Knowledge Translation Process Research Articles

ScreenABLE: Breast Cancer Screening among Women with Disabilities from Community Identified Challenges to Community-Based Programs.

Women with disabilities are an unrecognized cancer disparities population who experience well-documented barriers to breast cancer screening. There is a critical need for targeted, community-directed programing to address these disparities. To describe the trajectory of a long-term community-academic partnership aimed at understanding and addressing breast cancer screening disparities among women with disabilities. Phase 1 was a thematic qualitative focus group study (n = 40) with women with physical disabilities to understand their breast cancer screening experiences. Phase 2 was the application of an equity-focused knowledge translation (KT) process that brought together breast cancer survivors with disabilities and graduate applied health students in KT collaboratives to create innovative, evidence-informed knowledge products. Phase 3 included the development of community-based programming. In phase 1, women with disabilities identified provider and patient barriers to breast cancer screening, including a lack of provider knowledge and respect for individuals with disabilities, lack of accessibility, the history of stigma and mistreatment within the health care setting, and treatment fatigue. In phase 2, KT collaboratives created the short film "ScreenABLE" to educate providers and community members about physical and attitudinal barriers to cancer screening. In phase 3, community, academic, and clinical partners collaborated to create ScreenABLE Saturday, a wellness fair and free accessible mammograms, for women with disabilities with programming developed to directly address cancer screening barriers identified from the phase 1 research. Long-term sustained partnerships between academic, disability, and clinical partners are needed to address the complex issues that perpetuate breast cancer screening disparities among women with disabilities.

Australian musculoskeletal physiotherapist's perceptions, attitudes and opinions towards pre-manipulative screening of the cervical spine prior to manual therapy: Report from the focus groups

BackgroundThe Australian Physiotherapy Association 2006 VBI Guidelines are used by many of the member organisations of IFOMPT. These Guidelines are due for revision incorporating recent research findings, international guides, and member's recommendations. PurposeTo identify and consider Australian musculoskeletal physiotherapists' recommendations to inform revision of the 2006 VBI Guidelines. MethodsFocus groups were conducted in the five larger Australian state capitals by an independent qualitative researcher and a subject expert. Qualitative data were collected from 41 musculoskeletal physiotherapists who were purposefully recruited for their broad range of experience and qualifications. The five stage Framework Analysis approach was used to analyse and interpret data. ResultsParticipants recommended that the revised Guidelines have a new title reflecting a broader risk assessment and management approach, encompassing both musculoskeletal and relevant cardio-vascular risks and informed by contemporary research evidence and clinical experience. Participants requested a positively worded stepwise guide to clinical reasoning for all cervical spine manual treatment scenarios including the process of gaining and recording consent. Participants advised on individual components of the Guidelines needing to be revised or removed. The revised Guidelines, once approved, need to be disseminated in written and electronic formats to all clinicians. Training and education are required to ensure appropriate uptake within and beyond the profession. Conclusions and implicationsTo ensure their clinical acceptance and utility, the Revised Guidelines need to reflect the current use and recommendations of musculoskeletal physiotherapists. Sound knowledge translation processes are then needed to ensure that the Guidelines are incorporated into practice.

Introduction to Knowledge Translation in Health Care Research

Knowledge translation may be understood as the process of synthesizing, disseminating, and exchanging information to appropriate audiences. This process is an essential component of research, ensuring that research findings reach the knowledge users in a cost-efficient and meaningful manner. However, novice investigators may sometimes believe knowledge translation equates to presentations at research conferences and publishing in a journal. The objective of this paper is to address this misconception by providing an overview of the knowledge translation process for novice investigators. The authors will first define knowledge translation and describe its importance in health care research. Following this brief introduction, a framework for knowledge translation, the Knowledge-to-Action Cycle, will be ex-amined to equip novice investigators with the essential knowledge and strategies they need to develop and implement successful research proposals. The information presented in this paper may enable novice investigators to understand and apply knowledge translation in their research, enhancing its applicability and usefulness. The authors conclude this paper by clarifying the various approaches, levels, and means of knowledge translation, and by constructing a brief overview of planning considerations for novice investigators engaging in knowledge translation.

