Medicine and Health Sciences Commons^™

A Critical Second Look At Integrated Knowledge Translation, Anita Kothari, Nadine Wathen

Anita Kothari

Integrated knowledge translation (IKT) requires active collaboration between researchers and the ultimate users of knowledge throughout a research process, and is being aggressively positioned as an essential strategy to address the problem of underutilization of research-derived knowledge. The purpose of this commentary is to assist potential "knowledge users", particularly those working in policy or service settings, by highlighting some of the more nuanced benefits of the IKT model, as well as some of its potential costs. Actionable outcomes may not be immediately (or ever) forthcoming, but the process of collaboration can result in group-level identity transformation that permits access to …

Disulfiram In The Management Of Alcohol Dependence: A Comprehensive Clinical Review, Amresh Srivastava

Amresh Srivastava

ABSTRACT Disulfiram remains a viable option as a treatment for alcohol dependence and has been shown in recent studies to be successful in treating patients with alco- hol dependence in a manner that is superior to both naltrexone and acamprosate. It is also useful in dual diagnosis patients and those with co-morbid cocaine and alcohol dependence. Although disulfiram’s me- chanism of action in alcohol dependence was long thought to be its effects as a psychological deterrent, more recent studies have uncovered potential anti- craving effects as well. Recent reviews exhort to the importance of supervised disulfiram therapy in high- lighting …

Getting To The Root Of The Problem: Health Promotion Strategies To Address The Social Determinants Of Health, Dana Gore, Anita Kothari

Anita Kothari

Although extensive research shows that the social determinants of health influence the distribution and course of chronic diseases, there is little programming in public health that addresses the social determinants as a disease prevention strategy. This paper discusses different types of health promotion initiatives and differentiates them based on whether they attempt to impact intermediate (environmental) determinants of health or structural determinants of health. We argue for the importance of programming targeted at the structural determinants as opposed to programming targeted solely at the immediate environment. Specifically, the former has more potential to create significant improvements in health, contribute to …

Enacting Accountability: Networked Governance, Canadian Ngos And The Fctc, Raphael Lencucha, Anita Kothari, Ronald Labonte

Anita Kothari

Accountability is a pressing challenge within the present system of international lawmaking. Scholars continue to examine the role of non-governmental organizations (NGOs) to encourage the accountability of governments during this process. The negotiation of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) provides an important context to examine accountability as it is and was inherently influenced by corporate interests and government economics, and involved extensive NGO participation. We conducted in depth interviews and document analysis to examine the role of Canadian NGO representatives in the negotiation of the FCTC. We highlight two sets of findings about Canadian …

Partnerships In Public Health: Lessons From Knowledge Translation And Program Planning, Shannon Sibbald, Anita Kothari, Debbie Rudman, Maureen Dobbins, Michael Rouse, Nancy Edwards, Dana Gore

Anita Kothari

The purpose of this study was to better understand how partnerships are initiated, maintained, and sustained in public health practice. A qualitative design was employed to conduct individual interviews and focus groups. The participants included practitioners from 6 purposively selected public health units in the Canadian province of Ontario that developed partnerships in program planning. It was found that partnerships play an essential role in program planning but that minimal information is available regarding the partnership process. Most partnerships are formed on an ad hoc basis, with little formalization. Public health professionals rely on their experiential knowledge when seeking out …

Uncovering Tacit Knowledge: A Pilot Study To Broaden The Concept Of Knowledge In Knowledge Translation, Anita Kothari, Julia Bickford, Nancy Edwards, Maureen Dobbins, Mechthild Meyer

Anita Kothari

BACKGROUND: All sectors in health care are being asked to focus on the knowledge-to-practice gap, or knowledge translation, to increase service effectiveness. A social interaction approach to knowledge translation assumes that research evidence becomes integrated with previously held knowledge, and practitioners build on and co-create knowledge through mutual interactions. Knowledge translation strategies for public health have not provided anticipated positive changes in evidence-based practice, possibly due in part to a narrow conceptualization of knowledge. More work is needed to understand the role of tacit knowledge in decision-making and practice. This pilot study examined how health practitioners applied tacit knowledge in …

Community-Based Knowledge Translation: Unexplored Opportunities, Anita Kothari, Rebecca Armstrong

Anita Kothari

BACKGROUND: Knowledge translation is an interactive process of knowledge exchange between health researchers and knowledge users. Given that the health system is broad in scope, it is important to reflect on how definitions and applications of knowledge translation might differ by setting and focus. Community-based organizations and their practitioners share common characteristics related to their setting, the evidence used in this setting, and anticipated outcomes that are not, in our experience, satisfactorily reflected in current knowledge translation approaches, frameworks, or tools.

