Knowledge translation strategies to improve the use of evidence in public health decision making in local government: intervention design and implementation plan

Background: Knowledge translation strategies are an approach to increase the use of evidence within policy and practice decision-making contexts. In clinical and health service contexts, knowledge translation strategies have focused on individual behavior change, however the multi-system context of public health requires a multi-level, multi-strategy approach. This paper describes the design of and implementation plan for a knowledge translation intervention for public health decision making in local government. Methods: Four preliminary research studies contributed findings to the design of the intervention: a systematic review of knowledge translation intervention effectiveness research, a scoping study of knowledge translation perspectives and relevant theory literature, a survey of the local government public health workforce, and a study of the use of evidence-informed decision-making for public health in local government. A logic model was then developed to represent the putative pathways between intervention inputs, processes, and outcomes operating between individual-, organizational-, and system-level strategies. This formed the basis of the intervention plan. Results: The systematic and scoping reviews identified that effective and promising strategies to increase access to research evidence require an integrated intervention of skill development, access to a knowledge broker, resources and tools for evidence-informed decision making, and networking for information sharing. Interviews and survey analysis suggested that the intervention needs to operate at individual and organizational levels, comprising workforce development, access to evidence, and regular contact with a knowledge broker to increase access to intervention evidence; develop skills in appraisal and integration of evidence; strengthen networks; and explore organizational factors to build organizational cultures receptive to embedding evidence in practice. The logic model incorporated these inputs and strategies with a set of outcomes to measure the intervention’s effectiveness based on the theoretical frameworks, evaluation studies, and decision-maker experiences. Conclusion: Documenting the design of and implementation plan for this knowledge translation intervention provides a transparent, theoretical, and practical approach to a complex intervention. It provides significant insights into how practitioners might engage with evidence in public health decision making. While this intervention model was designed for the local government context, it is likely to be applicable and generalizable across sectors and settings. (Continued on next page) * Correspondence: armr@unimelb.edu.au Jack Brockhoff Child Health and Wellbeing Program, McCaughey VicHealth CentreMelbourne School of Population and Global Health, University of Melbourne, Level 5/207 Bouverie Street, Carlton, Victoria, Australia Full list of author information is available at the end of the article Implementation Science © 2013 Armstrong et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Armstrong et al. Implementation Science 2013, 8:121 http://www.implementationscience.com/content/8/1/121

[1]  J. Higgins,et al.  Cochrane Handbook for Systematic Reviews of Interventions , 2010, International Coaching Psychology Review.

[2]  Martin O'Flaherty,et al.  The Use of Research Evidence in Public Health Decision Making Processes: Systematic Review , 2011, PloS one.

[3]  R. Armstrong,et al.  Knowledge translation strategies for facilitating evidence‐informed public health decision making among managers and policy‐makers , 2011 .

[4]  Rebecca Armstrong,et al.  Using logic models to capture complexity in systematic reviews , 2011, Research synthesis methods.

[5]  Boyd Swinburn,et al.  An exploratory cluster randomised controlled trial of knowledge translation strategies to support evidence-informed decision-making in local governments (The KT4LG study) , 2011, BMC public health.

[6]  Maureen Dobbins,et al.  A knowledge management tool for public health: health-evidence.ca , 2010, BMC public health.

[7]  Michael G. Wilson,et al.  SUPPORT Tools for evidence-informed health Policymaking (STP) 4: Using research evidence to clarify a problem. , 2009, Health research policy and systems.

[8]  J. Dearing Applying Diffusion of Innovation Theory to Intervention Development , 2009, Research on social work practice.

[9]  B. Swinburn,et al.  Australia and New Zealand Health Policy Open Access Moving beyond 'rates, Roads and Rubbish': How Do Local Governments Make Choices about Healthy Public Policy to Prevent Obesity? , 2022 .

[10]  R. Brownson,et al.  Examining the Role of Training in Evidence-Based Public Health: A Qualitative Study , 2009, Health promotion practice.

[11]  Alan Shiell,et al.  Theorising Interventions as Events in Systems , 2009, American journal of community psychology.

[12]  L. Green,et al.  Diffusion Theory and Knowledge Dissemination, Utilization, and Integration in Public Health , 2009, Annual review of public health.

[13]  Sarah Bowen,et al.  More than "using research": the real challenges in promoting evidence-informed decision-making. , 2009, Healthcare policy = Politiques de sante.

[14]  J. Eldredge,et al.  The effect of training on question formulation among public health practitioners: results from a randomized controlled trial. , 2008, Journal of the Medical Library Association : JMLA.

[15]  M. Petticrew,et al.  "We're not short of people telling us what the problems are. We're short of people telling us what to do": An appraisal of public policy and mental health , 2008, BMC public health.

