Knowledge Translation Study Research Articles

Learn@Lunch: Developing a continuing professional development programme to raise knowledge and awareness of drinking alcohol as an occupation in later life

Introduction: Occupational therapists in acute practice are increasingly likely to work routinely with people in later life who drink alcohol. Therefore, this knowledge translation study aimed to evaluate the development of a continuing professional development Learn@Lunch programme, designed to enhance awareness and understanding of occupational therapists who work in an acute hospital setting, of drinking alcohol as an occupation in later life. Method: Guided by the Promoting Action of Research Implementation in Health Sciences framework, the continuing professional development programme was developed, and a qualitative evaluation undertaken. This included pre- and post-focus groups with occupational therapists ( n = 8) in an acute setting, where the programme was delivered, pre- and post-programme delivery interviews with the research champion recruited from the site, and one interview with the Allied Health Professions Service Lead. Findings: Findings indicate the Learn@Lunch continuing professional development programme enhanced therapist knowledge and understanding of the changing patterns of drinking alcohol in later life. However, practical barriers exist impacting how participants perceived the value and delivery of the programme. Conclusion: Learn@Lunch was an effective continuing professional development programme and supported enhanced knowledge and awareness of drinking alcohol as an occupation in later life, leading to changes in local acute occupational therapy practice.

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.

A Living Lab for Family Centered Knowledge Exchange in Pediatric Rehabilitation and Development Research: A Study Protocol

Background Historically, the experiences and voices of children and youth living with neurodiversity or rehabilitation needs and their families have not been fully represented in health research. Formative research in this context indicates that families value learning from the experiences of other families as well as from empirical research. However, innovative systems are needed to support this imperative. In response, we co-designed a virtual living lab with families and clinicians to support family-centered knowledge exchange in neurodiversity and rehabilitation research. Living labs are collaborative, user-centered, long-term, and multimethod systems with potential to support the exchange of knowledge of lived experience. This proposal outlines a longitudinal arts-based and qualitative research study that incorporates storytelling as a powerful tool to elicit and exchange stories of lived experience through the virtual living lab, and subsequent usability testing of the platform. Methods and Analysis Stage 1- We will conduct an integrated knowledge translation study inclusive of user centered lab design and construction. Stage 2- We will conduct a 6-month longitudinal qualitative storytelling study with 30–40 participants including neurodiverse children and youth ages 5–19 years, their siblings, and parent/guardians, guided by the F-words framework which is based on the International Classification of Functioning, Disability, and Health. Following user-registration within the virtual lab, participants will complete a minimum of 1 story monthly, accompanied by an arts-based component, for 6 months. Conclusion Findings will inform the co-development of an arts-based knowledge translation resource to communicate key findings. Stage 3- A subset of families will be sampled to complete usability testing of the living lab platform and storytelling feature using a sequential explanatory mixed methods design. Usability evaluation will inform future platform refinements and provide indications of acceptability and use across subgroups.

Front-Line Insights Into the Social Determinants of Health in Housing Instability: A Multi-Province Study.

Individuals experiencing housing instability face significant health inequities. Addressing housing instability requires an understanding of the factors that contribute to these inequities-a responsibility that has been assumed by community-based organizations. Interviewing individuals from 3 Canadian provinces, the present study aimed to examine the perspectives of individuals from front-line services of the social determinants of health (SDoH) needs of individuals experiencing housing instability. As part of a larger knowledge translation study, we conducted 8 semi-structured interviews with individuals from front-line services (eg, shelter workers and shelter mental health nurses) in Canada (Nova Scotia, Saskatchewan, and Alberta) and used thematic analysis to identify predominant unmet SDoH needs. Individuals from front-line services discussed the roles of many SDoH that may perpetuate housing instability in their clients. These included: (1) limited social supports; (2) poor access to health services; (3) poor opportunities for income and employment; (4) lack of transportation; (5) gender-based discrimination; (6) race-based discrimination; and (7) limited access to education and limited literacy skills. This study reveals how front-line service providers observe SDoH factors contributing to housing instability and create barriers to accessing support services. They advocate for a multi-system approach to addressing intersecting SDoH factors to validate clients' experiences and help them achieve stable housing. Additionally, more research and consultation with front-line providers are necessary to understand and overcome systemic barriers to stable housing.

