Step KTA 7.C

Assess barriers (B) to use of tools relating lessons learned. Survey KUs to understand why they may be unable/unwilling to use the tools or apply the lessons learned.

Primary Findings

Secondary Findings

Primary findings

Barriers

Mutual trust for trusts sake cannot be established without effort and time. The conditions necessary for information sharing must be built incrementally. The phases of trust between agencies are economy-based, information-based (behaviors are reasonably predictable), and lastly identification based trust. 
Survey findings
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An absence of trust between researchers and stakeholders can impede knowledge translation. Negative perceptions or past experiences of researchers or stakeholders can adversely influence the start-up and continuity of a research project. Be sure to probe early and often during interactions between researcher and stakeholders for signs of skepticism or mistrust and have strategies available to remedy them.
Project evaluation findings.
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Factors that may limit or impede the ability of knowledge translation to positively impact stakeholder behaviour and decision-making include the resources required by an organization to apply the knowledge; the compatibility of the leadership style and organizational culture; the alignment of existing organization structures and processes; and the impact of organizational politics. Researchers may be better positioned to influence these factors if they secure training for, and experience with organizational change.
Project evaluation findings.
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Knowledge translation literacy — Policy development process — Many researchers do not understand the policy development process or how they might influence it, and may benefit from seminars that explain how government works.
Literature review and experience.
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Knowledge translation literacy — Research methods and results — Many decision-makers and policy-makers lack a critical understanding about the methods that are used to conduct research (or have the time to independently acquire it) and as a result, are unable to assess the quality of the findings they may receive. They may also be unclear about how to interpret and apply the findings.
Literature review and experience.
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One of the factors that can impede knowledge translation is incomplete knowledge. In some cases, research findings provide only a subset of the total knowledge that is required to fully understand an issue. Researchers should ensure that knowledge users are aware of any limitations.
Literature review and conceptual framework development.
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Researchers and stakeholders are usually able to quickly identify situations where rhetoric has replaced agreed upon and expected project behaviour. Rhetoric often triggers mistrust and a re-evaluation of commitments in response. Consider ‘partnering’ in collaborative research as one example. Partnering with stakeholders is a relatively new trend in research. Researchers and stakeholders must be able to consistently demonstrate, through their words and actions that genuine partnering behavior will occur. This can be challenging, especially early in the project when the capabilities of the respective parties are not fully known to each other. Creating formal (e.g., joint development of deliverables) and informal (e.g., social events) opportunities for parties to interact can help to provide evidence of agreed upon behaviour or provide a shared platform to challenge exceptions.
Project evaluation findings.
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When using the Knowledge to Action Process model to effect an evidence-based change (e.g., in a clinical practice), it is critical to identify potential barriers that may interfere with the successful application of the new knowledge. One way to identify potential barriers is to conduct focus groups with key stakeholders.
Applying the Graham Knowledge to Action Process model in stroke rehabilitation.
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Methods

According to the researcher’s guide to planning for knowledge translation there are five essential elements of knowledge translation, including: the problem (the problem or issue to be addressed by the research/knowledge), context (the circumstances surrounding the user and researcher), knowledge (properties of the pre-existing knowledge/evidence about the problem or the generation of new knowledge/evidence), intervention (specific activities designed to translate knowledge/research into action), and use (ways in which the knowledge/research is or might be used). For each element, a series of questions is provided. Each question encourages the researcher to think broadly and deeply about the knowledge translation implications. Elements and related questions are evidence-based, which adds to their credibility.
Knowledge translation guidance for researchers.
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Tips

Knowledge brokering — knowledge brokers should factor-in the potential influences of powerful intangibles, such as, the political environment of the project, its stakeholders and organization(s); confidentiality protocols and practices; and, competing interests and priorities.
Description of knowledge broker roles.
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Stakeholder engagement strategies must be tailored to each stakeholder group. Strategies to engage strategic direction-setters will be different from strategies required to engage perception-influencers and/or adopters.
Literature review and case example.
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The inherently complex nature of knowledge translation implies that, to be comprehensive, there would need to be an equally complex set of knowledge translation guidelines. This is not practical for design or practice, as it could involve a significant number of permutations and combinations and could easily overwhelm a researcher — especially a novice one. One alternative is to provide a simple template that explains the essential knowledge translation guideline categories (e.g. problem statement, research context, knowledge objectives, possible research interventions, and potential knowledge uses) and associates sample questions and hypothetical examples with each category to reinforce deliberation, understanding and application.
Knowledge translation guidance for researchers.
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When it comes to knowledge application, health professions, policy-makers and managers of public health organizations tend to rely on the use of complementary types of knowledge in a context where explicit research knowledge does not usually dominate.
Literature review and conceptual framework development.
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When it comes to knowledge application, technical experts are inclined to depend almost exclusively on explicit knowledge. For example, evidence-based medicine is dominated by an intensive use of explicit knowledge.
Literature review and conceptual framework development.
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Secondary findings

Barriers

In many cases, public policy making does not follow a linear process. The process can be unpredictable. Policy issues can languish for years and even decades on the governmental agenda. Only a relatively small number of them may ever make it to the decision agenda.
Source: Kingdon (2003). In: Lavis, John (2006)

In many ways, public policy making can be a challenging process. Often, when a policy issue is placed on the government agenda for a decision, battles can be fought over how the policy is framed. The viability of a policy and its options often hinge on how the underlying issue or problem is framed.
Source: Kingdon (2003). In: Lavis, John (2006)

Individuals’ (knowledge users’) negative attitudes toward research evidence and lack of skill and expertise can decrease the prospects for research use.
Source: Lavis (2005). In: Lavis, John (2006)

New knowledge might not be used if it cannot be readily applied to policy and practice imperatives, or if it is released in the context of heated or incompatible political contexts.
Source: Boutiler (2001). In: Jansson, S. M., Benoit, C., Casey, L., Phillips, R., & Burns, D. (2010)

Researchers that use the integrated KT (which leverages the involvement of key stakeholders from research inception to completion) process may encounter several challenges when they attempt to use research evidence to influence government policy in program delivery. Research evidence competes for the attention of policy-makers with other influencers, such as, public opinion, institutional constraints and fiscal constraints. Researchers can strengthen the likelihood of KT success by better understanding the policy-making process, regularly interacting with policy-makers, building trusted relationships and partnerships, and engaging in the timely communication of research findings.

Source: Waddell (2005). In: McGrath, P.J., Lingley-Pottie, P., Johnson Emberly, D., Thurston,C., McLean, C. (2009)

Stakeholders may not respond well to imbalances in the distribution of decision-making power, process controls or project resources. Researcher should try to achieve a balance or explain why differences must exist.
Source: Martens (2005). In: Jansson, S. M., Benoit, C., Casey, L., Phillips, R., & Burns, D. (2010)

Methods

Enlightenment model of knowledge translation – A process whereby researchers help policy-makers to understand an issue in a new light, redefining the dominant interpretation of an issue based upon new evidence.
Source: Weiss (1979). In: Murphy, K., Wolfus, B. & Lofters, A. (2011)

Tips

When designing a knowledge translation communication strategy, researchers should consider the possibility of external factors that may impede or facilitate the process.
Source: Hughes (2000); Bauman (2006). In: Wilson, P.M., Petticrew, M., Calnan, M. W. & Nazareth, I. (2010)