Knowledge Transfer And Exchange Research Articles

Structural barriers to knowledge transfer and exchange among men and women in low-, middle- and high-income countries: an international cross-sectional study with vaccine researchers in 44 countries

BackgroundGlobally, women constitute 30% of researchers. Despite an increasing proportion of women in research, they are still less likely to have international collaborations. Literature on barriers to knowledge transfer and exchange (KTE) between men and women remains limited. This study aimed to assess perceived gender barriers to KTE activities in vaccination-related research in low-, middle- and high-income countries.MethodsThis was a cross-sectional data assessment from a self-administered questionnaire distributed to researchers in the field of vaccination research. The administered questionnaire was developed and validated by WHO and McMaster University. Descriptive statistics were carried out. Structural factors of KTE were assessed using 12 statements measured with a five-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). An index ranging from 12 to 60 points was created to assess structural factors of KTE, with higher score indicating fewer perceived barriers. Multivariable linear regression modelling was applied to examine the association between KTE barriers and gender.ResultsA total of 158 researchers were included in the analysis. Regardless of gender and country of affiliation, researchers experienced challenges with respect to KTE activities; particularly factors related to the availability of human and financial resources and level of technical expertise among their target audience. We were also able to identify perceived facilitators among men and women, such as the presence of structures that link researchers and target audiences, the investment of target audiences in KTE efforts and the presence of stable contacts among target audiences. Our linear regression analysis showed that women perceived more barriers than men (R2 = 0.014; B = −1.069; 95% CI −4.035; 1.897).ConclusionsMen and women shared common perspectives on barriers to KTE. KTE activities could be strengthened by improving structural efforts to reduce gender differences and increase collaborations between researchers and their target audience.

Examination of tools associated with the evaluation of knowledge uptake and utilization: A scoping review

Knowledge transfer and exchange (KTE) has become an integral part of organizational practice. Evaluation of KTE, as well as knowledge products generated through this process, is important for understanding the effectiveness of KTE strategies. This scoping review aimed to identify tools and frameworks used to evaluate knowledge uptake and utilization (KUU).The search strategy included review of PubMed and Scopus databases, hand searching of relevant journals, and citation tracing. Over 6500 abstracts were screened; 292 full-text articles were shortlisted by two reviewers.Seventy-two articles described tools for evaluating KUU. A total of 23 tools could be generally applied to knowledge products/processes used in different sectors; 36 evaluation tools were designed for specific knowledge products (i.e., websites); 9 tools were discipline-specific (i.e., medical field), and four articles described evaluations of knowledge products/processes using alternative methods such as Google Analytics or qualitative methods. The majority of tools (n = 40, 56 %) focused on usability of a knowledge product or process.This scoping review identified various tools being used to assess the effectiveness and impact of KTE processes/products, however, the measures were as varied as the projects, and were often not designed to evaluate KTE in particular.

Creating Productive Tensions: Clinicians Working with Patients as Peer Researchers in a Community-Based Participatory Research Study of the Lived Experience of HIV-Associated Neurocognitive Disorder (HAND)

About 50% of people living with HIV will develop HIV-associated neurocognitive disorder (HAND) during their lifetime, and we know that cognitive issues are a concern for people living with HIV. However, limited information exists regarding how HAND is managed and coped with, or how cognitive issues are discussed with others, including health care professionals. Following a community-based research approach, we conducted 25 interviews in 2016 aimed to (1) build the capacity of people living with HIV, (2) facilitate participant recruitment and data collection, (3) increase the validity and reliability of our data analysis results, and (4) facilitate knowledge transfer and exchange regarding HAND. After thorough training, we engaged a number of peer researchers living with HAND in the analysis and knowledge transfer and exchange (KTE) phases of the study. This engagement prompted a number of tensions between the clinicians and the peers that we learned to navigate and make productive. We conclude that it is possible to engage patients and providers only if careful attention, time and human resources are provided to navigating the emerging tensions. The outcomes of our study suggest that engaging an interdisciplinary team across multiple sites with PRAs is a valuable method for comprehensively exploring the lived experience of a complex chronic condition such as HAND.

Evolution of an International Research Collaborative in HIV and Rehabilitation: Community Engaged Process, Lessons Learned, and Recommendations.

