Knowledge Translation Research Research Articles

The process of developing an augmented reality (AR) tool for knowledge translation on climate change-related experiences among youth in Kenya

This report details a qualitative methodological approach of developing an Augmented Reality (AR) tool which integrates digital storytelling for context-specific, accessible, scalable participatory research knowledge translation on climate-related sexual health experiences among youth (aged 16-25 years) in Kenya. AR, which engages audiences through virtual images overlayed on the real world in real-time, enhances learning and knowledge retention. This suggests the potential for using this increasingly accessible technology in knowledge translation, despite such use being understudied. Our AR tool meaningfully incorporates seven digital storytelling videos made by youth in Kenya through a study in 2023, to amplify youth voices while illustrating complex pathways between four climate-related factors (drought, floods, extreme heat, and excess winds) and three HIV vulnerabilities (gender-based violence, early marriage, and transactional sex). The aim of this paper is to describe the design of an AR tool for knowledge translation, youth empowerment, and health promotion, and to outline how it can be harnessed for sexual health and climate change education to inform future knowledge translation approaches with youth climate-affected issues.

Sowing seeds in decolonial cracks for pluriversity: reflections from arts–research co-productions on sustainability themes

This article shares the author’s reflections on what decolonial cracks for recreating UK universities as sustainable pluriversities emerge from encounters and engagement in three arts–research co-productions relating to sustainability and justice: a training process led by a professional storyteller on converting political-ecology research into short, spoken ten-minute stories, the co-production of visual summaries and a role-playing game on sustainable value chains, and the collaboration producing an immersive audiovisual exhibition on ‘Can we fly-less?’. This article makes an empirically based case that engaging in co-production on arts–research knowledge translation can help identify decolonial cracks to sow the seeds of pluriversity, that is, epistemically diverse institutions for public good that recognise present patterns of colonially rooted injustices and unsustainability, in UK academia. Drawing on relational, deep-listening conversations with six collaborators on the projects, three artists and three researchers, the article highlights benefits arising from the creative collaborations, such as social, transformative learning and critical introspection, and research acquiring a life beyond the page and becoming accessible to a broader audience. However, they also emphasised institutional barriers such as perverse incentives in current academic conventions, such as little or no recognition for knowledge translation, unequal starting points among permanent/precarious or salaried/non-salaried staff, and uncooperative monitoring and application systems, which render identifying these decolonial cracks and seeds necessary. With a methodology rooted in its conceptual, relational approach, the article highlights decolonial cracks in current academia, and transformative seeds to reimagine it in a more decolonial and sustainable image befitting of a pluriversity.

Knowledge translation in Indigenous health research: voices from the field.

To better understand what knowledge translation activities are effective and meaningful to Indigenous communities and what is required to advance knowledge translation in health research with, for, and by Indigenous communities. Workshop and collaborative yarning. Lowitja Institute International Indigenous Health Conference, Cairns, June 2023. About 70 conference delegates, predominantly Indigenous people involved in research and Indigenous health researchers who shared their knowledge, experiences, and recommendations for knowledge translation through yarning and knowledge sharing. Four key themes were developed using thematic analysis: knowledge translation is fundamental to research and upholding community rights; knowledge translation approaches must be relevant to local community needs and ways of mobilising knowledge; researchers and research institutions must be accountable for ensuring knowledge translation is embedded, respected and implemented in ways that address community priorities; and knowledge translation must be planned and evaluated in ways that reflect Indigenous community measures of success. Knowledge translation is fundamental to making research matter, and critical to ethical research. It must be embedded in all stages of research practice. Effective knowledge translation approaches are Indigenous-led and move beyond Euro-Western academic metrics. Institutions, funding bodies, and academics should embed structures required to uphold Indigenous knowledge translation. We join calls for reimaging health and medical research to embed Indigenous knowledge translation as a prerequisite for generative knowledge production that makes research matter.

