Production and use of rapid responses during the COVID-19 pandemic in Quebec (Canada): perspectives from evidence synthesis producers and decision makers.

BACKGROUND: The COVID-19 pandemic has required evidence to be made available more rapidly than usual, in order to meet the needs of decision makers in a timely manner. These exceptional circumstances have caused significant challenges for organizations and teams responsible for evidence synthesis. They had to adapt to provide rapid responses to support decision-making. This study aimed to document (1) the challenges and adaptations made to produce rapid responses during the pandemic, (2) their perceived usefulness, reported use and factors influencing their use and (3) the methodological adaptations made to produce rapid responses. METHODS: A qualitative study was conducted in 2021 with eight organizations in the health and social services system in Quebec (Canada), including three institutes with a provincial mandate. Data collection included focus groups (n = 9 groups in 8 organizations with 64 participants), interviews with decision makers (n = 12), and a document analysis of COVID-19 rapid responses (n = 128). A thematic analysis of qualitative data (objectives 1 and 2) and a descriptive analysis of documents (objective 3) were conducted. RESULTS: The results highlight the teams and organizations' agility to deal with the many challenges encountered during the pandemic (e.g., increased their workloads, adoption of new technological tools or work processes, improved collaboration, development of scientific monitoring, adaptation of evidence synthesis methodologies and products). The challenge of balancing rigor and speed was reported by teams and organizations. When available at the right time, rapid responses have been reported as a useful tool for informing or justifying decisions in a context of uncertainty. Several factors that may influence their use were identified (e.g., clearly identify needs, interactions with producers, perceived rigor and credibility, precise and feasible recommendations). Certain trends in the methodological approaches used to speed up the evidence synthesis process were identified. CONCLUSIONS: This study documented rapid responses producers' experiences during the COVID-19 pandemic in Quebec, and decision makers who requested, consulted, or used these products. Potential areas of improvements are identified such as reinforce coordination, improve communication loops, clarify guidelines or methodological benchmarks, and enhance utility of rapid response products for decision makers.

A scoping review of theories, models and frameworks used or proposed to evaluate knowledge mobilization strategies.

BACKGROUND: Evaluating knowledge mobilization strategies (KMb) presents challenges for organizations seeking to understand their impact to improve KMb effectiveness. Moreover, the large number of theories, models, and frameworks (TMFs) available can be confusing for users. Therefore, the purpose of this scoping review was to identify and describe the characteristics of TMFs that have been used or proposed in the literature to evaluate KMb strategies. METHODS: A scoping review methodology was used. Articles were identified through searches in electronic databases, previous reviews and reference lists of included articles. Titles, abstracts and full texts were screened in duplicate. Data were charted using a piloted data charting form. Data extracted included study characteristics, KMb characteristics, and TMFs used or proposed for KMb evaluation. An adapted version of Nilsen (Implement Sci 10:53, 2015) taxonomy and the Expert Recommendations for Implementing Change (ERIC) taxonomy (Powell et al. in Implement Sci 10:21, 2015) guided data synthesis. RESULTS: Of the 4763 search results, 505 were retrieved, and 88 articles were eligible for review. These consisted of 40 theoretical articles (45.5%), 44 empirical studies (50.0%) and four protocols (4.5%). The majority were published after 2010 (n = 70, 79.5%) and were health related (n = 71, 80.7%). Half of the studied KMb strategies were implemented in only four countries: Canada, Australia, the United States and the United Kingdom (n = 42, 47.7%). One-third used existing TMFs (n = 28, 31.8%). According to the adapted Nilsen taxonomy, process models (n = 34, 38.6%) and evaluation frameworks (n = 28, 31.8%) were the two most frequent types of TMFs used or proposed to evaluate KMb. According to the ERIC taxonomy, activities to "train and educate stakeholders" (n = 46, 52.3%) were the most common, followed by activities to "develop stakeholder interrelationships" (n = 23, 26.1%). Analysis of the TMFs identified revealed relevant factors of interest for the evaluation of KMb strategies, classified into four dimensions: context, process, effects and impacts. CONCLUSIONS: This scoping review provides an overview of the many KMb TMFs used or proposed. The results provide insight into potential dimensions and components to be considered when assessing KMb strategies.

When the messenger is more important than the message: an experimental study of evidence use in francophone Africa.

BACKGROUND: Epistemic injustices are increasingly decried in global health. This study aims to investigate whether the source of knowledge influences the perception of that knowledge and the willingness to use it in francophone African health policy-making context. METHODS: The study followed a randomized experimental design in which participants were randomly assigned to one of seven policy briefs that were designed with the same scientific content but with different organizations presented as authors. Each organization was representative of financial, scientific or moral authority. For each type of authority, two organizations were proposed: one North American or European, and the other African. RESULTS: The initial models showed that there was no significant association between the type of authority or the location of the authoring organization and the two outcomes (perceived quality and reported instrumental use). Stratified analyses highlighted that policy briefs signed by the African donor organization (financial authority) were perceived to be of higher quality than policy briefs signed by the North American/European donor organization. For both perceived quality and reported instrumental use, these analyses found that policy briefs signed by the African university (scientific authority) were associated with lower scores than policy briefs signed by the North American/European university. CONCLUSIONS: The results confirm the significant influence of sources on perceived global health knowledge and the intersectionality of sources of influence. This analysis allows us to learn more about organizations in global health leadership, and to reflect on the implications for knowledge translation practices.

