Healthcare Policy

Healthcare Policy 7(2) October 2011 : 83-120.doi:10.12927/hcpol.2011.22620
Research Paper

Knowledge Translation in Mental Health: A Scoping Review

Elliot M. Goldner, Victoria Jeffries, Dan Bilsker, Emily Jenkins, Matthew Menear and Lisa Petermann

Abstract

Intensified knowledge translation (KT) efforts are considered important in the field of mental health in order to accelerate the implementation of various developments in research, policy and practice. A scoping review of KT focused on the field of mental health was undertaken to help inform development of a Knowledge Exchange Centre being initiated by the Mental Health Commission of Canada. A systematic search of publications in English and French identified 187 publications that met inclusion criteria. Relevant literature was found across a number of disparate thematic research areas: implementation science, community-based and participatory action research, shared decision-making studies, mental health literacy research, network analysis and studies directly addressing KT. The available literature is concerned predominantly with KT efforts between a few specific stakeholder dyads. A paradigm shift has been emerging and has resulted in a progressively broader perspective, incorporating a wider range of participants and increased valuing of experiential knowledge.

The "scoping review" is a methodology designed to quickly and systematically identify the breadth of literature in an area being researched. It has four major functions: (a) to map the current state of literature in an area of interest, (b) to determine the usefulness or feasibility of conducting a systematic review, (c) to summarize and disseminate research findings to an audience (e.g., policy makers, healthcare providers) and (d) to identify gaps or areas where further research is required (Arksey and O'Malley 2005; Levac et al. 2010). It may be contrasted with the systematic review, which is more restricted in focus and seeks to answer particular research questions from the available literature.

This scoping review was undertaken to inform strategic planning for the development of a Knowledge Exchange Centre (KEC) – a component of the Mental Health Commission of Canada, a national organization created in 2007 through a federal endowment with a 10-year mandate to help improve mental health in Canada. The KEC, now being developed, will constitute one of the Commission's key initiatives and will seek to mobilize knowledge that will bring about action aimed to achieve meaningful and robust improvements to mental health in Canada. Development of the strategic plan for the KEC involved a review of the existing literature addressing knowledge translation (KT) focused on mental health issues.

The following definition of KT, advanced by the Canadian Institutes of Health Research (2010), has been widely adopted in the field of healthcare and was used in this study:

[A] dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system. This process takes place within a complex system of interactions between researchers and knowledge users.

Interest in KT is not confined to the field of healthcare and has permeated many disciplines, including education, marketing, engineering, economics, information technology, community development and various business enterprises. In regard to health services research and health policy, Canadian contributors have often been at the forefront of developments in KT research, theory and practice (e.g., Barwick et al. 2009; Dobbins et al. 2009; Driedger et al. 2010; Gagnon 2009; Goering et al. 2003; Grimshaw et al. 2001; Jacobson et al. 2003; Lavis et al. 2006; Légaré et al. 2010; Lomas 1993, 2000; McGrath et al. 2009; Mitton et al. 2007; Straus et al. 2009; Waddell et al. 2005). The potential value of KT in achieving improvements in healthcare delivery and health outcomes has generated substantial enthusiasm, and KT has become a prominent element within Canadian health research funding organizations (e.g., Lomas 2000; Graham and Tetroe 2009). Evidence for the effectiveness of KT is accumulating gradually, but remains limited (Mitton et al. 2007). In approaching this scoping review of mental health-related KT we sought to cast a wide net, examining a broad range of findings, ideas and developments, while also aiming to identify gaps, unanswered questions and challenges that might emerge in reviewing the published literature.

Methods

This scoping review followed five steps:

1. Development of research questions

Three questions guided selection of relevant sources: (a) What is the nature of research activity concerning KT focused on mental health? (b) What types of KT initiatives have been studied in relation to mental health? and (c) What is the nature of research activity concerning processes of KT among stakeholders relevant to mental health?

2. Location of relevant publications

A total of 22 terms were used to search 11 electronic databases of published scientific literature. Search terms included knowledge exchange, knowledge transfer, knowledge translation, knowledge linkage, knowledge mobilization, knowledge management, knowledge sharing, knowledge utilization, knowledge distribution, knowledge diffusion, knowledge realization, knowledge embodiment, knowledge sharing + transfer, implementation research, research + use, information sharing, knowledge economy, knowledge level, organizational behaviour, evidence-based practice, diffusion of innovation and action research. An initial literature search was undertaken in English and, subsequently, a search of the French literature using translations of these terms was carried out. This latter search took into account linguistic differences, such as single English terms being captured by multiple French terms (e.g., knowledge being referred to as connaissance or savoir).

The 11 electronic databases searched included PsycINFO, CINAHL, Consumer Health Complete, EconLit, Global Health, Health Source – Consumer and Nursing/Academic editions, MEDLINE, SocINDEX, PubMed and Érudit. This search procedure gathered approximately 10,000 abstracts. These abstracts were then searched for keywords related to mental health, including mental, psyc (an abbreviation appropriate for both psychology- and psychiatry-related papers), depression, schizophrenia and anxiety. This secondary search reduced the list of abstracts to 326. These remaining abstracts were manually reviewed by members of the research team using the screening tool described in the next section. Papers were included if they addressed KT in the area of mental health and were published in peer-reviewed journals or dissertation abstracts in English or French. All papers were included regardless of publication date. We focused on the area of mental health broadly but excluded papers focused on low-income countries because of the likely differences in the structures and processes of exchange and communication of knowledge from those that exist in Canada.

Following these steps, 123 abstracts were identified initially as meeting our inclusion criteria. Preliminary analysis of the abstracts and discussion identified additional research areas as likely places to find relevant publications that did not appear in the initial round of searches. We also hand-searched reference lists of highly relevant papers and included those known to the authors, collecting an additional 64 abstracts. We chose to include dissertations with published literature rather than grey literature because of the substantial differences in audience for publicly available reports and unpublished dissertations, which can often be found only via university library memberships.

3. Screening and selection of publications

A screening tool was developed to determine relevance of papers to the exchange of knowledge related to mental health and code the type of data provided (e.g., empirical data, reviews, theoretical discussions). At the end of this process, 187 papers were deemed relevant, with 82% inter-rater agreement. Raters met to discuss disagreements in coding, and decisions about including or excluding papers were made jointly.

4. Organizing publications by use of appropriate framework

The papers were organized and coded as per the scoping review process proposed by Arksey and O'Malley (2005). Each of the 187 publications was categorized by country based on the location of the first author. We categorized the research approach as either quantitative, qualitative, discussion or other and included additional descriptors of research design based on design characteristics that were stated within the papers when these were included.

The publications were also categorized utilizing the knowledge exchange framework adopted by the Mental Health Commission of Canada (see Figure 1) in regard to the stakeholder groups that the KT addressed. The six stakeholder groups are as follows: (a) people with lived experience (PWLE) of mental health problems, which is a group that is broader than "patients," "clients" or "service-users," because the group is not limited to those who receive services but includes anyone who has experienced mental health problems directly; (b) family caregivers, i.e., family and friends of people with lived experience who may provide care and support; (c) policy makers; (d) researchers; (e) providers of mental health care; and (f) other stakeholders who interact with people suffering from mental health problems, e.g., employers, police or the general public. Publications were classified in regard to type of exchange, identifying KT to have occurred either within one group of stakeholders, i.e., within group; between two groups, i.e., dyad; or across three or more stakeholder groups, i.e., polyad. The stakeholder groups that were involved were identified.


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5. Elucidation of key themes

This scoping review enabled identification of key themes emerging from within the existing literature on mental health–related KT. By illuminating these themes, we were able to examine key issues, areas of focus and potential gaps.

Results

A full listing of the 187 publications obtained through our systematic search procedures in tabular form, organized by publication date (from earliest to most recent year of publication) and classified into the categories described in this section is available online at: https://www.longwoods.com/content/22620.

Year of publication

Figure 2 shows our findings regarding the publication dates of the papers that were selected in this review. Most papers were published relatively recently; the majority appeared in the literature over the four-year period immediately preceding this study, i.e., from 2007 to 2010.


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Country

Publications emanated largely from research conducted in the United States (67; 36%), Canada (62; 33%), the United Kingdom (20; 11%) and Australia (19; 10%), with additional contributions from researchers located in the Netherlands, Sweden, Germany, Iceland, France, Austria, Finland, New Zealand and China.

Research approach and research design

Of the 187 publications, 59 (32%) were categorized as discussion papers. Another 51 studies (27%) were classified as utilizing quantitative research methodologies. These included 22 studies (43% of the quantitative group) described as randomized controlled trials, two of which were designated to be cluster-randomized controlled trials. Other research designs found in the quantitative group included non-randomized controlled trials, pre–post trials, trials with waiting list controls and cross-sectional surveys.

There were 51 (27%) studies classified as qualitative in research approach. These included 26 studies (50% of the qualitative group) that were described as utilizing a participatory action research design. Additional descriptors for qualitative studies included case studies, whereas others described the use of focus group, interview-based or thematic analysis methods.

There were 36 publications (19%) that were classified as "other" in their research approach. These included 13 publications (36% of the "other" group) classified as reviews and 10 studies (28% of the "other" group) classified as using mixed-methods research designs (i.e., combining both quantitative and qualitative research approaches).

