Research evidence communication for policy-makers: a rapid scoping review on frameworks, guidance and tools, and barriers and facilitators.

BACKGROUND: Communication is a multifaceted process, ranging from linear, one-way approaches, such as transmitting a simple message, to continuous exchanges and feedback loops among stakeholders. In particular the COVID-19 pandemic underscored the critical need for timely, effective and credible evidence communication to increase awareness, levels of trust, and evidence uptake in policy and practice. However, whether to improve policy responses in crises or address more commonplace societal challenges, comprehensive guidance on evidence communication to decision-makers in health policies and systems remains limited. Our objective was to identify and systematize the global evidence on frameworks, guidance and tools supporting effective communication of research evidence to facilitate knowledge translation and evidence-informed policy-making processes, while also addressing barriers and facilitators. METHODS: We conducted a rapid scoping review following the Joanna Briggs Manual. Literature searches were performed across eight indexed databases and two sources of grey literature, without language or time restrictions. The methodological quality of included studies was assessed, and a narrative-interpretative synthesis was applied to present the findings. RESULTS: We identified 16 documents presenting either complete frameworks or framework components, including guidance and tools, aimed at supporting evidence communication for policy development. These frameworks outlined strategies, theoretical models, barriers and facilitators, as well as insights into policy-makers' perspectives, communication needs, and preferences. Three primary evidence communication strategies, comprising eleven sub-strategies, emerged: "Health information packaging", "Targeting and tailoring messages to the audience", and "Combined communication strategies". Based on the documented barriers and facilitators at micro, meso and macro levels, critical factors for successful communication of evidence to policy-makers were identified. CONCLUSIONS: Effective communication is indispensable for facilitating knowledge translation and evidence-informed policy-making. Nonetheless gaps persist in frameworks designed to enhance research communication to policy-makers, particularly regarding the effectiveness of multiple communication strategies. To advance in this field, the development of comprehensive frameworks incorporating implementation strategies is warranted. Additionally, barriers and facilitators to implementing effective communication must be recognized and addressed taking diverse contexts into consideration. Registration https://zenodo.org/record/5578550.

Dynamic measurements of geographical accessibility considering traffic congestion using open data: a cross-sectional assessment for haemodialysis services in Cali, Colombia.

Background: Many cities with traffic congestion lack accessibility assessments accounting for traffic congestion and equity considerations but have disaggregated georeferenced municipal-level open data on health services, populations, and travel times big data. We convened a multistakeholder intersectoral collaborative group that developed a digital, web-based platform integrating open and big data to derive dynamic spatial-temporal accessibility measurements (DSTAM) for haemodialysis services. We worked with stakeholders and data scientists and considered people's places of residence, service locations, and travel time to the service with the shortest travel time. Additionally, we predicted the impacts of strategically introducing haemodialysis services where they optimise accessibility. Methods: Cross-sectional analyses of DSTAM, accounting for traffic congestion, were conducted using a web-based platform. This platform integrated traffic analysis zones, public census and health services datasets, and Google Distance Matrix API travel-time data. Predictive and prescriptive analytics identified optimal locations for new haemodialysis services and estimated improvements. Primary outcomes included the percentage of residents within a 20-min car drive of a haemodialysis service during peak and free-flow traffic congestion. Secondary outcomes focused on optimal locations to maximise accessibility with new services and potential improvements. Findings were disaggregated by sociodemographic characteristics, providing an equity perspective. The study in Cali, Colombia, used geographic and disaggregated sociodemographic data from the adjusted 2018 Colombian census. Predicted travel times were obtained for two weeks in 2020. Findings: There were substantial traffic variations. Congestion reduced accessibility, especially among marginalised groups. For 6-12 July, free-flow and peak-traffic accessibility rates were 95.2% and 45.0%, respectively. For 23-29 November, free-flow and peak traffic accessibility rates were 89.1% and 69.7%. The locations where new services would optimise accessibility had slight variation and would notably enhance accessibility and health equity. Interpretation: Establishing haemodialysis services in targeted areas has significant potential benefits. By increasing accessibility, it would enhance urban health and equity. Funding: No external or institutional funding was received.

"From All, To All": Implementing a collaborative online conference to reflect on the daily living of individuals with cerebral palsy.

BACKGROUND: Translating knowledge to improve paediatric rehabilitation has become a research area of interest. This study describes the development and evaluation of an online conference that brought together perspectives of individuals with cerebral palsy (CP), families, health care professionals, and researchers to discuss the daily living of individuals with CP. METHODS: We anchored the development and implementation of the online conference in the action cycle of the Knowledge to Action Framework. To develop the meeting, we included representatives from each stakeholder group in the programme committee. The conference programme was designed having the lifespan perspective of individuals with CP, from birth to adulthood, as its central core, with themes related to daily living (e.g., self-care, mobility, and continuing education). Participants' satisfaction with the conference was assessed using an anonymized online survey sent to all participants. RESULTS: The conference had 1656 attendees, of whom 675 answered the online satisfaction survey. Most participants rated the structure of the conference (i.e., quality of the technical support, audio and video, and online platform) and discussed topics (i.e., relevance, content, discussion, speakers, and available time) positively. CONCLUSION: Collaborative conferences that include stakeholders throughout the planning and implementation are a viable, effective knowledge translation strategy that allows for sharing experiences and disseminating knowledge among families and individuals with CP, health care professionals, and researchers.

