The Psychologists in Diabetes Group are a mix of psychologists working clinically in paediatric and adult diabetes services, and researchers working in the areas of health psychology and health services research in Ireland. One aim of our group is to support knowledge translation and exchange regarding the psychosocial impact of diabetes. Identifying effective ways to disseminate research findings to health service decision makers e.g. through knowledge translation activities, can enhance evidence-informed decision making (1). One type of knowledge translation activity is “exchange” which supports researchers, policy makers and senior managers to build and maintain relationships (2). We undertook an exchange activity, which sought to increase health-decision and policy makers’ awareness of the need to improve access to psychology services for people with diabetes in Ireland, and, to build relationships for knowledge translation and exchange between our group and health-decision and policy makers. We used Lavis and colleagues’ knowledge translation framework to guide the exchange activity design and delivery (3) (see Table 1).
Table 1. Description of the knowledge translation strategies used for the exchange activity.
| KT1 Framework component (3) | Strategy · Strategy rationale
| Application |
| To whom should research knowledge be transferred? | Health policy decision-makers (3) · We sought to transfer research and practice knowledge to those who can directly or indirectly influence relevant policy (3) | We met with an official from the Department of Health who provides expert medical and policy advice and assistance to the Minister for Health and liaises with other key health policy decision-makers i.e. the National Clinical Programme for Diabetes. |
| How should research knowledge be transferred? | An interactive engagement process (i.e. involving interaction) (3, 4) · Interactive engagement processes, versus passive ones, may be the most effective KT approach for any audience (3) | Representatives from our group had an in-person meeting with officials from the Department of Health. |
| What research knowledge should be transferred? | Policy brief and an oral presentation used as communication tools (4) · Actionable messages from synthesised research knowledge versus single research reports (1) and research in the form of “ideas,” not “data,” most influence decision making (5) | We prepared a policy brief and brought copies to the meeting. A member of our group gave an oral presentation outlining the research to practice gap. The policy brief and oral presentation contained actionable messages. |
| By whom should research knowledge be transferred? | Messenger credibility (6) · Messenger(s) should have credibility with the target audience, possess the skills and experience needed to transfer the research knowledge, and, have time and resources to do so (1, 6) | Six psychologists, two researchers, one person with diabetes and one knowledge broker attended the meeting.2 All contributors to the oral preparation and policy brief were listed on the presentation. This included the National Clinical Lead for the National Clinical Programme for Diabetes, who supported the meeting. |
1KT = Knowledge Translation, 2One group member is a researcher, diabetes psychologist practitioner and person with diabetes. One group member is a diabetes psychologist practitioner and acted as a knowledge broker between the group and the Health policy decision-makers.
Key learnings from this knowledge exchange activity included:
The importance of the knowledge broker role Knowledge brokers are uniquely positioned to connect research and decision making processes (2) (7). One member of our group, with experience of health system decision making structures and research structures, adopted this role for the purpose of this exchange activity. The knowledge broker role was instrumental in arranging the exchange activity and in framing our groups’ key message to fit with health-decision and policy makers’ goals and professional culture. This role remains pivotal in linking the group with other health-decision and policy makers identified during the exchange activity.
Using preferred modes of communication In preparation for and during the exchange activity we used established modes of dissemination to convey our message to decision makers; written policy brief, narrative descriptions and communicating as a group (8). Communicating as a group with a mix of research skills and clinical experience enabled us to ground our message in published evidence and address issues of importance to practitioners and people with diabetes and their carers. Preparing a policy brief encouraged us to convey a focused and actionable message and enabled us to initiate dialogue with other health-decision and policy makers. For instance, we disseminated our policy brief to a number of National Clinical Programmes within the health service to initiate dialogue with these groups.