Type of exchange and groups

Of the total publications, 115 (62%) addressed KT between two stakeholder groups, or dyads. More than half of those studies (62; 54% of those classified as dyads) addressed KT between researchers and providers. Another 24 studies (21% of those classified as dyads) addressed KT between PWLE and providers.

A total of 61 publications (33%) were found to involve KT across three or more stakeholder groups, or polyads. These publications addressed KT across various combinations of stakeholder groups. The most frequent group combinations were PWLE–provider–researcher (9; 15% of polyads) and provider–policy maker–researcher (8; 13% of polyads).

There were 11 publications (6%) that appeared to focus on KT within one stakeholder group, described in Table 1 as "within group." Of these, 8 (73% of those classified as "within group") focused on KT within groups of providers.

Authors Year Title Publication Country Research approach Research design Type of exchange Groups
Byrnes, E. & Johnson, J.H. 1981 Change technology and the implementation of automation in mental healthcare settings Behavior Research Methods 13(4): 573-80 USA Discussion Discussion Dyad Provider-Policy maker
Backer T.E., Liberman, R.P., Kuehnel, T.G. 1986 Dissemination and adoption of innovative psychosocial interventions Journal of Consulting and Clinical Psychology 54(1): 111-18 USA Discussion Discussion Polyad Provider-Policy maker-Researcher
Ray, W.A., Blazer, D.G., Schaffner, W., Federspiel, C.F. 1987 Reducing antipsychotic drug prescribing for nursing home patients: a controlled trial of the effect of an educational visit American Journal of Public Health 77: 1448-50 USA Quantitative Non-randomized controlled trial Dyad Provider-Researcher
Tremblay, M.-A. & Poirier, C. 1989 La Construction culturelle de la recherche psychosociale en santé mentale : les enjeux scientifiques et sociopolitiques Santé Mentale au Québec 14(1): 11-34 Canada Discussion Discussion Dyad Provider-Researcher
Andersen, S.M. & Harthorn, B.H. 1990 Changing the psychiatric knowledge of primary care physicians: the effects of a brief intervention on clinical diagnosis and treatment General Hospital Psychiatry 12: 177-90 USA Quantitative Quasi-experimental Dyad Provider-Researcher
Badger, T.A., Mishel, M.H., Biocca, L.J. et al. 1991 Depression assessment and management: evaluating a community-based mental health training program for nurses Public Health Nursing 8: 170-75 USA Quantitative Pre-post Dyad Provider-Researcher
Steadman, H.J. 1992 Boundary spanners: a key component for the effective interactions of the justice and mental health systems Law and Human Behavior 16(1): 75-87 USA Discussion Discussion Dyad Provider-Other
Avorn, J., Soumerai, S.B., Everitt, D.E. et al. 1992 A randomized trial of a program to reduce the use of psychoactive drugs in nursing homes New England Journal of Medicine 327: 168-73 USA Quantitative Randomized controlled trial Dyad Provider-Researcher
Rutz, W., von Knorring, L., Walinder, J. 1992 Long-term effects of an educational program for general practitioners given by the Swedish Committee for the Prevention and Treatment of Depression Acta Psychiatrica Scandinavica 85: 83-88 Sweden Quantitative Pre-post Dyad Provider-Researcher
Ray, W.A., Taylor J.A., Meador, K.G. et al. 1993 Reducing antipsychotic drug use in nursing homes: a controlled trial of provider education Archives of Internal Medicine 153: 713-21 USA Quantitative Non-randomized controlled trial Dyad Provider-Researcher
Clément, M., Ouellet, F., Coulombe, L. et al. 1995 Le partenariat de recherche : éléments de définition et ancrage dans quelques études de cas Service Social 44(2): 147-64 Canada Discussion Discussion Dyad Provider-Researcher
de Burgh, S., Mattick, R.P., Donnelly, N. et al. 1995 A controlled trial of educational visiting to improve benzodiazepine prescribing in general practice Australian Journal of Public Health 19: 142-48 Australia Quantitative Randomized controlled trial Dyad Provider-Researcher
Kendrick, T., Burns T., Freeling, P. 1995 Randomised controlled trial of teaching general practitioners to carry out structured assessments of their long-term mentally ill patients British Medical Journal 311: 93-97 UK Quantitative Randomized controlled trial Dyad Provider-Researcher
Constantino, V. & Nelson, G. 1995 Changing relationships between self-help groups and mental health professionals: shifting ideology and power Canadian Journal of Community Mental Health 14(2): 55-70 Canada Qualitative Focus groups Polyad PWLE-Family-Provider
Hill, C.E. & Fraser, G.J. 1995 Local knowledge and rural mental health reform Community Mental Health Journal 31(6): 553-68 USA Discussion Discussion, participatory action theory Polyad PWLE-Family-Provider-Policy maker-Researcher
Hannaford, P.C., Thompson, C., Simpson, M. 1996 Evaluation of an educational programme to improve the recognition of psychological illness by general practitioners British Journal of General Practice 46: 333-37 UK Quantitative Pre-post Dyad Provider-Researcher
Campbell, J. 1996 Toward collaborative mental health outcome systems New Directions for Mental Health Services 71: 69-78 USA Discussion Discussion Dyad PWLE-Provider
Burns, T., Millar, E., Garland, C. et al. 1998 Randomised controlled trial of teaching practice nurses to carry out structured assessments of patients receiving depot antipsychotic injections British Medical Journal 48(437): 1845-48 UK Quantitative Randomized controlled trial Dyad Provider-Researcher
Gask, L., Usherwood, T., Thompson, H. et al. 1998 Evaluation of a training package in the assessment and management of depression in primary care Medical Education 32: 190-98 UK Other Mixed methods Dyad Provider-Researcher
Goldberg, H.I., Wagner, E.H. et al. 1998 A randomized controlled trial of CQI teams and academic detailing: can they alter compliance with guidelines? Joint Commission Journal on Quality Improvement 24: 130-42 USA Quantitative Randomized controlled trial Dyad Provider-Researcher
Gerrity, M.S., Cole, S.A., Dietrich, A.J. et al. 1999 Improving the recognition and management of depression: is there a role for physician education? Journal of Family Practice: 48(12): 949-57 USA Quantitative Randomized controlled trial Dyad Provider-Researcher
Mason, J. & Freemantle, N. 1999 The effect of the distribution of Effective Healthcare Bulletins on prescribing selective serotonin reuptake inhibitors in primary care Health Trends 30: 120-25 UK Quantitative Pre-post Dyad Provider-Researcher
Worrall, G., Angel, J., Chaulk, P. et al. 1999 Effectiveness of an educational strategy to improve family physicians' detection and management of depression: a randomized controlled trial Canadian Medical Association Journal 161(1): 37-40 Canada Quantitative Randomized controlled trial Dyad Provider-Researcher
Poirier, M., Larose, S., Ste-Marie, F. et al. 1999 Splendeurs et miséres de la concertation locale en santé mentale : un regard du terrain Canadian Journal of Community Mental Health 18(2): 113-29 Canada Discussion Discussion Within group Provider-Provider
Brown, J.B., Shye, D. et al. 2000 Controlled trials of CQI and academic detailing to implement a clinical practice guideline for depression Joint Commission Journal on Quality Improvement 26(1): 39-54 USA Quantitative Randomized controlled trial Dyad Provider-Researcher
Heslop, L., Elsom, S., Parker, N. 2000 Improving continuity of care across psychiatric and emergency services: combining patient data within a participatory action research framework Journal of Advanced Nursing 31(1): 135-43 Australia Qualitative Participatory action research Dyad Provider-Researcher
Thompson, C., Kinmonth, A.L., Stevens, L. et al. 2000 Effects of a clinical practice guideline and practice-based education on detection and outcome of depression in primary care: Hampshire Depression Project randomised controlled trial The Lancet 355(9199): 185-91 UK Quantitative Randomized controlled trial Dyad Provider-Researcher
Townsend, E., Birch, D.E., Langley, J. et al. 2000 Participatory research in a mental health clubhouse Occupational Therapy Journal of Research 20(1): 18-44 USA Qualitative Participatory action research Dyad PWLE-Researcher
Corrigan, P.W., Steiner, L., McCracken, S.G. et al. 2001 Strategies for disseminating evidence-based practices to staff who treat people with serious mental illness Psychiatric Services 52(12): 1598-606 USA Other Review Dyad Provider-Policy maker
Rosenheck, R.A. 2001 Organizational process: a missing link between research and practice Psychiatric Services 52: 1607-12 USA Discussion Discussion Dyad Provider-Policy maker
Baker, R., Reddish, S., Robertson, N. et al. 2001 Randomised controlled trial of tailored strategies to implement guidelines for the management of patients with depression in general practice British Journal of General Practice 51: 737-41 UK Quantitative Randomized controlled trial Dyad Provider-Researcher
Hodges, B., Inch, C., Silver, I. 2001 Improving the psychiatric knowledge, skills and attitudes of primary care physicians American Journal of Psychiatry 158: 1579-86 Canada Other Review Dyad Provider-Researcher
Lesage, A.D., Stip, E., Grunberg, F. 2001 "What's up, doc?" The context, limitations and issues for clinicians in evidence-based medicine Canadian Journal of Psychiatry 46(5): 396-402 Canada Discussion Discussion Dyad Provider-Researcher
Lin, E.H., Simon, G.E., Katzelnick, D.J. et al. 2001 Does physician education on depression management improve treatment in primary care? Journal of General Internal Medicine 16: 614-19 USA Quantitative Pre-post Dyad Provider-Researcher
Naismith, S.L., Hickie, I.B., Scott, E.M. et al. 2001 Effects of mental health training and clinical audit on general practitioners' management of common mental disorders Medical Journal of Australia 175 (Suppl.): S42-47 Australia Quantitative Pre-post Dyad Provider-Researcher
