The Knowledge Translation Toolkit: Bridging the Know-Do Gap: A Resource for Researchers

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Edited by: Gavin Bennett & Nasreen Jessani

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  • Front Matter
  • Back Matter
  • Subject Index
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    List of Tables

    • 3.1 Excerpts from the Bruner Foundation Evaluative Thinking Self-assessment Tool 39
    • 4.1 Stakeholder Table 56
    • 5.1 REACH-Policy: Knowledge, Dialogue, Capacity 92
    • 6.1 Example of a Communication Strategy 123
    • 8.1 Budget for 18 Radio Spots 161
    • 15.1 Logframe Outline 236
    • 15.2 Example of a Modular Matrix (Outputs x Impacts) 238

    List of Figures

    • 1.1 Models of Knowledge Translation 5
    • 2.1 The KM Strategy: Legs, Flows, Processes 11
    • 2.2 Steps in Starting Up a Community of Practice 18
    • 3.1 The Feedback Loop 25
    • 3.2 Evaluative Thinking Processes 26
    • 3.3 The Formal AAR Process 31
    • 4.1 Prioritizing Audiences 51
    • 4.2 Force Field Analysis 59
    • 4.3 Policy Network Map: HIV/AIDS in Country X 61
    • 4.4 Influence Mapping 62
    • 4.5 The Policy-making Process 63
    • 5.1 The Policy Pie 77
    • 6.1 The Communications Feedback Loop 122
    • 7.1 Inverted Pyramid Writing 136
    • 7.2 Sample Brochure/Leaflet Layout 147
    • 8.1 The Three-message Speech 169
    • 8.2 Capture Attention; Deliver Instant Impact 173
    • 12.1 Pillow Talk 206
    • 12.2 Good Slide and Bad Slide 209
    • 12.3 Preparation 209
    • 12.4 Poster Examples 211
    • 14.1 The Completed Newsletter 223
    • 15.1 Three Stages of Outcome Mapping 240

    List of Boxes

    • 2.1 Organic Knowledge Management 9
    • 2.2 Knowledge 10
    • 2.3 Why Conduct a Knowledge Audit? 12
    • 2.4 A Selection of KM Tools and Techniques 14
    • 2.5 When is Peer Assist Useful? 19
    • 2.6 Steps in Conducting a Peer Assist 19
    • 3.1 Evaluative Thinking in Kenya and Malawi 42
    • 4.1 Building Research Policy Links During an Economic Transition: The Vietnam Economic Research Network 51
    • 4.2 Mercury in the Amazon—The Power of Opinion Leaders 54
    • 4.3 From Slum Dwellers to Urban Planners—The Power of Social Participation in Jakarta 57
    • 4.4 Working to Improve Nutrition through Participatory Cropping Systems in Malawi 65
    • 4.5 Mapping the Policy Context in Zambia 66
    • 5.1 Facilitators and Barriers to Research Utilization 71
    • 5.2 When it Comes to Research Evidence: What do Decision-makers Look For? 75
    • 5.3 Deliberative Dialogues 75
    • 5.4 Viewing Evidence in Context 77
    • 5.5 Public Sector Anti-retroviral Treatment in the Free State, South Africa 80
    • 5.6 Urban Ecosystems and Human Health in South Africa 82
    • 5.7 Tobacco Control and Taxes: Win-win in Jamaica 83
    • 5.8 What Distinguishes Brokering? 85
    • 5.9 Attempts to Create KTPs 86
    • 5.10 Addressing Maternal and Neonatal Mortality in Benin 90
    • 5.11 How REACH used “Safe Harbour” Meetings 91
    • 5.12 The Zambia Forum for Health Research (ZAMFOHR): Resource Centre Plans 93
    • 6.1 Communication—Not a “Soft” Element 105
    • 6.2 Survey Questions to Assess External Perceptions 106
    • 6.3 Communication Objectives in Action: The International Monetary Fund 108
    • 6.4 TEHIP: Affecting Policy and Practice Simultaneously 109
    • 6.5 Top Tips for Developing Messages 113
    • 6.6 The Graded-entry (Staged) Format 114
    • 6.7 EVIPNet—Triggering National Policy Dialogues 115
    • 6.8 Connecting the Dots: Public Health and Privatization of Public Services in South Africa 116
    • 6.9 Fighting Second-hand Smoke in Guatemala 118
    • 6.10 Message Checklist 120
    • 7.1 Sections of a Scientific Paper 134
    • 7.2 Truth and Reconciliation Commissions: A Global Reality Check 135
    • 7.3 Who's Who in a Newspaper Office 136
    • 7.4 Format of an Embargoed Press Release 140
    • 7.5 Roles the Media can Play in the Research Process 141
    • 7.6 Supporting a Policy Brief 142
    • 7.7 Policy Brief on Support for Scaling up Artemisinin Combination Therapies (ACTs) in Treatment of Simple P. Falciparum Malaria in Burkina Faso 143
    • 7.8 Promoting Women's Rights within Decentralized Systems 147
    • 7.9 The Power of a Pamphlet: Health Warnings about the Narghile (Waterpipe) 148
    • 7.10 Reducing Petty Corruption in Senegal's Health System 150
    • 8.1 From Tobacco to Bamboo 153
    • 8.2 Cochabamba, Bolivia—Urban Solid Waste: Using TV to Engage the Public 157
    • 8.3 The EQUINet Story—Radio as Part of a Multi-pronged Approach 159
    • 8.4 Internet Behaviour is Fundamentally “Social” 164
    • 8.5 Why Create a Blog? 166
    • 8.6 Five Common Web Mistakes 166
    • 8.7 The “Nodding-off” Indicator 170
    • 8.8 Emotional versus Intellectual Content 170
    • 8.9 From Waste Sorters to Policy Stokers… the Case of the Mbeubeuss Landfill 171
    • 8.10Conference Report: Implementing the Comprehensive Care and Treatment Programme for HIV and AIDS Patients in the Free State: Sharing Experiences 174
    • 9.1 Managing Storytelling 180
    • 9.2 Stories and Tacit Knowledge 181
    • 9.3 Using Theatre to Influence Policy, Politics, Practice, and People 182
    • 11.1 Types of Two-pagers 190
    • 11.2 The Completed Policy Brief 196
    • 12.1 Avoiding Distractions 207
    • 13.1 Who Needs to Receive Your Message? 215
    • 13.2 Failing at Email 216
    • 13.3 Alternative Browsers 217
    • 13.4 Some Basic Definitions 217
    • 13.5 Tabbed Browsing 218
    • 15.1 Five Key Evaluation Questions 227
    • 15.2 Words versus Numbers 229
    • 15.3 Five Evaluation Criteria 231
    • 15.4 Characteristics of Participatory Evaluations 233
    • 15.5 Differences between LFA and OM 242
    • 15.6 Blending Maps and Logs 243