Are adjunct treatments effective in improving pain and function when added to exercise therapy in people with patellofemoral pain? A systematic review with meta-analysis and appraisal of the quality of interventions

ObjectiveTo compare the effectiveness of adjunct treatments combined with exercise to exercise alone in people with patellofemoral pain (PFP) and explore the quality of intervention descriptions in randomised controlled trials...

What role can 'health decision-makers' play in supporting knowledge translation of health and medical research?

CEmbedding research users into the research process can better support its translation into health systems and services. Still, the role of health decision-makers (HDMs) as research partners is poorly understood. HDMs, such as policymakers, administrators, directors or other managers, understand the broader contexts of a health service and have a mandate to facilitate change where appropriate, so they could play an important partnership role in research activities.

Hypertension in sub-Saharan Africa: the current profile, recent advances, gaps, and priorities.

Recent global and regional reports consistently confirm the high and increasing prevalence of hypertension in sub-Saharan Africa (SSA), with poor detection, treatment, and control rates. This narrative review summarises the burden of hypertension in SSA and recent findings from community-based hypertension management strategies. We further outline prominent risk factors according to recent data and associated underlying mechanisms for hypertension development. An extensive review of literature showed that most countries have reported on the prevalence of hypertension during 2017-2023, despite limitations linked to the lack of nationally representative studies, heterogeneity of sampling and data collection methods. Task-shifting approaches that assign roles to model patients and community health workers reported improved linkage to healthcare services and adherence to medication, with inconsistent findings on blood pressure (BP)-lowering effects over time. The regularly reported risk factors include unhealthy diet, sedentary lifestyle, increased adiposity and underweight, ageing, level of education, and/or income as well as psychosocial factors. Newer data on the pathophysiological mechanisms leading to hypertension and potential areas of intervention are reported from children and adults and include, among others, salt-handling and volume overload, endothelial function, BP dipping patterns and the role of human immunodeficiency virus. To conclude, significant strides have been made in data reporting from SSA on the burden of hypertension in the region as well as biomarker research to improve understanding and identification of areas of intervention. However, gaps remain on linkage between knowledge generation, translation, and implementation research. Coordinated studies addressing both discovery science and public health are crucial to curb hypertension development and improve management in SSA.

172 Roles and Expectations for Evaluators within a Learning Health System

OBJECTIVES/GOALS: Our objective is to explore the evolving role of evaluators within Learning Health Systems (LHSs) and the implications for evaluation approaches in these dynamic healthcare environments. We aim to disseminate lessons learned to help inform best practices for other CTSA hubs operating under a LHS model. METHODS/STUDY POPULATION: Our investigation builds upon our prior qualitative analysis of the LHS literature and contextualization of unique challenges, and potential remedies, of a LHS in Academic Health Centers. As evaluators, we are particularly interested in understanding how evaluation work is conducted in LHSs and exploring ways to optimize the role of evaluators and their skillset in this context. For this investigation, we examined the competencies necessary for evaluators working in LHS and the specialized evaluation approaches needed to fulfill these requirements. Our approach drew from multi-faceted data and experience. We leveraged insights from our literature review, direct experience within WFUSOM CTSI, and discussions with other evaluators. This combination of data sources provided the foundation for our analysis. RESULTS/ANTICIPATED RESULTS: We expect that as more health systems move toward the LHS model, they will have an increased need for various forms of evaluation, requiring resources well beyond what they are currently dedicating to evaluation. Expectations for evaluators will be enhanced in the following distinct, yet complementary, categories: generating new knowledge and translating research knowledge into practice. Anticipated results include identifying essential competencies for evaluators in LHS, such as data proficiency, clinical understanding, and adaptive skills. We also expect to uncover various evaluation approaches specific to LHS, including quality improvement studies, pragmatic trials, and stakeholder-engaged research. DISCUSSION/SIGNIFICANCE: Understanding the evolving role of evaluators and specialized evaluation approaches in LHS is crucial. It enhances the ability to generate localized evidence, customize interventions, and improve patient care. This knowledge empowers healthcare systems to adapt, innovate and deliver high-quality care for a higher impact on patient outcomes.