An Evidence Map of Research Linking Dietary Sugars to Potentially Related Health Outcomes

BackgroundEvidence mapping is an emerging tool used to systematically identify, organize, and summarize the quantity, distribution, and characteristics of published studies with the goal of identifying knowledge gaps and future research needs. ObjectiveThe aim of the study was to present an evidence-map database of all published studies that investigated dietary sugars and to select health outcomes for explicating research trends and gaps. MethodsTo update an evidence-map database previously published in 2013, we performed a literature search in MEDLINE to identify English-language, peer-reviewed human intervention and prospective cohort studies published from January 2013 to December 2016. Abstracts and full-text articles were dual screened on the basis of predefined eligibility criteria. We classified outcomes into 7 health outcome categories that are potentially affected by dietary sugar. Data from the updated evidence-map database were merged with those from the previous database for analysis and charting. ResultThere were 918 sugar and control intervention arms from a total of 298 intervention studies from 1966 to December 2016. A variety of sugar interventions were investigated across the included intervention studies, and it appears that the research interest across all outcome categories (cardiovascular disease risks, diabetes risks, body weight, body composition, appetite, dietary intake, and liver health–related outcomes) sharply increased from 2006. Bubble plots showed research gaps in long-term intervention studies and in intervention studies in patients with diabetes. In contrast, all 25 included cohort studies had long-term follow-up durations and much larger sample sizes than did intervention studies. None of the cohort studies evaluated dietary intake outcomes, and only one cohort study each examined appetite- and liver health–related outcomes. ConclusionThe research trends and research gaps have not changed since 2013 when the original evidence-map database was updated. With continuous updating, evidence mapping can facilitate the process of knowledge translation and possibly reduce research waste. Curr Dev Nutr 2018;2:nzy059.

Knowledge Translation Process among Academic Researchers: A Case Study of Bushehr University of Medical Sciences

Abstract Today, most of the results and knowledge obtained from national and international research do not actually change the health status of people, which has led to a gap or distance between knowledge and practice. This research was a descriptive survey and examined the status of the knowledge translation process among the researchers of Bushehr University of Medical Sciences, Iran, from 2011 to 2015. The study population consisted of the researchers of the Bushehr University of Medical Sciences, who were chosen using a completely randomized design. 83 researchers were finally selected by the inclusion criteria of presenting or collaborating on at least five approved areas of research during the 2011–2015 period. Data collection was undertaken using the Assessment Questionnaire of Academic Researchers Knowledge Translation Activities, with its psychometric test also used. The results showed that the researchers’ performance was rated in the fields of transfer of the research question, knowledge production, knowledge transfer and promoting the use of evidence with 64, 75, 63 and 67 % of the total score (mean± SD) of 19.40 ± 3.89, 26.30 ± 3.97, 37.79 ± 6.89 and 13.39 ± 3.41 respectively. Based on the results of this study, the performance of the researchers in the process of knowledge translation was at a desired level while, in the fields of the research tool, the researchers had the best research performance in knowledge production and promoting the use of evidence, transfer of research question and knowledge transfer (all at the desirable level). However, the gap between knowledge and practice of the researchers in the fields of transfer of the research question and knowledge transfer was noticeable. Therefore, in order to strengthen all aspects of the research activities of the knowledge translation process, the provision of proper premises and structure will be a priority for the university’s research and technology departments.

