Knowledge translation is a fundamental scientific paradigm, aiming to close the gap between research and practice.
Although health researchers and pharmaceutical companies do not hesitate to invest a fortune in research areas, such as biomedical research, clinical trials, risk management, and professional development; data shows that healthcare systems worldwide fail to provide affordable services and effective treatment to patients.
In fact, it can take up to 20 years for research knowledge collected via randomized controlled trials to be implemented in practice. The underutilization of evidence-based knowledge across medical settings and the growing complexity of today’s healthcare systems can result in unnecessary risks and skyrocketing costs.
For instance, patients in the US receive only 55% of recommended care, and approximately 20%-30% of patients across the globe receive care that is not needed (Grimshaw et al., 2012).
The know-do gap in research has been recognized as a major obstacle to improved health outcomes and drug development.
Consequently, numerous initiatives have been created to reduce this gap and tackle processes, such as quality assurance, technology transfer, innovation diffusion, evidence-informed policy, and implementation research. Although such terms are overlapping, the definition of “knowledge translation” has gained currency across Canada and the rest of the world.
Knowledge translation – also known as research utilization in Europe and dissemination or uptake in the US – refers to the process of transferring scientific knowledge, or what we’ve learned through research, into practice (Straus, Tetroe & Graham, 2011).
To be more precise, the Canadian Institutes of Health Research defines this process as “a dynamic and iterative process that includes the synthesis, dissemination, exchange and ethically sound application of knowledge to improve health, provide more effective health services and products and strengthen the healthcare system.”
Knowledge translation is not only about the passive transfer of evidence for clinical research but the optimal utilization of evidence-based data across different levels of the healthcare system (e.g., consumers, healthcare professionals, researchers, and policymakers).
The importance of knowledge translation in healthcare is immense. Despite the relatively new terminology, knowledge translation can be traced back to the beginning of the last century when sociologist Gabriel Tarde attempted to explain the nature of innovation diffusion (Grimshaw et al., 2012).
Evidence proves that conducting research and publishing the results is not enough for an innovation or a medical intervention to be implemented into practice.
To provide an example, although clinical trials show that statins can benefit post-stroke patients, statins are rarely prescribed in practice. Moreover, policymaking processes seldom include citable research or evidence from systematic reviews.
Knowledge translation research can enhance knowledge uptake and target numerous barriers to behavior and policy change at different levels of the healthcare system (e.g., lack of integrated information, poor standards of care, patients’ attitudes).
Note that one of the main challenges is the lack of knowledge management skills, such as insufficient time to read and the inability to appraise the huge volume of research publications.
To overcome barriers to behavior change, knowledge translation researchers must determine the know-do gap and explore the context of knowledge uptake in order to implement and assess effective research strategies in practice (Straus, Tetroe & Graham, 2011).
As stated above, effective models should target all those involved in healthcare decision-making (e.g., patients, clinicians, policymakers, researchers, the public) and should consider the knowledge being disseminated (e.g., clinical, biomedical).
Understanding the barriers and the context of knowledge translation is one of the first steps towards closing the know-do gap in healthcare.
In the vast labyrinths of scientific research, the numbers of research publications and contradicting data are increasing.
As clinicians, consumers, and policymakers often lack the time and skills needed to appraise research publications and individual studies; systematic reviews become the most effective methods to transfer knowledge and evidence-based data.
Note that programs, such as the Cochrane Collaboration, aim to help healthcare practitioners and consumers access easy-to-comprehend knowledge syntheses.
Knowledge translation should reach all levels of the healthcare system, with target audiences depending on the context of research.
For example, regulatory bodies and pharmaceutical companies might benefit from research sufficient to warrant a drug’s withdrawal from the market, while patients and providers might benefit from data demonstrating advantages from a treatment.
The key messages should be easy to comprehend by different audiences (e.g., policy briefs for policymakers).
