Preventing Childhood Obesity - Evidence Policy and Practice.pdf

Knowledge translation and exchange for obesity prevention
through the simple diffusion of information (e.g.
development and dissemination of research reports).
However, it is now acknowledged that, at a minimum,
knowledge translation and exchange ( KTE ) must
involve the building and maintenance of collaborative
relationships between and among key stakeholders
and researchers. 5,6
In a more traditional sense, knowledge translation
( KT ) has been defined as the “ exchange, synthesis and
ethically sound application of research findings within
a complex set of interactions among researchers and
knowledge users ”. 7 The processes and types of knowledge
used in more contemporary KTE processes refer
not only to research findings or research evidence. 8
Knowledge can be viewed as either explicit or tacit.
Explicit knowledge is information that can be
explained in words or symbols and is often written
down. 9 It can, therefore, be easily shared or copied
(e.g., a program evaluation that is published in a peer -
reviewed journal). Tacit knowledge is generated
through experience. It is, therefore, difficult to share
without some level of interpersonal contact (e.g.,
sharing professional expertise in identifying options
for working with refugee families to promote healthy
9
eating). In obesity prevention, decision making
requires the careful consideration of a number of
forms of knowledge, which can be viewed as either
tacit or explicit including theory, intervention
research, community views, local context, policy evaluation
and expert opinion. This process occurs in the
“ action cycle ” outlined in Figure 22.1 .
This chapter explores how to use research evidence
within a KTE framework that considers different types
of knowledge to address obesity prevention.
The c haracteristics of KTE n eeded
to s upport o besity p revention
Interaction
It appears that an essential component of KTE is
interaction between various constituents. 11,12 This
may involve researchers, decision makers, policy -
makers, practitioners and communities. The communication
of knowledge can be operationalized using a
number of mechanisms, including websites, knowledge
brokers, tailored or targeted messages, email,
health messages, networks and formal and informal
11,13
meetings.
Multi - s ectoral a pproach
As discussed widely in the evidence sections of this
book, to be effective, action to address obesity needs
to take a multi - sectoral approach. KTE processes
must, therefore, acknowledge the influences (e.g.
political, historical), types of knowledge and accountability
requirements operating within each relevant
sector. For example, some sectors may rely more
heavily on types of knowledge (e.g., modeling is used
within the transport sector) unfamiliar to individuals
working in the health sector. 14
The key to working across multiple sectors is communication
and engagement. Part of the challenge is
that those working outside the health sector may not
view their work as health - related or relevant to obesity
prevention. Exposure to new ideas (particular related
to the determinants of health), concepts of evidence
and different ways of working are essential to supporting
evidence - informed decision making for obesity
prevention. Those working in the health sector may
begin to build these relationships by involving key
partners (e.g., schools, early childhood services, transport,
food supply) in health - related decision making.
Other strategies may include offering to share advice
in the development of policy related to the determinants
of obesity prevention, sharing key publications
with key contacts, summarizing research evidence
likely to be of relevance or interest to these partners,
and building formal networks with interested parties
to support evidence synthesis and generation. It goes
without saying that nurturing these relationships
takes time and commitment.
Understanding c ontext
Context refers to the “ social, political and/or organizational
setting in which an intervention was evaluated,
or in which it is to be evaluated ” . 15 It must
also capture the characteristics of those living and
working within these settings (e.g., demographics).
Understanding the context in which knowledge was
originally created is as important as understanding the
context where knowledge will ultimately be applied. 15,16
For example, if you were planning the implementation
of a school - based intervention, it would be
important to understand why a particular school -
based intervention worked in rural New Zealand as
well as considering whether it could be applied in
metropolitan Sydney.
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