Using the Knowledge to Action Framework in practice: a citation analysis and systematic review.

Becky Field,Andrew Booth,Irene Ilott,Kate Gerrish

doi:10.1186/s13012-014-0172-2

Abstract

BackgroundConceptual frameworks are recommended as a way of applying theory to enhance implementation efforts. The Knowledge to Action (KTA) Framework was developed in Canada by Graham and colleagues in the 2000s, following a review of 31 planned action theories. The framework has two components: Knowledge Creation and an Action Cycle, each of which comprises multiple phases. This review sought to answer two questions: ‘Is the KTA Framework used in practice? And if so, how?’MethodsThis study is a citation analysis and systematic review. The index citation for the original paper was identified on three databases—Web of Science, Scopus and Google Scholar—with the facility for citation searching. Limitations of English language and year of publication 2006-June 2013 were set. A taxonomy categorising the continuum of usage was developed. Only studies applying the framework to implementation projects were included. Data were extracted and mapped against each phase of the framework for studies where it was integral to the implementation project.ResultsThe citation search yielded 1,787 records. A total of 1,057 titles and abstracts were screened. One hundred and forty-six studies described usage to varying degrees, ranging from referenced to integrated. In ten studies, the KTA Framework was integral to the design, delivery and evaluation of the implementation activities. All ten described using the Action Cycle and seven referred to Knowledge Creation. The KTA Framework was enacted in different health care and academic settings with projects targeted at patients, the public, and nursing and allied health professionals.ConclusionsThe KTA Framework is being used in practice with varying degrees of completeness. It is frequently cited, with usage ranging from simple attribution via a reference, through informing planning, to making an intellectual contribution. When the framework was integral to knowledge translation, it guided action in idiosyncratic ways and there was theory fidelity. Prevailing wisdom encourages the use of theories, models and conceptual frameworks, yet their application is less evident in practice. This may be an artefact of reporting, indicating that prospective, primary research is needed to explore the real value of the KTA Framework and similar tools.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-014-0172-2) contains supplementary material, which is available to authorized users.

Highlights

Conceptual frameworks are recommended as a way of applying theory to enhance implementation efforts
Several conceptual frameworks are pertinent for implementation scientists, including Promoting Action on Research Implementation in Health Services (PARIHS) [5,10] the Consolidated Framework for Implementation Research (CFIR) [3] as well as the Knowledge to Action (KTA) Framework [1]
We focused on the application of, and theory fidelity to, the KTA Framework

Summary

Introduction

Conceptual frameworks are recommended as a way of applying theory to enhance implementation efforts. Health professionals across the globe share the challenges of translating the best available evidence into actual health interventions in a timely way to provide the most effective care and service. The Knowledge to Action Framework [1] (‘the KTA Framework’) is a conceptual framework intended to help those concerned with knowledge translation deliver sustainable, evidence-based interventions. Conceptual frameworks are recommended as a way of preparing for the multiple, dynamic and interactive factors that influence the uptake of evidence in practice [3,4,5]. Potential benefits from applying a conceptual framework include making the process of knowledge translation more systematic, with greater likelihood of changed practice and spread of evidence [4,6,7,8,9]. Several conceptual frameworks are pertinent for implementation scientists, including Promoting Action on Research Implementation in Health Services (PARIHS) [5,10] the Consolidated Framework for Implementation Research (CFIR) [3] as well as the KTA Framework [1]

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