Open Access
Open Peer Review

This article has Open Peer Review reports available.

How does Open Peer Review work?

Conservation of resources theory and research use in health systems

  • Celeste Alvaro1Email author,
  • Renée F Lyons2,
  • Grace Warner3,
  • Stevan E Hobfoll4,
  • Patricia J Martens5,
  • Ronald Labonté6 and
  • E Richard Brown7
Implementation Science20105:79

DOI: 10.1186/1748-5908-5-79

Received: 13 November 2009

Accepted: 20 October 2010

Published: 20 October 2010

Abstract

Background

Health systems face challenges in using research evidence to improve policy and practice. These challenges are particularly evident in small and poorly resourced health systems, which are often in locations (in Canada and globally) with poorer health status. Although organizational resources have been acknowledged as important in understanding research use resource theories have not been a focus of knowledge translation (KT) research. What resources, broadly defined, are required for KT and how does their presence or absence influence research use?

In this paper, we consider conservation of resources (COR) theory as a theoretical basis for understanding the capacity to use research evidence in health systems. Three components of COR theory are examined in the context of KT. First, resources are required for research uptake. Second, threat of resource loss fosters resistance to research use. Third, resources can be optimized, even in resource-challenged environments, to build capacity for KT.

Methods

A scan of the KT literature examined organizational resources needed for research use. A multiple case study approach examined the three components of COR theory outlined above. The multiple case study consisted of a document review and key informant interviews with research team members, including government decision-makers and health practitioners through a retrospective analysis of four previously conducted applied health research studies in a resource-challenged region.

Results

The literature scan identified organizational resources that influence research use. The multiple case study supported these findings, contributed to the development of a taxonomy of organizational resources, and revealed how fears concerning resource loss can affect research use. Some resources were found to compensate for other resource deficits. Resource needs differed at various stages in the research use process.

Conclusions

COR theory contributes to understanding the role of resources in research use, resistance to research use, and potential strategies to enhance research use. Resources (and a lack of them) may account for the observed disparities in research uptake across health systems. This paper offers a theoretical foundation to guide further examination of the COR-KT ideas and necessary supports for research use in resource-challenged environments.

Background

Knowledge translation (KT) is the 'exchange, synthesis, and ethically-sound application of knowledge -- within a complex system of interactions among researchers and users -- to accelerate the capture of the benefits of research through improved health, more effective services and products, and a strengthened healthcare system' [1]. Accordingly, KT spans all steps in between the creation of knowledge and its application to benefit society, with an emphasis on effective partnerships among researchers and users. In practice, KT strategies may involve activities to ensure that research evidence is available and used in decision-making to determine policies, programs, and practices to improve health. Like any change process, KT requires resources and the elasticity that is afforded by their availability. Given this proposition, what insight does the KT literature offer concerning research use in resource-challenged environments? Over the past 10 years, considerable effort has been placed on KT and evidence-based decision-making and in understanding and improving capacity for research use within health systems (i.e., federal health departments, provincial or state departments of health, district or regional health authorities, hospitals, community health organizations [2, 3]). Despite the growing number of frameworks [49], strategies [1014], and investments in KT [1517], there has been limited research in the development of explanations of research use. Research examining theory-based approaches to KT (e.g., cognitive and behavioural change) has been mainly applied to changing clinical practitioner behaviour [1820] rather than health systems. However, the work of Dobson and Fitzgerald [21], Lavis et al. [2225], and Kitson [26] has contributed to an increased understanding about the challenges of using evidence, approaches to using research evidence, and the organizational support that is necessary for research use in resource-challenged environments.

Research that examines KT in the context of developing countries suggests that there is substantial variation in the capacity for research uptake among health systems [2729]. Low- and middle-income countries often lack the human and financial resource capacity to act on research evidence as they struggle to keep up with basic healthcare demands. At minimum, research uptake requires functioning health systems and an adequate number of skilled health workers [30]. Within developed countries, resources are also thought to be stretched beyond capacity as systems are pressed to do more with less, and healthcare costs continue to rise with our aging population and increasing rates of chronic disease [31, 32]. Resources are not limited to money, objects, and people. Values, skills, conditions, and culture are resources by virtue of their value in effecting change and facilitating the acquisition of additional resources. Although resources such as values, skills, conditions, and culture are seemingly more intangible in comparison to more tangible resources with a physical presence, they serve to build resiliency and provide a degree of elasticity necessary to adapt to change. Resource scarcity can enhance resistance to using evidence to change policy and practice and drive people to conserve existing resource pools [33]. A lack of resources, or the threat of losing existing resources, may limit receptivity and responsiveness to research within health systems. Consequently, operating below specific resource thresholds may contribute to a widening 'health systems gradient' wherein organizations with fewer resources fall further behind organizations with greater resources.

A perceived lack of resources may have important consequences for research use in addition to the actual lack of resources. Health systems managers and staff face concurrent demands of using evidence to improve the quality of patient care, within the parameters of accountability and cost-effectiveness. New research evidence can be perceived as a threat to the status quo because it must be incorporated within existing structures, often without increased resources to institute change. Research in the nursing context, in particular, has identified perceived barriers to research use (including resource deficits) that lead to the resentment of policy and/or practice changes implicated in the emerging research evidence [3442]. As evident in the stress and coping literature, individuals and groups become increasingly aversive to risk and show bias in favor of conservation in the face of stress [43]. Given that stress, and resistance to change, is elevated in resource-challenged environments, a greater understanding of the underlying mechanisms by which resources contribute to research use is needed.

Resource theories

Resource theories offer the potential to understand the role of organizational resources in the uptake of research evidence. Resource theories are based on the premise that a minimum resource threshold is necessary for performance, with increasing difficulty arising as demands increase and outweigh the available resource pools [44]. Resource theories have a long history and span several disciplines, including: cognitive psychology [4547], biology [48], ecology [49], social psychology [50, 51], community psychology [52], economics [53], and sociology [54, 55]. Although researchers have adapted resource theories to understand seemingly disparate phenomena, a constant theme across all disciplines is that resources are key determinants of performance, adaptation, and change.

Conservation of resources theory

In contrast to other resources theories, conservation of resources (COR) theory is of particular interest in understanding research use because it goes beyond merely linking resources to performance. COR theory [56, 57] emerged from resource and psychosocial theories of stress and human motivation. Social scientists who study stress have found that personal resources (e.g., perceived control, self-efficacy, perceptions of improvement) and social resources (e.g., emotional support, assistance from friends and family) buffer against the potential negative impact of stressful life events [5861]. COR theory extends prior theories by acknowledging that stress stems from the combined effect of the subjective perception of an event as taxing or exceeding available resources [6264] and the objective or actual environmental circumstances that threaten or cause depletion of people's resources [6567].

COR theory has been used as an explanatory model for organizational stress in health systems and other organizations [6875]. COR theory [76, 77] may also contribute to understanding the function of resources in KT and how perceived or actual resource constraints affect research use in health systems. The main principles and corollaries of COR theory have been reviewed extensively elsewhere [78]. For the purposes of our research, we extracted three themes of COR theory (Table 1) that are of particular relevance in understanding limitations in capacity to using research and building the resilience for health systems change in resource-challenged environments.
Table 1

COR theory themes

COR theory theme one:

Resources are required for adaptation and change

COR theory theme two:

The threat of loss leads to the protection of assets

COR theory theme three:

Resources must be optimized for adaptation

Theme one: Resources are required for adaptation and change

In COR theory, resources are defined as objects, conditions, personal characteristics, and energies that are either themselves valued for survival, directly or indirectly, or that serve as a means of achieving these resources [7982]. Object resources have a physical presence (e.g., clothing, shelter). Condition resources are structures or states (e.g., status at work, good health) that allow access to or the possession of other resources. Personal resources include skills and traits (e.g., occupational skills, self-esteem). Energy resources (e.g., money, knowledge) are those whose value is derived from their ability to be exchanged for other resources. It seems reasonable to predict that organizational resources may affect health systems capacity for research use in the same way that resources affect adaptation in individuals, groups, communities, and organizations.

Although the concept of stages of change was not outlined in Hobfoll's COR theory [83], various stage based models of change suggest that some types of resources may be more important than others and that some resources may be more important at different stages of the implementation process than others [8487].

Theme two: The threat of loss leads to the protection of assets

Individuals and groups are threatened by the potential or actual loss of resources, and are therefore motivated to obtain, retain, foster, and protect valued resources for anticipated future needs [88, 89]. Those with fewer resources are more vulnerable to resource loss, less capable of resource gain, and highly risk-averse so they often opt to maintain existing resources rather than risk resource depletion [9093]. Research has shown that, although they are generally in favour of research use, individuals and groups within resource-challenged health systems conserve resources for everyday and future 'rainy day' challenges [94]. Implementing research evidence takes resources and can have considerable implications for policy and practice. Understandably, threat can serve to increase risk aversion, to amplify resistance to change, and to limit action on research evidence.

Theme three: Resources must be optimized for adaptation

According to Hobfoll [95], the impact of resource loss far outweighs the impact of equivalent resource gain. Nonetheless, individuals and social units (including systems) with greater resources are often less vulnerable to resource loss, more capable of resource gain, and more 'elastic' (i.e., able to take risks) than their resource-challenged counterparts. Therefore, resources must be invested to gain additional resources and to offset the potential or actual loss of resources [96]. Although initially biased in favour of resource conservation, individuals and social units can direct themselves to enhance resources. Strategic resource investment, resource manipulation, resource mobilization (i.e., employing resources one possesses or calling upon resources available within one's environment), and resource substitutions (i.e., using specific resources in one domain to compensate for a lack of resources in another domain) are important in bolstering capacity for research use [97].

COR theory has recently been applied to the study of how communities cope with natural disaster [98], and terrorism [99], as well as how individuals within organizations cope with occupational stress [100105]. The evidence in support of COR theory as it relates to resource-challenged regions' capacity to cope with natural disaster (e.g., drought) is particularly revealing. Resource-challenged regions continually operate in a state of depleted resources. When an external event (i.e., natural disaster) occurs, the event creates added stress on the system and causes a change in the level of resources available [106, 107]. Still, some regions that are repeatedly affected by disaster do demonstrate remarkable resilience. Such resilience is, in part, due to pro-active coping interventions aimed at buffering against the negative impact of stress, such as assessing resource-related capacity to cope with stress, fostering preparedness before resources are strained, or increasing resource pools within the community or organization.

In this research, we conducted a scan of the KT literature to identify organizational resources that contribute to research use and examined the three components of COR theory via a multiple-case study. The purpose, methods, and results of the scan and multiple-case study are described in turn, followed by a discussion of the overall findings and potential contributions of our research.

Methods

Identifying organizational resources

Search Methods

Relevant databases (such as PubMed, Psych Info, Web of Science) were searched using search terms that were agreed upon by lead author and principal investigators. The following key terms (or a combination thereof) were included: knowledge translation, knowledge transfer, knowledge exchange, knowledge utilization/use/uptake, research utilization/use/uptake, barriers to [key term], and facilitators of [key term].

Inclusion and exclusion criteria

No limitations were placed on publication date (the search was conducted between 2006 and 2008). Publication bibliographies were searched to identify additional literature. Online resources (such as funding agency websites, and websites of academic research centres with a focus on KT), and grey literature on KT in health systems were also included. The initial search yielded approximately 1,200 articles. The articles were reduced to include only those published in English language peer-reviewed journals that were related to organizational and/or systems level research uptake (approximately 100 articles). The articles were themed according to theoretical papers, literature reviews, research studies (including quantitative and qualitative), and commentaries. It should be noted that the majority of articles were descriptive in nature.

Search results

There was remarkable consistency in the types of resources identified in the literature. The scan resulted in the generation of an extensive list of organizational resources that contribute to research use (See items in Additional file 1: Table s1 that are identified with the subscripta[108412]).

Multiple-case study

A multiple-case study [413, 414] that consisted of key informant interviews was designed to confirm the list of resources derived from the literature, identify additional organizational resources, and develop a taxonomy of organizational resources required for research use. This method allowed for an initial exploration of the COR theory themes and their relevance in health systems.

Selection of cases

A case was defined as a collaborative research initiative between an academic research centre and a health policy or healthcare organization. Following an initial review of potential cases, four cases were selected. The four selected cases included diverse team members (i.e., researchers, practitioners, voluntary agencies, and government), represented varying time frames that ranged from short-term (i.e., one year or less) to long-term (i.e., multi-year), were initiated because the research evidence indicated that change was necessary (i.e., research was identified, synthesized, or conducted), and ranged from having a direct impact on policy and/or practice to having little or no impact on policy and/or practice. The research projects took place in a relatively 'resource-challenged environment' - Atlantic Canada.

Case one: Urban bikeways

The urban bikeways (UB) project was a relatively short-term (approximately one year) initiative to provide an evidence-based argument for developing safe cycling in an urban region of Canada. A research report that provided a synthesis of research on bikeway systems was carefully developed with decision makers in mind and presented to city council. Researchers actively engaged with municipal staff and city councillors in the research process and the development of a report that was presented to City Council. These activities were instrumental in the establishment of a municipal committee to promote and oversee the development of UBs.

Case two: Rural stroke services

The rural stroke services (RSS) project was a nationally funded long-term (six year) community alliance for health research to improve stroke prevention and treatment in rural communities, using one community as the unit of analysis. This project consisted of multiple studies including a needs assessment for persons post-stroke, a best practice scan, and asset mapping plus several strategies including community forums, and working groups to develop and implement an evidence-based change strategy.

Case three: Food cost and security

The food cost and security (FSS) project was a multi-year partnership between an academic research centre, national agencies, and community organizations. The purpose of this research was to build capacity to address the issue of food cost and security at community, provincial and national levels. Project activities included gathering evidence on the cost of food, local advocacy to develop a strategy to impact food security policy, and the use research findings to advocate for broader social change concerning food security.

Case four: Treatment of depression in rural seniors

The depression in rural seniors (DRS) project was a relatively short-term (one year) project representing a partnership between an academic research centre, affiliated universities, provincial departments of health, a provincial non-profit mental health association, a national mental health association, community organizations, and a subset of local senior citizens. The purpose was to examine access to mental health services for seniors suffering from depression, and to develop a social marketing strategy to encourage seniors to seek mental health services. However, a direct impact on policy or practice was not observed.

Participants

A letter of invitation requesting their participation in this study was sent to 57 researchers, government representatives, non-governmental organization (NGO) staff, and practitioners affiliated with the four projects described above. A list of individuals who were involved with each of the research projects described above was obtained from the principal investigator. An information sheet describing the research objectives, procedures, and ethics approval was included with the letter of invitation. Two weeks later, participants received a follow-up telephone call to confirm receipt of the information package and their interest in participating in an interview. Face-to-face interviews were then scheduled with 44 participants: 13 health systems policy makers, 11 researchers, 10 clinicians, 9 community health organization representatives, and 1 NGO representative (77% response rate) in the four Atlantic Canadian Provinces. The remaining 23% of those invited declined to participate on the basis of their availability and/or perceived relevance as participants in the study. Those who declined were asked to identify someone who may be more appropriate to contact. There was equal representation of participants across all four cases. The rationale for selecting participants ranging from researchers, policy makers, to practitioners was to ensure that perspectives on research uptake were obtained from individuals across various levels within health systems in partnership with researchers.

