Knowledge translation: a case study on pneumonia research and clinical guidelines in a low- income country
Identifieur interne : 000237 ( Main/Exploration ); précédent : 000236; suivant : 000238Knowledge translation: a case study on pneumonia research and clinical guidelines in a low- income country
Auteurs : Sophie Goyet [Cambodge] ; Hubert Barennes [France] ; Therese Libourel [France] ; Johan Van Griensven [Cambodge, Belgique] ; Roger Frutos [France] ; Arnaud Tarantola [Cambodge]Source :
- Implementation Science : IS [ 1748-5908 ] ; 2014.
Abstract
The process and effectiveness of knowledge translation (KT) interventions targeting policymakers are rarely reported. In Cambodia, a low-income country (LIC), an intervention aiming to provide evidence-based knowledge on pneumonia to health authorities was developed to help update pediatric and adult national clinical guidelines. Through a case study, we assessed the effectiveness of this KT intervention, with the goal of identifying the barriers to KT and suggest strategies to facilitate KT in similar settings.
An extensive search for all relevant sources of data documenting the processes of updating adult and pediatric pneumonia guidelines was done. Documents included among others, reports, meeting minutes, and email correspondences. The study was conducted in successive phases: an appraisal of the content of both adult and pediatric pneumonia guidelines; an appraisal of the quality of guidelines by independent experts, using the AGREE-II instrument; a description and modeling of the KT process within the guidelines updating system, using the Unified Modeling Language (UML) tools 2.2; and the listing of the barriers and facilitators to KT we identified during the study.
The first appraisal showed that the integration of the KT key messages in pediatric and adult guidelines varied with a better efficiency in the pediatric guidelines. The overall AGREE-II quality assessments scored 37% and 44% for adult and pediatric guidelines, respectively. Scores were lowest for the domains of ‘rigor of development’ and ‘editorial independence.’ The UML analysis highlighted that time frames and constraints of the involved stakeholders greatly differed and that there were several missed opportunities to translate on evidence into the adult pneumonia guideline. Seventeen facilitating factors and 18 potential barriers to KT were identified. Main barriers were related to the absence of a clear mandate from the Ministry of Health for the researchers and to a lack of synchronization between knowledge production and policy-making.
Study findings suggest that stakeholders, both researchers and policy makers planning to update clinical guidelines in LIC may need methodological support to overcome the expected barriers.
Url:
DOI: 10.1186/1748-5908-9-82
PubMed: 24969242
PubMed Central: 4094455
Affiliations:
- Belgique, Cambodge, France
- Aquitaine, Languedoc-Roussillon, Nouvelle-Aquitaine, Occitanie (région administrative)
- Bordeaux, Montpellier, Paris
- Université Montpellier 2, Université de Bordeaux
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Le document en format XML
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2, CPBS, UMR 5236 CNRS-UM1-UM2, Montpellier, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université Montpellier 2, CPBS, UMR 5236 CNRS-UM1-UM2, Montpellier</wicri:regionArea><placeName><settlement type="city">Montpellier</settlement></placeName><orgName type="university">Université Montpellier 2</orgName><placeName><settlement type="city">Montpellier</settlement><region type="region" nuts="2">Occitanie (région administrative)</region><region type="old region" nuts="2">Languedoc-Roussillon</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I9">Intertryp, UMR 17, IRD-Cirad, Campus international de Baillarguet, 34398 Montpellier, Cedex 5, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Intertryp, UMR 17, IRD-Cirad, Campus international de Baillarguet, 34398 Montpellier, Cedex 5</wicri:regionArea><wicri:noRegion>Cedex 5</wicri:noRegion><wicri:noRegion>Cedex 5</wicri:noRegion></affiliation></author><author><name sortKey="Tarantola, Arnaud" sort="Tarantola, Arnaud" uniqKey="Tarantola A" first="Arnaud" last="Tarantola">Arnaud Tarantola</name><affiliation wicri:level="1"><nlm:aff id="I1">Epidemiology and Public Health Unit, Institut Pasteur, Phnom Penh, Cambodia</nlm:aff><country xml:lang="fr">Cambodge</country><wicri:regionArea>Epidemiology and Public Health Unit, Institut Pasteur, Phnom Penh</wicri:regionArea><wicri:noRegion>Phnom Penh</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24969242</idno><idno type="pmc">4094455</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4094455</idno><idno type="RBID">PMC:4094455</idno><idno type="doi">10.1186/1748-5908-9-82</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000293</idno><idno type="wicri:Area/Pmc/Curation">000293</idno><idno type="wicri:Area/Pmc/Checkpoint">000199</idno><idno