A Network of Sites and Upskilled Therapists to Deliver Best-Practice Stroke Rehabilitation of the Arm: Protocol for a Knowledge Translation Study

Implementation of evidence-informed rehabilitation of the upper limb is variable, and outcomes for stroke survivors are often suboptimal. We established a national partnership of clinicians, survivors of stroke, researchers, healthcare organizations, and policy makers to facilitate change. The objectives of this study are to increase access to best-evidence rehabilitation of the upper limb and improve outcomes for stroke survivors. This prospective pragmatic, knowledge translation study involves four new specialist therapy centers to deliver best-evidence upper-limb sensory rehabilitation (known as SENSe therapy) for survivors of stroke in the community. A knowledge-transfer intervention will be used to upskill therapists and guide implementation. Specialist centers will deliver SENSe therapy, an effective and recommended therapy, to stroke survivors in the community. Outcomes include number of successful deliveries of SENSe therapy by credentialled therapists; improved somatosensory function for stroke survivors; improved performance in self-selected activities, arm use, and quality of life; treatment fidelity and confidence to deliver therapy; and for future implementation, expert therapist effect and cost-effectiveness. In summary, we will determine the effect of a national partnership to increase access to evidence-based upper-limb sensory rehabilitation following stroke. If effective, this knowledge-transfer intervention could be used to optimize the delivery of other complex, evidence-based rehabilitation interventions.

Disseminating sleep education to graduate psychology programs online: A knowledge translation study to improve the management of insomnia.

Despite the negative impact of poor sleep on mental health, evidence-based insomnia management guidelines have not been translated into routine mental healthcare. Here, we evaluate a state-wide knowledge translation effort to disseminate sleep and insomnia education to graduate psychology programs online using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) evaluation framework. Using a non-randomized waitlist control design, graduate psychology students attended a validated six-hour online sleep education workshop delivered live as part of their graduate psychology program in Victoria, Australia. Sleep knowledge, attitudes, and practice assessments were conducted pre- and post-program, with long-term feedback collected at 12 months. Seven out of ten graduate psychology programs adopted the workshop (adoption rate = 70%). The workshop reached 313 graduate students, with a research participation rate of 81%. The workshop was effective at improving students' sleep knowledge and self-efficacy to manage sleep disturbances using Cognitive Behavioral Therapy for Insomnia (CBT-I), compared to the waitlist control with medium-to-large effect sizes (all p <.001). Implementation feedback was positive, with 96% of students rating the workshop as very good-to-excellent. Twelve-month maintenance data demonstrated that 83% of students had used the sleep knowledge/skills learned in the workshop in their clinical practice. However, more practical training is required to achieve CBT-I competency. Online sleep education workshops can be scaled to deliver cost-effective foundational sleep training to graduate psychology students. This workshop will accelerate the translation of insomnia management guidelines into psychology practice to improve sleep and mental health outcomes nationwide.

An examination of the psychosocial consequences experienced by children and adolescents living with congenital heart disease and their primary caregivers: a scoping review protocol

