Browsing by Author "Esmail, Rosmin"

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    A scoping review of full-spectrum knowledge translation theories, models, and frameworks
    (2020-02-14) Esmail, Rosmin; Hanson, Heather M; Holroyd-Leduc, Jayna; Brown, Sage; Strifler, Lisa; Straus, Sharon E; Niven, Daniel J; Clement, Fiona M
    Abstract Background Application of knowledge translation (KT) theories, models, and frameworks (TMFs) is one method for successfully incorporating evidence into clinical care. However, there are multiple KT TMFs and little guidance on which to select. This study sought to identify and describe available full-spectrum KT TMFs to subsequently guide users. Methods A scoping review was completed. Articles were identified through searches within electronic databases, previous reviews, grey literature, and consultation with KT experts. Search terms included combinations of KT terms and theory-related terms. Included citations had to describe full-spectrum KT TMFs that had been applied or tested. Titles/abstracts and full-text articles were screened independently by two investigators. Each KT TMF was described by its characteristics including name, context, key components, how it was used, primary target audience, levels of use, and study outcomes. Each KT TMF was also categorized into theoretical approaches as process models, determinant frameworks, classic theories, implementation theories, and evaluation frameworks. Within each category, KT TMFs were compared and contrasted to identify similarities and unique characteristics. Results Electronic searches yielded 7160 citations. Additional citations were identified from previous reviews (n = 41) and bibliographies of included full-text articles (n = 6). Thirty-six citations describing 36 full-spectrum were identified. In 24 KT TMFs, the primary target audience was multi-level including patients/public, professionals, organizational, and financial/regulatory. The majority of the KT TMFs were used within public health, followed by research (organizational, translation, health), or in multiple contexts. Twenty-six could be used at the individual, organization, or policy levels, five at the individual/organization levels, three at the individual level only, and two at the organizational/policy level. Categorization of the KT TMFs resulted in 18 process models, eight classic theories, three determinant frameworks, three evaluation frameworks, and four that fit more than one category. There were no KT TMFs that fit the implementation theory category. Within each category, similarities and unique characteristics emerged through comparison. Conclusions A systematic compilation of existing full-spectrum KT TMFs, categorization into different approaches, and comparison has been provided in a user-friendly way. This list provides options for users to select from when designing KT projects and interventions. Trial registration A protocol outlining the methodology of this scoping review was developed and registered with PROSPERO (CRD42018088564).
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    Characteristics of knowledge translation theories, models and frameworks for health technology reassessment: expert perspectives through a qualitative exploration
    (2021-04-29) Esmail, Rosmin; Clement, Fiona M; Holroyd-Leduc, Jayna; Niven, Daniel J; Hanson, Heather M
    Abstract Background Health Technology Reassessment (HTR) is a process that systematically assesses technologies that are currently used in the health care system. The process results in four outputs: increase use or decrease use, no change, or de-adoption of a technology. Implementation of these outputs remains a challenge. The Knowledge Translation (KT) field enables to transfer/translate knowledge into practice. KT could help with implementation of HTR outputs. This study sought to identify which characteristics of KT theories, models, and frameworks could be useful, specifically for decreased use or de-adoption of a technology. Methods A qualitative descriptive approach was used to ascertain the perspectives of international KT and HTR experts on the characteristics of KT theories, models, and frameworks for decreased use or de-adoption of a technology. One-to-one semi-structured interviews were conducted from September to December 2019. Interviews were audio recorded and transcribed verbatim. Themes and sub-themes were deduced from the data through framework analysis using five distinctive steps: familiarization, identifying an analytic framework, indexing, charting, mapping and interpretation. Themes and sub-themes were also mapped to existing KT theories, models, and frameworks. Results Thirteen experts from Canada, United States, United Kingdom, Australia, Germany, Spain, and Sweden participated in the study. Three themes emerged that illustrated the ideal traits: principles that were foundational for HTR, levers of change, and steps for knowledge to action. Principles included evidence-based, high usability, patient-centered, and ability to apply to the micro, meso, macro levels. Levers of change were characterized as positive, neutral, or negative influences for changing behaviour for HTR. Steps for knowledge to action included: build the case for HTR, adapt research knowledge, assess context, select interventions, and assess impact. Of the KT theories, models, and frameworks that were mapped, the Consolidated Framework for Implementation Research had most of the characteristics, except ability to apply to micro, meso, macro levels. Conclusions Characteristics that need to be considered within a KT theory, model, and framework for implementing HTR outputs have been identified. Consideration of these characteristics may guide users to select relevant KT theories, models, and frameworks to apply to HTR projects.
