Knowledge Transfer project Planning Aban 1389 KTE-TUMS Group

A five-step approach to knowledge transfer 1.Message (WHAT?) 2.Target Audience ( To WHOM?) 3.Messenger (BY WHOM?) 4.Knowledge transfer process and support system (HOW?) 5.Evaluation (with what EFFECT should it be transferred?)

Body of research The research literature strongly suggests that research organizations should transfer actionable message from a body of research knowledge, not simply a single research report or the results of a single study.

The basic unit of knowledge translation should be systematic reviews or other syntheses of the global evidence base. Always?

Level of Evidence

Is it correct to consider individual studies as the unit of knowledge translation? This is inappropriate when the targets for knowledge translation are patients, health care professionals and policy makers. Individual studies rarely, by themselves, provide sufficient evidence for policy or practice changes.

Why? 1. Individual studies can often lead to a conclusion very different from that of a systematic review of all available studies. 2. Research in the form of “ideas,” not “data,” most influences decision making.

Information that is drawn from a body of knowledge, rather than from a single study, can better enhance both the applicability and validity of the knowledge. The results of single studies are less likely to generate a robust conclusion. They could also be too specific to be applicable to other contexts, populations, and conditions. Therefore, it is suggested that systematic reviews should be applied to identify standards for information selection and packaging.

Not all research can or should have an impact Some bodies of research knowledge will not generate a “take-home” message, because either the research has no apparent application for decision makers or the findings are not conclusive.

Lavis has argued that the 'natural unit' for research translation should be 'actionable messages' arising from systematic reviews, and that the effort of promoting research findings to a given category of user should be concentrated on the fraction of systematic reviews that have an actionable message for that particular audience

This suggests that undertaking a priori to 'disseminate' the findings of a particular piece of public health research in the public domain (as opposed to making the findings visible to others working within the overall translation framework) might, in some cases, be inefficient or even harmful.

Message (WHAT?) “Actionable messages” are preferable to single research reports or the results of single studies. Actionable message Synthesis of research knowledge Individual studies, articles and reports Basic, theoretical and methodological innovations

The first published study on a scientific question may find the most exaggerated effect size and that as further evidence is gathered, effect sizes tend to diminish. Ioannidis, J. (2006). PLOS Clinical Trials 1(7); e36. doi: /journal.pctr

RESULTS FOR CANADA’S APPLIED RESEARCH CENTRES Surveyed 175 applied health or economic/social research centers on knowledge transfer (KT) What is transferred? % frequently/always –Summaries or synthesis 34 –Actionable messages 30 i.e. over two-thirds are still doing knowledge transfer with raw results from single studies

“What should be transferred?” The question “What should be transferred?” challenges knowledge translators to identify the key messages for different target audiences and to fashion these in language and knowledge translation products that are easily assimilated by different audiences.

For Example Patient Decision Aids for patients Clinical practice guidelines for health care professionals Actionable messages for policy makers

How research or any type of findings are packaged and presented can impact how readily the knowledge is to put into practice. It is sometimes useful, for example, to move away from more ‘academic’ presentations of the research findings (e.g. graphs and charts) and to use, instead, stories or anecdotes to convey the information.

Tailoring your Findings for Research Users

It has also been suggested that “to make the most out of research evidence and to reach policy makers, give them something in a paragraph to get their attention; better still if you can give one sentence that can be a slogan, a mantra they can repeat..” The language of the message is also important. For example, to influence decision makers, the research information should be in the form of “ideas” not “data.”

Other Aspects: Safety Ethics Cost-effectiveness Effectiveness Organizational issues

Of course, these ideas or take-home messages are best considered a starting point for a discussion with policy makers and managers rather than a cookbook remedy. Summaries are intended to augment collaboration between researchers and decision makers, not replace it altogether.

What do we want to disseminate? It is essential, that you and your team have a shared vision and common understanding of what it is you want to disseminate together with a way of describing this to those that are outside your project and who may stand to benefit from your work.

When preparing a message to transfer, it is also necessary to consider what information will be most useful to the audience. Effective messages show the audience the practical applications of the knowledge – why the information matters to them.