    List of Abbreviations

    AARAfter Action Reviews
    ACTsArtemisinin-based Combination Therapies
    AIAppreciative Inquiry
    AIDSAcquired Immune Deficiency Syndrome
    ARVAntiretroviral Drug
    CD-ROMCompact Disc, Read-Only-Memory
    CHSRFCanadian Health Services Research Foundation
    CMOChief Medical Officer
    CoPCommunity of Practice
    DFIDDepartment for International Development
    DVDDigital Video Disc
    ETEvaluative Thinking
    EVIPNetEvidence Informed Policy Network
    FCTCFramework Convention on Tobacco Control
    FOAFFriend-of-a-Friend
    HEHorizontal Evaluation
    HIVHuman Immunodeficiency Virus
    HRCSHealth Research Capacity Strengthening
    IDRCInternational Research Development Center
    IGMInform, Guide, and Motivate
    IMFInternational Monetary Fund
    ITNsInsecticide-treated Nets
    JAMAJournal of the American Medical Association
    KMKnowledge Management
    KTKnowledge Translation
    KTPKnowledge Translation Platform
    LFALogical Framework Approach
    LMICLow and Middle Income Countries
    M&EMonitoring and Evaluation
    MBMegabyte
    MCMale Circumcision
    MICMinistry of Information and Communications
    MSCMost Significant Change
    NGONon-governmental Organization
    NOELsNod-off Episodes per Lecture
    NPDNational Policy Dialogue
    NPI-AfricaNairobi Peace Initiative-Africa
    NRTNutritional Research Team
    ODIOverseas Development Institute
    OECDOrganization for Economic Cooperation and Development
    OMOutcome Mapping
    PSPermanent Secretary
    PVParticipatory Video
    REACHRegional East African Community Health
    RMResearch Matters
    SADCSmiss Agency for Development and Cooperation
    SMARTSpecific, Measurable, Achievable, Realistic, Time-bound
    TEHIPTanzania Essential Health Interventions Project
    THRIThailand Health Research Institute
    UNUnited Nations
    UNAIDSThe Joint United Nations Programme on HIV/AIDS
    UNICEFUnited Nations International Children's Emergency Fund
    UQAMUniversité du Québec à Montréal
    VASSVietnam Academy of Social Sciences
    VERNVietnam Economic Research Network
    WHOWorld Health Organization
    WWFWorld Wildlife Fund
    ZAMFOHRZambia Forum for Health Research
    ZHRCZonal Health Resource Centers

