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Knowledge Translation Research to Promote Behavior Changes in Rehabilitation: Use of Theoretical Frameworks and Tailored Interventions: A Scoping Review

Published:February 06, 2021DOI:https://doi.org/10.1016/j.apmr.2021.01.076

      Highlights

      • The Knowledge-to-Action Framework is the most frequently used theoretical approach.
      • Local evidence-based recommendations are more often implemented than clinical practice guidelines.
      • Coding knowledge translation strategies to consensus terminology facilitates comparison across studies.
      • Theory-informed tailored interventions are emerging in rehabilitation research.

      Abstract

      Objective

      To describe knowledge translation (KT) research as a means of changing practice behaviors in rehabilitation. We specifically aimed to explore how theories, models, and frameworks (TMFs) are used to guide KT, guide methods to tailor KT interventions, and evaluate outcomes. We hypothesized these methods would have increased over the past 10 years.

      Data Sources

      We identified articles through searches conducted using databases Cumulative Index to Nursing and Allied Health, MEDLINE, PubMed, Academic Search Premier, and previous reviews from January 2000 to April 2020. Search terms included physical therapy, occupational therapy, speech-language pathology, knowledge translation, and knowledge-to-action (KTA).

      Study Selection

      Two authors interpedently screened titles, abstracts, and full-text articles. Studies were included if behavior change of rehabilitation practitioners was measured. Systematic reviews, protocols, and capacity-building interventions were excluded.

      Data Extraction

      Three authors extracted information on study design, theoretical frameworks, intervention strategies, and outcome evaluation.

      Data Synthesis

      Fifty-six studies were included in the review. Sixteen (29%) reported the use of a theoretical framework to guide the KT process. Since 2013, the KTA framework was used 35% of the time. Twenty-two studies (39%) reported barrier assessments to tailor interventions, and 82% were published after 2013. However, barrier assessment in the local context was only conducted 64% of the time. Outcomes of tailored interventions were most frequently measured using chart audits (50%) and questionnaires (41%). Further, the link between KT theory, specific barriers, and selection of intervention strategies was not consistently described.

      Conclusions

      Over the past 7 years, there has been an increase in the use of KT TMFs and tailored interventions. Recommendations for future research include the use of TMFs to guide local barrier assessment, KT strategy selection, intervention development, and overall KT process and mapping barriers to selected intervention strategies.

      Keywords

      List of abbreviations:

      CFIR (Consolidated Framework for Implementation Research), ERIC (Expert Recommendations for Implementing Change), KT (knowledge translation), KTA (knowledge-to-action), PT (physical therapist), TMFs (theories), models (and frameworks)
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