A regionally based precision medicine implementation initiative in North Africa:The PerMediNA consortium

Precision Medicine is being increasingly used in the developed world to improve health care. While several Precision Medicine (PM) initiatives have been launched worldwide, their implementations have proven to be more challenging particularly in low- and middle-income countries. To address this issue, the “Personalized Medicine in North Africa” initiative (PerMediNA) was launched in three North African countries namely Tunisia, Algeria and Morocco. PerMediNA is coordinated by Institut Pasteur de Tunis together with the French Ministry for Europe and Foreign Affairs, with the support of Institut Pasteur in France. The project is carried out along with Institut Pasteur d’Algérie and Institut Pasteur du Maroc in collaboration with national and international leading institutions in the field of PM including Institut Gustave Roussy in Paris. PerMediNA aims to assess the readiness level of PM implementation in North Africa, to strengthen PM infrastructure, to provide workforce training, to generate genomic data on North African populations, to implement cost effective, affordable and sustainable genetic testing for cancer patients and to inform policy makers on how to translate research knowledge into health products and services. Gender equity and involvement of young scientists in this implementation process are other key goals of the PerMediNA project.In this paper, we are describing PerMediNA as the first PM implementation initiative in North Africa. Such initiatives contribute significantly in shortening existing health disparities and inequities between developed and developing countries and accelerate access to innovative treatments for global health.

One size doesn't fit all: methodological reflections in conducting community-based behavioural science research to tailor COVID-19 vaccination initiatives for public health priority populations.

Promoting the uptake of vaccination for infectious diseases such as COVID-19 remains a global challenge, necessitating collaborative efforts between public health units (PHUs) and communities. Applied behavioural science can play a crucial role in supporting PHUs' response by providing insights into human behaviour and informing tailored strategies to enhance vaccination uptake. Community engagement can help broaden the reach of behavioural science research by involving a more diverse range of populations and ensuring that strategies better represent the needs of specific communities. We developed and applied an approach to conducting community-based behavioural science research with ethnically and socioeconomically diverse populations to guide PHUs in tailoring their strategies to promote COVID-19 vaccination. This paper presents the community engagement methodology and the lessons learned in applying the methodology. The community engagement methodology was developed based on integrated knowledge translation (iKT) and community-based participatory research (CBPR) principles. The study involved collaboration with PHUs and local communities in Ontario, Canada to identify priority groups for COVID-19 vaccination, understand factors influencing vaccine uptake and co-design strategies tailored to each community to promote vaccination. Community engagement was conducted across three large urban regions with individuals from Eastern European communities, African, Black, and Caribbean communities and low socioeconomic neighbourhoods. We developed and applied a seven-step methodology for conducting community-based behavioural science research: (1) aligning goals with system-level partners; (2) engaging with PHUs to understand priorities; (3) understanding community strengths and dynamics; (4) building relationships with each community; (5) establishing partnerships (community advisory groups); (6) involving community members in the research process; and (7) feeding back and interpreting research findings. Research partnerships were successfully established with members of prioritized communities, enabling recruitment of participants for theory-informed behavioural science interviews, interpretation of findings, and co-design of targeted recommendations for each PHU to improve COVID-19 vaccination uptake. Lessons learned include the importance of cultural sensitivity and awareness of sociopolitical context in tailoring community engagement, being agile to address the diverse and evolving priorities of PHUs, and building trust to achieve effective community engagement. Effective community engagement in behavioural science research can lead to more inclusive and representative research. The community engagement approach developed and applied in this study acknowledges the diversity of communities, recognizes the central role of PHUs, and can help in addressing complex public health challenges.

