Know-do Gap Research Articles

Protocol for a mixed-methods study to explore implementation outcomes of the Phone-based Interventions under Nurse Guidance after Stroke (PINGS-II) across 10 hospitals in Ghana

BackgroundStroke survivors are at a substantially higher risk for adverse vascular events driven partly by poorly controlled vascular risk factors. Mobile health interventions supported by task shifting strategies have been...

Task-shifting of prolonged exposure for primary care (PE-PC) for PTSD in a semirural setting in South Africa: A pilot implementation study.

Implementation science (IS) has received increased attention as it provides a means to bridge the know-do gap to implement evidence-based interventions in real-world settings. Against this backdrop, posttraumatic stress disorder (PTSD) is a global mental health concern (Koenen et al., 2017), especially in low- and middle-income countries characterized by limited trained health professionals, infrastructure, and limited access to evidence-based mental health care (Chen et al., 2017). Over the last 3 decades, effective trauma-focused psychotherapies (TFPs) for PTSD have been developed (Hamblen et al., 2019). Prolonged exposure therapy (PE) is a first-line TFP for PTSD (Hamblen et al., 2019), yet the dissemination and implementation of PE have been limited to specialty care settings in developed or industrialized countries (Booysen & Kagee, 2020). Implementation science provides an opportunity for disseminating and implementing TFPs like PE in low- and middle-income countries. This article describes mixed-method data from a pilot implementation study of an abbreviated version of PE, known as prolonged exposure for primary care (S. A. M. Rauch, Kim, et al., 2023), in a semirural city in the Eastern Cape of South Africa. Importantly, prolonged exposure for primary care shows a significant reduction in PTSD when provided by lay counselors and good feasibility and acceptability. In addition, we reflect on the barriers and facilitators related to implementation research within a low-resourced community, namely, (a) training lay counselors, (b) cultural diversity, and (c) mental health literacy. Mental health literacy is proposed as an essential component to consider in implementation science, especially in low-resourced communities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

How to assess conditions for the acceptance of climate change adaptation measures by applying implementation probability Bayesian Networks in participatory processes

Climate change adaptation measures are best identified participatorily, yet their implementation poses challenges. While Bayesian Network (BN) modeling has been widely used to assess how adaptation measures mitigate risks, we present how to develop, in a participatory process, an innovative BN type that quantifies the implementation probability of adaptation measures by considering conditions for actors’ acceptance as well as cultural worldviews. The BN structure was derived from participatorily identified causal networks, while the conditional probability tables were straightforwardly developed with stakeholder-assigned weights. Sensitivity analysis shows how BN structure and parameters influence the BN results. We found that our approach achieves knowledge integration and learning without overwhelming stakeholders with technical details. As BNs enable exploring scenarios, stakeholders learn that many plausible futures exist. Integrating our approach in participatory adaptation processes contributes to identifying the best combinations of implementation actions, reducing the “know-do gap” in local adaptation challenges.

Understanding international, practice-based, stakeholder perspectives on implementation of complex suicide prevention interventions: A qualitative exploration.

Complex interventions combining multiple evidence-based strategies have gained substantial traction in suicide prevention across the world. However, implementing these interventions in real-life settings is fraught with several challenges, significant resource demands, and evidence on the merits of implementing complex interventions remains a topic of debate. This study explores the real-world experiences of implementing complex interventions, including challenges, lessons learned, and the way forward. Sixteen participants (nine leaders, five implementors, and two lived experience advocates) from varied professional backgrounds and experiences were purposively recruited from six high-income countries and one low- and middle-income country. Participants were encouraged to reflect on their experiences of implementing complex suicide prevention interventions in their specific country contexts. Thematic analysis was conducted to identify, organize, and offer real-world insights into challenges, lessons learned, and what is needed as the way forward. Important themes related to challenges and lessons learned emerged: (a) stakeholder characteristics, engagement, and dynamics; (b) resources such as funding priorities and capacity; (c) contextual factors including larger sociocultural beliefs, policies, and legislation surrounding suicide and its prevention; (d) nature of lived experience engagement; (e) design and approach to interventions; (f) delivery of interventions; and (g) the scope of evaluation. The study yielded important insights into practice recommendations related to the implementation of complex suicide prevention interventions on the ground. Important pathways for designing interventions, collaboration, and stakeholder engagement for future implementation efforts were discussed. These real-life experiences and lessons learned from international experts are critical in understanding and bridging the know-do gap. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Implementation research: an approach to overcoming the know-do gap

Implementation research: an approach to overcoming the know-do gap

Implementation of Obesity Science Into Clinical Practice: A Scientific Statement From the American Heart Association.

