Development of the Translating Allied Health Knowledge (TAHK) Framework

Document Type: Original Article

Authors

1 Occupational Therapy, Health & Social Development, Deakin University, Geelong, VIC, Australia

2 Occupational Therapy, North West Mental Health, Melbourne, VIC, Australia

3 Occupational Therapy, Barwon Health, Geelong, VIC, Australia

4 Occupational Therapy, Western Health, Melbourne, VIC, Australia

Abstract

Background
While evidence-based practice is a familiar concept to allied health clinicians, knowledge translation (KT) is less well known and understood. The need for a framework that enables allied health clinicians to access and engage with KT was identified. The aim of this paper is to describe the development of the Translating Allied Health Knowledge (TAHK) Framework.
 
Methods
An iterative and collaborative process involving clinician and academic knowledge partners was utilised to develop the TAHK Framework. Multiple methods were utilised during this process, including a systematic literature review, steering committee consultation, mixed methods survey, benchmarking and measurement property analysis.
 
Results
The TAHK Framework has now been finalised, and is described in detail. The framework is structured around four domains – Doing Knowledge Translation, Social Capital for Knowledge Translation, Sustaining Knowledge Translation and Inclusive Knowledge Translation – under which 14 factors known to influence allied health KT are classified. The formulation of the framework to date has laid a rigorous foundation for further developments, including clinician support and outcome measurement.
 
Conclusion
The method of development adopted for the TAHK Framework has ensured it is both evidence and practice based, and further amendments and modifications are anticipated as new knowledge becomes available. The Framework will enable allied health clinicians to build on their existing capacities for KT, and approach this complex process in a rigorous and systematic manner. The TAHK Framework offers a unique focus on how knowledge is translated by allied health clinicians in multidisciplinary settings.