Transforming research systems for meaningful engagement: a reflexive thematic analysis of spinal cord injury researchers’ barriers and facilitators to using the integrated knowledge translation guiding principles

Purpose To develop an in-depth understanding of spinal cord injury (SCI) researchers’ barriers and facilitators to deciding to use 1) a partnered approach to research and, 2) systematically developed principles for guiding Integrated Knowledge Translation (IKT) in spinal cord injury research (IKT Guiding Principles). Methods Qualitative interview study with North American SCI researchers who were interested in using a partnered research approach. The research was conducted using an IKT approach, and interview data were analyzed using reflexive thematic analysis. Results Thirteen SCI researchers whose research focused on prevention, clinical, rehabilitation, and/or community SCI research were interviewed. Three themes were co-constructed with partners: 1) the principles are necessary but not sufficient for the implementation of a partnered approach to research; 2) relational capacity building is needed; and 3) institutional transformation is needed to value, resource, and support meaningful engagement. Conclusions Supporting change that enables SCI researchers to adopt and implement the IKT Guiding Principles will require transformation at the individual (theme 1), relational (theme 2), and institutional levels (theme 3). Findings provide clear, practical, and tangible actions to promote change that can support meaningful engagement in the SCI Research System.

Digital Knowledge Translation Tools for Disseminating Sexual and Reproductive Health Information to Adolescents: Protocol for an Evidence Gap Map Review.

Digital or eHealth knowledge translation (KT) interventions have been identified as useful public health tools, particularly to advance sexual and reproductive health (SRH) among adolescents. Existing literature reviews on digital health interventions for adolescents' SRH demonstrate limitations, including shortcomings in reporting and comprehensiveness that limit the utility and trustworthiness of findings. However, there is a lack of evidence synthesis on the effectiveness of available digital or mobile health KT tools to promote SRH interventions for adolescents. We aim to identify, map, and describe existing empirical evidence on the digital KT tools developed to improve adolescent SRH outcomes globally. This study will be conducted using an evidence gap map (EGM) approach to address the objectives, including reviewing relevant literature and a landscape analysis of the outcomes of interest. The following electronic databases will be searched for retrieval of literature: MEDLINE (1946-present), Embase (1974-present), and Global Health (1910-present) via OVID; CINAHL (1936-present) via EBSCOhost; Scopus (1976-present); and Cochrane Library (1993-present) via Wiley. We will include only those studies that focused on adolescents aged 10-19 years and addressed SRH outcomes. We will include experimental studies (randomized or cluster randomized and nonrandomized controlled trials, including quasi-randomized, controlled before-after, and interruptive time series) and observational studies, that is, including prospective cohort and case-control studies. The experimental and observational studies will only be included in the presence of control or comparison arms. Studies with a historical control arm will be excluded. The systematic review software, Covidence (Ventas Health Innovation), will be used to screen and select the studies. Further, 2 independent reviewers will complete the first and second levels of screening of studies and any conflicts arising will be resolved by consensus between the 2 reviewers or by involving the third reviewer. We will conduct the quality assessment of all included studies using the Risk of Bias tool for randomized controlled trials and nonrandomized controlled trials, and AMSTAR2 for systematic reviews. Papers screening, data extraction, and synthesis will be completed by March 2024. We will use EPPI-Mapper (The International Public Policy Observatory) software to generate an online evidence map and to produce the tables and figures for the descriptive report. This EGM review will identify areas with high-quality, evidence-based digital KT tools (for immediate scale and spread) and areas where few or no KT tools exist (for targeted KT tool development and research or policy prioritization). This protocol focused on mapping eHealth KT tools that have been used in the literature to address SRH among adolescents. This will be the first EGM exercise to map digital KT tools to promote adolescents' SRH and will incorporate a range of published sources. DERR1-10.2196/55081.

