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      Stakeholder Perspectives of Attributes and Features of Context Relevant to Knowledge Translation in Health Settings: A Multi-Country Analysis

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background: Context is recognized as important to successful knowledge translation (KT) in health settings. What is meant by context, however, is poorly understood. The purpose of the current study was to elicit tacit knowledge about what is perceived to constitute context by conducting interviews with a variety of health system stakeholders internationally so as to compile a comprehensive list of contextual attributes and their features relevant to KT in healthcare.

          Methods: A descriptive qualitative study design was used. Semi-structured interviews were conducted with health system stakeholders (change agents/KT specialists and KT researchers) in four countries: Australia, Canada, the United Kingdom, and the United States. Interview transcripts were analyzed using inductive thematic content analysis in four steps: (1) selection of utterances describing context, (2) coding of features of context, (3) categorizing of features into attributes of context, (4) comparison of attributes and features by: country, KT experience, and role.

          Results: A total of 39 interviews were conducted. We identified 66 unique features of context, categorized into 16 attributes. One attribute, Facility Characteristics, was not represented in previously published KT frameworks. We found instances of all 16 attributes in the interviews irrespective of country, level of experience with KT, and primary role (change agent/KT specialist vs. KT researcher), revealing robustness and transferability of the attributes identified. We also identified 30 new context features (across 13 of the 16 attributes).

          Conclusion: The findings from this study represent an important advancement in the KT field; we provide much needed conceptual clarity in context, which is essential to the development of common assessment tools to measure context to determine which context attributes and features are more or less important in different contexts for improving KT success.

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          Three approaches to qualitative content analysis.

          Hsiu-Fang Hsieh, Sarah Shannon (2016)
          Content analysis is a widely used qualitative research technique. Rather than being a single method, current applications of content analysis show three distinct approaches: conventional, directed, or summative. All three approaches are used to interpret meaning from the content of text data and, hence, adhere to the naturalistic paradigm. The major differences among the approaches are coding schemes, origins of codes, and threats to trustworthiness. In conventional content analysis, coding categories are derived directly from the text data. With a directed approach, analysis starts with a theory or relevant research findings as guidance for initial codes. A summative content analysis involves counting and comparisons, usually of keywords or content, followed by the interpretation of the underlying context. The authors delineate analytic procedures specific to each approach and techniques addressing trustworthiness with hypothetical examples drawn from the area of end-of-life care.
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            Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

            Laura Damschroder, David Aron, Rosalind E Keith … (2009)
            Background Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. Methods We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. Results The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were identified related to individual characteristics, and eight constructs were identified related to process (e.g., plan, evaluate, and reflect). We present explicit definitions for each construct. Conclusion The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories. It can be used to guide formative evaluations and build the implementation knowledge base across multiple studies and settings.
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              Whatever happened to qualitative description?

              Margarete Sandelowski (2000)
              The general view of descriptive research as a lower level form of inquiry has influenced some researchers conducting qualitative research to claim methods they are really not using and not to claim the method they are using: namely, qualitative description. Qualitative descriptive studies have as their goal a comprehensive summary of events in the everyday terms of those events. Researchers conducting qualitative descriptive studies stay close to their data and to the surface of words and events. Qualitative descriptive designs typically are an eclectic but reasonable combination of sampling, and data collection, analysis, and re-presentation techniques. Qualitative descriptive study is the method of choice when straight descriptions of phenomena are desired. Copyright 2000 John Wiley & Sons,
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                Author and article information

                Journal
                Journal ID (nlm-ta): Int J Health Policy Manag
                Journal ID (publisher-id): Int J Health Policy Manag
                Journal ID (publisher-id): Kerman University of Medical Sciences
                Title: International Journal of Health Policy and Management
                Publisher: Kerman University of Medical Sciences
                ISSN (Electronic): 2322-5939
                Publication date Collection: August 2022
                Publication date (Electronic): 01 May 2021
                Volume: 11
                Issue: 8
                Pages: 1373-1390
                Affiliations
                1Department of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON, Canada.
                2Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
                3Monash Health, Melbourne, VIC, Australia.
                4School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.
                5Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
                6Faculty of Health, School of Nursing, Dalhousie University, Halifax, NS, Canada.
                7IWK Health Centre, Halifax, NS, Canada.
                8Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
                9Statistics Canada, Ottawa, ON, Canada.
                10School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
                11School of Health Sciences, University of Melbourne, Melbourne, VIC, Australia.
                12Women’s College Hospital, Toronto, ON, Canada.
                13McMaster University, Hamilton, ON, Canada.
                14University College London, London, UK.
                15Ontario Ministry of Health and Long-Term Care, Toronto, ON, Canada.
                16University of Calgary, Calgary, AB, Canada.
                Author notes
                [* ]Correspondence to: Janet E. Squires Email: jasquires@ 123456ohri.ca
                Author information
                https://orcid.org/0000-0003-2208-7189
                https://orcid.org/0000-0001-5065-2726
                https://orcid.org/0000-0001-7917-3657
                https://orcid.org/0000-0002-3669-1216
                Article
                DOI: 10.34172/ijhpm.2021.32
                PMC ID: 9808341
                PubMed ID: 34060269
                SO-VID: 12ad01b5-0f21-4a31-a975-86610bf0f975
                Copyright © © 2022 The Author(s); Published by Kerman University of Medical Sciences
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 22 May 2020
                Date accepted : 13 March 2021
                Page count
                Tables: 5, References: 84, Pages: 18
                Categories
                Subject: Original Article

                Keywords: context,knowledge translation,implementation
                Data availability:
                Keywords: context, knowledge translation, implementation

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