Messenger credibility is another vital fact to consider in knowledge translation, which can be supported via an authoritative endorsement by a respected figure or a research group. Messages can be transferred by an individual (e.g., researcher), organization, or healthcare system.
Knowledge infrastructures also play a crucial role; they can be divided into technological (e.g., search engines) and organizational components (e.g., data analysts). (Grimshaw et al., 2012).
After identifying the know-do gap, researchers must assess barriers to knowledge translation and adapt knowledge to the local context. Barriers, which often obstruct different levels of the healthcare system, can be identified via surveys, focus groups, interviews, or observations.
Common barriers impact different healthcare levels: structural (e.g., financial restraints), organizational (e.g., lack of equipment), peer-group (e.g., poor standards of care), professionals (e.g., skills), professional-patients interaction (e.g., communication).
To provide an example, as professionals often overestimate their performance by approximately 20%-30%, individual capacities, training, and motivations should be explored further (Llopis et al., 2018).
For the successful utilization of research knowledge, behavior change interventions should be selected and tailored according to the local context. Grimshaw et al. (2012) systematized the following interventions divided into three categories:
Interventions to facilitate communication and decision-making; strategies to support behavior change; and techniques to educate consumers:
With numerous barriers and a variety of interventions, knowledge translation becomes a complex process that should be monitored effectively. Outcomes and practical impact should be assessed on a regular basis to sustain continued knowledge use and exchange.
Closing the know-do gap in medical research is essential as failure to transfer research findings into practice contributes to more than $200 billion of wasted funding and poor health outcomes (Graham, Kothari & McCutcheon, 2018).
To enhance dissemination and improve health outcomes, Web 2.0 technologies are becoming intergraded part of knowledge translation (Bernhardt, Mays & Kreuter, 2011). Web 2.0 technologies refer to apps and Internet-based tools with user-centered designs that facilitate interactive information sharing.
One of the main features of such technologies is that users can create content and exercise control through such digital tools. In contrast to passive Web 1.0 technologies, Web 2.0 tools empower users and their role in digital healthcare (Valdez et al., 2016).
Such tools have been implemented by numerous federal agencies, such as the Centers for Disease Control and Prevention, and engage prospective end-users from different directions. Users can either share one-to-one communication or engage in interactive communication (e.g., online forums).
Web 2.0 tools can overcome geographical barriers and allow users to form partnerships through conferences, virtual meetings, and calls. Success stories and influencers can also reshape the uptake of knowledge and highlight the demand for evidence-based medicine.
Note that to promote research products and increase the accessibility of services, smart tagging and search engine optimization are common strategies to create content based on search engine indexing.
Buttons or badges (defined as graphics with embedded links for information), widgets or gadgets (defined as applications that can be displayed from one site to another), and RSS feeds (defined as updated content of interest) are also used to engage users and promote knowledge translation.
Some of the most prominent types of new media and Web 2.0 technologies for knowledge translation include:
Knowledge translation is paramount to closing the gap between research and practice. The underutilization of evidence-based data results in poor health outcomes and unnecessary expenditures.
For instance, despite the high level of funding in the US, Americans experience poorer health outcomes compared to other developed nations.
Knowledge translation research aims to foster the optimal utilization of evidence-based information (e.g., systematic reviews) at different levels of the healthcare system (e.g., professionals, consumers, and policymakers).
To enhance knowledge uptake, knowledge translation researchers should understand the context of knowledge translation and target a wide variety of barriers to behavior change (e.g., lack of knowledge management skills), which will help them close the know-do gap in medical research.
Successful interventions include printed materials, audits, interactive apps, contracts, pull activities, push strategies, and much more.
One of the most popular strategies to enhance knowledge dissemination is the use of new media and Web 2.0 tools, such as social networking platforms, blogs, and sharing websites.
In the end, knowledge translation is an ongoing process that involves the frequent assessment of interventions, outcomes, and practical impact.
Continued knowledge use and exchange are essential in closing the know-do gap in research. Because moving research knowledge into practice settings can improve health outcomes and reduce waste in research!
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