Knowledge Translation Tools Research Articles

Physical activity interventions to prevent and manage type 2 diabetes in Aboriginal and Torres Strait Islander people: a systematic review.

To review evidence regarding the impact of physical activity interventions for preventing and managing type 2 diabetes in Aboriginal and Torres Strait Islander Australians. We searched for published reports of physical activity interventions for preventing and managing type 2 diabetes in Indigenous adults (18 years or older). There were no exclusion criteria regarding study type or duration, frequency, length, or intensity of physical activity, except that short term interventions were excluded. We assessed the quality of each study using the Joanna Briggs Institute (JBI) critical appraisal tools and the ethical and methodological quality of studies from an Indigenous Australian perspective with the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE) Critical Appraisal Tool. MEDLINE; Scopus, Embase (Elsevier); Cumulative Index to Nursing and Allied Health Literature (CINAHL), Sports Discus, PsycINFO (EBSCO); Informit Complete; ProQuest Dissertations and Theses, and ProQuest Health and Medicine; each from their inception to 30 October 2022. The database searches identified 703 potentially relevant records; after removing duplicates and initial screening, the full text of 27 articles was assessed for eligibility. Nine studies met our inclusion criteria: two randomised controlled trials, five cohort studies, one quasi-experimental study, and one repeated cross-sectional study. Eight studies were rated as being of low or medium quality (median JBI score, 54%; interquartile range [IQR], 36-64%); seven studies were rated as being of low to medium ethical and methodological quality from the Indigenous perspective (median CREATE score, 50%; IQR, 36-64%). Six studies reported changes in glycated haemoglobin (HbA1c) levels, of which two (both cohort studies) reported significantly lower mean HbA1c levels after the intervention, but only one publication provided detailed results. No randomised controlled trials that investigated the effect of a combination of physical activity and dietary change for Indigenous Australians diagnosed with type 2 diabetes were identified. Differences in study design, outcome variables, and the small number of studies precluded meta-analysis. Quality research into the impact of physical activity interventions on type 2 diabetes in Indigenous people is sparse. To improve research translation, studies that involve Indigenous community members at all levels of the research process are needed. PROSPERO CRD42021247496 (prospective).

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.

A scoping review of early childhood support for Aboriginal and Torres Strait Islander children living with a disability in regional, rural and remote settings.

Many experts and communities have concerns about how National Disability Insurance Scheme services are provided to Aboriginal and Torres Strait children. This study was undertaken at the request of the NPY Women's Council in partnership with the researchers, to explore supports for Aboriginal and Torres Strait Islander children living with a disability in their remote areas. This scoping review aims to (a) explore the barriers and enablers to accessing disability support services for families of young Aboriginal and Torres Strait Islander children (0-8 years) living in regional, rural and remote settings, and (b) summarise best practice approaches for accessing support for young children in these settings. The search was run in three electronic databases, as well as grey literature sources. We assessed the quality of included publications using the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange tool. A narrative synthesis was supported by thematic analysis. From an initial search (557 citations), we identified 13 eligible documents. Most documents were peer-reviewed articles of qualitative studies. Key themes identified included the following: (1) Holistic approach, (2) Understanding disability, (3) Consistent relationships, (4), Flexibility, (5) Simplify system and (6) Enhance communication. This scoping review has revealed gaps in the provision of quality, culturally responsive disability services for families of Aboriginal and Torres Strait Islander children living in regional, rural and remote areas of Australia. A family-centred, flexible approach will help address their needs. Future research is required to design and evaluate models of care for Aboriginal and Torres Strait Islander children.

Choosing Wisely in Physical Medicine and Rehabilitation: Developing Canadian Recommendations for Resource Stewardship

ABSTRACT Choosing Wisely Canada (CWC) aims to reduce potentially harmful or unnecessary diagnostic investigations and practices in health care delivery. A committee of the Canadian Association of Physical Medicine & Rehabilitation (PM&R) surveyed the general membership seeking suggestions on new or revised PM&R CWC recommendations. Draft recommendations were revised and refined with an emphasis on resource stewardship and alignment with the CWC mission. The updated 2023 CWC recommendations for PM&R are to avoid: (1) investigating and treating asymptomatic bacteriuria in patients with neurogenic bladder; (2) recommending more than a brief period of physical and cognitive rest after mild traumatic brain injury; (3) starting opioid treatment for chronic noncancer pain without exhausting other approaches; (4) ordering diagnostic imaging for low back pain in the absence of red flags; (5) repeating injections without evaluating patients’ responses to them; and, (6) recommending carpal tunnel release without first confirming nerve entrapment with electrodiagnostic studies or ultrasonography. We present unique implementation tools to equip practitioners with quality improvement strategies to adopt these recommendations into their practices. Future work will include developing recommendations that consider planetary health co-benefits, creating knowledge translation tools, and assessing the impact of recommendation adoption into clinical practice.