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    Classification schemes for knowledge translation interventions: a practical resource for researchers
    (2017-12-06) Slaughter, Susan E; Zimmermann, Gabrielle L; Nuspl, Megan; Hanson, Heather M; Albrecht, Lauren; Esmail, Rosmin; Sauro, Khara; Newton, Amanda S; Donald, Maoliosa; Dyson, Michele P; Thomson, Denise; Hartling, Lisa
    Abstract Background As implementation science advances, the number of interventions to promote the translation of evidence into healthcare, health systems, or health policy is growing. Accordingly, classification schemes for these knowledge translation (KT) interventions have emerged. A recent scoping review identified 51 classification schemes of KT interventions to integrate evidence into healthcare practice; however, the review did not evaluate the quality of the classification schemes or provide detailed information to assist researchers in selecting a scheme for their context and purpose. This study aimed to further examine and assess the quality of these classification schemes of KT interventions, and provide information to aid researchers when selecting a classification scheme. Methods We abstracted the following information from each of the original 51 classification scheme articles: authors’ objectives; purpose of the scheme and field of application; socioecologic level (individual, organizational, community, system); adaptability (broad versus specific); target group (patients, providers, policy-makers), intent (policy, education, practice), and purpose (dissemination versus implementation). Two reviewers independently evaluated the methodological quality of the development of each classification scheme using an adapted version of the AGREE II tool. Based on these assessments, two independent reviewers reached consensus about whether to recommend each scheme for researcher use, or not. Results Of the 51 original classification schemes, we excluded seven that were not specific classification schemes, not accessible or duplicates. Of the remaining 44 classification schemes, nine were not recommended. Of the 35 recommended classification schemes, ten focused on behaviour change and six focused on population health. Many schemes (n = 29) addressed practice considerations. Fewer schemes addressed educational or policy objectives. Twenty-five classification schemes had broad applicability, six were specific, and four had elements of both. Twenty-three schemes targeted health providers, nine targeted both patients and providers and one targeted policy-makers. Most classification schemes were intended for implementation rather than dissemination. Conclusions Thirty-five classification schemes of KT interventions were developed and reported with sufficient rigour to be recommended for use by researchers interested in KT in healthcare. Our additional categorization and quality analysis will aid in selecting suitable classification schemes for research initiatives in the field of implementation science.
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    Knowledge translation and health technology reassessment: identifying synergy
    (2018-08-30) Esmail, Rosmin; Hanson, Heather; Holroyd-Leduc, Jayna; Niven, Daniel J; Clement, Fiona
    Abstract Background Health Technology Reassessment (HTR) is an emerging field that shifts the focus from traditional methods of technology adoption to managing technology throughout its lifecycle. HTR is a mechanism to improve patient care and system efficiency through a reallocation of resources away from low-value care towards interventions and technologies that are high value. To achieve this, the outputs of HTR and its recommendations must be translated into practice. The evolving field of knowledge translation (KT) can provide guidance to improve the uptake of evidence-informed policies and recommendations resulting from the process of HTR. This paper argues how the theories, models and frameworks from KT could advance the HTR process. Discussion First, common KT theories, models and frameworks are presented. Second, facilitators and barriers to KT within the context of HTR are summarized from the literature. Facilitators and barriers to KT include ensuring a solid research evidence-base for the technology under reassessment, assessing the climate and context, understanding the social an political context, initiating linkage and exchange, having a structured HTR Process, adequate resources, and understanding the roles of researchers, knowledge users, and stakeholders can enhance knowledge translation of HTR outputs. Third, three case examples at the individual (micro), organizational (meso), and policy (macro) levels are used to illustrate to describe how a KT theory, model or framework could be applied to a HTR project. These case studies show how selecting and applying KT theories, models and frameworks can facilitate the implementation of HTR recommendations. Conclusion HTR and KT are synergistic processes that can be used to optimize technology use throughout its lifecycle. We argue that the application of KT theories, models and frameworks, and the assessment of barriers and facilitators to KT can facilitate translation of HTR recommendations into practice.
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    Response to letter to the editor
    (2020-07-02) Esmail, Rosmin; Hanson, Heather M; Holroyd-Leduc, Jayna; Brown, Sage; Strifler, Lisa; Straus, Sharon E; Niven, Daniel J; Clement, Fiona M
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    Understanding the Relationship Between Health Technology Reassessment and Knowledge Translation
    (2020-10-18) Esmail, Rosmin; Clement, Fiona M.; Hanson, Heather M.; Holroyd-Leduc, Jayna M.; Niven, Daniel J.
    Until now, it was not well understood how the field of Knowledge Translation (KT) would be applicable to Health Technology Reassessment (HTR). This thesis reports on three studies to determine how KT approaches are used to translate HTR outputs to achieve the desired outcomes. The first study was a scoping review of full-spectrum (phases of planning/design, evaluation, implementation, sustainability/scalability) KT Theories, Models, Frameworks (KT TMFs). Thirty-six KT TMFs were identified and categorized according to five approaches: process models, determinant frameworks, classic theories, implementation theories, and evaluation frameworks. It provided a starting point for the selection of KT TMFs for HTR. The second study employed a modified Delphi process and expert survey to review the 36 full-spectrum KT TMFs and determined which may be suitable for HTR. The three-round modified Delphi process resulted in 16 KT TMFs. Twenty-two international experts (11 KT and 11 HTR) were surveyed. None of the 16 KT TMFs reached ≥ 70% agreement when ratings of “yes” were considered. However when ratings of “yes” and “partially yes” were combined, the Consolidated Framework for Implementation Research (CFIR) was considered the most suitable by both KT and HTR experts (86%). One additional KT TMF was selected by KT experts: the Knowledge-to-Action framework. HTR experts selected two additional KT TMFs: the co-KT framework and the Plan-Do-Study-Act cycle. The third study involved 13 one-to-one semi-structured interviews on characteristics of KT TMFs that were important to consider for the HTR outputs of decreased use or de-adoption of a technology. Four foundational principles, three levers of change, and five steps for knowledge to action emerged as KT TMF traits for HTR. From the KT TMFs that were mapped onto the characteristics, CFIR had the most characteristics (11/12) missing only the ability to map to the micro, meso, macro levels. This is the first body of work that examines the relationship between HTR and KT. The findings offer guidance to users on the application of KT TMFs to the HTR process and implementation of its outputs. Practical use of these KT TMFs to the HTR process will provide further advancement in this area.