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Knowledge Translation and Exchange (KTE)

 

Knowledge translation is "a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound application of knowledge."  (Canadian Institutes of Health Research, or CIHR)  The CIHR definition goes on to say: "This process takes place within a complex system of interactions between researchers and knowledge users which may vary in intensity, complexity and level of engagement depending on the nature of the research and the needs of the particular knowledge user."

The exchange of knowledge is "collaborative problem-solving between researchers and decision-makers that happens through linkage and exchange. Effective knowledge exchange involves interaction between decision makers and researchers and results in mutual learning through the process of planning, producing, disseminating and applying existing or new research in decision-making." (Canadian Foundation for Healthcare Improvement)

The processes of linkage, researcher-decision maker interaction, and knowledge exchange can be facilitated in many instances by an intermediary person (or organization) who serves as a knowledge broker.  "knowledge brokering" is defined as:  “all the activity that links decision makers with researchers, facilitating their interaction so that they are able to better understand each other’s goals and professional cultures, influence each other’s work, forge new partnerships, and promote the use of researchbased evidence in decision-making.” (Canadian Health Services Research Foundation)

The WVU ICRC has adopted this approach in several instances as an outgrowth of partnership development.  The following case studies describe our approach to KTE through knowledge brokering:

 

Knowledge Translation: translation of opioid overdose prevention programs with take-home naloxone (OOP/THN) to rural southern WV, and Central Appalachia 

This is a continuing effort initiated in early Summer 2012, when the WVU ICRC outreach director joined a strategic planning working group in Region 5 of the Governor’s substance abuse prevention regions of WV (see ICRC Partnership 2 section of this report). A strategic goal called for 15% reduction of opioid overdose deaths, with a supporting objective: initiate a research collaboration between WVU ICRC and county coalitions in the region to study program feasibility. A researcher-community team developed a successful proposal for WV CTSI funds, and data collection for the feasibility study is currently underway in Boone, Logan, Mingo, Raleigh and Wyoming Counties in WV.

West Virginia experiences the highest rate (28.5 deaths per 100,000 population) of unintentional drug-related poisoning (overdose) deaths among all 50 states and the District of Columbia. By comparison, the U.S. rate is 10.5/100,000. Although this 2012 WV rate represents a 12.8% reduction from 2011 (32.7), the toll remains unacceptable. Heroin overdose prevention programs that have been implemented in urban centers since the 1990s, and that feature 1) training drug users in overdose recognition, overdose response, and naloxone administration, and 2) prescribing naloxone kits (for either intramuscular injection or intranasal spray) to them, are shown to be effective in reversing overdoses. Similar programs in southern WV and other rural areas in central Appalachia (as well as other rural areas across the nation), may save lives. This WVU ICRC outreach activity looks ahead to the impact of reducing prescription opioid and heroin OD deaths in rural WV, Central Appalachia, and U.S.

 

Knowledge Translation: translation of an advanced, validated diagnostic/screening tool for major depression disorder and suicidality 

WVU ICRC outreach is engaged with state partners in an effort to evaluate the implementation and associated costs of an advanced major depression disorder diagnostic screening tool. The Outreach program first recognized the potential of the CAD-MDD/suicide tool at a briefing conducted in July 2013 for the benefit of West Virginia public health officials, legislators, government administrators, advocates, and behavioral health care providers. Although most attendees were convinced of the validity and potential of the tools, concern was expressed about the costs of implementing them in practice. The ICRC Outreach program proposed that a pilot implementation/cost evaluation study be undertaken as an initial step in fostering the adoption of these tools in West Virginia. A research team was formulated with WVU and external partners, and a successful proposal for funding was developed.

Major depressive disorder (MDD) is a known risk factor for suicide. Depression is often undetected and untreated, so tools that enable broader, timelier, and more effective screening will improve detection of suicide risk, and subsequently lead to referral and treatment. In addition to studying and, with positive results, promoting wide adoption of the CAD-MDD/suicide tool in West Virginia, a parallel effort to assess and increase the referral and treatment capacity among WV behavioral health providers is essential. The current study, funded under the Exploratory Research Program of WVU ICRC, focuses upon implementing this tool in hospital emergency departments. Future efforts will include other medical and behavioral health care facilities in WV. WVU ICRC has since discussed the implementation of these tools, and the need to assess WV behavioral health care capacity, with other state partners in anticipation of a broader implementation effort following the pilot.