An Environmental Scan of Online Generalized Anxiety Resources for Canadian Youth

Background: A recent priority-setting exercise reported that youth are interested in understanding what the early signs and symptoms of generalized anxiety are, and when they should seek help. This environmental scan aimed to understand what information is currently available online for Canadian youth about the signs and symptoms of generalized anxiety disorder, what resources are available for self-assessment, and what are youth’s behaviors, experiences, and information needs around seeking help. Method: We conducted an environmental scan of Internet resources and academic literature in August 2020. Information Sources were categorized relating to the research concepts regarding signs and symptoms, self-assessments, information needs, and experiences. We complimented our environmental scan with youth consultations to understand how generalized anxiety resources are perceived by youth, and what if anything could be improved about the information they are receiving. Consultations were conducted over Zoom with three Canadian Youth Advisory Groups (2 local, 1 national) and took a semistructured focus group format. Results: Of the 12874 identified Information Sources inclusion criteria were met by 98. The majority of Information Sources on signs and symptoms ( n = 62) were webpage-based articles ( n = 53, 85%), and 38 (61%) specifically stated that they were targeting youth. Seventy-one percent ( n = 12) of the 17 self-assessment resources were provided by private organizations. The resources varied markedly in the post-assessment support provided to youth according to their source (i.e., private, academic, and governmental). The key considerations highlighted by youth across the consultations suggested resources needed to be; youth friendly; align with a credible institute (e.g., University and Health Institution); and provide tangible action items post-online assessment. Conclusions: Awareness of the information and resources available to youth, coupled with an understanding of their help-seeking behaviors and information needs regarding generalized anxiety can help support the development and dissemination of appropriate knowledge translation tools targeting youth.

Health research evidence: its current usage in health planning, determinants and readiness to use knowledge translation tools among health planning teams in Tanzania—an exploratory mixed-methods study protocol

IntroductionAchieving universal health coverage requires using research evidence to inform decision-making. However, little information is available on the use of research evidence in planning in lower middle-income countries, including Tanzania....

Citations in Wikipedia for understanding research reach.

Wikipedia is the most frequently accessed online health information resource and is well positioned as a valuable tool for public health communication and knowledge translation. The authors aimed to explore their institution's health and medical research reach by analyzing its presence in Wikipedia articles. In October 2022, a comprehensive database search was constructed in PubMed to retrieve clinical evidence syntheses published by at least one author affiliated with McMaster University from 2017 to 2022, inclusive. Altmetric Explorer was queried using PubMed Identifiers and article titles to access metadata and Wikipedia citation data. 3,582 health evidence syntheses from at least one McMaster University affiliated author were analyzed. Six percent (n=219) of health evidence syntheses from the authors' institution were cited 568 times in 524 unique Wikipedia articles across 28 different language editions. 45% of citations appeared in English Wikipedia, suggesting a broad global reach for the institutions' research outputs. When adjusted for open access publications, 8% of McMaster University's health evidence syntheses appear in Wikipedia. Altmetric Explorer is a valuable tool for exploring the reach of an institution's research outputs. Isolating Altmetric data to focus on Wikipedia citations has value for any institution wishing to gain more insight into the global, community-level reach of its contributions to the latest health and medical evidence.