Evidence-Based Diabetes Care in Indonesia—Knowledge Translation and the Transfer of Best Practice

Indonesia is continuously among the top ten countries worldwide in the number of people living with diabetes. Evidence-based practice (EBP) has the potential to improve the effectiveness and efficiency of diabetes care. However, the strategy to efficiently translate the best evidence into practice isof particular concern in developing countries. The overall aim of this thesis is to explore the status of knowledge translation on diabetes care in Indonesia. To answer that, we conducted various assessment on each of the stages on the knowledge translation process. Initially we conducted a survey to assess the degree of awareness, agreement, adoption and adherence of general practitioners (GPs) in Indonesia to type 2 diabetes mellitus guidelines, and their association with characteristics of the responders. The survey found that high awareness of the Indonesian type 2 diabetes guideline does not necessary lead to adoption or adherence to recommendations important for outcomes and quality of care. However, the awareness-to-adherence model helps in identifying barriers for the use of guidelines. We then evaluated the quality of an Indonesian type 2 diabetes guideline (Perkeni’s guideline 2011) adapted from four international guidelines. We found that the process underlying the Indonesian type 2 diabetes guideline development is curtailed due to being under-resourced and the use of the cited suboptimal source guidelines might risk the validity of the recommendations it contains. Implementation of evidence-based practice principles such as those proposed by ADAPTE collaboration should be adhered to when guideline are derived from other guidelines to be used in other than its original context or circumstances. We also conducted an evaluation of the quality of reporting of the risk of bias of the Indonesian medical research. As we found only a small proportion of Indonesian studies which have high quality reporting or methods, we recommend to endorse and follow international reporting guidelines to improve the quality of future studies. In the end we learned that although EBP is a concept which originated from developed countries, its implementation in developing countries like Indonesia is highly relevant. The development of the knowledge and skills on EBP in Indonesia is progressing as there are efforts in integrating evidence-based practice in the medical curriculum along with continuing professional development activities. However, to achieve health benefits, the evidence must be moved into action. This thesis helps identified some gaps in the knowledge creation and application especially on diabetes care. The gaps on the knowledge creation include limited number and low quality of evidence on diabetes care, very little production of systematic reviews on the problems related to diabetes care which are relevant to Indonesian situation and low rigor of development as well as low applicability of the existing diabetes guidelines. The remaining gaps should be assessed thoroughly using rigorous methods which involve relevant stakeholders. The effort should be followed by the continuous action cycle of the knowledge translation process. Promoting the knowledge translation process should be done simultaneously with the evidence-based practice capacity building to achieve improvement in health care in a developing country like Indonesia.

Implementation Process and Impacts of a Participatory HIV Research Project with Key Populations.

A participatory HIV research project was conducted with sex workers (SW) and men who have sex with men (MSM) to understand epidemiological HIV dynamics and associated sociobehavioural factors among these vulnerable groups. We examine the impact of this project, critically analysing the processes undertaken and focusing on the advantages and the challenges faced. A partnership was built through two Community Advisory Boards (CABs) and a Scientific Commission (SC). Regular meetings, workshops, and focus groups were conducted with CABs, SC, and partners to assess the processes and outcomes of the project implementation. This participatory research produced change processes with impacts at different levels: individuals, community organizations, health professionals, academics, and policy-makers. Advantages of the participatory process were encountered but also challenges, evidencing the dynamic and complex nature of each project's stage. This project showed that participatory research can work as an intervention. Indeed, it triggered a dynamic and interactive process of knowledge coproduction and translation into effective community-oriented health actions and policies. The participatory research reproduced an innovative alliance for HIV prevention and sexual health promotion responsive to local needs and priorities. Further efforts are needed to systematize and evaluate the processes and impacts of participatory health research.

