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Implementation Science
Published in: Implementation Science 1/2010

Open Access 01-12-2010 | Research article

Using knowledge brokers to facilitate the uptake of pediatric measurement tools into clinical practice: a before-after intervention study

Authors: Dianne J Russell, Lisa M Rivard, Stephen D Walter, Peter L Rosenbaum, Lori Roxborough, Dianne Cameron, Johanna Darrah, Doreen J Bartlett, Steven E Hanna, Lisa M Avery

Published in: Implementation Science | Issue 1/2010

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Abstract

Background

The use of measurement tools is an essential part of good evidence-based practice; however, physiotherapists (PTs) are not always confident when selecting, administering, and interpreting these tools. The purpose of this study was to evaluate the impact of a multifaceted knowledge translation intervention, using PTs as knowledge brokers (KBs) to facilitate the use in clinical practice of four evidence-based measurement tools designed to evaluate and understand motor function in children with cerebral palsy (CP). The KB model evaluated in this study was designed to overcome many of the barriers to research transfer identified in the literature.

Methods

A mixed methods before-after study design was used to evaluate the impact of a six-month KB intervention by 25 KBs on 122 practicing PTs' self-reported knowledge and use of the measurement tools in 28 children's rehabilitation organizations in two regions of Canada. The model was that of PT KBs situated in clinical sites supported by a network of KBs and the research team through a broker to the KBs. Modest financial remuneration to the organizations for the KB time (two hours/week for six months), ongoing resource materials, and personal and intranet support was provided to the KBs. Survey data were collected by questionnaire prior to, immediately following the intervention (six months), and at 12 and 18 months. A mixed effects multinomial logistic regression was used to examine the impact of the intervention over time and by region. The impact of organizational factors was also explored.

Results

PTs' self-reported knowledge of all four measurement tools increased significantly over the six-month intervention, and reported use of three of the four measurement tools also increased. Changes were sustained 12 months later. Organizational culture for research and supervisor expectations were significantly associated with uptake of only one of the four measurement tools.

