Knowledge Brokers and Evidence Informed Decision Making: Reflections on a creative KT role

1
Knowledge Brokers and Evidence Informed Decision
MakingReflections on a creative KT role
Paula Robeson RN, MScN Maureen Dobbins, RN,
PhD Kara DeCorby, MSc Donna Ciliska RN, PhD
2
Research objectives

• To evaluate the impact of a knowledge broker as
  part of a larger knowledge transfer (KT) strategy
  
• To promote evidence-informed public health
  decision making

3
Study design

• RCT with parallel qualitative data collection and
  analysis
• Canadian health regions (n108)
• Knowledge broker services as intervention

4
Scope of brokering activities

• Providing support
• Mentoring
• Facilitating
• Knowledge skill development
• KT activities within organizations
• Resource development
• Disseminating

5
KB intervention group

• 30 Canadian public health decision makers
• Representation from across Canada
• Stratified using Statistics Canada Peer Groups

6
KB intervention

• Initial and ongoing needs assessment
• Minimum monthly contact (tailored)
• Telephone
• Email
• Initiated by client /or KB
• Regional workshop offered
• Tailored site visit offered

7
Data sources

• Knowledge brokers journal
• Health region documents

8
Data collection and analysis

• Document collection
• Journal entries
• Analysis using Nvivo 2.0

9
Data analysis

• 2 researchers coded together
• Basic coding guide to organize data
• Reached agreement on coding
• Written summaries coded on as memos

10
Insights Perceived usefulness of KB role

• ? perception of utility
• ? value of knowledge skill development
• Clarified individual roles in evidence-informed
  decision making (EIDM)
• ? value placed on assistance to overcome existing
  barriers EIDM

11
Insights Successes

• Early personal contact
• Initial ongoing needs assessments
• Knowledge skill development needs,
  opportunities, barriers
• Common issues needs
• Tailored intervention
• Assessment results
• Type of organization
• Level of decision making

12
Insights Successes

• Personalized service
• KB efforts associated with ve progress
• ? Knowledge skill development
• ? Advocacy efforts re organizational change
• Development of supportive networks
• ? Access to useful practical quality resources
• ? Use of systematic reviews

13
Insights Challenges

• Highly varied participant characteristics
• Changes in systems, organizations, roles
• Management
• Time
• Workload
• Competing priorities
• Resources

14
Insights Challenges

• Tendency towards a recipe card approach
• Lack of evidence re broader scope of health
  issues
• Integrated prevention/health promotion
• Perception that unique regional issues restrict
  the ability to draw from knowledge in other
  contexts
• Lack of communication with other decision makers
  or regions

15
Insights The KB Role

• Knowledge and skill development
• EIDM
• Acquire
• Appraise
• Adapt
• Apply
• Knowledge transfer within organizations
• Assistance in promoting a supportive
  organizational culture

16
Insights The KB Role

• Network development, maintenance, facilitation
• Relationship development maintenance
• Clients
• Researchers
• Others

17
Lingering questions Informing future research

• KB involvement
• Dose effect
• Frequency
• Duration
• Internal vs. External
• Time in the planning cycle
• Focus of KB activities
• Individual vs organization
• Decision-making level
• Participant engagement strategies

18
Lingering questions Informing future research

• Staging timing of KB involvement
• Establish EIDM values
• Capitalize on interest in EIDM
• Balance doing for vs. facilitating to do for
  themselves
• KB knowledge, skills, other characteristics
• Maintaining continuity in times of restructuring
  change

19
Conclusion

• KBs represent an emerging approach to the
  promotion of evidence-informed public health
  practice
• Numerous benefits and challenges are met in
  working with a widely-dispersed, national study
  sample
• Needs assessments allowed KBs to customize
  approaches to decision makers activities within
  their respective health regions

20
Implications for policy and practice

• Need for knowledge brokering activity to support
  health regions in EIDM
• Need for focus on multiple levels of
  organizations

21
Acknowledgements

• The research project gratefully acknowledges the
  support of
• Canadian Institutes of Health Research
• The City of Hamilton Public Health Research,
  Education and Development (PHRED) Program