    Foreword

    Despite significant increases in investment and some notable successes, infectious diseases continue to exert a heavy toll on many countries, particularly in sub-Saharan Africa. Also, the burden of chronic and non-communicable diseases is rising, including the poorest countries of Africa, Asia, Latin America, and the Caribbean. Climate change and emerging infectious diseases are increasingly recognized as a global threat. Many countries are far from being on track to achieve the Millennium Development Goals. Simultaneously, the world is facing its most serious financial crisis in many decades.

    When resources are scarce, it is particularly important to use them wisely: the health problems causing suffering and millions of premature deaths every year cannot afford wasted time or money. Policies and interventions must reflect the best possible current knowledge. New research—in both implementation and basic social and natural science—is needed. In addition, there is a huge “know-do gap” that needs closing, by applying to policy and practice what is already known. Both researchers and decision-makers can do better in helping to make sure this happens. The Research Matters Knowledge Translation Toolkit is a practical contribution to this effort.

    Over several years, the Governance, Equity, and Health (GEH) program at Canada's International Development Research Centre (IDRC) and the Swiss Agency for Development and Cooperation (SDC) have been working together to link research and evidence more closely with policy and practice in health development. GEH supports innovative ideas and practice that encourage political and governance challenges, equity concerns, and health policy and systems questions to be addressed together. It supports research that seeks to better understand and redress health inequities facing people in low and middle-income countries (LMICs). Linking research with action in an on-going dialogue is crucial to this endeavour. The Research Matters (RM) team, working with researchers and decision-makers to foster the action-oriented dialogue we call “Knowledge Translation”, has yielded a wealth of ideas and experience. In this toolkit, the RM team shares some of these concepts and practical tips with you, inviting you to try them, share them, comment, and help achieve the goals of health and social equity.

    This Toolkit is offered primarily to researchers on issues related to LMICs and takes its inspirations from the field of health systems research. However, it will be of interest to many other audiences as well. You will see within it stories of effective KT by researchers in all areas of development supported by IDRC. It is not a book of recipes—it aims to open new understanding, provoke debate, and build skills in asking and beginning to answer the many new questions that complex development challenges force us to address. Readers will not become experts in KT, nor is success guaranteed. However, readers will come away with new ideas and methods to get started right now, along with thoughts about whom else to include, how to learn more, and renewed commitment and confidence to try something challenging, new, and important.

    The Research Matters KT Toolkit is a unique contribution for researchers and to the KT field more broadly. It is shaped by direct, on-the-ground work and on-going dialogue with researchers and reflects their creativity, courage, and commitment—many of whom work under difficult and risky conditions. We hope this contribution will make them stronger and more effective champions of social equity by truly “making research matter.”

    Dr ChristinaZarowsky Director, HIV and AIDS Research Centre, University of the Western Cape Program Leader for IDRC's Governance, Equity and Health Program (2003–07)

    Acknowledgements

    Research Matters (RM), a collaboration of the International Development Research Centre (IDRC) and Swiss Agency for Development and Cooperation (SDC), wishes to express its sincere thanks to all those who contributed towards the success of this book. First and foremost we wish to thank all contributors for their valuable technical input and their collegiality during the development of this guide. The current version of the Knowledge Translation Toolkit has benefited from continuous and dedicated input from Sandy Campbell, the original champion of this publication. IDRC/SDC Research Matters is particularly indebted to him. Significant contributors to this current version include Sandy Campbell, Anne-Marie Schryer-Roy, Nasreen Jessani, Andrew Hubbertz, Gavin Bennett and Anna Seifried.

    Technical inputs on earlier drafts of select chapters came from: Christina Zarowsky, Kevin Kelpin, Amy Etherington, Sarah Earl, John Lavis, Graham Reid, Rosemary Kennedy, Alastair Ager, Dominique Rychen, Adrian Gnagi, Claudia Kessler, Harriet Nabudere, Ritz Kakuma, Joel Lehmann, TJ Ngulube, and many other members and partners of IDRC's Research for Health Equity program. Several chapters were presented, distributed, and discussed at various workshops in 2007, 2008, 2009, and 2010 in Kenya, Tanzania, Uganda, Cameroon, Ethiopia, Zambia, USA, Lebanon, and Canada.