COLLABORATIVE RESEARCH, CAPACITY BUILDING AND KNOWLEDGE TRANSLATION DEVELOPMENT FOR RESEARCH ON ADVERSE BIRTH OUTCOMES AND THE ENVIRONMENT

Abstract BACKGROUND The DoMiNO (Data mining & Neonatal outcomes) project explores the relationship between the environment and adverse birth outcomes. The project applies Integrated Knowledge Translation; a collaborative approach that builds on the participation, expertise and perspectives of interdisciplinary researchers, clinicians and knowledge-users, to ground and enhance the depth and breadth of research and to facilitate knowledge translation. Understanding the components that impact team building processes can contribute to supporting collaborative efforts. OBJECTIVES Based on the DoMiNO project we present major components that contributed to building team capacity for knowledge creation and the development of a knowledge translation plan. DESIGN/METHODS We use this project’s Integrated Knowledge Translation process as a case study in a qualitative evaluation of the ongoing research collaboration (experience and learnings) following team engagement in the research process (e.g., meetings, informal interactions). Participants included all 24 DoMiNO team members. Data were collected through interviews, focus groups, surveys and participant observations, all adding to the cumulative understanding of the collaborative research process and the knowledge translation plan evolution. All data were coded and analyzed using thematic analysis procedures. RESULTS Findings highlight the interrelated components of building capacity to support the research progress, co-production and knowledge translation plan development. These components include commitment, work etiquette, balancing perspectives, power and ownership, as well as communication, transparency, learning/ sharing knowledge and alignment. These contribute to building relationships, trust and capacity. Once those were established and research deliverables were clearer, the main messages and attainable knowledge translation goals were identified. The knowledge translation Several components contribute to capacity building and the development of the KT plan. In this complex context, it is an ongoing iterative process that evolves through time, as the team works and builds capacity. Identifying and supporting the essential components of team development could optimize capacity building. plan was then articulated to identify potential users, audiences, and strategies. CONCLUSION Several components contribute to capacity building and the development of the KT plan. In this complex context, it is an ongoing iterative process that evolves through time, as the team works and builds capacity. Identifying and supporting the essential components of team development could optimize capacity building.

Getting inTOUCH: outcomes of a knowledge translation intervention for tactile assessment knowledge, barriers, and practice in paediatric therapists working with children with cerebral palsy

Background: Tactile impairments are common in children with cerebral palsy (CP), however assessment is not routinely carried out by therapists. We investigated a multi-faceted Knowledge Translation intervention to improve Knowledge, remove Barriers and enhance Practice of tactile assessments by paediatric therapists.Method: Twelve therapists from a state-wide service for children with CP (seven physiotherapists, five occupational therapists; 12 female) received: written information, demonstration videos, a face-to-face workshop, equipment provision, and on-call mentoring. Therapists completed pre–post-intervention questionnaires reporting their perceived tactile assessment Knowledge, current Practices and implementation Barriers.Results: Following intervention, therapists improved Knowledge of correct (1) tactile impairment prevalence in children with CP (pre 3/12; post 9/12), (2) tactile assessment items (e.g. Registration – pre 1/12; post 9/12; Localisation – pre 2/12; post 10/12), and (3) equipment choice (e.g. Monofilaments – pre 1/12; post 10/12). Tactile assessment Practice improved slightly. All major clinician-level implementation Barriers were resolved and less obvious organisational-level Barriers were identified for follow-up.Conclusion: A 12-month multi-faceted Knowledge Translation intervention can improve tactile assessment Knowledge, resolve major clinician-level implementation Barriers, and identify less obvious organisational-level Barriers to be addressed to achieve maximum Practice improvement. Ongoing multi-faceted knowledge translation processes are essential for high-performing organisations.Implications for rehabilitationA multi-faceted knowledge translation intervention significantly improved paediatric therapists’ knowledge of the items and equipment necessary for tactile assessment.A 12-month intervention can address clinician-level barriers of knowledge, confidence, and access to equipment and assist in the identification of less obvious organisational-level barriers.Consideration of motivational readiness for change, intervention timelines, monitoring of emergent barriers, and fitting tactile assessment into a broader assessment framework are critical for improving uptake of tactile assessment in practice.