Analysis of the Brazilian-Portuguese Content on Autism Spectrum Disorder Available on YouTube Videos.

AIMS: Information about Autism Spectrum Disorder (ASD) is available in different videos on YouTube. However, these videos might present inaccurate or outdated information. The aims of this study were to 1) identify characteristics of Brazilian-Portuguese videos about ASD (i.e., type of content, number of views, likes, and dislikes); 2) analyze the content of informative videos about ASD, by assessing their trustworthiness and overall quality; and 3) investigate the most popular topics of informative videos about ASD over time. METHODS: This is a cross-sectional study that investigated Brazilian-Portuguese ASD content on YouTube. Videos were selected by two examiners and categorized as experiential or informative. The Discern checklist and the Global Quality Score (GQS) were used to analyze the trustworthiness and quality of informative videos. RESULTS: In total, 216 videos were analyzed, of which 19.5% and 85% were classified as experiential and informative, respectively. The majority of informative videos presented moderate trustworthiness and quality. Videos about ASD clinical aspects were the most popular. CONCLUSION: YouTube offers a large number of experiential and informative videos on ASD. However, some of these videos fail to present reliable and additional sources of information for stakeholders. Efforts to promote knowledge translation about ASD on YouTube are necessary.

An evidence-informed policymaking (EIPM) competency profile for the Brazilian Health System developed through consensus: process and outcomes.

BACKGROUND: Evidence-informed policymaking (EIPM) requires a set of individual and organizational knowledge, skills and attitudes that should be articulated with background factors and needs. In this regard, the development of an EIPM competency profile is important to support the diagnosis, planning and implementation of EIPM. PURPOSE: To present the process and outcomes of the development of an EIPM competency profile by an expert committee, to be applied in different contexts of the Brazilian Health System. METHODS: A committee of experts in EIPM shared different views, experiences and opinions to develop an EIPM competency profile for Brazil. In six consensus workshops mediated by facilitators, the committee defined from macro problems to key actions and performances essential for the competency profile. The development steps consisted of: (1) Constitution of the committee, including researchers, professionals with practical experience, managers, and educators; (2) Development of a rapid review on EIPM competency profiles; (3) Agreement on commitments and responsibilities in the processes; (4) Identification and definition of macro problems relating to the scope of the competency profile; and (5) Outlining of general and specific capacities, to be incorporated into the competency profile, categorized by key actions. RESULTS: The development of the EIPM competency profile was guided by the following macro problems: (1) lack of systematic and transparent decision-making processes in health policy management; (2) underdeveloped institutional capacity for knowledge management and translation; and (3) incipient use of scientific evidence in the formulation and implementation of health policies. A general framework of key actions and performances of the EIPM Competency Profile for Brazil was developed, including 42 specific and general key actions distributed by area of activity (Health Management, Scientific Research, Civil Society, Knowledge Translation, and Cross-sectional areas). CONCLUSIONS: The competency profile presented in this article can be used in different contexts as a key tool for the institutionalization of EIPM.

Plataforma tecnológica como suporte para translação do conhecimento em saúde / Technological platform as a support for health knowledge translation / La plataforma tecnológica como soporte para la transferencia de conocimientos en salud

A translação do conhecimento (TC) visa à utilização prática dos resultados de pesquisas científicas e o monitoramento dos benefícios causados à saúde da população. O objetivo deste estudo foi instrumentalizar a instância de suporte à TC por meio da identificação dos requisitos funcionais de uma proposta de plataforma tecnológica. Fundamentando-se no Design Science Research, o estudo se enquadra como uma pesquisa qualitativa procurando resolver um problema prático num contexto específico. Por meio de um grupo focal confirmatório com profissionais e pesquisadores de um instituto de ciência e tecnologia em saúde, foram identificadas 11 categorias de requisitos funcionais: Órgãos Regulatórios, Infraestrutura de Implementação, Banco de Dados, Capacitações em TC, Eventos de TC, Perfil de Consultas, Portal TC, Avaliação de Iniciativas, Apoio Institucional, Ferramenta de Busca Parametrizada e Prospecção de Projetos de Pesquisa. A modelagem da proposta contemplou as sugestões de funcionalidades para instrumentalizar o processo de aplicação prática dos conhecimentos decorrentes das pesquisas

Knowledge translation (KT) aims at the practical use of scientific research results and the monitoring of the benefits caused to the population's health. The objective of this study was to instrumentalize the TC support instance by identifying the functional requirements of a proposed technological platform. Based on Design Science Research, the study is framed as qualitative research seeking to solve a practical problem in a specific context. Through a confirmatory focus group with professionals and researchers from a health science and technology institute, 11 categories of functional requirements were identified: Regulatory Bodies, Implementation Infrastructure, Database, Capacity Building, KT Events, Query Profile, KT Portal, Initiative Evaluation, Institutional Support, Parameterized Search Tool, and Research Project Prospecting. The modeling of the proposal contemplated the suggestions of functionalities to instrumentalize the process of the practical application of the knowledge resulting from the research