    All reasonable precautions have been taken to verify the information contained in this publication, and the opinions of the contributors are written and published in good faith. However, the published material is distributed without warranty of any kind, either expressed or implied. Responsibility for the interpretation and use of the material lies with the reader.

    Introduction: The Difference Between a Paper and a Purpose

    The primary audience for this book is researchers in systems and policy research, seeking to strengthen their capacity at the individual and at the organizational level, from particular research projects to larger issues of organizational development. This book emphasizes that successful publication on the part of researchers is not “job finished.” It is “job started.” And then sets out what more must be done—and how—to drive the research findings to wherever they need to be to provide real and maximum benefit to policy, to practice, to people.

    In the context of evidence-to-policy, there can be only four reasons for the “know-do” gap. People with the ability and authority to use good information to design their action either:

    • Don’t know – that the information exists, or what action to take, or
    • Don’t understand – the information, what it means, why it is important, or
    • Don’t care – see the information as irrelevant, not beneficial to their agenda, or
    • Don’t agree – think the information is misguided or false.

    The tools in this book will help researchers ensure that their good science reaches more people, is more clearly understood, and is more likely to lead to positive action. In sum, that their work becomes more useful, and therefore more valuable.

    That demands better “communication”—the transmission of information that is relevant and in a form that is meaningful to all those who might benefit from it. It therefore informs, guides, and motivates. Only when that is achieved does latent information become active knowledge. Knowledge Translation (KT) is the process which delivers that change.

    KT helps ensure the answers leave the target in no doubt that:

    I must stop and look at this – it's interesting

    This is for my agenda – it's relevant

    I understand – it's clear and credible

    I must do something about it – it's compelling

    This toolkit therefore comprises:

    The Concept (Section I) – closing the know-do gap: turning knowledge into action.

    The Audience (Section II) – identifying who has the power to take action (policy/practice).

    The Message (Section III) – packaging the knowledge appropriately for that audience.

    The Medium (Section IV) – delivering the message, closing the gap, triggering the action.

    The Tools (Section V) – a few more thoughts about the methods of doing all those things.

    This is Knowledge Translation. It makes research matter.

    Stories

    Demonstrative examples of successful, innovative, and daring KT techniques by research teams all over the world are sprinkled throughout the book. Here are snippets of those stories.

    Kenya—From Tobacco to Bamboo

    A research project on “alternative livelihoods” for former tobacco growers is so relevant to policy that instead of researchers promoting their idea to government, the government is running TV documentaries to promote the research to the public!

    South Africa—Radio as Part of a Multipronged Approach

    Strong KT through publications, the web, conferences, radio spots, and a seminar has changed the image of a research team working on health equity from “radical” to “key advisors.” The team itself—EQUINET—is a collaboration between professionals, researchers, civil society organizations, and policy makers.

    Kenya and Malawi—Evaluative Thinking

    The “Health Research Capacity Strengthening” initiatives in Kenya and Malawi are harnessing the dynamism of ET not only to change research capacity, but also to design themselves. This KT tool is working equally on the “know” and the “do” sides.

    Beirut—The Power of a Pamphlet

    Effective KT often requires numerous tools in a complex communication programme, but sometimes just the right one tool, in the right place, at the right time, can move mountains. Research on the hazards of the narghile (smoking) pipe achieved global impact with a single pamphlet at a WHO conference.

    Brazil—Mercury Research

    Research on the source of mercury contamination in the Amazon had two unexpected and major outcomes. It successfully traced a source of mercury contamination; but then used its findings and KT processes, in the wider context, to do much more—it helped prevent illness, save lives, improve diets, address environmental damage, and tapped into the influential role of women in these communities to build social networks that are bringing profound long-term benefits to the way villagers communicate and partner with the local authorities.

    Malawi—Seek and Solve at the Same Time

    A research team assessing the linkage between soil fertility, nutrition, and health among poor rural communities used KT and a participatory ecosystems approach to involve farmers and communities so closely with their study that the means of identifying the problem became the means of solving it—simultaneously!

    South Africa—Homes Versus Housing

    Slum dwellers who moved to new housing estates were neither happier nor healthier. Research identified the disconnect between city planners, managers, and communities; KT brought them together, and not only did the dialogue bring an investment shift toward improving rather than replacing low-quality homes, but also spawned networks and institutional collaborations that are now addressing a wide range of other urban issues.