Knowledge Translation

Knowledge translation (KT) provides a lens to examine the process of moving research-informed knowledge into early intervention practice (P. Sudsawad, 2007). The process of KT entails cognitive, affective, and behavioral stages that are mediated by factors intrinsic and extrinsic to the practitioner. Facilitators and barriers to this process may exist at the level of the practitioner, practice environment, or research evidence (P. J. Manns, A. V. Norton, & J. Darrah, 2015). The conceptual framework described in this article utilized the Diffusions of Innovations Theory and the Ottawa Model of Research Use concurrently to examine factors that influence the process of KT for the early intervention (EI) workforce (J. Logan & I. D. Graham, 1998 ; E. M. Rogers, 1983 , 2003b). The information gathered from the utilization of KT frameworks can generate recommendations for change and tailor KT initiatives to meet the professional development needs of EI providers (B. J. Cunningham, P. Rosenbaum, & M. Hidecker, 2016 ; A. Hudon, M. Gervais, & M. S. Hunt., 2015 ; D. Levac, S. M. N. Clegg, C. Camden, L. M. Rivard, & C. Missiuna, 2015).

Using Complexity to Simplify Knowledge Translation Comment on "Using Complexity and Network Concepts to Inform Healthcare Knowledge Translation".

Putting health theories, research and knowledge into practice is a challenge referred to as the knowledge-toaction gap. Knowledge translation (KT), and its related concepts of knowledge mobilization, implementation science and research impact, emerged to mitigate this gap. While the social interaction view of KT has gained currency, scholars have not easily made a link between KT and the concept of complexity. Kitson and colleagues suggest we ought to examine the role of complexity in KT processes using defined theories and concepts borrowed from network and complex adaptive systems theory. They further argue that better KT outcomes might be achieved using this new lens. There remain, however, several critical considerations for this sort of theory application to work in the real-world. Complexity and network theory offer explanatory power about the KT problem, but these theories are less helpful for understanding solutions.

Applying KT Network Complexity to a Highly-Partnered Knowledge Transfer Effort Comment on "Using Complexity and Network Concepts to Inform Healthcare Knowledge Translation".

The re-conceptualization of knowledge translation (KT) in Kitson and colleagues’ manuscript "Using Complexity and Network Concepts to Inform Healthcare Knowledge Translation" is an advancement in how one can incorporate implementation into the KT process. Kitson notes that "the challenge is to explain how it might help in the healthcare policy, practice, and research communities." We propose that these concepts are well presented when considering highly-partnered research that includes all sectors. In this manuscript we provide an example of highly-partnered KT effort framed within the KT Complexity Network Theory. This effort is described by identifying the activities and sectors involved.

Promoting evidence informed policymaking for maternal and child health in Nigeria: lessons from a knowledge translation workshop.

Background: Knowledge translation (KT) is a process that ensures that research evidence gets translated into policy and practice. In Nigeria, reports indicate that research evidence rarely gets into policymaking process. A major factor responsible for this is lack of KT capacity enhancement mechanisms. The objective of this study was to improve KT competence of an implementation research team (IRT), policymakers and stakeholders in maternal and child health to enhance evidence-informed policymaking. Methods: This study employed a “before and after” design, modified as an intervention study. The study was conducted in Bauchi, north-eastern Nigeria. A three-day KT training workshop was organized and 15 modules were covered including integrated and end-of-grant KT; KT models, measures, tools and strategies; priority setting; managing political interference; advocacy and consensus building/negotiations; inter-sectoral collaboration; policy analysis, contextualization and legislation. A 4-point Likert scale pre-/post-workshop questionnaires were administerd to evaluate the impact of the training, it was designed in terms of extent of adequacy; with “grossly inadequate” representing 1 point, and “very adequate” representing 4 points.Results: A total of 45 participants attended the workshop. There was a noteworthy improvement in the participants’ understanding of KT processes and strategies. The range of the preworkshop mean of participants knowledge of modules taught was from 2.04-2.94, the range for the postworkshop mean was from 3.10–3.70 on the 4-point Likert scale. The range of percentage increase in mean for participants’ knowledge at the end of the workshop was from 13.3%–55.2%.Conclusion: The outcome of this study suggests that using a KT capacity building programme e.g., workshop, health researchers, policymakers and other stakeholders can acquire capacity and skill that will facilitate evidence-to-policy link.