Obesity is a recognized public health epidemic with a prevalence that continues to increase dramatically in nearly all populations, impeding progress in reducing incidence rates of cardiovascular disease. Over the past decade, obesity science has evolved to improve knowledge of its multifactorial causes, identifying important biological causes and sociological determinants of obesity. Treatments for obesity have also continued to develop, with more evidence-based programs for lifestyle modification, new pharmacotherapies, and robust data to support bariatric surgery. Despite these advancements, there continues to be a substantial gap between the scientific evidence and the implementation of research into clinical practice for effective obesity management. Addressing barriers to obesity science implementation requires adopting feasible methodologies and targeting multiple levels (eg, clinician, community, system, policy) to facilitate the delivery of obesity-targeted therapies and maximize the effectiveness of guideline-driven care to at-need patient populations. This scientific statement (1) describes strategies shown to be effective or promising for enhancing translation and clinical application of obesity-based research; (2) identifies key gaps in the implementation of obesity science into clinical practice; and (3) provides guidance and resources for health care professionals, health care systems, and other stakeholders to promote broader implementation and uptake of obesity science for improved population-level obesity management. In addition, advances in implementation science that hold promise to bridge the know-do gap in obesity prevention and treatment are discussed. Last, this scientific statement highlights implications for health research policy and future research to improve patient care models and optimize the delivery and sustainability of equitable obesity-related care.

Implementation of Interprofessional Pharmaceutical Care Initiatives: Lessons Learned from Successful Bottom-Up Initiatives in Primary Care.

Although there is evidence that interprofessional, person-centred, integrated care is important for optimising pharmaceutical care of older people with polypharmacy, this way of working is often not implemented in practice. The aim of this study was to identify common characteristics of successful interprofessional initiatives and factors influencing their implementation, in order to close this know-do gap. A qualitative, explorative design with in-depth semi-structured interviews was used. Flemish primary healthcare professionals (HCPs) and patients aged over 75, involved in successful initiatives of interprofessional pharmaceutical care for older people with polypharmacy, were included. Inductive analysis was conducted to identify main topics. Fifteen HCPs and four patients, involved in nine interprofessional initiatives, were interviewed. In all initiatives the HCPs had interprofessional consultations about older people with polypharmacy. The interaction between the characteristics of the initiatives and the context had an important impact on the implementation. These context factors were positioned under the micro-, meso- and macro context. Implementation strategies, actions to enhance the initiatives' adoption, corresponded with three themes: communication and influence, coordination by different stakeholders, and (dis)incentives. The identification of these success factors might inspire HCPs, providers of interprofessional education and policymakers to facilitate interprofessional pharmaceutical care.

What drives poor quality of care for child diarrhea? Experimental evidence from India.

Most health care providers in developing countries know that oral rehydration salts (ORS) are a lifesaving and inexpensive treatment for child diarrhea, yet few prescribe it. This know-do gap has puzzled experts for decades. Using randomized experiments in India, we estimated the extent to which ORS underprescription is driven by perceptions that patients do not want ORS, provider's financial incentives, and ORS stock-outs (out-of-stock events). Patients expressing a preference for ORS increased ORS prescribing by 27 percentage points. Eliminating stock-outs increased ORS provision by 7 percentage points. Removing financial incentives did not affect ORS prescribing on average but did increase ORS prescribing at pharmacies. We estimate that perceptions that patients do not want ORS explain 42% of underprescribing, whereas stock-outs and financial incentives explain only 6 and 5%, respectively.

Use of Knowledge Translation Action Framework to Improve Physical Therapy Rehabilitation Outcomes in Concussion Management.

