline Tetroe, and Ian D. Graham, 291–299. Oxford: Wiley-Blackwell.

                                                                                                                                                DOI: 10.1002/9781444311747Save Citation »Export Citation »E-mail Citation »

                                                                                                                                                This article, an appendix to a larger text about knowledge translation (KT) in health care, discusses ethical principles to “downstream” research process of KT, which requires ethical discussion and framing even more than the “upstream” knowledge creation process. Focusing on the principles of utility and justice, the authors suggest some considerations when planning KT, including equity of benefits and risks, efficient stewardship, and building ethical partnerships.

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                                                                                                                                                • Walton, Mat. 2012. An ethical evaluation of evidence: A stewardship approach to public health policy. Public Health Ethics 5.1: 16–21.

                                                                                                                                                  DOI: 10.1093/phe/phr037Save Citation »Export Citation »E-mail Citation »

                                                                                                                                                  Part of the emerging body of literature on population and public health ethics, this article presents a case study of applying an ethical framework to research use in public health policymaking, within the context of previously articulated ethical concerns regarding evidence-based practice in health policy.

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                                                                                                                                                  • Willinsky, John, and Juan Pablo Alperin. 2011. The academic ethics of open access to research and scholarship. Ethics and Education 6.3: 217–223.

                                                                                                                                                    DOI: 10.1080/17449642.2011.632716Save Citation »Export Citation »E-mail Citation »

                                                                                                                                                    Frames changing times in scholarly communication as an opportunity to recast the focus of academic ethics. The authors argue that while academic ethics is typically understood as the avoidance of doing “bad” (e.g., plagiarism, breaching participant confidentiality), there is also “positive action” within academic ethics, which largely includes effective dissemination practices to make research outputs as widely accessible as possible, to the broadest possible audiences.

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