Knowledge Translation for Improving Health Masoud Solaymani-Dodaran MD MPH PhD FFPH CCT

Knowledge Translation for Improving Health Definition of Knowledge translation The concept of improving health Examples of what has been done ◦ What we have done ◦ What others have done (NICE) My impression

Definition of Knowledge translation The concept of improving health Examples of what has been done ◦ What we have done ◦ What others have done (NICE) My impression Knowledge Translation for Improving Health

CIHR definition of KT ◦ Canadian Institutes of Health Research (CIHR) is the major federal agency responsible for funding health research in Canada. It is the successor to the Medical Research Council of Canada Knowledge translation (KT) is defined as a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system.

An old problem KT is a relatively new term that is used to describe a relatively old problem - the underutilization of evidence-based research in systems of care. Underutilization of evidence-based research is often described as a gap between 'what is known' and 'what is currently done' in practice settings ◦ Technical Brief # , NCDDR (the National Center for the Dissemination of Disability Research)

Definition of Knowledge translation The concept of improving health Examples of what has been done ◦ What we have done ◦ What others have done (NICE) My impression Knowledge Translation for Improving Health

WHO definition of health Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

Social determinants of Health 1. Income and Social Status 2. Social Support Networks 3. Education and Literacy 4. Employment/Working Conditions 5. Social Environments 6. Physical Environments 7. Personal Health Practices and Coping Skills 8. Healthy Child Development 9. Biology and Genetic Endowment 10. Health Services 11. Gender 12. Culture

Steps in improving health Setting national health goals e.g reduce the inc. of … Setting targets to achieve goals that should be SMART (Specific, Measurable, Achievable, Relevant, Timed)

Steps in forming and implementing policy Political tasks ◦ Define a public health issue ◦ Develop broad goals ◦ Place it in broad policy agenda ◦ develop strategy for moving issue to front ◦ Media coverage, advertising, PH campaign, lobbying ◦ Develop specific policy ◦ Evaluate/modify/ implement Managerial tasks ◦ Identify key players ◦ Build a coalition of support ◦ Determine state of public opinion and identify ways to change ◦ Identify obstacles to implementation ◦ Compromise and bargain ◦ Determine the appropriate timing for attempt in implementation

Developing a local plan for implementation Situation analysis Consultation Review of published information to find intervention Assessment of feasibility, acceptability, costs, and benefits of these interventions Estimate of resources needed to carry out the plan Formulation of recommendations for action Preparation of planning document

Definition of Knowledge translation The concept of improving health Examples of what has been done ◦ What we have done ◦ What others have done (NICE) My impression Knowledge Translation for Improving Health

KT activities in IUMS

Definition of Knowledge translation The concept of improving health Examples of what has been done ◦ What we have done ◦ What others have done (NICE) My impression Knowledge Translation for Improving Health

NICE National Institute of Clinical Excellence Established in 1999 (statutory) budget: 68.5 m pounds Employs around 638 staff More than 2,000 experts engage with NICE processes Its role is to provide ◦ authoritative, independent advice on different health- related interventions and pathways of care; ◦ increase fairness in access to treatments ◦ to be a national source of robust clinical guidance ◦ to speed up the uptake of cost-effective treatments in the NHS

NICE In 2005 merge with Health Development Agency to include public health Following the Health and Social Care Act 2012, extended its remit into adult and children’s social care to help promote the integration of NHS, public health and social care.

NICE’s aim NICE’s aim is to be the principal UK source of evidence and advice to support health, public health and social care practice, commissioning and local decision-making, including practical support to help put recommendations into practice. It provides advice to the health and care system on what interventions and forms of practice are effective and cost-effective.

NICE functions Guidelines for health, public health and social care Technology appraisals Highly Specialized Technology Evaluations Medical and diagnostics guidance Interventional procedures guidance Quality Standards Quality and Outcomes Framework (QOF) Clinical Commissioning Group Outcomes Indicator Set (CCGOIS) Evidence for Health and Social Care Evidence resources British National Formulary (BNF) and British National Formulary for Children (BNFC). Medicines and prescribing support

Definition of Knowledge translation The concept of improving health Examples of what has been done ◦ What we have done ◦ What others have done (NICE) My impression Knowledge Translation for Improving Health

My impression