**Knowledge Translation in Context: Indigenous, Policy and Community Settings.** Edited by Elizabeth M. Banister, Bonnie J. Leadbeater, and E. Anne Marshall. Toronto: University of Toronto Press, 2011. Hardcover: 211 p. ISBN: 9781442641792. Price: CAD $45.00. Available from: www.utppublishing.com

How can we systematically ensure that people apply evidence in practice? Within various fields, including the social sciences and health sciences, there is frustration that research findings are not translated into practical applications at the individual, population, or community levels. Banister, Leadbeater, and Marshall have compiled a text that attempts to overcome the “know-do” gap by outlining the barriers and facilitators of knowledge translation (KT) in the academic, policy, and indigenous community contexts. They emphasize a paradigm shift among academics-practitioners so that research knowledge is not valued over the community’s experience or contextual knowledge.

The 12 chapters in *Knowledge Translation in Context* focus on how knowledge translation is context dependent and context sensitive. The introductory chapter by Leadbeater, Banister, and Marshall lays the groundwork by adopting the Canadian Institute for Health Research (CIHR) definition of knowledge translation but expanding it to refer to all populations. They highlight the social disparities that exist within communities and the power imbalances and communication gaps that exist between researchers and consumers of research knowledge. Part I of the text focuses on partnerships between communities and academics. Part II focuses on the challenges of translating research findings into public policy. Part III focuses on how knowledge translation with indigenous communities could be improved by acknowledging cultural realities and employing integrated knowledge translation methodologies. Collectively, these parts of the text offer practical examples of barriers and facilitators of knowledge translation practices in academic-community settings, policy development, and indigenous contexts.

## Part I: Community-University Contexts

Chapter 2 highlights some of the challenges faced by academics or researchers working with not-for-profit organizations that may have limited resources, high staff turnover, funding uncertainties, and shifts in priorities (as determined by stakeholders or boards). In such cases, the authors suggest using knowledge brokers in the KT process because they are trusted by all parties, understand the priorities of each partner, and forge partnerships that promote the use of evidence in decision making. Similarly, Marshall and Guenette (Chapter 3) acknowledge that there are multiple cultures and power dynamics involved in community-based research because there are differences

within multidisciplinary university-based research teams, within communities, and between academic researchers and the communities that they engage. They provide practical tips for engaging with these differences.

McGee (Chapter 4) suggests that if research information is tailored to the audience it will contribute to effective programs, operations, and policies. However, she also points out that some communities reject expert outsiders and are suspicious of researchers based on previous experiences. Using examples, the author suggests evaluative inquiry as a tool to engage in KT projects. Although this section encourages those in positions of power (academics) to initiate dialogue and build relationships with communities, it also points out that universities are rife with internal competition for grants and funding and there are power dynamics that value the contributions of some staff or faculty and specific departments (or even some research methodologies) over others. Few tips are provided for how academia can overcome these internal challenges.

Because local context is important for how practitioners implement research, Chapter 5 suggests that research flow must be considered a two-way street. The authors convincingly suggest that if KT is to succeed, practitioner interests must drive researchers' questions and researchers must strive to share their research evidence (in the form of “actionable messages”) with practitioners. Practitioners face challenges in locating, accessing, and interpreting research evidence; therefore the authors suggest that knowledge brokers “summarize, distill, and disseminate knowledge to the field” (p. 85).