Interview guide and procedures

All procedures and instruments/materials were approved by the university's Human Research Ethics Board. A semi-structured interview guide to examine the COR theory themes was developed and adapted for relevance to each case. The interviews for case studies one, two, and four were conducted by the lead author. The interviews for case study three were conducted by a graduate research assistant who was trained and coached through a series of mock interviews, subtleties of COR theory, and was responsible for coding all interviews. Thus, the level of sophistication in conducting the interviews was comparable across the two interviewers. Interview guides were sent to participants in advance of the interview. Interviews were conducted in person and audiotaped at the participants' workplace. The interviewer began by asking the participant to describe his or her role in the respective project. To assess participants' understanding of resources required for research use and to initiate thinking about resources, participants were asked to identify resources they perceive to be necessary for research use on a general level. Interview questions assessed three central COR-KT themes: Resources are required for adaptation and change; the threat of loss motivates the protection of assets; and resources must be optimized for adaptation.

COR-KT theme one: Resources are required for adaptation and change (in the context of research)

At the beginning of a semi-structured one-hour interview, participants were asked to indicate the factors (or resources) they believed to be necessary for the uptake of research evidence within health systems (question two). Responses to these questions were compiled and cross-referenced with those found in the literature and were used to develop the taxonomy of organizational resources (see Additional file 1, Table s1).

In keeping with the notion that resource needs may vary as a function of the stages of research uptake (see the overview of COR-KT themes described earlier in this paper), participants were asked to describe the resources available at three points during the research uptake process: the early stages of research uptake, the implementation stage, and the later stages of sustaining newly implemented policies and/or practices (questions three and four).

COR-KT theme two: The threat of loss leads to the protection of assets

Participants were asked to identify any concerns about resources that arose throughout the course of the project, resource losses associated with research uptake, and actions taken to offset concerns. Participants were also asked to identify actual resource losses and gains that resulted from research uptake, the stage at which losses or gains occurred, and what, if any, actions they engaged in to compensate for the losses or capitalize on the gains (questions six and seven).

COR-KT theme three: Resources must be optimized for adaptation

Participants were asked to identify what, if any, resources were invested in using research to make changes to policy and/or practice, how these investments differed across the stages of research uptake, and the consequences of these investments (or lack of investment) (question eight). Participants were also asked about how they (or their organization) capitalized on resource strengths and compensated for resource weaknesses (question nine).

Coding and analysis to develop the taxonomy of organizational resources

Using the composite list in Additional file 1, Table s1, two independent raters grouped similar items, created a category name for each grouping of resources, and identified subcategories within each grouping. Raters then classified each item according to the overall category and the subcategory to which it belonged. Inter-rater reliability, assessed using the intra-class correlation coefficient [415], was r (80) = 0.94, p < 0.01 for the overall category and r (62) = 0.93, p < 0.01 for the component within the overall category. Disagreements between raters typically reflected the somewhat overlapping nature of the categories of resources and were resolved through discussion. The items were then arranged into an initial taxonomy of organizational (health systems) resources that are perceived by the literature and the respondents to influence research use.

Coding and analysis of COR-KT themes

Digital voice recordings of the interviews were transcribed verbatim and reviewed for accuracy. The transcripts were imported into QSR International's NVivo7 for coding and analysis. Thematic coding of all transcripts was completed by two independent coders. Themes were identified according to a priori categories derived from the KT and COR theory literature as well as newly emerging categories using NVivo7's node feature for each interview question. Disagreements between coders were resolved through discussion. NVivo7 reports generated the number of mentions of a given theme as well as a summary of quotes for each theme. SPSS 15.0 was used solely for the purpose of organization and to generate summaries of the data. Each of the themes generated through analysis using the NVivo7 software was assigned a numeric code. These data were entered into SPSS 15.0 along with the case study, type of respondent, and interview question number. The SPSS 15.0 output was used to generate frequency tables to assist in identifying predominant themes emerging from the interview data that have been summarized as text only in the results section of this paper.

Results

COR-KT themes

The findings of the multiple-case study are organized below according to the three COR-KT themes (Table 1). It should be noted that the interviews reached saturation wherein the general thematic content described by participants was consistent across the four cases.

COR-KT theme one: Resources are required for adaptation and change (in the context of research use)

For the most part, the organizational resources identified by interview participants were consistent with those identified in the literature scan (see the items with the subscript ab in Additional file 1, Table s1). Examples of these organizational resources include the accessibility of research evidence, the availability of incentives to use research evidence, opportunities for interactions between researchers and users of research, and the presence of a knowledge broker. Participants also identified organizational resources that had not been found in the literature (see the items with the subscript c in Additional file 1, Table s1); e.g., perceived economic efficiencies or limited costs (perceived or actual) associated with evidence-informed change, perceived need to act on research evidence, and satisfaction with prior research use efforts.

Organizational resources generally fit into four overlapping categories: organizational culture, human resources, economic resources, and condition resources (or states) within the organization (see Additional file 1, Table s1). To classify organizational resources and describe their conceptual relationship, we use the term vector to refer to the categories of organization resources [e.g., [416]]. We consider the four vectors separately, while acknowledging that quantitative methods and analyses are needed to determine the interrelatedness of the vectors. Within each vector are several dimensions (or groupings of similar elements). Components of the dimensions are described as elements. The vectors, dimensions, and elements within each dimension summarized below and are presented in Additional file 1, Table s1).

(1) Organizational culture

The organizational culture vector is defined by the norms and expectations concerning behavior and procedures related to research uptake within an organization [417]. Seven dimensions of organizational culture appear to be related to research uptake: 1.1. Policies and practices that guide research use; 1.2. Training to use research evidence; 1.3. Access to research evidence; 1.4. Organizational leadership; 1.5. Organizational flexibility; 1.6. Organizational buy-in; and 1.7. Organizational history.

(2) Human resources

The human resources vector is defined by characteristics of individuals within the organization. Characteristics of individuals greatly shape the organizational culture. Thus, it follows that specific characteristics of individuals may build resiliency and facilitate research uptake within health systems. Five dimensions of human resources appear to be related to research uptake: 2.1. Personal characteristics (e.g., attitudes, perceptions, motivation); 2.2. Skills/qualifications; 2.3 Activities; 2.4. The presence of change agents; and 2.5. Staffing.

(3) Economic resources

The economic resources vector is defined by the monetary or financial aspects of an organization. Four dimensions of economic resources are related to research uptake: 3.1 Budget constraints; 3.2. Spending flexibility; 3.3. Investment in research use activities; and 3.4. Economic dependency. Flexibility in how economic resources are allocated is particularly important. If economic resources are solely tied to fixed costs, with little opportunity to invest in evidence-informed change, organizations have limited capacity for research uptake.

(4) Condition resources

Current or situational time-limited conditions within the organization can affect its capacity for research use. Situational conditions can provide a catalyst for change and the opportunity to modify existing policies and/or policies. Alternatively, situational constraints may stifle research uptake. Three dimensions of condition resources related to research uptake are: 4.1 Time/Timing; 4.2. The absence of conflict; and 4.3. Opportunity.

Resource needs as a function of the stages of research uptake

The results of the multiple case study support the notion that resource needs differ as a function of the stage of KT. Therefore, the discussion of resources and their importance is considered in the context of stages in the research uptake process. The type of participant (Researcher, Policy maker, or Practitioner) and case (UB, RSS, FCS, and DRS) are identified for each quote. A range of responses were selected purposefully to demonstrate similarities and differences that exist from different categories of participants across each of the four cases.

Resource needs at the initial stages of research uptake

During the initial stages of research uptake, (i.e., at the discovery of and consideration of new research evidence) organizational culture were identified as important:

'I think organizational culture [is most critical in the beginning]. If ... particular organizations weren't open to partnering, even having the right people in the right places and the latitude to work on it within their positions, we wouldn't have moved [forward].' -- Researcher, FCS

'... I think the organizational culture recognized the value of research to practice. And they were given the opportunity to participate in decision making opportunities, like being part of working groups, the forum, being invited to the forum, and being as participants.' -- Policy maker, RSS

'The organization values, the leadership, the access, the exposure, are really pro-research, and we need to embark on this project because it is very important and our organization supports that.' -- Practitioner, RSS

Aspects of organizational culture that were perceived to initiate and support research use included the accessibility of research evidence, the presence of policies/infrastructure to support research use, and the belief in the benefits of research use:

'The organization invests in research-related articles, partly due to the affiliation with the [University].' -- Policy maker, RSS

'Opportunities do exist to foster learning and development of research skills.' -- Practioner, RSS

'I think there was more a feeling of freedom of moving between the political and the administrative sides of the organization.' -- Practitioner, RSS

'[Capacity building efforts were focused on] education and skills development versus addressing the root causes and looking at policy and system's change.' - Researcher, FCS

As evident from the above quotes, participants identified the need for investment in infrastructure and activities to support research use. Although the overall categories of resources identified were consistent across participants, some differences emerged in the types of resources that were identified as playing a prominent role in the initial stages of research uptake. Policy makers tended to emphasize the importance of flexibility within the organizational structure to make changes as new research evidence emerges. Competing demands and the need for equal distribution of resources were often reported to be a barrier to research uptake:

'In rural Nova Scotia, it is a struggle for resources. When you have limited resources, you have to be equitable about where to allocate funds. Do you put it here or there? Do you take it from here or there?' -- Policy maker, RSS

Practitioners tended to emphasize the need for sufficient time for advancing research use activities:

'Their [management] contributions and support would have been in the way of providing staff time to go to meeting and providing openings within their departmental meetings.' -- Practitioner, RSS

Researchers emphasized the importance of a new organizational receptivity to research use:

'There is an openness in the departments to hear about [research]. They are aware of it now. We went to a Policy Advisory Committee and presented it. And there is more and more with the [government] strategy.' -- Researcher, UB

Resource needs at the implementation stage of research uptake

During the implementation stage of research uptake (i.e., once the decision has been made to act on research evidence), both human resources (e.g., champions, skilled staff who make a commitment sustain change) and economic resources (e.g., available resources, flexibility to reallocate economic resources) were reported as prominent themes in the uptake of research evidence. In particular, the presence of a champion or facilitator was considered to be among the most valuable resources in seeking the support of others for evidence-based change:

'One of the reasons that our work has been successful is that we've had some real champions leading the work.' -- Policy maker, FCS

'Under human resources, I think what was really key is now they have champions identified, with actually high respect in our organization. [Examples include a medical doctor and a stroke navigator].' -- Researcher, RSS

There were a few champions, I'll say, within the organization that were motivated and energized to help make some stroke care improvements.' -- Policy maker, RSS

'Having people in place to implement best practices: That was most important later on ... but to get there, you need the support of the organization.' -- Practitioner, RSS

Participants acknowledged that organizational culture is inextricably linked to characteristics of the individuals within the organization; most notably, the extent to which individuals are receptive to research/innovation, possess a research use orientation, and hold shared beliefs with others in the organization, and openness to collaboration (e.g., between researchers, decision makers, and practitioners):

'...Certainly in terms of readiness to proceed with trying out some of the best practices and the recommendations in the document, [our organization] was way far ahead of some of the [organizations in] other districts.' -- Policy maker, UB

'There are individuals in the organization who were really motivated and willing to adapt to change, and were really key players.' -- Researcher, UB

Aspects of economic resources that were reported to facilitate research uptake during the implementation stage included dedicated funds or the flexibility within the budget to reallocate funds. It was noted that change should occur with the realization of potential benefits and efficiencies from implementing new research evidence:

'Economic resources, I think there was definitely a realization that in order to improve stroke care to the recommended levels that were in the stroke strategy document, that money was going to be required. Not that is wasn't known all the way along, but I think they were thinking more in terms of what exactly do we need. Is it two OTs [occupational therapists] or three, or three speech pathologists, or what exactly is it? And starting to think about what dollars would have to go along with that.' -- Policy maker, RSS

Participants' comments illustrate the importance of time to establish and foster relationships between researchers, policy makers, and practitioners to effect change. Consequently, short-term collaborations may have limited impact if major systems change is required.

Resource needs at the later stages of research uptake

During the later stages of sustaining newly implemented policies and/or practices, human resources and economic resources were considered to be essential for sustaining any changes to policy and/or practice resulting from research evidence:

'[We] need the resources to do it ...ultimately, dollars and human resources.' -- Researcher, RSS

Dedicated staff with a flexible workload to engage in change efforts were thought to play an important role in sustaining policy and/or practice changes in the later stages of research uptake. Economic resources including funds to sustain new policies and/or practices as well as a financially supportive system were considered to be increasingly important at this stage of research uptake, particularly when the changes were brought about through the course of a limited term funded research project.

COR-KT theme two: The threat of loss leads to the protection of assets

A central component of COR theory is the notion that the threat of resource loss results in the guarding of existing resources and risk aversion (i.e., pushback on research use). The fear of resource loss over potential benefits was documented in the four cases. All participants expressed some hesitation or resistance to engage in research use activities; however concerns differed among policy makers, practitioners, and researchers.

Policy makers were primarily concerned with the impact of dedicating resources to change policy and/or practice in one area to the detriment of other programs.:

'There was a fear that money would be taken away from other programs to be able to do this...' -- Policy maker, RSS

Practitioner concerns stemmed from having an unmanageable workload, decreased time, and role confusion:

'I am only one person! I was quite overwhelmed...where do you put your time and how do you make those decisions?' -- Practitioner, RSS

Concerns were expressed about the availability of health system support for the sustainability of a change that was being tested. However the concerns about loss varied as a function of stages in the KT pipeline. In the early stages:

'There were concerns about becoming involved because previous experience with research had left them unsatisfied [and led to a breakdown in trust]' -- Researcher, DRS

'Before you put the time and effort into it...is it sustainable? How are people going to respond to it? What directions will they be given? And will we be prepared for the potential outcomes in terms of resource allocation and capacity to respond.' - Policy maker, DRS

The later stages of a grant, termination of grant funding, and the coordination that comes with it, contributed to concerns about the sustainability of engaging in research use activities:

'All of a sudden, it was the end of the project, and the money was gone, the person was gone ... so a sense of disappointment that we didn't accomplish what we had hoped to ...' -- Community partner, DRS

'But what happened when the project ends is you no longer have that overarching coordination...[we] saw the differences ... it fell back to the provinces to implement and sustain the activity on a provincial basis because you lost that coordination.' -- Policy maker, DRS

'So if anything, after the money was done, all of these things became more strained.' -- Practitioner, DRS

In summary, worries over potential resource loss were heightened if participants had prior negative experiences with research. This issue was particularly salient if past research collaborations had resulted in losing a champion or losing skilled staff. Negative experiences with past research initiatives served to exacerbate resistance to research use and increased the scepticism concerning the benefits of changing practice and/or policy.