van Eijk, M.E.C., Avorn, J., Porsius, A.J. et al. 2001 Reducing prescribing of highly anticholinergic antidepressants for elderly people: randomised trial of group versus individual academic detailing British Medical Journal 322: 654-57 Netherlands Quantitative Randomized controlled trial Dyad Provider-Researcher
Broner, N., Franczak, M., Dye, C. et al. 2001 Knowledge transfer, policy making and community empowerment: a consensus model approach for providing public mental health and substance abuse services Psychiatric Quarterly 72(1): 79-102 USA Discussion Discussion, consensus model policy making Polyad Provider-Policy maker-Researcher-Other
Torrey, W.C., Drake, R.E., Dixon, L. et al. 2001 Implementing evidence-based practices for persons with severe mental illnesses Psychiatric Services 52: 45-50 USA Discussion Discussion Polyad PWLE-Family-Provider-Policy maker-Researcher
Bate, S.P. & Robert, G. 2002 Knowledge management and communities of practice in the private sector: lessons for modernizing the National Health Service in England and Wales Public Administration 80(4): 643-66 UK Discussion Discussion Dyad Provider-Policy maker
Fleury, M.J., Mercier, C., Denis, J.-L. 2002 Regional planning implementation and its impact on integration of a mental healthcare network International Journal of Health Planning and Management 17(4): 315-32 Canada Qualitative case study Dyad Provider-Policy maker
Rempfer, M. & Knott, J. 2002 Participatory action research: a model for establishing partnerships between mental health researchers and persons with psychiatric disabilities Occupational Therapy in Mental Health 17(3/4): 151-65 USA Discussion Discussion, participatory action theory Dyad PWLE-Researcher
Ochocka, J., Janzen, R., Nelson, G. 2002 Sharing power and knowledge: professional and mental health consumer/survivor researchers working together in a participatory action research project Psychiatric Rehabilitation Journal 25(4): 379 Canada Qualitative Participatory action Polyad PWLE-Provider-Researcher
Kates, N. 2002 Nouvelles approches : collaboration entre dispensateurs de soins primaires et de santé mentale Santé Mentale au Québec 27(2): 93-108 Canada Discussion Discussion Within group Provider-Provider
Goering, P., Butterill, D., Jacobson, N. et al. 2003 Linkage and exchange at the organizational level: a model of collaboration between research and policy Journal of Health Services Research & Policy 8: 14-19 Canada Discussion Discussion Dyad Policy maker-Researcher
Azocar, F., Cuffel, B., Goldman, W. et al. 2003 The impact of evidence-based guideline dissemination for the assessment and treatment of major depression in a managed behavioral health care organization Journal of Behavioral Health Services Research 30(1): 109-18 USA Quantitative Randomized controlled trial Dyad Provider-Researcher
Charest, R.-M. 2003 La Recherche pour servir les intérêts cliniques et sociaux Psychologie Québec 5 Canada Discussion Discussion Dyad Provider-Researcher
Gilbody, S.M., Whitty, P.M., Grimshaw, J.M. et al. 2003 Improving the detection and management of depression in primary care Quality and Safety in Health Care 12: 149-55 UK Discussion Discussion, article review Dyad Provider-Researcher
Lecomte, Y. 2003 Développer de meilleures pratiques Santé Mentale au Québec 28(1): 9-36 Canada Discussion Discussion Dyad Provider-Researcher
Nadeau, L. 2003 Le Processus d'élaboration des lignes directrices pour de meilleures pratiques : l'exemple des troubles concomitants de santé mentale, d'alcoolisme et de toxicomanie Santé Mentale au Quebec 28(1): 37-53 Canada Other Guideline development Dyad Provider-Researcher
Fenton, W.S. 2003 Shared decision-making: a model for the physician-patient relationship in the 21st century? Acta Psychiatrica Scandinavica 107(6): 401-02 USA Discussion Discussion, shared decision-making Dyad PWLE-Provider
Van Korff, M., Katon, W., Rutter, C. et al. 2003 Effect on disability outcomes of a depression relapse prevention program Psychosomatic Medicine 65: 938-43 USA Quantitative Randomized controlled trial Dyad PWLE-Provider
Ross, E., Ali, A., Toner, B. 2003 Investigating issues surrounding depression in adolescent girls across Ontario: a participatory action research project Canadian Journal of Community Mental Health 22(1): 55-68 Canada Qualitative Participatory action Dyad PWLE-Researcher
Ganju, V. 2003 Implementation of evidence-based practices in state mental health systems Schizophrenia Bulletin 29(1): 125-31 USA Discussion Discussion Polyad Provider-Policy maker-Researcher
Malm, U., Ivarsson, B., Allebeck, P. et al. 2003 Integrated care in schizophrenia: a two-year randomized controlled study of two community-based treatment programs Acta Psychiatrica Scandinavica 107(6): 415-23 Sweden Quantitative Randomized controlled trial Polyad PWLE-Family-Provider
Kirmayer, L., Simpson, C., Cargo, M. 2003 Healing traditions: culture, community and mental health promotion with Canadian Aboriginal peoples Australasian Psychiatry 11(SI): S15-S23 Canada Discussion Discussion Polyad PWLE-Family-Provider-Policy maker-Researcher-Other
Vingilis, E., Hartford, K., Schrecker, T. et al. 2003 Integrating knowledge generation with knowledge diffusion and utilization: a case study analysis of the consortium for applied research and evaluation in mental health. Canadian Journal of Public Health 94(6): 468-71 Canada Qualitative Participatory action, single case design Polyad PWLE-Family-Provider-Policy maker-Researcher-Other
Sullivan, M.P., Kessler, L., Le Clair, J.K. et al. 2004 Defining best practices for specialty geriatric mental health outreach services: lessons for implementing mental health reform Canadian Journal of Psychiatry 49(7): 458-66 Canada Other Review Dyad Provider-Policy maker
Van Os, J., Altamura, A.C., Bobes, J. et al. 2004 Evaluation of the two-way communication checklist as a clinical intervention: results of a multinational, randomized controlled trial British Journal of Psychiatry 184: 79-83 Netherlands Quantitative Questionnaire data Dyad PWLE-Provider
Neufeldt, A.H. 2004 What does it take to transform mental health knowledge into workplace practice? Towards a theory of action HealthcarePapers 5(2): 118-32 Canada Discussion Discussion Polyad Provider-Policy maker-Researcher
Gotham, H.J. 2004 Diffusion of mental health and substance abuse treatments: development, dissemination and implementation Clinical Psychology Science and Practice 11(2): 160-77 USA Discussion Discussion Polyad Provider-Policy maker-Researcher
de Crespigny, C., Emden, C., Kowanko, I., Murray, H. 2004 A partnership model for ethical Indigenous research Collegian: Journal of the Royal college of Nursing Australia 11(4): 7-13 Australia Qualitative Participatory action research Polyad PWLE-Family-Provider-Researcher
Sadavoy, J., Meier, R., Ong, A.Y. 2004 Barriers to access to mental health services for ethnic seniors: the Toronto Study Canadian Journal of Psychiatry 49(3): 192-99 Canada Qualitative Participatory action, grounded theory Polyad PWLE-Family-Provider-Researcher
Minore, B., Boone, M., Katt, M. et al. 2004 Addressing the realities of healthcare in northern Aboriginal communities through participatory action research Journal of Interprofessional Care 18(4): 360-68 Canada Other Mixed methods, participatory action research Polyad PWLE-Provider-Policy maker
Sundar, P. & Ochocka, J. 2004 Bridging the gap between dreams and realities related to employment and mental health: implications for policy and practice Canadian Journal of Community Mental Health 23(1): 75-89 Canada Qualitative Participatory action Polyad PWLE-Provider-Researcher
Waddell, C., Lavis, J.N., Abelson, J. et al. 2005 Research use in children's mental health policy in Canada: maintaining vigilance amid ambiguity Social Science & Medicine 61(8): 1649-57 Canada Qualitative Interviews Dyad Policy maker-Researcher
Bourbonnais, R., Gauthier, N., Vézina, M. et al. 2005 Une intervention en centres d'hébergement et de soins de longue durée visant á réduire les problémes de santé mentale liés au travail Pistes 7(2) Canada Other Mixed methods, participatory action research, qualitative evaluation, questionnaires Dyad Provider-Researcher
Eisses, A.M.H. et al. 2005 Care staff training in detection of depression in residential homes for the elderly British Journal of Psychiatry 186: 404-09 Netherlands Quantitative Randomized controlled trial Dyad Provider-Researcher
Rousseau, C., Alain, N., DePlaen, S. et al. 2005 Repenser la formation continue dans le réseau de la santé et des services sociaux : l'expérience des séminaires interinstitutionnels en intervention transculturelle Nouvelles Pratiques Sociales 17(2): 109-25 Canada Qualitative Case study Dyad Provider-Researcher
Ruzek, J.I., Friedman, M.J., Murray, S. 2005 Toward a knowledge management system for postraumatic stress disorder treatment in veterans' healthcare Psychiatric Annals 35(11): 911-20 USA Discussion Discussion Dyad Provider-Researcher
Bowen, S. & Martens, P. 2005 Demystifying knowledge translation: learning from the community Journal of Health Services Research & Policy 10: 203-11 Canada Qualitative Participatory action research Dyad Provider-Researcher
Glisson, C. & Schoenwald, S.K. 2005 The ARC organizational and community intervention strategy for implementing evidence-based children's mental health treatments Mental Health Services Research 7(4): 243-59 USA Other Review Polyad Family-Provider-Policy maker-Other
Jorm, A.F., Christensen, H., Griffiths, K.M. 2005 The impact of beyondblue: the national depression initiative on the Australian public's recognition of depression and beliefs about treatments Australian & New Zealand Journal of Psychiatry 39(4): 248-54 Australia Quantitative Non-randomized controlled trial Polyad Policy maker-Researcher-Other
Spaniol, S. 2005 "Learned hopefulness": an arts-based approach to participatory action research Art Therapy 22(2): 86-91 USA Qualitative Participatory action, arts-based, conference format Polyad PWLE-Provider-Researcher
