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 …

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 …

Social Determinants Of Health In Canada: Are Healthy Living Initiatives There Yet? A Policy Analysis, Dana Gore, Anita Kothari

Anita Kothari

Introduction: Preventative strategies that focus on addressing the social determinants of health to improve healthy eating and physical activity have become an important strategy in British Columbia and Ontario for combating chronic diseases. What has not yet been examined is the extent to which healthy living initiatives implemented under these new policy frameworks successfully engage with and change the social determinants of health. Methods: Initiatives active between January 1, 2006 and September 1, 2011 were found using provincial policy documents, web searches, health organization and government websites, and databases of initiatives that attempted to influence to nutrition and physical activity …

The Use Of Tacit And Explicit Knowledge In Public Health: A Qualitative Study, Anita Kothari, Debbie Rudman, Maureen Dobbins, Michael Rouse, Shannon Sibbald, Nancy Edwards

Anita Kothari

Background Planning a public health initiative is both a science and an art. Public health practitioners work in a complex, often time-constrained environment, where formal research literature can be unavailable or uncertain. Consequently, public health practitioners often draw upon other forms of knowledge.

Methods Through use of one-on-one interviews and focus groups, we aimed to gain a better understanding of how tacit knowledge is used to inform program initiatives in public health. This study was designed as a narrative inquiry, which is based on the assumption that we make sense of the world by telling stories. Four public health units …

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 …

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 …

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 …

Mapping As A Knowledge Translation Tool For Ontario Early Years Centres: Views From Data Analysts And Managers, Anita Kothari, S. Michelle Driedger, Julia Bickford, Jason Morrison, Michael Sawada, Ian D. Graham, Eric Crighton

Anita Kothari

Background: Local Ontario Early Years Centres (OEYCs) collect timely and relevant local data, but knowledge translation is needed for the data to be useful. Maps represent an ideal tool to interpret local data. While geographic information system (GIS) technology is available, it is less clear what users require from this technology for evidence-informed program planning. We highlight initial challenges and opportunities encountered in implementing a mapping innovation (software and managerial decision-support) as a knowledge translation strategy.

Methods: Using focus groups, individual interviews and interactive software development events, we taped and transcribed verbatim our interactions with nine OEYCs in Ontario, Canada. …

Correction: Using Participatory Design To Develop (Public) Health Decision Support Systems Through Gis, S. Michelle Driedger, Anita Kothari, Jason Morrison, Michael Sawada, Eric J. Crighton, Ian D. Graham

Anita Kothari

Background: Organizations that collect substantial data for decision-making purposes are often characterized as being 'data rich' but 'information poor'. Maps and mapping tools can be very useful for research transfer in converting locally collected data into information. Challenges involved in incorporating GIS applications into the decision-making process within the non-profit (public) health sector include a lack of financial resources for software acquisition and training for nonspecialists to use such tools. This on-going project has two primary phases. This paper critically reflects on Phase 1: the participatory design (PD) process of developing a collaborative web-based GIS tool.

Methods: A case study …

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 …