Knowledge Translation BJ LeJeune, CVRT, CRC

Research to Practice: Is it too big a leap?

Evidence-Based Practice Evidence-based practice (EBP) "is the integration of best research evidence with clinical expertise and [consumer] values" (Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000, p. 1). Clinical expertise refers to the use of practice skills and past experience to rapidly identify each [consumer's] unique circumstances and characteristics, "their individual risks and benefits of potential interventions, and their personal values and expectations."

Hierarchy of Levels of Best Research Evidence (Boothroyd,2006) Literature Review of Research Findings Randomized Controlled Experimental Research Non-randomized Controlled Experimental Research Single Subject (Retrospective, Replicated) Case Studies (Retrospective) Expert Opinion

In our field what are best levels of research evidence? Best Research! Systemized Literature Review of Research Findings Single Subject (Retrospective, Replicated) Pre-Post Test measure of capabilities Case Studies (Retrospective) Expert Opinion

NIDRR Commitment to Useful Research (No, that is not an Oxymoron!) All NIDRR grantees share a goal “to promote the generation and effective use of knowledge in areas of importance to individuals with disabilities and their families” (NIDRR Long-Range Plan for 2013- 2017).

What is Knowledge Translation? The term knowledge translation (KT) is increasing in importance and used in the fields of public health, medicine, and now in rehabilitation research. KT is a relatively new term in our field to describe an old problem – the under-utilization of evidence-based research in systems of care and practice.

Research to Policy and Practice Knowledge Translation Research Policy Makers and Service Providers Consumer Needs

Question Do you use recent research findings to establish practice or policy guidelines in serving consumers who have visual impairments? _____Yes ______No ???

How does research make it into practice? Practical, applicable and relevant Presented in a way that expands possibilities Move from “content absorption” to “conversation utilization” Partnerships, Collaborations and Cooperative Activities Levesque, P. (October, 2013). Knowledge Translation Measurement. KT Expo Conference for NIDRR Grantees.

Common Obstacles to Research Usage The research is not relevant to practice. The research is not timely. The research is not communicated in ways relevant to the user. Administrative pressures overwhelm research based- evidence in decision making. Source: Allen, P., et al. (2007). Commissioning research that is used: the experience of the NHS Services delivery and organization research development programme. Evidence & Policy, 3 (1):119-134 as presented by Levesque, P. (October, 2013). Knowledge Translation Measurement. KT Expo Conference for NIDRR Grantees.

Enhancing Employment Outcomes NIDRR Research Goals VR Agency Goals Short range research outcomes – Gain Knowledge Intermediate range research outcomes – Changes in Practice Long range research outcomes – Policy Changes Short range –Increase in applicable knowledge for direct service providers Intermediate – Improved practice, procedures that impact individual consumer employment outcomes Long Range – Significant and relevant policy development that increase employment outcomes for consumers

Question What is the typical lag time from research findings in health research until those findings are put into practice? 5 years 12 years 17 years 4. 21 years ???

Stats on Knowledge Translation for Health-Related Research Eighty six percent of research never makes it into practice. Of the remaining 14%, there is a 17 year lag on research to practice Several areas where research gets bogged down in the translation process. Establishing Research Priorities Peer Review Process Publication Priorities Lack of development of Guidelines for practice Dissemination process – is the information getting to the right people in a viable format? http://jrs.sagepub.com/content/104/12/510.full

Question What do you think is the most effective way your direct service providers, such as Rehabilitation Counselors, learn about “Best Practice” or Evidence Based Practice Guidelines? Read journal articles In-service training On-line training In their graduate training program Research is not emphasized or useful

What are current resources to find research based professional development training? The NRTC on Blindness and Low Vision at Mississippi State University Technical Assistance Continuing Education Centers (RSA Funded) University Programs Envision Hadley School for the Blind Perkins The Carroll Center American Foundation for the Blind Lighthouse International Other private agencies and vendor-based training

NRTC Dissemination: Training Activities Vision Specialist Program www.distance.msstate.edu/vision/index.html On-line Continuing Education Training Multi-Module Courses http://blind.msstate.edu/training/training/ Short Courses (Free for CRC credit) http://ntac.blind.msstate.edu/courses/ Articles to read and digest (www.blind.msstate.edu) National Technical Assistance Website (www.ntac.blind.msstate.edu)

NRTC Workshops with State Agencies Grant allowed for 2 joint funded state workshops per year In the first four years we have had 9: KY, MS (2), MA (2), ME, DC (2), WV Topics have included: Medical Aspects of Blindness and Low Vision, TBI and Vision Loss, Successful Placement of Older Blind Adults, Adjustment to Vision Loss, Transition, Cross-Generational Communications, Job Readiness, and Strategies to Enhance Employment Outcomes from Current Research Activities

Other NRTC Training Activities Vision Specialist in Vocational Rehabilitation Graduate Certificate (In the last 5 years we have had 36 graduates from 22 states: GA, VA, CO, TX, AL, AL, LA, MS, ME, MI, CA, WA, DC, OR, NC, NV, ND, TN, FL, MN, ID, MD) Webinars with Hadley School for the Blind, NW TACE X, and South-Central TACE VI, Southeast TACE IV, and East Coast TACE V Training Workshops with Mississippi Department of Education, MAER, University of Southern Mississippi, Mississippi Deaf-Blind Children and Youth,

Dissemination: Technical Assistance National Technical Assistance Website (www.ntac.blind.msstate.edu) Email Discussion Group Talk with a Researcher Conference calls Call 662-325-2001 Email nrtc@colled.msstate.edu

Other Dissemination Activities Peer Reviewed Journal Articles Other articles and monographs Guidelines for Consumers and Service Providers (on website) Conference Presentations

Bridging the Gap! Research Practice

References and Resources Boothroyd, A. (September, 2006). Adult aural rehabilitation: What is it? Does it work? State of the Science Conference on Hearing Enhancement. Gallaudet University, Washington, DC. Levesque, P. (October, 2013). Knowledge Translation Measurement. KT Expo Conference for NIDRR Grantees. Webinar.