La traslación del conocimiento (TC) tiene como objetivo el uso práctico de los resultados de la investigación científica y el seguimiento de los beneficios causados a la salud de la población. El objetivo de este estudio fue instrumentalizar la instancia de apoyo a la TC a través de la identificación de requisitos funcionales de una plataforma tecnológica propuesta. Basado en Design Science Research, el estudio se enmarca como una investigación cualitativa que busca resolver un problema práctico en un contexto específico. A través de un grupo focal confirmatorio con profesionales e investigadores de un instituto de ciencia y tecnología de la salud, se identificaron 11 categorías de requisitos funcionales: Órganos Reguladores, Infraestructura de Implementación, Base de Datos, Capacitación, Eventos de TC, Perfil de Consulta, Portal de TC, Evaluación de Iniciativas, Apoyo Institucional, Herramienta de Búsqueda Parametrizada y Prospección de Proyectos de Investigación. El modelado de la propuesta incluyó las sugerencias de funcionalidades para instrumentalizar el proceso de aplicación práctica del conocimiento surgido de la investigación

Routinizing the Use of Evidence in Policy - What Is Needed? Comment on "Sustaining Knowledge Translation Practices: A Critical Interpretive Synthesis".

In their study of sustaining knowledge translation (KT) practices, Borst et al found that this process is an interplay of: (i) constructing and extending networks, (ii) creating contexts that support KT practices, and (iii) understanding how actors create, maintain, and disrupt institutions. Their article is an important contribution to the body of research promoting KT. In this commentary we reflect on the convergences and differences between the concepts of 'sustaining' and 'institutionalizing' KT, highlighting domains and processes related to the institutionalization, providing an analysis of KT landscape in Brazil and making a case for the need to increase countries' routine use of evidence.

Strategies for communicating scientific evidence on healthcare to managers and the population: a scoping review.

BACKGROUND: Health evidence needs to be communicated and disseminated in a manner that is clearly understood by decision-makers. As an inherent component of health knowledge translation, communicating results of scientific studies, effects of interventions and health risk estimates, in addition to understanding key concepts of clinical epidemiology and interpreting evidence, represent a set of essential instruments to reduce the gap between science and practice. The advancement of digital and social media has reshaped the concept of health communication, introducing new, direct and powerful communication platforms and gateways between researchers and the public. The objective of this scoping review was to identify strategies for communicating scientific evidence in healthcare to managers and/or population. METHODS: We searched Cochrane Library, Embase®, MEDLINE® and other six electronic databases, in addition to grey literature, relevant websites from related organizations for studies, documents or reports published from 2000, addressing any strategy for communicating scientific evidence on healthcare to managers and/or population. RESULTS: Our search identified 24 598 unique records, of which 80 met the inclusion criteria and addressed 78 strategies. Most strategies focused on risk and benefit communication in health, were presented by textual format and had been implemented and somehow evaluated. Among the strategies evaluated and appearing to yield some benefit are (i) risk/benefit communication: natural frequencies instead of percentages, absolute risk instead relative risk and number needed to treat, numerical instead nominal communication, mortality instead survival; negative or loss content appear to be more effective than positive or gain content; (ii) evidence synthesis: plain languages summaries to communicate the results of Cochrane reviews to the community were perceived as more reliable, easier to find and understand, and better to support decisions than the original summaries; (iii) teaching/learning: the Informed Health Choices resources seem to be effective for improving critical thinking skills. CONCLUSION: Our findings contribute to both the knowledge translation process by identifying communication strategies with potential for immediate implementation and to future research by recognizing the need to evaluate the clinical and social impact of other strategies to support evidence-informed policies. Trial registration protocol is prospectively available in MedArxiv (doi.org/10.1101/2021.11.04.21265922).

Evaluation of Mpox Knowledge, Stigma, and Willingness to Vaccinate for Mpox: Cross-Sectional Web-Based Survey Among Sexual and Gender Minorities.