Perreault, M., Bonin, J.-P., Veilleux, R. et al. 2005 Expérience de formation croisée dans un contexte d'intégration des services en réseau dans le sud-ouest de Montréal Canadian Journal of Community Mental Health 24(1): 35-49 Canada Other Mixed methods, questionnaires and focus groups Within group Provider-Provider
Garland, A.F., Plemmons, D., Koontz, L. 2006 Research-practice partnership in mental health: lessons from participants Administration and Policy in Mental Health and Mental Health Services Research 33(5): 517-28 USA Qualitative Semi-structured interviewing Dyad Provider-Researcher
Hahn, S., Needham, I., Abderhalden, C. 2006 The effect of a training course on mental health nurses' attitudes on the reasons of patient aggression and its management Journal of Psychiatric and Mental Health Nursing 12(2): 197-204 Switzerland Quantitative Quasi-experimental, pre-post test Dyad Provider-Researcher
Horvitz-Lennon, M., Kilbourne, A.M., Pincus, H.A. 2006 From silos to bridges: meeting the general healthcare needs of adults with severe mental illnesses Health Affairs 25(3): 659-69 USA Discussion Discussion Dyad Provider-Researcher
Ingadottir, E. & Thome, M. 2006 Evaluation of a web-based course for community nurses on postpartum emotional distress Scandinavian Journal of Caring Sciences 20: 86-92 Iceland Quantitative Non-randomized controlled trial Dyad Provider-Researcher
Rinfret-Raynor, M., Dubé, M., Drouin, C. 2006 Le Dépistage de la violence conjugale dans les centre hospitaliers : implantation et évaluation d'un ensemble d'outils Nouvelles Pratiques Sociales 19(1): 72-90 Canada Qualitative Case study Dyad Provider-Researcher
Wimpenny, K., Forsyth, K., Jones, C., Evans, E., Colley, J. 2006 Group reflective supervision: thinking with theory to develop practice British Journal of Occupational Therapy 69(9): 423-28 UK Qualitative Participatory action research Dyad Provider-Researcher
Beresford, P. & Branfield, F. 2006 Developing inclusive partnerships: user-defined outcomes, networking and knowledge - a case study Health and Social Care in the Community 14(5): 436-44 UK Qualitative Interviews Dyad PWLE-Provider
Deegan, P.E. & Drake, R.E. 2006 Shared decision-making and medication management in the recovery process Psychiatric Services 57(11): 1636-39 USA Discussion Discussion Dyad PWLE-Provider
Hamann, J., Langer, B., Winkler, V. et al. 2006 Shared decision-making for inpatients with schizophrenia Acta Psychiatrica Scandinavica 114: 265-73 Germany Quantitative Randomized controlled trial Dyad PWLE-Provider
Jared, R., Adams, J.R., Drake, R.E. 2006 Shared decision-making and evidence-based practice Community Mental Health Journal 42(1): 87-105 USA Discussion Discussion Dyad PWLE-Provider
Mahone, I.H. 2006 Medication decision-making by persons with serious mental illness Dissertation Abstracts International: Section B: The Sciences and Engineering. US: ProQuest Information & Learning USA Quantitative Cross-sectional correlational study Dyad PWLE-Provider
Penn, D.L., Simpson, L.E., Leggett, S., Edie, G., Wood, L. 2006 The development of a website to promote the mental and physical health of sons and daughters of Vietnam veterans of Australia Journal of Consumer Health on the Internet 10(4): 45-63 Australia Qualitative Participatory action Dyad PWLE-Researcher
Ditrano, C.J., Silverstein, L.B., Bordeaux, L. 2006 Listening to parents' voices: participatory action research in the schools Professional Psychology: Research and Practice 37: 359-66 USA Qualitative Participatory action research Polyad Family-Provider-Researcher
Knapp, M., Funk, M., Curran, C. et al. 2006 Economic barriers to better mental health practice and policy Health Policy and Planning 21(3): 157-70 UK Discussion Discussion Polyad Provider-Policy maker-Other
Knightbridge, S.M., King, R., Rolfe, T.J. 2006 Using participatory action research in a community-based initiative addressing complex mental health needs Australian & New Zealand Journal of Psychiatry 40(4): 325-32 Australia Qualitative Participatory action research Polyad PWLE-Family-Provider-Policy maker-Researcher
Bluthenthal, R.N., Jones, L., Fackler-Lowrie, N. 2006 Witness for wellness: preliminary findings from a community-academic participatory research initiative Ethnicity and Disease 16(SI): 18-34 USA Other Mixed methods, participatory action research Polyad PWLE-Family-Provider-Researcher-Other
Thomas, P., Seebohm, P., Henderson, P., Munn-Giddings, C., Yasmeen, S. 2006 Tackling race inequalities: community development, mental health and diversity Journal of Public Mental Health 5(2): 13-19 Canada Qualitative Focus groups Polyad PWLE-Policy maker-Researcher
Craven, M.A. & Bland, R. 2006 Better practices in collaborative mental healthcare: an analysis of the evidence base Canadian Journal of Psychiatry 51(SI): 7S-74S Canada Other Systematic review Polyad PWLE-Provider-Decision-makers
Wills, C.E. & Holmes-Rovne, M. 2006 Integrating decision-making and mental health interventions research: research directions Clinical Psychology: Science and Practice 13(1): 9-25 USA Discussion Discussion Polyad PWLE-Provider-Policy maker
Waddell, C., Shepherd, C.A., Lavis, J.N. et al. 2007 Balancing rigour and relevance: researchers' contributions to children's mental health policy in Canada Evidence & Policy: A Journal of Research, Debate and Practice 3(2): 181-95 Canada Qualitative Interviews Dyad Policy maker-Researcher
Lesage, A.D. 2007 Les Programmes de premier épisode de schizophrénie et une médecine fondee sur les données factuelles : un cas de syndrome des habits de l'empereur? Canadian Journal of Psychiatry 32(1): 333-49 Canada Discussion Discussion Dyad Provider-Researcher
Wong, S.Y.S., Cheung, A.K.Y, Lee, A. et al. 2007 Improving general practitioners' interviewing skills in managing patients with depression and anxiety: a randomized controlled clinical trial Medical Teacher 29: e175-e183 China Quantitative Randomized controlled trial Dyad Provider-Researcher
Brekke, J.S., Ell, K., Palinkas, L. 2007 Translational science at the National Institute of Mental Health: can social work take its rightful place? Research on Social Work Practice 17(1): 123-33 USA Discussion Discussion Dyad Provider-Researcher
Adams, J.R., Drake, R.E., Wolford, G.L. 2007 Shared decision-making preferences of people with severe mental illness Psychiatric Services 58: 1219-21 USA Quantitative Cross-sectional survey Dyad PWLE-Provider
Deegan, P.E. 2007 The lived experience of using psychiatric medication in the recovery process and a shared decision-making program to support in the recovery process Psychiatric Rehabilitation Journal 31(1): 62-69 USA Discussion Discussion Dyad PWLE-Provider
Loh, A., Simon, D., Wills, C.E. et al. 2007 The effects of a shared decision-making intervention in primary care of depression: a cluster-randomized controlled trial Patient Education and Counseling 67(3): 324-32 Germany Quantitative Cluster-randomized controlled trial Dyad PWLE-Provider
Priebe, S., McCabe, R., Bullenkamp, J. et al. 2007 Structured patient-clinician communication and one-year outcome in community mental healthcare British Journal of Psychiatry 191: 420-26 UK Quantitative Cluster-randomized controlled trial Dyad PWLE-Provider
Schauer, C., Everett, A., del Vecchio, P. et al. 2007 Promoting the value and practice of shared decision-making in mental healthcare Psychiatric Rehabilitation Journal 31(1): 54-61 USA Discussion Discussion Dyad PWLE-Provider
Swanson, K.A., Bastani, R., Rubenstein, L.V. et al. 2007 Effect of mental healthcare and shared decision-making on patient satisfaction in a community sample of patients with depression Medical Care Research and Review 64(4): 416-30 USA Quantitative Cross-sectional survey Dyad PWLE-Provider
Buist, A., Speelman, C., Hayes, B., Reay, R., Milgrom, J. 2007 Impact of education on women with perinatal depression Obstetrics & Gynecology 28(1): 49-54 Australia Quantitative Pre-post Dyad PWLE-Researcher
Lucock, M., Barber, R., Jones, A., Lovell, J. 2007 Service users' views of self-help strategies and research in the UK Journal of Mental Health 16(6): 795-805 UK Qualitative Participatory action Dyad PWLE-Researcher
Cole, N. 2007 Depression awareness: community-based approach Australian Psychologist 42(2): 161-66 Australia Quantitative Pre-post survey Dyad Researcher-Other
Hallett, J., Brown, G., Maycock, B., Langdon, P. 2007 Changing communities, changing spaces: the challenges of health promotion outreach in cyberspace Promotion & Education 14(3): 150-54 Australia Qualitative Case study, participatory action research Dyad Researcher-Other
Jacobson, N., Ochocka, J., Wise, J., Janzen, R. 2007 Inspiring knowledge mobilization through a communications policy: the case of a community-university research alliance Progress in Community Health Partnerships: Research, Education and Action 1(1): 99-104 Canada Qualitative Participatory action research Polyad Family-Provider-Policy maker-Researcher
Sax, P. 2007 Finding common ground: parents speak out about family-centered practices Journal of Systemic Therapies 26(3): 72-90 USA Qualitative Participatory action Polyad Family-Provider-Researcher
Garretsen, H.F.L., Bongers, I.M.B., Roo, A.A. de et al. 2007 Bridging the gap between science and practice: do applied academic centres contribute to a solution? Journal of Comparative Social Welfare 23(1): 49-59 Netherlands Discussion Discussion, case examples Polyad Provider-Policy maker-Researcher
Levesque, P., Davidson, S., Kidder, K. 2007 Knowledge exchange for attention deficit hyperactivity disorder research: an integrated evidence and knowledge exchange framework leading to more effective research dissemination practices Journal of the Canadian Academy of Child and Adolescent Psychiatry 16(2): 51-56 Canada Discussion Discussion Polyad Provider-Policy maker-Researcher-Other