BackgroundThe chronicity of congenital heart disease (CHD) comes with significant psychosocial consequences for both children and adolescents living with CHD and their primary caregivers. Children and adolescents living with CHD undergo multiple traumatizing invasive surgical and medical procedures, struggle with disabilities resulting from their CHD, face unfair scrutiny and marginalization, and are at risk for mental health issues. Primary caregivers of children and adolescents living with CHD deal with increased stress, fear, anxiety, depression, and financial burden. The overarching objectives of this scoping review are to (1) determine the current state of knowledge on negative psychosocial consequences experienced by children and adolescents living with CHD and their primary caregivers in high-income countries and (2) inform research aimed at developing interventions in high-income countries to decrease the negative psychosocial consequences experienced by children and adolescents living with CHD and their primary caregivers.MethodsDatabases and grey literature searched will include MEDLINE, CINAHL, EMBASE, PsycINFO, CENTRAL, Scopus, ProQuest Theses and Dissertations, and Google advanced search. Citation mining of included studies and relevant review articles will be completed. Studies will be screened by title and abstract and then full text by two independent reviewers, using pre-defined inclusion and exclusion criteria. Quality analysis will be conducted on all included studies by two reviewers using MMAT Version 2018. Studies will not be excluded due to quality assessment. Data from all eligible studies will be independently extracted by the two reviewers and verified by consensus. Data will be presented and synthesized in evidence tables to examine potential patterns.DiscussionThe results of this review will provide recognition of the psychosocial impact of CHD and its treatments on children and adolescents living with CHD and their primary caregivers. It will also highlight interventions that have been developed to decrease these psychosocial consequences. The results from this review will inform a future integrated knowledge translation study by the first author aimed at decreasing one or more of the negative psychosocial consequences experienced by children or adolescents living with CHD and their primary caregivers.Systematic review registrationOpen Science Framework (OSF) Registration, https://doi.org/10.17605/OSF.IO/ZXYGW

A digital innovation typology: Navigating the complexity of emerging technologies to negotiate health systems research with young people.

This study aims to explore young people's perspectives of emerging technologies and health systems research in an adolescent health community of practice. The context of this integrated knowledge translation study is the Wellbeing Health & Youth Centre of Research Excellence in Adolescent Health. A theory-building, non-systematic review was conducted to examine the concepts and interrelationships of emerging technologies associated with digital innovation and health systems. This typology informed the design of an online workshop with young people to explore their views, concerns, and ideas about health systems research. A digital innovation typology was identified to differentiate and explain emerging technology concepts and interrelationships that can be applied to the health systems context. Aligned with this typology, youth perspectives about digital health challenges and opportunities were identified to support future research, policy, and practice. The integrated findings from this study can assist the navigation of complex emerging technologies, and the negotiation of equitable health systems research, between youth and adult stakeholders. Further, with these typology-related resources, mutual learning and the public involvement of young people in health systems research and priority setting agendas can be supported.

Spring-infusors: How a simple and small solution can create king-sized complexity.

The aims of the study were to investigate family and hospital staff views about the use of spring-infusor devices for administration of intravenous antibiotic medications, to examine if the device is acceptable and feasible and to map a process for implementation. A qualitative study with a pragmatist approach, within a larger, mixed methods knowledge translation study. Data were collected by semi-structured interviews with patients who have cystic fibrosis and their parents and focus groups and interviews with hospital staff. Interviews were concluded when no new themes were identified. Thematic analysis and process mapping was undertaken. Six parents, nine children and 30 staff were interviewed. Families preferred spring-infusors. Staff knowledge, experience and attitudes toward spring-infusor use was varied. All staff acknowledged that their role is to support patient-centred care. Spring-infusors are preferred by families and clinicians above other IV administration devices but misconceptions about spring-infusor use and numerous procedural challenges reduced their use.

Gamification of dementia education in hospitals: a knowledge translation project.

This knowledge translation study qualitatively explores strategies that facilitated hospital staff engagement in online educational games for dementia education. Interdisciplinary staff (n = 2010) in 10 hospitals played online games to learn about basic communication techniques. We identified five facilitating strategies, E-GAME: Easy access to learning, Give both extrinsic and intrinsic rewards, Apply implementation science theory, Multiple tools, and Evaluation. This article offers useful tips for educators to innovate dementia education for practice improvement.

Sustainability of evidence-based practices in the management of infants with bronchiolitis in hospital settings - a PREDICT study protocol

