Esmail Rosmin, Clement Fiona M, Holroyd-Leduc Jayna, Niven Daniel J, Hanson Heather M
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10 TRW Building, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
Alberta Health Services, Calgary, Alberta, Canada.
BMC Health Serv Res. 2021 Apr 29;21(1):401. doi: 10.1186/s12913-021-06382-8.
Health Technology Reassessment (HTR) is a process that systematically assesses technologies that are currently used in the health care system. The process results in four outputs: increase use or decrease use, no change, or de-adoption of a technology. Implementation of these outputs remains a challenge. The Knowledge Translation (KT) field enables to transfer/translate knowledge into practice. KT could help with implementation of HTR outputs. This study sought to identify which characteristics of KT theories, models, and frameworks could be useful, specifically for decreased use or de-adoption of a technology.
A qualitative descriptive approach was used to ascertain the perspectives of international KT and HTR experts on the characteristics of KT theories, models, and frameworks for decreased use or de-adoption of a technology. One-to-one semi-structured interviews were conducted from September to December 2019. Interviews were audio recorded and transcribed verbatim. Themes and sub-themes were deduced from the data through framework analysis using five distinctive steps: familiarization, identifying an analytic framework, indexing, charting, mapping and interpretation. Themes and sub-themes were also mapped to existing KT theories, models, and frameworks.
Thirteen experts from Canada, United States, United Kingdom, Australia, Germany, Spain, and Sweden participated in the study. Three themes emerged that illustrated the ideal traits: principles that were foundational for HTR, levers of change, and steps for knowledge to action. Principles included evidence-based, high usability, patient-centered, and ability to apply to the micro, meso, macro levels. Levers of change were characterized as positive, neutral, or negative influences for changing behaviour for HTR. Steps for knowledge to action included: build the case for HTR, adapt research knowledge, assess context, select interventions, and assess impact. Of the KT theories, models, and frameworks that were mapped, the Consolidated Framework for Implementation Research had most of the characteristics, except ability to apply to micro, meso, macro levels.
Characteristics that need to be considered within a KT theory, model, and framework for implementing HTR outputs have been identified. Consideration of these characteristics may guide users to select relevant KT theories, models, and frameworks to apply to HTR projects.
卫生技术评估（HTR）是一个系统评估当前在医疗保健系统中使用的技术的过程。该过程产生四种结果：增加使用或减少使用、无变化或淘汰某项技术。这些结果的实施仍然是一个挑战。知识转化（KT）领域能够将知识转化为实践。KT有助于HTR结果的实施。本研究旨在确定KT理论、模型和框架的哪些特征可能有用，特别是对于减少技术使用或淘汰技术。
采用定性描述方法，以确定国际KT和HTR专家对减少技术使用或淘汰技术的KT理论、模型和框架特征的看法。2019年9月至12月进行了一对一的半结构化访谈。访谈进行了录音并逐字转录。通过框架分析，使用五个独特步骤从数据中推导主题和子主题：熟悉、确定分析框架、索引、制表、映射和解释。主题和子主题也被映射到现有的KT理论、模型和框架。
来自加拿大、美国、英国、澳大利亚、德国、西班牙和瑞典的13位专家参与了该研究。出现了三个主题，说明了理想特征：HTR的基础原则、变革杠杆以及知识转化为行动的步骤。原则包括基于证据、高可用性、以患者为中心以及适用于微观、中观、宏观层面的能力。变革杠杆的特点是对HTR行为改变有积极、中性或负面影响。知识转化为行动的步骤包括：为HTR建立案例、调整研究知识、评估背景、选择干预措施以及评估影响。在所映射的KT理论、模型和框架中，实施研究综合框架具有大多数特征，但缺乏适用于微观、中观、宏观层面的能力。
已确定在用于实施HTR结果的KT理论、模型和框架中需要考虑的特征。考虑这些特征可能会指导用户选择相关的KT理论、模型和框架应用于HTR项目。