BACKGROUND: The 2022 multicountry mpox outbreak positioned the condition as a public health emergency of international concern. By May 2023, Brazil ranked second globally in the cumulative number of mpox cases and deaths. The higher incidence of mpox among gay and other men who have sex with men in the current mpox outbreak deepens the stigma and discrimination against sexual and gender minorities (SGM). This might worsen the structural barriers impacting access to health services, which ultimately leads to undertesting and underreporting of cases. There are no data available on mpox knowledge and stigma in Latin America. OBJECTIVE: We aimed to evaluate mpox knowledge, stigma, and willingness to vaccinate for mpox among SGM, and to describe sociodemographic and behavioral characteristics according to self-reported mpox diagnosis. METHODS: A cross-sectional, internet-based survey was conducted in a convenience sample of adults (aged >18 years) living in Brazil recruited through advertisements on dating apps, social media, referral institutions for infectious diseases websites, and mass media (October-November 2022). We compared participants' characteristics according to self-reported mpox diagnosis using chi-square test or Fisher exact test for qualitative variables and Kruskal-Wallis test for quantitative variables. RESULTS: We enrolled 6236 participants: 5685 (91.2%) were cisgender men; 6032 (96.7%) were gay, bisexual, or pansexual; 3877 (62.2%) were White; 4902 (78.7%) had tertiary education; and 4070 (65.2%) reported low or middle income. Most participants (n=5258, 84.4%) agreed or strongly agreed that "LGBTQIA+ individuals are being discriminated and stigmatized due to mpox." Mpox awareness was 96.9% (n=6044), and 5008 (95.1%) were willing to get vaccinated for mpox. Overall, 324 (5.2%) reported an mpox diagnosis. Among these, 318 (98.1%) reported lesions, 178 (56%) local pain, and 316 (99.4%) sought health care. Among participants not reporting a diagnosis, 288 (4.9%) had a suspicious lesion, but only 158 (54.9%) of these had sought health care. Compared to participants with no diagnosis, those reporting an mpox diagnosis were younger (P<.001), reported more sex partners (P<.001), and changes in sexual behavior after mpox onset (P=.002). Moreover, participants diagnosed with mpox reported more frequently being tested for HIV in the prior 3 months (P<.001), living with HIV (P<.001), currently using HIV pre-exposure prophylaxis (P<.001), and previous sexually transmitted infection diagnosis (P<.001). CONCLUSIONS: Our results point to high mpox knowledge and willingness to vaccinate among SGM in Brazil. Participants self-reporting mpox diagnosis more frequently reported to be living with HIV, STI diagnosis, and current pre-exposure prophylaxis use, highlighting the importance of an mpox assessment that includes comprehensive sexual health screenings. Efforts to decrease stigma related to mpox among SGM are necessary to avoid mpox underdiagnosis.

Community-Based Knowledge Translation Strategies for Maternal, Neonatal, and Perinatal Outcomes: A Systematic Review of Quantitative and Qualitative Data.

Objective: To identify and assess the effect of community-based Knowledge Translation Strategies (KTS) on maternal, neonatal, and perinatal outcomes. Methods: We conducted systematic searches in Medline, Embase, CENTRAL, CINAHL, PsycInfo, LILACS, Wholis, Web of Science, ERIC, Jstor, and Epistemonikos. We assessed the certainty of the evidence of the studies using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Results: We identified seven quantitative and seven qualitative studies. Quantitative findings suggest that there is a possible effect on reducing maternal mortality (RR 0.65; 95% CI, 0.48-0.87; moderate evidence certainty); neonatal mortality (RR 0.79; 95% CI 0.70-0.90; moderate evidence certainty); and perinatal mortality (RR 0.84; 95% CI 0.77-0.91; moderate evidence certainty) in women exposed to KTS compared to those who received conventional interventions or no intervention at all. Analysis of qualitative studies identified elements that allowed to generate benefit effects in improving maternal, neonatal, and perinatal outcomes. Conclusion: The KTS in maternal, neonatal, and perinatal outcomes might encourage the autonomy of communities despite that the certainty of evidence was moderate.

Keep posting and following social media profiles about physical therapy, but be aware! A cross-sectional study of social media posts on Instagram and Twitter.

BACKGROUND: Social media is established as a communication channel that is useful to disseminate scientific information. While social media can disseminate high quality information, it can also facilitate the spread of false or misleading information. Furthermore, social media is considered a self-promotion environment that can have several aspects related to personal marketing. OBJECTIVE: To systematically search and review social media posts verifying whether the posts about physical therapy interventions reported sources of information; the presence of aspects suggesting conflicts of interest (COI); whether information was presented to facilitate knowledge acquisition; the reach of information posted; and the use and quality of the cited scientific references. METHODS: Searches were performed on Instagram and Twitter using #reabilitação for Portuguese posts, and #rehabilitation for English posts. The inclusion criteria were posts including terms related to physical therapy and presenting interventions along with their purposes. The searches and screening processes were performed by at least two independent researchers. RESULTS: Of 1,145 pre-selected posts, 632 posts were included, of which 14% cited references as source of information, 57% presented potential COI, and 9% facilitated knowledge acquisition. The posts received the mean ± SD of 88 ± 593 likes and profiles had a mean of 5,162 ± 37,240 followers. Considering the posts that cited references, most posts presented consistent information (51%) and 6% presented only positives outcomes (selection bias). Many references were of poor methodological quality (39%). CONCLUSION: The present study enlightens the fact that most posts on Instagram and Twitter regarding physical therapy interventions did not report or use sources to support the information disseminated. Also, most posts were not created to facilitate knowledge acquisition. REGISTRATION NUMBER: PROSPERO register database (CRD42021276941).

Competency profiles for evidence-informed policy-making (EIPM): a rapid review.

