By Caroline Poirrier, Akshara Valmeekanathan, Robert Borst and Taylor Williamson
The Canadian Institute of Health Research’s focus on communication, interaction, and tailoring information allows us to define the “what” of knowledge translation, yet the “how” continues to elude our grasp. To highlight new thinking on the “how”, the Translating Evidence to Action Thematic Working Group hosted a webinar on June 19th to understand the classification and institutionalization of knowledge translation platforms, or KTPs. In presentations by Nasreen Jessani, Robert Borst, Caroline Poirrier, and Akshara Valmeekanathan, the webinar provided a diverse panel of experts who highlighted key characteristics of platforms, examples of how they operate, and lessons learned about their creation.
Our presentations kicked off with Nasreen Jessani providing a primer on knowledge translation. She discussed the various influences on knowledge translation efforts, definitions of institutionalization, and a framework for understanding different models of connecting research producers and research users.
Next, Robert Borst described the use of ethnographic methods to study KTPs, identifying three types of mundane, or routine work that specifically relate to KTPs’ responsiveness and functioning: 1) embedding work; 2) institutional work; and 3) boundary work. In practice, these three types of work are intertwined. The embedding work focuses on KTPs’ use of existing supranational infrastructure, e.g. EVIPNet or Cochrane. Most platforms organized education and training programs, and created connections within and between existing organizations. At the same time, they remained part of their host universities, hospitals, and government offices. The KTPs distinguished themselves from their host organizations by negotiating boundaries, which allowed the platforms to retain a relatively formal structure while still being flexible and independent enough to organize their own knowledge translation activities. By emphasizing boundaries, institutionalization is approached as an ongoing process without a clear end that depends on the specific local circumstances. This perspective may be used to understand what KTPs do to become more, or less, institutionalized.
Third, Caroline Poirrier, presented a study that analyzed knowledge translation through the lens of “evidence translators” (e.g. evidence producers, policymakers, or intermediaries), examining who translators are, their roles, and the factors that facilitate or constrain their ability to perform those roles effectively. In the successful cases of knowledge translation, the policymaker-researcher link was firmly established, and informal knowledge translation platforms were created – either within the government or between the government and an evidence producer. Creating these KTPs required relationship building, co-creation of research questions around salient issues, and building ownership and buy-in around feasible solutions. One case led to the creation of a national council of evaluation with the mandate to evaluate all government social programs rigorously; in other cases, actors sought to institutionalize relationships between policymakers and researchers.
Finally, Akshara Valmeekanathan presented on the growing knowledge translation role of URCs. While URCs have a defined mission to strengthen the link between public health practice and academia, there is little literature exploring the KTP functions that they engender. Her study mapped 12 URCs against KTP functions across three categories – knowledge, dialogue and capacity – and 12 functions, outlined in the Knowledge Translation Toolkit. Designating URCs as KTPs posed key boundary-setting questions: Should a URC exhibit all functions of a KTP to be designated as one? And if a URC appears to perform multiple activities under one KTP category, but a few or none in others, can it still be considered a KTP? Despite these questions, URCs offered several structural advantages: offering dedicated financial and human resources, championing their unique reputation and branding, leveraging their semi-autonomous nature to go beyond traditional funding mechanisms, and encouraging faculty to think beyond publishing papers and take on a broader outlook towards policy influence.
The discussions that took place during this webinar identified the following three key themes:
- KTPs do not have static boundaries. Single-issue or ad hoc mechanisms are relatively common, but it is unclear if a KTP requires a more formalized mechanism, such as a University-based Research Center (URC) or other infrastructure that includes staff or administrative backing. These fuzzy boundaries are often a function of differing definitions of institutionalization. At a minimum, a KTP seems to require some mix of knowledge, dialogue and capacity functions. KTPs appear to be distinguished from advocacy platforms through an emphasis on independent, rigorous evidence for decision making.
- Despite the unclear boundaries, embedding KTPs into formal institutions, such as URCs, provides advantages over less formal mechanisms, including dedicated human and financial resources, unique branding and reputation, and semi-autonomous status; however, there are often large costs and competing priorities with establishing more formal mechanisms.
- Temporary arrangements led to formal platforms, as the value of arrangements become apparent. Factors for these informal mechanisms to become more institutionalized, e.g. the development of more formal relationships and collaborations, included the strength of relationships between researchers and policy makers, the extent of co-creation of research questions, and research user ownership and buy-in of solutions.
These presentations and discussions highlight the need to continue to explore the functions and boundaries of KTPs, the salience of research questions and solutions, and their institutional arrangements. While KTPs may have unclear boundaries, the goal of providing space for researchers and policymakers to own, produce, and interpret evidence is clear. Many different mechanisms, from formal arrangements to ad hoc processes, can be used to achieve this goal, and institutionalize the infrastructure, norms, and approaches that drive evidence-informed policy.