School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
The Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montreal, Quebec, Canada.
J Eval Clin Pract. 2021 Aug;27(4):836-846. doi: 10.1111/jep.13482. Epub 2020 Sep 25.
Despite the available evidence to support optimal practices in rehabilitation, significant knowledge practice gaps persist. Opinion leaders (OLs) and knowledge brokers (KBs) can enhance the success of knowledge translation (KT) interventions and improve uptake of best practices among clinicians. However, the literature on the mechanisms underpinning OLs'/KBs' activities, and guidance on the type of support needed for successful implementation of these roles in rehabilitation contexts is scarce. This research aimed to highlight the differences and similarities between OLs and KBs with respect to context, mechanism, and outcomes as well as describe the common patterns of OLs and KBs by creating a context-mechanism-outcomes configuration.
We conducted a realist review to synthesize the available evidence on OLs/KBs as active KT strategies. A search was conducted across five databases up to November 2019. Two independent reviewers extracted the data using a structured form. A context-mechanism-outcome configuration was used to conceptualize a cumulative portrait of the features of OLs/KBs roles.
The search identified 3282 titles after removing duplicates. Seventeen studies (reported in 20 articles) were included in the review. Findings suggest a number of desirable features of OLs/KBs roles that may maximize the achievement of targeted outcomes namely being (a) embedded within their organization as "insiders"; (b) adequately skilled to perform their role; (c) identified as able to fulfil the role; (d) appropriately trained; and (e) able to use different KT interventions.
Findings of this realist review converge to create a context-mechanism-outcomes configuration with suggestions to optimally utilize OLs/KBs in rehabilitation. The configurations suggest desirable features that can lead to a greater potential to achieve targeted goals. It is preferable that OLs/KBs be embedded in the organization and that they are adequately skilful and well-trained. Also, OLs/KBs should perform the required roles using KT interventions adapted to the local context.
尽管有支持康复最佳实践的现有证据，但仍存在显著的知识实践差距。意见领袖（OLs）和知识经纪人（KBs）可以增强知识转化（KT）干预措施的成功，并提高临床医生对最佳实践的接受度。然而，关于 OLs' / KBs 活动的基础机制以及关于在康复环境中成功实施这些角色所需支持类型的文献很少。本研究旨在突出 OLs 和 KBs 在背景、机制和结果方面的差异和相似之处，并通过创建上下文-机制-结果配置来描述 OLs 和 KBs 的常见模式。
我们进行了一项真实主义综述，以综合有关 OLs / KBs 作为积极 KT 策略的现有证据。从 2019 年 11 月之前的五个数据库中进行了搜索。两名独立的审查员使用结构化表格提取数据。使用上下文-机制-结果配置来概念化 OLs / KBs 角色的特征的累积画像。
搜索去除重复项后确定了 3282 个标题。有 17 项研究（在 20 篇文章中报道）被纳入综述。研究结果表明，OLs / KBs 角色的一些理想特征可能会最大限度地实现目标结果，这些特征包括：（a）作为“内部人员”嵌入其组织；（b）具备执行角色的适当技能；（c）被确定为能够履行角色；（d）接受适当的培训；（e）能够使用不同的 KT 干预措施。
本真实主义综述的研究结果汇聚在一起，创建了一个上下文-机制-结果配置，提出了在康复中最佳利用 OLs / KBs 的建议。配置建议了可以导致更大的实现目标潜力的理想特征。OLs / KBs 最好嵌入在组织中，并且他们应该具备足够的技能和良好的培训。此外，OLs / KBs 应该使用适合当地情况的 KT 干预措施来执行所需的角色。