Research Output and Knowledge Translation Among Faculty Members of University of Technology, Jamaica

Universities are very important assets to produce research knowledge. The three major responsibilities of university faculty members are teaching, research, and community service. Balancing these three responsibilities is often very challenging, and the work that suffers most is research. The government of every nation looks up to its universities to produce research knowledge. The goal is to investigate the research output and knowledge translation among faculty members at Jamaica’s national university. A descriptive quantitative cross-sectional design was used for this study. This design was used to collect data from faculty members at one point in time. Most of the respondents (56.3%) perceived a lack of protected time for research as a barrier to research productivity. Seventy-five percent of the respondents reported having published one research article as the first author in the last two years. The majority (75%) of the respondents have concerns about the research policy of the university. The most common perceived barrier to knowledge translation (KT) was a lack of awareness of the concept of KT. The faculty members are experiencing challenges in conducting research and translating research findings. Keywords: Knowledge translation, Research output.

Research Knowledge Translation in Sensory Integration-Based Therapy: Exploring Subjectivity of Clinical Expertise.

Background. Clinical expertise is the mechanism through which practitioners implement other components of evidence-based practice (EBP). Within occupational therapy practice, intervention approaches that are both closely and loosely aligned with Ayres' Theory of Sensory Integration are widespread, offering a unique opportunity to investigate the subjective nature of clinical expertise in EBP. Purpose. This qualitative study explored motivations to offer sensory integration-based interventions, and factors informing occupational therapists' clinical decision making in relation to an arguably contentious evidence base. Method. Six post-graduate sensory integration trained UK occupational therapists participated in individual semi-structured interviews. Interviews were transcribed, member-checked and analyzed using thematic coding analysis. Findings. Despite sound understanding of theory and continuous efforts to develop clinical knowledge, non-traditional hierarchies of evidence notably inform clinical decisions. The clinical expertise required for integration of patient preferences, clinical state and circumstances, and research evidence is informed by pragmatic responses to facilitators and barriers across contexts, combined with unique profession-specific identity factors. Implications. While empirical healthcare research is ideally undertaken under controlled conditions, realities of clinical practice are rarely so clear cut. Study findings highlight important subjective factors that are central to real-world research knowledge translation and further understanding of the clinical expertise component of EBP.

Through the big top: An exploratory study of circus-based artistic knowledge translation in rural healthcare services, Québec, Canada.

The conventional methods and strategies used for knowledge translation (KT) in academic research often fall short in effectively reaching stakeholders, such as citizens, practitioners, and decision makers, especially concerning complex healthcare issues. In response, a growing number of scholars have been embracing arts-based knowledge translation (ABKT) to target a more diverse audience with varying backgrounds and expectations. Despite the increased interest, utilization, and literature on arts-based knowledge translation over the past three decades, no studies have directly compared traditional knowledge translation with arts-based knowledge translation methods. Thus, our study aimed to evaluate and compare the impact of an arts-based knowledge translation intervention-a circus show-with two traditional knowledge translation interventions (webinar and research report) in terms of awareness, accessibility, engagement, advocacy/policy influence, and enjoyment. To conduct this exploratory convergent mixed method study, we randomly assigned 162 participants to one of the three interventions. All three knowledge translation methods were used to translate the same research project: "Rural Emergency 360: Mobilization of decision-makers, healthcare professionals, patients, and citizens to improve healthcare and services in Quebec's rural emergency departments (UR360)." The findings revealed that the circus show outperformed the webinar and research report in terms of accessibility and enjoyment, while being equally effective in raising awareness, increasing engagement, and influencing advocacy/policy. Each intervention strategy demonstrates its unique array of strengths and weaknesses, with the circus show catering to a diverse audience, while the webinar and research report target more informed participants. These outcomes underscore the innovative and inclusive attributes of Arts-Based Knowledge translation, showcasing its capacity to facilitate researchers' engagement with a wider array of stakeholders across diverse contexts. As a relevant first step and a complementary asset, arts-based knowledge translation holds immense potential in increasing awareness and mobilization around crucial health issues.

