Abstract
Development or synthesis of the best clinical research is in itself insufficient to change practice. Knowledge translation (KT) is an emerging field focused on moving knowledge into practice, which is a non-linear, dynamic process that involves knowledge synthesis, transfer, adoption, implementation, and sustained use. Successful implementation requires using KT strategies based on theory, evidence, and best practice, including tools and processes that engage knowledge developers and knowledge users. Tools can provide instrumental help in implementing evidence. A variety of theoretical frameworks underlie KT and provide guidance on how tools should be developed or implemented. A taxonomy that outlines different purposes for engaging in KT and target audiences can also be useful in developing or implementing tools. Theoretical frameworks that underlie KT typically take different perspectives on KT with differential focus on the characteristics of the knowledge, knowledge users, context/environment, or the cognitive and social processes that are involved in change. Knowledge users include consumers, clinicians, and policymakers. A variety of KT tools have supporting evidence, including: clinical practice guidelines, patient decision aids, and evidence summaries or toolkits. Exemplars are provided of two KT tools to implement best practice in management of neck pain—a clinician implementation guide (toolkit) and a patient decision aid. KT frameworks, taxonomies, clinical expertise, and evidence must be integrated to develop clinical tools that implement best evidence in the management of neck pain.
Highlights
Evidence-based practice [1, 2] is conducted through five steps: defining a clinical question, finding the evidence that addresses that issue, determining the quality of evidence, making an evidence-based decision by calibrating the best evidence with patient values and clinical experience, and evaluating the outcomes
We provide a taxonomy of Knowledge translation (KT) interventions that can be used to classify existing tools or develop a KT strategy, and highlight examples of KT tools that can be used to implement neck pain evidence into practice
The Cervical Overview Group (COG) has observed the rapid increase in availability of randomized controlled trial (RCT) evidence over the course of their systematic reviews, having retrieved 24 RCTs in 1996; 88 by 2006; and 351 by 2011. This is further highlighted by our overview methods paper where we identified 202 systematic reviews and 57 clinical practice guidelines (CPGs) that form the evidence informing management of neck pain [21]
Summary
Evidence-based practice [1, 2] is conducted through five steps: defining a clinical question, finding the evidence that addresses that issue, determining the quality of evidence, making an evidence-based decision by calibrating the best evidence with patient values and clinical experience, and evaluating the outcomes. The purposes of this paper is to review issues relevant to moving neck pain evidence into practice by considering: the gap between knowledge and action, the theoretical underpinnings that can be used to develop new KT tools or interventions, and evidence supporting specific KT tools. We provide a taxonomy of KT interventions that can be used to classify existing tools or develop a KT strategy, and highlight examples of KT tools that can be used to implement neck pain evidence into practice.
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