Effective interventions and knowledge are in existence to help solve health inequities around the globe. However, with limited knowledge uptake, and application many populations of the world remain disadvantaged on the matters concerning their health. According to KTDRR (2007), Graham and his associates developed the knowledge-to-Action (KTA) framework after reviewing action theories in the 2000s. The KTA framework is meant to be useful in informing the application of research knowledge by various stakeholders among them policymakers, practitioners, the public, and the patients. According to Davidson et al. (2015), the KTA process consists of the action and the knowledge creation components. This research discusses the KTA framework in detail and it application in improving hand hygiene compliance.
The KTA process tends to be dynamic and complex. KTDRR (2007) asserts that the two components of the KTA process lack a definite boundary among their various phases as well as between themselves. The action component phases can occur simultaneously or sequentially, and they can also be influenced by the knowledge-creation-component. According to KTDRR (2007) knowledge in the KTA process in most cases is conceptualized as research-based or empirically derived. Moreover, it incorporates other ways of knowing among them the experiential way of knowledge. Nevertheless, the KTA framework puts more emphasis on the presence of a collaboration between the knowledge users and the knowledge producers through the entire KTA process.
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The knowledge creation component has three unique phases including knowledge products/tools, knowledge synthesis, and knowledge inquiry. According to KTDRR (2007) knowledge creation appears like an inverted funnel with many pieces of knowledge at the knowledge inquiry phase. As knowledge moves to the next phases its vast pieces are reduced after undergoing the knowledge syntheses processes. Nevertheless, knowledge is further reduced to a small number of products or tools, which facilitates knowledge implementation. KTDRR (2007) asserts that as the knowledge moves through the entire process it is more refined and distilled thus becoming more applicable to the stakeholders. Therefore, the needs of potential users of knowledge can easily be incorporated into the various phases of knowledge creation, including formulating research questions such that they address the issues highlighted by the users, customizing information for various parties as well as customizing the dissemination methods to better reach the intended parties.
The action component encompasses all the activities necessary to apply the knowledge. Davidson et al. (2015) assert that the inventors of the KTA framework conceptualized the action component as a dynamic process, whereby the various phases in the cycle tend to influence each other as well as be affected by the process of knowledge creation. More often, the action cycle begins with a group of individuals or a single person identifying the issue and the knowledge necessary in solving it (KTDRR, 2007). The first action phase also needs to appraise knowledge itself on the aspects of usefulness and validity in solving the issue at hand, which is then adapted to cater for the problem at hand.
The second step in the action cycle involves assessing facilitators and barriers related to the potential adopters, knowledge itself as well as the setting where the knowledge is to be applied. Thus, with feedback on this phase one can start execution and develop a plan if possible as well as formulate strategies that enable the creation of awareness and implementing knowledge (KTDRR, 2007). After executing knowledge, the framework needs monitoring of the application. The monitoring process is important as it determines the plan and strategies effectiveness to allow modification or adjusting accordingly. Nevertheless, one also needs to evaluate the effects of applying the knowledge in the KTA process to ascertain whether the application has resulted in the desired outcomes among the practitioners, patients and to the system.
Below is an image of the Knowledge-to-Action Process according to (KTDRR, 2007)
In the healthcare system implementing a research-based type of knowledge in the real-life situation is challenging with many riddled barriers. For example, improving hand hygiene compliance requires synthesizing the available data on the subject matter and then contextualize the resulting knowledge before the implementation process. Tailoring is also necessary when introducing evidence-based knowledge interventions in healthcare practice to help overcome the various local barriers. According to KTDRR (2007), improving hand hygiene compliance is prone to some form of local barriers such as water inadequacies, lack of knowledge of the importance of the approach, lack of money to purchase the soaps and sanitizers. Therefore, the Generation of knowledge and its implementation of new and existing solutions according to the KTA process is a cyclical process.
The application of the KTA process to improve hand hygiene compliance is necessary. This process allows one to assess the effectiveness through analyzing the problems at every stage of knowledge inquiry, synthesis, as well as the exchange process, therefore allowing one to record them in discussion forums, and reports hence develop a solution to the issue. According to KTDRR (2007), the action phases in the KTA framework tend to be unidirectional such that every action phase is capable of being influenced by the phase preceding it or the other way round. Therefore, while employing the KTA framework to improve hand hygiene compliance and noticing the information is not employed as intended, the outline emphasizes on reviewing the strategies and plans for improvement of the knowledge uptake.
To improve hand hygiene compliance, the KTA framework requires that knowledge be adapted such that it fits with the local context. Moreover, sustaining the knowledge use one ought to anticipate changes that may come thus adapting accordingly for more effective results (KTDRR, 2007). The KTA framework is the most effective in improving hand hygiene compliance, as it is more detailed explaining clearly, what is necessary for effective results in improving hand hygiene compliance.
References
Davison, C., Ndumbe-Eyoh, S., & Clement, C. (2015). A critical examination of knowledge to action models and implications for promoting health equity. International Journal For Equity In Health , 14 (59). Retrieved 22 September 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4460698/ .
Knowledge Translation for Disability & Rehabilitation Research (KTDRR). (2007). Knowledge Translation: Introduction to Models, Strategies, and Measures [Ebook]. The National Center for the Dissemination of Disability Research. Retrieved 22 September 2020, from https://ktdrr.org/ktlibrary/articles_pubs/ktmodels/.