Gut Microbiota and Vascular Diseases: An Update

Vascular diseases, including atherosclerosis, aneurysms, and vascular calcification, are a leading cause of morbidity and mortality worldwide. In past decades, the gut microbiota has been found to be an indispensable population exerting effects on hosts under physiological and pathological conditions. Gut microbiota-derived metabolites, such as trimethylamine-N-oxide and short-chain fatty acids, mediate these effects by regulating vascular cells systematically. Translation of research knowledge to clinical scenarios has led to the development of new therapies including dietary interventions and metabolite inhibitors. This review describes recent advancements in understanding of the interplay between the gut microbiota and vascular dysfunction, and potential treatments for vascular diseases.

Nurse engagement in antibiotic time-outs: The collaborative process of leveraging design to disseminate research findings.

Research findings and knowledge translation are typically disseminated via presentations at professional meetings and publication in peer-review journals. However, other opportunities to translate research evidence into practice exist, including the use of visual cues. The aim of this paper is to describe the collaborative process of translating key research findings into a clear and compelling visual communication tool. As part of a multimodal research dissemination strategy, the researchers partnered with the University Health Communication Design Program faculty to develop a visual communication strategy to promote the use of antibiotic time-outs by nurses in a health system. An environmental poster was identified as an appropriate mode of communication for its potential to convey a message quickly, impactfully, and economically. Five-step systematic approach, including feedback from end-users. To augment our research dissemination strategy, an action-oriented visual communication tool in the form of a 36x48 inch poster was created within four weeks and placed in the work environment. Unit nursing leaders and staff decided on poster locations for maximum nurse engagement with the message. Creating visual communication to display scientific information is an important skill, but most nurse researchers never receive any formal training that encourages participation in collaborative development of visual communication tools. Our collaboration, was iterative, reflective, and provided a unique opportunity for shared learning. Partnering with health communication designers to expand research reach and impact is invaluable and should be considered as part of a dissemination strategy. Clinical nurses' benefit from 'seeing' the science narrowed to a simple message in order to spark dialogue or remind them what they need to 'do'.

Understanding how and under what circumstances integrated knowledge translation works for people engaged in collaborative research: metasynthesis of IKTRN casebooks.

Interaction and collaboration between researchers, patients/public, clinicians, managers and policy-makers are necessary to enhance the relevance and use of research, improve planning, and optimize healthcare delivery and outcomes. The Integrated Knowledge Translation Research Network (IKTRN) published four casebooks from 2019 to 2021, describing varied approaches to research co-production. Our aim was to examine the case studies to extend existing theoretical and empirical perspectives about how co-production works. We used metasynthesis, a qualitative research design that includes seven iterative steps (clarify the purpose, delineate the case studies included, extract and code the data, derive themes from the coded data, determine the relationships of the themes to research co-production, synthesize the concepts, and build theory). A total of 35 cases was reviewed. The aggregate findings of this metasynthesis identified multiple contextual and process factors, barriers, and facilitators that influence integrated knowledge translation (IKT), and a range of IKT activities that increased the likelihood of success of co-production during research. In comparing the findings from the metasynthesis with existing literature, we found a number of consistencies, but also new information about barriers, facilitators, IKT activities and outcomes, thereby adding to our understanding about factors that influence co-production. This metasynthesis provided concrete examples to optimize co-produced clinical and health system research. More research is needed to fully understand how to overcome some challenging modifiable barriers, establish relationships, facilitate communication, overcome power differentials and create processes for knowledge-users working across boundaries (clinical practice and research) to stay engaged and participate fully in research endeavours.

775-P: Predictors of Glycemic Control in Older People with Type 2 Diabetes Treated with iGlarLixi—A Pooled Analysis

