The Maritime SPOR SUPPORT Unit (MSSU) Bridge Process: An Integrated Knowledge Translation Approach to Address Priority Health Issues and Increase Collaborative Research in Nova Scotia, Canada

Document Type : Original Article

Authors

1 Maritime SPOR SUPPORT Unit, Research and Innovation, Nova Scotia Health, Halifax, NS, Canada

2 Nova Scotia Department of Health and Wellness, Halifax, NS, Canada

3 Maritime SPOR SUPPORT Unit, Research and Innovation, Nova Scotia Health, Halifax, Canada

4 Department of Community Health & Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada

Abstract

Background 
There is evidence of the benefits of integrated knowledge translation (IKT), yet there is limited research outlining the purpose of a knowledge broker (KB) within this approach. The MSSU acts as a KB to support patient-oriented research across the Maritime provinces in Canada. The “Bridge Process” was developed by the Nova Scotia site as a strategy that involves work leading up to and following the Bridge Event. The process supports research addressing priority health topics discussed at the event by stakeholder groups. The objectives of this paper were to 1) describe the outputs/outcomes of this IKT approach; and 2) examine the role of the KB.

Methods 
Quantitative data were collected from registration and evaluation surveys. Outputs are described with descriptive statistics. Qualitative data were collected through evaluation surveys and internal documents. Data related to KB tasks were categorized into three domains: 1) Knowledge Manager, 2) Linkage and Exchange Agent and 3) Capacity Developer.

Results 
The Bridge Process was implemented four times. A total of 314 participants including government, health, patient/citizen, community, and research personnel attended the events. We identified 24 priority topics, with 7 led by teams receiving support to complete related projects. Participants reported improved understanding of the research gaps and policy needs and engaged with individuals they would not have otherwise. Although patients/citizens attended each Bridge Event, only 61% of participants who completed an evaluation survey indicated that they were ‘actively engaged in group discussion’. The KB’s role was identified in all three domains of Knowledge Manager (e.g., defining questions), Linkage and Exchange Agent (e.g., engaging stakeholders,), and Capacity Builder (e.g., research interpretation).

Conclusion 
The MSSU facilitated an IKT approach by acting as a KB throughout the Bridge Process. This deliberative and sequential process served as an effective strategy to increase collaborative health research in the province.