Nagel, T. & Thompson, C. 2007 AIMHI NT "mental health storyteller mob": developing stories in mental health Australian e-Journal for the Advancement of Mental Health 6(2): 1-6 Australia Qualitative Participatory action, survey Polyad PWLE-Family-Provider-Policy maker-Researcher
Hoolihan, B., Grosvenor, J., Kurtz, H. et al. 2007 Utilizing technology to raise mental health literacy in small rural towns Learning in Health and Social Care 6(3): 145-55 Australia Quantitative Cross-sectional survey Polyad PWLE-Provider-Other
Moore, D.E., Niebler, S.E., Schlundt, D.G. et al. 2007 A conceptual model for using action inquiry technologies to address disparities in depression Journal of Continuing Education in the Health Professions 27: 55-64 USA Discussion Discussion, participatory action research, conceptual model Polyad PWLE-Provider-Policy maker
Cleary, M., Walter, G., Luscombe, G. 2007 Spreading the word: disseminating research results to patients and carers Acta Neuropsychiatrica 19(4): 224-29 Australia Discussion Discussion Polyad PWLE-Provider-Policy maker-Researcher
Janzen, R., Nelson, G., Hausfather, N., Ochocka, J. 2007 Capturing system-level activities and impacts of mental health consumer-run organizations American Journal of Community Psychology 39(3/4): 287-99 USA Other Mixed methods, participatory action research Polyad PWLE-Provider-Policy maker-Researcher-Other
Spring, B. 2007 Evidence-based practice in clinical psychology: what it is, why it matters - what you need to know Journal of Clinical Psychology 63(7): 611-31 USA Discussion Discussion Polyad PWLE-Provider-Researcher
Lind, C. 2007 The power of adolescent voices: co-researchers in mental health promotion Educational Action Research 15(3): 371-83 Canada Qualitative Participatory action Polyad PWLE-Provider-Researcher-Other
Bell, J.S., Aslani, P., McLachlan, A.J., Whitehead, P., Chen, T. 2007 Mental health case conferences in primary care: content and treatment decision-making Research in Social & Administrative Pharmacy 3(1): 86-103 Canada Qualitative Case conferences Within group Provider-Provider
Cohen, J. & Mannarino, A.P. 2008 Disseminating and implementing trauma-focused CBT in community settings Trauma Violence Abuse 9(4): 214-26 USA Other Review Dyad Provider-Policy maker
Barwick, M.A., Boydell, K.M., Stasiulis, E. et al. 2008 Research utilization among children's mental health providers Implementation Science 3(19) Canada Quantitative Cross-sectional survey Dyad Provider-Researcher
Bilsker, D., Anderson, J., Samra, J. et al. 2008 Behavioural interventions in primary care: an implementation trial Canadian Journal of Community Mental Health 27: 179-89 Canada Quantitative Pre-post Dyad Provider-Researcher
Boydell, K.M., Stasiulis, E., Barwick, M. et al. 2008 Challenges of knowledge translation in rural communities: the case of rural children's mental health Canadian Journal of Community Mental Health 27(1): 49-63 Canada Qualitative Focus groups Dyad Provider-Researcher
Chagnon, F., Houle, J., Daigle, M. et al. 2008 Application des connaissances scientifiques en prevention du suicide : vérification d'une stratégie fondée sur la communauté de pratique Frontiéres 21(1): 90-97 Canada Qualitative Community of practice Dyad Provider-Researcher
Self, R., Rigby, A., Leggett, C., Paxton, R. 2008 Clinical Decision Support Tool: a rational needs-based approach to making clinical decisions Journal of Mental Health 17(1): 33-48 UK Other Mixed methods, participatory action, cluster analysis, concurrent validity Dyad Provider-Researcher
Thompson, A., Sullivan, S.A., Barley, M. et al. 2008 The DEBIT trial: an intervention to reduce antipsychotic polypharmacy prescribing in adult psychiatry wards - a cluster-randomised controlled trial Psychological Medicine 38: 705-15 UK Quantitative Pragmatic cluster-randomized controlled trial Dyad Provider-Researcher
Deegan, P., Rapp, C., Holter, M. et al. 2008 A program to support shared decision-making in an outpatient psychiatric medication clinic Psychiatric Services 59(6): 603-05 USA Qualitative Focus groups Dyad PWLE-Provider
Hamann, J., Mendel, R.T., Fink, B. et al. 2008 Patients' and psychiatrists' perceptions of clinical decisions during schizophrenia treatment Journal of Nervous and Mental Disease 196(4): 329-32 Germany Other Mixed methods, interviews and questionnaires Dyad PWLE-Provider
Stringer, B., Van Meijel, B., De Vree, W. et al. 2008 User involvement in mental healthcare: the role of nurses Journal of Psychiatric and Mental Health Nursing 15: 678-83 Netherlands Other Literature review Dyad PWLE-Provider
Moll, S. & Clements, E.P. 2008 Workplace mental health: developing an employer resource through partnerships in knowledge translation Occupational Therapy Now 10(5): 17-19 Canada Discussion Discussion Dyad Researcher-Other
Han, S.S. & Weiss, B. 2008 Sustainability of teacher implementation of school-based mental health programs Journal of Abnormal Child Psychology 33(6): 665-79 USA Other Review Polyad Provider-Policy maker-Other
Grol, R. 2008 Knowledge transfer in mental healthcare: how do we bring evidence into day-to-day practice? Canadian Journal of Psychiatry 53(5): 275-76 Canada Discussion Discussion Polyad Provider-Policy maker-Researcher
Unutzer, J. 2008 Evidence-based treatments for anxiety and depression: lost in translation? Depression and Anxiety 25(9): 726-29 USA Discussion Discussion Polyad Provider-Policy maker-Researcher
Smolders, M., Laurant, M., Roberge, P. et al. 2008 Knowledge transfer and improvement of primary and ambulatory care for patients with anxiety Canadian Journal of Psychiatry 53(5): 277-93 Netherlands Other Review with meta-analysis Polyad Provider-Policy maker-Researcher
Westhues, A., Ochocka, J., Jacobson, N., Simich, L., Maiter, S., Janzen, R. et al. 2008 Developing theory from complexity: reflections on a collaborative mixed-method participatory action research study Qualitative Health Research 18(5): 701-17 Canada Qualitative Participatory action, grounded theory, abduction, synthesis Polyad PWLE-Family-Provider-Researcher-Other
Lindamer, L.A., Lebowitz, B.D., Hough, R.L. 2008 Public-academic partnerships: improving care for older persons with schizophrenia through an academic-community partnership Psychiatric Services 59(3): 236-39 USA Discussion Case example Polyad PWLE-Provider-Policy maker-Researcher
Chambers, D.A. 2008 Advancing the science of implementation: a workshop summary Administration and Policy in Mental Health & Mental Health Services Research 35 (1/2): 3-10 USA Discussion Discussion Polyad PWLE-Provider-Researcher
Patel, S.R., Bakken, S., Ruland, C. 2008 Recent advances in shared decision-making for mental health Current Opinion in Psychiatry 21(6): 606-12 USA Other Review Polyad PWLE-Provider-Researcher
Pickett-Schenk, S.A., Lippincott, R.C., Bennett, C. et al. 2008 Improving knowledge about mental illness through family-led education: the journey of hope Psychiatric Services 59(1): 49-56 USA Quantitative Randomized trial with waiting list control group Within group Family-Family
Kimberly, J. & Cook, J.M. 2008 Organizational measurement and the implementation of innovation in mental health services Administration and Policy in Mental Health & Mental Health Research 35: 11-20 USA Other Review Within group Provider-Provider
Pignatiello, A., Boydell, K., Teshima, J., Volpe, T. 2008 Supporting primary care through paediatric telepsychiatry Canadian Journal of Community Mental Health 27(2): 139-51 Canada Qualitative Participant evaluation Within group Provider-Provider
Franx, G., Kroon, H., Grimshaw, J. et al. 2008 Organizational change to transfer knowledge and improve quality and outcomes of care for patients with severe mental illness: a systematic overview of reviews Canadian Journal of Psychiatry 53(5): 294-305 Netherlands Other Systematic review, overview of reviews Within group Researcher-Researcher
Pullmann, M.D. 2009 Participatory research in systems of care for children's mental health American Journal of Community Psychology 44(1/2): 43-53 USA Discussion Discussion, participatory action framework Dyad Family-Researcher
Danseco, E., Sundar, P., Kasprzak, S. et al. 2009 Are we there yet? Evaluation and the knowledge translation journey Journal of the Canadian Academy of Child and Adolescent Psychiatry 18(1): 7-15 Canada Discussion Discussion, case example Dyad Policy maker-Researcher
Isaac, M., Elias, B., Katz, L.Y., Belik, S., Deane, F.P., Enns, M.W., Sareen, J. 2009 Gatekeeper training as a preventative intervention for suicide: a systematic review Canadian Journal of Psychiatry 54 (4): 260-68 Canada Other Systematic review Dyad Provider-Other
Stolee, P., McAiney, C.A., Hillier, L.M. et al. 2009 Sustained transfer of knowledge to practice in long-term care: facilitators and barriers of a mental health learning initiative Gerontology & Geriatrics Education 30(1): 1-20 Canada Qualitative Interviews Dyad Provider-Policy maker
Barwick, M.A., Peters, J., Boydell, K.J. 2009 Getting to uptake: do communities of practice support the implementation of evidence-based practice? Canadian Academy of Child & Adolescent Psychiatry 18: 16-29 Canada Quantitative Randomized controlled trial Dyad Provider-Researcher
Brekke, J.S., Phillips, E., Pancake, L. et al. 2009 Implementation practice and implementation research: a report from the field Research on Social Work Practice 19S: 592-601 USA Discussion Discussion Dyad Provider-Researcher
Happell, B., Moxham, L., Reid-Searl, K., Dwyer, T., Kahl, J., Morris, J. et al. 2009 Promoting mental healthcare in a rural paediatric unit through participatory action research Australian Journal of Rural Health 17(3): 155-60 Australia Qualitative Focus groups Dyad Provider-Researcher
Harpaz-Rotem, I. & Rosenheck, R.A. 2009 Tracing the flow of knowledge: geographic variability in the diffusion of prazosin use for the treatment of posttraumatic stress disorder nationally in the Department of Veterans Affairs Archives of General Psychiatry 66(4): 417-21 USA Quantitative Geographic surveillance, administrative data analysis Dyad Provider-Researcher