Exploring Caregiver Learning and Experiences Caring for a Child With Heart Failure: A Qualitative Study

BackgroundPaediatric heart failure poses life-long, burdensome symptoms for the health care system and families. Diagnosis and discharge are stressful and anxiety-provoking for caregivers. They face uncertainty about their child’s health and become responsible for administering complex care in the home. Little is known about this topic. Our study aimed to explore caregiver learning and experiences caring for a child with heart failure to design and implement a knowledge translation tool. MethodsQualitative description guided our study. Recruitment occurred in a tertiary cardiac centre in Edmonton, Alberta, Canada. Data collection and analysis occurred concurrently until data redundancy was achieved. Inductive conventional content analysis was used to develop categories. ResultsEleven interviews identified 2 main categories. One relates to how traumatic life experiences impact learning (eg, new diverse ways of learning, stress steepens the learning curve, and learning heart failure takes time). The other relates to families’ new life reality after diagnosis (eg, emotional distress and the new reality). ConclusionsThis study provides insight into caregivers’ learning needs and experiences caring for a child with heart failure. Caregivers describe how the trauma of having their child diagnosed with heart failure negatively impacts their learning capabilities and way of life going forward. Caregiver learning experiences and preferences for digital platforms is also highlighted. This knowledge will inform the design of an online educational tool about pediatric heart failure for caregiver audiences. This tool will empower and improve caregiver decision-making related to their child’s daily heart failure management, with the goal to positively impact clincal outcomes, lessen stress and anxiety.

Ontario Midwifery Clients' Experiences with the Management of Hyperbilirubinemia

Hyperbilirubinemia is the most common reason for the hospitalization of a newborn within the first week of life. Very little is known, however, about the impact this diagnosis and subsequent management has on parents, particularly within the midwifery context. The Clinical Knowledge Translation department at the Association of Ontario Midwives conducted a multimethod qualitative research study in 2017 to better understand the experiences of midwifery clients whose newborns have been diagnosed with and required management of severe hyperbilirubinemia. Three focus-group discussions and one in-depth, in-person interview were conducted with midwifery clients in Ontario. Findings were analyzed using NVivo software, resulting in the extraction of key themes. Clients discussed how the transition from midwifery-led care to care being led by other health care providers in the hospital impacted them in the postpartum period. Clients also observed changes in the continuity of care provided by their midwives during management of hyperbilirubinemia, and discussed both the positive and negative impacts these changes had on their broader experience of the early postpartum period. These findings have informed the development of a series of knowledge translation tools that support midwives in providing optimal care to clients whose infants require phototherapy. This article has been peer reviewed.

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.

What's the big IDEA? Incorporating inclusion, diversity, equity, and access (IDEA) in population health nutrition research and practice.

Historically, the constructs of inclusion, diversity, equity, and access (IDEA) have not been sufficiently considered or included in population health nutrition research and practice. Consequently, current nutrition assessment benchmarks and knowledge translation tools may not accurately or adequately reflect diversity in the Canadian population or produce meaningful dietary guidance. The purpose of this current opinion paper is to introduce the population health nutrition research and practice framework and explore the current application of IDEA within this framework. Recommendations are offered to incorporate the constructs of IDEA along the continuum of future nutrition research and services to improve population nutritional health.

Four year evaluation of a parent advisory group to support a research program for knowledge translation in child health

BackgroundIn 2016, we developed a pediatric parent advisory group to inform our research program which creates innovative knowledge translation (KT) tools for parents on priority topics related to acute childhood illness. We implemented a mixed methods strategy to evaluate the experiences of group members. The purpose of this paper is to present the findings from parent evaluations over four years and to discuss our experiences collaborating with the group over a multi-year period.MethodsWe conducted year-end surveys and interviews of group members to understand parents’ perceptions of their experiences, group management, researcher interaction, and other outcomes of advisory group participation from 2018 to 2021. We applied a mixed methods approach, collecting and analyzing both quantitative (survey) and qualitative (survey/interview) data. Survey data were analyzed by term using descriptive statistics (i.e., frequencies, percentages). Open-ended survey responses were analyzed by conventional content analysis. Interview data were analysed thematically.ResultsYear-end survey response rates and interview participation varied over the years. Responses to evaluation questions were generally positive and most improved over time. Results prompted changes to improve P-PAG operations, such as changes to location of meetings, communications about the group’s purpose, offering sufficient context for discussion items, and providing feedback about how members’ input was used. Themes identified from the qualitative data related to the importance of certain aspects of group functioning, positive views of the group’s current management, and potential areas for improvement. Parents regularly expressed a desire for more diversity in the group’s membership and an interest in hearing more about how the research program’s activities fit into the broader healthcare system and their impacts on health outcomes.ConclusionsOur experience in establishing, managing, and evaluating a parent advisory group over many years has resulted in valuable insights regarding patient engagement in health research and sustaining an advisory group over time. We have learned that an intentional and iterative approach with regular evaluations and responsive changes has been essential for fostering meaningful engagement. Significant resources are required to maintain the group; in turn, the group has made substantial and diverse contributions to the research program and its outputs.

