Sharing Evidence-Informed Messages
Researchers can get caught in a one-size-fits-all process of dissemination, "failing to tailor the content, timing, setting, and format of dissemination to the audience."9 But dissemination goes well beyond simply making research available through the traditional vehicles of journal publication and academic conference presentations. It involves a process of extracting the main messages or key implications derived from research results and communicating them to targeted groups of decision makers and other stakeholders in a way that encourages them to factor research implications into their work. In fact, for knowledge translation to be effective, a number of components are necessary. Among these is the need for face-to-face contact between those who generate research knowledge and those who can use it; and the need for researchers to learn to communicate in a more user-friendly way.78 This section provides an overview of the elements of a successful dissemination strategy. In addition, this section provides insights into using opinion leaders to disseminate and implement "best evidence" as well as measuring the impact of one's dissemination strategy.
Proposed objective
Students should prepare a dissemination plan for relaying their evidence-informed messages to their target audience(s). This plan should provide suggestions for evaluation.
Preparing a dissemination strategy
Today there is clear guidance about how to develop and implement a successful dissemination strategy. Most recently, comprehensive workbooks that guide knowledge transfer planning have surfaced to facilitate the planning process.79,22 The most recent of these, From Research to Practice: A Knowledge Transfer Planning Guide, is organized around five basic principles, or questions, developed to put the theory of knowledge transfer into practice.22 To put the five principles into action, the authors recommend asking:
- What is the message?
- Who is the audience?
- Who is the messenger?
- What is the transfer method? and
- What is the expected outcome?
Mythbusters and Evidence Boost were developed with the wants and needs of policy makers and managers in mind. Written in accessible language and using effective storytelling techniques, these two-page research summaries deliver actionable key messages from the best available research evidence in a way that is appropriate for these audiences. Inherently, these summaries were designed with the five above questions in mind. However, a promising dissemination strategy requires additional thought and consideration. From CHSRF's perspective, a successful dissemination strategy will ultimately aim to:
- extract clear, simple and active main messages or key implications from research results;
- identify credible "carriers" of the message;
- pinpoint key decision-maker audiences for the messages; and
- develop ways to deliver the messages that are appropriate to the audiences being targeted and that encourage them to factor the research implications into their work.
From Research to Practice: A Knowledge Transfer Planning Guide will guide those interested in developing a strategy that meets these aims.22
Relying on opinion leaders to disseminate best evidence
One method that holds promise as a strategy to bridge evidence-practice gaps is using opinion leaders or champions to disseminate and implement best evidence. Opinion leaders are not new. In fact, they were commonly referred to as "educational influentials" in the early research literature.80,81 A recently updated Cochrane review that aimed to assess the effectiveness of the use of local opinion leaders in improving the behaviour of healthcare professionals and patient outcomes found that opinion leaders can successfully promote evidence-based practice.82
The promising findings of educational influentials and opinion leaders in influencing health professionals' clinical practice inspired CHSRF to experiment with relying on champions for disseminating research summaries to decision makers and others. CHSRF continues to rely on champions — including individuals or organizations — to disseminate Mythbusters and Evidence Boost. For example, to disseminate the Mythbuster, "Myth: The risks of immunizing children often outweigh the benefits," CHSRF worked with the Canadian Coalition for Immunization Awareness &Promotion, which is housed within the Canadian Public Health Association. Already well-connected in the public health arena, this coalition and its counterparts were credible messengers for disseminating CHSRF's summary. In addition to circulating the summary electronically and in print to their community of public health professionals, the coalition identified an opportunity for including the summary as an insert in delegates' packages at the 7th Canadian Immunization Conference. The timing of this conference could not have been better, as it was scheduled at the same time the Mythbuster was due to be released.
The process of identifying opinion leaders is often an organic process that may begin when one is getting to know the audience (see step three of this resource). Sometimes, individuals' and organizations' names continue to pop up during a literature search, too (see step two). Paying attention to these names and conducting further research is helpful in determining if these persons and organizations may be appropriate and willing sources for disseminating a research summary. Determining the strategy for dissemination is also an organic process. As in the case with the Mythbuster on immunization, the opportunities for dissemination came about through ongoing discussions between CHSRF and the coalition.
Measuring impact
Until recently, evaluation of knowledge transfer strategies has been a particularly under-explored area. Lavis et al.83 suggest some possible reasons for this are a lack of infrastructure for evaluation; a lack of knowledge of how to undertake such an evaluation; the difficulties associated with undertaking an evaluation; and concern about how the findings of an evaluation will be acted on.
Today, Reardon et al.22 recommend that anyone planning a knowledge transfer plan ought to consider what impact the knowledge transfer project will have. Considering this question helps determine not only the scope of a given plan but also the best approach to use. Impacts may be considered in three ways:
- indirect use — changes in attitudes or awareness;
- direct use — changes in policies, procedures or programs; and
- tactical use — using research to validate decisions already made.22
For a more formal evaluation, performance measures for knowledge transfer should be appropriate to the target audience and objectives.83