Lamont, S., Walker, P., Brunero, S. 2009 "Teaching an old dog new tricks": a practice development approach to organizational change in mental health Practice Development in Health Care 8(2): 65-76 Australia Qualitative Participatory action Dyad Provider-Researcher
Nadeau, L. 2009 Evaluation préliminaire d'un projet de soins concertés en santé mentale jeunesse á Montréal : faire face á l'incertitude institutionnelle et culturelle Santé Mentale au Québec 34(1): 127-42 Canada Qualitative Case study Dyad Provider-Researcher
Perreault, M., Perreault, N., Withaeuper, D. et al. 2009 Le Défi du traitement et de la prévention des troubles concomitants sur la base de données probantes Criminologie 42(1): 91-114 Canada Discussion Discussion Dyad Provider-Researcher
Robitaille, D. & Boudreault, D. 2009 Expérience d'une équipe de santé mentale de premiére ligne dans l'optimisation des soins Santé Mentale au Québec 34(1): 207-19 Canada Qualitative Case study Dyad Provider-Researcher
Ward, V.L., House, A.O., Hamer, S. 2009 Knowledge brokering: exploring the process of transferring knowledge into action BMC Health Services Research 16: 9-12 UK Other Description of research plan Dyad Provider-Researcher
Applbaum, K. 2009 "Consumers are patients!" Shared decision-making and treatment: non-compliance as a business opportunity Transcultural Psychiatry 46(1): 107-30 USA Discussion Discussion Dyad PWLE-Provider
Drake, R.E., Cimpean, D., Torrey, WC. 2009 Shared decision-making in mental health: prospects for personalized medicine Dialogues in Clinical Neuroscience 11(4): 455-63 USA Discussion Discussion Dyad PWLE-Provider
Houle, J., Lespérance, F., Beaulieu, M.D. 2009 Partager la décision dans le traitement de la dépression Le Médecin du Québec 44(10): 27-31 Canada Discussion Discussion Dyad PWLE-Provider
Joosten, E.A.G. et al. 2009 Shared decision-making reduces drug use and psychiatric severity in substance-dependent patients Psychotherapy and Psychosomatics 78(4): 245-53 Netherlands Quantitative Randomized controlled trial Dyad PWLE-Provider
Vatne, S., Bjornerem, H., Hoem, E. 2009 One approach to improving the care for depression and anxiety disorders has been to "package" evidence-based efficacious treatment components into effective programs of care Scandinavian Journal of Caring Sciences 23: 84-92 Norway Qualitative Interviews Dyad PWLE-Provider
McDaid, S. 2009 An equality of condition framework for user involvement in mental health policy and planning: evidence from participatory action research Disability & Society 24(4): 461-74 Ireland Qualitative Participatory action Dyad PWLE-Researcher
Oh, E., Jorm, A.F., Wright, A. 2009 Perceived helpfulness of websites for mental health information Social Psychiatry & Psychiatric Epidemiology 44(4): 293-99 Australia Quantitative Cross-sectional survey Dyad Researcher-Oher
Bapat, S., Jorm, A., Lawrence, K. 2009 Evaluation of a mental health literacy training program for junior sporting clubs Australasian Psychiatry 17: 475-79 Australia Quantitative Pre-post Dyad Researcher-Other
Blignault, I., Woodland, L., Ponzio, V. et al. 2009 Using a multifaceted community intervention to reduce stigma about mental illness in an Australian Macedonian community Health Promotion Journal of Australia 20(3): 227-33 Australia Quantitative Pre-post Dyad Researcher-Other
López, Steven R., Lara, M., Kopelowicz, A., Solano, S., Foncerrada, H. 2009 La CLAve to increase psychosis literacy of Spanish-speaking community residents and family caregivers Journal of Consulting and Clinical Psychology 77(4): 763-74 USA Quantitative Pre-post Polyad Family-Researcher-Other
Chorpita, B.F. & Regan, J. 2009 Dissemination of effective mental health treatment procedures: maximizing the return on a significant investment Behaviour Research and Therapy 47(11): 990-93 USA Discussion Discussion Polyad Provider-Policy maker-Researcher
Luck, J., Hagigi, F., Parker, L.E., Yano, E.M., Rubenstein, L.V., Kirchner, J.E. 2009 A social marketing approach to implementing evidence-based practice in VHA QUERI: the TIDES depression collaborative care model Implementation Science 4: 64 USA Qualitative Case study Polyad Provider-Policy maker-Researcher
Perreault, M., Wiethaueper, D., Perreault, N., Bonin, J.-P, Brown, T.G., Brunaud, H. 2009 Meilleures pratiques et formation dans le contexte du continuum des services en santé mentale et en toxicomanie : le programme de formation croisée du sud-ouest de Montréal Santé Mentale au Québec 34(1): 143-60 Canada Qualitative Case study Polyad Provider-Researcher-Other
Curran, J. & Newton, M. 2009 Theme issue on knowledge translation Journal of the Canadian Academy of Child and Adolescent Psychiatry 18(1): 2-3 Canada Discussion Discussion, editorial Polyad PWLE-Family-Provider-Policy maker-Researcher
Harrison, A., & Brandling, J. 2009 Improving mental healthcare for older people within a general hospital in the UK Nursing & Health Sciences 11(3): 293-300 UK Qualitative Participatory action research Polyad PWLE-Family-Provider-Researcher
Manion, I., Buchanan, D.H., Cheng, M. et al. 2009 Embedding evidence-based practice in child and youth mental health in Ontario Evidence & Policy: A Journal of Research, Debate & Practice 5(2): 141-53 Canada Discussion Discussion, case examples Polyad PWLE-Family-Provider-Researcher-Other
de Wolff, A., Cabezas, P., Chamberlain, L. et al. 2009 The creation of "We Are Neighbours": participatory research and recovery Canadian Journal of Community Mental Health 28(2): 61-72 Canada Qualitative Participatory action research Polyad PWLE-Policy maker-Researcher
Mitton, C., Adair, C.E., McKenzie, E., Patten, S., Waye-Perry, B., Smith, N. 2009 Designing a knowledge transfer and exchange strategy for the Alberta Depression Initiative: contributions of qualitative research with key stakeholders International Journal of Mental Health Systems 3(1): 11 Canada Qualitative Focus groups Polyad PWLE-Provider-Policy maker
McGrath, P.J., Lingley-Pottie, E., Thurston, C., McLean, C. 2009 Integrated knowledge translation in mental health: family help as an example Journal of the Canadian Academy of Child and Adolescent Psychiatry 18: 30-37 Canada Qualitative Case study Polyad PWLE-Provider-Policy maker-Researcher
Drake, R.E., Wilkniss, S.M., Frounfelker, R.L., et al. 2009 The Thresholds-Dartmouth partnership and research on shared decision-making Psychiatric Services 60(2): 142-44 USA Discussion Discussion Polyad PWLE-Provider-Researcher
Lyons, J.S. 2009 Knowledge creation through total clinical outcomes management: a practice-based evidence solution to address some of the challenges of knowledge translation Journal of the Canadian Academy of Child and Adolescent Psychiatry 18(1): 38-45 Canada Discussion Discussion, case sample of KE framework Polyad PWLE-Provider-Researcher
Maar, M.A., Erskine, B., McGregor, L., Larose, T.L., Sutherland, M.E., Graham, D. et al. 2009 Innovations on a shoestring: a study of a collaborative community-based Aboriginal mental health service model in rural Canada International Journal of Mental Health Systems 3: 27 Canada Qualitative Participatory action, ethnographic Polyad PWLE-Provider-Researcher
Gozlan, G. Acef, S., Petitqueux-Glaser, C. 2009 Vers des soins intégrés en santé mentale: l'expérience du réseau Prépsy Santé Mentale au Québec 34(1): 221-38 France Discussion Case example Within group Provider-Provider
Hamilton, A.B., Cohen, A.N., Young, A.S. 2009 Organizational readiness in specialty mental healthcare Journal of General Internal Medicine 25 (Suppl. 1): 27-31 USA Other Mixed methods, questionnaire and semi-structured interviews Within group Provider-Provider
Proctor, E.K., Landsverk, J., Aarons, G. et al. 2009 Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges Administration and Policy in Mental Health & Mental Health Services Research 36(1): 24-34 USA Discussion Discussion Within group Researcher-Researcher
Lévesque, L., Ducharme, F., Caron, C. et al. 2010 A partnership approach to service needs assessment with family caregivers of an aging relative living at home: a qualitative analysis of the experiences of caregivers and practitioners International Journal of Nursing Studies 47(7): 876-87 Canada Qualitative Thematic analysis Dyad Family-Provider
Byrne, M.K., Willis, A., Deane, F.P. et al. 2010 Training inpatient mental health staff how to enhance patient engagement with medications: Medication Alliance training and dissemination outcomes in a large US mental health hospital Journal of Evaluation in Clinical Practice 16(1): 114-20 USA Quantitative Pre-post Dyad Provider-Researcher
Moxham, L., Dwyer, T., Happell, B., Reid-Searl, K., Kahl, J., Morris, J., et al. 2010 Recognising our role: improved confidence of general nurses providing care to young people with a mental illness in a rural paediatric unit Journal of Clinical Nursing 19(9/10): 1434-42 Australia Qualitative Participatory action Dyad Provider-Researcher
Gray, R., White, J., Schulz, M. et al. 2010 Enhancing medication adherence in people with schizophrenia: an international programme of research International Journal of Mental Health Nursing 19(1): 36-44 UK Other Mixed methods, concept mapping Dyad PWLE-Provider
Glisson, C., Schoenwald, S.K., Hemmelgarn, A. et al. 2010 Randomized trial of MST and ARC in a two-level evidence-based treatment implementation strategy Journal of Consulting and Clinical Psychology 78(4): 537-50 USA Quantitative Randomized controlled trial Polyad Family-Provider-Policy maker-Other
Duncan, E., Best, C., Hagen, S. 2010 Shared decision-making interventions for people with mental health conditions Cochrane Database of Systematic Reviews (January) 20(1) UK Other Systematic review Polyad PWLE-Provider-Other
Lane et al. 2010 Des guides novateurs pour soutenir l'amélioration des pratiques en CSSS Psychologie Québec 27(1): 31-33 Canada Discussion Discussion Polyad PWLE-Provider-Policy maker-Researcher

