Cited by 227Health Policy Implementation ScienceHealth Sciences Research and EducationClinical practice guidelines implementation

The DOI matches its Crossref record; 27 of the 27 references it cites were found in a registry or an index; 1 of the 31 sources its claims cite were checked for support.

Scoping review identifies significant number of knowledge translation theories, models, and frameworks with limited use

Open access

Abstract

Objectives To conduct a scoping review of knowledge translation (KT) theories, models, and frameworks that have been used to guide dissemination or implementation of evidence-based interventions targeted to prevention and/or management of cancer or other chronic diseases.Study design and setting We used a comprehensive multistage search process from 2000 to 2016, which included traditional bibliographic database searching, searching using names of theories, models and frameworks, and cited reference searching. Two reviewers independently screened the literature and abstracted the data.Results We found 596 studies reporting on the use of 159 KT theories, models, or frameworks. A majority (87%) of the identified theories, models, or frameworks were used in five or fewer studies, with 60% used once. The theories, models, and frameworks were most commonly used to inform planning/design, implementation and evaluation activities, and least commonly used to inform dissemination and sustainability/scalability activities. Twenty-six were used across the full implementation spectrum (from planning/design to sustainability/scalability) either within or across studies. All were used for at least individual-level behavior change, whereas 48% were used for organization-level, 33% for community-level, and 17% for system-level change.Conclusion We found a significant number of KT theories, models, and frameworks with a limited evidence base describing their use.

Overview

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Written from the paper’s full text.

TL;DR

This scoping review identified 596 studies reporting on the use of 159 knowledge translation (KT) theories, models, or frameworks to guide dissemination or implementation of evidence-based interventions for cancer or other chronic diseases. Most identified KT theories, models, and frameworks had limited use, with 87% used in five or fewer studies and 60% used once.

Key findings

  • The review included 596 studies plus 47 companion reports, reporting on 159 KT theories, models, or frameworks used to guide 627 KT interventions to disseminate or implement 927 clinical interventions.
  • 139 (87%) of the theories, models, or frameworks were used in five or fewer studies, and 95 (60%) were used once; the three most frequently used were Bandura’s Social Cognitive Theory (168 studies), Prochaska and DiClemente’s Transtheoretical Model of Behavior Change (141 studies), and Rosenstock’s Health Belief Model (67 studies).
  • The theories, models, or frameworks were most commonly used to inform planning/design (81%), implementation (67%), and evaluation (55%) activities, and least commonly used to inform dissemination (32%) and sustainability/scalability (23%) activities; 26 were used across the full implementation spectrum.
  • All 159 were used for at least individual-level behavior change, while 48% were used for organization-level, 33% for community-level, and 17% for system-level change; 11% addressed all four levels of behavior change.

Methods

  • Scoping review following Arksey and O’Malley and the Joanna Briggs Institute Reviewers’ Manual, reported using PRISMA; an integrated KT approach engaged knowledge users at all phases.
  • Comprehensive multistage search from 2000–2016 included bibliographic databases (MEDLINE, EMBASE, PsycINFO), named theory/model/framework searching, cited reference searching, grey literature, and reference-list screening; the BeHEMoTh framework informed the search, and 305 names of KT theories, models, or frameworks were compiled.
  • Two reviewers independently screened titles/abstracts and full texts, with calibration exercises and discrepancies resolved by consensus or a third reviewer; data were abstracted on study, theory/model/framework, and KT intervention characteristics, and synthesis included subgroup analyses by context, stage of care, and level of behavior change.

Limitations

  • The paper states potential misclassification of theories, models, and frameworks because study authors used terms inconsistently; it also states English-language restriction, exclusion of book chapters, focus on cancer and other chronic diseases, no assessment of the limitations or validity evidence of the theories/models/frameworks, no quality appraisal of included studies, and no contact with authors for missing information.
  • The paper states that using the Knowledge-to-Action stages in a linear approach may not capture the iterative nature of KT work, and that the operational definition of theory/model/framework could have affected the number identified and included.
  • Evident from the text: the search ended in 2016, so theories, models, or frameworks published after that period would not be captured; the paper also cautions against using frequency of use as an indicator of quality.

