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      A cross-sectional study of the number and frequency of terms used to refer to knowledge translation in a body of health literature in 2006: a Tower of Babel?

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          Abstract

          Background

          The study of implementing research findings into practice is rapidly growing and has acquired many competing names ( e.g., dissemination, uptake, utilization, translation) and contributing disciplines. The use of multiple terms across disciplines pose barriers to communication and progress for applying research findings. We sought to establish an inventory of terms describing this field and how often authors use them in a collection of health literature published in 2006.

          Methods

          We refer to this field as knowledge translation (KT). Terms describing aspects of KT and their definitions were collected from literature, the internet, reports, textbooks, and contact with experts. We compiled a database of KT and other articles by reading 12 healthcare journals representing multiple disciplines. All articles published in these journals in 2006 were categorized as being KT or not. The KT articles (all KT) were further categorized, if possible, for whether they described KT projects or implementations (KT application articles), or presented the theoretical basis, models, tools, methods, or techniques of KT (KT theory articles). Accuracy was checked using duplicate reading. Custom designed software determined how often KT terms were used in the titles and abstracts of articles categorized as being KT.

          Results

          A total of 2,603 articles were assessed, and 581 were identified as KT articles. Of these, 201 described KT applications, and 153 included KT theory. Of the 100 KT terms collected, 46 were used by the authors in the titles or abstracts of articles categorized as being KT. For all 581 KT articles, eight terms or term variations used by authors were highly discriminating for separating KT and non-KT articles (p < 0.001): implementation, adoption, quality improvement, dissemination, complex intervention (with multiple endings), implementation (within three words of) research, and complex intervention. More KT terms were associated with KT application articles (n = 13) and KT theory articles (n = 18).

          Conclusions

          We collected 100 terms describing KT research. Authors used 46 of them in titles and abstracts of KT articles. Of these, approximately half discriminated between KT and non-KT articles. Thus, the need for consolidation and consistent use of fewer terms related to KT research is evident.

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          Most cited references18

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          Changing provider behavior: an overview of systematic reviews of interventions.

          Increasing recognition of the failure to translate research findings into practice has led to greater awareness of the importance of using active dissemination and implementation strategies. Although there is a growing body of research evidence about the effectiveness of different strategies, this is not easily accessible to policy makers and professionals. To identify, appraise, and synthesize systematic reviews of professional educational or quality assurance interventions to improve quality of care. An overview was made of systematic reviews of professional behavior change interventions published between 1966 and 1998. Forty-one reviews were identified covering a wide range of interventions and behaviors. In general, passive approaches are generally ineffective and unlikely to result in behavior change. Most other interventions are effective under some circumstances; none are effective under all circumstances. Promising approaches include educational outreach (for prescribing) and reminders. Multifaceted interventions targeting different barriers to change are more likely to be effective than single interventions. Although the current evidence base is incomplete, it provides valuable insights into the likely effectiveness of different interventions. Future quality improvement or educational activities should be informed by the findings of systematic reviews of professional behavior change interventions.
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            Optimal search strategies for retrieving scientifically strong studies of treatment from Medline: analytical survey.

            To develop and test optimal Medline search strategies for retrieving sound clinical studies on prevention or treatment of health disorders. Analytical survey. 161 clinical journals indexed in Medline for the year 2000. Sensitivity, specificity, precision, and accuracy of 4862 unique terms in 18 404 combinations. Only 1587 (24.2%) of 6568 articles on treatment met criteria for testing clinical interventions. Combinations of search terms reached peak sensitivities of 99.3% (95% confidence interval 98.7% to 99.8%) at a specificity of 70.4% (69.8% to 70.9%). Compared with best single terms, best multiple terms increased sensitivity for sound studies by 4.1% (absolute increase), but with substantial loss of specificity (absolute difference 23.7%) when sensitivity was maximised. When terms were combined to maximise specificity, 97.4% (97.3% to 97.6%) was achieved, about the same as that achieved by the best single term (97.6%, 97.4% to 97.7%). The strategies newly reported in this paper outperformed other validated search strategies except for two strategies that had slightly higher specificity (98.1% and 97.6% v 97.4%) but lower sensitivity (42.0% and 92.8% v 93.1%). New empirical search strategies have been validated to optimise retrieval from Medline of articles reporting high quality clinical studies on prevention or treatment of health disorders.
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              A guide to knowledge translation theory.

              Despite calls over several decades for theory development, there remains no overarching knowledge-translation theory. However, a range of models and theoretical perspectives focused on narrower and related areas have been available for some time. We provide an overview of selected perspectives that we believe are particularly useful for developing testable and useful knowledge-translation interventions. In addition, we discuss adjuvant theories necessary to complement these perspectives. We draw from organizational innovation, health, and social sciences literature to illustrate the similarities and differences of various theoretical perspectives related to the knowledge-translation field.A variety of theoretical perspectives useful to knowledge translation exist. They are often spread across disciplinary boundaries, making them difficult to locate and use. Poor definitional clarity, discipline-specific terminology, and implicit assumptions often hinder the use of complementary perspectives. Health care environments are complex, and assessing the setting prior to selecting a theory should be the first step in knowledge-translation initiatives. Finding a fit between setting (context) and theory is important for knowledge-translation initiatives to succeed. Because one theory will not fit all contexts, it is helpful to understand and use several different theories. Although there are often barriers associated with combining theories from different disciplines, such obstacles can be overcome, and to do so will increase the likelihood that knowledge-translation initiatives will succeed.
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                Author and article information

                Journal
                Implement Sci
                Implementation Science : IS
                BioMed Central
                1748-5908
                2010
                12 February 2010
                : 5
                : 16
                Affiliations
                [1 ]Health Information Research Unit, Department of Clinical Epidemiology and Biostatistics, McMaster University Faculty of Health Sciences, 1200 Main Street West, Hamilton, ON, Canada
                [2 ]School of Nursing, McMaster University Faculty of Health Sciences, 1200 Main Street West, Hamilton, ON, Canada
                [3 ]National Collaborating Centre for Methods and Tools, McMaster University, 1685 Main Street West, Hamilton, ON, Canada
                [4 ]American Association of Medical Colleges, 2501 M Street Northwest, Washington DC, USA
                [5 ]Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, Canada
                [6 ]Family and Community Medicine, and Health Policy, Management and Evaluation, St Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, Canada
                Article
                1748-5908-5-16
                10.1186/1748-5908-5-16
                2834600
                21080976
                830be2c6-8fc2-4af8-a1ac-bfa0a4c0a637
                Copyright ©2010 McKibbon et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 April 2009
                : 12 February 2010
                Categories
                Research Article

                Medicine
                Medicine

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