There were several marked differences between long-term and short-term projects involving research use. The salience of resource loss over the potential gains of research use was particularly strong among the participants in short-term projects. Participants conveyed a sense that there was insufficient time to develop a strong university-community partnership. Projects that received only short-term funding suffered from the lack of a strong research or policy champion. Participants reported that trust was not well-established between policy makers, community partners, and researchers. Limited communication between partners was perceived to decrease confidence in the recommended policy changes that resulted from the research. Interestingly, confidence in the research evidence was largely intertwined with the relationships between researchers, policy makers, practitioners, and community partners.

Involvement in long-term projects that connected directly to the development of health system changes seemed to build confidence among the service providers, allayed fears of resource loss, and increased capacity to act on research evidence. Participants in long-term projects reported that there was sufficient time to conduct the research, translate the findings, and facilitate system changes. Time, coupled with additional money and further involvement in partnerships appeared to generate greater receptivity to using evidence.

COR-KT theme three: Resources must be optimized for adaptation

All participants identified strategies that maximized the use of existing resources to gain buy-in. In particular, participants reported the value of a champion to create momentum among staff and buy in among decision makers:

'A champion makes all the difference in the world [in gaining buy-in and involvement].' -- Researcher, RSS

Ongoing education and training opportunities about the issue and approaches to addressing it, capitalizing on existing partnerships and collaborations served to bolster confidence in the ability to act on research evidence:

'[The principal investigator] had a history and a reputation for working in the area of food security ... provided credibility.'-- Researcher, FCS

'They encouraged...They allowed us, as clinicians, to go to the forum. And certainly several of us going involved with working groups.' -- Practitioner, RSS

'All new projects that are being built are being built to accommodate bicyclists as well. So if we are re-building a roadway, an existing roadway, if the opportunity exists, we widen the roadway to incorporate bike lanes ... bikeway projects would be tacked onto existing pre-planned, much larger roadway building projects.' -- Policy maker, UB

Together, these engagement strategies empowered individuals and teams within health systems and cultivated efficacy to enact evidence based change. Receptivity to research use was bolstered with confidence that improvements to service would result. Participants' comments reflect the importance of leveraging an existing resource -- even through a seemingly small act such as encouraging staff participation at a scheduled event -- and serves to create a culture shift and momentum towards implementing changes based on evidence. It appears that resource optimization occurs when threat of resource loss is countered with perceived benefits are associated with the outcomes of research use. In many cases, participants expressed excitement for resulting changes and reported an eagerness to engage in future research use activities:

'Benefits include the prevention of strokes among those who might otherwise have had strokes, potential for earlier and more effective treatment, and improved potential for quality of healthcare across the spectrum ... from prevention to rehabilitation.' -- Policy maker, RSS

'I think that we are going to gain a healthier population, a healthier future, a healthier environment. Not that we have gained it. These are long term things [that we will continue to act on].'-- Researcher, FCS

Although organizational resources can be optimized to enhance research uptake, there appears to be a threshold to optimization. Participants suggested that it is not as simple as 'making do with existing resources.' The provision of financial resources from the province that supported improvements to stroke care at the regional level helped to sustain momentum:

'Because of the money, we received equipment that enabled us to do a better job, increase our human resources, and become a more integrated team moving forward' -- Researcher, RSS

'So now that the province has awarded funding for the stroke program, I think there is excitement and commitment. And actually having resources really gives people an opportunity to do a lot of brainstorming and that kind of thing.' -- Policy maker, RSS

'If the Heart and Stroke Foundation hadn't pushed for the funding to go with it, the project might have been at the same place -- ending with no sustainability ... serendipitous.' -- Researcher, RSS

As evident from the multiple case study, there is some variation in how the COR-KT themes play out across the four cases. However, the four cases were consistent in providing evidence that the three COR-KT themes manifest in the health systems context and at varying stages of research uptake: Resources are required for research uptake; threat of resource loss leads to the protection of assets; and resources must be optimized for adaptation.

Discussion

The purpose of this paper was to examine the potential applicability of COR theory to explaining health systems capacity for research use through the identification of resources needed for the uptake of research evidence into policy and/or practice and how resources, or a lack of them, influences receptivity to research use. A scan of the KT literature was conducted to identify the types of resources required for research uptake. A multiple case study was conducted to further classify the types of resources required for research uptake and validate the three central COR-KT themes in the context of research use in health systems.

Recent KT literature has focused on the application of cognitive-behavioral theories to individual practitioner behavior change (e.g., prescribing behavior) [418, 419]. However, systems level changes require their own theoretical foundations. Consistent with the KT literature, our research provides evidence that organizational resources facilitate the uptake of research evidence (COR-KT theme one). We developed a taxonomy of organizational resources that favor research use within health systems, and thereby offer support for the initial COR theory theme as applied to KT (i.e., resources are required for research use).

Beyond identifying factors whose presence or absence affects research use, we provided preliminary support for the remaining COR-KT themes. The first COR-KT theme (e.g., resources are required for research use) was found to be widely documented in the KT literature. The value added by COR-KT theory to the extant KT literature stems from the remaining two COR-KT themes concerning the threat of resource loss in resource-challenged environments and how resources can be optimized to support research use; and the extension of COR theory to include change in resource needs as a function of stages in the research uptake process. The concept of loss is critically important in resource-challenged environments. Fear of resource loss can limit engagement in research use activities, and further contribute to the health systems gradient. Furthermore, our research suggests that overcoming resource constraints through the optimization of resources, even in resource-challenged environments, can support research use.

Our research extends both the literature on COR theory as well as the KT literature by revealing the potential importance of resource needs at various stages during the research uptake process. It may not be the total number of resources that builds capacity for research use. Rather, some resources may be more critical to research uptake than others, and some resources may be more or less critical at various stages of implementing the findings that derive from research. In light of this finding, what elements, if changed, will create better conditions for research uptake -- perhaps using a staged process? Although COR-KT theory considers the role of resource manipulations (and/or substitutions) in research uptake, their effects may be dependent upon the domain (or vector). For example can a resource in one vector (e.g., money) compensate for a lack of resources in another domain (e.g., leadership)?

Limitations

This preliminary research provided some support for the value of COR-KT theory themes in the context of research use. However, the results of this research must be interpreted in light the following caveats. First, the multiple-case study was based on specific research projects. In these cases, the perceived benefits of being involved in a facilitated research project may have enhanced the group's motivation to engage in research use. Additionally, the promise of new resources (e.g., additional equipment, staff, prestige) may have provided much needed incentives to manipulate existing resources in the hopes of acquiring additional resources -- perhaps suggesting the need for external supports in place to engage potential research users. Furthermore, the research was conducted in a relatively economically depressed region of Canada. However, examination of how COR-KT principles play out in resource-challenged environments is needed on a more global level. Presumably, loss aversion would be exaggerated in regions with even fewer resources and require greater strategic investment to offset fear of resource loss.

A synthesis of the KT literature led to the development of a taxonomy of organizational resources central to research use within health systems and offers support for the notion that resources are critical for adaptation and change (i.e., COR theory principle one). For descriptive purposes, the organizational resources are presented as four distinct vectors. Further empirical testing of COR-KT theory in the health systems context is required. In the current research, we began to conceptualize the role of resources and tested some ideas using qualitative methods. Quantitative research is needed to validate the classification of resources presented in the taxonomy (see Additional file 1, Table s1). Specifically, factor analysis would determine the extent to which the four categories of organizational resources represent distinct constructs and confirm whether the indicators within each of the categories reliably measure the same construct. Additionally, a greater understanding of the wider determinants of the elements (i.e., those in the external environment) that influence the presence of resources within an organization is needed. The KT literature, and our research, acknowledges the importance of external resources (e.g., a political culture of receptivity to research and innovation, financial incentives and support for research and innovation, and favorable public attitudes toward research and innovation) in fostering the capacity for research uptake within an organization. Given that health systems are nested within larger systems, is it possible to classify external resources to the same extent as organizational resources?

Summary

COR-KT theory may offer promise for understanding research uptake in resource-challenged contexts. However, it is not a prescription or formula for change. While the resulting COR-KT model may not capture the full complexity of the health systems environment, the theory development and research findings should stimulate a better understanding of the effect of resource limitations on research use and generate more thinking about practical strategies to optimize existing resources for evidence-informed health systems improvement. In particular, our research may contribute to the understanding of how changes to policy, programs, and/or practices can affect perceived threats to existing resources, with consideration of the disparities between high-, middle-, and low-resource countries and social groups [420, 421].

Authors' information

CA is an Assistant Professor (Research) at the Atlantic Health Promotion Research Centre, Faculty of Health Professions, Dalhousie University, 209 - 1535 Dresden Row, Halifax, NS B3J 3T1, Canada. RFL holds a Chair in Complex Chronic Disease and is the Scientific Director of Bridgepoint Collaboratory for Research and Innovation, Bridgepoint Health, University of Toronto, as well as a Canada Research Chair in Health Promotion, Professor, and Senior Scientist (on leave) at the Atlantic Health Promotion Research Centre, Dalhousie University, 209 - 1535 Dresden Row, Halifax, NS B3J 3T1, Canada. GW is an Assistant Professor in the School of Occupational Therapy, Dalhousie University, 5869 University Avenue, Halifax, NS B3H 3J5, Canada. SEH is a Professor and Chairperson of the Department of Behavioral Sciences at Rush University and Medical College, 1653 W. Congress Parkway, Chicago, ILL 60612-3244, USA. PJM is Director and Senior Researcher of the Manitoba Centre for Health Policy; Professor in the Department of Community Health Sciences, Faculty of Medicine, University of Manitoba; CIHR/PHAC Applied Public Health Chair (2008-2013); 408 - 727 McDermot Avenue, Winnipeg, MB R3E 3P5, Canada. RL is a Canada Research Chair in Globalization and Health Equity at the Institute of Population Health, and a Professor in the Department of Epidemiology and Community Medicine, University of Ottawa, 1 Stewart Street, Ottawa, ON K1N 6N5, Canada. ERB is the Director of the UCLA Center for Health Policy Research, and Professor in the School of Public Health, University of California, 10960 Wilshire Blvd., Suite 1550, Los Angeles, CA 90024, USA.

Declarations

Acknowledgements

This research was supported by a Canadian Institutes of Health Research (CIHR) grant (KTS-73427) awarded to Renée Lyons and Grace Warner (Co-Principal Investigators) of the Atlantic Health Promotion Research Centre (AHPRC). Special thanks are extended to AHPRC (including Sandra Crowell, Lynn Langille, and Susan Marsh) for their feedback on various drafts of this manuscript, word processing, and administrative tasks related to this publication; Nancy MacVicar, Allison McNeil, and Jennifer Kilfoil for assistance with data collection, the coding of interview data, and the preparation of summary tables of results; and Mary Ann Martell for the transcription of digitally recorded interviews.

Authors’ Affiliations

(1)
Atlantic Health Promotion Research Centre, Faculty of Health Professions, Dalhousie University
(2)
Bridgepoint Collaboratory for Research and Innovation, Bridgepoint Health, University of Toronto; Atlantic Health Promotion Research Centre, Dalhousie University
(3)
School of Occupational Therapy, Dalhousie University
(4)
Department of Behavioral Sciences at Rush University and Medical College
(5)
Manitoba Centre for Health Policy, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba
(6)
Institute of Population Health, Department of Epidemiology and Community Medicine, University of Ottawa
(7)
UCLA Center for Health Policy Research, School of Public Health, University of California