Discussion and Conclusion

Over the past decade, we found an exponential increase in the number of publications focused on KT in mental health. This increase appears to be consistent with growing interest in and awareness of this topic among the research community (e.g., OMHAKEN 2011).

The large proportion of publications (42%) that were found to be of Canadian origin may be related to the endorsement of the importance of KT by Canadian research organizations such as the Canadian Health Services Research Foundation (Lomas 2000) and the Canadian Institutes of Health Research (Graham and Tetroe 2009).

The publications we identified covered a wide range of research approaches and designs. A large proportion (59%) were discussion papers, often advocating for the importance of KT in mental health services or advancing theoretical frameworks. However, there were also sizeable numbers of studies that applied qualitative, quantitative and mixed-method designs.

Papers that addressed the provider–researcher dyad tended to examine the effectiveness of efforts to change knowledge or behaviour among healthcare providers through KT interventions, often using an implementation science paradigm. Of these, only five studies report no improvement (Azocar et al. 2003; Goldberg et al. 1998; Lin et al. 2001; Ray et al. 1987; Thompson et al. 2000). The remaining studies indicate that carefully planned KT produces meaningful improvement in knowledge and practice regarding care for mental health problems (e.g., Avorn et al. 1992; Badger et al. 1991; Baker et al. 2001; B Brown et al. 2000; Gask et al. 1998; Gerrity et al. 1999; Hannaford et al. 1996; Mason and Freemantle 1999; Naismith et al. 2001; Ray et al. 1987; Rutz et al. 1992; van Eijk et al. 2001; Worrall et al. 1999). It is worth highlighting several Canadian studies:

  • Barwick and colleagues (2009) randomly assigned mental health clinicians to a community of practice (CoP) or practice as usual (PaU) condition to support training in a newly implemented level of functioning outcome measurement tool. Practitioners in the CoP condition demonstrated greater use of the tool in practice, better content knowledge and greater satisfaction with implementation supports than PaU participants.
  • Chagnon and colleagues (2008) helped develop a community of practice for researchers and providers working in the field of suicide prevention. Over a one-year period, a series of interventions designed to facilitate KT between members were carried out; several platforms (meetings, websites, listservs, online discussions and forums) allowed members to appraise their practices and integrate new knowledge on suicide prevention–related issues. The study by Chagnon and colleagues (2008) examined a CoP that was largely virtual in nature, whereas the study by Barwick and colleagues (2009) addressed an in vivo (face-to-face) CoP.
  • In a study by Worrall and colleagues (1999), family physicians were randomly assigned to a three-hour, case-based educational session on clinical practice guidelines (CPGs) for depression and access to a psychiatrist for consultation or to a control group that received the CPG without the educational session or consultation. While there was no difference in rates of diagnosis or prescription, more patients in the intervention group were taking antidepressants at six-month follow-up, and referrals to psychiatry were slightly higher for this group.
  • Bilsker and colleagues (2008) studied implementation of a one-hour educational session outlining interventions for depression and risky alcohol use and delivered to a sample of 85 family physicians. The interventions used a supported self-management approach and included free patient access to appropriate self-management resources. The study initially evaluated physicians' implementation of these interventions over a two-month period. Physician uptake of the depression intervention was significantly greater than uptake of the risky drinking intervention (32% versus 10%). A follow-up at six months post-training (depression intervention only) demonstrated fairly good maintenance of intervention delivery.

In addition to these Canadian studies cited above, research studies conducted in the United States and other countries have also examined KT interventions that seek to enhance primary mental healthcare services and improve outcomes of common mental health problems, primarily depressive disorders (e.g., Brown et al. 2000; Gerrity et al. 1999; Hodges et al. 2001; Naismith et al. 2001). More "active" KT approaches, such as implementation and dissemination activities described by Lomas (1993), have been found to be more effective in producing behavioural change and improved outcomes when compared with "passive" approaches described by Lomas (1993) as diffusion, such as mailing out clinical guidelines to primary care physician offices or posting information on a physician association website. A study in the United Kingdom (Baker et al. 2001) randomized family physicians to an intervention group that received a tailored implementation designed to assist them in adopting new clinical guidelines for treatment of depression. They were found to have adopted the new practices, and their patients with depression had better outcomes than those treated by a control group of family physicians who were notified of the new guidelines but did not receive the targeted KT implementation efforts.

Of the 115 studies classified as dyadic knowledge exchange, 24 (21%) involved interactions between the PWLE–Provider dyad. KT between these two groups, in the form of shared decision-making, has become an increasingly common focus within the literature. As described by Drake and colleagues (2009):

The healthcare provider (often a team of professionals) brings expertise in understanding the medical problem, the possible interventions and the potential benefits and risks of alternatives. The patient (often assisted by family or support network members) brings expertise related to understanding the individual's values, goals, supports, and preferences.

Shared decision-making between PWLE and providers has also been studied through a series of randomized controlled trials examining the impacts of shared decision-making upon treatment satisfaction, quality of life and symptomatic improvement for schizophrenia, depression and substance use disorder (Hamann et al. 2006; Joosten et al. 2009; Loh et al. 2007; Malm et al. 2003; Priebe et al. 2007; Van Korff et al. 2003; Van Os et al. 2004). Overall, these studies indicate that shared decision-making enhances individuals' sense of involvement and likelihood of adhering to treatment. However, studies have not yet been able to demonstrate long-term benefits or improvements in function.