How Do Clinicians Learn About Knowledge Translation? An Investigation of Current Web-Based Learning Opportunities.

BackgroundClinicians are important stakeholders in the translation of well-designed research evidence into clinical practice for optimal patient care. However, the application of knowledge translation (KT) theories and processes may present conceptual and practical challenges for clinicians. Online learning platforms are an effective means of delivering KT education, providing an interactive, time-efficient, and affordable alternative to face-to-face education programs.ObjectiveThis study investigates the availability and accessibility of online KT learning opportunities for health professionals. It also provides an analysis of the types of resources and associated disciplines retrieved by a range of KT synonyms.MethodsWe searched a range of bibliographic databases and the Internet (Google advanced option) using 9 KT terms to identify online KT learning resources. To be eligible, resources had to be free, aimed at clinicians, educational in intent, and interactive in design. Each term was searched using two different search engines. The details of the first 100 websites captured per browser (ie, n=200 results per term) were entered into EndNote. Each site was subsequently visited to determine its status as a learning resource. Eligible websites were appraised for quality using the AACODS (Authority, Accuracy, Coverage, Objectivity, Date, Significance) tool.ResultsWe identified 971 unique websites via our multiple search strategies. Of these, 43 were health-related and educational in intent. Once these sites were evaluated for interactivity, a single website matched our inclusion criteria (Dementia Knowledge Translation Learning Centre).ConclusionsKT is an important but complex system of processes. These processes overlap with knowledge, practice, and improvement processes that go by a range of different names. For clinicians to be informed and competent in KT, they require better access to free learning opportunities. These resources should be designed from the viewpoint of the clinician, presenting KT’s multifaceted theories and processes in an engaging, interactive way. This learning should empower clinicians to contextualize and apply KT strategies within their own care settings.

Creation of an Integrated Knowledge Translation Process to Improve Pediatric Emergency Care in Canada

ABSTRACTTREKK (Translating Emergency Knowledge for Kids) was established to address knowledge needs to support care of children in general emergency departments. To achieve this goal, we developed an integrated knowledge translation (KT) process based on identified priorities to create the TREKK Evidence Repository, containing “knowledge pyramids” and Bottom Line Recommendations (summary documents) on the diagnosis and treatment of emergency pediatric conditions. The objective of this article is to describe our methods for developing and disseminating the TREKK Evidence Repository to improve pediatric emergency care in Canada. Our work was guided by the research question: Can an integrated KT process address an information gap in healthcare practice? We utilized a pyramid-shaped framework, built upon the “4S” hierarchy of evidence model, to provide detailed evidence appropriate to stakeholders’ needs. For each priority condition (asthma, bronchiolitis, croup, etc.), clinical advisors and KT experts collaborated to create a Bottom Line Recommendation and to select guidelines, reviews, and key studies for that condition’s topic area in the Evidence Repository on the TREKK website (trekk.ca). Targeted promotion, including a social media campaign, communicated the availability of new topics in the Evidence Repository and available knowledge tools. Feedback from 35 end-users on pilot versions of the Evidence Repository was positive with 91% indicating that they would use the resource in the emergency department. Using an integrated KT process, we responded to end-users’ requests for varying level of information on priority pediatric conditions through the creation of knowledge tools and development of a process to identify and vet high quality evidence-based resources.

Media reporting of ProtecT: a disconnect in information dissemination?