type="wicri:Area/Ncbi/Merge">000249</idno><idno 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uniqKey="Barennes H" first="Hubert" last="Barennes">Hubert Barennes</name><affiliation wicri:level="1"><nlm:aff id="I2">Agence Nationale de recherche sur le SIDA et les hépatites, Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Agence Nationale de recherche sur le SIDA et les hépatites, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="I3">ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Université de Bordeaux, F-33000 Bordeaux, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Université de Bordeaux, F-33000 Bordeaux</wicri:regionArea><placeName><region type="region" nuts="2">Nouvelle-Aquitaine</region><region type="old region" nuts="2">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName><orgName type="university">Université de Bordeaux</orgName></affiliation><affiliation wicri:level="3"><nlm:aff id="I4">INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000 Bordeaux</wicri:regionArea><placeName><region type="region" nuts="2">Nouvelle-Aquitaine</region><region type="old region" nuts="2">Aquitaine</region><settlement type="city">Bordeaux</settlement></placeName></affiliation></author><author><name sortKey="Libourel, Therese" sort="Libourel, Therese" uniqKey="Libourel T" first="Therese" last="Libourel">Therese Libourel</name><affiliation wicri:level="4"><nlm:aff id="I5">Université Montpellier 2, UMR Espace Dev, IRD-UM2-UAG-ULR, Montpellier, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université Montpellier 2, UMR Espace Dev, IRD-UM2-UAG-ULR, Montpellier</wicri:regionArea><placeName><settlement type="city">Montpellier</settlement></placeName><orgName type="university">Université Montpellier 2</orgName><placeName><settlement type="city">Montpellier</settlement><region type="region" nuts="2">Occitanie (région administrative)</region><region type="old region" nuts="2">Languedoc-Roussillon</region></placeName></affiliation></author><author><name sortKey="Van Griensven, Johan" sort="Van Griensven, Johan" uniqKey="Van Griensven J" first="Johan" last="Van Griensven">Johan Van Griensven</name><affiliation wicri:level="1"><nlm:aff id="I6">Sihanouk Hospital Center of HOPE, Phnom Penh, Cambodia</nlm:aff><country xml:lang="fr">Cambodge</country><wicri:regionArea>Sihanouk Hospital Center of HOPE, Phnom Penh</wicri:regionArea><wicri:noRegion>Phnom Penh</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I7">Institute of Tropical Medicine, Antwerp, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Institute of Tropical Medicine, Antwerp</wicri:regionArea><wicri:noRegion>Antwerp</wicri:noRegion></affiliation></author><author><name sortKey="Frutos, Roger" sort="Frutos, Roger" uniqKey="Frutos R" first="Roger" last="Frutos">Roger Frutos</name><affiliation wicri:level="4"><nlm:aff id="I8">Université Montpellier 2, CPBS, UMR 5236 CNRS-UM1-UM2, Montpellier, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université Montpellier 2, CPBS, UMR 5236 CNRS-UM1-UM2, Montpellier</wicri:regionArea><placeName><settlement type="city">Montpellier</settlement></placeName><orgName type="university">Université Montpellier 2</orgName><placeName><settlement type="city">Montpellier</settlement><region type="region" nuts="2">Occitanie (région administrative)</region><region type="old region" nuts="2">Languedoc-Roussillon</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I9">Intertryp, UMR 17, IRD-Cirad, Campus international de Baillarguet, 34398 Montpellier, Cedex 5, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Intertryp, UMR 17, IRD-Cirad, Campus international de Baillarguet, 34398 Montpellier, Cedex 5</wicri:regionArea><wicri:noRegion>Cedex 5</wicri:noRegion><wicri:noRegion>Cedex 5</wicri:noRegion></affiliation></author><author><name sortKey="Tarantola, Arnaud" sort="Tarantola, Arnaud" uniqKey="Tarantola A" first="Arnaud" last="Tarantola">Arnaud Tarantola</name><affiliation wicri:level="1"><nlm:aff id="I1">Epidemiology and Public Health Unit, Institut Pasteur, Phnom Penh, Cambodia</nlm:aff><country xml:lang="fr">Cambodge</country><wicri:regionArea>Epidemiology and Public Health Unit, Institut Pasteur, Phnom Penh</wicri:regionArea><wicri:noRegion>Phnom Penh</wicri:noRegion></affiliation></author></analytic><series><title level="j">Implementation Science : IS</title><idno type="eISSN">1748-5908</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The process and effectiveness of knowledge translation (KT) interventions targeting policymakers are rarely reported. In Cambodia, a low-income country (LIC), an intervention aiming to provide evidence-based knowledge on pneumonia to health authorities was developed to help update pediatric and adult national clinical guidelines. Through a case study, we assessed the effectiveness of this KT intervention, with the goal of identifying the barriers to KT and suggest strategies to facilitate KT in similar settings.