[16]  Jennifer Duffy,et al.  Bridging the Gap Between Prevention Research and Practice: The Interactive Systems Framework for Dissemination and Implementation , 2008, American journal of community psychology.

[17]  Elizabeth Waters,et al.  Improving the reporting of public health intervention research: advancing TREND and CONSORT. , 2008, Journal of public health.

[18]  France Légaré,et al.  Health research funding agencies' support and promotion of knowledge translation: an international study. , 2008, The Milbank quarterly.

[19]  Daniela C. Schröter,et al.  Logic Modeling Methods in Program Evaluation , 2008, Journal of MultiDisciplinary Evaluation.

[20]  K. Hofman,et al.  Implementation Science , 2007, Science.

[21]  C. Adair,et al.  Knowledge transfer and exchange: review and synthesis of the literature. , 2007, The Milbank quarterly.

[22]  Vivek Goel,et al.  The impact of context on evidence utilization: a framework for expert groups developing health policy recommendations. , 2006, Social science & medicine.

[23]  A. Zwi,et al.  Pathways to “Evidence-Informed” Policy and Practice: A Framework for Action , 2005, PLoS medicine.

[24]  I. Chalmers If evidence-informed policy works in practice, does it matter if it doesn't work in theory? , 2005 .

[25]  Jennifer G. Robinson,et al.  Evidence-based public health: an evolving concept. , 2004, American journal of preventive medicine.

[26]  H. Graham,et al.  Evidence for public health policy on inequalities: 1: The reality according to policymakers , 2004, Journal of Epidemiology and Community Health.

[27]  Nabil Amara,et al.  New Evidence on Instrumental, Conceptual, and Symbolic Utilization of University Research in Government Agencies , 2004 .

[28]  A. Haines,et al.  Informed choices for attaining the Millennium Development Goals: towards an international cooperative agenda for health-systems research , 2004, The Lancet.

[29]  Allan Best,et al.  Health promotion dissemination and systems thinking: towards an integrative model. , 2003, American journal of health behavior.

[30]  Iain Chalmers,et al.  Trying to do more Good than Harm in Policy and Practice: The Role of Rigorous, Transparent, Up-to-Date Evaluations , 2003 .

[31]  M. Drummond,et al.  USING EVIDENCE IN THE DEVELOPMENT OF LOCAL HEALTH POLICIES , 2002, International Journal of Technology Assessment in Health Care.

[32]  A. Oxman,et al.  Health policy-makers' perceptions of their use of evidence: a systematic review , 2002, Journal of health services research & policy.

[33]  John N Lavis,et al.  Examining the role of health services research in public policymaking. , 2002, The Milbank quarterly.

[34]  Jeremy M. Grimshaw,et al.  Changing Provider Behavior: An Overview of Systematic Reviews of Interventions , 2001, Medical care.

[35]  Annie Millar,et al.  Logic models: a systems tool for performance management , 2001 .

[36]  M. Petticrew,et al.  Good intentions and received wisdom are not enough , 2000, Journal of epidemiology and community health.

[37]  Jennie Popay,et al.  How are policy makers using evidence? Models of research utilisation and local NHS policy making , 2000, Journal of epidemiology and community health.

[38]  C. Estabrooks The conceptual structure of research utilization. , 1999, Research in nursing & health.

[39]  L. Bickman The functions of program theory , 1987 .

[40]  C. Weiss The many meanings of research utilization. , 1979 .

[41]  E. Rogers,et al.  Diffusion of innovations , 1964, Encyclopedia of Sport Management.

[42]  R. Armstrong Evidence-informed public health decision-making in local government , 2011 .

[43]  D. Oxman Support tools for evidence-informed health Policymaking (STP) 17:Dealing with insufficient research evidence , 2010 .

[44]  Roy Cameron,et al.  A description of a knowledge broker role implemented as part of a randomized controlled trial evaluating three knowledge translation strategies , 2009 .

[45]  R. Brownson,et al.  Evidence-based public health: a fundamental concept for public health practice. , 2009, Annual review of public health.

[46]  S. Benita,et al.  Analysis for Policy: Evidence-Based Policy in Practice , 2007 .

[47]  S. Nutley,et al.  Evidence-into-Practice Agenda From Knowing to Doing : A Framework for Understanding the , 2003 .

[48]  Martin J Buxton,et al.  The utilisation of health research in policy-making : concepts , examples and methods of assessment , 2003 .

[49]  野中 郁次郎,et al.  The Knowledge-Creating Company: How , 1995 .

[50]  A. Kothari,et al.  Implementation Science Is Research Working for You? Validating a Tool to Examine the Capacity of Health Organizations to Use Research , 2022 .

[51]  Shawna L. Mercer,et al.  A randomized controlled trial evaluating the impact of knowledge translation and exchange strategies , 2009, Implementation science : IS.