Knowledge Translation Tools are Emerging to Move Neck Pain Research into Practice

Abstract

Development or synthesis of the best clinical research is in itself insufficient to change practice. Knowledge translation (KT) is an emerging field focused on moving knowledge into practice, which is a non-linear, dynamic process that involves knowledge synthesis, transfer, adoption, implementation, and sustained use. Successful implementation requires using KT strategies based on theory, evidence, and best practice, including tools and processes that engage knowledge developers and knowledge users. Tools can provide instrumental help in implementing evidence. A variety of theoretical frameworks underlie KT and provide guidance on how tools should be developed or implemented. A taxonomy that outlines different purposes for engaging in KT and target audiences can also be useful in developing or implementing tools. Theoretical frameworks that underlie KT typically take different perspectives on KT with differential focus on the characteristics of the knowledge, knowledge users, context/environment, or the cognitive and social processes that are involved in change. Knowledge users include consumers, clinicians, and policymakers. A variety of KT tools have supporting evidence, including: clinical practice guidelines, patient decision aids, and evidence summaries or toolkits. Exemplars are provided of two KT tools to implement best practice in management of neck pain—a clinician implementation guide (toolkit) and a patient decision aid. KT frameworks, taxonomies, clinical expertise, and evidence must be integrated to develop clinical tools that implement best evidence in the management of neck pain.

Fast tracking the design of theory-based KT interventions through a consensus process

“…BCTs identified to facilitate the target behaviour consisted of resources to facilitate the use of multimodal care , including the following: 1) chart note templates with integrated multimodal treatment decision boxes to replace existing data collection forms in the office [ 52 ]; 2) sheets/handouts to facilitate the prescribing of exercises and other activities during routine appointments; 3) pocket cards as easy reference sources to reinforce important day-to-day clinical decision criteria [ 53 ]; and 4) an existing smartphone application for patients (Stanford Patient Education Research Center: http://patienteducation.stanford.edu/ ) to encourage them to increase their level of physical activity. We plan to provide public access to these tools on a new website of the CCGI ( http://www.chiroguidelines.org ), which already contains treatment information targeting practitioners, patients and decision-makers in the profession.…”

Promoting consistent use of the communication function classification system (CFCS)

“…Characteristics of individuals at five levels of innovation [22] Relevance to the development of the knowledge translation intervention [15,22] Innovators: First adopters of new tools.…”

“…The goal of the KT intervention was to establish fidelity of the CFCS tool, so that it was used in a comparable manner by a group of SLPs [21,22]. A web-based intervention outlining how and with whom the CFCS should be used was developed and disseminated to the 67 SLPs working in three PSLP locations in Southwestern Ontario via e-mail [22,23].…”

“…A web-based intervention outlining how and with whom the CFCS should be used was developed and disseminated to the 67 SLPs working in three PSLP locations in Southwestern Ontario via e-mail [22,23]. The intervention was a PowerPoint slideshow hosted on the website (www.canchild.ca) of CanChild Centre for Childhood Disability Research, a well-known and reputable leader of research in the field of children's rehabilitation.…”

The Treatment of Neck Pain–Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline

“…[117][118][119][120] When prescribed, the amount of supervision and types of exercises do not follow practice guidelines and are not linked to the degree of patient impairment. 118,121 On the patient side, adherence to prescribed exercise programs is often low. 122 The promotion of physical activity, including exercise, is a first-line treatment considered important in the prevention and treatment of musculoskeletal pain and its related comorbidities (eg, coronary heart disease, type 2 diabetes, and depression).…”