Human immunodeficiency virus (HIV) is increasingly considered a chronic illness. Rehabilitation can address some of the health challenges of people living with HIV (PLWHIV); however, the field is emerging. We describe our experience establishing an international collaborative in HIV and rehabilitation research using a community engaged approach. The Canada-UK (now Canada-International) HIV and Rehabilitation Research Collaborative (CIHRRC) is a network of more than 85 PLWHIV, researchers, clinicians, and representatives from community-based organizations collectively working to advance knowledge on HIV and rehabilitation. Activities and outcomes include facilitating knowledge transfer and exchange (KTE), establishing and strengthening multistakeholder partnerships, and identifying new and emerging priorities in the field. Collaboration and support from community organizations fostered mechanisms to raise the profile of, and evidence for, rehabilitation in the context of HIV. Considerations of scope, partnership, and sustainability are important. We offer recommendations for developing an international community-academic-clinical research collaborative using a community-engaged approach. Research networks involving community-academic-clinical partnerships can help to promote KTE and establish a coordinated response for addressing priorities in an emerging field.

Improving Quality of Radiotherapy Care Across Ontario Using a Community of Practice Approach

Background: Communities of Practice (CoPs) are defined as “a group of people who share a concern, a set of problems, or a passion about a topic, and who deepen their knowledge and expertise by interacting on an ongoing basis”. This concept was developed by Wegner and Lave in 1991, based on the theory that learning is more than just acquiring knowledge, but rather involves being socialized into a practice and developing an identity within a community. Cancer Care Ontario (CCO) is the provincial governments advisor on the cancer system and this work documents CCO's use of CoPs to help advance the quality of care in radiotherapy in Ontario, Canada. Aim: After the divestment of radiotherapy care from a centralised structure into individual hospitals in 2003/2004, there was a marked decrease in communication between the 14 Regional Cancer Centres (RCCs) in Ontario. As a means to rebuild the sense of community among radiation medicine programs (encompassing oncologists, physicists and radiation therapists), and to facilitate communication between the RCCs, the Radiation Treatment Program (RTP) at CCO developed and organized a CoP program. The three aims were knowledge creation, knowledge transfer and exchange (KTE), and community building. The ultimate goal was to improve the safety and quality of radiotherapy by reducing variation in practice between centers. Methods: Seven CoPs have been established since 2010; 3 are disease specific (head and neck, gynecologic and lung cancers) with multidisciplinary representation from oncologists, physicists, and radiation therapists. The other 4 CoPs are single-discipline (radiation therapy, physics, radiation safety officers, clinical specialist radiation therapists) to allow for practice specific knowledge-sharing and innovation. All CoPs are led and driven by volunteer members who identify and prioritize key quality issues and select corresponding projects to pursue. Results: CCO's CoPs have produced several knowledge products, including endorsed clinical guidance documents (5), and practical implementation tools (5), with over 20 additional products currently in development. Members have delivered numerous international and national KTE presentations and hosted 51 workshops. CoP guidance documents have 1: Improved safety ( “Implementation Strategy for Radiation Safety Straps” with 100% implementation across RCCs) 2: Standardized care ( “Contouring Nomenclature - Head and Neck Cancer”) with adoption of recommendations province-wide 3: Supported infrastructure improvements (“ MRI Simulation guideline document”). Conclusion: Overall, the RTP's CoP program has been effective in achieving its main three aims: knowledge creation, KTE, and community building. This approach of a member-driven voluntary CoP should be explored and modeled in other healthcare settings as a means to develop and share knowledge, reduce variation in care, standardize practice and improve patient care.

How is the use of research evidence in health policy perceived? A comparison between the reporting of researchers and policy-makers