For older adults (>65 years) with type 2 diabetes (T2D), iGlarLixi can be a simple and effective therapeutic option. We aimed to identify factors associated with achieving target HbA1c <7% and derived Time in Range (dTIR) ≥70% in this population in response to once daily iGlarLixi. This post-hoc, pooled analysis of 4 randomized trials included 465 people advancing from oral (LixiLan-O), GLP-1 RA (LixiLan-G), or insulin (LixiLan-L; SoliMix) therapies to iGlarLixi for 26 or 30 weeks. HbA1c and dTIR responses were assessed at baseline (BL) and end of treatment (EOT) for each participant and classified as attained (<7.0% or dTIR ≥70%) or unattained (≥7.0% or <70%). dTIR was calculated from 7-point self-monitored plasma glucose profiles from the three LixiLan studies (LixiLan-O. G, and L). Potential predictive factors were analyzed by univariable and multivariable stepwise logistic regression. Overall, 60% of participants achieved HbA1c <7.0% and 87.5% achieved dTIR ≥70%. Predictors of attained HbA1c response (p<0.05) included lower BL HbA1c and lower BL insulin dose. Predictor of attained dTIR response (p<0.05) was higher BL fasting plasma glucose (FPG; Table), while sex, T2D duration, and obesity had no predictive value. To conclude, in older people with T2D treated with iGlarLixi, consideration of BL HbA1c and FPG, as well as BL insulin dose may improve achieving individualized glycemic targets. Disclosure M.Munshi: Consultant; Sanofi. R.Ritzel: Consultant; Novo Nordisk, Sanofi, Speaker's Bureau; Novo Nordisk, Sanofi, Pfizer Inc., Merck Sharp & Dohme Corp., Lilly. R.J.Mccrimmon: Advisory Panel; Sanofi, Speaker's Bureau; Novo Nordisk A/S. I.Hramiak: Research Support; Eli Lilly and Company, Novo Nordisk, Sanofi, Speaker's Bureau; Canadian Medical & Surgical Knowledge Translation Research Group (CMS), Insulet Corporation, Medtronic, Merck & Co., Inc., Bayer Inc. F.Lauand: Employee; Sanofi. L.Melas-melt: None. E.Souhami: Employee; Sanofi, Stock/Shareholder; Sanofi. J.Rosenstock: Advisory Panel; Applied Therapeutics Inc., Boehringer Ingelheim Inc., Eli Lilly and Company, Novo Nordisk, Oramed Pharmaceuticals, Sanofi, Zealand Pharma A/S, Intarcia Therapeutics, Inc., Hanmi Pharm. Co., Ltd., Research Support; Applied Therapeutics Inc., Boehringer Ingelheim Inc., Eli Lilly and Company, Merck & Co., Inc., Novartis, Novo Nordisk, Pfizer Inc., Sanofi, Intarcia Therapeutics, Inc. Funding Sanofi

799-P: Predictors of Glycemic Control by Derived Time in Range for People with Type 2 Diabetes Advancing with iGlarLixi—A Pooled Analysis