Given the central role of the media in disseminating information to the public, we analyzed news coverage of the recent publication from ProtecT to assess views on treatment, the level of detail presented and degree of bias. We applied a predefined search strategy to identify all news articles reporting on ProtecT within 30 days of its publication. Articles were independently assessed by two urologists and two lay persons using five-point Likert scales. Descriptive statistics and analysis of variance were used. Of 33 unique articles identified, 20 (61%) conveyed negative views on definitive treatment for localized prostate cancer (PCa), while 29 (88%) expressed favorable views of active surveillance/monitoring (AM). Nevertheless, fewer than half of the articles described what AM entails (n=15; 46%) or the rate of treatment in the AM arm (n=12; 36%). Moreover, while 32 (97%) articles highlighted the absence of a difference in cancer-specific mortality at 10 years, only 17 (52%) mentioned the need for longer follow-up. A total of 17 (52%) articles had a notable degree of perceived bias (⩾4/5 on Likert scale), with shorter articles (P=0.02), articles covering few content areas (P=0.03) and articles that did not detail what AM entails (P=0.003) containing significantly increased bias. The majority of news articles regarding ProtecT presented an adverse view of definitive treatment for localized PCa relative to AM, but failed to highlight key nuances of the trial. Healthcare professionals and the lay public should be cautious in acquiring medical news through the general media. Additionally, the urologic community must continue to improve the quality of disseminated information, for example, through proactively engaging with the media, through social media and/or through participation in continuing education lecture series, so as to guide the knowledge translation process, especially upon publication of such potentially influential studies.

Evaluating policy-relevant research: lessons from a series of theory-based outcomes assessments

The increasing external demand from research funders and research managers to assess, evaluate and demonstrate the quality and the effectiveness of research is well known. Less discussed, but equally important, is the evolving interest and use of research evaluation to support learning and adaptive management within research programmes. This is especially true in a research-for-development context where research competes with other worthy alternatives for overseas development assistance funding and where highly complex social, economic and ecological environments add to evaluation challenges. Researchers and research managers need to know whether and how their interventions are working to be able to adapt and improve their programmes as well as to be able to satisfy their funders. This paper presents a theory-based research evaluation approach that was developed and tested on four policy-relevant research activities: a long-term forest management research programme in the Congo Basin; a large research programme on forests and climate change; a multi-country research project on sustainable wetlands management, and; a research project of the furniture value chain in one district in Indonesia. The first used Contribution Analysis and the others used purpose-built outcome evaluation approaches that combined concepts and methods from several approaches. Each research evaluation began with documentation of a theory of change (ToC) that identified key actors, processes and results. Data collected through document reviews, key informant interviews and focus group discussions were analysed to test the ToCs against evidence of outcomes in the form of discourse, policy formulation and practice change. The approach proved valuable as a learning tool for researchers and research managers and it has facilitated communication with funders about actual and reasonable research contributions to change. Evaluations that employed a participatory approach with project scientists and partners noticeably supported team learning about past work and about possible adaptations for the future. In all four cases, the retrospective ToC development proved challenging and resulted in overly-simplistic ToCs. Further work is needed to draw on social scientific theories of knowledge translation and policy processes to develop and further test more sophisticated theories of change. This theory-based approach to research evaluation provides a valuable means of assessing research effectiveness (summative value) and supports learning and adaptation (formative value) at the project or programme scale. The approach is well suited to the research-for-development projects represented by the case studies, but it should be applicable to any research that aspires to have a societal impact. This article is published as part of a collection on the future of research assessment.

