Critical examination of knowledge-to-action models and implications for promoting health equity
Davison, C.M. & National Collaborating Centre for Determinants of Health. (2013). Antigonish, NS:
National Collaborating Centre for Determinants of Health, St. Francis Xavier University. Canada
Available online at: http://bit.ly/ZVrvZo
The purpose of this paper was to review and critically examine the usefulness of existing knowledge to action models for promoting health equity.
Dramatic inequalities in health and social circumstances across Canada are well documented. Knowledge and effective interventions exist to address many of these inequities. However, awareness, uptake, and the use of interventions can be poor and poorer still with respect to interventions to improve the health of disadvantaged populations.
This gap between knowledge and action to improve health equity is of increasing concern to public health researchers and practitioners, globally.
What we did
We conducted a comprehensive literature search to identify pre-existing knowledge to action (KTA) models. Models were critiqued and given a health equity support score.
What we found
We identified forty-eight pre-existing models. Using the health equity score, six models scored between 8 and 10 of a maximum 12 points.
These six promising models all mentioned equity, justice or a similar concept. Attention to multisectoral approaches or actions were the factor often lacking in the identified models.
The concepts of knowledge brokering, integrative processes, such as those in indigenous health research, and Ecohealth applied to KTA all emerged as areas of possible promise.
• Knowledge Brokering Frameworks
• Framework for Research Transfer
• Joint Venture Model of Knowledge Utilization
• Translational Research Framework to Address Health Disparities
• Model of Knowledge Translation and Exchange with Northern Aboriginal Communities
• Ecohealth Model applied to knowledge translation
Existing models can help guide knowledge translation to support action on the social determinants of health and health equity. There is a need to further develop and test models. This process should be informed by Ecohealth approaches, participatory, and integrative research.
Implications for public health
• Existing knowledge translation models can help guide the application of knowledge to inform public health action to improve health equity. The six models identified are promising examples of knowledge to action models that can support action on the social determinants of health.
• The most relevant models are those with principles and values reflective of equity and social justice.
• Use of these models will enable public health organizations working towards addressing the social determinants of health to:
• Identify equity as a goal;
• Involve stakeholders;
• Prioritize multisectoral engagement;
• Draw knowledge from multiple sources;
• Recognize the importance of contextual factors; and
• Have a proactive or problem-solving approach.
• There is room to develop and test more robust equity supporting models. This conversation will require attention to the criteria proposed in this paper…..”
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