BACKGROUND: Evidence-informed policy-making (EIPM) requires a set of individual and organizational capacities, linked with background factors and needs. The identification of essential knowledge, skills and attitudes for EIPM can support the development of competency profiles and their application in different contexts. PURPOSE: To identify elements of competency (knowledge, skills and attitudes) for EIPM, according to different professional profiles (researcher, health professional, decision-maker and citizen). METHODS: Rapid umbrella review. A structured search was conducted and later updated in two comprehensive repositories (BVSalud and PubMed). Review studies with distinctive designs were included, published from 2010 onwards, without language restrictions. Assessment of the methodological quality of the studies was not performed. A meta-aggregative narrative synthesis was used to report the findings. RESULTS: Ten reviews were included. A total of 37 elements of competency were identified, eight were categorized as knowledge, 19 as skills and 10 as attitudes. These elements were aggregated into four competency profiles: researcher, health professional, decision-maker and citizen. The competency profiles included different sets of EIPM-related knowledge, skills and attitudes. STRENGTHS AND LIMITATIONS: This study is innovative because it aggregates different profiles of competency from a practical perspective, favouring the application of its results in different contexts to support EIPM. Methodological limitations are related to the shortcuts adopted in this review: complementary searches of the grey literature were not performed, and the study selection and data extraction were not conducted in duplicate. FINAL CONSIDERATIONS: CONCLUSIONS AND IMPLICATIONS OF THE FINDINGS: EIPM requires the development of individual and organizational capacities. This rapid review contributes to the discussion on the institutionalization of EIPM in health systems. The competency profiles presented here can support discussions about the availability of capacity and the need for its development in different contexts.

Knowledge translation in rehabilitation settings in low, lower-middle and upper-middle-income countries: a scoping review.

PURPOSE: This review aims to identify the barriers and facilitators to knowledge use and Knowledge Translation (KT) strategies in rehabilitation in low, lower-middle, and upper-middle-income countries (LMICs). MATERIALS AND METHODS: A scoping review of studies of KT in rehabilitation in LMICs contexts using the Arksey and O'Malley Framework was conducted. A comprehensive search of MEDLINE and 10 other databases was undertaken to identify studies conducted primarily in LMICs. RESULTS: From the initial 15.606 titles identified; 27 articles were included for final analysis. Our analysis identified the following themes: Professional culture and context; KT interventions; and the conceptualization and application of KT and Evidence Based Practice (EBP). Individual-level barriers to KT included lack of skills, knowledge about EBP and English language, lack of motivation, and decision-making power. Facilitators to KT included positive attitudes and motivation. Organization-level barriers included lack of time, lack of financial resources, limited access to scientific journals, and applicability of research to rural settings. Facilitators included adequate financial and physical resources, a supportive management environment, and the existence of training and continuing education programs. CONCLUSION: This review identified common and unique barriers and facilitators to KT in LMICs when compared to KT studies conducted in high-income settings.IMPLICATIONS FOR REHABILITATIONKnowledge Translation from academic institutions to rehabilitation clinical practice in low and upper-middle-income countries is important to support evidence-based practice and patient outcomes.Barriers at the individual level include professionals' ability to understand English and knowledge of the evidence-based practice.Organization-level barriers included lack of time to access and implement new practices, lack of financial and personal resources, limited access to scientific journals, and applicability of research to rural settings.Training and continuing education programs are needed to support rehabilitation professionals' efforts to achieve the application of evidence-based practice in clinical practice.

Translation and cross-cultural adaptation of the knowledge translation planning template for the brazilian context / Traducción y adaptación intercultural de la plantilla de planificación para la traducción de conocimiento al contexto brasileño / Tradução e adaptação transcultural da ferramenta knowledge translation planning template para o contexto brasileiro

ABSTRACT Objective: to translate, cross-culturally adapt, and validate the content of the Knowledge Translation Planning Template, a research dissemination planning tool, into Brazilian Portuguese. Method: this is a methodological study, sequentially divided into six stages: initial translation, translation synthesis, back-translation, judges' committee, pre-test, and approval of the adapted version by the instrument author. The judge's committee assessed content validity using the modified Kappa and Content Validity Index. The test was conducted with teachers and students from a Federal University of Santa Catarina graduate program. Results: the process of translating and back-translating the tool showed no discrepancies in terms of meaning. The committee was composed of seven judges who carried out semantic, cultural, and conceptual evaluations and made notes on the translation of the content. At this stage, the content validity showed excellent values for the Content Validity Index and modified Kappa, with 0.99 and 0.816, respectively. The tool was tested with 30 teachers and postgraduate students, where 90% of the respondents considered the tool to be sufficiently comprehensive and that all the items were relevant to the purpose of the instrument. In the last stage, the documents were analyzed together with the author of the original tool and the final version was approved. Conclusion: the Modelo de Planejamento de Tradução do Conhecimento results from a careful translation process, cross-cultural adaptation, and tool content validation. This has resulted in a tool that is applicable and understood by the target audience, which shows consistency in the equivalence of translation and cross-cultural adaptation for Brazil.