Keywords


  1. Graham ID, Kothari A, McCutcheon C, Alvarez G, Banner D, Botti M, et al. Moving knowledge into action for more effective practice, programmes and policy: Protocol for a research programme on integrated knowledge translation. Implement Sci. 2018 Feb 2;13(1):22.
  2. Kothari A, Wathen CN. A critical second look at integrated knowledge translation. Health Policy Amst Neth. 2013 Feb;109(2):187–91.
  3. Pakenham-Walsh N. Learning from one another to bridge the “know-do gap.” BMJ. 2004 Nov 11;329(7475):1189.
  4. Rycroft-Malone J, Burton CR, Bucknall T, Graham ID, Hutchinson AM, Stacey D. Collaboration and co-production of knowledge in healthcare: Opportunities and challenges. Vol. 5, International Journal of Health Policy and Management. Kerman University of Medical Sciences; 2016. p. 221–3.
  5. Lambert K, Mahoney K, Parfrey PS. Changing Health-Related Behaviors 4: Realizing Impact of Health Research Through Knowledge Translation. Methods Mol Biol Clifton NJ. 2021;2249:597–612.
  6. Lawrence LM, Bishop A, Curran J. Integrated Knowledge Translation with Public Health Policy Makers: A Scoping Review. Healthc Policy Polit Sante. 2019 Feb;14(3):55–77.
  7. Hoekstra F, Mrklas KJ, Khan M, McKay RC, Vis-Dunbar M, Sibley KM, et al. A review of reviews on principles, strategies, outcomes and impacts of research partnerships approaches: A first step in synthesising the research partnership literature. Vol. 18, Health Research Policy and Systems. BioMed Central Ltd.; 2020.
  8. Gagliardi AR, Dobrow MJ. Identifying the conditions needed for integrated knowledge translation (IKT) in health care organizations: qualitative interviews with researchers and research users. BMC Health Serv Res. 2016 Jul 12;16:256.
  9. Gagliardi AR, Berta W, Kothari A, Boyko J, Urquhart R. Integrated knowledge translation (IKT) in health care: A scoping review. Implement Sci. 2016;11(1):1–12.
  10. Straus SE, Tetroe J, Graham ID, editors. Knowledge Translation in Health Care. Knowledge Translation in Health Care. Chichester, UK: John Wiley & Sons, Ltd; 2013.
  11. Jagosh J, MacAulay AC, Pluye P, Salsberg J, Bush PL, Henderson J, et al. Uncovering the benefits of participatory research: Implications of a realist review for health research and practice. Vol. 90, Milbank Quarterly. Milbank Q; 2012. p. 311–46.
  12. Collie A, Zardo P, McKenzie DM, Ellis N. Academic perspectives and experiences of knowledge translation: A qualitative study of public health researchers. Evid Policy. 2016 May 1;12(2):163–82.
  13. Boaz A, Hanney S, Jones T, Soper B. Does the engagement of clinicians and organisations in research improve healthcare performance: A three-stage review. Vol. 5, BMJ Open. BMJ Publishing Group; 2015. p. e009415.
  14. Adily A, Black D, Graham ID, Ward JE. Research engagement and outcomes in public health and health services research in Australia. Aust N Z J Public Health. 2009;33(3):258–61.
  15. Bowen S, Botting I, Graham ID, Huebner LA. Beyond “two cultures”: Guidance for establishing effective researcher/health system partnerships. Int J Health Policy Manag. 2017;6(1):27–42.
  16. McLean RKD, Graham ID, Bosompra K, Choudhry Y, Coen SE, MacLeod M, et al. Understanding the performance and impact of public knowledge translation funding interventions: Protocol for an evaluation of Canadian Institutes of Health Research knowledge translation funding programs. Implement Sci. 2012 Jun 22;7(1):1–16.
  17. Nyström ME, Karltun J, Keller C, Andersson Gäre B. Collaborative and partnership research for improvement of health and social services: Researcher’s experiences from 20 projects. Health Res Policy Syst. 2018 May 30;16(1):46.
  18. Mitton C, Adair CE, McKenzie E, Patten SB, Perry BW. Knowledge transfer and exchange: Review and synthesis of the literature. Milbank Q. 2007 Dec;85(4):729–68.
  19. Wensing M, Grol R. Knowledge translation in health: how implementation science could contribute more. BMC Med. 2019 Dec;17(1):88.
  20. Bornbaum CC, Kornas K, Peirson L, Rosella LC. Exploring the function and effectiveness of knowledge brokers as facilitators of knowledge translation in health-related settings: A systematic review and thematic analysis. Vol. 10, Implementation Science. BioMed Central Ltd.; 2015. p. 162.
