Research Translation: the global perspective

Disclosure of interests

• Co-chair Cochrane Knowledge Translation International Advisory Group

• Director of Cochrane Australia

• Member Cochrane Governing Board

• Employee Monash University

• Funding from NHMRC, Cochrane, Monash and DoHA

‘There is a gap between today’s scientific advances and their application: between what we know and what is actually being done.....

Action without knowledge is wasted effort, just as knowledge without action is wasted resource’.

LEE Jong-wook

WHO Director General 2003-2006

The problem: many healthcare practice and policy decisions are not based on research evidence

Guiding Principle 10: Research knowledge that can lead to benefit should be effectively disseminated to end users. Where appropriate, the usage of new knowledge should be supported and facilitated.

Definitions and concepts: What is research translation?

• Ensuring stakeholders* are aware of and use research evidence to inform their health and healthcare decision-making

• Ensuring research is informed by current available evidence and the experiences and information needs of stakeholders

Grimshaw et al, Implement Sci 2012

*stakeholders include:

• healthcare professionals • consumers of health care (i.e. patients,

family members, carers) • policy makers • educators • research funders • researchers

Some frameworks from home…

• Stakeholder prioritisation processes

• Variation in practice

• Registries • Audit • Evaluations

• Knowledge translation strategies

• Implementation science

• Research Priorities • Primary Research • Research Syntheses • Guidelines • Policy briefs

Knowing what we need to know

Knowing what we need to do

Doing what we know we need to do

Knowing we are doing what we know

we need to do

Produce Evidence

Translate into Policy & Practice Measure Practice

Identify Gaps

Context Catalyst Culture Capacity

Our approach to designing and evaluating strategies for implementation to practice

Step 1. Who needs to do what, differently?

Step 2. Using a theoretical framework, which barriers and enablers need to be addressed?

Step 3. Which intervention components could overcome the modifiable barriers and enhance the enablers?

Step 4. How can behaviour change be measured and understood?

When to invest in research translation? Is the body of evidence strong?

Based on systematic review of all trials, we are reasonably certain that this is an effective practice or policy.

Is it important?

Is it an area of high importance, prevalence or burden? Will there be an impact on health, equity or health care quality improvement?

Is there a documented gap?

Is the evidence inconsistent with prevailing practice or existing policy?

Can we measure impact?

Is there data through which we can measure practice, policy and health outcomes?

Cochrane’s vision is a world of improved health where decisions about health and health care are informed by high- quality, relevant and up-to-date synthesized research evidence. To achieve this we need excellent knowledge translation to accompany our excellent systematic review production.

Task Exchange

Development approach

• Developed by a working group of experienced KT leaders, internal and external to Cochrane

• Build on the many existing and ongoing KT activities in Cochrane

• Extensive consultation with Cochrane community

• Formal needs analysis with diverse group of internal and external stakeholders

• Synthesis and drafting of the framework by working group

• Approved by Cochrane Board in April 2017

• Formal Implementation plan: formation of oversight high level advisory group with working groups for each theme

• Skilled lean Central team for co-ordination and support

Themes

Prioritization Strengthening processes to identify and prioritize important reviews Working with partners to produce and share reviews

Development of a multi-attribute priority-setting tool for ranking research priorities

Present Cochrane evidence in multiple formats, languages and modes, and disseminate these effectively Target audiences relevant to message

Packaging/push:

Packaging/push: Translations

LANGUAGE

TRANSLATIONS

Facilitating Pull Make it easier to use Cochrane evidence and grow our stakeholders’ capacity for evidence use

Exchange Form and maintain meaningful partnerships and forums for dialogue with our users and to support our KT work

“Bridging the know-do gap is one of the most important challenges for public health in this century”.

Contribute to a culture of evidence informed health care

Improve climate/building demand:

Acknowledgements

Jo Anthony, Sylvia de Haan and Karen Head

Cochrane KT Advisory Group

John Lavis

Rachel Churchill

Denise Thomson

Rebecca Armstrong

Maureen Dobbins

Sophie Hill

Craig Lockwood

Pierre Ongolo-Zogo

Nancy Santesso

Taryn Young