BackgroundThe use of health policy and systems research (HPSR) to inform health policy-making is an international challenge. Incorporating HPSR into decision-making primarily involves two groups, namely researchers (knowledge producers) and policy-makers (knowledge users). The purpose of this study was to compare the perceptions of Israeli health systems and policy researchers and health services policy-makers regarding the role of HPSR, factors influencing its uses and potential facilitators and barriers to HPSR, and implementation of knowledge transfer and exchange (KTE) activities.MethodsA cross-sectional survey was administered to researchers and policy-makers in Israel. The survey consisted of seven closed questions. Descriptive analyses were carried out for closed-ended questions and comparative analysis were conducted between groups using the χ2 test.ResultsA total of 37 researchers and 32 policy-makers responded to the survey. While some views were in alignment, others showed differences. More policy-makers than researchers perceived that the use of HPSR in policy was hindered by practical implementation constraints, whereas more researchers felt that its use was hindered by a lack of coordination between knowledge producers and users. A larger percentage of policy-makers, as compared to researchers, reported that facilitators to the KTE process are in place and a larger percentage of researchers perceived barriers within the KTE environment. A larger percentage of policy-makers perceived KTE activities were in place as compared to researchers. Results also showed large differences in the perceptions of the two groups regarding policy formulation and which organisations they perceived as exerting strong influence on policy-making.ConclusionsThis research demonstrated that there are differences in the perceptions of knowledge producers and users about the process of KTE. Future work should focus on minimising the challenges highlighted here and implementing new KTE activities. These activities could include making the researchers aware of the most effective manner in which to package their results, providing training to policy-makers and assuring that policy-makers have technical access to appropriate databases to search for HPSR. These results underscore the need for the groups to communicate and clarify to each other what they can offer and what they require.

A network of LIFE projects to promote the transfer and exchange of knowledge on environment and health

Eleven projects within the LIFE programme (through which the Directorate-General for Environment of the European Commission provides funding for projects aim at protecting environment and nature) addressing environmental-health-related issues have been involved in a collaborative network called KTE LIFE EnvHealth Network. The shared issues tackled by that projects are knowledge transfer and exchange (KTE). The objective of the LIFE programme is to support the implementation of the environmental legislation in the European Union, to provide new tools and knowledge that will help to better protect both the territory and the communities. Transferring knowledge to decision makers, at the appropriate and effective level, is therefore a central function of the projects. The Network promotes national and international networking, which intends to involve other projects, to provide methodological support, to make information and successful practices circulate, with the aim of multiplying the energies of each project involved.

Scientists’ engagement in knowledge transfer and exchange: individual factors, variety of mechanisms and users

This article aims to provide a deeper understanding of the individual factors behind scientists' involvement in a wide variety of knowledge transfer and exchange (KTE) activities. By doing so, the article addresses three major shortcomings in the literature. First, this article considers scientists' involvement in both formal and informal KTE activities. Secondly, the study focuses not only on KTE activities with the private sector, but also with other types of agents. Thirdly, the article adopts an individual approach to distinguish between three types of KTE predictors: individual capacities, training and career trajectories, and motivations. Overall, the results of the regression model applied to a sample of 1,295 researchers active in the largest public research organization in Spain (CSIC) suggest that, while some individual features are connected to some KTE activities, other individual predictors (e.g. multitasking and interdisciplinarity) are more evenly associated to a variety of KTE mechanisms and users. Based on those findings, the article offers policy recommendations to craft more accurate policies to encourage scientists' KTE engagement.

Integrated Knowledge Transfer and Exchange: An Organizational Approach for Stakeholder Engagement and Communications

Knowledge transfer and exchange (KTE) is a process of making relevant research information available and accessible for use in practice or policy. Integrated KTE, where knowledge users are engaged in the research process, is considered to better facilitate uptake and use. The objective of this paper is to describe a fully integrated KTE approach developed over the past 20 years. Key concepts related to knowledge user engagement as well as the integration of communications within KTE are described. The organizational KTE approach is flexible and can be adapted to a variety of research areas.