  21. Ward V, House A, Hamer S, V Ward SH. Knowledge brokering: The missing link in the evidence to action chain? Evid Policy. 2009;5(3):267–79.
  22. Canadian Institutes of Health Research (CIHR). CIHR Jargon Buster For Research Terms [Internet]. 2020. Available from: https://cihr-irsc.gc.ca/e/documents/cihr_jargon_buster-en.pdf
  23. Bornstein S, Baker R, Navarro P, Mackey S, Speed D, Sullivan M. Putting research in place: An innovative approach to providing contextualized evidence synthesis for decision makers. Syst Rev. 2017 Nov 2;6(1).
  24. Memorial University of Newfoundland. CHRSP Methodology: Rapid Evidence Reports [Internet]. 2022. Available from: https://www.mun.ca/nlcahr/chrsp/chrsp-methodology-rapid-evidence-reports/
  25. Government of Canada. Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans – TCPS 2 (2018) – Chapter 2: Scope and Approach [Internet]. Panel on Research Ethics. 2018. Available from: https://ethics.gc.ca/eng/tcps2-eptc2_2018_chapter2-chapitre2.html
  26. Hsieh HF, Shannon SE. Three Approaches to Qualitative Content Analysis. Qual Health Res. 2005 Nov;15(9):1277–88.
  27. Nova Scotia Health Authority. QEII Foundation Translating Research Into Care (TRIC) Healthcare Improvement Research Program [Internet]. 2022. Available from: http://www.cdha.nshealth.ca/qeii-tric
  28. Zych MM, Berta WB, Gagliardi AR. Initiation is recognized as a fundamental early phase of integrated knowledge translation (IKT): qualitative interviews with researchers and research users in IKT partnerships. BMC Health Serv Res. 2019 Dec;19(1):772.
  29. Tetroe JM, Graham ID, Foy R, Robinson N, Eccles MP, Wensing M, et al. Health research funding agencies’ support and promotion of knowledge translation: an international study. Milbank Q. 2008;86(1):125–55.
  30. Rycroft‐Malone J, Graham ID, Kothari A, McCutcheon C. Building Blocks for Research Coproduction: Reflections and Implications. In: Graham ID, Rycroft‐Malone J, Kothari A, McCutcheon C, editors. Research Co‐Production in Healthcare [Internet]. 1st ed. Wiley; 2022 [cited 2022 Aug 22]. p. 290–302. Available from: https://onlinelibrary.wiley.com/doi/10.1002/9781119757269.ch16
  31. Cardwell FS, Elliott SJ, Clarke AE. The value of hackathons in integrated knowledge translation (iKT) research: Waterlupus. Health Res Policy Syst. 2021 Nov 24;19(1):138.
  32. Black A, Strain K, Wallsworth C, Charlton SG, Chang W, McNamee K, et al. What constitutes meaningful engagement for patients and families as partners on research teams? J Health Serv Res Policy. 2018 Jul;23(3):158–67.
  33. Hearld KR, Hearld LR, Hall AG. Engaging patients as partners in research: Factors associated with awareness, interest, and engagement as research partners. SAGE Open Med. 2017 Dec;5:205031211668670.
  34. Domecq JP, Prutsky G, Elraiyah T, Wang Z, Nabhan M, Shippee N, et al. Patient engagement in research: a systematic review. BMC Health Serv Res. 2014 Dec;14(1):89.
  35. Crockett LK, Shimmin C, Wittmeier KDM, Sibley KM. Engaging patients and the public in Health Research: experiences, perceptions and training needs among Manitoba health researchers. Res Involv Engagem. 2019 Dec;5(1):28.
  36. Wensing M, Grol R. Knowledge translation in health: How implementation science could contribute more. Vol. 17, BMC Medicine. BioMed Central Ltd.; 2019. p. 88.
  37. Hoxie-Setterstrom G, Hoglund B. School wellness policies: Opportunities for change. J Sch Nurs Off Publ Natl Assoc Sch Nurses. 2011;27(5):330–9.
  38. Ward V, House A, Hamer S. Knowledge brokering: The missing link in the evidence to action chain? Evid Policy. 2009;5(3):267–79.
  39. Ward V, Smith S, House A, Hamer S. Exploring knowledge exchange: A useful framework for practice and policy. Soc Sci Med. 2012 Feb;74(3):297–304.
  40. Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations. Milbank Q. 2004;82(4):581–629.
  41. Bullock H, Watson A, Goering P. Building for Success: Mental Health Research With an Integrated Knowledge Translation Approach. Can J Commun Ment Health. 2010 Jan 1;29(S5):9–21.

Articles in Press, Accepted Manuscript
Available Online from 07 January 2023
  • Receive Date: 30 October 2021
  • Revise Date: 29 November 2022
  • Accept Date: 02 January 2023
  • First Publish Date: 07 January 2023