BackgroundUnderstanding how and why de-implementation of low-value practices is sustained remains unclear. The Paediatric Research in Emergency Departments International CollaboraTive (PREDICT) Bronchiolitis Knowledge Translation (KT) Study was a cluster randomised controlled trial conducted in 26 Australian and New Zealand hospitals (May-November 2017). Results showed targeted, theory-informed interventions (clinical leads, stakeholder meetings, train-the-trainer workshop, targeted educational package, audit/feedback) were effective at reducing use of five low-value practices for bronchiolitis (salbutamol, glucocorticoids, antibiotics, adrenaline and chest x-ray) by 14.1% in acute care settings. The primary aim of this study is to determine the sustainability (continued receipt of benefits) of these outcomes at intervention hospitals two-years after the removal of study supports. Secondary aims are to determine sustainability at one-year after removal of study support at intervention hospitals; improvements one-and-two years at control hospitals; and explore factors that influence sustainability at intervention hospitals and contribute to improvements at control hospitals.MethodsA mixed-methods study design. The quantitative component is a retrospective medical record audit of bronchiolitis management within 24 hours of emergency department (ED) presentations at 26 Australian (n = 20) and New Zealand (n = 6) hospitals, which participated in the PREDICT Bronchiolitis KT Study. Data for a total of 1800 infants from intervention and control sites (up to 150 per site) will be collected to determine if improvements (i.e., no use of all five low-value practices) were sustained two- years (2019) post-trial (primary outcome; composite score); and a further 1800 infants from intervention and control sites will be collected to determine sustained improvements one- year (2018) post-trial (secondary outcome). An a priori definition of sustainability will be used. The qualitative component will consist of semi-structured interviews with three to five key emergency department and paediatric inpatient medical and nursing staff per site (total n = 78-130). Factors that may have contributed to sustaining outcomes and/or interventions will be explored and mapped to an established sustainability framework.DiscussionThis study will improve our understanding of the sustainability of evidence-based bronchiolitis management in infants. Results will also advance implementation science research by informing future de-implementation strategies to reduce low-value practices and sustain practice change in paediatric acute care.Trial registrationAustralian and New Zealand Clinical Trials Registry No: ACTRN12621001287820.

Preparing an integrated self-management support intervention for people living with schizophrenia: Creating collaborative spaces.

This article describes the planning and development of a novel self-management support protocol,self-management engaging together (SET) for Health, purposefully designed and embedded within traditional case management services to be accessible to people living with schizophrenia and comorbidities. Drawing on established self-management principles, SET for Health was codesigned by researchers, healthcare providers and clients, to create a practical and meaningful intervention to support the target group to manage their own health and wellness. Decision making is described behind tailoring the self-management innovation to meet the needs of an at risk, disadvantaged group served by tertiary, public health care in Canada. This integrated knowledge translation (IKT) study used a descriptive approach to document the process of planning and operationalizing the SET for Health intervention as a part of routine care in two community-based teams providing predominantly schizophrenia services. Diffusion of innovations literature informed planning. The setting was strategically prepared for organizational change. A situational assessment and theoretical frameworks identified contextual elements to be addressed. Existing established self-management approaches for mental illness were appraised. When a review of established approaches revealed incongruence with the aims and context of service delivery, common essential elements were distilled. To facilitate collaborative client-provider self-management conversations and self-management learning opportunities, core components were operationalized by the use of tailored interactive tools. The materials coproduced by clients and providers offered joint reference tools, foundational for capacity-building and recognition of progress. Planning and developing a model of self-management support for integration into traditional schizophrenia case management services required attention to the complex social ecological nature of the treatment approach and the workplace context. Demonstration of proof of concept is described in a separate paper.

Barriers to Physiotherapists' Use of Professional Development Tools for Chronic Pain: A Knowledge Translation Study.

Purpose: The Pain Science Division (PSD) is a special interest group of the Canadian Physiotherapy Association that serves physiotherapists who have an interest in better understanding and managing patients' pain. The PSD developed evidence-based resources for its members with the goal of improving patient care by supporting professional development. However, online metrics tracking access to these resources indicated that access was low. The purpose of this study was to identify the barriers PSD members encountered to the use of PSD resources and to recommend interventions to address these barriers guided by the Theory and Techniques Tool (TTT). Method: We distributed an online survey to PSD members across Canada. We used the TTT, a knowledge translation tool, to guide the design of the questionnaire and identify actionable findings. Results: Response rates from 621 non-student members and 1,470 student members were 26.9% and 1.4%, respectively. Based on the frequency of practising physiotherapists' (n=167) agreement with items in the TTT, the primary barriers to use of the PSD resources were forgetting that the resources were available and forgetting to use them. Conclusions: The TTT can be used to identify barriers to use of professional development tools.