Healthcare Professionals' Perspectives on Improving Family-Centred Pain Care in a Tertiary Pediatric Centre.

Despite being a core component of family-centered and compassionate care, children's pain is often undertreated in Canadian hospitals. Nurses' and other healthcare professionals' (HCPs) ability to understand and respond to a child and their family's pain care needs is integral to improving this care in a family-centered manner. To understand nurses' and other HCPs' perceptions of child and family needs to make care more collaborative and patient- and family-centered. Eighteen participants were recruited and represented the specialties of nursing (n = 8), psychology (n = 1), child life services (n = 2), medicine/surgery (n = 3), and administration/leadership (n = 4); 3 of the administrators had a nursing background. Transcripts were analysed using a semantic, inductive approach with two coders using a codebook to ensure reliability. Participants felt that pain care was important, but that it needs to take greater priority in the hospital. In our analysis, we identified four core needs that nurses and other HCPs have to provide better pain care: 1. Better acknowledgement of child and family experiences; 2. Better visual and written knowledge translation tools for patients and families; 3. Better provision of verbal pain education to children and families by nurses and other HCPs; and 4. Help for patients and families to advocate for better pain care when they feel their needs are not being met. Nurses and other HCPs value patient- and family-centered pain care, and wish to empower families to advocate for it when it is sub-optimal.

Getting a "SMART START" to gestational diabetes mellitus education: a mixed-methods pilot evaluation of a knowledge translation tool in primary care.

South Asian people living in Canada face higher rates of gestational diabetes mellitus (GDM) compared to national trends. The objective of this study was to design and pilot test a knowledge translation (KT) tool to support GDM prevention counselling in primary care. This study is a mixed-methods pilot evaluation of the "SMART START" KT tool involving 2 family physicians in separate practices and 20 pregnant South Asians in Ontario, Canada. We conducted the quantitative and qualitative components in parallel, developing a joint display to illustrate the converging and diverging elements. Between January and July 2020, 20 South Asian pregnant people were enrolled in this study. A high level of acceptability was received from patients and practitioners for timing, content, format, language, and interest in the interventions delivered. Quantitative findings revealed gaps in patient knowledge and behaviour in the following areas: GDM risk factors, the impact of GDM on the unborn baby, weight gain recommendations, diet, physical activity practices, and tracking of weight gain. From the qualitative component, we found that physicians valued and were keen to engage in GDM prevention counselling. Patients also expressed personal perceptions of healthy active living during pregnancy, experiences, and preferences with gathering and searching for information, and key preventative behaviours. Building on this knowledge can contribute to the design and implementation of other research opportunities or test new hypotheses as they relate to GDM prevention among South Asian communities.

Leveraging Wikipedia in undergraduate health sciences education: a key tool for information literacy and knowledge translation.

Academic institutions and libraries are familiar with Wikipedia. There is growing momentum in higher education for using Wikipedia as a learning tool in various contexts. These include, but are not limited to, the use of Wikipedia-based assignments to teach information literacy, science communication, evidence-based practice, and more. Although there is growing acceptance of Wikipedia's value in the classroom, there are limited exemplars available for how it is applied in undergraduate health sciences education. This program description describes a librarian instructed course in the Bachelor of Health Sciences Program at McMaster University in which students dedicate one academic term to learning about Wikipedia content production and making contributions to a health-related Wikipedia article of their choice. In the five iterations of this course that have been offered, undergraduate health sciences students have made significant contributions to 25 health-related articles in Wikipedia. They have added more than 120,000 words and over 2,000 references to high-quality literature. In class, conversations emerged about the meaningfulness of the editing Wikipedia, information literacy, and knowledge translation.