Translating new evidence into clinical practice is a dynamic and iterative process. Research is ever evolving specific to concussion rehabilitation and requires a systematic approach rooted in science for translation into clinical practice. The knowledge-to-action (KTA) cycle framework is an effective strategy to ensure optimal outcomes and sustainability. The objective of this study was to investigate changes in clinical outcomes and clinician self-efficacy specific to concussion management in a suburban health care system utilizing the KTA framework. Pretraining and posttraining intervention study. Rehabilitation professionals were electronically surveyed pre-post targeted concussion educational intervention. Questions were adapted from the General Self-Efficacy scale and tailored specifically to confidence in current concussion management. Retrospective chart reviews were also completed pre-post knowledge translation educational intervention to examine practice patterns. Data from the presurvey and retrospective chart review were utilized to identify the know-do gap and design intentional educational interventions. Statistical analysis was performed utilizing SPSS (version 28). Within-group differences revealed an increase in confidence with evaluation (P = .01), intervention (P = .01), and consultation (P = .01) in concussion management. When comparing physical therapists who participated in the intervention with those who did not, there was significantly higher self-confidence in all areas (P ≤ .001) for those who engaged in the educational intervention. Pre-post chart reviews revealed improvement in clinical practice patterns in the following constructs: use of patient-reported outcome measures (P ≤ .001), objective outcome measures (P = .002), exertional testing (P ≤ .001), completion of comprehensive evaluation (P ≤ .001), and use of evidence-based practice (P ≤ .001). Utilizing the KTA framework resulted in improved self-efficacy of clinicians as well as improved clinical practice patterns in concussion management in an outpatient hospital-based practice. The KTA framework is a potential tool for translating current evidence related to concussion management for improved clinical outcomes.

Implementation of interprofessional pharmaceutical care initiatives: lessons learned from successful bottom-up initiatives in primary care

Background: Although there is evidence that interprofessional, person-centred, integrated care is important for optimising pharmaceutical care of older persons with polypharmacy, this way of working is often not implemented in practice. Identification and description of successful initiatives between physicians, pharmacists and nurses, their context and implementation strategies are important to close this know-do gap.
 Objective: The aim of this study was to identify common characteristics of successful interprofessional initiatives and factors influencing the implementation of these initiatives.
 Methods: A qualitative, explorative design with in-depth semi-structured interviews was used. Flemish primary healthcare professionals and patients aged over 75, involved in successful initiatives for interprofessional pharmaceutical care of older persons with polypharmacy, were included. Inductive analysis was conducted to identify main topics.
 Results: Several interprofessional initiatives, successfully implemented in primary healthcare, were explored. Fifteen healthcare professionals and four patients involved in these initiatives were interviewed. In all initiatives the healthcare professionals had interprofessional consultations about older persons with polypharmacy. Five common characteristics could be identified in these initiatives: a) bottom-up design with voluntary participation of healthcare professionals, b) team made decisions, c) the presence of a project coordinator d) consultation with older persons and e) the availability of supporting documents. The interaction between the characteristics of the initiatives and the context had an important impact on the implementation. These context factors were positioned under a) the micro context – including personal characteristics of healthcare professionals and interprofessional relations, b) the meso context - including a culture of cooperation, scale and available time, and c) the macro context, including the political context and ICT possibilities. Implementation strategies, actions to enhance the adoption of the initiatives, were identified and corresponded with three themes: communication and influence, coordination of different stakeholders, and incentives or disincentives.
 Discussion: Raising the visibility of these success stories will inspire healthcare professionals, providers of interprofessional education and policymakers to facilitate interprofessional pharmaceutical care. Since patients seemed to have limited interest in collaboration strategies of their healthcare professionals, more in-depth research to explore patients’ expectations is suggested.

ADVANCING ADOPTION AND SUSTAINABILITY OF AGE-FRIENDLY INITIATIVES THROUGH SYNERGIES AND IMPLEMENTATION SCIENCE

Abstract For communities interested in adopting age-friendly principles, the plethora of age-friendly initiatives (i.e., age-, disability-, and dementia-friendly cities and communities; age-friendly universities, health systems, and public health systems) can be overwhelming. For rural, frontier, underserved, and under-resourced communities, it can be challenging to consider tackling even one such initiative. A major barrier to implementation is the know-do gap between what is known and what gets accomplished in practice. This gap is widened as a result of overly complex models and practices that are difficult to disseminate and scale, difficult to reproduce, or do not apply across settings. The know-do gap can be effectively bridged by focusing on core features common across age-friendly ecosystem initiatives. To successfully advance this work, it is important to consider strategies to maximize the collective impact of age-friendly initiatives and explore opportunities to tailor these initiatives so they can be successfully adapted for and adopted by various settings, contexts, and populations. Using an implementation science approach, three models will be introduced (Strengths-Based Interprofessional Practice and Education (SB-IPE); Micro-, Meso-, Macro- M3: Aligning Your Nexus Through a Systems Lens; and Kennedy Model of Sustainability) to facilitate the adoption and sustainability of evidence-based age-friendly principles, programs, and policies.