Adherence to ESPEN guidelines and associations with postoperative outcomes in upper gastrointestinal cancer resection: results from the multi-centre NOURISH point prevalence study.

Postoperative nutrition support is an essential component of management in upper gastrointestinal (UGI) cancer resection, however there is limited knowledge of current clinical practice. This study aimed to describe the postoperative nutrition support received by patients undergoing UGI cancer resections, assess adherence with ESPEN surgical guideline recommendations, and to investigate differences between oesophageal, gastric and pancreatic surgeries. The secondary aim was to explore the association of adherence with ESPEN guidelines and provision of nutrition support, with surgical complications and length of stay (LOS). The NOURISH point prevalence study was conducted between September 2019-June 2020 across 27 Australian tertiary centres. Malnutrition was diagnosed using subjective global assessment. Data on postoperative diet codes, prescription of nutrition support (oral (ONS), enteral (EN), parenteral (PN)) and nutritional adequacy were collected by dietitians for the first 10 days of admission. Fisher's exact test was used to determine differences in nutritional management and adherence to ESPEN guidelines between surgery types. Multivariate regression analysed associations with surgical outcomes. Two-hundred participants were included (42% pancreatic, 33% oesophageal, 25% gastric surgery). Overall, only 34.9% (n=53) met the guideline recommendations that were applicable to them. Early oral intake of fluids or solids (within 24h post surgery) was initiated for 23.5% (n=47), whilst ONS/EN/PN was initiated for 49.5% (n=99). Only 25% of pancreatic surgeries had nutrition support initiated on the first postoperative day compared to 86.4% of oesophageal and 42.0% of gastric surgeries (p<0.001). In those who were 'nil by mouth', EN/PN were commenced within 24h for 51.0% (n=78), with 18.5% and 45.2% for pancreatic and gastric surgeries compared to 86.0% in oesophageal surgeries (p<0.001). In malnourished patients, 35.7% (n=30) commenced EN within 24h, with 11.1% and 31.8% for pancreatic and gastric compared to 73.1% in oesophageal surgeries (p<0.001). For patients meeting <60% energy/protein requirements for ≥7 days, only 14.8% (n=9) received EN/PN, with 2.5% and 16.7% of pancreatic and gastric compared to 75.0% of oesophageal surgeries (p<0.001). The number of days spent 'nil by mouth' or 'clear fluids' without EN/PN, as well as number of days with <60% estimated requirements met were independently associated with increased LOS and complications. Overall, there was poor adherence to the majority of assessed ESPEN guidelines, and care for patients undergoing pancreatic and gastric surgeries was less compliant than oesophagectomy. Poor nutritional adequacy was associated with increased LOS and complications. There is a clear need for knowledge translation and implementation studies to increase adherence to evidence-based recommendations in the Australian setting supported by an understanding of barriers and enablers to optimal postoperative nutrition management.

Pay Attention to This: A Knowledge Translation Study of ADHD and its Brain Basis to Preservice and In-Service Teachers

The purpose of the present study was to develop a knowledge translation (KT) activity for educators about the brain in children and adolescents with attention deficit hyperactivity disorder (ADHD). The goal was to increase our participants’ knowledge about ADHD and its brain basis. In addition to neuroscience content, the KT activity included the personal story of the lead researcher’s lived experience with ADHD to provide context, and to inform the participants’ perceptions of ADHD. Framed in an action research paradigm, our study undertook three cycles of reflection, planning, action, and observation to develop and improve a knowledge translation activity. The knowledge translation activity was presented to 48 preservice and in-service teachers and members of the public across Canada, with a mixed methods approach to evaluate the outcomes. The findings demonstrated that this knowledge translation activity was effective in enhancing participant knowledge about ADHD. Quantitively, a non-significant trend was observed that participants shifted their perceptions from social and behavioural causes to brain-based causes of ADHD. Qualitatively, the participants indicated making connections between the personal story and neuroscience. Effective KT requires a review of context vocabulary and opportunity for teacher interaction. Teachers are aware of several behavioural management strategies but do not have a clear idea of how or why they work. Teaching neuroscience to teachers allows for a discussion of neurodiversity and a strength-based approach to programming and accommodation. This research could help guide future knowledge translation research into the benefits of combining personal lived experience with neuroscience content.&#x0D; Keywords: knowledge translation, neuroscience, attention deficit hyperactivity disorder, lived experience, storytelling, action research, neurodiversity