Conclusions

KBs positively influenced PTs' self-reported knowledge and self-reported use of the targeted measurement tools. Further research is warranted to investigate whether this is a feasible, cost-effective model that could be used more broadly in a rehabilitation setting to facilitate the uptake of other measurement tools or evidence-based intervention approaches.
Appendix
Available only for authorised users
Literature
1.
Haynes RB: What kind of evidence is it that Evidence-Based Medicine advocates want healthcare providers and consumers to pay attention to?. BMC Health Serv Res. 2002, 2: 3-10.1186/1472-6963-2-3.CrossRefPubMedPubMedCentral
2.
American Physical Therapy Association: Who are physical therapists and what do they do?. Phys Ther. 2001, 81: S31-42.
3.
Palisano RJ, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B: Development and Validation of a Gross Motor Function Classification System for children with cerebral palsy. Dev Med Child Neurol. 1997, 39: 214-223. 10.1111/j.1469-8749.1997.tb07414.x.CrossRefPubMed
4.
Palisano RJ, Rosenbaum P, Bartlett D, Livingstone M: Content validity of the expanded and revised Gross Motor Function Classification System. Dev Med Child Neurol. 2008, 50: 744-750. 10.1111/j.1469-8749.2008.03089.x.CrossRefPubMed
5.
Russell D, Rosenbaum P, Cadman D, Gowland C, Hardy S, Jarvis S: The Gross Motor Function Measure: A means to evaluate the effects of physical therapy. Dev Med Child Neurol. 1989, 31: 341-352. 10.1111/j.1469-8749.1989.tb04003.x.CrossRefPubMed
6.
Russell D, Avery L, Rosenbaum P, Raina P, Walter S, Palisano R: Improved scaling of the Gross Motor Function Measure for children with cerebral palsy: Evidence of reliability and validity. Phys Ther. 2000, 80: 873-885.PubMed
7.
Russell D, Rosenbaum P, Avery L, Lane M: The Gross Motor Function Measure (GMFM-66 andGMFM-88) User's Manual. 2002, London, MacKeith Press
8.
Avery LM, Russell DJ, Raina PS, Walter SD, Rosenbaum PL: Rasch analysis of the Gross Motor Function Measure: Validating the assumptions of the Rasch model to create an interval level measure. Arch Phys Med Rehab. 2003, 84: 697-705.CrossRef
9.
Rosenbaum PL, Walter SD, Hanna SE, Palisano RJ, Russell DJ, Raina P, Wood E, Bartlett DJ, Galuppi BE: Prognosis for Gross Motor Function in Cerebral Palsy: Creation of motor development curves. JAMA. 2002, 288: 1357-1363. 10.1001/jama.288.11.1357.CrossRefPubMed
10.
Russell D, Rosenbaum P, Lane M, Gowland C, Goldsmith C, Boyce W, Plews N: Training users in the Gross Motor Function Measure: Methodological and practical issues. Phys Ther. 1994, 74: 630-636.PubMed
11.
Lane M, Russell D: Gross Motor Function Measure (GMFM) Self-instructional Training CDROM [CD-ROM]. 2003, London, Mac Keith Press
12.
Palisano RJ, Hanna SE, Rosenbaum P, Russell DJ, Walter SD, Wood E, Raina P, Galuppi B: Validation of a model of gross motor function for children with cerebral palsy. Phys Ther. 2000, 80: 974-985.PubMed
13.
Russell DJ, Leung KM, Rosenbaum PL: Accessibility and perceived clinical utility of the GMFM-66: Evaluating therapists' judgements of a computer-based scoring program. Phys Occup Ther Pediatr. 2003, 23 (3): 45-58.PubMed
14.
Russell DJ, Gorter JW: Assessing functional differences in gross motor skills in children with cerebral palsy who use an ambulatory aid or orthoses: Can the GMFM-88 help?. Dev Med Child Neurol. 2005, 47: 462-467. 10.1017/S0012162205000897.CrossRefPubMed
15.
Palisano R, Cameron D, Rosenbaum PL, Walter SD, Russell D: Stability of the Gross Motor Function Classification System. Dev Med Child Neurol. 2006, 48: 424-428. 10.1017/S0012162206000934.CrossRefPubMed
16.
Rosenbaum PL, Palisano RJ, Bartlett DJ, Galuppi BE, Russell DJ: Development of the Gross Motor Function Classification System for cerebral palsy. Dev Med Child Neurol. 2008, 50: 249-253. 10.1111/j.1469-8749.2008.02045.x.CrossRefPubMed
17.
Hanna SE, Bartlett DJ, Rivard L, Russell DJ: Reference curves for the Gross Motor Function Measure (GMFM-66): Percentiles for clinical description and tracking over time among children with cerebral palsy. Phys Ther. 2008, 88: 596-607. 10.2522/ptj.20070314.CrossRefPubMedPubMedCentral
18.
Gorter JW, Ketelaar M, Rosenbaum P, Helders PJM, Palisano R: Use of the Gross Motor Function Classification System in infants with cerebral palsy: The need for reclassification at age 2 or older. Dev Med Child Neurol. 2009, 51: 46-52. 10.1111/j.1469-8749.2008.03117.x.CrossRefPubMed
19.
Hanna SE, Rosenbaum PL, Bartlett DJ, Palisano RJ, Walter SD, Avery L, Russell DJ: Stability and decline in gross motor function among children and youth with cerebral palsy aged 2 to 21 years. Dev Med Child Neurol. 2009, 51: 295-302. 10.1111/j.1469-8749.2008.03196.x.CrossRefPubMed
20.
Hanna SE, Russell DJ, Bartlett DJ, Kertoy ML, Rosenbaum PL, Wynn K: Measurement practices in pediatric rehabilitation: A survey of physical therapists, occupational therapists, and speech-language pathologists in Ontario. Phys Occup Ther Pediatr. 2007, 27: 25-42.PubMed