</p></sec><sec><title>Methods</title><p>An extensive search for all relevant sources of data documenting the processes of updating adult and pediatric pneumonia guidelines was done. Documents included among others, reports, meeting minutes, and email correspondences. The study was conducted in successive phases: an appraisal of the content of both adult and pediatric pneumonia guidelines; an appraisal of the quality of guidelines by independent experts, using the AGREE-II instrument; a description and modeling of the KT process within the guidelines updating system, using the Unified Modeling Language (UML) tools 2.2; and the listing of the barriers and facilitators to KT we identified during the study.</p></sec><sec><title>Results</title><p>The first appraisal showed that the integration of the KT key messages in pediatric and adult guidelines varied with a better efficiency in the pediatric guidelines. The overall AGREE-II quality assessments scored 37% and 44% for adult and pediatric guidelines, respectively. Scores were lowest for the domains of ‘rigor of development’ and ‘editorial independence.’ The UML analysis highlighted that time frames and constraints of the involved stakeholders greatly differed and that there were several missed opportunities to translate on evidence into the adult pneumonia guideline. Seventeen facilitating factors and 18 potential barriers to KT were identified. Main barriers were related to the absence of a clear mandate from the Ministry of Health for the researchers and to a lack of synchronization between knowledge production and policy-making.</p></sec><sec><title>Conclusions</title><p>Study findings suggest that stakeholders, both researchers and policy makers planning to update clinical guidelines in LIC may need methodological support to overcome the expected barriers.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Chopra, M" uniqKey="Chopra M">M Chopra</name></author><author><name sortKey="Mason, E" uniqKey="Mason E">E Mason</name></author><author><name sortKey="Borrazzo, J" uniqKey="Borrazzo J">J Borrazzo</name></author><author><name sortKey="Campbell, H" uniqKey="Campbell H">H Campbell</name></author><author><name sortKey="Rudan, I" uniqKey="Rudan I">I Rudan</name></author><author><name sortKey="Liu, L" uniqKey="Liu L">L Liu</name></author><author><name sortKey="Black, 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Harrison</name></author><author><name sortKey="Graham, Id" uniqKey="Graham I">ID Graham</name></author><author><name sortKey="Van Den Hoek, J" uniqKey="Van Den Hoek J">J van den Hoek</name></author><author><name sortKey="Dogherty, Ej" uniqKey="Dogherty E">EJ Dogherty</name></author><author><name sortKey="Carley, Me" uniqKey="Carley M">ME Carley</name></author><author><name sortKey="Angus, V" uniqKey="Angus V">V Angus</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ward, V" uniqKey="Ward V">V Ward</name></author><author><name sortKey="House, A" uniqKey="House A">A House</name></author><author><name sortKey="Hamer, S" uniqKey="Hamer S">S Hamer</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Belgique</li><li>Cambodge</li><li>France</li></country><region><li>Aquitaine</li><li>Languedoc-Roussillon</li><li>Nouvelle-Aquitaine</li><li>Occitanie (région administrative)</li></region><settlement><li>Bordeaux</li><li>Montpellier</li><li>Paris</li></settlement><orgName><li>Université Montpellier 2</li><li>Université de Bordeaux</li></orgName></list><tree><country name="Cambodge"><noRegion><name sortKey="Goyet, Sophie" sort="Goyet, Sophie" uniqKey="Goyet S" first="Sophie" last="Goyet">Sophie Goyet</name></noRegion><name sortKey="Tarantola, Arnaud" sort="Tarantola, Arnaud" uniqKey="Tarantola A" first="Arnaud" last="Tarantola">Arnaud Tarantola</name><name sortKey="Van Griensven, Johan" sort="Van Griensven, Johan" uniqKey="Van Griensven J" first="Johan" last="Van Griensven">Johan Van Griensven</name></country><country name="France"><noRegion><name sortKey="Barennes, Hubert" sort="Barennes, Hubert" uniqKey="Barennes H" first="Hubert" last="Barennes">Hubert Barennes</name></noRegion><name sortKey="Barennes, Hubert" sort="Barennes, Hubert" uniqKey="Barennes H" first="Hubert" last="Barennes">Hubert Barennes</name><name sortKey="Barennes, Hubert" sort="Barennes, Hubert" uniqKey="Barennes H" first="Hubert" last="Barennes">Hubert Barennes</name><name sortKey="Frutos, Roger" sort="Frutos, Roger" uniqKey="Frutos R" first="Roger" last="Frutos">Roger Frutos</name><name sortKey="Frutos, Roger" sort="Frutos, Roger" uniqKey="Frutos R" first="Roger" last="Frutos">Roger Frutos</name><name sortKey="Libourel, Therese" sort="Libourel, Therese" uniqKey="Libourel T" first="Therese" last="Libourel">Therese Libourel</name></country><country name="Belgique"><noRegion><name sortKey="Van Griensven, Johan" sort="Van Griensven, Johan" uniqKey="Van Griensven J" first="Johan" last="Van Griensven">Johan Van Griensven</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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