References

  1. Canadian Institutes of Health Research Knowledge Translation Strategy. 2008, [http://www.cihr.ca/e/26574.html]
  2. World Health Organization: Bridging the 'know-do' gap in global health. 2007, [http://www.who.int/kms/en/]Google Scholar
  3. Kitson A: The need for systems change: Reflections on knowledge translation and organizational change. Journal of Advanced Nursing. 2008, 65 (1): 217-228. 10.1111/j.1365-2648.2008.04864.x.PubMedGoogle Scholar
  4. Jacobson N, Butterill D, Goering P: Development of a framework for knowledge translation: understanding user context. Journal of Health Services Research and Policy. 2003, 8 (2): 94-99. 10.1258/135581903321466067.PubMedGoogle Scholar
  5. Kitson A, Harvey G, McCormack B: Enabling the implementation of evidence-based practice: a conceptual framework. Quality in Health Care. 1998, 7 (3): 149-158. 10.1136/qshc.7.3.149.PubMedPubMed CentralGoogle Scholar
  6. Landry R: The Knowledge-value chain: a conceptual framework for knowledge translation in health. Bulletin of the World Health Organization. 2006, 84 (8): 597-602. 10.2471/BLT.06.031724.PubMedPubMed CentralGoogle Scholar
  7. Lavis JN: Assessing country-level efforts to link research to action. Bulletin of the World Health Organization. 2006, 84 (8): 10.2471/BLT.06.030312.
  8. Pathman DE: The awareness-to-adherence model of the steps to clinical guidelines compliance: The case of Pediatric Vaccine Recommendations. Medical Care. 1996, 34 (9): 873-889. 10.1097/00005650-199609000-00002.PubMedGoogle Scholar
  9. Logan J, Graham ID: Toward a comprehensive interdisciplinary model of health care research use. Science Communication. 1998, 20 (2): 227-246. 10.1177/1075547098020002004.Google Scholar
  10. Pathman DE: The awareness-to-adherence model of the steps to clinical guidelines compliance: The case of Pediatric Vaccine Recommendations. Medical Care. 1996, 34 (9): 873-889. 10.1097/00005650-199609000-00002.PubMedGoogle Scholar
  11. Landry R: Maximizing Dissemination: Two knowledge translation planning tools for stroke teams. 2006, [http://www.ahprc.dal.ca/pdf/kt/2006_KTDocument.pdf]Google Scholar
  12. Lomas J: Improving research dissemination and uptake in the health sector: Beyond the sound of one hand clapping. 1997, [http://www.chsrf.ca/knowledge_transfer/pdf/handclapping_e.pdf]Google Scholar
  13. Lomas J: Using 'Linkage and Exchange' to move research into policy at a Canadian Foundation. Health Affairs. 2000, 19: 236-240. 10.1377/hlthaff.19.3.236.PubMedGoogle Scholar
  14. Lyons R: Piloting knowledge brokers to promote integrated stroke care in Atlantic Canada. Evidence in action, acting on evidence: A casebook of health services and policy research knowledge translation stories. Edited by: CIHR. 2006, 57-60.Google Scholar
  15. Canadian Health Services Research Foundation: Knowledge Transfer and Exchange website. 2005, [http://www.chsrf.ca/knowledge_transfer/index_e.php]Google Scholar
  16. Canadian Institutes of Health Research: About Knowledge Translation. 2005, [http://www.cihr-irsc.gc.ca/e/29418.html]Google Scholar
  17. Canadian Institutes of Health Research: 2005, [http://www.cihr-irsc.gc.ca]
  18. Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N: Changing the behavior of healthcare professionals: the use of theory in promotinf the uptake of research findings. Journal of Clinical Epidemiology. 2005, 58: 107-112. 10.1016/j.jclinepi.2004.09.002.PubMedGoogle Scholar
  19. Grimshaw J: Changing provider behavior: An overview of systematic reviews of interventions. Medical Care. 2001, 39 (8): 2-45. 10.1097/00005650-200108002-00002.Google Scholar
  20. Grimshaw J, Eccles M, Tetroe J: Implementing Clinical Guidelines: Current Evidence and Future Implications. Journal of Continuing Educ Health Prof. 2004, 24: S31-S37. 10.1002/chp.1340240506.Google Scholar
  21. Dopson S, Fitzgerald L: Knowledge to Action? Evidence-based health care in context [20,21]. 2005, Oxford: Oxford University PressGoogle Scholar
  22. Lavis J, Oxman AD, Moynihan R, Paulsen EJ: Evidence-informed health policy 1 - Synthesis of findings from a multi-method study of organizations that support the use of research evidence. Implementation Science. 2008, 3 (53): 7-Google Scholar
  23. Lavis J, Oxman AD, Moynihan R, Paulsen EJ: Evidence-informed health policy 2 - Survey of organizations that support the use of research evidence. Implementation Science. 2008, 3 (54): 17-Google Scholar
  24. Lavis J, Oxman AD, Moynihan R, Paulsen EJ: Evidence-informed health policy 3 - Interviews with the directors of organizations that support the use of research evidence. Implementation Science. 2008, 3 (55): 10-Google Scholar
  25. Lavis J, Oxman AD, Moynihan R, Paulsen EJ: Evidence-informed health policy 4 - Case descriptions of organizations that support the use of research evidence. Implementation Science. 2008, 3 (56): 9-Google Scholar
  26. Kitson A: The need for systems change: Reflections on knowledge translation and organizational change. Journal of Advanced Nursing. 2008, 65 (1): 217-228. 10.1111/j.1365-2648.2008.04864.x.PubMedGoogle Scholar
  27. Tugwell P: Health Research Profile to assess the capacity of low and middle income countries for equity-oriented research. BMC Public Health. 2006, 6: 10.1186/1471-2458-6-151.Google Scholar
  28. World Health Organization: Report from the Ministerial Summit of Health Research. 2004, [http://www.who.int/rpc/summit/documents/summit_report_final2.pdf]Google Scholar
  29. World Health Organization: World Report on Knowledge for Better Health: Strengthening Health Systems. 2004, [http://www.scielosp.org/pdf/bwho/v83n1/v83n1a18.pdf]Google Scholar
  30. (COHRED) C.o.H.R.f.D: Statement 2007: Are international health research programs doing enough to develop research systems and skills in low and middle income countries?. 2007, [http://www.cohred.org/sites/default/files/COHREDStatement2007ResponsibleVerticalProgrammingLOWRES.pdf]Google Scholar
  31. World Health Organization: Report from the Ministerial Summit of Health Research. 2004, [http://www.who.int/rpc/summit/documents/summit_report_final2.pdf]Google Scholar
  32. World Health Organization: World Report on Knowledge for Better Health: Strengthening Health Systems. 2004, [http://www.scielosp.org/pdf/bwho/v83n1/v83n1a18.pdf]Google Scholar
  33. Hurst SA: Physicians' views on resource availability and equity in four European health care systems. BMC Health Services Research. 2007, 7: 10.1186/1472-6963-7-137.Google Scholar
  34. Hurst SA: Physicians' views on resource availability and equity in four European health care systems. BMC Health Services Research. 2007, 7: 10.1186/1472-6963-7-137.Google Scholar
  35. Estabrooks CA: Mapping the research utilization field in nursing. Canadian Journal of Nursing Research. 1999, 31 (1): 53-72.PubMedGoogle Scholar
  36. Estabrooks CA: Modeling the individual determinants of research utilization. Western Journal of Nursing Research. 1999, 21 (6): 758-772. 10.1177/01939459922044171.PubMedGoogle Scholar
  37. Estabrooks CA: Individual determinants of research utilization: a systematic review. Journal of Advanced Nursing. 2003, 43 (5): 506-520. 10.1046/j.1365-2648.2003.02748.x.PubMedGoogle Scholar
  38. Fink R, Thompson C, Bonnes D: Overcoming barriers and promoting the use of research in practice. Journal of Nursing Administration - JONA. 2005, 35 (3): 121-129.Google Scholar
  39. Funk S, Champagne M, Tornquist E: Barriers: the barriers to research utilization scale. Applied Nursing Research. 1991, 4 (1): 39-45. 10.1016/S0897-1897(05)80052-7.PubMedGoogle Scholar
  40. Greenhalgh R: Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly. 2004, 82: 581-629. 10.1111/j.0887-378X.2004.00325.x.PubMedPubMed CentralGoogle Scholar
  41. Rycroft-Malone J: An exploration of the factors that influence the implementation of evidence into practice. Journal of Clinical Nursing. 2004, 13: 913-924. 10.1111/j.1365-2702.2004.01007.x.PubMedGoogle Scholar
  42. Rycroft-Malone J: Ingredients for Change: Revisiting a conceptual model. Qual. Saf. Health Care. 2006, 11: 174-180. 10.1136/qhc.11.2.174.Google Scholar
  43. Hobfoll SE: Stress, Culture and Community. 1998, New York, Plenum PressGoogle Scholar
  44. Wickens CD: Processing resources in attention. Varieties of attention. Edited by: Parasuraman R, Davies DR. 1984, Academic Press: New York, 63-102.Google Scholar
  45. Wickens CD: Processing resources in attention. Varieties of attention. Edited by: Parasuraman R, Davies DR. 1984, Academic Press: New York, 63-102.Google Scholar
  46. Kahneman D: Attention and Effort. 1973, New Jersey, Prentice-Hall: Englewood CliffsGoogle Scholar
  47. Norman D, Bobrow D: On data-limited and resource-limited processing. Journal of Cognitive Psychology. 1975, 7: 44-60. 10.1016/0010-0285(75)90004-3.Google Scholar
  48. Cabanac M, Russek M: Regulated biological systems. Journal of biological Systems. 2000, 8: 141-149.Google Scholar
  49. Tilman D: Resource competition and community structure. 1982, Princeton, NJ: Princeton University PressGoogle Scholar
  50. Foa EB, Foa UG: Resource theory of social exchange. Contemporary topics in social psychology. Edited by: Thibaut JW, Spence JT, Carson RC. 1976, General Learning Press: Morristown, NJ, 99-131.Google Scholar
  51. Foa UG, Foa EB: Societal structures of the mind. 1974, Springfield, Illinois: ThomasGoogle Scholar
  52. Rappaport J: Community Psychology: Values, research, and action. 1977, New York: Holt, Rinehart, and WinstonGoogle Scholar
  53. Olalla M: The resource-based theory and human resources. International Advances in Economic Research. 1999, 5: 84-92. 10.1007/BF02295034.Google Scholar
  54. Cohen J: Strategy or identity: new theoretical paradigms and contemporary social movements. Social Research. 1985, 52 (4): 663-716.Google Scholar
  55. Freeman J: Social Movements of the 60s and 70s. 1983, New York: LongmanGoogle Scholar
  56. Hobfoll SE: Stress, Culture, and Community. 1998, New York, Plenum PressGoogle Scholar
  57. Hobfoll SE: Conservation of resources: A new attempt at conceptualizing stress. American Psychologist. 1989, 44 (3): 513-524.PubMedGoogle Scholar
  58. Folkman S, Moskowitz JT: Coping: Pitfalls and Promise. Annual Review of Psychology. 2004, 55: 745-774. 10.1146/annurev.psych.55.090902.141456.PubMedGoogle Scholar
  59. Lazarus RS, Folkman S: Stress appraisal and coping. 1984, New York: SpringerGoogle Scholar
  60. McFarland C, Alvaro C: The impact of motivation on temporal comparisons: Coping with traumatic events by perceiving personal growth. Journal of Personality and Social Psychology. 2000, 79: 327-343. 10.1037/0022-3514.79.3.327.PubMedGoogle Scholar
  61. Taylor SE, Brown JD: Illusions and well-being: A social psychological perspective on mental health. Psychological Bulletin. 1988, 103: 193-210. 10.1037/0033-2909.103.2.193.PubMedGoogle Scholar
  62. Lazarus RS, Folkman S: Stress appraisal and coping. 1984, New York: SpringerGoogle Scholar
  63. Sarason IG: Experimental approaches to test anxiety: Attention and the use of information. Anxiety: Current trends in theory and research. Edited by: Spielberger CD. 1972, Academic Press: New YorkGoogle Scholar
  64. Sarason IG: Test anxiety, attention, and the general problem of anxiety. Stress and anxiety. Edited by: Spielberger CD, Sarason IG. 1975, Hemisphere: Washington, DC, 165-187.Google Scholar
  65. Cannon WB: The wisdom of the body. 1932, New York: Norton, 2Google Scholar
  66. Seyle H: The Physiology and pathology of exposure to stress. 1950, Montreal: ActaGoogle Scholar
  67. Seyle H: Annual report of stress. 1951, McGraw-Hill: New YorkGoogle Scholar
  68. Bakker AB: Job resources boost work engagement, particularly when job demands are high. Journal of Educational Psychology. 2007, 99: 274-284. 10.1037/0022-0663.99.2.274.Google Scholar
  69. Glebocka A, Lisowska E: Professional burnout and stress among polish physicians explained by the Hobfoll resources theory. Journal of Physiology and Pharmacology. 2007, 58: 243-252.Google Scholar
  70. Gorter R: Positive engagement and job resources in dental practice. Community Dentistry and Oral Epidemiology. 2008, 36: 47-54.PubMedGoogle Scholar
  71. Grant A, Campbell E: Doing good, doing harm, being well and burning out: The interactions of perceived prosocial and antisocial impact in service work. Journal of occupational and organizational psychology. 2007, 80: 665-691. 10.1348/096317906X169553.Google Scholar
  72. Halbesleben J, Rathert C: Linking physician burnout and patient outcomes: Exploring the dyadic relationship between physicians and patients. Health Care Management Review. 2008, 33: 29-39.PubMedGoogle Scholar
  73. Harris R, Harris K, Harvey P: A test of competing models of the relationships among perceptions of organizational politics, perceived organizational support, and individual outcomes. Journal of Social Psychology. 2007, 147: 631-655. 10.3200/SOCP.147.6.631-656.PubMedGoogle Scholar
  74. Innstrand S: Positive and negative work-family interaction and burnout: A longitudinal study of reciprocal relations. Work and Stress. 2008, 22: 1-15. 10.1080/02678370801975842.Google Scholar
  75. Luthans F: The mediating role of psychological capital in the supportive organizational climate -- employee performance relationship. Journal of Organizational Behavior. 2008, 29: 219-238. 10.1002/job.507.Google Scholar
  76. Hobfoll SE: Stress, Culture, and Community. 1998, New York, Plenum PressGoogle Scholar
  77. Hobfoll SE: Conservation of resources: A new attempt at conceptualizing stress. American Psychologist. 1989, 44 (3): 513-524.PubMedGoogle Scholar
  78. Hobfoll SE: Stress, Culture, and Community. 1998, New York, Plenum PressGoogle Scholar
  79. Hobfoll SE: Stress, Culture, and Community. 1998, New York, Plenum PressGoogle Scholar
  80. Hobfoll SE: Conservation of resources: A new attempt at conceptualizing stress. American Psychologist. 1989, 44 (3): 513-524.PubMedGoogle Scholar
  81. Foa EB, Foa UG: Resource theory of social exchange. Contemporary topics in social psychology. Edited by: Thibaut JW, Spence JT, Carson RC. 1976, General Learning Press: Morristown, NJ, 99-131.Google Scholar
  82. Foa UG, Foa EB: Societal structures of the mind. 1974, Springfield, Illinois: ThomasGoogle Scholar
  83. Hobfoll SE: Conservation of resources: A new attempt at conceptualizing stress. American Psychologist. 1989, 44 (3): 513-524.PubMedGoogle Scholar
  84. Aspinwall LG: The Psychology of Future-Oriented Thinking: From Acheivement to Proactive Coping, Adaptation, and Aging. Motivation and Emotion. 2005, 29 (4): 203-235. 10.1007/s11031-006-9013-1.Google Scholar
  85. Hobfoll SE: The impact of communal-mastery versus self-mastery on emotional outcomes during stressful conditions: A prospective study of Native American women. American Journal of Community Psychology. 2002, 30 (6): 853-871. 10.1023/A:1020209220214.PubMedGoogle Scholar
  86. Hobfoll SE: Resource loss, resource gain, and emotional outcomes among inner city women. Journal of Personality and Social Psychology. 2003, 84 (3): 632-643. 10.1037/0022-3514.84.3.632.PubMedGoogle Scholar
