A framework for equity-oriented knowledge translation

Description

The framework or "cascade of steps" for equity-oriented knowledge translation (Tugwell et al., 2006a) was developed to support the knowledge translation and implementation step of the equity-effectiveness loop (Tugwell et al., 2006b). The cascade demonstrates how to assess and prioritize barriers and facilitators to the equitable access and use of interventions across important socioeconomic (SES) factors. Identified barriers and facilitators are then used to develop a KT strategy that is tailored to relevant target audiences. This framework also provides guidance on how to evaluate your KT strategy and approaches for knowledge management and sharing of best practices.

Tugwell and colleagues (2006b) published the community equity-effectiveness loop for developing and evaluating interventions and policies that focus on reducing health inequities across all populations. The cascade outlines a process for knowledge translation that takes into account identified barriers and facilitators of the equitable access and use of interventions.

The cascade itself consists of five sequential stages. The authors provide guidance on how to complete each step and use two public health examples to illustrate the application of the method.

Steps for Using Method/Tool

The five steps of the community equity-effectiveness loop are:

1. Identify barriers and facilitators across SES factors for the relevant audiences, defined by the 6 "Ps" (i.e., public, patient, press, practitioner, policy-maker, and private sector)
2. Prioritize modifiable barriers across the 6 Ps by SES
3. Choose KT interventions to address key barriers by adapting evidence, including evidence-based actionable messages, tailored for relevant audiences by SES
4. Determe KT effectiveness by evaluating both process and health outcomes using appropriate study designs by SES
5. Disseminate, diffuse and apply to other clinical conditions for 6Ps