Tribal gaps in Malaria in relation to KAP in East Godavari District, Andhra Pradesh

ABSTRACT Objectives: To assess the level of GAPS in knowledge, attitudes and practices among tribal people regarding malaria disease. To assess the interassociation among knowledge, attitude and practices of scores. Materials and Methods: A cross-sectional study was performed in tribal areas of East Godavari District for a period of one year during 2013. Sample size was calculated as 1136. Multistage Random sampling method was used to identify the 4 PHC’s in 4 directions of tribal areas and sample was equally distributed. In that study subjects were selected by using a simple Random method. Data were collected by using a pre-tested, semi-structured questionnaire and results were displayed. Setting: Tribal area of east Godavari district, Andhra Pradesh State, India Participants: Study subjects were selected by simple random method Results: Knowledge–practice gap for source of mosquito breeding 5.99%, for the prevention of mosquito breeding sources and for the implementation of minor engineering measures it is 10.51%. For bush cutting, the knowledge practice gap is -20.07%. For potted plants, the knowledge practice gap is -8.45%. For broken pots, it is 68.93%. IRS is performed outside the house not inside the house. The KAP-GAP for screening is nil. Covering oneself with a blanket to prevent man–mosquito contact is 6.96%. Conclusions: In our study, we found Know-do gap or KAP-GAP in all aspects of prevention of mosquito breeding places and personal protective measures. Regarding the interassociation among knowledge, attitudes and practices, they were associated with each other with significant difference.

Know-do gap for sick child care and drivers of knowledge and practice among health extension workers in four regions of Ethiopia: a cross-sectional study

ObjectiveThough efforts were made to expand community-based sick child healthcare in Ethiopia, the quality of care provided remained low. Improving quality of care requires understanding providers’ knowledge of appropriate care...

Assessing Use, Usefulness, and Application of the High Impact Practices in Family Planning Briefs and Strategic Planning Guides.

In global health, persistent barriers and challenges to bridging the gap between research and practice remain critical to address in most health areas. The High Impact Practices (HIPs) briefs and strategic planning guides aim to bridge the know-do gap in family planning (FP) by facilitating research utilization and knowledge sharing and also providing a summary of experiential knowledge from experts. The purpose of this qualitative study was to assess the use, usefulness, and application of these 2 knowledge products developed by the HIP Partnership for decision-makers and implementers in low- and middle-income countries (LMICs). This research used in-depth interviews with FP stakeholders from various LMICs to assess the use, usefulness, and application of 2 HIP products for FP decision-makers and implementers. The analysis was shaped by an adapted logic model framework to assess HIP product reach, engagement, usefulness, learning, and action. We interviewed 35 FP professionals from January to March 2021. Participants reported that HIP products have a wide reach, have garnered positive engagement, and were useful. Participants generally liked the current format of the HIP products and reported using them to inform program design, guide discussions with partners, enhance personal knowledge, support advocacy work, and strengthen the guidance they provide to colleagues in the field. The participants shared important feedback to improve the development and dissemination of HIP products, particularly a need to enhance local access and use. The study highlighted the importance of knowledge products, such as the HIP briefs and strategic planning guides, to make evidence and experiential knowledge accessible to a wide audience. These can be valuable tools for policymakers and program implementers to ensure public health practices are evidence-based and integrate experiential knowledge.

Approaches to monitoring and evaluation of knowledge translation platforms in low- and middle-income countries: A scoping review