  87. Hobfoll SE, Lilly RS: Resource conservation as a strategy for community psychology. Journal of Community Psychology. 1993, 21: 128-148. 10.1002/1520-6629(199304)21:2<128::AID-JCOP2290210206>3.0.CO;2-5.Google Scholar
  88. Hobfoll SE: Stress, Culture, and Community. 1998, New York, Plenum PressGoogle Scholar
  89. Hobfoll SE: Conservation of resources: A new attempt at conceptualizing stress. American Psychologist. 1989, 44 (3): 513-524.PubMedGoogle Scholar
  90. Hobfoll SE: Stress, Culture, and Community. 1998, New York, Plenum PressGoogle Scholar
  91. Holahan CJ: Resource loss, resource gain, and depressive symptoms: A 10-year model. Journal of Personality and Social Psychology. 1999, 77 (3): 620-630. 10.1037/0022-3514.77.3.620.PubMedGoogle Scholar
  92. Holahan CJ, Moos RH: Personality, Coping, and Family Resources in Stress Resistance: A Longitudical Analysis. Journal of Personality and Social Psychology. 1986, 51 (2): 389-10.1037/0022-3514.51.2.389.PubMedGoogle Scholar
  93. Hobfoll SE, Leiberman JR: Personality and social resources in immediate and continued stress resistance among women. Journal of Personality and Social Psychology. 1987, 52: 18-26. 10.1037/0022-3514.52.1.18.PubMedGoogle Scholar
  94. Hurst SA: Physicians' views on resource availability and equity in four European health care systems. BMC Health Services Research. 2007, 7: 10.1186/1472-6963-7-137.Google Scholar
  95. Hobfoll SE: Conservation of resources: A new attempt at conceptualizing stress. American Psychologist. 1989, 44 (3): 513-524.PubMedGoogle Scholar
  96. Hobfoll SE: Stress, Culture, and Community. 1998, New York, Plenum PressGoogle Scholar
  97. Hobfoll SE: Stress, Culture, and Community. 1998, New York, Plenum PressGoogle Scholar
  98. Zamani GH, Gorgievski-Duijvesteijn MJ, Zarafshani K: Coping with Drought: Towards a Multilevel Understanding Based on Conservation of Resources Theory. Human Ecology. 2006, 34: 677-692. 10.1007/s10745-006-9034-0.Google Scholar
  99. Berberian M: Communal Rebuilding After Destruction: The World Trade Center Children's Mural Project. Psychoanalytic Social Work. 2003, 10 (1): 27-41. 10.1300/J032v10n01_04.Google Scholar
  100. Shamai M: Personal Experience in Professional Narratives: The Role of Helpers' Families in Their Work With Terror Victims. Family Process. 2005, 44 (2): 203-10.1111/j.1545-5300.2005.00054.x.PubMedGoogle Scholar
  101. de Jong J: Stressors, Resources, and Strain at Work: A Longitudinal Test of the Triple-Match Principle. Journal of Applied Psychology. 2006, 91 (5): 1359-1374. 10.1037/0021-9010.91.5.1359.Google Scholar
  102. Freedy JR, Hobfoll SE: Stress Inoculation for Reduction of Burnout: A Conservation of Resources Approach. Anxiety, Stress, and Coping. 1994, 6: 311-325. 10.1080/10615809408248805.Google Scholar
  103. Halbesleben JRB: Sources of Social Support and Burnout: A Meta-Analytic Test of the Conservation of Resources Model. Journal of Applied Psychology. 2006, 91 (5): 1134-1145. 10.1037/0021-9010.91.5.1134.PubMedGoogle Scholar
  104. Hobfoll SE, Shriom : Stress and burnout in the workplace: Conservation of Resources. Handbook of organization behavior. Edited by: Golembiewski RT. 1993, Marcel Dekker: New York, 41-60.Google Scholar
  105. Lapierre LM, Hackett RD, Taggar S: A Test of the Links between Family Interference with Work, Job Enrichment and Leader-Member Exchange. Applied Psychology: An International Review. 2006, 55 (4): 489-511. 10.1111/j.1464-0597.2006.00234.x.Google Scholar
  106. Westman M: Organizational Stress through the Lens of Conservation of Resources (COR) Theory. Research in Occupational Stress and Well Being. 2004, 167-220. full_text. JAIGoogle Scholar
  107. Zamani GH, Gorgievski-Duijvesteijn MJ, Zarafshani K: Coping with Drought: Towards a Multilevel Understanding Based on Conservation of Resources Theory. Human Ecology. 2006, 34: 677-692. 10.1007/s10745-006-9034-0.Google Scholar
  108. Berwick DM: Disseminating innovations in health care. JAMA. 2003, 289 (15): 1969-1975. 10.1001/jama.289.15.1969.PubMedGoogle Scholar
  109. Bowen S: The Need to Know project evaluation 2002-2004. 2004, [http://www.rha.cpe.umanitoba.ca/pdf_brochures/NTK_eval_sept_04.pdf]Google Scholar
  110. Bowen S, Zwi AB: Pathways to 'Evidence-Informed' Policy and Practice: A Framework for Action. Policy Forum. 2005, 2 (7): 0600-0608.Google Scholar
  111. Berwick DM: Disseminating innovations in health care. JAMA. 2003, 289 (15): 1969-1975. 10.1001/jama.289.15.1969.PubMedGoogle Scholar
  112. Bowen S: The Need to Know project evaluation 2002-2004. 2004, [http://www.rha.cpe.umanitoba.ca/pdf_brochures/NTK_eval_sept_04.pdf]Google Scholar
  113. Bowen S, Zwi AB: Pathways to 'Evidence-Informed' Policy and Practice: A Framework for Action. Policy Forum. 2005, 2 (7): 0600-0608.Google Scholar
  114. Kitson A, Harvey G, McCormack B: Enabling the implementation of evidence-based practice: a conceptual framework. Quality in Health Care. 1998, 7 (3): 149-158. 10.1136/qshc.7.3.149.PubMedPubMed CentralGoogle Scholar
  115. Berwick DM: Disseminating innovations in health care. JAMA. 2003, 289 (15): 1969-1975. 10.1001/jama.289.15.1969.PubMedGoogle Scholar
  116. Bowen S: The Need to Know project evaluation 2002-2004. 2004, [http://www.rha.cpe.umanitoba.ca/pdf_brochures/NTK_eval_sept_04.pdf]Google Scholar
  117. Bowen S, Zwi AB: Pathways to 'Evidence-Informed' Policy and Practice: A Framework for Action. Policy Forum. 2005, 2 (7): 0600-0608.Google Scholar
  118. Shaperman J, Backer TE: The role of knowledge utilization in adopting innovations from academic medical centers. Hospital and Health Services Administration. 1995, 40 (3): 401-413.PubMedGoogle Scholar
  119. Lavis J: How can research organizations more effectively transfer research knowledge to decision makers?. The Milbank Quarterly. 2003, 81: 221-248. 10.1111/1468-0009.t01-1-00052.PubMedPubMed CentralGoogle Scholar
  120. Jacobson N, Butterill D, Goering P: Organizational factors that influence university-based researchers' engagement in knowledge transfer activities. Science Communication. 2004, 25 (3): 246-259. 10.1177/1075547003262038.Google Scholar
  121. International Development Research Centre, Coalition for Global Health Research, and U.o.O. Institute for Population Health: Knowledge Translation in Health and Development: Research to Policy Strategies. 2003, [http://web.idrc.ca/uploads/user-S/10963022581KT_in_Health_and_Development.pdf]Google Scholar
  122. Landry R: The Knowledge-value chain: a conceptual framework for knowledge translation in health. Bulletin of the World Health Organization. 2006, 84 (8): 597-602. 10.2471/BLT.06.031724.PubMedPubMed CentralGoogle Scholar
  123. (COHRED) C.o.H.R.f.D: Statement 2007: Are international health research programs doing enough to develop research systems and skills in low and middle income countries?. 2007, [http://www.cohred.org/sites/default/files/COHREDStatement2007ResponsibleVerticalProgrammingLOWRES.pdf]Google Scholar
  124. World Health Organization: Report from the Ministerial Summit of Health Research. 2004, [http://www.who.int/rpc/summit/documents/summit_report_final2.pdf]Google Scholar
  125. Bowen S: The Need to Know project evaluation 2002-2004. 2004, [http://www.rha.cpe.umanitoba.ca/pdf_brochures/NTK_eval_sept_04.pdf]Google Scholar
  126. Bowen S, Zwi AB: Pathways to 'Evidence-Informed' Policy and Practice: A Framework for Action. Policy Forum. 2005, 2 (7): 0600-0608.Google Scholar
  127. Bradley EH: Translating research into practice: Speeding the adoption of innovative health care programs. 2004, [http://www.commonwealthfund.org/programs/elders/bradley_translating_research_724.pdf]Google Scholar
  128. De Long DW, Fahey L: Diagnosing cultural barriers to knowledge management. The Academy of Management Executive. 2000, 14 (4): 113-127.Google Scholar
  129. Figueroa ME, Kincaid DL, Rani M, Lewis G: Communication for social change: An integrated model for measuring the process and its outcomes. Communication for Social Change Working Paper Series. 2002, 1: 1-41.Google Scholar
  130. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  131. Kitson A, Harvey G, McCormack B: Enabling the implementation of evidence based practice: a conceptual framework. Quality in Health Care. 1998, 7: 149-158. 10.1136/qshc.7.3.149.PubMedPubMed CentralGoogle Scholar
  132. Kitson A: Approaches used to implement research findings into nursing practice: report of a study tour to Australia and New Zealand. International Journal of Nursing Practice. 2001, 7 (6): 392-405. 10.1046/j.1440-172X.2001.00310.x.PubMedGoogle Scholar
  133. Logan J, Graham ID: Toward a comprehensive interdisciplinary model of health care research use. Science Communication. 1998, 20 (2): 227-246. 10.1177/1075547098020002004.Google Scholar
  134. Bowen S: The Need to Know project evaluation 2002-2004. 2004, [http://www.rha.cpe.umanitoba.ca/pdf_brochures/NTK_eval_sept_04.pdf]Google Scholar
  135. Bowen S, Zwi AB: Pathways to 'Evidence-Informed' Policy and Practice: A Framework for Action. Policy Forum. 2005, 2 (7): 0600-0608.Google Scholar
  136. De Long DW, Fahey L: Diagnosing cultural barriers to knowledge management. The Academy of Management Executive. 2000, 14 (4): 113-127.Google Scholar
  137. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  138. Kitson A, Harvey G, McCormack B: Enabling the implementation of evidence based practice: a conceptual framework. Quality in Health Care. 1998, 7: 149-158. 10.1136/qshc.7.3.149.PubMedPubMed CentralGoogle Scholar
  139. Kitson A: Approaches used to implement research findings into nursing practice: report of a study tour to Australia and New Zealand. International Journal of Nursing Practice. 2001, 7 (6): 392-405. 10.1046/j.1440-172X.2001.00310.x.PubMedGoogle Scholar
  140. Greenhalgh T: Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly. 2004, 82 (4): 1-33. 10.1111/j.0887-378X.2004.00325.x.Google Scholar
  141. Williamson P: From dissemination to use: Management and organizational barriers to the application of health services research findings. Health Bulletin. 1992, 50 (1): 78-86.PubMedGoogle Scholar
  142. International Development Research Centre, Coalition for Global Health Research, and U.o.O. Institute for Population Health: Knowledge Translation in Health and Development: Research to Policy Strategies. 2003, [http://web.idrc.ca/uploads/user-S/10963022581KT_in_Health_and_Development.pdf]Google Scholar
  143. Figueroa ME, Kincaid DL, Rani M, Lewis G: Communication for social change: An integrated model for measuring the process and its outcomes. Communication for Social Change Working Paper Series. 2002, 1: 1-41.Google Scholar
  144. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  145. Kitson A: Approaches used to implement research findings into nursing practice: report of a study tour to Australia and New Zealand. International Journal of Nursing Practice. 2001, 7 (6): 392-405. 10.1046/j.1440-172X.2001.00310.x.PubMedGoogle Scholar
  146. Williamson P: From dissemination to use: Management and organizational barriers to the application of health services research findings. Health Bulletin. 1992, 50 (1): 78-86.PubMedGoogle Scholar
  147. Zahra SA, George G: Absorptive capacity: A review, reconceptualization, and extension. Academy of Management Executive. 2002, 27 (2): 185-203.Google Scholar
  148. Kiefer L: Fostering evidence-based decision making in Canada: Examining the need for a Canadian Population and Public Health Evidence Centre and Research Network. Canadian Journal of Public Health. 2005, 96 (3): I1-I19.PubMedGoogle Scholar
  149. Kothari A, Birch S, Charles C: 'Interaction' and research utilisation in health policies and programs: Does it work?. Health Policy. 2005, 71 (1): 117-125. 10.1016/j.healthpol.2004.03.010.PubMedGoogle Scholar
  150. Landry R, Lyons R, Amara N, Warner G, Ziam S, Halilem N, Kerouak M: Two knowledge translation planning tools for stroke teams. 2006, [http://www.ahprc.dal.ca/pdf/kt/2006_KTDocument.pdf]Google Scholar
  151. Bowen S: The Need to Know project evaluation 2002-2004. 2004, [http://www.rha.cpe.umanitoba.ca/pdf_brochures/NTK_eval_sept_04.pdf]Google Scholar
  152. Bowen S, Zwi AB: Pathways to 'Evidence-Informed' Policy and Practice: A Framework for Action. Policy Forum. 2005, 2 (7): 0600-0608.Google Scholar
  153. Shaperman J, Backer TE: The role of knowledge utilization in adopting innovations from academic medical centers. Hospital and Health Services Administration. 1995, 40 (3): 401-413.PubMedGoogle Scholar
  154. Lavis J: How can research organizations more effectively transfer research knowledge to decision makers?. The Milbank Quarterly. 2003, 81: 221-248. 10.1111/1468-0009.t01-1-00052.PubMedPubMed CentralGoogle Scholar
  155. International Development Research Centre, Coalition for Global Health Research, and U.o.O. Institute for Population Health: Knowledge Translation in Health and Development: Research to Policy Strategies. 2003, [http://web.idrc.ca/uploads/user-S/10963022581KT_in_Health_and_Development.pdf]Google Scholar
  156. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  157. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-45. 10.1002/chp.49.PubMedGoogle Scholar
  158. Lemieux-Charles L, McGuire W, Ilsa B: Building interorganizational knowledge for evidence-based health system change. Health Care Management Review. 2002, 27 (3): 48-59.PubMedGoogle Scholar
  159. Beyer JM, Trice HM: The utilization process: A conceptual framework and synthesis of empirical findings. Administrative Science Quarterly. 1982, 27: 591-622. 10.2307/2392533.Google Scholar
  160. Moynihan R: Using health research in policy and practice: case studies from nine countries. 2004, Academy Health, [http://www.milbank.org/reports/0409Moynihan/0409_318_TEXT_r2.pdf]Google Scholar
  161. Norman CD, Huerta T: Knowledge transfer and exchange through social networks: building foundations for a community practice within tobacco control. Implementation Science. 2006, 1 (20):
  162. Lavis JN: Assessing country-level efforts to link research to action. Bulletin of the World Health Organization. 2006, 84 (8): 10.2471/BLT.06.030312.
  163. Logan J, Graham ID: Toward a comprehensive interdisciplinary model of health care research use. Science Communication. 1998, 20 (2): 227-246. 10.1177/1075547098020002004.Google Scholar
  164. Lomas J: Improving research dissemination and uptake in the health sector: Beyond the sound of one hand clapping. 1997, [http://www.chsrf.ca/knowledge_transfer/pdf/handclapping_e.pdf]Google Scholar
  165. Estabrooks CA: Mapping the research utilization field in nursing. Canadian Journal of Nursing Research. 1999, 31 (1): 53-72.PubMedGoogle Scholar
  166. Estabrooks CA: Modeling the individual determinants of research utilization. Western Journal of Nursing Research. 1999, 21 (6): 758-772. 10.1177/01939459922044171.PubMedGoogle Scholar
  167. Berwick DM: Disseminating innovations in health care. JAMA. 2003, 289 (15): 1969-1975. 10.1001/jama.289.15.1969.PubMedGoogle Scholar