Highlights

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Keywords

Main Subjects


  1. Department of Health. Review of Australian government health workforce programs. Canberra: Australian Government, Department of Health; 2013.
  2. Donini-Lenhoff FG. Coming together, moving apart: a history of the term allied health in education, accreditation, and practice. J Allied Health. 2008;37(1):45-52.
  3. Allied Health Professions Australia (AHPA). Allied Health Professions 2018. https://ahpa.com.au/allied-health-professions/.
  4. Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. BMJ. 1996;312(7023):71-72.
  5. Glasziou PP, Del Mar C, Salisbury J. Evidence-based medicine workbook. Malden, MA: John Wiley & Sons; 2009.
  6. Nevo I, Slonim-Nevo V. The myth of evidence-based practice: Towards evidence-informed practice. Br J Soc Work. 2011;41(6):1176-1197. doi:10.1093/bjsw/bcq149
  7. Grimmer-Somers K, Lekkas P, Nyland L, Young A, Kumar S. Perspectives on research evidence and clinical practice: a survey of Australian physiotherapists. Physiother Res Int. 2007;12(3):147-161. doi:10.1002/pri.363
  8. Harding KE, Porter J, Horne-Thompson A, Donley E, Taylor NF. Not enough time or a low priority? Barriers to evidence-based practice for allied health clinicians. J Contin Educ Health Prof. 2014;34(4):224-231. doi:10.1002/chp.21255
  9. Hoffman LM, Ireland M, Hall-Mills S, Flynn P. Evidence-based speech-language pathology practices in schools: findings from a national survey. Lang Speech Hear Serv Sch. 2013;44(3):266-280. doi:10.1044/0161-1461(2013/12-0041)
  10. Callender L, Brown R, Driver S, Dahdah M, Collinsworth A, Shafi S. Process for developing rehabilitation practice recommendations for individuals with traumatic brain injury. BMC Neurol. 2017;17(1):54. doi:10.1186/s12883-017-0828-z
  11. Verloo H, Desmedt M, Morin D. Beliefs and implementation of evidence-based practice among nurses and allied healthcare providers in the Valais hospital, Switzerland. J Eval Clin Pract. 2017;23(1):139-148. doi:10.1111/jep.12653
  12. Bucknall T, Hitch D. Connections, Communication and Collaboration in Healthcare's Complex Adaptive Systems Comment on "Using Complexity and Network Concepts to Inform Healthcare Knowledge Translation". Int J Health Policy Manag. 2017;7(6):556-559. doi:10.15171/ijhpm.2017.138
  13. Straus SE, Tetroe J, Graham I. Defining knowledge translation. CMAJ. 2009;181(3-4):165-168. doi:10.1503/cmaj.081229
  14. Atack L, Luke R. Impact of an online course on infection control and prevention competencies. J Adv Nurs. 2008;63(2):175-180. doi:10.1111/j.1365-2648.2008.04660.x
  15. Lokker C, McKibbon KA, Wilczynski NL, et al. Finding knowledge translation articles in CINAHL. Stud Health Technol Inform. 2010;160(Pt 2):1179-1183.
  16. Wright N. First-time knowledge brokers in health care: the experiences of nurses and allied health professionals of bridging the research-practice gap. Evid Policy. 2013;9(4):557-570. doi:10.1332/174426413X13836462527470
  17. Hitch D, Rowan S, Nicola-Richmond K. A case study of knowledge brokerage in occupational therapy. Int J Ther Rehabil. 2014;21(8):389-396. doi:10.12968/ijtr.2014.21.8.389
  18. Gupta S, Moosa D, MacPherson A, Allen C, Tamari IE. Effects of a 12-month multi-faceted mentoring intervention on knowledge, quality, and usage of spirometry in primary care: a before-and-after study. BMC Pulm Med. 2016;16(1):56. doi:10.1186/s12890-016-0220-6
  19. Atwal A, Spiliotopoulou G. Knowledge transfer: developing guidelines for occupational therapists working with people with lower limb amputations. Br J Occup Ther. 2011;74(3):109. doi:10.4276/030802211x12996065859120
  20. Moodie ST, Kothari A, Bagatto MP, Seewald R, Miller LT, Scollie SD. Knowledge translation in audiology: promoting the clinical application of best evidence. Trends Amplif. 2011;15(1):5-22. doi:10.1177/1084713811420740
  21. Brosseau L, Wells GA, Tugwell P, et al. Ottawa Panel evidence-based clinical practice guidelines for the management of osteoarthritis in adults who are obese or overweight. Phys Ther. 2011;91(6):843-861. doi:10.2522/ptj.20100104