Background: Knowledge Translation Platforms (KTP) attempt to bridge the "know-do gap" between researchers and policymakers. This study summarized the evidence on activities, as well as methods of monitoring and evaluation projects of KTPs in Low- and Middle-Income Countries (LMICs). Methods: The Arksey and O’Malley methodology for scoping reviews was used. The databases accessed include Medline, Global Health, CINAHL, EBSCO and Cochrane library databases. Only Studies that indicated range of activities, tools or methods used in monitoring and evaluating KTP to achieve the implementation of evidence informed policymaking in LMICs were included. The key words used includes Knowledge Translation, Monitoring and Evaluation, Platforms and Low- and Middle-Income countries. Results: Total of 3150 hits were obtained from the searched databases. 750 duplicates were identified and removed resulting to 2398 articles. Using title screening, 2123 articles were excluded resulting in 275 articles for abstract screening. Abstract screening led to exclusion 246 articles, leaving 29 articles for the full-text screening. Full-text screening resulted to exclusion of 25 articles resulting to 4 articles that meet the inclusion criteria. No relevant articles were obtained from the reference list screening and grey literature search. Conclusion: Evidence shows that Case study methodology is the predominate method of evaluating KTPs. The shortest time duration from generation to use of evidence in decision making was noticed to be 1-year. The range of activities used to monitor KTP in bridging the “know do gap” includes stakeholder’s engagement, building capacity, priority setting, meeting with stakeholders, generating policy brief, litmus testing of brief, stakeholders dialogue, evidence brief and dialogue review, disseminating of findings and implementation. The minimum and maximum number of activities performed in each KTP process is 5 and 8 activities respectively.

Prevalence of refractive error among Dongarias and use of Folding Phoropter (FoFo) as a field device enabling implementation research in this indigenous community. Tribal Odisha Eye Disease Study (TOES) Report # 13.

To evaluate the prevalence of uncorrected refractive error (URE) among Dongarias-a particularly vulnerable tribal group in Rayagada, Odisha, India and evaluate if folding phoropter (FoFo) can help achieve on-site correction of URE. This was a cross-sectional study. FoFo was used for people with URE. Spherical equivalent (SE) spectacles based on the FoFo refraction were dispensed when distance visual acuity improved to > 6/12. Others were referred to fixed eye centres. Multivariable logistic regression evaluated the relationship of URE with sociodemographic characters and factors predicting acceptance of FoFo. In the study, 7.5% (95% confidence interval [CI]:7-8) people had URE, and included 4% with severe vision impairment and 36% with moderate visual impairment. URE was less common in children. Simple hyperopia was more common in females (25.3% vs 19.3%); compound myopic astigmatism was more common in males (27.4% vs 20.2%). People older than 50 years (p <0.0001) and females (p <0.0001) were more likely to have URE. Ninety-four people accepted FoFo on-site refraction and received SE spectacles; the acceptance was better in the younger (15-29 years old) and literate people (p <0.0001). URE was the second most common cause of visual impairment in older adults and was higher in females. Within its technological limit, FoFo could be used in the field for correcting URE and obviating the need for travel, thus bridging the know-do gap for the marginalised Dongaria community.

The Patient Safety Adoption Framework: A Practical Framework to Bridge the Know-Do Gap.

Many patient safety initiatives fail to be adopted and implemented, even when proven effective. This creates the well-recognized know-do gap, referring to the discrepancy between what healthcare workers know should be done based on evidence and what takes place in practice. We aimed to develop a framework to improve the adoption and implementation of patient safety initiatives. We conducted a background literature review followed by qualitative interviews with patient safety leaders to identify barriers and facilitators to adoption and implementation. Inductive thematic analysis was used to generate themes that informed the development of the framework. We used a consensus-building approach to co-create the framework and guidance tool with an Ad Hoc Committee made up of subject-matter experts and patient family advisors. The framework was tested for utility, feasibility, and acceptability through qualitative interviews. The Patient Safety Adoption Framework contains 5 domains and 6 subdomains. The domains are leadership (subdomains: prioritization, accountability, governance), culture and context, process (subdomains: co-creation, high reliability, engagement), meaningful measurement, and person-centeredness. A guidance tool was developed to provide practical guidance for improvement teams using the framework. Testing affirmed the framework and guidance tool with a high degree of acceptability, feasibility, and utility among implementers and subject-matter experts. The Patient Safety Adoption Framework provides the essential components necessary to facilitate the adoption and implementation of patient safety initiatives. The framework offers a roadmap for healthcare organizations striving to close the know-do gap.

The Unexpected Benefits of a Decolonized Knowledge Translation Initiative for Indigenous Mother Participants.

