Select, Tailor, Implement Interventions

Knowledge translation interventions need to be tailored to specific barriers for change, similar to a clinical treatment tailored to a diagnosed health problem.

Examples of Knowledge Translation Intervention

• Education Intervention
  • Passive educational interventions
    • Written guidelines, workshops, lectures and conferences
  • Active educational interventions
    • Opinion leadership, educational outreach visits, development of 'quality circles,' active self-study material or website
• Professional intervention that brings information close to the point of decision making
  • Reminders and decision support (informatics), audit-and-feedback, and knowledge brokering (facilitate linkage between researchers and decision makers).
• Patient-directed interventions
  • Health literacy intervention
  • Clinical decision-making intervention that focuses on improving patients' clinical communication skills and the development of patient decision aids
  • Self-care intervention that focuses on patient self-management education and improved access to patients' own information
• Organizational interventions (a top-down approach to revise the professional role and develop a special-purpose multidisciplinary team with the goal of implementing following):
  • Quality management such as encouraging feedback from patients and rank-and-file staff upwards
  • Change of management such as developing cultural change program and empowerment program
  • Organizational evidence-based practice guideline
  • Organizational knowledge creation and synthesis

Examples of linking KT intervention with barrier to knowledge use

• Knowledge
  • Barrier: Learning style, learning conceptions, innovation adoption behavior, use of communication channels
    Intervention: Use various information delivery methods or adapt information to individual needs
  • Barrier: Domain knowledge, professional knowledge, complexity of the innovation, intelligence, cognitive competences
    Intervention: Change the mix of professional skills in the organization
• Attitude/Motivation
  • Barrier: Intention goal setting, stages of change, persuasion
    Intervention: Provide information, social influence, action planning according to needs
  • Barrier: Outcome expectancies, attributions of behavior, impact, centrality, duration of the innovation
    Intervention: Provide education and feedback, adapt the innovation to improve consequences
  • Barrier: Attitudes, utilities, advantage, costs, risks of the innovation
    Intervention: Provide education on consequences
  • Barrier: Perceptions of other behavioral, social, professional roles, compatibility, visibility of the innovation, social comparison
    Intervention: Organize social influence
  • Barrier: Perceived behavioral control, self-confidence
    Intervention: Provide skills training
  • Barrier: Satisfaction with performance, attractiveness of the innovation
    Intervention: Provide feedback; provide education and counseling to change individual standards
• Behavior
  • Barrier: Coping behaviors, observational learning, central/peripheral route
    Intervention: Provide feedback and reminders to enable self-regulation; provide education and counseling to change individual standards.
  • Barrier: Competence, behavioral capability, flexibility, divisibility, triability of the innovation
    Intervention: Provide education to improve competency; use decision support systems.
• Interaction in professional teams
  • Barrier: Objectives, group vision, task orientation, group norms
    Intervention: Change team members or decision processes
  • Barrier: Group composition, participation safety
    Intervention: Provide training to change group processes
• Structure of professional networks
  • Barrier: Change agents, opinion leaders, source of the message
    Intervention: Identify and involve formal and informal leaders
  • Barrier: Range, density, multiplexity, weak ties, etc
    Intervention: Involve change agents to transfer information; develop networks to create more "weak" linkages
• Organizational structures
  • Barrier: Clinical protocols, benchmarking, systems perspective
    Intervention: Implement integrated care systems, e.g., chronic care model
  • Barrier: Flexible delivery system, minimum specification, formalization, fragmentation, operational variety
    Intervention: Redesign specific services in the organization
  • Barrier: Constancy of purpose, management in different stages, centralization, management attitudes/tenure, administrative intensity
    Intervention: Recruit and train specific types of leaders
  • Barrier: Differentiation, professionalism
    Intervention: Change the mix of professional skills in the organization
• Organizational processes
  • Barrier: Training of professionals, talent-developing programs, process mindedness, continuous education, concern for measurement, experimental mindset
    Intervention: Create teams for improvement
  • Barrier: Patient mindedness, reactiveness, scanning imperative, complexity, external influence, suppliers as partners
    Intervention: Undertake patient satisfaction activities
  • Barrier: Climate of openness, generative relationships, involvement of nonmedical professionals, employee mindedness, cooperation focus, multiple advocates, ownership, cultural diversity, involvement of target group
    Intervention: Undertake care provider satisfaction activities; use appropriate information and communication technology for the transfer of information
• Organizational resources
  • Barrier: Competence base, organizational intelligence, creativity, knowledge information systems
    Intervention: Change the mix of professional skills in the organization
  • Barrier: Size of teams
    Intervention: Merge/split organizations or departments
• Societal factors
  • Barrier: Education and legal protection related to body of knowledge
    Intervention: Revise professional roles
  • Barrier: Public relations, political action
    Intervention: Undertake activities to influence policymakers
• Financial incentives
  • Barrier: Rewards, simple attractors, resources, structures for rewards, slack resources, support for innovation, provider utility function
    Intervention: Change the provider reimbursement and patient copayment
  • Barrier: Budgets, capitation, etc., supplier induced demand
    Intervention: Change the provider reimbursement and patient copayment
  • Barrier: Cost improvement, switching costs related to innovation
    Intervention: Change the financial system for health care
  • Barrier: Maturity of the market
    Intervention: Introduce market characteristics such as financial risk and improved information for users