Impact of an organization-wide knowledge translation strategy to support evidence-informed public health decision making

Maureen Dobbins,Reza Yousefi-Nooraie,Robyn L Traynor,Stephanie Workentine,Jennifer Yost

doi:10.1186/s12889-018-6317-5

Abstract

BackgroundThe public health sector is moving toward adopting evidence-informed decision making into practice, but effort is still required to effectively develop capacity and promote contextual factors that advance and sustain it. This paper describes the impact of an organization-wide knowledge translation intervention delivered by knowledge brokers on evidence-informed decision making knowledge, skills and behaviour.MethodsA case study design was implemented with the intervention and data collection tailored to the unique needs of each case (health department). A knowledge broker provided training workshops and mentored small groups through a seven step process of evidence-informed decision making. The intervention was delivered over 22 months; data related to evidence-informed decision making knowledge, skills and behaviour were collected at baseline and follow-up. Mixed effects regression models were developed to assess the impact of involvement in the intervention on the evidence-informed decision making outcomes.ResultsData from a total of 606 health department staff were collected during baseline: 207 (33%) staff from Case A, 304 (28%) from Case B, and 95 (47%) from Case C. There were a total of 804 participants at follow-up: 258 (42%) from Case A, 391 from Case B (37%), and 155 (50%) from Case C. Statistically significant increases in knowledge and skills were observed overall, and in all three health departments. An increase in evidence-informed decision making behaviour was observed among those intensively involved in the intervention from all cases (statistically significant in Case A). The organizational characteristics of strategic priority, leadership, readiness, and choice of staff emerged as important factors in the change process.ConclusionsKnowledge brokering is a promising organizational knowledge translation intervention to support evidence-informed decision making. The intervention appeared to have the greatest impact on those who became actively engaged with the knowledge broker in the intervention. Active participation in face-to-face training activities with a knowledge broker, focused specifically on evidence-informed decision making skill development, led to the greatest impact on associated behaviours, knowledge, and skills. Several organizational factors emerged as integral to success of the knowledge translation intervention.

Highlights

The public health sector is moving toward adopting evidence-informed decision making into practice, but effort is still required to effectively develop capacity and promote contextual factors that advance and sustain it
Staff from all divisions were encouraged to participate in the study and the number of eligible staff remained constant throughout the study
The purpose of this study was to evaluate the impact of a knowledge translation (KT) intervention delivered by knowledge brokers (KB) on Evidenceinformed decision making (EIDM) knowledge, skills and behaviour among public health professionals working in three public health departments in Ontario, Canada

Summary

Introduction

The public health sector is moving toward adopting evidence-informed decision making into practice, but effort is still required to effectively develop capacity and promote contextual factors that advance and sustain it. While the expectation to engage in and demonstrate EIDM exists, public health professionals and organizations require support to acquire the necessary knowledge, skills, infrastructure, and context for EIDM. Key challenges include: limited time; demanding workloads; competing priorities; emerging crises; limited capacity for searching, appraising, and applying research evidence; limited knowledge management skills and infrastructure; resistance to change; unsupportive organizational culture and leadership; the political context of decision making; and the ever-expanding evidence base [2, 11,12,13,14,15,16,17]. With many identified barriers to EIDM, there is a need to identify effective and sustainable knowledge translation (KT) strategies to enhance the capacity for public health organizations and workforce to operate in an evidence-informed way [2, 12, 14, 18]

Objectives

Methods

Results

Discussion

Conclusion