RESUMEN Objetivo: realizar la traducción, adaptación transcultural y validar el contenido de la Plantilla de Planificación para la Traducción del Conocimiento para el idioma portugués de Brasil. Método: estudio metodológico que siguió seis etapas: traducción inicial, síntesis de la traducción, retrotraducción, comité de expertos, pretest y aprobación de la versión adaptada por la autora de la herramienta. Em el comité de expertos, la validez del contenido se calculó mediante el índice de validez de contenido y el Kappa modificado. El pre-test se realizó con profesores y estudiantes de un programa de postgrado en la Universidad Federal de Santa Catarina. Resultados: el proceso de traducción y retrotraducción de la herramienta no mostró discrepancias en términos de significado. El comité estuvo formado por siete expertos que evaluaron los aspectos semánticos, culturales y conceptuales y realizaron observaciones sobre la traducción del contenido. En esta etapa, la validez de contenido mostró valores excelentes para el Índice de Validez de Contenido y el Kappa modificado, con 0,99 y 0,816 respectivamente. La herramienta se probó con 30 profesores y estudiantes de posgrado, donde el 90% de los encuestados consideraron que la herramienta era lo suficientemente completa y que todos los elementos eran pertinentes para el propósito de la herramienta. En la fase final, se analizaron los documentos junto con la autora de la herramienta original y se aprobó la versión final. Conclusión: el "Modelo de Planejamento de Tradução do Conhecimento" es el resultado de un proceso riguroso de traducción, adaptación transcultural y validación de contenido de la herramienta. El resultado fue una herramienta aplicable y comprensible para el público destinatario, y que muestra coherencia en la equivalencia de la traducción y la adaptación transcultural para Brasil.

RESUMO Objetivo: realizar a tradução, adaptação transcultural e validar o conteúdo da Knowledge Translation Planning Template para língua portuguesa do Brasil. Método: estudo metodológico, que seguiu seis etapas: tradução inicial, síntese da tradução, retrotradução, comitê de juízes, pré-teste e aprovação da versão adaptada pela autora da ferramenta. No comitê de juízes a validade do conteúdo foi calculada por meio do Índice de Validade de Conteúdo e Kappa modificado. O pré-teste foi realizado com docentes e discentes de um programa de pós-graduação da Universidade Federal de Santa Catarina. Resultados: o processo de tradução e retrotradução da ferramenta não apresentou discrepâncias em termos de significado. O comitê foi composto por sete juízes que realizaram avaliação semântica, cultural, conceitual e realizaram apontamentos quanto à tradução do conteúdo. Nesta etapa, a validade de conteúdo apresentou valores excelentes de Índice de Validade de Conteúdo e Kappa modificado, com 0,99 e 0,816 respectivamente. A ferramenta foi testada com 30 docentes e discentes de pós-graduação, onde 90% dos respondentes consideraram a ferramenta suficientemente abrangente, e que todos os itens são relevantes ao propósito da ferramenta. Na última etapa, os documentos foram analisados em conjunto com a autora da ferramenta original e a versão final foi aprovada. Conclusão: o Modelo de Planejamento de Tradução do Conhecimento é resultado de um processo criterioso de tradução, adaptação transcultural e validação de conteúdo da ferramenta. Isso gerou uma ferramenta aplicável e compreendida pelo público-alvo, a qual apresenta consistência na equivalência da tradução e adaptação transcultural para o Brasil.

Aplicação do saber científico: a translação do conhecimento em um instituto de ciência e tecnologia em saúde pública / Application of scientific knowledge: knowledge translation in an institute of science and technology in public health / Aplicación del saber científico: la traslación de conocimiento en un instituto de ciencia y tecnología en salud pública

Resumo: A translação do conhecimento (TC) tem como propósito a utilização prática dos resultados de pesquisas científicas e o monitoramento dos benefícios causados à saúde da população. Na área de saúde, o governo e, principalmente, a sociedade esperam que os investimentos em pesquisas obtenham resultados que vão além da produção e da publicação do conhecimento, e provoquem soluções como políticas públicas, sistemas, produtos e tecnologias para beneficiar a saúde da população. Contudo, verifica-se ainda a necessidade de superar diversos desafios para eliminar as lacunas existentes entre a investigação e a aplicação. O objetivo deste estudo é propor estratégias, com base na identificação de barreiras e fatores facilitadores de um instituto de ciência e tecnologia (ICT) em saúde, para fomentar o processo de transformação do conhecimento científico, gerado nas pesquisas, em ações e produtos que contribuam para a melhoria da saúde da população. Os relatos das entrevistas, realizadas com 16 pesquisadores, permitiram a identificação de 10 categorias de barreiras, tendo destaque: "financiamento em ciência, tecnologia e informação (CT&I) limitado" e "apoio técnico insuficiente para a translação do conhecimento". "Infraestrutura e apoio institucional" foi a categoria de fatores facilitadores mais citada pelos participantes. Por fim, foi desenvolvido o artefato "estratégias e abordagens para superação de barreiras à implementação de resultados de pesquisa". Entre as estratégias, sugere-se a inclusão de uma disciplina de TC nos programas de pós-graduação stricto sensu e a criação de uma instância na estrutura organizacional do ICT voltada à prestação de suporte técnico e gerencial à aplicação de resultados de pesquisa.

Abstract: Knowledge translation (KT) aims at the practical use of scientific research results and at the monitoring of the benefits caused to the population's health. In health, the government and especially society expect that investments in research will produce results that go beyond the production and publication of knowledge, provoking outcomes such as public policies, systems, products, and technologies to benefit the health of the population. However, closing the gaps between research and application requires overcoming a number of challenges. This study aimed to propose strategies to foster the process of transforming the scientific knowledge generated in research into actions and products that contribute to improving the population's health based on the identification of barriers and facilitating factors of a health science and technology institute. The reports of interviews conducted with 16 researchers showed 10 categories of barriers, especially: "limited funding to the science and technology institute" and "insufficient technical support for knowledge translation". "Infrastructure and institutional support" was the facilitating factor category participants mentioned the most. Finally, we developed the artifact "strategies and approaches for overcoming barriers to implement research results". Among the strategies, we suggest the inclusion of a knowledge translation discipline in stricto sensu graduate programs and the creation of an instance in the organizational structure of the science and technology institute to technically and managerially support the application of research results.