  168. Lavis J: How can research organizations more effectively transfer research knowledge to decision makers?. The Milbank Quarterly. 2003, 81: 221-248. 10.1111/1468-0009.t01-1-00052.PubMedPubMed CentralGoogle Scholar
  169. Bradley EH: Translating research into practice: Speeding the adoption of innovative health care programs. 2004, [http://www.commonwealthfund.org/programs/elders/bradley_translating_research_724.pdf]Google Scholar
  170. Figueroa ME, Kincaid DL, Rani M, Lewis G: Communication for social change: An integrated model for measuring the process and its outcomes. Communication for Social Change Working Paper Series. 2002, 1: 1-41.Google Scholar
  171. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  172. Kitson A: Approaches used to implement research findings into nursing practice: report of a study tour to Australia and New Zealand. International Journal of Nursing Practice. 2001, 7 (6): 392-405. 10.1046/j.1440-172X.2001.00310.x.PubMedGoogle Scholar
  173. Greenhalgh T: Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly. 2004, 82 (4): 1-33. 10.1111/j.0887-378X.2004.00325.x.Google Scholar
  174. Williamson P: From dissemination to use: Management and organizational barriers to the application of health services research findings. Health Bulletin. 1992, 50 (1): 78-86.PubMedGoogle Scholar
  175. Zahra SA, George G: Absorptive capacity: A review, reconceptualization, and extension. Academy of Management Executive. 2002, 27 (2): 185-203.Google Scholar
  176. Landry R, Lyons R, Amara N, Warner G, Ziam S, Halilem N, Kerouak M: Two knowledge translation planning tools for stroke teams. 2006, [http://www.ahprc.dal.ca/pdf/kt/2006_KTDocument.pdf]Google Scholar
  177. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-45. 10.1002/chp.49.PubMedGoogle Scholar
  178. Lemieux-Charles L, McGuire W, Ilsa B: Building interorganizational knowledge for evidence-based health system change. Health Care Management Review. 2002, 27 (3): 48-59.PubMedGoogle Scholar
  179. Beyer JM, Trice HM: The utilization process: A conceptual framework and synthesis of empirical findings. Administrative Science Quarterly. 1982, 27: 591-622. 10.2307/2392533.Google Scholar
  180. Moynihan R: Using health research in policy and practice: case studies from nine countries. 2004, Academy Health, [http://www.milbank.org/reports/0409Moynihan/0409_318_TEXT_r2.pdf]Google Scholar
  181. Farkas M: Knowledge dissemination and utilization in gerontology: An organizing framework. The Gerontologist. 2003, 43 (1): 47-56.PubMedGoogle Scholar
  182. Baker GR, King H, MacDonald JL, Horbar JD: Using organizational assessment surveys for improvement in neonatal intensive care. Pediatrics. 111 (4): 156-152.
  183. Fox FV, Staw BM: The trapped administrator: Effects of job insecurity and policy resistance upon commitment to a course of action. Administrative Science Quarterly. 1979, 24: 449-471. 10.2307/2989922.Google Scholar
  184. Knudsen MP, von Zedtwitz M: Transfering capacity: The flipside of absorptive capacity. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  185. Lavis JN: Towards systematic reviews that inform health care management and policy-making. Journal of health services research and policy. 2005, 10 (1): S-35-S48. 10.1258/1355819054308549.Google Scholar
  186. Aage T: Absorptive capabilities in industrial districts: The role of knowledge creation and learning and boundary spanning mechanisms. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  187. Rycroft-Malone J: Getting evidence into practice: ingredients for change. Nursing Standard. 2002, 16 (37): 38-43.PubMedGoogle Scholar
  188. Rycroft-Malone J: Ingredients for change: Revisiting a conceptual framework. Quality Safety Health Care. 2002, 11: 174-180. 10.1136/qhc.11.2.174.Google Scholar
  189. Bradley EH: Translating research into practice: Speeding the adoption of innovative health care programs. 2004, [http://www.commonwealthfund.org/programs/elders/bradley_translating_research_724.pdf]Google Scholar
  190. Kothari A, Birch S, Charles C: 'Interaction' and research utilisation in health policies and programs: Does it work?. Health Policy. 2005, 71 (1): 117-125. 10.1016/j.healthpol.2004.03.010.PubMedGoogle Scholar
  191. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-45. 10.1002/chp.49.PubMedGoogle Scholar
  192. Baker RG: Using organizational assessment surveys for improvement in neonatal intensive care. Pediatrics. 2003, 111 (4): e419-e425.PubMedGoogle Scholar
  193. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  194. Williamson P: From dissemination to use: Management and organizational barriers to the application of health services research findings. Health Bulletin. 1992, 50 (1): 78-86.PubMedGoogle Scholar
  195. Lemieux-Charles L, McGuire W, Ilsa B: Building interorganizational knowledge for evidence-based health system change. Health Care Management Review. 2002, 27 (3): 48-59.PubMedGoogle Scholar
  196. Lavis JN: How can research organizations more effectively transfer research knowledge to decision makers?. The Milbank Quarterly. 2003, 81 (2): 221-248. 10.1111/1468-0009.t01-1-00052.PubMedPubMed CentralGoogle Scholar
  197. Logan J, Graham ID: Toward a comprehensive interdisciplinary model of health care research use. Science Communication. 1998, 20 (2): 227-246. 10.1177/1075547098020002004.Google Scholar
  198. Estabrooks CA: Mapping the research utilization field in nursing. Canadian Journal of Nursing Research. 1999, 31 (1): 53-72.PubMedGoogle Scholar
  199. Estabrooks CA: Modeling the individual determinants of research utilization. Western Journal of Nursing Research. 1999, 21 (6): 758-772. 10.1177/01939459922044171.PubMedGoogle Scholar
  200. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  201. Landry R, Lyons R, Amara N, Warner G, Ziam S, Halilem N, Kerouak M: Two knowledge translation planning tools for stroke teams. 2006, [http://www.ahprc.dal.ca/pdf/kt/2006_KTDocument.pdf]Google Scholar
  202. Lemieux-Charles L, McGuire W, Ilsa B: Building interorganizational knowledge for evidence-based health system change. Health Care Management Review. 2002, 27 (3): 48-59.PubMedGoogle Scholar
  203. Moynihan R: Using health research in policy and practice: case studies from nine countries. Academy Health 2004, [http://www.milbank.org/reports/0409Moynihan/0409_318_TEXT_r2.pdf]
  204. Farkas M: Knowledge dissemination and utilization in gerontology: An organizing framework. The Gerontologist. 2003, 43 (1): 47-56.PubMedGoogle Scholar
  205. Rycroft-Malone J: Getting evidence into practice: ingredients for change. Nursing Standard. 2002, 16 (37): 38-43.PubMedGoogle Scholar
  206. Lavis JN: How can research organizations more effectively transfer research knowledge to decision makers?. The Milbank Quarterly. 2003, 81 (2): 221-248. 10.1111/1468-0009.t01-1-00052.PubMedPubMed CentralGoogle Scholar
  207. Lavis JN: How can research organizations more effectively transfer research knowledge to decision makers?. The Milbank Quarterly. 2003, 81 (2): 221-248. 10.1111/1468-0009.t01-1-00052.PubMedPubMed CentralGoogle Scholar
  208. Grimshaw J: Is the involvement of opinion leaders in the implementation of research findings a feasible strategy?. Implementation Science. 2006, 1 (3):
  209. Graham I, Logan J: Innovations in knowledge translation and continuity of care. Canadian Journal of Nursing Research. 2004, 36: 89-103.PubMedGoogle Scholar
  210. Lomas J: Improving research dissemination and uptake in the health sector: Beyond the sound of one hand clapping. 1997, [http://www.chsrf.ca/knowledge_transfer/pdf/handclapping_e.pdf]Google Scholar
  211. Bradley EH: Translating research into practice: Speeding the adoption of innovative health care programs. 2004, [http://www.commonwealthfund.org/programs/elders/bradley_translating_research_724.pdf]Google Scholar
  212. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  213. Kothari A, Birch S, Charles C: 'Interaction' and research utilisation in health policies and programs: Does it work?. Health Policy. 2005, 71 (1): 117-125. 10.1016/j.healthpol.2004.03.010.PubMedGoogle Scholar
  214. Lemieux-Charles L, McGuire W, Ilsa B: Building interorganizational knowledge for evidence-based health system change. Health Care Management Review. 2002, 27 (3): 48-59.PubMedGoogle Scholar
  215. Moynihan R: Using health research in policy and practice: case studies from nine countries. 2004, Academy Health, [http://www.milbank.org/reports/0409Moynihan/0409_318_TEXT_r2.pdf]Google Scholar
  216. Farkas M: Knowledge dissemination and utilization in gerontology: An organizing framework. The Gerontologist. 2003, 43 (1): 47-56.PubMedGoogle Scholar
  217. Rycroft-Malone J: Getting evidence into practice: ingredients for change. Nursing Standard. 2002, 16 (37): 38-43.PubMedGoogle Scholar
  218. Lavis JN: How can research organizations more effectively transfer research knowledge to decision makers?. The Milbank Quarterly. 2003, 81 (2): 221-248. 10.1111/1468-0009.t01-1-00052.PubMedPubMed CentralGoogle Scholar
  219. Logan J, Graham ID: Toward a comprehensive interdisciplinary model of health care research use. Science Communication. 1998, 20 (2): 227-246. 10.1177/1075547098020002004.Google Scholar
  220. Estabrooks CA: Mapping the research utilization field in nursing. Canadian Journal of Nursing Research. 1999, 31 (1): 53-72.PubMedGoogle Scholar
  221. Estabrooks CA: Modeling the individual determinants of research utilization. Western Journal of Nursing Research. 1999, 21 (6): 758-772. 10.1177/01939459922044171.PubMedGoogle Scholar
  222. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  223. Kothari A, Birch S, Charles C: 'Interaction' and research utilisation in health policies and programs: Does it work?. Health Policy. 2005, 71 (1): 117-125. 10.1016/j.healthpol.2004.03.010.PubMedGoogle Scholar
  224. Lemieux-Charles L, McGuire W, Ilsa B: Building interorganizational knowledge for evidence-based health system change. Health Care Management Review. 2002, 27 (3): 48-59.PubMedGoogle Scholar
  225. Beyer JM, Trice HM: The utilization process: A conceptual framework and synthesis of empirical findings. Administrative Science Quarterly. 1982, 27: 591-622. 10.2307/2392533.Google Scholar
  226. Farkas M: Knowledge dissemination and utilization in gerontology: An organizing framework. The Gerontologist. 2003, 43 (1): 47-56.PubMedGoogle Scholar
  227. Grimshaw J: Is the involvement of opinion leaders in the implementation of research findings a feasible strategy?. Implementation Science. 2006, 1 (3):
  228. Graham I, Logan J: Innovations in knowledge translation and continuity of care. Canadian Journal of Nursing Research. 2004, 36: 89-103.PubMedGoogle Scholar
  229. Lavis J: How can research organizations more effectively transfer research knowledge to decision makers?. The Milbank Quarterly. 2003, 81: 221-248. 10.1111/1468-0009.t01-1-00052.PubMedPubMed CentralGoogle Scholar
  230. International Development Research Centre, Coalition for Global Health Research, and U.o.O. Institute for Population Health: Knowledge Translation in Health and Development: Research to Policy Strategies. 2003, [http://web.idrc.ca/uploads/user-S/10963022581KT_in_Health_and_Development.pdf]Google Scholar
  231. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  232. International Development Research Centre, Coalition for Global Health Research, and U.o.O. Institute for Population Health: Knowledge Translation in Health and Development: Research to Policy Strategies. 2003, [http://web.idrc.ca/uploads/user-S/10963022581KT_in_Health_and_Development.pdf]Google Scholar
  233. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  234. Landry R, Lyons R, Amara N, Warner G, Ziam S, Halilem N, Kerouak M: Two knowledge translation planning tools for stroke teams. 2006, [http://www.ahprc.dal.ca/pdf/kt/2006_KTDocument.pdf]Google Scholar
  235. Kitson A: Approaches used to implement research findings into nursing practice: report of a study tour to Australia and New Zealand. International Journal of Nursing Practice. 2001, 7 (6): 392-405. 10.1046/j.1440-172X.2001.00310.x.PubMedGoogle Scholar
  236. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-45. 10.1002/chp.49.PubMedGoogle Scholar
  237. International Development Research Centre, Coalition for Global Health Research, and U.o.O. Institute for Population Health: Knowledge Translation in Health and Development: Research to Policy Strategies. 2003, [http://web.idrc.ca/uploads/user-S/10963022581KT_in_Health_and_Development.pdf]Google Scholar
  238. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  239. Lavis J: How can research organizations more effectively transfer research knowledge to decision makers?. The Milbank Quarterly. 2003, 81: 221-248. 10.1111/1468-0009.t01-1-00052.PubMedPubMed CentralGoogle Scholar
  240. Greenhalgh T: Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly. 2004, 82 (4): 1-33. 10.1111/j.0887-378X.2004.00325.x.Google Scholar
  241. Dal Zotto C: Absorptive Capacity and Knowledge Transfer Between Venture Capital Firms and Their Portfolio Companies. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  242. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  243. Kitson A: Approaches used to implement research findings into nursing practice: report of a study tour to Australia and New Zealand. International Journal of Nursing Practice. 2001, 7 (6): 392-405. 10.1046/j.1440-172X.2001.00310.x.PubMedGoogle Scholar
  244. Zahra SA, George G: Absorptive capacity: A review, reconceptualization, and extension. Academy of Management Executive. 2002, 27 (2): 185-203.Google Scholar
  245. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-45. 10.1002/chp.49.PubMedGoogle Scholar
  246. Lemieux-Charles L, McGuire W, Ilsa B: Building interorganizational knowledge for evidence-based health system change. Health Care Management Review. 2002, 27 (3): 48-59.PubMedGoogle Scholar
  247. Moynihan R: Using health research in policy and practice: case studies from nine countries. 2004, Academy Health, [http://www.milbank.org/reports/0409Moynihan/0409_318_TEXT_r2.pdf]Google Scholar
  248. Rycroft-Malone J: Getting evidence into practice: ingredients for change. Nursing Standard. 2002, 16 (37): 38-43.PubMedGoogle Scholar
  249. Figueroa ME, Kincaid DL, Rani M, Lewis G: Communication for social change: An integrated model for measuring the process and its outcomes. Communication for Social Change Working Paper Series. 2002, 1: 1-41.Google Scholar
  250. Lemieux-Charles L, McGuire W, Ilsa B: Building interorganizational knowledge for evidence-based health system change. Health Care Management Review. 2002, 27 (3): 48-59.PubMedGoogle Scholar
  251. Graham I, Logan J: Innovations in knowledge translation and continuity of care. Canadian Journal of Nursing Research. 2004, 36: 89-103.PubMedGoogle Scholar
  252. Dal Zotto C: Absorptive Capacity and Knowledge Transfer Between Venture Capital Firms and Their Portfolio Companies. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  253. Landry R: The Knowledge-value chain: a conceptual framework for knowledge translation in health. Bulletin of the World Health Organization. 2006, 84 (8): 597-602. 10.2471/BLT.06.031724.PubMedPubMed CentralGoogle Scholar