FC3: “Empowering Health & Social Service Providers in Addressing Social Isolation & Loneliness in Older Adults”

“Social isolation among older adults is associated with increased change of premature death; depression; dementia, disability from chronic diseases; poor mental health; increased use of health and support services; reduced quality of life; poor general health; and an increased number of falls.” (National Academies of Sciences, Engineering, and Medicine (2020).Without question, the global pandemic has significantly exacerbated both the prevalence and awareness of social isolation and loneliness as a growing health and societal challenge for older populations.“Because of growing calls for Canada’s health-care systems to identify, prevent and mitigate loneliness as part of COVID-19-related public health efforts, there is a unique opportunity to build capacity to identify and intervene with older adults who are experiencing social isolation or loneliness.” National Institute on Aging (2022).Over the past two decades, the Canadian Coalition for Seniors’ Mental Health (CCSMH) has developed a number of internationally recognized clinical guidelines in support of mental health for older adults. CCSMH is responding to the growing mental health crisis of isolation and loneliness with the development of evidence-based guidelines, to support the vital work of health and social service providers across Canada. The focus of these guidelines is to develop a broad range of evidence-based, manageable, and stepped care approaches to identify and address social isolation and loneliness in older adults. It is recognized that this topic is extremely complex and vast in potential scope. Through the guidance of a national working group of experts, these guidelines will draw upon both academic and grey literature, as well as on the experience of a diversity of health and social service providers, older adults, and their caregivers. This project will also provide guidance, promoting wellness and reducing the risk of social isolation with targeted messaging, knowledge translation and useful tools for supporting social connection among those at highest risk.This presentation will share the Guidelines’ preliminary recommendations, as well as data from two national surveys alongside other insights gained from ongoing research and stakeholder engagement.

Improving Erectile Dysfunction Management Among Asian Men With Diabetes Using the Knowledge Translation Intervention.

Erectile dysfunction (ED) is frequently undermanaged due to communication barriers, particularly among Asian men. We looked at how ED discussion and treatment were affected by the patient's prompt sheet and the Knowledge Translation Tools in the Management of Erectile Dysfunction (LASTED). We conducted a quasi-experimental study in a primary care clinic in Kedah, Malaysia involving 120 Asian men with diabetes. In the intervention group, patients were given a prompt sheet to indicate their intention to discuss or receive ED treatment, and physicians were provided with LASTED to assist with ED consultation. The control group patients received standard care from their physicians. The intervention increased the initiation of ED discussion up to 66.7% compared with 8.3% in the control group. In the intervention group, 57.5% of patients were prescribed phosphodiesterase-5 inhibitors and men with ED of moderate severity were more likely to be prescribed oral ED medication. Use of the LASTED flipchart was associated with prescription of phosphodiesterase-5 inhibitors (P = .011) and patient satisfaction with ED consultation (P <.001). Our study suggests that using the LASTED flipchart and patient's prompt sheet together may encourage ED conversation and medication prescription particularly when working with Asian men who frequently view ED as a taboo subject.

Encouraging diversity in family engagement in research: Reflections on the development of knowledge translation tools

BackgroundFamily engagement in research is crucial to generating relevant, impactful, and meaningful priorities and outcomes. Although there has been increased awareness and value for patient-oriented research, most patient partners in North America are from Western, educated, industrialized, rich and democratic societies. Encouraging underserviced and marginalized populations to join the partnerships is important. This project demonstrates the development of two knowledge translation tools created to encourage diversity in patient-family and researcher partnerships.Case studyOur diverse cross-Canadian team embodies the family-researcher partnership as it consists of two research personnel from non-Western origins with immigrant experiences, a parent with lived experience, and a project director. All group members have experience in the field of mental health and neurodevelopmental conditions. Four infographics were created: 3 patient-oriented ones (in English, Chinese, and Farsi) and 1 researcher-targeted one. Content for the infographics were generated to address common barriers to patient engagement identified from literature reviews, as well as key concepts discussed during the McMaster University Continuing Education Family Engagement in Research Certificate Course sponsored by CanChild & Kids Brain Health Network. Peer consultations helped to improve the infographics to be more culturally sensitive and appealing. The patient-oriented infographic presents concise bullet points about 5 main topics: (1) what is research, (2) reasons to join, (3) your role, (4) talking to researchers, and (5) how to join. The researcher-targeted infographic presents concise bullet points about 4 topics: 1) why team up with diverse patient partners, (2) ways to partner, (3) how to connect, and (4) talking to diverse partners.ConclusionInfographics were co-designed to encourage diversity in family engagement in research. Lessons learned throughout the project include barriers encountered (e.g., team collaboration considerations, design limitations) and strategies that facilitated the project (e.g., online collaboration platforms). Future directions include translations into other languages, increased dissemination across agencies, and evaluating the effectiveness of the infographic tools.