  22. Warner G. Synthesizing research evidence for therapists providing home-based rehabilitative care. Phys Occup Ther Geriatr. 2013;31(2):115-127. doi:10.3109/02703181.2013.771296
  23. Kredo T, Bernhardsson S, Machingaidze S, et al. Guide to clinical practice guidelines: the current state of play. Int J Qual Health Care. 2016;28(1):122-128. doi:10.1093/intqhc/mzv115
  24. Moore JL, Raad J, Ehrlich-Jones L, Heinemann AW. Development and use of a knowledge translation tool: the rehabilitation measures database. Arch Phys Med Rehabil. 2014;95(1):197-202. doi:10.1016/j.apmr.2013.09.010
  25. Archambault PM, Bilodeau A, Gagnon MP, et al. Health care professionals' beliefs about using wiki-based reminders to promote best practices in trauma care. J Med Internet Res. 2012;14(2):e49. doi:10.2196/jmir.1983
  26. Bowden FM, Lordly D, Thirsk J, Corby L. Phase II Practice-based Evidence in Nutrition (PEN) evaluation: interviews with key informants. Can J Diet Pract Res. 2012;73(1):e233-240. doi:10.3148/73.1.2012.e233
  27. Doran D, Paterson J, Clark C, et al. A pilot study of an electronic interprofessional evidence-based care planning tool for clients with mental health problems and addictions. Worldviews Evid Based Nurs. 2010;7(3):174-184. doi:10.1111/j.1741-6787.2010.00191.x
  28. Campbell L, Novak I, McIntyre S, Lord S. A KT intervention including the evidence alert system to improve clinician's evidence-based practice behavior--a cluster randomized controlled trial. Implement Sci. 2013;8:132. doi:10.1186/1748-5908-8-132
  29. Scott SD, Albrecht L, O'Leary K, et al. Systematic review of knowledge translation strategies in the allied health professions. Implement Sci. 2012;7:70. doi:10.1186/1748-5908-7-70
  30. Imms C, Kerr C, Novak I, et al. Knowledge translation for allied health professionals working with children with cerebral palsy: effects on evidence-based knowledge and practice. Physiotherapy. 2016;102(Suppl 1):e35-36. doi:10.1016/j.physio.2016.10.049
  31. Haines TP, Waldron NG. Translation of falls prevention knowledge into action in hospitals: what should be translated and how should it be done? J Safety Res. 2011;42(6):431-442. doi:10.1016/j.jsr.2011.10.003
  32. Girard A, Rochette A, Fillion B. Knowledge translation and improving practices in neurological rehabilitation: managers' viewpoint. J Eval Clin Pract. 2013;19(1):60-67. doi:10.1111/j.1365-2753.2011.01769.x
  33. Nilsen P. Making sense of implementation theories, models and frameworks. Implement Sci. 2015;10:53. doi:10.1186/s13012-015-0242-0
  34. Smith M, Wilkinson H, Gallagher M. ‘It's what gets through people's radars isn't it’: relationships in social work practice and knowledge exchange. Contemp Soc Sci. 2013;8(3):292-306. doi:10.1080/21582041.2012.751499
  35. Forhan M, Law M. An evaluation of a workshop about obesity designed for occupational therapists. Can J Occup Ther. 2009;76(5):351-358. doi:10.1177/000841740907600506
  36. Birken SA, Powell BJ, Shea CM, et al. Criteria for selecting implementation science theories and frameworks: results from an international survey. Implement Sci. 2017;12(1):124. doi:10.1186/s13012-017-0656-y
  37. Greenhalgh T. Knowledge to action: there is no tooth fairy. https://www.cebm.net/2015/11/knowledge-to-action-there-is-no-tooth-fairy/ . Published September 19, 2018.
  38. Squires JE, Graham ID, Hutchinson AM, et al. Understanding context in knowledge translation: a concept analysis study protocol. J Adv Nurs. 2015;71(5):1146-1155. doi:10.1111/jan.12574
  39. Pain T, Kingston G, Askern J, Smith R, Phillips S, Bell L. How are allied health notes used for inpatient care and clinical decision-making? A qualitative exploration of the views of doctors, nurses and allied health professionals. Health Inf Manag. 2017;46(1):23-31. doi:10.1177/1833358316664451
  40. Dorning H, Bardsley MNI. “focus on AHPs”: Quality Watch Health Foundation; 2014. http://www.nuffieldtrust.org.uk/publications/focus-allied-health-professionals.   
  41. Buchan J, Law D. A review of allied health workforce models and structures: A report to the Victorian Ministerial Advisory Committee for Allied Health. Melbourne: Victorian Government; 2016.