  254. Figueroa ME, Kincaid DL, Rani M, Lewis G: Communication for social change: An integrated model for measuring the process and its outcomes. Communication for Social Change Working Paper Series. 2002, 1: 1-41.Google Scholar
  255. Kitson A: Approaches used to implement research findings into nursing practice: report of a study tour to Australia and New Zealand. International Journal of Nursing Practice. 2001, 7 (6): 392-405. 10.1046/j.1440-172X.2001.00310.x.PubMedGoogle Scholar
  256. Landry R: The Knowledge-value chain: a conceptual framework for knowledge translation in health. Bulletin of the World Health Organization. 2006, 84 (8): 597-602. 10.2471/BLT.06.031724.PubMedPubMed CentralGoogle Scholar
  257. Estabrooks CA: Mapping the research utilization field in nursing. Canadian Journal of Nursing Research. 1999, 31 (1): 53-72.PubMedGoogle Scholar
  258. Estabrooks CA: Modeling the individual determinants of research utilization. Western Journal of Nursing Research. 1999, 21 (6): 758-772. 10.1177/01939459922044171.PubMedGoogle Scholar
  259. Lavis J: How can research organizations more effectively transfer research knowledge to decision makers?. The Milbank Quarterly. 2003, 81: 221-248. 10.1111/1468-0009.t01-1-00052.PubMedPubMed CentralGoogle Scholar
  260. Figueroa ME, Kincaid DL, Rani M, Lewis G: Communication for social change: An integrated model for measuring the process and its outcomes. Communication for Social Change Working Paper Series. 2002, 1: 1-41.Google Scholar
  261. Ferlie E: The nonspread of innovations: The mediating role of professionals. Academy of Management Journal. 2005, 48 (1): 117-134.Google Scholar
  262. Landry R: The Knowledge-value chain: a conceptual framework for knowledge translation in health. Bulletin of the World Health Organization. 2006, 84 (8): 597-602. 10.2471/BLT.06.031724.PubMedPubMed CentralGoogle Scholar
  263. Estabrooks CA: Mapping the research utilization field in nursing. Canadian Journal of Nursing Research. 1999, 31 (1): 53-72.PubMedGoogle Scholar
  264. Estabrooks CA: Modeling the individual determinants of research utilization. Western Journal of Nursing Research. 1999, 21 (6): 758-772. 10.1177/01939459922044171.PubMedGoogle Scholar
  265. Bradley EH: Translating research into practice: Speeding the adoption of innovative health care programs. 2004, [http://www.commonwealthfund.org/programs/elders/bradley_translating_research_724.pdf]Google Scholar
  266. Williamson P: From dissemination to use: Management and organizational barriers to the application of health services research findings. Health Bulletin. 1992, 50 (1): 78-86.PubMedGoogle Scholar
  267. Greenhalgh T: Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly. 2004, 82 (4): 1-33. 10.1111/j.0887-378X.2004.00325.x.Google Scholar
  268. Williamson P: From dissemination to use: Management and organizational barriers to the application of health services research findings. Health Bulletin. 1992, 50 (1): 78-86.PubMedGoogle Scholar
  269. Kothari A, Birch S, Charles C: 'Interaction' and research utilisation in health policies and programs: Does it work?. Health Policy. 2005, 71 (1): 117-125. 10.1016/j.healthpol.2004.03.010.PubMedGoogle Scholar
  270. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-45. 10.1002/chp.49.PubMedGoogle Scholar
  271. Beyer JM, Trice HM: The utilization process: A conceptual framework and synthesis of empirical findings. Administrative Science Quarterly. 1982, 27: 591-622. 10.2307/2392533.Google Scholar
  272. Baker RG: Using organizational assessment surveys for improvement in neonatal intensive care. Pediatrics. 2003, 111 (4): e419-e425.PubMedGoogle Scholar
  273. Ferlie E: The nonspread of innovations: The mediating role of professionals. Academy of Management Journal. 2005, 48 (1): 117-134.Google Scholar
  274. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-4. 10.1002/chp.49.PubMedGoogle Scholar
  275. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-45. 10.1002/chp.49.PubMedGoogle Scholar
  276. Baker RG: Using organizational assessment surveys for improvement in neonatal intensive care. Pediatrics. 2003, 111 (4): e419-e425.PubMedGoogle Scholar
  277. Kothari A, MacLean L, Edwards N: Research Transfer: An Evaluation Workbook. 2005Google Scholar
  278. Landry R: The Knowledge-value chain: a conceptual framework for knowledge translation in health. Bulletin of the World Health Organization. 2006, 84 (8): 597-602. 10.2471/BLT.06.031724.PubMedPubMed CentralGoogle Scholar
  279. Logan J, Graham ID: Toward a comprehensive interdisciplinary model of health care research use. Science Communication. 1998, 20 (2): 227-246. 10.1177/1075547098020002004.Google Scholar
  280. Fink R, Thompson C, Bonnes D: Overcoming barriers and promoting the use of research in practice. Journal of Nursing Administration - JONA. 2005, 35 (3): 121-129.Google Scholar
  281. Funk S, Champagne M, Tornquist E: Barriers: the barriers to research utilization scale. Applied Nursing Research. 1991, 4 (1): 39-45. 10.1016/S0897-1897(05)80052-7.PubMedGoogle Scholar
  282. Rycroft-Malone J: An exploration of the factors that influence the implementation of evidence into practice. Journal of Clinical Nursing. 2004, 13: 913-924. 10.1111/j.1365-2702.2004.01007.x.PubMedGoogle Scholar
  283. Berwick DM: Disseminating innovations in health care. JAMA. 2003, 289 (15): 1969-1975. 10.1001/jama.289.15.1969.PubMedGoogle Scholar
  284. Shaperman J, Backer TE: The role of knowledge utilization in adopting innovations from academic medical centers. Hospital and Health Services Administration. 1995, 40 (3): 401-413.PubMedGoogle Scholar
  285. Bradley EH: Translating research into practice: Speeding the adoption of innovative health care programs. 2004, [http://www.commonwealthfund.org/programs/elders/bradley_translating_research_724.pdf]Google Scholar
  286. De Long DW, Fahey L: Diagnosing cultural barriers to knowledge management. The Academy of Management Executive. 2000, 14 (4): 113-127.Google Scholar
  287. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  288. Kitson A: Approaches used to implement research findings into nursing practice: report of a study tour to Australia and New Zealand. International Journal of Nursing Practice. 2001, 7 (6): 392-405. 10.1046/j.1440-172X.2001.00310.x.PubMedGoogle Scholar
  289. Greenhalgh T: Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly. 2004, 82 (4): 1-33. 10.1111/j.0887-378X.2004.00325.x.Google Scholar
  290. Williamson P: From dissemination to use: Management and organizational barriers to the application of health services research findings. Health Bulletin. 1992, 50 (1): 78-86.PubMedGoogle Scholar
  291. Kiefer L: Fostering evidence-based decision making in Canada: Examining the need for a Canadian Population and Public Health Evidence Centre and Research Network. Canadian Journal of Public Health. 2005, 96 (3): I1-I19.PubMedGoogle Scholar
  292. Landry R, Lyons R, Amara N, Warner G, Ziam S, Halilem N, Kerouak M: Two knowledge translation planning tools for stroke teams. 2006, [http://www.ahprc.dal.ca/pdf/kt/2006_KTDocument.pdf]Google Scholar
  293. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-45. 10.1002/chp.49.PubMedGoogle Scholar
  294. Beyer JM, Trice HM: The utilization process: A conceptual framework and synthesis of empirical findings. Administrative Science Quarterly. 1982, 27: 591-622. 10.2307/2392533.Google Scholar
  295. Baker RG: Using organizational assessment surveys for improvement in neonatal intensive care. Pediatrics. 2003, 111 (4): e419-e425.PubMedGoogle Scholar
  296. Lavis JN: How can research organizations more effectively transfer research knowledge to decision makers?. The Milbank Quarterly. 2003, 81 (2): 221-248. 10.1111/1468-0009.t01-1-00052.PubMedPubMed CentralGoogle Scholar
  297. Greenhalgh T: Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly. 2004, 82 (4): 1-33. 10.1111/j.0887-378X.2004.00325.x.Google Scholar
  298. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-4. 10.1002/chp.49.PubMedGoogle Scholar
  299. Greenhalgh T: Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly. 2004, 82 (4): 1-33. 10.1111/j.0887-378X.2004.00325.x.Google Scholar
  300. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-45. 10.1002/chp.49.PubMedGoogle Scholar
  301. Baker RG: Using organizational assessment surveys for improvement in neonatal intensive care. Pediatrics. 2003, 111 (4): e419-e425.PubMedGoogle Scholar
  302. Santesso N, Tugwell P: Knowledge Translation in Developing Countries. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 87-96. 10.1002/chp.55.PubMedGoogle Scholar
  303. Greenhalgh T: Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly. 2004, 82 (4): 1-33. 10.1111/j.0887-378X.2004.00325.x.Google Scholar
  304. Logan J, Graham ID: Toward a comprehensive interdisciplinary model of health care research use. Science Communication. 1998, 20 (2): 227-246. 10.1177/1075547098020002004.Google Scholar
  305. Berwick DM: Disseminating innovations in health care. JAMA. 2003, 289 (15): 1969-1975. 10.1001/jama.289.15.1969.PubMedGoogle Scholar
  306. Moynihan R: Using health research in policy and practice: case studies from nine countries. 2004, Academy Health, [http://www.milbank.org/reports/0409Moynihan/0409_318_TEXT_r2.pdf]Google Scholar
  307. Farkas M: Knowledge dissemination and utilization in gerontology: An organizing framework. The Gerontologist. 2003, 43 (1): 47-56.PubMedGoogle Scholar
  308. International Development Research Centre, Coalition for Global Health Research, and U.o.O. Institute for Population Health: Knowledge Translation in Health and Development: Research to Policy Strategies. 2003, [http://web.idrc.ca/uploads/user-S/10963022581KT_in_Health_and_Development.pdf]Google Scholar
  309. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  310. Baker RG: Using organizational assessment surveys for improvement in neonatal intensive care. Pediatrics. 2003, 111 (4): e419-e425.PubMedGoogle Scholar
  311. International Development Research Centre, Coalition for Global Health Research, and U.o.O. Institute for Population Health: Knowledge Translation in Health and Development: Research to Policy Strategies. 2003, [http://web.idrc.ca/uploads/user-S/10963022581KT_in_Health_and_Development.pdf]Google Scholar
  312. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  313. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-45. 10.1002/chp.49.PubMedGoogle Scholar
  314. International Development Research Centre, Coalition for Global Health Research, and U.o.O. Institute for Population Health: Knowledge Translation in Health and Development: Research to Policy Strategies. 2003, [http://web.idrc.ca/uploads/user-S/10963022581KT_in_Health_and_Development.pdf]Google Scholar
  315. Bradley EH: Translating research into practice: Speeding the adoption of innovative health care programs. 2004, [http://www.commonwealthfund.org/programs/elders/bradley_translating_research_724.pdf]Google Scholar
  316. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  317. Landry R: The Knowledge-value chain: a conceptual framework for knowledge translation in health. Bulletin of the World Health Organization. 2006, 84 (8): 597-602. 10.2471/BLT.06.031724.PubMedPubMed CentralGoogle Scholar
  318. Lomas J: Using 'Linkage and Exchange' to move research into policy at a Canadian Foundation. Health Affairs. 2000, 19: 236-240. 10.1377/hlthaff.19.3.236.PubMedGoogle Scholar
  319. Lyons R: Piloting knowledge brokers to promote integrated stroke care in Atlantic Canada. Evidence in action, acting on evidence: A casebook of health services and policy research knowledge translation stories. Edited by: CIHR. 2006, 57-60.Google Scholar
  320. Canadian Health Services Research Foundation: Knowledge Transfer and Exchange website. 2005, [http://www.chsrf.ca/knowledge_transfer/index_e.php]Google Scholar
  321. Rycroft-Malone J: Ingredients for Change: Revisiting a conceptual model. Qual. Saf. Health Care. 2006, 11: 174-180. 10.1136/qhc.11.2.174.Google Scholar
  322. International Development Research Centre, Coalition for Global Health Research, and U.o.O. Institute for Population Health: Knowledge Translation in Health and Development: Research to Policy Strategies. 2003, [http://web.idrc.ca/uploads/user-S/10963022581KT_in_Health_and_Development.pdf]Google Scholar
  323. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  324. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-45. 10.1002/chp.49.PubMedGoogle Scholar
  325. Aage T: Absorptive capabilities in industrial districts: The role of knowledge creation and learning and boundary spanning mechanisms. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  326. Rycroft-Malone J: Getting evidence into practice: ingredients for change. Nursing Standard. 2002, 16 (37): 38-43.PubMedGoogle Scholar
  327. Rycroft-Malone J: Ingredients for change: Revisiting a conceptual framework. Quality Safety Health Care. 2002, 11: 174-180. 10.1136/qhc.11.2.174.Google Scholar
  328. Baker RG: Using organizational assessment surveys for improvement in neonatal intensive care. Pediatrics. 2003, 111 (4): e419-e425.PubMedGoogle Scholar
  329. Lavis JN: How can research organizations more effectively transfer research knowledge to decision makers?. The Milbank Quarterly. 2003, 81 (2): 221-248. 10.1111/1468-0009.t01-1-00052.PubMedPubMed CentralGoogle Scholar
  330. Estabrooks CA: Mapping the research utilization field in nursing. Canadian Journal of Nursing Research. 1999, 31 (1): 53-72.PubMedGoogle Scholar
  331. Estabrooks CA: Modeling the individual determinants of research utilization. Western Journal of Nursing Research. 1999, 21 (6): 758-772. 10.1177/01939459922044171.PubMedGoogle Scholar
  332. Greenhalgh R: Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly. 2004, 82: 581-629. 10.1111/j.0887-378X.2004.00325.x.PubMedPubMed CentralGoogle Scholar
  333. Landry R: The Knowledge-value chain: a conceptual framework for knowledge translation in health. Bulletin of the World Health Organization. 2006, 84 (8): 597-602. 10.2471/BLT.06.031724.PubMedPubMed CentralGoogle Scholar
  334. Lomas J: Using 'Linkage and Exchange' to move research into policy at a Canadian Foundation. Health Affairs. 2000, 19: 236-240. 10.1377/hlthaff.19.3.236.PubMedGoogle Scholar
  335. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  336. Kiefer L: Fostering evidence-based decision making in Canada: Examining the need for a Canadian Population and Public Health Evidence Centre and Research Network. Canadian Journal of Public Health. 2005, 96 (3): I1-I19.PubMedGoogle Scholar
  337. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-45. 10.1002/chp.49.PubMedGoogle Scholar
  338. Lemieux-Charles L, McGuire W, Ilsa B: Building interorganizational knowledge for evidence-based health system change. Health Care Management Review. 2002, 27 (3): 48-59.PubMedGoogle Scholar