The value of different sources of evidence We presented an overview of the current gaps in access to psychology services for people with diabetes in Ireland. The overview was informed by international systematic review evidence, international and national clinical guidelines, national audit data and clinical case studies. The use of narrative descriptions (clinical case studies and qualitative data of people with diabetes, parents/carers and healthcare providers) and an audit report of national data highlighting the “substantial deficits” in access to psychological care for people with diabetes in hospital settings (9) were effective ways of conveying the gap in access to services, as they drew the interest of the knowledge broker. This is in line with findings that case studies or narrative descriptions are considered a valid source of evidence for policymakers (6). The incorporation of practice-based research, conducted in Ireland, examining the effectiveness of psychological intervention for people with diabetes and their families may have strengthened our key message. This highlighted the importance of research evidence, which is embedded in clinical context to influence health-decision and policy makers.
The need to strategically plan knowledge exchange activities and processes This experience highlighted to us the issue of who should do such dissemination activities (7). This exchange activity supported us in identifying, and building relationships with health-decision and policy makers with whom the group can strategically engage e.g. the National Clinical Programme for Diabetes. Engagement with health-decision and policy makers supported us in identifying strategic actions to support our aim of knowledge translation and exchange on the psychosocial impact of diabetes. e.g. aligning our next steps with national policy, specifically with goal two of Sláintecare; ‘Provide high quality accessible and safe care that meets the needs of the population’. However, continuing to build and maintain relationships with identified decision makers and following through on identified strategic actions will be challenging given the nature of the group as a disparate group of busy people, for whom disseminating research is difficult to prioritise (8). To address this, the Psychologists in Diabetes group will continue to meet on a bimonthly basis to share knowledge and explore ways of continuing to support and advance knowledge translation in relation to the psychosocial impact of diabetes.
Undertaking this knowledge translation and exchange process helped us to identify and communicate effectively with the relevant health-decision and policy makers. This generated awareness among health-decision and policy makers of the research to practice gap in the provision of psychological services for people with diabetes in Ireland. Undertaking this knowledge exchange activity, initiated a longer knowledge translation and exchange process and supported us to strategically plan our next steps in addressing the challenge of providing psychological services for people with diabetes who need and can benefit from them.
Picture: Members of the Psychologists in Diabetes Group who participated in the knowledge translation activity. (l-r): Niamh McGrath, Katarzyna Gajewska, Sharon O’Sullivan, Mary Morrissey, Andrea Habenicht, Claire Crowe, Mairead Dempsey.
References
- Grimshaw JM, Eccles MP, Lavis JN, Hill SJ, Squires JE. Knowledge translation of research findings. Implementation science. 2012;7(1):50.
- Lomas J. The in-between world of knowledge brokering. Bmj. 2007;334(7585):129-32.
- Lavis JN, Robertson D, Woodside JM, McLeod CB, Abelson J. How can research organizations more effectively transfer research knowledge to decision makers? The Milbank Quarterly. 2003;81(2):221-48.
- Lavis JN, Permanand G, Oxman AD, Lewin S, Fretheim A. SUPPORT Tools for evidence-informed health Policymaking (STP) 13: Preparing and using policy briefs to support evidence-informed policymaking. Health Research Policy and Systems. 2009;7(1):S13.
- Weiss CH. Policy research: data, ideas, or arguments? In: Wittrock B, Weiss CH, Wollman H, Wagner P, editors. Social Sciences and Modern States: National Experiences and Theoretical Crossroads. Advances in Political Science. Cambridge: Cambridge University Press; 1991. p. 307-32.
- Shonkoff JP. Science, policy, and practice: Three cultures in search of a shared mission. Child development. 2000;71(1):181-7.
- Purtle J, Brownson RC, Proctor EK. Infusing science into politics and policy: The importance of legislators as an audience in mental health policy dissemination research. Administration and Policy in Mental Health and Mental Health Services Research. 2017;44(2):160-3.
- Otten JJ, Dodson EA, Fleischhacker S, Siddiqi S, Quinn EL. Peer Reviewed: Getting Research to the Policy Table: A Qualitative Study With Public Health Researchers on Engaging With Policy Makers. Preventing chronic disease. 2015;12.