21.
Law M, King G, Russell D, MacKinnon E, Hurley P, Murphy C: Measuring outcomes in children's rehabilitation: A decision protocol. Arch Phys Med Rehabil. 1999, 80: 629-636. 10.1016/S0003-9993(99)90164-8.CrossRefPubMed
22.
Cochrane LJ, Olson CA, Murray S, Dupuis M, Tooman T, Hayes S: Gaps between knowing and doing: Understanding and assessing the barriers to optimal healthcare. J Contin Educ Health Prof. 2007, 27: 94-102. 10.1002/chp.106.CrossRefPubMed
23.
Saleh MN, Korner-Bitenskey N, Snider L, Malouin F, Mazer B, Kennedy E, Roy MA: Actual versus best practices for young children with cerebral palsy: A survey of paediatric occupational therapists and physical therapists in Quebec, Canada. Dev Neurorehabil. 2008, 11: 60-80. 10.1080/17518420701544230.CrossRefPubMed
24.
25.
Ketelaar M, Russell DJ, Gorter JW: The challenge of moving evidence-based measures into clinical practice: Lessons in knowledge translation. Phys Occup Ther Pediatr. 2008, 28: 191-206. 10.1080/01942630802192610.CrossRefPubMed
26.
Barwick MA, Peters J, Boydell K: Getting to uptake: Do communities of practice support the implementation of evidence-based practice?. J Can Acad Child Adolesc Psychiatry. 2009, 18: 16-29.PubMedPubMedCentral
27.
Menon A, Korner-Bitensky N, Kastner M, McGibbon A, Straus S: Strategies for rehabilitation professionals to move evidence based knowledge into practice: A systematic review. J Rehabil Med. 2009, 41: 1024-1032. 10.2340/16501977-0451.CrossRefPubMed
28.
29.
Dobbins M, Robeson P, Ciliska D, Hanna S, Cameron R, O'Mara L, DeCorby K, Mercer S: A description of a knowledge broker role implemented as part of a randomized controlled trial evaluating three knowledge translation strategies. Implement Sci. 2009, 4: 23-10.1186/1748-5908-4-23.CrossRefPubMedPubMedCentral
30.
Robeson P, Dobbins M, DeCorby K: Life as a knowledge broker in public health. Journal of the Canadian Health Libraries Association. 2008, 29: 79-82.CrossRef
31.
Dobbins M, Hanna SE, Ciliska D, Manske S, Cameron R, Mercer SL, O'Mara L, DeCorby K, Robeson P: A randomized controlled trial evaluating the impact of knowledge translation and exchange strategies. Implement Sci. 2009, 4: 61-10.1186/1748-5908-4-61.CrossRefPubMedPubMedCentral
32.
van Kammen J, Jansen C, Bonsel G, Kremer J, Evers J, Wladimoroff J: Technology assessment and knowledge brokering: The case of assisted reproduction in The Netherlands. Int J Technol Assess Healthcare. 2006, 22: 302-306.CrossRef
33.
Lyons R, Warner G, Langille L, Phillips SJ: Piloting knowledge brokers to promote integrated stroke care in Atlantic Canada. Evidence in action, acting on evidence: A casebook of health services and policy research knowledge translation stories. 2006, Ottawa, Canadian Institutes of Health Research, 57-60.
34.
Scott-Findlay S, Golden-Biddle K: Understanding how organizational culture shapes research use. J Nurs Adm. 2005, 35: 359-365.CrossRefPubMed
35.
Graham ID, Logan J, Harrison MB, Straus SE, Tetroe J, Caswell W, Robinson N: Lost in knowledge translation: Time for a map?. J Contin Educ Health Prof. 2006, 26: 13-24. 10.1002/chp.47.CrossRefPubMed
36.
Rivard LM, Russell DJ, Roxborough L, Ketelaar M, Bartlett D, Rosenbaum P, Promoting the use of measurement tools in practice: A mixed-methods study of the activities and experiences of physical therapist knowledge brokers. Phys Ther. 2010, 90: 1580-1590. 10.2522/ptj.20090408.CrossRefPubMed
37.
Fleuren M, Wiefferink K, Paulussen T: Determinants of innovation within healthcare organizations. Int J Qual Healthcare. 2004, 16 (2): 107-123. 10.1093/intqhc/mzh030.CrossRef
38.
Hedeker D: MIXNO: a computer program for mixed-effects nominal logistic regression. J Stat Software. 1999, 4 (5): 1-92.CrossRef
39.
Adams AS, Soumerai SB, Lomas J, Ross-Degnan D: Evidence of self-report bias in assessing adherence to guidelines. Int J Qual Healthcare. 1999, 11: 187-192. 10.1093/intqhc/11.3.187.CrossRef
40.
Russell D, Rivard L, Walter S, Roxborough L, Cameron D, Rosenbaum P, Bartlett D, Darrah J, Hanna S: Moving cerebral palsy research into practice: Do knowledge brokers make a difference?. Dev Med Child Neurol. 2009, 51 (Suppl. 2): 76-
41.
Russell D, Rivard L, Walter S, Rosenbaum P, Bartlett D, Roxborough L, Cameron D, Darrah J, Hanna S, Avery L: Knowledge brokers to facilitate evidence-based practice: Long-term follow-up of a successful knowledge translation strategy. Dev Med Child Neurol. 2009, 51 (Suppl. 5): 24-
Metadata
Title
Using knowledge brokers to facilitate the uptake of pediatric measurement tools into clinical practice: a before-after intervention study
Authors
Dianne J Russell
Lisa M Rivard
Stephen D Walter
Peter L Rosenbaum
Lori Roxborough
Dianne Cameron
Johanna Darrah
Doreen J Bartlett
Steven E Hanna
Lisa M Avery
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2010
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/1748-5908-5-92

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