Resumen: La traslación del conocimiento (TC) tiene como propósito el uso práctico de los resultados de investigaciones científicas y el seguimiento de los beneficios causados a la salud de la población. En el área de la salud, el gobierno y, sobre todo, la sociedad esperan que las inversiones en investigaciones obtengan resultados que vayan más allá de la producción y publicación de conocimiento, y provoquen resultados, como políticas públicas, sistemas, productos y tecnologías en beneficio de la salud de la población. Sin embargo, se observa aun la necesidad de superar diversos desafíos para eliminar las brechas entre la investigación y la aplicación. El objetivo de este estudio es proponer estrategias con base en la identificación de barreras y factores facilitadores de un instituto de ciencia y tecnología (ICT) en salud, para fomentar el proceso de transformación del conocimiento científico generado en las investigaciones en acciones y productos que contribuyan a mejorar la salud de la población. Los relatos de las entrevistas a 16 investigadores permitieron identificar 10 categorías de barreras, con énfasis en: "financiación en CT&I limitado" y "apoyo técnico insuficiente para la traslación del conocimiento". "Infraestructura y apoyo institucional" fue la categoría de factores facilitadores más citada por los participantes. Finalmente, se desarrolló el artefacto "estrategias y enfoques para la superación de barreras a la implementación de resultados de investigación". Entre las estrategias, se sugiere la inclusión de una asignatura de TC en los programas de posgrado stricto sensu y la creación de una instancia en la estructura organizacional del ICT orientada a brindar apoyo técnico y gerencial a la aplicación de los resultados de la investigación.

Development of a Clinical Practice Guideline for Lower Limb Amputees. A Knowledge Translation Process in a Middle Income Country.

Background and Aim: Knowledge translation processes are necessary for improving patients' and communities' health outcomes. The aim of this study was to systematically develop evidence-based recommendations for people over 16 years of age who are in risk for or have suffered a lower limb amputation for medical reasons (vascular, diabetes mellitus) or trauma (civilian or military trauma) in order to improve function, quality of life, decrease complications and morbidity. Methods: Following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach we developed a Clinical Practice Guideline (CPG) for lower limb amputees with funding from the Ministry of Health in Colombia and participation of a multidisciplinary group. We included patients' preferences. Based on the scope, purposes and objectives the questions were elaborated with the PECOT strategy. The evidence search was performed for each question in the main databases: Cochrane Library, Embase and PubMed, without time limit or language restriction. Teams were formed with thematic experts and clinical epidemiologists to review the clinical studies, describe the evidence, and evaluate the quality of the body of evidence with the GRADE methodology. The recommendations were made according to the judgments proposed by the GRADE working group. We conducted a stakeholder's dialogue as a mechanism for the external validation of the guideline implementation. Results: The CPG included 43 recommendations related to the diagnosis, surgical treatment, rehabilitation, prescription and adaptation of the prosthesis. They were strong in favor 37.2, weak in favor 53.5, strong against 2.3, Weak against 7.0%. Quality of evidence was high in 0, moderate in 11.6, low in 58.1, and very low 30.2%. Discussion: In 93% of the recommendations, the quality of the evidence was between low and very low. This is why it was so important to validate and discuss each recommendation with an expanded multidisciplinary group. The research group identified 25 interventions and five milestones to be prioritized in the implementation and in the stakeholder's dialogue participants identified opportunities and barriers for implementation of recommendations. Conclusion: It is necessary to develop a national policy for implementation strategies of CPG recommendations that promotes the necessary arrangements for the provision of services for diagnosis, treatment, and rehabilitation of individuals with amputations.

Association Between Cross-Limb Transfer and Practice Organization.

Although the importance of practice has been evidenced in early studies of cross-limb transfer, the association between cross-limb transfer and practice organization remains unknown. The two primary means of organizing practice are constant practice (CP) and variable practice (VP). When the same generalized motor program governs the motor responses, VP produces better transfer than CP. Thus, we hypothesized that VP would generate a higher cross-limb transfer level than CP. We assigned 40 participants to CP or VP groups and conducted an experiment consisting of three phases: pre-test, practice, and transfer test. At pre-test, all participants practiced eight trials of a sequence key-pressing task with the non-dominant hand (NDH). After the pre-test, all participants performed a practice phase of 72 trials with the dominant hand, but CP and VP groups underwent their different practice schedules (CP or VP) such that the CP group practiced a sequence key-pressing task in one sequence, and the VP group practiced four different sequences randomly. On the transfer test all partcipants completed eight trials with the NDH 24 hours after the practice phase. The CP group showed better performance than the VP group on the transfer test, and we concluded that the effects of practice organization in cross-limb transfer are distinct from intra- and inter-task transfer such that the specificity of practice explained the benefits of CG.