Participatory action research designs are well utilized in studies that involve PWLE. These approaches seek to incorporate the knowledge and skills of PWLE into various facets of research process, such as design, planning, implementation, analysis, reporting and dissemination. For example, Ross and colleagues (2003) worked with a group of young women to design and conduct focus groups with 48 adolescent girls across Ontario eliciting a set of themes helpful in planning interventions for adolescent depression. Participatory action research may be challenging to accomplish. McDaid (2009) worked with a group of participants and identified the following barriers to their equal participation: unequal cultural, physical, mental and economic resources, time and power; discrimination; and lack of respect for their experiential knowledge and emotional expression. Considerable dedication and commitment is often required to accomplish effective participatory action research.

Most publications concerning KT between the researcher–policy maker dyad comprise theoretical discussions of key issues affecting KT between these stakeholder groups. The lack of evaluative research has been identified by Mitton and colleagues (2008) as a major problem:

It is not hard to find opinion pieces and anecdotal reports about how to do KTE [knowledge transfer and exchange], but a limited reporting of actual KTE implementation and even more limited formal evaluation leaves those seeking to develop their own KTE efforts at a loss for evidence based strategies.

Some empirical studies of mental health–related KT between researchers and policy makers have been conducted in Canada, using qualitative methods and gathering data from focus groups or through stakeholder interviews:

  • Waddell and colleagues (2007) report results of comprehensive interviews with researchers and funding decision-makers in order to identify barriers to KT in children's mental health policy efforts. Identified barriers included researchers' lack of motivation to maximize KT and neglect of strategies to foster knowledge uptake.
  • Goering and colleagues (2003) present a case study of a project to enhance KT between researchers and policy makers by partnership between a research unit and a public agency for mental health policy. This included regular meetings between researchers and policy makers, initiation of interactive research projects and collaborative dissemination of research findings. The formalization of a structured agreement with shared activities and commitments provides an example of organizational linkage and exchange as described by Lomas (2000). A framework is shared that may be used by others seeking to build stable and mutually beneficial organizational relationships.

A number of studies address KT between researchers and the general public. Mental health–related KT in this domain generally involves the translation of scientific evidence via social marketing campaigns, websites, various communications media (including social media) to the general population, often seeking to increase mental health literacy. A recent Canadian report concluded that although Canadians are found to have a relatively high level of mental health literacy compared to citizens of other countries, "[s]tigma and discrimination toward persons with mental illness continue to be problematic in Canadian society" (CAMIMH 2008).

There is an informative empirical literature concerning the effectiveness of interventions to enhance the mental health literacy of general populations (e.g., Jorm et al. 2003; Wright et al. 2006; Goldney and Fisher 2008). Perhaps the most ambitious attempt to increase mental health literacy at a population level was the beyondblue program in Australia, which focused on depression awareness and beliefs. This extensive national campaign, undertaken over several years, was associated with improvements in knowledge by the general public about depression and its remediation (Jorm et al. 2005).

A notable group of publications (61; 33%) was concerned with the exchange of knowledge among multiple stakeholders. Most of these publications report on qualitative investigation of KT among participant groups. We referred to these studies as polyadic, emphasizing their inclusion of multiple types of participants (i.e., polyads) in the KT process. The following are three Canadian examples:

  • Westhues and colleagues (2008) sought to improve mental health service delivery to people of diverse cultural backgrounds. They engaged community members of various cultural and linguistic groups, service providers, governmental organizations and researchers. Working groups facilitated the concentration of multiple types of knowledge, subsequently exchanged among groups. This approach allowed a diverse group of stakeholders to create a framework for improving mental healthcare across cultural–linguistic communities.
  • McGrath and colleagues (2009) applied an "integrated KT" strategy (i.e., engaging all stakeholders in KT at the beginning of the project and keeping them intimately involved throughout) to the implementation of a distance-based children's mental health program. They involved a wide range of participants (e.g., physicians, policy makers, service users and others) in all project phases, enabling ongoing KT among diverse stakeholder groups. The authors concluded that the integrated KT strategy was effective "in supporting the transfer of this research project into clinical practice" (McGrath et al. 2009: 30).
  • Perreault and colleagues (2005, 2009) initiated a cross-training program for providers from different networks or sectors (e.g., mental health, substance use, police) who interact with people with concomitant mental health and substance use problems. Providers led or engaged in various training activities, including joint workshops and meetings, researcher presentations and staff rotations. Aiming to improve coordination and integration of care, the program also promoted shared knowledge, understanding and feelings of interdependence among participants.

A small but intriguing cluster of publications focus upon KT at the organizational rather than individual level (Isett and Provan 2004; Morrissey et al. 1997, 2005; Provan et al. 2005; Provan and Milward 1995, 2001). This type of research has been referred to as network analysis:

Network analysis allows for the examination and comparison of relationships between two organizations (dyads), among clusters or cliques of organizations, and among all of the organizations comprised by the network. (Provan et al. 2005: 605)

For example, Provan and Milward (1995) conducted a network analysis of four community mental health systems engaged in integrated service delivery, each consisting of a network of mental health service providers, social service providers and funding agencies. Networks were evaluated for the strength of linkage and exchange among organizations and effectiveness of service delivery. The researchers found that network effectiveness could be explained by various structural and contextual factors, such as the degree of integration and stability that exists within the network.

Relevant publications tended to fall into a number of different "pockets" or thematic areas within the scientific literature. These include implementation science, community-based and participatory-action research, shared decision-making studies, mental health literacy research, network analysis and studies directly addressing KT. This full range of relevant literature is scattered across a variety of disparate research themes that are not usually assembled or considered together.

Overall, there appears to be a robust interest in addressing KT in relation to mental health issues, with strong representation from Canadian stakeholder groups. This appears to have been a burgeoning area of study in recent years, and valuable information is now becoming available to help guide activities and efforts aimed at improving various facets of the mental health "system."

In the field of mental health, KT approaches appear to be undergoing a paradigm shift. Researchers continue to play a unique role in generating, disseminating and exchanging valuable scientific knowledge, but they have been joined by other key stakeholder groups such as policy makers, healthcare providers, family members and, importantly, people with lived experience of mental health problems. The value of experiential knowledge is better recognized (Caron-Flinterman et al. 2005), and KT is better understood to be a diverse and sometimes complex set of steps that involve the participation of diverse actors. This shift has been described explicitly in a framework document of the Canadian Mental Health Association (n.d.) and may prove to have far-reaching effects upon mental health research, policy and practice.

Limitations

Limitations of the current scoping review include the possibility that some relevant publications may not have been located despite use of systematic search methods and iterative steps to minimize omissions. Application of the inclusion criteria used in selecting studies for review may have been imperfect despite high ratings on tests of inter-rater reliability, and there was inevitable subjectivity in the decision-making process when considering whether studies were or were not relevant. The current findings cannot be assumed to be valid in relation to low-income countries, as we excluded studies that focused on KT in such regions. In addition, we recognize the possibility that the results of this process may not be truly comprehensive, owing to the ambiguity surrounding conceptualizations of KT in combination with the relative isolation of some KT research areas.


Échange de connaissances en santé mentale : analyse de la situation

Résumé

On considère que les efforts d'échange de connaissances (EC) dans le domaine de la santé mentale sont essentiels pour accélérer la mise en œuvre de diverses avancées dans la recherche, les politiques et la pratique. Une analyse de la situation des activités d'EC dans le domaine de la santé mentale a été effectuée pour éclairer la création d'un Centre d'échange des connaissances étant initié par la Commission de la santé mentale du Canada. Une recherche systématique des publications en anglais et en français a permis de répertorier 187 titres qui répondaient aux critères d'inclusion. La littérature pertinente était classée sous diverses thématiques de recherche: science de mise en œuvre, activités de recherches participatives axées sur la communauté, études sur la prise de décision partagée, recherche sur les compétences informationnelles en santé mentale, analyse des réseaux ou études qui traitent directement de l'EC. Cette littérature porte principalement sur les efforts d'EC qui mettent en jeu quelques paires d'intervenants particuliers. Un changement de paradigme présentement en cours a donné lieu à une vue d'ensemble de plus en plus vaste, en incorporant une plus grande gamme de participants et en valorisant de plus en plus les connaissances expérientielles.

About the Author

Elliot M. Goldner, MHSc, MD Professor, Centre for Applied Research in Mental Health & Addiction Faculty of Health Sciences, Simon Fraser University Vancouver, BC

Victoria Jeffries, MA Student, Centre for Applied Research in Mental Health & Addiction Faculty of Health Sciences, Simon Fraser University Vancouver, BC

Dan Bilsker, PhD Adjunct Professor, Centre for Applied Research in Mental Health & Addiction Faculty of Health Sciences, Simon Fraser University Vancouver, BC

Emily Jenkins, RN, MPH Student, School of Nursing, University of British Columbia Vancouver, BC

Matthew Menear, MPH Student, Department of Social and Preventive Medicine Faculty of Medicine, University of Montreal Montreal, QC

Lisa Petermann, PhD Director, Knowledge Exchange Centre Mental Health Commission of Canada Calgary, AB

Correspondence may be directed to: Dr. Elliot M. Goldner, Professor, Faculty of Health Sciences, Simon Fraser University, Harbour Centre, 2400 – 515 West Hastings St., Vancouver, BC V6B 5K3; tel. 778-782-5148; e-mail: egoldner@sfu.ca.

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