A major aim of evidence-based medicine is to protect patients from ineffective or harmful treatments while ensuring that appropriate treatments are offered. In an ideal world, once a treatment is rigorously evaluated, results are incorporated into clinical guidelines which, in turn, inform health care delivery policies. However, the process that leads to effective sustainable solutions to health problems is in fact nonlinear, and different forms of evidence are needed at different stages by different parties. Knowledge translation is a complex and multidimensional concept that demands a comprehensive understanding of its mechanisms, methods, and measurements, as well as of its influencing factors at the individual and contextual levels—and the interaction between both those levels.
This chapter begins by presenting the definitions of knowledge translation and discussing the underlying basis for translational research under three often-cited phases. We outline the differences between these phases and illustrate that each step can generate new research questions which must be answered through a research continuum that requires different methods and constant two-way engagement with the global research community. Then the knowledge translation strategies and their applications are explored, drawn from specific examples from the field of cardiovascular disease. Finally, several methods and approaches to training in knowledge translation, types of studies, and funding issues will be presented.
Many terms have been used to describe the process of putting knowledge into action, from the term “implementation science” used in the United Kingdom and Europe to the terms “knowledge transfer and uptake” used in the United States. In Canada, however, the terms “knowledge transfer and exchange” and “knowledge translation” are commonly used. The common element among these different terms is a move beyond the simple dissemination of knowledge into actual use of knowledge. Knowledge translation is the process which leads from evidence based medicine to sustainable solutions for health problems.
- Essentially, knowledge translation is an interactive process underpinned by effective exchanges between researchers who create new knowledge and those who use it. As stated by the Canadian Institutes of Health Research, bringing users and creators of knowledge together during all stages of the research cycle is fundamental to successful knowledge transfer.
Knowledge translation is defined by the Canadian Institutes of Health Research as a dynamic and iterative process that includes the synthesis, dissemination, exchange and ethically sound application of knowledge to improve health, provide more effective health services and products, and strengthen the health care system. This definition has been adapted by others, including the United States National Center for Dissemination of Disability Research and the World Health Organization.
Most recently, the National Center for the Dissemination of Disability Research proposed another working definition of knowledge translation as “the collaborative and systematic review, assessment, identification, aggregation, and practical application of high-quality disability and rehabilitation research by key stakeholders (ie, consumers, researchers, practitioners, and policymakers) for the purpose ...