  339. Beyer JM, Trice HM: The utilization process: A conceptual framework and synthesis of empirical findings. Administrative Science Quarterly. 1982, 27: 591-622. 10.2307/2392533.Google Scholar
  340. Fox FV, Staw BM: The trapped administrator: Effects of job insecurity and policy resistance upon commitment to a course of action. Administrative Science Quarterly. 1979, 24: 449-471. 10.2307/2989922.Google Scholar
  341. Aage T: Absorptive capabilities in industrial districts: The role of knowledge creation and learning and boundary spanning mechanisms. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  342. Ferlie E: The nonspread of innovations: The mediating role of professionals. Academy of Management Journal. 2005, 48 (1): 117-134.Google Scholar
  343. Bradley EH: Translating research into practice: Speeding the adoption of innovative health care programs. 2004, [http://www.commonwealthfund.org/programs/elders/bradley_translating_research_724.pdf]Google Scholar
  344. Farkas M: Knowledge dissemination and utilization in gerontology: An organizing framework. The Gerontologist. 2003, 43 (1): 47-56.PubMedGoogle Scholar
  345. Rycroft-Malone J: Getting evidence into practice: ingredients for change. Nursing Standard. 2002, 16 (37): 38-43.PubMedGoogle Scholar
  346. Fox FV, Staw BM: The trapped administrator: Effects of job insecurity and policy resistance upon commitment to a course of action. Administrative Science Quarterly. 1979, 24: 449-471. 10.2307/2989922.Google Scholar
  347. Lemieux-Charles L, McGuire W, Ilsa B: Building interorganizational knowledge for evidence-based health system change. Health Care Management Review. 2002, 27 (3): 48-59.PubMedGoogle Scholar
  348. Baker RG: Using organizational assessment surveys for improvement in neonatal intensive care. Pediatrics. 2003, 111 (4): e419-e425.PubMedGoogle Scholar
  349. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-45. 10.1002/chp.49.PubMedGoogle Scholar
  350. Baker RG: Using organizational assessment surveys for improvement in neonatal intensive care. Pediatrics. 2003, 111 (4): e419-e425.PubMedGoogle Scholar
  351. Logan J, Graham ID: Toward a comprehensive interdisciplinary model of health care research use. Science Communication. 1998, 20 (2): 227-246. 10.1177/1075547098020002004.Google Scholar
  352. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-45. 10.1002/chp.49.PubMedGoogle Scholar
  353. Aage T: Absorptive capabilities in industrial districts: The role of knowledge creation and learning and boundary spanning mechanisms. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  354. International Development Research Centre, Coalition for Global Health Research, and U.o.O. Institute for Population Health: Knowledge Translation in Health and Development: Research to Policy Strategies. 2003, [http://web.idrc.ca/uploads/user-S/10963022581KT_in_Health_and_Development.pdf]Google Scholar
  355. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  356. Lemieux-Charles L, McGuire W, Ilsa B: Building interorganizational knowledge for evidence-based health system change. Health Care Management Review. 2002, 27 (3): 48-59.PubMedGoogle Scholar
  357. Fox FV, Staw BM: The trapped administrator: Effects of job insecurity and policy resistance upon commitment to a course of action. Administrative Science Quarterly. 1979, 24: 449-471. 10.2307/2989922.Google Scholar
  358. Rycroft-Malone J: Getting evidence into practice: ingredients for change. Nursing Standard. 2002, 16 (37): 38-43.PubMedGoogle Scholar
  359. Aage T: Absorptive capabilities in industrial districts: The role of knowledge creation and learning and boundary spanning mechanisms. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  360. Greenhalgh R: Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly. 2004, 82: 581-629. 10.1111/j.0887-378X.2004.00325.x.PubMedPubMed CentralGoogle Scholar
  361. Rycroft-Malone J: An exploration of the factors that influence the implementation of evidence into practice. Journal of Clinical Nursing. 2004, 13: 913-924. 10.1111/j.1365-2702.2004.01007.x.PubMedGoogle Scholar
  362. Rycroft-Malone J: Ingredients for Change: Revisiting a conceptual model. Qual. Saf. Health Care. 2006, 11: 174-180. 10.1136/qhc.11.2.174.Google Scholar
  363. Bowen S, Zwi AB: Pathways to 'Evidence-Informed' Policy and Practice: A Framework for Action. Policy Forum. 2005, 2 (7): 0600-0608.Google Scholar
  364. International Development Research Centre, Coalition for Global Health Research, and U.o.O. Institute for Population Health: Knowledge Translation in Health and Development: Research to Policy Strategies. 2003, [http://web.idrc.ca/uploads/user-S/10963022581KT_in_Health_and_Development.pdf]Google Scholar
  365. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  366. Lemieux-Charles L, McGuire W, Ilsa B: Building interorganizational knowledge for evidence-based health system change. Health Care Management Review. 2002, 27 (3): 48-59.PubMedGoogle Scholar
  367. Moynihan R: Using health research in policy and practice: case studies from nine countries. 2004, Academy Health, [http://www.milbank.org/reports/0409Moynihan/0409_318_TEXT_r2.pdf]Google Scholar
  368. Rycroft-Malone J: Getting evidence into practice: ingredients for change. Nursing Standard. 2002, 16 (37): 38-43.PubMedGoogle Scholar
  369. Rycroft-Malone J: Ingredients for change: Revisiting a conceptual framework. Quality Safety Health Care. 2002, 11: 174-180. 10.1136/qhc.11.2.174.Google Scholar
  370. Rycroft-Malone J: An exploration of the factors that influence the implementation of evidence into practice. Journal of Clinical Nursing. 2004, 13: 913-924. 10.1111/j.1365-2702.2004.01007.x.PubMedGoogle Scholar
  371. Bowen S: The Need to Know project evaluation 2002-2004. 2004, [http://www.rha.cpe.umanitoba.ca/pdf_brochures/NTK_eval_sept_04.pdf]Google Scholar
  372. Bowen S, Zwi AB: Pathways to 'Evidence-Informed' Policy and Practice: A Framework for Action. Policy Forum. 2005, 2 (7): 0600-0608.Google Scholar
  373. Kitson A: Approaches used to implement research findings into nursing practice: report of a study tour to Australia and New Zealand. International Journal of Nursing Practice. 2001, 7 (6): 392-405. 10.1046/j.1440-172X.2001.00310.x.PubMedGoogle Scholar
  374. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-45. 10.1002/chp.49.PubMedGoogle Scholar
  375. Farkas M: Knowledge dissemination and utilization in gerontology: An organizing framework. The Gerontologist. 2003, 43 (1): 47-56.PubMedGoogle Scholar
  376. Baker RG: Using organizational assessment surveys for improvement in neonatal intensive care. Pediatrics. 2003, 111 (4): e419-e425.PubMedGoogle Scholar
  377. Kothari A, MacLean L, Edwards N: Research Transfer: An Evaluation Workbook. 2005Google Scholar
  378. Santesso N, Tugwell P: Knowledge Translation in Developing Countries. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 87-96. 10.1002/chp.55.PubMedGoogle Scholar
  379. Bowen S: The Need to Know project evaluation 2002-2004. 2004, [http://www.rha.cpe.umanitoba.ca/pdf_brochures/NTK_eval_sept_04.pdf]Google Scholar
  380. Bowen S, Zwi AB: Pathways to 'Evidence-Informed' Policy and Practice: A Framework for Action. Policy Forum. 2005, 2 (7): 0600-0608.Google Scholar
  381. Lavis J: How can research organizations more effectively transfer research knowledge to decision makers?. The Milbank Quarterly. 2003, 81: 221-248. 10.1111/1468-0009.t01-1-00052.PubMedPubMed CentralGoogle Scholar
  382. International Development Research Centre, Coalition for Global Health Research, and U.o.O. Institute for Population Health: Knowledge Translation in Health and Development: Research to Policy Strategies. 2003, [http://web.idrc.ca/uploads/user-S/10963022581KT_in_Health_and_Development.pdf]Google Scholar
  383. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  384. Lavis JN: How can research organizations more effectively transfer research knowledge to decision makers?. The Milbank Quarterly. 2003, 81 (2): 221-248. 10.1111/1468-0009.t01-1-00052.PubMedPubMed CentralGoogle Scholar
  385. Kothari A, MacLean L, Edwards N: Research Transfer: An Evaluation Workbook. 2005Google Scholar
  386. Santesso N, Tugwell P: Knowledge Translation in Developing Countries. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 87-96. 10.1002/chp.55.PubMedGoogle Scholar
  387. Aage T: Absorptive capabilities in industrial districts: The role of knowledge creation and learning and boundary spanning mechanisms. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  388. Lavis J: How can research organizations more effectively transfer research knowledge to decision makers?. The Milbank Quarterly. 2003, 81: 221-248. 10.1111/1468-0009.t01-1-00052.PubMedPubMed CentralGoogle Scholar
  389. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-45. 10.1002/chp.49.PubMedGoogle Scholar
  390. Beyer JM, Trice HM: The utilization process: A conceptual framework and synthesis of empirical findings. Administrative Science Quarterly. 1982, 27: 591-622. 10.2307/2392533.Google Scholar
  391. Rycroft-Malone J: An exploration of the factors that influence the implementation of evidence into practice. Journal of Clinical Nursing. 2004, 13: 913-924. 10.1111/j.1365-2702.2004.01007.x.PubMedGoogle Scholar
  392. Rycroft-Malone J: Ingredients for Change: Revisiting a conceptual model. Qual. Saf. Health Care. 2006, 11: 174-180. 10.1136/qhc.11.2.174.Google Scholar
  393. Jansen JJP, Van den Bosch FAJ, Volberda HW: Managing potential and realized absorptive capacity: Antecedents and consequences. DRUID conference on Creating, Sharing, and Transferring Knowledge. 2003, Copenhagen, DenmarkGoogle Scholar
  394. Greenhalgh T: Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly. 2004, 82 (4): 1-33. 10.1111/j.0887-378X.2004.00325.x.Google Scholar
  395. Kothari A, Birch S, Charles C: 'Interaction' and research utilisation in health policies and programs: Does it work?. Health Policy. 2005, 71 (1): 117-125. 10.1016/j.healthpol.2004.03.010.PubMedGoogle Scholar
  396. Lavis JN: Research, Public Policymaking and Knowledge-Translation Processes: Canadian Efforts to Build Bridges. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 37-45. 10.1002/chp.49.PubMedGoogle Scholar
  397. Beyer JM, Trice HM: The utilization process: A conceptual framework and synthesis of empirical findings. Administrative Science Quarterly. 1982, 27: 591-622. 10.2307/2392533.Google Scholar
  398. Moynihan R: Using health research in policy and practice: case studies from nine countries. 2004, Academy Health, [http://www.milbank.org/reports/0409Moynihan/0409_318_TEXT_r2.pdf]Google Scholar
  399. Farkas M: Knowledge dissemination and utilization in gerontology: An organizing framework. The Gerontologist. 2003, 43 (1): 47-56.PubMedGoogle Scholar
  400. Rycroft-Malone J: Getting evidence into practice: ingredients for change. Nursing Standard. 2002, 16 (37): 38-43.PubMedGoogle Scholar
  401. Rycroft-Malone J: Ingredients for change: Revisiting a conceptual framework. Quality Safety Health Care. 2002, 11: 174-180. 10.1136/qhc.11.2.174.Google Scholar
  402. Graham I, Logan J: Innovations in knowledge translation and continuity of care. Canadian Journal of Nursing Research. 2004, 36: 89-103.PubMedGoogle Scholar
  403. Jacobson N, Butterill D, Goering P: Development of a framework for knowledge translation: understanding user context. Journal of Health Services Research and Policy. 2003, 8 (2): 94-99. 10.1258/135581903321466067.PubMedGoogle Scholar
  404. Lomas J: Improving research dissemination and uptake in the health sector: Beyond the sound of one hand clapping. 1997, [http://www.chsrf.ca/knowledge_transfer/pdf/handclapping_e.pdf]Google Scholar
  405. Estabrooks CA: Mapping the research utilization field in nursing. Canadian Journal of Nursing Research. 1999, 31 (1): 53-72.PubMedGoogle Scholar
  406. Estabrooks CA: Modeling the individual determinants of research utilization. Western Journal of Nursing Research. 1999, 21 (6): 758-772. 10.1177/01939459922044171.PubMedGoogle Scholar
  407. Landry R: Two knowledge translation planning tools for stroke teams. 2006Google Scholar
  408. Beyer JM, Trice HM: The utilization process: A conceptual framework and synthesis of empirical findings. Administrative Science Quarterly. 1982, 27: 591-622. 10.2307/2392533.Google Scholar
  409. International Development Research Centre, Coalition for Global Health Research, and U.o.O. Institute for Population Health: Knowledge Translation in Health and Development: Research to Policy Strategies. 2003, [http://web.idrc.ca/uploads/user-S/10963022581KT_in_Health_and_Development.pdf]Google Scholar
  410. Moynihan R: Using health research in policy and practice: case studies from nine countries. 2004, Academy Health, [http://www.milbank.org/reports/0409Moynihan/0409_318_TEXT_r2.pdf]Google Scholar
  411. Santesso N, Tugwell P: Knowledge Translation in Developing Countries. The Journal of Continuing Education in the Health Professions. 2006, 26 (1): 87-96. 10.1002/chp.55.PubMedGoogle Scholar
  412. Kothari A, Birch S, Charles C: 'Interaction' and research utilisation in health policies and programs: Does it work?. Health Policy. 2005, 71 (1): 117-125. 10.1016/j.healthpol.2004.03.010.PubMedGoogle Scholar
  413. Stake RE: Multiple Case Study Analysis. 2006, New York: The Guilford PressGoogle Scholar
  414. Yin RK: Case Study Research: Design and Methods. Applied Social Research Methods Series. 2003, Thousand Oaks, CA: Sage Publications, Inc. 181, 5: ThirdGoogle Scholar
  415. Shrout P, Fleiss JL: Intraclass corellations: Uses in assessing rater reliability. Psychological Bulletin. 1979, 86: 420-428. 10.1037/0033-2909.86.2.420.PubMedGoogle Scholar
  416. Ouimet M: What factors induce health care decision-makers to use clinical evidence guidelines? Evidence from provincial health ministries, regional health authorities, and hospitals in Canada. Social Science and Medicine. 2006, 62: 964-976. 10.1016/j.socscimed.2005.06.040.PubMedGoogle Scholar
  417. Cooke RA, Szumal JL: Measuring normative beliefs and shared behavioral expectations in organizations: The reliability and validity of the Organizational Culture Inventory. Psychological Reports. 1993, 72 (3): 1299-1330.Google Scholar
  418. Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N: Changing the behavior of healthcare professionals: the use of theory in promotinf the uptake of research findings. Journal of Clinical Epidemiology. 2005, 58: 107-112. 10.1016/j.jclinepi.2004.09.002.PubMedGoogle Scholar
  419. Grimshaw J: Changing provider behavior: An overview of systematic reviews of interventions. Medical Care. 2001, 39 (8): 2-45. 10.1097/00005650-200108002-00002.Google Scholar
  420. Health Disparities Task Group: Reducing Health Disparities - Roles of the Health Sector: Discussion Paper. 2004, Public Health Agency of CanadaGoogle Scholar
  421. Ross NA: Unpacking the socioeconomic health gradient: A Canadian intrametropolitan research program. 2005, Health Canada/McGill UniversityGoogle Scholar

Copyright

© Alvaro et al; licensee BioMed Central Ltd. 2010

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.