    Benin—The Power of One Meeting

    A single and simple symposium in Benin—about mothers and babies—was such a powerful demonstration of collaboration between researchers, civil society, and decision-makers that it is influencing health policy-making throughout West Africa.

    Jamaica—Tobacco Myths

    In a fine example of “pull” research, scientists identified “fear of revenue loss” as a major obstacle to policy on tobacco control through pricing. By study, they found the tax level that would deter smokers and increase revenue. Price-driven Control policies were immediately implemented.

    Tanzania—Affecting Policy and Practice

    Attempts at national scale-up of successful health interventions are few. The TEHIP “Legacy” initiative describes the pivotal role of Zonal Health Resource Centers in relieving Tanzania of its staggering burden of disease and realizing the county's Millennium Development Goal for health by 2015. PowerPoint presentations and media articles led to an upsurge in interest and change.

    Guatemala—Second-Hand Smoke

    Research-backed efforts to ban smoking in restaurants and bars got nowhere for many years until the research team launched a combined mass-media and policy brief campaign. A few months later, the ban was legislated and enforced.

    Senegal—Medical Services

    Petty corruption bedevilled the health system for many years, until Transparency International used focus groups, interviews, and observation to get the facts, and then hit the public psyche with research findings through a report, a national forum, a media campaign, and the political bombshell of cartoons. Reform has begun.

    South Africa—Water

    Privatization of essential services was already a major policy thrust with national momentum, so when researchers identified a health downside they had to sell their message against a strong counter-current. They had to use every KT tool in the book to succeed; but succeed they did and are now policy advisors to the process!

    Global KT—Women's Rights

    KT techniques and values are not only engaged by specific research projects; Canada's IDRC have used them to test colloquial evidence and simultaneously formed networks, spread concepts, developed tools, and promoted positive global impacts—for example, on women's rights.

    Senegal—From Waste Sorters to Policy Stokers

    The power of stakeholder consultations and platforms was demonstrated by a municipality in Dakar, with such success that it gave a “World Urban Forum” voice to waste-pickers who were both living off and suffering from the offerings of a massive dumpsite.

    Jakarta—Participatory Planning

    A slum community in Jakarta that was forcibly evicted as an urban hazard, is coming back with plans for a “dream development” of the space—thanks to a participatory planning exercises and partnerships with the other stakeholders.

    Vietnam—Economic Restructuring

    By engaging policy-makers from the outset, a research team in Vietnam has had its work guided by policy dilemmas and questions, and has been appointed as an official advisor to government. The relationship is facilitated by a website, policy and economic briefs, and a policy workshop.

    Kenya—The Truth Behind Truth Commissions

    By using KT methods to share insights on Truth and Reconciliation Commissions, work in one city is informing a whole continent and making a major contribution to global peace-building.

    Zambia—Equity Gauge

    A health equity project using theatre and video to engage communities, to get them to think through and express their key issues, then used a competition between dramatic performances to deliver a powerful message direct from the grassroots to a national audience that included senior policy-makers. The effects were as dramatic as the show!

    Bolivia—Waste Management

    By informing the public and policy-makers about their anti-pollution and pro-recycling strategies, municipal authorities achieved maximum compliance when they asked residents to assist with solid waste management. Multiple forms of involvement and knowledge sharing from researchers earned immense cooperation from the community and decision-makers alike.

  • About the Editors

    Gavin Bennett is a journalist, author, and strategic communication consultant. Born in Kenya and educated in Uganda, Kenya, South Africa, and UK, he has 40 years’ experience in writing and editing, mass media, professional journals, and other print and video productions in Africa, Europe, and the Americas. He has won a number of national and global awards for his strategic advice and project implementation for multinational corporations, government parastatals, NGOs, academic institutions, and projects of his own initiative.

    Nasreen Jessani is currently a part of the Knowledge Translation and Policy Task Force of WHO's Food-borne Diseases Epidemiology Reference Group. She was a Program Officer with the Governance, Equity and Health Program of Canada's International Development Research Centre (IDRC), where she spearheaded the IDRC/SDC Research Matters initiative. She has worked with Constella Future's Group International, Family Health International, the World Health Organization, the Bangladesh Rural Advancement Commission (BRAC), and the International Labor Organization. She has a background in global public health policy and management and has previously served on WHO EVIPNet's Global Steering Group.


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