In constructing any message, it is important to focus on the 5Cs: sure it Clear: a message is easy to understand, Concise: a message is easy to read, Consistent: a message is related to information that is consistent with other existing information, Compelling: a message offers something that commands attention, Continuous: a message has follow-up to make is not forgotten or overlooked.

An actionable message can be defined by considering these questions: –Why is this issue important? –What does the research evidence tell us about this issue? –Do we know whether and to what extent current decision-making differs from optimal/informed decision making? –Who should act and what should be done?

Messages/products should be jargon free and should be pilot tested in order to assess their acceptability to the targeted audience.

The research summary must extract clear, simple and active main messages or key implications from research results, while directing readers to the full research reports for more specific details.

BEING ECONOMICAL BUT LIVELY WITH WORDS Summaries, like news articles, will suffer from passive verbs, run-on sentences, mixed metaphors and clichés. In particular, "readers notice sloppy writing and they don't forgive." To ensure every idea flows logically into the next, it is best to use simple declarative sentences, each sticking to one idea. This kind of writing is easier to understand and will better hold the readers' attention.

Key messages for what Messages from body of researches Tailoring your Findings for Research Users “Evidence is an important part, but not the only part of effective decision-making. The use of evidence is most successful when local differences are factored into the decision-making process, whether at the clinical, system, or policy level”

A five-step approach to knowledge transfer 1.Message (WHAT?) 2.Target Audience ( To WHOM?) 3.Messenger (BY WHOM?) 4.Knowledge transfer process and support system (HOW?) 5.Evaluation (with what EFFECT should it be transferred?) Lavis, J; et al. (2003). « How Can Research Organizations More Effectively Transfer Research Knowledge to Decision-Makers »; The Milbank Quarterly, 81 (2) :

Target Audiences A message’s target audience must be clearly identified. Multiple audience-specific messages are needed. Research knowledge alone may not impact decisions.

The term “target audience or group” can be used to describe the different groups of stakeholders connected to your project. It is important to identify and be clear about who your stakeholders are and then you need to be able to map them to one of the categories of the awareness, understanding, and action model.

Target Audience (WHO?) –Identify the most appropriate target audience(s) for each message and fine- tune the message and approach to knowledge transfer for each target audience

Typical targets Macro level (policies) –Ministry of health –Regional health authorities –Regulatory agencies Meso level (management) –Hospital managers –Department and program managers Micro level (practice) –Colleges and associations of physicians/nurses –Physicians, nurses, other health care providers –Patients, people

The Challenge of Identifying Specific Target Audiences! 1.Who can act on the basis of the available research knowledge? 2.Who can influence those who can act? 3.With which of these target audience(s) can we expect to have the most success? 4.Which messages pertain most directly to them?

Handy Hints 1) Think about how you can present your project's outputs/outcomes as benefits/solutions. 2) Place yourself in the "shoes" of each target audience/group and think about what problems you would be looking for.

To Whom Should Knowledge Be Transferred? type of r research Potential Stakeholder basicclinicalHealth Service Population Health Patients+++ Professional+++ Local administrator ++++ National policy maker +++

To Whom Should Knowledge Be Transferred? type of r research Potential Stakeholder basicclinicalHealth Service Population Health Regulatory Bodies Industry Research Funder +++ Researchers +++

The relative importance of different target audiences will also vary by the results of research. Lack of benefit or harms from a drug: policy makers, regulatory bodies and industry Benefits from a drug: patients, providers, local administrators, national policy makers, regulatory bodies and industry.

The research literature does not explain how to select the target audiences for a message, only that once a target audience is identified, the specific knowledge-transfer strategy should be fine-tuned to the type of the decisions the decision makers face.

Learning about these decision-making environments often requires a significant investment of time and financial resources.

Key message for “To whom” Identify and be clear about who your stakeholders are and then you need to be able to map them to one of the categories of the awareness, understanding, and action model.

A five-step approach to knowledge transfer 1.Message (WHAT?) 2.Target Audience ( To WHOM?) 3.Messenger (BY WHOM?) 4.Knowledge transfer process and support system (HOW?) 5.Evaluation (with what EFFECT should it be transferred?) Lavis, J; et al. (2003). « How Can Research Organizations More Effectively Transfer Research Knowledge to Decision-Makers »; The Milbank Quarterly, 81 (2) :