Putting Knowledge into ActionSocial Networks in the Context of Mental Health Promotion

Dr. Cameron NormanDalla Lana School of Public Health

Learning Objectives

Familiarize with the various terms, theories and approaches associated with ‘knowledge translation’ and its family of activities

Understand the role of social networks in facilitating learning and behaviour change

Recognize the organizational and cultural barriers to successful integration of knowledge into new practices

From what we know to what we doIt is taking a generation to transform knowledge created in ‘the lab’ into useful health practices and even longer for policies

E.g., First Surgeon General’s Report on Smoking: 1964; Climate change research in 1970’s

If better knowledge and evidence-informed practice is the answer -- what is the question?

Diffusion of InnovationsCreating fit between people, values, needs and circumstances requiring knowledge

Multiple Stages

Agenda Setting

Matching

Redefining or restructuring

Clarifying

Routinizing

Ottawa Model of Research Use

GRAHAM, I. D. & LOGAN, J., (2004). INNOVATIONS IN KNOWLEDGE TRANSFER AND CONTINUITY OF CARE, CANADIAN JOURNAL OF NURSING RESEARCH PP. 89–103

CIHR Knowledge to Action Process Model

Knowledge TranslationPopularized by the Canadian Institutes of Health Research

Model to conceptualize how knowledge is created, transfered, and adopted into practice within health sciences

Similar terms:

Knowledge transfer & exchange

Knowledge mobilization

Translational research

Education & Learning?

KT Fundamentals

Synthesis

Dissemination

Exchange

Ethically sound

Application of knowledge

Knowledge Brokers

Conceived as a strategy to bring people and ideas together through a knowledgeable intermediary

Knowledge brokering ‘draws researchers and decision-makers out of their silos’ (CHSRF, 2007)

Knowledge brokers require:

Solid technical knowledge

Strong communication skills

Conflict resolution & negotiation skills

Facilitation & leadership competencies

Generations of Knowledge Application

Generation Language Focus

1960 - mid 1990’s

DisseminationDiffusion

Knowledge transferKnowledge uptake

Knowledge product

mid 1990’s - present

Knowledge exchangeKnowledge

process

2008(?) -- Knowledge integrationKnowledge

contextBEST, A. , HYATT, R.A., & NORMAN, C.D. (2008). KNOWLEDGE INTEGRATION:

CONCEPTUALIZING COMMUNICATIONS IN CANCER CONTROL SYSTEMS. PATIENT EDUCATION & COUNSELING, 71, 319-327

Knowledge Transfer

Knowledge is a product

The key process is a handoff from research producers to research users

Knowledge is generalizable across contexts

Degree of use is a function of effective packaging (i.e., better communication = better use)

Knowledge ExchangeKnowledge comes from multiple sources -- research, theory and practice

Social relationships are key vehicles for learning; collaboration and dialogue are critical

Knowledge is context-linked and must be adapted

Degree of use is a function of effective relationships and processes (e.g., best practices)

Knowledge IntegrationKnowledge emerges and is embedded within priorities, culture and context

Explicit and tacit knowledge go together

Relationships are mediated by organizational and systemic structures and require a systems view

Degree of use is a function of integration within the system

BEST, A. , HYATT, R.A., & NORMAN, C.D. (2008). KNOWLEDGE INTEGRATION: CONCEPTUALIZING COMMUNICATIONS IN CANCER CONTROL SYSTEMS. PATIENT

EDUCATION & COUNSELING, 71, 319-327

Putting Knowledge Translation & Integration into Action

Communities of Practice

Voluntary, self-organized, focussed collectives of people and organizations who work toward common understanding on a given issue

No centralized command structure

Create networks of knowledge through sharing, collaboration, and common language development

Communities of Practice

WENGER, E. (1998). COMMUNITIES OF

PRACTICE: LEARNING, MEANING AND IDENTITY.

CAMBRIDGE, UK: CAMBRIDGE UNIVERSITY

PRESS

Social Networks

"In a world where individuals make decisions based not only on their own judgments but also on the judgments of others, quality is not enough”

Watts, D (2003). Six Degrees, p.250

Norman, CD & Huerta, T (2006).Implementation Science, 1, (1), 20

HUERTA, NORMAN, BEST, MORTIMER, MOOR & BUCHAN (unpublished)

Why we Interact: Thoughts About Networks

“Birds of a feather flock together”

“You complete me”

“There’s power in numbers”

“Surround yourself with good people”

“Its not what you know, it’s who you know”

“Keep your friends close and your enemies closer”

Networking Theories

Structural holes (A friend of a friend)

Balance (Bridge building)

Collective Action

Proximity

Contagion

Birds of a Feather...

Homophily

homo (gr): “Same” + phil (gr): “Love”

A dyad theory that expresses the degree to which individuals interact based on similar characteristics and attitudes. This can explain segregation or differentiation (network closeness or distance)

A friend of yours...

Balance

Unlike homophily (which inspires creation of relationships with those who are similar), balance drives towards those who have relationships with those we are related to

You complete me...

Structural Holes

Based on economic models such as opportunity costs

Suggests we build relationships with others that provide unique skills, knowledge, resources, etc..

Focus is on ‘boundary spanners’

Actor-level theory

Norman, Charnaw-Burger, Yip, Saad & Lombardo (2010). Journal of Evaluation in Clinical Practice.

Networks & Health

Those with more obese social relations were more likely to be obese themselves

What does this suggest?

What are the implications of this finding?

Bearman PS, Moody J, Stovel K.(2004) Chains of affection: The structure of adolescent romantic and sexual networks. American Journal of Sociology, Vol. 110, (1).

Some Thoughts & Questions

What do KTA activities look like in your place of work or study?

How can our understanding of community help us put knowledge into action sooner?

How do we account for quality (& who’s standards are we applying)?

What other theories can help us out?