Improving the adherence to COVID-19 preventive measures in the community: Evidence brief for policy.

Objectives: To identify evidence-based strategies to improve adherence to the preventive measures against the coronavirus disease (COVID-19) at the community level. Method: This is an evidence brief for policy, combining research evidence specific to contextual knowledge from stakeholders. A systematic search was performed in 18 electronic databases, gray literature, and a handle search, including only secondary and tertiary studies that focused on the adherence of the general population to COVID-19 preventive measures in the community. Two reviewers, independently, performed the study selection, data extraction, and assessment of the quality of the studies. Relevant evidence has been synthesized to draft evidence-based strategies to improve adherence. These strategies were circulated for external endorsement by stakeholders and final refinement. Endorsement rates >80%, 60-80% and <60% were considered high, moderate, and low respectively. Results: Eleven studies, with varying methodological qualities were included: high (n = 3), moderate (n = 3), low (n = 1), and critically low (n = 4). Three evidence based strategies were identified: i. Risk communication; ii. Health education to the general public, and iii. Financial support and access to essential supplies and services. The rates of endorsement were: 83% for risk communication, 83% for health education, and 92% for financial support and access to essential supplies and services. The evidence showed that an increase in knowledge, transparent communication, and public awareness about the risks of COVID-19 and the benefits of adopting preventive measures results in changes in people's attitudes and behavior, which can increase adherence. In addition, the guarantee of support and assistance provides conditions for people to adopt and sustain such measures. Conclusions: These strategies can guide future actions and the formulation of public policies to improve adherence to preventive measures in the community during the current COVID-19 pandemic and other epidemics.

Collaboration between health system decision makers and professional researchers to coproduce knowledge, a scoping review.

BACKGROUND: Recent literature uses different terms and approaches to the collaboration between researchers and health system decision-makers in the research process. In 2012, the World Health Organisation proposed to "Embed research within decision-making processes". Yet, important contributions use other terms and perspectives for the same issue. This scoping review aimed to identify these terms, approaches, their application and eventual influence on the utilization of evidence. METHODS: We searched papers published between January 2000 and February 2019 in English, Spanish, French and Portuguese in the databases of PubMed, Scielo, Google Scholar and EBSCOhost, thus accessing MedicLatina, MEDLINE Complete and eBook Collection. Our main inclusion criterion was the participation of health personnel in non-clinical research activities. We considered three domains for in depth analysis: Definition, name and description of the participation of decision makers and health staff; Forms of collaboration and actual/effective participation of health staff in research; Eventual influence on the utilization of research results. RESULTS: We identified 607 articles and selected 74 for full text analysis. Nineteen different terms are currently used in twelve countries to describe the participation of health decision-makers and staff in research activities. Most publications refer to Integrated Knowledge Translation or Embedded Research, and were published in Canada and the United Kingdom. Forty-five papers discuss the participation of health staff in research activities; 20 leading the whole process and 21 as collaborators. CONCLUSIONS: The identification of the different terms and approaches to the close collaboration of health staff and decision-makers with professional researchers is essential to promote its effective application and influence on the utilization of evidence. Yet, it is also necessary to insist in their co-participation throughout the whole investigation process as a relevant way to improve research results uptake, strengthen health systems and advance towards universal health coverage.

Strategies to promote evidence use for health programme improvement: learning from the experiences of embedded implementation research teams in Latin America and the Caribbean.

BACKGROUND: To achieve global health targets, innovative approaches are needed to strengthen the implementation of efficacious interventions. New approaches in implementation research that bring together health system decision-makers alongside researchers to collaboratively design, produce and apply research evidence are gaining traction. Embedded implementation research (EIR) approaches led by decision-maker principal investigators (DM PIs) appear promising in this regard. Our aim is to describe the strategies study teams employ in the post-research phase of EIR to promote evidence-informed programme or policy improvement. METHODS: We conducted a prospective, comparative case study of an EIR initiative in Bolivia, Colombia and Dominican Republic. Guided by a conceptual framework on EIR, we used semi-structured key informant interviews (n = 51) and document reviews (n = 20) to examine three decision-maker-led study teams ("cases"). Focusing on three processes (communication/dissemination, stakeholder engagement with evidence, integrating evidence in decision-making) and the main outcome (enacting improvements), we used thematic analysis to identify associated strategies and enabling or hindering factors. RESULTS: Across cases, we observed diverse strategies, shaped substantially by whether the DM PI was positioned to lead the response to study findings within their sphere of work. We found two primary change pathways: (1) DM PIs implement remedial measures directly, and (2) DM PIs seek to influence other stakeholders to respond to study findings. Throughout the post-research phase, EIR teams adapted research use strategies based on the evolving context. CONCLUSIONS: EIR led by well-positioned DM PIs can facilitate impactful research translation efforts. We draw lessons around the importance of (1) understanding DM PI positionality, (2) ongoing assessment of the evolving context and stakeholders and (3) iterative adaptation to dynamic, uncertain circumstances. Findings may guide EIR practitioners in planning and conducting fit-for-purpose and context-sensitive strategies to advance the use of evidence for programme improvement.