RéSUMé: CONTEXTE: Les injustices épistémiques sont de plus en plus décriées dans le domaine de la santé mondiale. Cette étude vise à déterminer si la source des connaissances influence la perception de ces connaissances et la volonté de les utiliser. MéTHODES: L'étude suit un devis expérimental randomisé dans lequel les participant·es ont été assigné·es au hasard à l'une des sept notes politiques conçues avec le même contenu scientifique, mais avec différentes organisations présentées comme autrices. Chaque organisation était représentative d'une autorité financière, scientifique ou morale. Pour chaque type d'autorité, deux organisations étaient proposées : l'une nord-américaine ou européenne, l'autre africaine. RéSULTATS: Les résultats montrent que le type d'autorité et la localisation des organisations autrices ne sont pas significativement associés à la qualité perçue et à l'utilisation instrumentale déclarée. Toutefois, des interactions entre le type d'autorité et la localisation étaient significatives. Ainsi, les analyses stratifiées ont mis en évidence que pour la qualité perçue, les notes de politique signées par l'organisme bailleur (autorité financière) africain obtenaient de meilleurs scores que les notes de politique signées par l'organisme bailleur nord-américain / européen. Tant pour la qualité perçue que pour l'utilisation instrumentale déclarée, ces analyses stratifiées ont révélé que les notes de politique signées par l'université africaine (autorité scientifique) étaient associées à des scores plus faibles que les notes de politique signées par l'université nord-américaine/européenne. INTERPRéTATION: Les résultats confirment l'influence significative des sources sur la perception des connaissances en santé mondiale et rappellent l'intersectionnalité de l'influence des sources d'autorité. Cette analyse nous permet à la fois d'en apprendre davantage sur les organisations qui dominent la scène de la gouvernance mondiale en santé et de réfléchir aux implications pour les pratiques d'application des connaissances.

A Knowledge Brokering Program in Burkina Faso (West Africa): Reflections from Our Experience.

Abstract-In Burkina Faso, inadequate interaction among researchers, decision makers, and practitioners, together with low use of research results, impedes the development of health policies and interventions to improve equity. A knowledge translation strategy was implemented as part of a research program. The broker and his team promoted links between actors (health agents, nongovernmental organizations, public administration, policy makers, researchers), provided them with research results related to their needs, and supported them in applying this knowledge in their practices. The strategy was first implemented in Kaya District, Burkina Faso. To increase impact on population health, the strategy included widening the sphere of action through collaboration with the Ministry of Health. The broker was affiliated with a public health consulting firm in the capital, Ouagadougou, and supported by Canadian experts and a senior Burkinabè broker. Evaluation shows that research use increased at the local level among health mutuals, regional nongovernmental organizations, and health professionals in Kaya, but the objective of reaching Ministry of Health decision makers was not achieved. Results highlight the need for better training in knowledge transfer for both local and international researchers and proper identification of the gateways to reach high level decision makers. This ambitious strategy encountered several obstacles: difficult access to decision makers, poor team communication, and broker's nonconducive working environment. Future brokering strategies should analyze the political situation in depth to determine when and how to approach national and regional decision makers; invest time and effort in developing different actors' (including researchers') knowledge transfer skills; and ensure sufficient and good quality communications and resources within the team.

The content of recurrent dreams in young adolescents.

Studies on children's recurrent dreams have been largely anecdotal and based on adults' recollections of dreams experienced during childhood. We collected 102 reports of recurrent dreams from a sample of young adolescents aged between 11 and 15years and scored the narratives using a range of content measures, including in relation to the threat simulation theory (TST) of dreaming. The most frequently reported themes involved confrontations with monsters or animals, followed by physical aggressions, falling and being chased. Recurrent dreams were more likely to include negative content elements than positive elements. Only half of the recurrent dreams contained threatening elements and their analysis provided mixed support for the TST. Differences between the content of recurrent dreams reported by young adolescent versus adults are discussed as are possible sex effects and key issues that remain to be addressed by future research.

Collaborative development and implementation of a knowledge brokering program to promote research use in Burkina Faso, West Africa.

Despite efforts expended over recent decades, there is a persistent gap between the production of scientific evidence and its use. This is mainly due to the difficulty of bringing such knowledge to health workers and decision-makers so that it can inform practices and decisions on a timely basis. One strategy for transferring knowledge to potential users, that is, gaining increasing legitimacy, is knowledge brokering (KB), effectiveness of which in certain conditions has been demonstrated through empirical research. However, little is known about how to implement such a strategy, especially in the African context. The KB program presented here is aimed specifically at narrowing the gap by making scientific knowledge available to users with the potential to improve health-related practices and decision making in Burkina Faso. The program involves Canadian and African researchers, a knowledge broker, health practitioners, and policy-makers. This article presents the collaborative development of the KB strategy and the evaluation of its implementation at year 1. The KB strategy was developed in stages, beginning with a scoping study to ensure the most recent studies were considered. Two one-day workshops were then conducted to explore the problem of low research use and to adapt the strategy to the Burkinabè context. Based on these workshops, the KB program was developed and brokers were recruited and trained. Evaluation of the program's implementation after the first year showed that: 1) the preparatory activities were greatly appreciated by participants, and most considered the content useful for their work; 2) the broker had carried out his role in accordance with the logic model; and 3) this role was seen as important by the participants targeted by the activities and outputs. Participants made suggestions for program improvements in subsequent years, stressing particularly the need to involve decision-makers at the central level.