Preterm birth: the role of knowledge transfer and exchange

BackgroundPreterm birth (PTB) is the leading cause of death in children under age five. Healthcare policy and other decision-making relevant to PTB may rely on obsolete, incomplete or inapplicable research evidence, leading to worsened outcomes. Appropriate knowledge transfer and exchange (KTE) strategies are an important component of efforts to reduce the global PTB burden. We sought to develop a ‘landscape’ analysis of KTE strategies currently used in PTB and related contexts, and to make recommendations for optimising programmatic implementation and for future research.MethodsIn the University of California, San Francisco’s Preterm Birth Initiative, we convened a multidisciplinary working group and examined KTE frameworks. After selecting a widely-used, adaptable, theoretically-strong framework we reviewed the literature to identify evidence-based KTE strategies. We analysed KTE approaches focusing on key PTB stakeholders (individuals, families and communities, healthcare providers and policymakers). Guided by the framework, we articulated KTE approaches that would likely improve PTB outcomes. We further applied the KTE framework in developing recommendations.ResultsWe selected the Linking Research to Action framework. Searches identified 19 systematic reviews, including two ‘reviews of reviews’. Twelve reviews provided evidence for KTE strategies in the context of maternal, neonatal and child health, though not PTB specifically; seven reviews provided ‘cross-cutting’ evidence that could likely be generalised to PTB contexts.For individuals, families and communities, potentially effective KTE strategies include community-based approaches, ‘decision aids’, regular discussions with providers and other strategies. For providers, KTE outcomes may be improved through local opinion leaders, electronic reminders, multifaceted strategies and other approaches. Policy decisions relevant to PTB may best be informed through the use of evidence briefs, deliberative dialogues, the SUPPORT tools for evidence-informed policymaking and other strategies.Our recommendations for research addressed knowledge gaps in regard to partner engagement, applicability and context, implementation strategy research, monitoring and evaluation, and infrastructure for sustainable KTE efforts.ConclusionsEvidence-based KTE, using strategies appropriate to each stakeholder group, is essential to any effort to improve health at the population level. PTB stakeholders should be fully engaged in KTE and programme planning from its earliest stages, and ideally before planning begins.

A Review on Community-Based Knowledge Transfer and Exchange (KTE) Initiatives for Promoting Well-Being in Older Adults

ABSTRACTKnowledge transfer and exchange (KTE) processes can facilitate evidence-informed community-based care for seniors, but understanding effective KTE in gerontology is limited. A scoping review was conducted to evaluate the current state of KTE in the community-based sector for seniors. Twelve articles met the inclusion criteria, which addressed a broad variety of topics including caregiving, elder abuse, falls prevention, home-rehabilitation, hospice and dementia care. Studies evaluated KTE practices (n = 8), developed a KTE intervention (n = 3), or explored research uptake (n = 1). Community-based initiatives for seniors informed by KTE processes are scarce, requiring further efforts at the research, practice and policy levels.

Sun Safety at Work Canada: Baseline evaluation of outdoor workplaces recruited to participate in a sun safety knowledge transfer and exchange intervention

PurposeIn 2014, an estimated 7000 skin cancer cases were attributed to occupational solar ultraviolet (UV) exposure in Canada (CAREX Canada, 2015). A knowledge transfer and exchange intervention project was initiated in three Canadian provinces to enhance sun safety in 14 workplaces with outdoor workers in two industry sectors – municipalities and electrical utilities. This manuscript is a detailed description of the method used for, and results from, the pre-intervention, developmental evaluation that was conducted in the first year of this two-year project. Design/methodologyA theory-based conceptual model helped direct a cross-case analysis of 22hours of interview and focus group data. The deductive and inductive analysis helped explore the workplace characteristics that emerged as potentially significant for the adoption of sun safety by participating workplaces, and helped evolve a project-specific conceptual model. FindingsThe electrical utilities (the utilities) and municipalities differed in their organizational structure, organizational safety culture, and readiness to change. These variables have been identified as being potentially predictive of a workplace’s engagement in implementing sun safety policies and practices. Originality/valueThe study is a knowledge transfer and exchange (KTE) intervention looking to enhance sun safety in 14 outdoor workplaces across Canada, which span the public and private sectors, while working within different legislative frameworks. The cross-case analysis methodology facilitated comparisons within and between cases to understand the factors that may lead to successful uptake of occupational sun safety knowledge and practice.

Views of health system policymakers on the role of research in health policymaking in Israel.