Integrated knowledge translation in nursing homes: exploring the experiences of practice development nurses

BackgroundPractice Development Nurses (PDNs) in Norwegian nursing homes (NHs) hold a specific responsibility for knowledge translation in this increasingly complex healthcare setting. They were involved as end users in an integrated knowledge translation (IKT) study, developing, testing and evaluating the IMPAKT (IMPlementation of Action to Knowledge Translation) intervention. PDNs participated in an educational programme tailored to their own defined needs. In a second intervention component, the PDNs applied their new skills with facilitation, in implementing the National Early Warning Score (NEWS2) in their respective NHs. The aim of this study was to explore 1) the PDNs’ experiences of participating in an IKT educational intervention, and 2) how they applied the learning in planning, tailoring and initial implementation of the NEWS2.MethodsThis is a qualitative exploratory study based on a phenomenological hermeneutical method. Study participants were PDNs working in the nine NHs in the intervention group of the IMPAKT trial. We conducted nine in-depth interviews and eight non-participatory observational sessions of the intervention delivery.ResultsThe PDNs expressed that the educational programme met their needs and enhanced their understanding about leading knowledge translation (KT). They reported a move from operating in a “big black box of implementation” to a professional and structured mode of KT. The gamechanger was a shift from KT as the PDNs’ individual responsibility to KT as an organizational matter. The PDNs reported enhanced competencies in KT and in their ability to involve and collaborate with others in their facility. Organizational contextual factors challenged their KT efforts and implementation of the NEWS2.ConclusionsThis study demonstrates that an IKT approach has the potential to advance and improve staff competencies and NH readiness for KT. However, individual motivations and competencies were challenged within an organizational culture which was less receptive to this new leadership role and level of KT activity.

Implementation of clinical practice guidelines for low back pain: A case control cohort study of knowledge translation in a multi-site healthcare organization.

The benefits of clinical practice guideline (CPG) adoption for the management of patients with back pain are well documented. However, the gap between knowledge creation and implementation remains wide with few studies documenting the iterative process of comprehensive implementation in clinical settings. The objective of this study was to improve adherent physical therapy care according to CPG's for low back pain and describe the knowledge to action (K2A) process used in a rural healthcare organization. A prospective case control cohort design was used to evaluate physical therapy provider practice changes during an 18 month intervention. Four clinical sites were selected, two of which received multifaceted educational and process interventions tailored to feedback from ongoing K2A cycle outcomes. Overall program assessment included monthly charge code reports for adherence and a pre-post survey of confidence for guideline use. Pragmatic Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) criteria were used to complete the process evaluation. A significant difference (p< 0.001, mean difference 13.5, CI [8.5,18.5]) for charge code adherence favoured education site-1 over control site-2 after implementation. Adherence scores remained above target at both education sites 18 months after implementation. Survey differences were significant for confidence scores at education sites in use of the cognitive behavioural category, overall treatment category use and guideline communication. Process evaluation supported multifaceted interventions tailored to education sites with average cost measured by staff education time of 15.5h per therapist trained. This study extends the literature of guideline implementation by describing the unique cycles required for promoting provider behaviour change within a rural healthcare system. Adherence and confidence results suggest increased provider CPG use which was supported by the process evaluation. This study demonstrates the importance of multiple site comparisons, long-term reporting and standardized frameworks for assessment of real-world CPG implementation.