  42. Raven M. Allied health practitioners in Australian primary health care. Adelaide: Primary Health Care Research & Information Service; 2014.
  43. Moore GF, Audrey S, Barker M, et al. Process evaluation of complex interventions: Medical Research Council guidance. BMJ. 2015;350:h1258. doi:10.1136/bmj.h1258
  44. Campbell M, Fitzpatrick R, Haines A, et al. Framework for design and evaluation of complex interventions to improve health. BMJ. 2000;321(7262):694-696.
  45. Burns KD, Wolfs W, Belanger P, McLaughlin K, Levin A. The KRESCENT Program: an initiative to match supply and demand for kidney research in Canada. Clin Invest Med. 2010;33(6):E356-367.
  46. Lane H, Sturgess T, Philip K, et al. What factors do allied health take into account when making resource allocation decisions? Int J Health Policy Manag. 2017;7(5):412-420. doi:10.15171/ijhpm.2017.105
  47. Pawson R, Tilley N. Realistic evaluation. Thousand Oaks, CA, US: Sage; 1997.
  48. Slade SC, Philip K, Morris ME. Frameworks for embedding a research culture in allied health practice: a rapid review. Health Res Policy Syst. 2018;16(1):1-15. doi:10.1186/s12961-018-0304-2
  49. Schofield T. Gendered organizational dynamics: the elephant in the room for Australian allied health workforce policy and planning? J Sociol. 2009;45(4):383-400. doi:10.1177/1440783309346479
  50. Turnbull C, Grimmer-Somers K, Kumar S, May E, Law D, Ashworth E. Allied, scientific and complementary health professionals: a new model for Australian allied health. Aust Health Rev. 2009;33(1):27-37.
  51. Boyce RA. Organisational governance structures in allied health services: a decade of change. Aust Health Rev. 2001;24(1):22-36.
  52. Rowe PA, Boyce RA, Boyle MV, O'Reilly K. A comparative analysis of entrepreneurial approaches within public healthcare organisations. Aust J Public Adm. 2004;63(2):16-30. doi:10.1111/j.1467-8500.2004.00375.x
  53. Metzler MJ, Metz GA. Translating knowledge to practice: an occupational therapy perspective. Aust Occup Ther J. 2010;57(6):373-379. doi:10.1111/j.1440-1630.2010.00873.x
  54. Thigpen S, Puddy RW, Singer HH, Hall DM. Moving knowledge into action: developing the rapid synthesis and translation process within the interactive systems framework. Am J Community Psychol. 2012;50(3-4):285-294. doi:10.1007/s10464-012-9537-3
  55. Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999;89(9):1322-1327.
  56. Jack S, Tonmyr L. Knowledge transfer and exchange: disseminating Canadian child maltreatment surveillance findings to decision makers. Child Indic Res. 2008;1(1):51-64. doi:10.1007/s12187-007-9001-3
  57. Lavis J, Ross S, McLeod C, Gildiner A. Measuring the impact of health research. J Health Serv Res Policy. 2003;8(3):165-170. doi:10.1258/135581903322029520
  58. Ask LN. Rogaland County Council and Universal Design. Stud Health Technol Inform. 2016;229:78-84.
  59. Adam P, Ovseiko PV, Grant J, et al. ISRIA statement: ten-point guidelines for an effective process of research impact assessment. Health Res Policy Syst. 2018;16(1):8. doi:10.1186/s12961-018-0281-5
  60. Hitch D, Pepin G, Stagnitti K. The pan occupational paradigm: development and key concepts. Scand J Occup Ther. 2018;25(1):27-34. doi:10.1080/11038128.2017.1337808
  61. Pennell KG, Thompson M, Rice JW, Senier L, Brown P, Suuberg E. Bridging research and environmental regulatory processes: the role of knowledge brokers. Environ Sci Technol. 2013;47(21):11985-11992. doi:10.1021/es4025244
  62. Kothari A, McCutcheon C, Graham ID. Defining integrated knowledge translation and moving forward: a response to recent commentaries. Int J Health Policy Manag. 2017;6(5):299-300. doi:10.15171/ijhpm.2017.15
  63. Nahapiet J, Ghoshal S. Social capital, intellectual capital, and the organizational advantage. Acad Manage Rev. 1998;23(2):242-266. doi:10.2307/259373
  64. Kislov R, Wilson P, Boaden R. The 'dark side' of knowledge brokering. J Health Serv Res Policy. 2017;22(2):107-112. doi:10.1177/1355819616653981
