Graham, I.D., Logan, J., Harrison, M.B., Straus, S.E., Tetroe J., Caswell, W. et. al. (2006). Lost in Knowledge Translation: Time for a Map? Journal of Continuing Education in the Health Professions, 26(1), 13-24.

Format: Peer-reviewed article

Type: Experience

Experience level of reader: Fundamental

Annotation: A review of terms and definitions related to effectively communicating research-based knowledge to stakeholders to facilitate awareness, interest and use. Describes the Knowledge to Action (KTA) Model which serves as a road map for guiding knowledge translation activities.

Setting(s) to which the reported activities/findings are relevant: Community, Federal lab, Government, Large business, Small business (less than 500 employees), University

Knowledge user(s) to whom the piece of literature may be relevant: Brokers, Researchers

Knowledge user level addressed by the literature: Individual

This article uses the Commercial Devices and Services version of the NtK Model

Carrier: Important to consider barriers to knowledge use for individuals as well as for organizations. Barriers for individuals may include existing knowledge, attitudes, skills or habits, with effective interventions including interactive educational sessions and outreach visits. Barriers at the level of the organizations may be addressed through reminder systems, modifying the documentation and audit process, changing staff levels or support equipment, or changing compensation/incentive systems.
Summary of the Knowledge To Action Model and its application to knowledge translation.
Occurrence of finding within the model: KTA Step 1.C, KTA Step 1.D, KTA Step 2.C, KTA Step 2.D

• Action Cycle within KTA Model — The action cycle takes a planned action approach which is a deliberate effort to change behaviors within social systems. The first step is to identify a problem or issue deserving attention and searching for knowledge that addresses the need. Any found knowledge — or newly generated knowledge — is critically appraised to determine its validity and usefulness for the problem.
  Summary of the Knowledge To Action Model and its application to knowledge translation.
  Occurrence of finding within the model: KTA Step 1.A, KTA Step 2.A

• Action Cycle within the KTA Model — The fourth step involves planning and executing the interventions to facilitate and promote awareness and implementation of the knowledge. This involves selecting and tailoring the interventions to the identified barriers and audiences.
  Summary of the Knowledge To Action Model and its application to knowledge translation.
  Occurrence of finding within the model: KTA Step 1.D, KTA Step 2.D

• Knowledge Translation — the primary purpose of KT is to address the gap between the base of knowledge from research along with related knowledge syntheses, and the implementation of this knowledge by key stakeholders. To address the gap between what is known and what is used.
  Summary of the Knowledge To Action Model and its application to knowledge translation.
  Occurrence of finding within the model: KTA Step 1.A, KTA Step 2.A, Gate 7

• Action Cycle within the KTA Model — The third step involves an assessment of the potential barriers to communication the knowledge to stakeholders, or that may interfere with stakeholder use of the knowledge. These may include issues related to the knowledge itself, the potential adopters, or the context/setting in which the knowledge will be use. Also important to consider any carriers to facilitate knowledge use.
  Summary of the Knowledge To Action Model and its application to knowledge translation.
  Occurrence of finding within the model: KTA Step 1.C, KTA Step 2.C

• Action Cycle within the KTA Model — the sixth step is to determine the impact on the target system that results from knowledge use. It is the only way to determine whether the efforts to promote knowledge use were successful and worthwhile.
  Summary of the Knowledge To Action Model and its application to knowledge translation.
  Occurrence of finding within the model: KTA Step 1.F, KTA Step 2.F

• Action Cycle within the KTA Model — The fifth step involves monitoring knowledge adoption and use. There are three types of knowledge use: 1) Conceptual use involving changing the users level of knowledge, understanding or attitudes; 2) Instrumental use where direct changes in behavior or practice occur; 3) Strategic use — where the knowledge is manipulated and applied to achieve unintended results.
  Summary of the Knowledge To Action Model and its application to knowledge translation.
  Occurrence of finding within the model: KTA Step 1.E, KTA Step 2.E

• Action Cycle within the KTA Model — the seventh step concerns approaches to sustain knowledge use. The barriers to continued use may be different than those encountered at initial use, but the process for addressing them still involves assessing barriers, tailoring interventions as carriers to overcome them, and establishing a feedback loop to monitor long-term use and its consequences.
  Summary of the Knowledge To Action Model and its application to knowledge translation.
  Occurrence of finding within the model: KTA Step 1.G, KTA Step 2.G

• Knowledge Creation Cycle is depicted as having three generations descending through a funnel, to represent how knowledge is sifted and filtered so that only the most useful knowledge is left for application. First generation knowledge is that created through research activity or through experiential activity. Second generation knowledge results from a process for the identification, appraisal and synthesis of studies or information related to a specific question. Third generation knowledge is embodied in summaries, practice guidelines and decision aids, where the knowledge is available in formats that meet the needs of targeted stakeholder groups.
  Summary of the Knowledge to Action Model and its application to knowledge translation.
  Occurrence of finding within the model: Gate 2, Gate 3, Step 3.8, Step 3.2, Step 3.5

• Action Cycle within the KTA Model — The second step involves adapting the validated knowledge to the local context. This involves valuing the utility of the knowledge to the problem, setting and circumstances, as well as tailoring the knowledge to the specific situation.
  Summary of the Knowledge To Action Model and its application to knowledge translation.
  Occurrence of finding within the model: KTA Step 1.B, KTA Step 2.B

Carrier: Knowledge Producers can facilitate the uptake of their research by addressing five questions: 1) What should be disseminated? 2) To whom should it be disseminated? 3) By whom should it be disseminated? 4) How should it be disseminated? 5) With what effect should it be disseminated? (Lavis, J et at [2003])
Occurrence of finding within the model: Gate 2, Gate 3, Step 3.8, Step 3.2, Step 3.5

Tip: Research-based knowledge is not used as a can-opener is used. Generic knowledge is seldom taken directly off the shelf and applied without some sort of vetting or tailoring to the local context. (Humberman M. [1987])
Occurrence of finding within the model: Step 3.8, Step 3.2, Step 2.2