Implementation of the Core Outcome Measures CPG: Assessing the Know-Do Gap

<h3>Research Objectives</h3> To assess the Know-Do Gap of physical therapist use of the clinical practice guideline recommended core set of outcome measures (OMs) for neurologic conditions. <h3>Design</h3> Mixed-methods knowledge translation study implementing the Knowledge to Action (KTA) Cycle. <h3>Setting</h3> One neurologic outpatient physical therapy organization with three clinical sites that primarily serves patients with neurologic conditions. <h3>Participants</h3> 19 physical therapists. <h3>Interventions</h3> Retrospective medical record review of initial evaluation and discharge documentation from a five month period (October 2019 - February 2020). <h3>Main Outcome Measures</h3> Frequency of use of outcome measures, including the six core outcome measures recommended in the neurological outcome measures clinical practice guideline. <h3>Results</h3> 225 notes were reviewed (evaluation = 134; discharge = 91), performed by 19 physical therapists. 39 unique OMs were used during the 5 month reporting period. Results of the six core OMs were performed at the following frequencies: Six Minute Walk Test 82.2% (n = 185); Berg Balance Scale 43.1% (n = 97); 5 Times Sit-to-Stand 16.9% (n = 38); 10 meter Walk Test 14.7% (n = 33); Functional Gait Assessment 3.1% (n = 7); and the Activities-Specific Balance Confidence Scale 1.8% (n =4). <h3>Conclusions</h3> Implementation of the six core OMs in this outpatient physical therapy organization was variable. This assessment of the know-do gap is the first step in the KTA Cycle. Future steps include continuing to utilize the KTA Cycle to increase uptake of the core set of OMs. <h3>Author(s) Disclosures</h3> Dr. Yorke has no disclosures. Dr. Trojanowski has no disclosures. Dr. Fritz serves on the MS scientific advisory board for Helius Medical.

What is “usual care” in the rehabilitation of upper limb sensory loss after stroke? Results from a national audit and knowledge translation study

Purpose To characterise the assessments and treatments that comprise “usual care” for stroke patients with somatosensory loss, and whether usual care has changed over time. Materials and methods Comparison of cross-sectional, observational data from (1) Stroke Foundation National Audit of Acute (2007–2019) and Rehabilitation (2010–2018) Stroke Services and (2) the SENSe Implement multi-site knowledge translation study with occupational therapists and physiotherapists (n = 115). Descriptive statistics, random effects logistic regression, and content analysis were used. Results Acute hospitals (n = 172) contributed 24 996 cases across audits from 2007 to 2019 (median patient age 76 years, 54% male). Rehabilitation services (n = 134) contributed organisational survey data from 2010 to 2014, with 7165 cases (median 76 years, 55% male) across 2016–2018 clinical audits (n = 127 services). Somatoensory assessment protocol use increased from 53% (2007) to 86% (2019) (odds ratio 11.4, 95% CI 5.0–25.6). Reported use of sensory-specific retraining remained stable over time (90–93%). Therapist practice reports for n = 86 patients with somatosensory loss revealed 16% did not receive somatosensory rehabilitation. The most common treatment approaches were sensory rehabilitation using everyday activities (69%), sensory re-education (68%), and compensatory strategies (64%). Conclusion Sensory assessment protocol use has increased over time while sensory-specific training has remained stable. Sensory rehabilitation in the context of everyday activities is a common treatment approach. Clinical trial registration number: ACTRN12615000933550 IMPLICATIONS FOR REHABILITATION Only a small proportion of upper limb assessments conducted with stroke patients focus specifically on sensation; increased use of standardised upper limb assessments for sensory loss is needed. Stroke patients assessed as having upper limb sensory loss frequently do not receive treatment for their deficits. Therapists typically use everyday activities to treat upper limb sensory loss and may require upskilling in sensory-specific retraining to benefit patients.

Building Parent Capacity and Child Well-Being in Early Intervention Playgroups: A Mixed-Methods Study of Knowledge Translation Through Collaboration

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This study explored the effectiveness of playgroups as part of comprehensive early intervention services using a team-based approach. OTs have a unique role in fostering an inclusive environment in which children participate in play while interacting with their parent and peers. Results from this mixed-methods study indicate that playgroups have potential to build parent competence, increase parent responsiveness, and support the social–emotional development of the child. Primary Author and Speaker: Sarah Fabrizi