This post-hoc, pooled analysis of 3 randomized controlled trials aimed to identify factors associated with achieving a derived Time in Range (dTIR) ≥70% at the end of treatment (EOT) with iGlarLixi in people with type 2 diabetes (T2D). dTIR was calculated from 7-point self-monitored plasma glucose (SMPG) profiles and assessed at baseline (BL) and EOT for people with T2D advancing from oral (LixiLan-O), insulin (LixiLan-L), or GLP-1 RA (LixiLan-G) therapy to once-daily iGlarLixi. Participants at EOT were classified as either achieving or not achieving dTIR ≥70%, and corresponding predictive BL characteristics were analyzed with univariable and multivariable stepwise logistic regression. Analyses (N=880) showed that 86% of participants achieved dTIR ≥70% with iGlarLixi; T2D duration and HbA1c at BL were greater in those with dTIR <70% (mean [SD] 11.35 [7.31] years and 8.26 [0.68] %) than those with dTIR ≥70% (10.40 [6.51] years and 7.96 [0.68] %), respectively. Post-meal SMPG at BL was higher in those not achieving dTIR ≥70%. Lower BL HbA1c (p=0.0205), BL insulin dose (p<0.0001), and hypoglycemia level 2 frequency (p=0.0139 for 1-3 vs 0 events; p=0.0172 for ≥4 vs 0) were predictors of attaining dTIR ≥70% (Table). HbA1c, insulin dose, and hypoglycemia frequency at BL were predictors of achieving target dTIR ≥70% in people with T2D advancing therapy with iGlarLixi. Disclosure I.Hramiak: Research Support; Eli Lilly and Company, Novo Nordisk, Sanofi, Speaker's Bureau; Canadian Medical & Surgical Knowledge Translation Research Group (CMS), Insulet Corporation, Medtronic, Merck & Co., Inc., Bayer Inc. J.P.Frias: Advisory Panel; Becton, Dickinson and Company, Pfizer Inc., Sanofi, Consultant; Akero Therapeutics, Inc., 89bio, Inc., Aimmune, Boehringer Ingelheim Inc., Eli Lilly and Company, Carmot Therapeutics, Inc., Echosens, Merck & Co., Inc., Metacrine, Inc., Novo Nordisk, Pfizer Inc., Sanofi, Employee; Ionis Pharmaceuticals, Research Support; Akero Therapeutics, Inc., 89bio, Inc., Altimmune, Axcella Health Inc., Boehringer Ingelheim Inc., Eli Lilly and Company, Intercept Pharmaceuticals, Inc., Carmot Therapeutics, Inc., Janssen Pharmaceuticals, Inc., Madrigal Pharmaceuticals, Inc., Merck & Co., Inc., Metacrine, Inc., Novo Nordisk, Oramed Pharmaceuticals, Novartis, Pfizer Inc., Sanofi, Speaker's Bureau; Eli Lilly and Company, Sanofi. H.Aydin: Advisory Panel; Sanofi, Novo Nordisk, Boehringer Ingelheim Inc., Speaker's Bureau; Novo Nordisk. F.Lauand: Employee; Sanofi. L.Melas-melt: None. E.Souhami: Employee; Sanofi, Stock/Shareholder; Sanofi. M.Haluzik: Advisory Panel; Novo Nordisk, Lilly Diabetes, Boehringer-Ingelheim, Research Support; Sanofi, Speaker's Bureau; Abbott, AstraZeneca. J.Rosenstock: Advisory Panel; Applied Therapeutics Inc., Boehringer Ingelheim Inc., Eli Lilly and Company, Novo Nordisk, Oramed Pharmaceuticals, Sanofi, Zealand Pharma A/S, Intarcia Therapeutics, Inc., Hanmi Pharm. Co., Ltd., Research Support; Applied Therapeutics Inc., Boehringer Ingelheim Inc., Eli Lilly and Company, Merck & Co., Inc., Novartis, Novo Nordisk, Pfizer Inc., Sanofi, Intarcia Therapeutics, Inc. Funding Sanofi

Wicked problems in a post-truth political economy: a dilemma for knowledge translation

The discipline of knowledge translation (KT) emerged as a way of systematically understanding and addressing the challenges of applying health and medical research in practice. In light of ongoing and emerging critique of KT from the medical humanities and social sciences disciplines, KT researchers have become increasingly aware of the complexity of the translational process, particularly the significance of culture, tradition and values in how scientific evidence is understood and received, and thus increasingly receptive to pluralistic notions of knowledge. Hence, there is now an emerging view of KT as a highly complex, dynamic, and integrated sociological phenomenon, which neither assumes nor creates knowledge hierarchies and neither prescribes nor privileges scientific evidence. Such a view, however, does not guarantee that scientific evidence will be applied in practice and thus poses a significant dilemma for KT regarding its status as a scientific and practice-oriented discipline, particularly within the current sociopolitical climate. Therefore, in response to the ongoing and emerging critique of KT, we argue that KT must provide scope for relevant scientific evidence to occupy an appropriate position of epistemic primacy in public discourse. Such a view is not intended to uphold the privileged status of science nor affirm the “scientific logos” per se. It is proffered as a counterbalance to powerful social, cultural, political and market forces that are able to challenge scientific evidence and promote disinformation to the detriment of democratic outcomes and the public good.