BackgroundThe use of research evidence in health policymaking is an international challenge. Health systems, including that of Israel, are usually characterized by scarce resources and the necessity to make rapid policy decisions. Knowledge transfer and exchange (KTE) has emerged as a paradigm to start bridging the “know-do” gap. The purpose of this study was to explore the views of health system policymakers and senior executives involved in the policy development process in Israel regarding the role of health systems and policy research (HSPR) in health policymaking, the barriers and facilitators to the use of evidence in the policymaking process, and suggestions for improving the use of HSPR in the policymaking process.MethodsA survey and an interview were verbally administered in a single face-to-face meeting with health system policymakers and senior executives involved in the policy development process in Israel. The data collection period was from July to October 2014. The potential participants included members of Knesset, officials from Israel’s Ministry of Health, Ministry of Finance, health services organizations, and other stakeholder organizations (i.e., National Insurance Institute). The close-ended questions were based on previous surveys that had been conducted in this field. Interviews were tape recorded and transcribed. Descriptive statistics were conducted for close ended survey-questions and thematic analysis was conducted for open-ended interview questions.ResultsThere were 32 participants in this study. Participants felt that the use of HSPR helps raise awareness on policy issues, yet the actual use of HSPR was hindered for many reasons. Facilitators do exist to support the use of HSPR in the policymaking process, such as a strong foundation of relationships between researchers and policymakers. However, many barriers exist such as the lack of relevance and timeliness of much of the currently available research to support decision-making and the paucity of funding to support research use. Suggestions to improve the use of HSPR focused on improving dissemination of research findings and ensuring that the research was more relevant and timely.ConclusionsThis research demonstrated that health systems policymakers in Israel perceive having strong relationships and collaborations with researchers however there is room for improvement, e.g. partnering in research projects to ensure relevance and use. Furthermore, health system policymakers seem to be interested in receiving relevant research in a more useable format and are open to using research in decision making.

Reducing the global burden of Preterm Birth through knowledge transfer and exchange: a research agenda for engaging effectively with policymakers

Preterm birth (PTB) is the world’s leading cause of death in children under 5 years. In 2013, over one million out of six million child deaths were due to complications of PTB. The rate of decline in child death overall has far outpaced the rate of decline attributable to PTB. Three key reasons for this slow progress in reducing PTB mortality are: (a) the underlying etiology and biological mechanisms remain unknown, presenting a challenge to discovering ways to prevent and treat the condition; (ii) while there are several evidence-based interventions that can reduce the risk of PTB and associated infant mortality, the coverage rates of these interventions in low- and middle-income countries remain very low; and (c) the gap between knowledge and action on PTB—the “know-do gap”—has been a major obstacle to progress in scaling up the use of existing evidence-based child health interventions, including those to prevent and treat PTB.In this review, we focus on the know-do gap in PTB as it applies to policymakers. The evidence-based approaches to narrowing this gap have become known as knowledge transfer and exchange (KTE). In our paper, we propose a research agenda for promoting KTE with policymakers, with an ambitious but realistic goal of reducing the global burden of PTB. We hope that our proposed research agenda stimulates further debate and discussion on research priorities to soon bend the curve of PTB mortality.Electronic supplementary materialThe online version of this article (doi:10.1186/s12978-016-0146-8) contains supplementary material, which is available to authorized users.

Healthy Canada by Design CLASP: Lessons learned from the first phase of an intersectoral, cross-provincial, built environment initiative.

The Healthy Canada by Design (HCBD) CLASP (Coalitions Linking Action and Science for Prevention) Initiative promotes the building of communities that support health by 1) facilitating the integration of health evidence into built environment decision-making; 2) developing new, cross-sector collaboration models and tools; and 3) fostering a national community of practice. A coalition of public health professionals, researchers, professional planners and non-governmental organization (NGO) staff from across Canada developed, implemented and participated in the Initiative. In the first phase, HCBD interventions took place for the most part in large urban and suburban settings in Quebec, Ontario and British Columbia. National knowledge transfer and exchange (KTE) activities were delivered both locally and nationally. Project participants developed tools or processes for collaboration between the health and the community planning sectors. These were designed to increase the capacity of the health sector to influence decisions about land use and transportation planning. Tool or process development was accompanied by pilot testing, evaluation, and dissemination of findings and lessons learned. On a parallel track, NGOs involved with HCBD led national KTE interventions. The first phase of HCBD demonstrated the potential for public health organizations to influence the built environment determinants of cancer and chronic diseases. Public health authorities forged relationships with several organizations with a stake in built environment decisions, including municipal and regional planning departments, provincial governments, federal government agencies, researchers, community groups and NGOs. The Initiative accomplished the following: 1) created new relationships across sectors and across health authorities; 2) improved the knowledge and skills for influencing land use planning processes among public health professionals; 3) increased awareness of health evidence and intent to change practice among built environment decision-makers; and 4) facilitated inclusion of health considerations in local plans, policies and decisions. The first phase of HCBD engaged built environment stakeholders, including public health professionals, planners, researchers, community groups and NGOs, in ways that would be expected to influence health risk factors and population health outcomes in the long term.