## Part II: Policy Contexts

McCabe (Chapter 6) suggests that there are four reasons that research has limited influence on policy: (i) “information generated from research may be used for negotiation among competing interests rather than for the decision itself,” (ii) “research is not always comprehensive or convincing enough to inform policy,” (iii) “decisions are made without a formal decision making process,” and (iv) “policy makers may fall back on what they know because they may not know what information they need.” This chapter provides practical tips and concrete suggestions on how to engage policy makers with research. To alleviate KT barriers in policy contexts, it is suggested that knowledge brokers link knowledge production and knowledge use among policy makers and that scholars can educate policy makers about how to evaluate scientific findings and the meaning of the effects demonstrated by research. Finally, examples are provided of the types of documents (press releases and research briefs) that are effective for policymakers. Lenton (Chapter 7) provides a model for KT at the political level and reminds readers that change in government policy is a slow process. Chapter 8
presents a very tangible goal: to make reports of systematic reviews accessible to users. Practical suggestions include having users generate short user-friendly summaries and asking different user groups to create reviews of reports highlighting those recommendations that would be relevant to their roles and contexts.

## Part III: Indigenous Contexts

Begoray and Banister (Chapter 9) suggest that effective KT with indigenous groups involves contextuality, collaboration, reciprocity, relationality, and reflexivity. In Chapter 10 the authors highlight how the Maori have always been involved in research, empirical observation, and theorizing but these may not conform to Western scientific concepts of objectivity and neutrality. Instead, the community favours a Maori-centered social constructionism. This framework is referred to as Kuapapa Maori Research as it integrates holistic, ecological, and communityarian approaches that enable communities to achieve their political aspirations of resistance to colonization and efforts to uphold sovereignty. Because context determines knowledge transfer, Smylie (Chapter 11) points out that it is crucial to pay attention to cultural protocols and practices when partnering with aboriginal communities given the history of colonization. She points out that “assumptions of modern-day biomedicine and epidemiology, combined with an emphasis on evidence based clinical practice and health care decision-making, contribute to a hierarchy of health knowledge in which Indigenous knowledge is devalued and marginalized” (p. 184). Instead, this text advocates for a community-based participatory action research model or CIHR’s integrated KT process where “stakeholders are involved in shaping the research questions, deciding on the methodology, helping with data collection and tool development, interpreting study findings, crafting the message and disseminating the research results” (p. 197). The closing chapter of the text identifies key facilitators and barriers to knowledge translation that must be considered in all KT efforts.

## Analysis

This text provides an excellent example of how practitioners can overcome barriers to knowledge translation and learn from failures. The text was very relevant to my role as a clinical librarian at London Health Sciences Centre (LHSC), an acute care teaching hospital in London, Ontario. For instance, at LHSC, Continuous

Quality Improvement Councils regularly engage with librarians to inform their practice (via the literature search service and by soliciting publication support) as they design quality improvement initiatives that focus on improving patient care, reducing waste, minimizing cost, or resolving issues faced by frontline nursing and allied health professionals.

Some may consider the lack of an explicit reference to librarians a shortcoming of this text. However, most librarians often work as covert knowledge brokers as they may interact with staff from multiple disciplines or departments [1]. Although the authors do not specifically mention librarians, various chapters in this text acknowledge that knowledge brokering contributes to the success of KT. Librarians would benefit from reading this text to understand the gap that currently exists in turning research knowledge into practice and how they might play the role of a knowledge broker within their organizations. Many libraries already focus on making research accessible by creating subject guides or pathfinders, highlighting open access journals and encouraging publications in such journals, or by promoting institutional repositories. However, there may be a broader role for information professionals to collaborate in KT initiatives if they think of partnering with research units or of using networks to span boundaries and build bridges within and beyond their organization.

The authors of *Knowledge Translation in Context* provide an excellent framework for librarians, community practitioners, and researchers by aggregating diverse project experiences from around the globe to summarize the barriers and facilitators to KT. This text provides invaluable advice to researchers on how to be effective partners in the KT process. As such, this should be on the reading list of every practitioner or academic involved in community based quality improvement initiatives that attempt to bridge the “knowing–doing” gap.

## Reference

1. Davenport TH, Prusak L *Working Knowledge: How Organizations Manage What They Know*. Boston, MASS: Harvard Business School Press; 1998.

### Minakshi Sharma

*Clinical Librarian, London Health Sciences Centre*

E-mail: minakshi.sharma@lhsc.on.ca