The ICRC views knowledge translation (KT) as a varied set of tools and methods for bridging the gap between the creation of new knowledge and its broad-based adoption and use by intended beneficiaries. We have defined two primary sets of beneficiaries: Immediately, clinicians across the U.S., who provide services to people with TBI; it is in their power to adopt (or not) practices based on the new knowledge generated by the ICRC. Ultimately, the beneficiaries are people with TBI, whose lives may be improved directly by their adopting new behaviors based on ICRC dissemination of information, or indirectly through new services being provided to them as a result of adoption by clinicians. We have incorporated principles of KT both into research project development and into core activities. In fact, the ICRC's training, dissemination, technical assistance and policy impact activities are part of its KT program.
KT has been fully incorporated into the development of all of the proposed research projects. The first (and most obvious) part of the KT strategy is to design research at the highest level of scientific rigor available for its stage of development. Results are more likely to be adopted to the degree that they are credible. A second part of the KT strategy is to ensure that interventions are created that adhere to "reality" - they need to fit constraints of potential adoption and usage defined by service providers and recipients. The best ways to incorporate this reality (ensuring ecological validity) are two: First, rely upon the voices of providers and recipients in obtaining input to guide the design of the intervention, through use of focus groups, cognitive interviewing and the like. Second, implement interventions in ways that mimic to the greatest extent possible the conditions that will hold sway in settings that are likely to adopt the intervention. Another principle we have adopted to optimize KT is to develop highly detailed manuals, which will be freely disseminated on our Web site once results have been published. In this way, others can duplicate the interventions that we develop.
Two examples of KT activities of the ICRC are described below.
Collaboration with Icahn School of Medicine at Mount Sinai's Masters of Public Health Program
Icahn School of Medicine, through its Department of Community and Preventive Medicine, offers a Masters of Public Health (MPH) degree, a two-year program. Course content tends to focus on disease and disease prevention rather than injury or injury prevention/control. Because much of the curriculum provides tools necessary for research in many disciplines including injury prevention and control, expansion of content to cover topics specific to injury prevention is planned as part of ICRC activities. In addition, a new course, Epidemiology of Injury and Disability Prevention, will be developed in collaboration with the MPH faculty.
Development of Web-Based TBI-Related Health and Wellness Materials
Acute rehabilitation programs typically educate patients and their families only about short-term medical and functional issues that are likely to arise after discharge (e.g., medications, a follow-up visit scheduled with a physician). Minimal education is directed at education about TBI-related health conditions or the impact of normal aging that place individuals with TBI at increased risk of morbidity. All too often, individuals with TBI and their families return to the community feeling they have inadequate information about how to live with disability. Consequently they are poorly prepared to cope effectively with new health problems that arise over time. While psycho-education has been shown to be useful in maximizing individual adjustment, enhancing living with a disability and minimizing secondary disability, only minimal consumer-friendly information is available for individuals with TBI about health-related challenges in living with brain injury.
Consequently, the goals of this project are to create health information modules related to healthy living, prevention of secondary disabilities and prevention of chronic conditions associated with TBI, and make them readily available on the web. These self-help materials will be developed by the project staff, with input from consumer focus groups. Issues to be explored with the focus groups will include identifying the health concerns of participants living with TBI, identifying what individuals would like to know about managing their health, what difficulties have been encountered in obtaining health care and staying healthy, and how health information would be best presented for maximal use. Health and wellness modules will be developed and placed on our Web site (www.tbicentral.org). To assist in compiling the modules, a thorough literature and web-based review will be conducted. Repeat focus groups will be conducted to elicit further refinement of content prior to placing materials on the web.
Modules to be developed will address a wide variety of health-related topics. The actual modules that will emerge may include all or some of the following:
- Improving Mental Health
- Benefits of Smoking Cessation
- Healthy Eating
- Benefits of Exercise
- The Importance of Preventive Medical Follow-Up
- Dealing with the Physical Challenges of TBI
- Preventing Recurrent Injury
- Dealing with Substance and Alcohol Abuse
- Safer Sex
The ICRC will also use traditional presentations and workshops to disseminate findings. A Calendar of Events listing of workshops, presentations, and other training opportunities is available in the Resources section.