  65. Hakkennes S, Dodd K. Guideline implementation in allied health professions: a systematic review of the literature. Qual Saf Health Care. 2008;17(4):296-300. doi:10.1136/qshc.2007.023804
  66. Hall AE, Bryant J, Sanson-Fisher RW, Fradgley EA, Proietto AM, Roos I. Consumer input into health care: Time for a new active and comprehensive model of consumer involvement. Health Expect. 2018;21(4):707-713. doi:10.1111/hex.12665
  67. McArthur A, Klugarova J, Yan H, Florescu S. Innovations in the systematic review of text and opinion. Int J Evid Based Healthc. 2015;13(3):188-195. doi:10.1097/xeb.0000000000000060
  68. Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467-473. doi:10.7326/m18-0850
  69. Cramm H, Short B, Donnelly CA. Knowledge translation and occupational therapy: A survey of Canadian university programs. Open J Occup Ther. 2016;4(4):1-11. doi:10.15453/2168-6408.1196
  70. Alison JA, Zafiropoulos B, Heard R. Key factors influencing allied health research capacity in a large Australian metropolitan health district. J Multidiscip Healthc. 2017;10:277-291. doi:10.2147/jmdh.s142009
  71. Campbell L, Novak I, McIntyre S, Lord S. A KT intervention including the evidence alert system to improve clinician's evidence-based practice behavior--a cluster randomized controlled trial. Implement Sci. 2013;8:132. doi:10.1186/1748-5908-8-132
  72. Hadouda S, Laroui HR, Lemay A, et al. Practice style traits of student occupational therapists and physical therapists. Can J Occup Ther. 2009;76(2):98-106. doi:10.1177/000841740907600207
  73. Novak I, Russell D, Ketelaar M. What works in knowledge translation: A systematic review. Adelaide: OT Australia Conference; 2013.
  74. Bradd P, Travaglia J, Hayen A. Allied health leadership in New South Wales: a study of perceptions and priorities of allied health leaders. Aust Health Rev. 2018;42(3):316-320. doi:10.1071/ah16135
  75. Hitch D, Lhuede K, Vernon L, Pepin G, Stagnitti K. Longitudinal evaluation of a knowledge translation role in occupational therapy. Knowledge Utilisation Colloquium; November 8-10, 2017; Melbourne, Australia.
  76. McCluskey A, Middleton S. Delivering an evidence-based outdoor journey intervention to people with stroke: barriers and enablers experienced by community rehabilitation teams. BMC Health Serv Res. 2010;10:18. doi:10.1186/1472-6963-10-18
  77. Bennett S, Whitehead M, Eames S, Fleming J, Low S, Caldwell E. Building capacity for knowledge translation in occupational therapy: learning through participatory action research. BMC Med Educ. 2016;16(1):257. doi:10.1186/s12909-016-0771-5
  78. Dawes M, Summerskill W, Glasziou P, et al. Sicily statement on evidence-based practice. BMC Med Educ. 2005;5(1):1. doi:10.1186/1472-6920-5-1
  79. Graham ID, Logan J, Harrison MB, et al. Lost in knowledge translation: time for a map? J Contin Educ Health Prof. 2006;26(1):13-24. doi:10.1002/chp.47
  80. Green G. Power to the people: to what extent has public involvement in applied health research achieved this? Research Involvement and Engagement. 2016;2(1):1-13. doi:10.1186/s40900-016-0042-y
  81. Kitson A, Brook A, Harvey G, et al. Using Complexity and Network Concepts to Inform Healthcare Knowledge Translation. Int J Health Policy Manag. 2017;7(3):231-243. doi:10.15171/ijhpm.2017.79
  82. Leach K, Hitch D, Neale S. Evaluating the implementation of an Early Stroke Discharge (ESD) program at Western Health: Preliminary Report. Melbourne: Western Health; 2017.
  83. Perry L, Grange A, Heyman B, Noble P. Stakeholders' perceptions of a research capacity development project for nurses, midwives and allied health professionals. J Nurs Manag. 2008;16(3):315-326. doi:10.1111/j.1365-2834.2007.00801.x
  84. Mickan S, Wenke R, Weir K, Bialocerkowski A, Noble C. Strategies for research engagement of clinicians in allied health (STRETCH): a mixed methods research protocol. BMJ Open. 2017;7(9):e014876. doi:10.1136/bmjopen-2016-014876
  85. Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50. doi:10.1186/1748-5908-4-50
  86. Kitson A, Harvey G, McCormack B. Enabling the implementation of evidence based practice: a conceptual framework. Qual Health Care. 1998;7(3):149-158.