Health systems and policy research evidence in health policy making in Israel: what are researchers' practices in transferring knowledge to policy makers?

BackgroundEnsuring the use of research evidence in health system management and policy decisions is an important challenge in this century. Knowledge transfer and exchange (KTE) has emerged as a paradigm to address the challenges and start closing the ‘know-do’ gap. This area of work is gaining momentum in most developed countries, yet, to date, no work has been performed in Israel within this area. The purpose of this study was to identify which KTE activities health systems and policy researchers in Israel have undertaken.MethodsA cross-sectional web-based survey of researchers who have conducted health systems and policy research in Israel was developed. The survey consisted of a demographics section, quantitative scales, and open-ended questions. The survey was sent to all health systems and policy researchers in Israel (n = 125).ResultsThe study response rate (28%) was relatively low as compared to other studies in the same field (range of 42% to 88%). Our survey found that more than a third of the health systems and policy researchers in Israel reported that they were frequently or always involved in the following KTE activities: interactions with target audience through the research process (i.e., during developing a research question or executing the research; 35% to 42%) or through formal or informal meetings during conferences, workshops, or conversations (40%). Less than half of the health systems and policy researchers in Israel are engaged in bridging activities aimed to facilitate target audiences to use research.ConclusionsThis is a fairly new area in Israel and therefore the level of engagement of researchers in KTE activities is not very high. The low response rates could be because KTE is a new field in Israel and minimal KTE initiatives have been undertaken. It is preferable to have higher response rates, yet, after several initiatives, this was the outcome. While the findings are relevant, they may not reflect the total population of health system and policy researchers in Israel. Health system and policy researchers in Israel need to be introduced to the benefits and potential advantages of KTE in an organized and systematic way.

Dissemination of performance information and continuous improvement

Developing a performance measure and reporting the results to support decision making at an individual level has yielded poor results in many health systems. The purpose of this paper is to highlight the factors associated with the dissemination of performance information that generate and support continuous improvement in health organizations. A systematic data collection strategy that includes empirical and theoretical research published from 1980 to 2010, both qualitative and quantitative, was performed on Web of Science, Current Contents, EMBASE and MEDLINE. A narrative synthesis method was used to iteratively detail explicative processes that underlie the intervention. A classification and synthesis framework was developed, drawing on knowledge transfer and exchange (KTE) literature. The sample consisted of 114 articles, including seven systematic or exhaustive reviews. Results showed that dissemination in itself is not enough to produce improvement initiatives. Successful dissemination depends on various factors, which influence the way collective actors react to performance information such as the clarity of objectives, the relationships between stakeholders, the system's governance and the available incentives. This review was limited to the process of knowledge dissemination in health systems and its utilization by users at the health organization level. Issues related to improvement initiatives deserve more attention. Knowledge dissemination goes beyond better communication and should be considered as carefully as the measurement of performance. Choices pertaining to intervention should be continuously prompted by the concern to support organizational action. While considerable attention was paid to the public reporting of performance information, this review sheds some light on a more promising avenue for changes and improvements, notably in public health systems.

How to Summarize a 6,000-Word Paper in a Six-Minute Video Clip

As part of our research team's knowledge transfer and exchange (KTE) efforts, we created a six-minute video clip that summarizes, in plain language, a scientific paper that describes why and how three teams of academic entrepreneurs developed new health technologies. Recognizing that video-based KTE strategies can be a valuable tool for health services and policy researchers, this paper explains the constraints and sources of inspiration that shaped our video production process. Aiming to provide practical guidance, we describe the steps and tools that we used to identify, refine and package the key content of the scientific paper into an original video format.

Concussion education and awareness support group: the value of a pilot clinical program as an essential Knowledge Transfer and Exchange (KTE) strategy

ObjectiveTo pilot test a concussion education and support workshop as a Knowledge Transfer and Exchange (KTE) intervention for enhancing knowledge and education post-concussion.DesignProspective, pre-post design to pilot test a KTE...

Sport concussion knowledge base, clinical practices, and needs for continuing medical education: a survey of family physicians and cross-border comparison

ObjectiveTo identify sport concussion knowledge base, practice patterns and current/preferred methods of Knowledge Transfer and Exchange (KTE) in two distinct populations of family physicians.DesignCross-sectional study, using a survey design.SettingAlberta, Canada...