Western health research's approach to knowledge translation (KT) has been criticized by Indigenous scholars, leaders, and communities for its misalignment with Indigenous ways of knowing and relational approaches to sharing knowledge. Conversely, Indigenous KT is understood as 'sharing what we know about living a good life' (Kaplan-Myrth & Smylie, 2006). Whereas KT in Euro-Western science contexts focuses on closing the know-do gap implying a separation of knowledge and action, knowledge in the Indigenous context is inherently practical and based on centuries old practices including oral traditions, experiential knowledge, and cross-cultural sharing. This article describes the development of a decolonized KT strategy. This community-engaged KT initiative was developed at the suggestion of Indigenous mothers who participated in a research study in Hamilton, Canada, which examined their experiences using health care to meet the health needs of their infants. Indigenous mothers participated in three main roles related to the KT activities: sharing their story in video, participating as team members on an Advisory Board, and directing the creation of a video series and website educational resource (KT strategy). Five Indigenous mothers participated as members of the Advisory Board. The process of participating had positive impacts on the mothers, namely, empowerment, strength, 'I am not alone', and healing. These unexpected findings, which go beyond the original project purpose to create an educational resource, show the significant and important benefits for research participants, particularly those from Indigenous communities, to be involved in decolonized KT strategies.

Knowledge, Attitude, Practice, and Perceived Barriers for the Compliance of Standard Precautions among Medical and Nursing Students in Central India.

The aim of this study was to assess and compare (a) the knowledge, attitude, and practice of standard precautions (SPs), (b) the knowledge of post-exposure management, and (c) the perceived barriers underlying the noncompliance with SPs among future healthcare professionals (HCPs), i.e., students of medical and nursing courses in Central India. A cross-sectional study was conducted in 2017-2018 among students of a medical and a nursing college using a pretested and modified questionnaire. Data were collected during 23 face-to-face sessions. Responses were scored according to standard guidelines of the Centers for Disease Control and Prevention and WHO, where each correct response was given a score of 1. Among 600 participants, 51% of medical students and 75% of nursing students could not select the correct definition of SPs from the given options. Sixty-five percent of medical students (275/423) and 82% of nursing students (145/177) were unaware of the term post-exposure prophylaxis. Overall, knowledge about personal protective equipment and hazard symbols was poor (<25%). Furthermore, although theoretical knowledge about hand hygiene was good (510/600; 85%), its implementation was poor (<30%). Sixty-four percent of participants believed that the use of hand rub replaced the need for handwashing, even for visibly soiled hands. Some of the participants believed that the use of PPE might offend patients (16%). High workload and poor knowledge were other significant barriers underlying the noncompliance with SPs. A suboptimal translation of participants' knowledge into practice is evident and signifies the presence of the know-do gap. Poor knowledge and inappropriate presumptions about the use of SPs discourage the practice of SPs. This results in increased healthcare-associated infections, increased treatment costs, and a suppressed social economy. The inclusion of a dedicated curriculum with repeated hands-on and practice-based training on SPs is suggested to minimize this know-do gap among future healthcare workers.

Identification of a know-do gap: An observational study of the assessment and treatment of dysphagia during inpatient stroke rehabilitation in primary healthcare in Norway

ABSTRACT Purpose Oropharyngeal dysphagia is a common swallowing impairment post-stroke managed by speech language pathologists (SLP). This article aims to demonstrate a local know-do gap assessment for usual dysphagia care for patients undergoing inpatient stroke rehabilitation in primary healthcare in Norway, which included an assessment of the functional level of the patients and characteristics and outcomes of treatment. Materials and methods In this observational study, we assessed the outcomes and interventions of patients admitted to inpatient rehabilitation following stroke. The patients received usual care from SLPs while the research team administered a dysphagia assessment protocol that included assessment of several swallowing domains including oral intake, swallowing, patient self-reported functional health status and health-related quality of life, and oral health. The treating SLPs documented the treatments provided in a treatment diary. Results Of 91 patients who consented, 27 were referred for SLP and 14 received treatment. During the median treatment period of 31.5 days (IQR = 8.8–57.0), patients received 7.0 treatment sessions (IQR = 3.8–13.5) of 60 minutes (IQR = 55–60). The patients who received SLP treatment demonstrated no/minor disorders (n = 7) and moderate/severe disorders (n = 7). Dysphagia treatments primarily included oromotor training and advice on bolus modification and were provided without association to dysphagia severity. Patients with moderate/severe swallowing impairments received slightly more SLP sessions over a longer time. Conclusions This study identified gaps between current and best practices and opportunities to improve assessment, decision-making, and implement evidence-based practices.