Knowledge Translation in Disability and Rehabilitation Research
The mission of NIDILRR is to generate new knowledge and promote its effective use to maximize the full inclusion and integration into society, employment, independent living, family support, and economic and social self-sufficiency of individuals with disabilities of all ages (NIDILRR, 2020). In 2003, Rappolt and colleagues argued that while rehabilitation therapists are strongly encouraged to apply research in their practices, structured and systematic strategies, and mechanisms to guide them in this process were limited. To advance clinical outcomes, NIDILRR identified KT as a critical component of its mandate (Rogers & Martin, 2009). NIDILRR’s Knowledge Translation Program aims to ensure that research is shared and applied by its KUs. NCDDR’s 2007 report, Knowledge Translation: Introduction to Models, Strategies and Measures (Sudsawad, 2007), provided an overview of KT approaches toward achieving KT within the sector. Now, over a decade later, the current monograph serves as a reflection and historical overview of advancements within the KT field.
During the past decade, a number of tools and efforts have been developed to facilitate the translation of knowledge and the commercialization of knowledge products. A Plain Language Summary Tool (PLST) was developed by the University of Washington’s Center for Technology and Disability Studies and the American Institutes for Research’s (AIR) Center on Knowledge Translation for Disability and Rehabilitation Research (KTDRR) to enhance the comprehension of systematic reviews by distilling findings into everyday language (KTDRR, 2013). In addition, KTDRR developed the Assessing Quality and Applicability of Systematic Reviews (AQASR) checklist to guide clinicians, researchers, and administrators in the assessment of the strengths and weaknesses of systematic reviews (Task Force on Systematic Review and Guidelines, 2013).
Since the 2007 NCDRR report, KT remains an important and relevant area of research in disability and rehabilitation sciences. Moore and colleagues (2017) call for the cultivation of a shared vision for collecting and implementing evidence-based practices in rehabilitation science (see Table 6). Specifically, the researchers describe a need for the development of a learning health care system that integrates clinical operations, research, patient engagement, and robust technology infrastructure to improve the quality of health care and generate new knowledge. The Model Systems Knowledge Translation Center (MSKTC) is another example of a center funded by NIDILRR that provides technical assistance and training around KT for NIDILRR grantees focused in the areas of spinal cord injury, traumatic brain injury, and burn injury research. NIDILRR has also funded other centers to support KT efforts of NIDILRR-funded grantees working in specific content areas such as Technology Transfer, the Center on Knowledge Translation for Employment Research (KTER), and the Americans with Disabilities Act Knowledge Translation Center (ADAKTC) (NIDILRR, 2020).
Further research is necessary to understand end-user perspectives, and needs and contexts within the field of rehabilitation sciences (Rogers & Martin, 2009). Petzold and colleagues (2010) further emphasize that for a KT strategy to be effective, clinicians must tailor them to address the audience-specific facilitators and barriers they face when treating a specific clientele.
Several authors call attention to one of the unique challenges of the rehabilitation field, namely, the diversity of translation needs across the subfields of rehabilitation, including physical therapy, occupational therapy, and speech-language pathology. Each profession appears to require nuanced approaches to KT that are formatted to their clinical workflow, needs, and context (Jones, Roop, Pohar, Albrecht, & Scott, 2015; Menon et al., 2009; Scott et al., 2012). In moving forward, Colquhoun and colleagues (2010) highlight the paucity of theory-driven KT strategies in rehabilitation science and call for greater attention to conceptual development specific to the needs of the field.
Table 6. Selected Examples of Summary Articles About KT in Disability and Rehabilitation Studies
|Study Aim and Key Lessons Learned
|Moore et al. (2017)
|Knowledge Translation in Rehabilitation Science: A Shared Vision
|Summarize KT-related proceedings from the 2016 IV STEP conference, and current KT in rehabilitation science. Propose an altered vision for a Learning Health Care System (LHCS) in clinical rehabilitation practice that includes the ongoing development, adaptation, and implementation of evidence-based practices. The authors emphasize that building a culture that supports learning and implementation of evidence-based practice is the most critical.
|Phillipson, Goodenough, Reis, & Fleming (2016)
|Applying Knowledge Translation Concepts and Strategies in Dementia Care Education for Health Professionals: Recommendations From a Narrative Literature Review
|Argue that dementia education programs are being developed for health professionals, but with limited guidance regarding what works in design and content. Their paper examines the types of KT strategies used for education of health professionals in dementia care, while further exploring enablers and barriers to KT in this context. Findings revealed that multiple rather than single learning exposures seem to support KT, alongside relevant tools (such as checklists, toolkits), and expert support. Suggest the PARiHS framework as useful in providing guidance to planners.
|Jones et al. (2015)
|Translating Knowledge in Rehabilitation: Systematic Review
|Authors undertook a systematic review to assess three key areas: (I) the state of science for KT strategies used in rehabilitation professions (physical therapy, occupational therapy, speech-language pathology); (II) the methodological approaches utilized in studies exploring KT strategies; and (III) report the extent to which KT interventions are described. Conclude with recommending that clinicians: (1) Match the education strategy to the KT goal and learner preferences; (2) use multimodal learning strategies for opportunities for feedback; (3) provide incentives to reach KT goals; (4) distil messages into simple and compelling formats; and (5) plan to change the workplace and not just the individual.
|Scott et al. (2012)
|Systematic Review of Knowledge Translation Strategies in the Allied Health Professions
|Present results of the first documented systematic review of KT strategies in five allied health disciplines (dietetics, occupational therapy, pharmacy, physiotherapy, and speech-language pathology). The review was limited by outcome reporting bias, which limited determination of intervention effectiveness. Findings generally revealed an over-reliance on educational strategies without a clear effect on the intended outcomes.
|Cameron et al. (2011)
|Knowledge Brokering in Children’s Rehabilitation Organizations: Perspectives from Administrators
|Suggest knowledge brokering as an effective way to encourage clinician behavior change to implement new knowledge. Describe the experience of administrators’ perceptions of the successes and challenges in using a knowledge broker (KB) to promote the use of evidence-based measures of motor function for children with cerebral palsy. Overall, findings suggested KBs as an effective medium for stimulating peer-to-peer and interdisciplinary learning. Yet, funding and resource constraints were highlighted as barriers.
|Petzold et al. (2010)
|Using the Knowledge-to-Action Process Model to Incite Clinical Change
|Apply the KTA Process Model to a series of national studies in stroke rehabilitation to demonstrate how the model is being used to increase the use of best practices in the management of prevalent post-stroke impairment. Findings reveal that personal and organizational barriers and facilitators influence successful adoption of evidence-based practice by clinicians. Further, clinicians must tailor KT strategies to address the audience-specific facilitators and barriers they face when treating a specific clientele. Finally, they suggest the KTA model as an effective guide in the complex KT process.
|Rogers & Martin (2009)
|Knowledge Translation in Disability and Rehabilitation Research
|Reflect on the KT landscape within Disability and Rehabilitation Research and situate KT in the broader context of understanding issues with knowledge flow. Further, they introduce Knowledge Value Mapping (KVM) to elucidate key KT networks to be maximized for dissemination. Findings reveal the significance of interests in the evidence translation process, emphasizing the relevance of understanding the KT context.
|Menon et al. (2009)
|Strategies for Rehabilitation Professionals to Move Evidence-Based Knowledge Into Practice: A Systematic Review
|Examined the effectiveness of single or multi-component KT interventions for improving knowledge, attitudes, and practice behaviors of rehabilitation clinicians. Authors identify active and multi-component KT strategies as most effective for behavior change.
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