Using knowledge brokers to facilitate the uptake of pediatric measurement tools into clinical practice: a before-after intervention study

Abstract

BackgroundThe use of measurement tools is an essential part of good evidence-based practice; however, physiotherapists (PTs) are not always confident when selecting, administering, and interpreting these tools. The purpose of this study was to evaluate the impact of a multifaceted knowledge translation intervention, using PTs as knowledge brokers (KBs) to facilitate the use in clinical practice of four evidence-based measurement tools designed to evaluate and understand motor function in children with cerebral palsy (CP). The KB model evaluated in this study was designed to overcome many of the barriers to research transfer identified in the literature.MethodsA mixed methods before-after study design was used to evaluate the impact of a six-month KB intervention by 25 KBs on 122 practicing PTs' self-reported knowledge and use of the measurement tools in 28 children's rehabilitation organizations in two regions of Canada. The model was that of PT KBs situated in clinical sites supported by a network of KBs and the research team through a broker to the KBs. Modest financial remuneration to the organizations for the KB time (two hours/week for six months), ongoing resource materials, and personal and intranet support was provided to the KBs. Survey data were collected by questionnaire prior to, immediately following the intervention (six months), and at 12 and 18 months. A mixed effects multinomial logistic regression was used to examine the impact of the intervention over time and by region. The impact of organizational factors was also explored.ResultsPTs' self-reported knowledge of all four measurement tools increased significantly over the six-month intervention, and reported use of three of the four measurement tools also increased. Changes were sustained 12 months later. Organizational culture for research and supervisor expectations were significantly associated with uptake of only one of the four measurement tools.ConclusionsKBs positively influenced PTs' self-reported knowledge and self-reported use of the targeted measurement tools. Further research is warranted to investigate whether this is a feasible, cost-effective model that could be used more broadly in a rehabilitation setting to facilitate the uptake of other measurement tools or evidence-based intervention approaches.

A systematic review of interventions to increase the use of standardized outcome measures by rehabilitation professionals

“…While nine studies reported various provider characteristics such as age, gender, years of experience, work location, and caseload levels, one study reported only the professional discipline of the providers (33), and one study reported only 'mental health providers' without specifying any further provider characteristics (25). Four of the studies included some characteristics of the patients in whom the outcome measure was being applied to (25,28,32,34). Most often, these characteristics included age and diagnosis.…”

“…There was one randomized controlled trial (31), two controlled before and after studies (29,35) , seven before and after studies (1,25,27,28,30,33,34), and one retrospective cohort study (32). Nine of the eleven studies had an overall quality rating of weak.…”

“…Two of the studies were in an outpatient pediatric setting (28,34). Seven of the studies targeted physiotherapists only (1,28,29,31,(33)(34)(35) , one study occurred with community mental health professions (unspecified but occupational therapy assumed) (25), one study each targeted occupational therapists only (30) and prosthetists only (27), and one study involved physiotherapists, occupational therapists and speech-language pathologists (32). While nine studies reported various provider characteristics such as age, gender, years of experience, work location, and caseload levels, one study reported only the professional discipline of the providers (33), and one study reported only 'mental health providers' without specifying any further provider characteristics (25).…”

What Do We Know about Knowledge Brokers in Paediatric Rehabilitation? A Systematic Search and Narrative Summary

“…Review of abstracts and/ or titles disqualified a further 1,496 papers that were deemed not potentially relevant to the review objective. We then obtained the remaining 17 papers for detailed review, which resulted in a total of four studies [37][38][39][40] meeting the eligibility criteria (see Figure 1). Two of these studies used mixed methods, one used qualitative methodology, and one used case presentation.…”

Institutionalising knowledge brokering as a sustainable knowledge translation solution in healthcare: how can it work in practice?

“…Recent quantitative research in healthcare has shown mixed results for short-term, knowledge management-based intermediary interventions (Dobbins et al, 2009;Russell, 2010). It seems unlikely that a consistent evidence base on the effectiveness of intermediary interventions will emerge, given the breadth of the concept, its context-dependent and contingent nature, and the complexity of the social processes involved-all of which will confound experimental research approaches.…”