KNOWLEDGE UPTAKE TRENDS:The Case of CHSRF’s Mythbusters

Jonathan SachsSelma DidicStephen PetersenKaye Phillips

Canadian Health Services Research Foundation

May 31, 2012

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Background CHSRF is an independent

organization dedicated to accelerating healthcare improvement and transformation for Canadians

Mythbusters summarizes the best available evidence to challenge a widely held belief about healthcare in Canada

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Motivation Mythbusters as a KT Tool

CHSRF is interested in the uptake of the its knowledge products Beyond self-perception

Objective Determine the uptake of the Mythbusters series and its

role in contributing to evidence-informed decision-making in Canada

In-depth case study of a research summary

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Defining and Measuring ‘Uptake’Uptake

Acquisition Application Effects of Application (Policy Change)

Indicators• Mythbusters are readily accessed by key audiences

• Mythbusters are referenced by key audiences•Mythbusters are applied to inform healthcare policy and decision-making• Mythbusters are used in an educational context

• Mythbusters contribute to evidence-informed policy changes that affect health services•Mythbusters contribute to strengthened capacity in research evidence use

MethodsWebsite AnalyticsNewsletter Subscription Analysis

Citation Analysis Key Informant Interviews

Key Informant Interviews

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Defining and Measuring ‘Uptake’ Methods

Google Analytics & e-Newsletter Subscription Analysis

Citation analysis Peer-reviewed journals, grey literature

11 Key informant interviews Identified from 3 key audiences of Mythbusters:

Educators Applied Research & Policy Community Government Policymakers

Inclusion Criteria: Citation or Self-Identification of Use

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Findings - Acquisition The Mythbusters series has evolved into one

of CHSRF’s flagship products

Web analytics 40-50,000 Unique page views annually Represents ~10% of all CHSRF web traffic

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Findings - Acquisition

11%

38%28%

14%

1%8%

Mythbuster 'Click-throughs' By Broad Institutitional Category

Non_Govt

Govt

Academic_Research

Delivery

Industry

Unknown

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Findings – Acquisition

29%

25%

17%

11%

5%

4%

3%2%

2%1%1%

Mythbuster ‘Click Throughs’ by Province

Ontario

British Columbia

Quebec

Alberta

Nova Scotia

Manitoba

Saskatchewan

New Brunswick

Newfoundland

PEI

Yukon

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Findings – Application Overall, Mythbusters have been cited in 239

documents since 2000.

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20120

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20

30

40

50

60

70

80

0 19 7

23 26

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46 44

7075

59

36

#of y

early

cita

tions

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Findings – Application Five Mythbusters made up 36% of all citations.

Myth: A parallel private system would reduce waiting times in the public system (46)

Myth: The aging population is to blame for uncontrollable healthcare costs (38)

Myth: User fees would stop waste and ensure better use of the healthcare system (26)

Myth: Seeing a nurse practitioner instead of a doctor is second-class care (24)

Myth: An ounce of prevention buys a pound of cure (22)

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Findings – Application

Journal paper/publication23%

Conference papers/an-nouncement or presentations

2%

Online/full paper 4%

Reports 24%Book/book chapter/textbook

5%

Thesis/student paper5%

Course syllabus10%

Trade literature (trade journals/online

brochures) 14%

Meeting Resolutions/Court decisions

1%

Media (Newspapers, Mag-azines, Wire Feeds)

13%

Mythbuster Citations - Source Types

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Findings – Application Factors that encourage ‘Application’

Summative/Short Evidence-Based Conversational/Accessible Language Framing/Style/Presentation Issue-Focused

Factors that would increase likelihood of ‘Application’ Increase confidence in Mythbusters Improve Dissemination/Communication Feedback/Communication Mechanisms for CHSRF

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Findings – Application

Educational Context Course curriculum

Improves understanding of contemporary health issues

Positive student reactions Capacity building

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Findings – Effects of ApplicationPolicy Context Mythbusters applied as a decision-support to inform

policy direction both directly and indirectly Health Canada (2010-2012)

User Fees Doctor Emigration to the USA

Nova Scotia Dept. of Health & Wellness (2010) ER Care

Winnipeg Regional Health Authority (2008) Chronic Disease

CIHI – End of Life Report (2007)

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Findings – Effects of Application Evidence that Mythbusters have played a role

in shifting the ‘culture of research use*’ over the last 12 years EvidenceNetwork.ca

2 Major CIHR grants Published 170 Op-Eds

Applied Researchers keep them ‘top of mind’ Speaking engagements ‘Service-oriented’ work

*Lomas, 1997

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Challenges of measuring policy change Complexity, Contribution

Limited to uptake of a single product

Website Statistics & Newsletter Limited sample from 2008-2012

Citation Analysis Databases

Key Informant Interviews Purposeful Sample

Limitations

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Implications

For CHSRF Reaffirms value of our knowledge products Allows for improvements to target key

audiences/effectivenessFor Wider Community Case study provides specific evidence of how

research ‘uptake’ can occur Findings can inform future efforts to

encourage research utilization

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Thank You!