DISCUSSION: Community-based organizations face a distinctive set of challenges and concerns related to engaging in the knowledge translation process, …

Knowledge-To-Action Processes In Shrtn Collaborative Communities Of Practice: A Study Protocol, James Conklin, Anita Kothari, Paul Stolee, Larry Chambers, Dorothy Forbes, Ken Le Clair

Anita Kothari

BACKGROUND: The Seniors Health Research Transfer Network (SHRTN) Collaborative is a network of networks that work together to improve the health and health care of Ontario seniors. The collaborative facilitates knowledge exchange through a library service, knowledge brokers (KBs), local implementation teams, collaborative technology, and, most importantly, Communities of Practice (CoPs) whose members work together to identify innovations, translate evidence, and help implement changes.This project aims to increase our understanding of knowledge-to-action (KTA) processes mobilized through SHRTN CoPs that are working to improve the health of Ontario seniors. For this research, KTA refers to the movement of research and experience-based …

If You Build It, They Still May Not Come: Outcomes And Process Of Implementing A Community-Based Integrated Knowledge Translation Mapping Innovation, S. Driedger, Anita Kothari, Ian Graham, Elizabeth Cooper, Eric Crighton, Melanie Zahab, Jason Morrison, Michael Sawada

Anita Kothari

Background: Maps and mapping tools through geographic information systems (GIS) are highly valuable for turning data into useful information that can help inform decision-making and knowledge translation (KT) activities. However, there are several challenges involved in incorporating GIS applications into the decision-making process. We highlight the challenges and opportunities encountered in implementing a mapping innovation as a KT strategy within the non-profit (public) health sector, reflecting on the processes and outcomes related to our KT innovations.

Methods: A case study design, whereby the case is defined as the data analyst and manager dyad (a two person team) in selected Ontario …

Is Research Working For You? Validating A Tool To Examine The Capacity Of Health Organizations To Use Research, Anita Kothari, Nancy Edwards, Nadia Hamel, Maria Judd

Anita Kothari

Background: 'Is research working for you? A self-assessment tool and discussion guide for health services management and policy organizations', developed by the Canadian Health Services Research Foundation, is a tool that can help organizations understand their capacity to acquire, assess, adapt, and apply research. Objectives were to: determine whether the tool demonstrated response variability; describe how the tool differentiated between organizations that were known to be lower-end or higher-end research users; and describe the potential usability of the tool.

Methods: Thirty-two focus groups were conducted among four sectors of Canadian health organizations. In the first hour of the focus group, …

Is Reporting On Interventions A Weak Link In Understanding How And Why They Work? A Preliminary Exploration Using Community Heart Health Exemplars, Barbara Riley, Joanne Macdonald, Omaima Mansi, Anita Kothari, Donna Kurtz, Linda Vontettenborn, Nancy Edwards

Anita Kothari

Background: The persistent gap between research and practice compromises the impact of multi-level and multi-strategy community health interventions. Part of the problem is a limited understanding of how and why interventions produce change in population health outcomes. Systematic investigation of these intervention processes across studies requires sufficient reporting about interventions. Guided by a set of best processes related to the design, implementation, and evaluation of community health interventions, this article presents preliminary findings of intervention reporting in the published literature using community heart health exemplars as case examples.

Methods: The process to assess intervention reporting involved three steps: selection of …

Public Health Decision Makers’ Informational Needs And Preferences For Receiving Research Evidence, Maureen Dobbins, Susan Jack, Helen Thomas, Anita Kothari

Anita Kothari

Objectives: The purpose of this study was to identify decision-makers’ preferences for the transfer and exchange of research knowledge. This article is focused on how the participants define evidence-based decision-making and their preferences for receiving research evidence to integrate into the decision-making process.

Methods: Semistructured interviews were conducted with a purposive sample of 16 Ontario public health decision-makers from six Ontario public health units in this fundamental qualitative descriptive study. The sample included nine program managers, six directors, and one Medical Officer of Health. Participants were asked to define the term evidence-based decision-making and identify preferred research dissemination strategies. The …

“Interaction” And Research Utilisation In Health Policies And Programs: Does It Work?, Anita Kothari, Stephen Birch, Cathy Charles

Anita Kothari

The objective of this study was to assess if interaction between users and producers of research is associated with a greater level of adoption of research findings in the design and delivery of health care programs. Responses to the dissemination of a research report on breast cancer prevention were compared between two groups of public health units in Ontario, Canada. Although all public health units received the report, only a subset of units was involved in the development of the report, while others were not. Research utilisation was conceptualized in terms of stages, including reading the report, information processing, and …

The Contextual Approach In Health Research: Two Empirical Studies, Anita Kothari

Anita Kothari

Researchers are being encouraged to consider contextual influences on health-related outcomes. To support this perspective, two context-sensitive studies were conducted. The first study explored the utilization of a research report by Ontario public health units, and examined whether utilization differed by involvement in the research process. Research utilization was conceptualized as a three stage process (reading, information processing and application). Using a case study design, results from three "involved" public health units and three "uninvolved" units demonstrated that inclusion in the research process led to a greater understanding of the analysis and increased the value associated with the report. Involvement …

Education In Schizophrenia Support For Families, Amresh Srivastava

Amresh Srivastava

No abstract provided.