1. The power of tailored messaging:
Preliminary results from
Canada’s first trial on knowledge
brokering
Maureen Dobbins RN, PhD
Kara DeCorby, MSc
Paula Robeson RN, MScN
Donna Cilisaka, RN, PhD
Helen Thomas, RN, MSc
Steve Hanna, PhD
Steve Manske, PhD
Shawna Mercer, PhD
Linda O’Mara
Roy, Cameron, PhD

2. Research Objectives
• evaluate the effectiveness of
knowledge transfer and exchange (KTE)
strategies
• promote evidence-informed decision
making (EIDM) in public health
• evaluate the usefulness of health-
evidence.ca
Canadian Cochrane Colloquium
February 12, 2007

3. Rationale
• a KT strategy is needed to move effective
research into public health policies and
programs
• the promotion of physical activity and healthy
body weight is a priority in the Canadian
health care system
• The feasibility and impact of a knowledge
broker (KB) needs further exploration within
the health care sector
Canadian Cochrane Colloquium
February 12, 2007

4. Study Design
• RCT
• Canadian health units (n=108)
• Unit of analysis - organization
• Study Participants - person most responsible and
actively involved in decisions related to physical
activity & healthy body weight program/policy
Canadian Cochrane Colloquium
February 12, 2007

5. Intervention
• 3 progressively more active intervention groups:
Control
Access to an online registry of effectiveness evidence at
health-evidence.ca
Tailored Messaging
Registry access + targeted messages containing
summaries and full text to 8 systematic reviews
Knowledge Brokering
Registry access + targeted messages + one-to-one
interaction with a knowledge broker
Canadian Cochrane Colloquium
February 12, 2007

6. Hypotheses
• The greater the intensity of the KT strategy
the greater the incorporation of evidence
• Specific characteristics of the organization will
explain variation between health units
• The greater the level of interaction in the KT
strategy the greater the satisfaction DM will
report on the usefulness of the intervention
Canadian Cochrane Colloquium
February 12, 2007

7. Health-evidence.ca
• accessible online registry of reviews of the
effectiveness of public health and health
promotion interventions
• approx 80% of 2,000 current registered users
are Canadian with the remaining 20% consisting
mainly of users from the U.S., Australia, and the
U.K.
• largest user groups are: public health nurses,
program managers, health promotion workers,
researchers, and program coordinators followed
by librarians, dieticians, medical officers of
health, and nutritionists.
Canadian Cochrane Colloquium
February 12, 2007

8. Scope of brokering activities:
• support
• mentoring
• knowledge & skill development
• resource development
• dissemination
• facilitating KT activities within
organizations
Canadian Cochrane Colloquium
February 12, 2007

9. Logistics:
• Fall 2004 – baseline survey and re-survey
• Fall/Winter 2004 – document collection
• October 2004 – KB hiring and orientation
• Jan – Dec 2005 – KT intervention
implemented
• February 2006 – post-intervention survey
• January 2007 – one-year follow-up and
qualitative interviews
Canadian Cochrane Colloquium
February 12, 2007

10. Knowledge utilization survey
• Specific outcome measures include:
– Incorporation of results of the
disseminated reviews into policy and/or
programming decision making processes
– Impact of results of the systematic reviews
on actual physical activity and healthy
body weight policy/programs
– The decision-making process itself
– Decision makers’ satisfaction with the KT
strategy
Canadian Cochrane Colloquium
February 12, 2007

11. Data Analysis
• KU survey data analysis using SPSS
15.0
• Qualitative data analysis by two
reviewers using Nvivo 2.0
– Data sources: health unit
documents, broker’s daily
reflective journal, in-depth
interviews
Canadian Cochrane Colloquium
February 12, 2007

12. Preliminary quantitative results
• 76% participation rate
• No significant differences between groups at
baseline
• 81.5% follow-up rate (post intervention)
• Tailored messaging was significantly more
effective in promoting EIDM compared to
knowledge brokering or control (p<.009)
• Extent to which organization valued
research evidence had a significant, but
differential impact on treatment effect
Canadian Cochrane Colloquium
February 12, 2007

13. Canadian Cochrane Colloquium
February 12, 2007

14. Qualitative Results
• Qualitative findings demonstrate a positive
effect of the KB on incorporation of
research results into decision making,
including:
– Increased value placed on EIDM,
knowledge and skill development in
the evidence-based process
– Increased value placed on KB’s role
in overcoming barriers
Canadian Cochrane Colloquium
February 12, 2007

15. Knowledge broker reflections
• common issues and needs
• identification of needs
• early personal contact
– Knowledge and skill development
– Advocacy efforts re organizational
change
– Development of supportive networks
– access to useful practical quality
resources
– use of systematic reviews
Canadian Cochrane Colloquium
February 12, 2007

16. Implications for Policy and Practice
• Unclear why we found these results and how to
interpret
• EIDM process is slow
• Outcomes need to be measured in the long term
• Impact of knowledge brokering is much more
complex than previously considered and very
difficult to measure objectively
• More empirical research on knowledge brokers is
needed
• Need to continue to develop capacity among
public health DM
Canadian Cochrane Colloquium
February 12, 2007

17. Looking ahead:
• Currently conducting qualitative interviews to
help explain quantitative results
• Developing a multi-year grant to continue to
evaluate the impact of brokering and tailored
messaging in the long-term
• Expanding focus to measure organizational
characteristics (precursors to EIDM)
Canadian Cochrane Colloquium
February 12, 2007

18. Acknowledgements
The research project gratefully acknowledges
the support of:
• Canadian Institutes of Health Research
(CIHR)
• The City of Hamilton Public Health Research,
Education and Development (PHRED)
Program
Canadian Cochrane Colloquium
February 12, 2007