Understanding the role of bereavement in the pathway to suicide

IntroductionBereavement is considered to be a common precursor of death by suicide. Studies suggest those bereaved by suicide may be particularly vulnerable to suicide themselves. Recently, there has been a concern over the number of deaths by suicide across UK and Europe. As a result, an increasing number have been exposed to bereavement by suicide. It remains unclear how these deaths might impact on future suicide rates.ObjectivesTo examine a two-year cohort of all suicides in Northern Ireland, in order to report on bereavements recorded in the records of those who died by suicide. To assess the bearing of these deaths on those left behind.AimsTo provide an estimate of the prevalence and types of bereavements that may have contributed towards the suicide.MethodsFollowing the sociological autopsy approach to studying death by suicide, data was collected from a range of sources, including GP records and Coroner records and interviews with bereaved relatives. The analyses draw on relatives’ accounts in order to increase our understanding of the impact of suicide bereavement. Interviews took place between 18 months and 5 years after the death by suicide.ResultsOf the 403 deaths by suicide, 15% of the individuals experienced bereavement and 9% bereavement by suicide. The results support the assertion in the literature that bereavement by suicide increases the risk of suicide through a process of suicide contagion.ConclusionsThe conclusion explains how the findings will be fed into knowledge translation processes, to provide future programs of suicide prevention research and changes to practice.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Tackling Gaps in The Implementation of The Lebanon National Salt Iodization Policy

Despite a universal salt iodization law in Lebanon, a recent nationally representative study highlighted that the median urinary iodine concentration in schoolchildren was only 66 μg/L and almost 75% of 6 to 10 year old schoolchildren have mild iodine deficiency. As a result, identifying and addressing the existing gaps in the implementation of the salt iodization process became a crucial necessity. Herewith, we document the knowledge translation process initiated by researchers together with an international non‐governmental organization, and its subsequent impact.In collaboration with the Knowledge to Policy (K2P) Center, a policy brief was developed to synthesize the local and international evidence and viable policy options. Despite a mandatory salt iodization law issued by the Lebanese government, implementation barriers including loopholes in the law, outdated infrastructure and capacity of salt producers were identified. The law was also poorly evaluated and monitored by related authorities. Three policy options to address the issue were put forward 1) amending the law; 2) strengthening implementation of salt iodization by ensuring adequate standards, infrastructure and capacity; and 3) monitoring and evaluating the implementation of the law at the production, retail and consumer levels by building an efficient system for routine data collection.The policy brief was shared with relevant stakeholders and a national policy dialogue was held. Based on the policy deliberations, the following recommendations were put forward and implemented: (1) the Ministry of Public Health issued a ministerial decree providing clarifications on the existing law, including standards and mechanisms for monitoring and evaluation; (2) with support from international actors, salt producers were trained on monitoring protocols; (3) a one‐year supply of potassium iodate for fortification has been guaranteed by the United Nations Children's Fund.Once all actions are in place, program evaluation will be done at one year post‐implementation through a market analysis of salt samples and the reassessment of national level iodine status. However, further engagement from governmental authorities is needed to develop mechanisms to ensure sustainability of external monitoring and overcome structural barriers salt producers encounter in importing potassium iodate.Support or Funding InformationThis work was funded by the Iodine Global Network and supported by the K2P Center.

The translation of sports injury prevention and safety promotion knowledge: insights from key intermediary organisations

BackgroundA recognised research-to-practice gap exists in the health research field of sports injury prevention and safety promotion. There is a need for improved insight into increasing the relevancy, accessibility and legitimacy of injury prevention and safety promotion research knowledge for sport settings. The role of key organisations as intermediaries in the process of health knowledge translation for sports settings remains under-explored, and this paper aims to determine, and describe, the processes of knowledge translation undertaken by a set of key organisations in developing and distributing injury prevention and safety promotion resources.MethodsThe National Guidance for Australian Football Partnerships and Safety (NoGAPS) project provided the context for this study. Representatives from five key NoGAPS organisations participated in individual face-to-face interviews about organisational processes of knowledge translation. A qualitative descriptive methodology was used to analyse participants’ descriptions of knowledge translation activities undertaken at their respective organisations.ResultsSeveral themes emerged around health knowledge translation processes and considerations, including (1) identifying a need for knowledge translation, (2) developing and disseminating resources, and (3) barriers and enablers to knowledge translation.ConclusionsThis study provides insight into the processes that key organisations employ when developing and disseminating injury prevention and safety promotion resources within sport settings. The relevancy, accessibility and legitimacy of health research knowledge is foregrounded, with a view to increasing the influence of research on the development of health-related resources suitable for community sport settings.