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Integrity signals

Registry

Crossref · 10.1016/j.jclinepi.2018.04.008

Cites

27 of 27 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

40 Own result · 23 Not checked yet · 13 Own method · 7 Own interpretation · 1 Partly supported · 1 No basis given · accuracy not yet measured

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  • It may state two separate claims as one. 27
  • The quote only partly states this claim. 1
  • Probably not a substantial claim. 33
51 of 51
  • The paper relies on this without support.

    The theories, models or frameworks reported in the included studies were accurately identified from the published reports.

    “To optimize feasibility, we did not contact study authors for clarity on the theories, models or frameworks used, or to obtain information missing from the included study.”
  • The paper relies on this without support.

    The search strategy achieved literature saturation for knowledge translation theories, models and frameworks.

    “Finally, to ensure literature saturation, we searched for additional articles by screening the reference lists of relevant systematic reviews identified during the first three stages of screening.”
  • The paper relies on this without support.

    The included studies' reports of using a knowledge translation theory, model or framework to guide dissemination or implementation are sufficient to characterize its use.

    “Articles were excluded if they mentioned a KT theory, model or framework (e.g., in the introduction or discussion sections) without reporting on using it to guide dissemination or implementation of a KT intervention.”
  • The authors state this as an assumption.

    The stages of the Knowledge-to-Action cycle can be used in a linear approach to frame the review, even though the cycle is intended to be used iteratively.

    “While we used the stages of the Knowledge-to-Action cycle in a linear approach to frame this review, this is not how the cycle was intended to be used.”
  • The paper relies on this without support.

    The 159 identified knowledge translation theories, models or frameworks are distinct entities and not overlapping or synonymous.

    “We identified 159 different KT theories, models and frameworks.”
  • The paper relies on this without support.

    End users have difficulty identifying an appropriate KT theory, model or framework to inform their work.

    “A decision support tool to help end users identify an appropriate KT theory, model or framework to inform their work would therefore be highly beneficial.”
  • The authors state this as an assumption.

    No larger review of KT theories, models and frameworks exists.

    “making it the largest review of KT theories, models and frameworks to our knowledge.”
  • The authors state this as an assumption.

    No prior comprehensive review of KT theories, models and frameworks used to guide dissemination or implementation of evidence-based interventions targeted to prevention and/or management of cancer or other chronic diseases exists.

    “To our knowledge, this is the first comprehensive review of KT theories, models and frameworks that have been used to guide dissemination or implementation of evidence-based interventions targeted to prevention and/or management of cancer or other types of chronic diseases.”
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Metadata

Authors
Strifler, L., Cardoso, R., McGowan, J., Cogo, E., Nincic, V., Khan, P. A., Scott, A., Ghassemi, M., MacDonald, H., Lai, Y., Treister, V., Tricco, A. C., & Straus, S. E.
Affiliations
  • St. Michael's Hospital (CA)
  • University of Ottawa (CA)
Corresponding author
Straus, Sharon E.
Venue
Journal of Clinical Epidemiology
Publisher
Elsevier BV
Published
2018-08
Volume
100
Pages
92-102
ISSN
0895-4356 (ISSN-L)
OpenAlex
W2796645918
Cited by
227
References
27
Citations by year
2026: 17 · 2025: 24 · 2024: 39 · 2023: 31 · 2022: 41 · 2021: 30 · 2020: 20 · 2019: 19 · 2018: 4
FWCI
3.30
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
  • TSpace (University of Toronto) (submittedVersion, cc-by-nc-nd)
Funders
  • Partenariat Canadien Contre Le Cancer
  • Canadian Institutes of Health Research
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Keywords
knowledge translation, implementation model, dissemination, evidence-based interventions, cancer prevention, chronic disease management, implementation planning, behavior change, organizational change, systemic change
MeSH terms
Female, Humans, Male, Models, Theoretical, Databases, Bibliographic, Evidence-Based Medicine, Translational Research, Biomedical

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