Optimizing Timing of Follow-Up Colonoscopy: A Pilot Cluster Randomized Trial of a Knowledge Translation Tool.

Endoscopists have low adherence to guideline-recommended colonoscopy surveillance intervals. We performed a cluster-randomized single-blind pilot trial in Winnipeg, Canada, to assess the effectiveness of a newly developed digital application tool that computes guideline-recommended follow-up intervals. Participant endoscopists were randomized to either receive access to the digital application (intervention group) or not receive access (control group). Pathology reports and final recommendations for colonoscopies performed in the 1-4 months before randomization and 3-7 months postrandomization were extracted. Generalized estimating equation models were used to determine whether the access to the digital application predicted guideline congruence. We included 15 endoscopists in the intervention group and 14 in the control group (of 42 eligible endoscopists in the city), with 343 patients undergoing colonoscopy before randomization and 311 postrandomization. Endoscopists who received the application made guideline-congruent recommendations 67.6% of the time before randomization and 76.1% of the time after randomization. Endoscopists in the control group made guideline-congruent recommendations 72.4% and 72.9% of the time before and after randomization, respectively. Endoscopists in the intervention group trended to have an increase in guideline adherence comparing postintervention with preintervention (odds ratio [OR]: 1.50, 95% confidence interval [CI] 0.82-2.74). By contrast, the control group had no change in guideline adherence (OR: 1.07, 95% CI 0.50-2.29). Endoscopists in the intervention group with less than median guideline congruence prerandomization had a significant increase in guideline-congruent recommendations postrandomization. An application that provides colonoscopy surveillance intervals may help endoscopists with guideline congruence, especially those with a lower preintervention congruence with guideline recommendations ( ClincialTrials.gov number, NCT04889352).

How do speech pathologists use the Australian Aphasia Rehabilitation Pathway to inform practice? A qualitative study

ABSTRACT Background Packaged evidence syntheses such as Best Practice Statements are important knowledge translation tools for improving healthcare provision. The Australian Aphasia Rehabilitation Pathway (AARP) is an online tool (www.aphasiapathway.com.au) based on the Aphasia Rehabilitation Best Practice Statements, developed to guide evidence-based aphasia services across the continuum of care. However, there has been no formal evaluation of the AARP’s implementation to date. Therefore, it is currently unknown whether and how speech pathologists use the AARP to guide their aphasia management practices, and how it can be enhanced to meet clinicians’ needs. Aims To explore Australian speech pathologists’ perceptions of (1) the usability and utility of the AARP, (2) how the AARP is currently used to inform aphasia management practices, (3) the potential impact of the AARP, and (4) how the AARP could be enhanced to meet clinicians’ identified needs. Methods and Procedures Semi-structured interviews guided by a framework for the development, implementation, evaluation, and reporting of online knowledge translation resources (Levac et al., 2015) were conducted with Australian speech pathologists working in aphasia services. Interviews were conducted via Zoom and accompanied by observations of participants’ self-navigation of the AARP. Qualitative content analysis of interview transcripts consisted of a combined deductive and inductive analytic approach. Outcomes and Results Eleven speech pathologists participated, who worked in predominantly public services in various clinical settings (acute, rehabilitation, and community) and had between 1 and 30 years of clinical experience. Cumulative AARP use over the previous 12-month period varied from 15 minutes to 10 hours. Participants identified a range of AARP benefits, such as being a source of knowledge and evidence, providing an overview of the patient journey, and providing resources. The AARP was used as a service improvement tool, a learning tool, and for accessing evidence, and was perceived to have direct and indirect impacts on knowledge and practice. Participants also recommended a number of enhancements to the AARP’s content and design to improve translation and clinical relevance, including updated recommendations, additional implementation resources, and improvements to layout and navigation. Conclusions The Australian Aphasia Rehabilitation Pathway was perceived as a valuable tool to inform evidence-based aphasia management. In order to remain relevant and useful, updated recommendations and links to clinically relevant resources are required. The suggested changes to content and design will inform an update of the AARP, which may in turn facilitate enhanced translation of evidence into practice and improve aphasia services.