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      Strategies to promote uptake and use of intimate partner violence and child maltreatment knowledge: an integrative review

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          Abstract

          Background

          Intimate partner violence (IPV) and child maltreatment (CM) are major social and public health problems. Knowledge translation (KT) of best available research evidence has been suggested as a strategy to improve the care of those exposed to violence, however research on how best to promote the uptake and use of IPV and CM evidence for policy and practice is limited. Our research asked: 1) What is the extent of IPV/CM-specific KT research? 2) What KT strategies effectively translate IPV/CM knowledge? and 3) What are the barriers and facilitators relevant to translating IPV/CM-specific knowledge?

          Methods

          We conducted an integrative review to summarize and synthesize the available evidence regarding IPV/CM-specific KT research. We employed multiple search methods, including database searches of Embase, CINAHL, ERIC, PsycInfo, Sociological Abstracts, and Medline (through April, 2013). Eligibility and quality assessments for each article were conducted by at least two team members. Included articles were analyzed quantitatively using descriptive statistics and qualitatively using descriptive content analysis.

          Results

          Of 1230 identified articles, 62 were included in the review, including 5 review articles. KT strategies were generally successful at improving various knowledge/attitude and behavioural/behavioural intention outcomes, but the heterogeneity among KT strategies, recipients, study designs and measured outcomes made it difficult to draw specific conclusions. Four key themes were identified: existing measurement tools and promising/effective KT strategies are underused, KT efforts are rarely linked to health-related outcomes for those exposed to violence, there is a lack of evidence regarding the long-term effectiveness of KT interventions, and authors’ inferences about barriers, facilitators, and effective/ineffective KT strategies are often not supported by data. The emotional and sometimes contested nature of the knowledge appears to be an important barrier unique to IPV/CM KT.

          Conclusions

          To direct future KT in this area, we present a guiding framework that highlights the need for implementers to use/adapt promising KT strategies that carefully consider contextual factors, including the fact that content in IPV/CM may be more difficult to engage with than other health topics. The framework also provides guidance regarding use of measurement tools and designs to more effectively evaluate and report on KT efforts.

          Electronic supplementary material

          The online version of this article (doi:10.1186/1471-2458-14-862) contains supplementary material, which is available to authorized users.

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          Most cited references98

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          Lost in knowledge translation: time for a map?

          There is confusion and misunderstanding about the concepts of knowledge translation, knowledge transfer, knowledge exchange, research utilization, implementation, diffusion, and dissemination. We review the terms and definitions used to describe the concept of moving knowledge into action. We also offer a conceptual framework for thinking about the process and integrate the roles of knowledge creation and knowledge application. The implications of knowledge translation for continuing education in the health professions include the need to base continuing education on the best available knowledge, the use of educational and other transfer strategies that are known to be effective, and the value of learning about planned-action theories to be better able to understand and influence change in practice settings.
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            Changing provider behavior: an overview of systematic reviews of interventions.

            Increasing recognition of the failure to translate research findings into practice has led to greater awareness of the importance of using active dissemination and implementation strategies. Although there is a growing body of research evidence about the effectiveness of different strategies, this is not easily accessible to policy makers and professionals. To identify, appraise, and synthesize systematic reviews of professional educational or quality assurance interventions to improve quality of care. An overview was made of systematic reviews of professional behavior change interventions published between 1966 and 1998. Forty-one reviews were identified covering a wide range of interventions and behaviors. In general, passive approaches are generally ineffective and unlikely to result in behavior change. Most other interventions are effective under some circumstances; none are effective under all circumstances. Promising approaches include educational outreach (for prescribing) and reminders. Multifaceted interventions targeting different barriers to change are more likely to be effective than single interventions. Although the current evidence base is incomplete, it provides valuable insights into the likely effectiveness of different interventions. Future quality improvement or educational activities should be informed by the findings of systematic reviews of professional behavior change interventions.
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              The impact of child sexual abuse on health: a systematic review of reviews.

              A large amount of studies and literature reviews on the consequences of child sexual abuse has appeared over the past twenty years. To prevent that the inconsistency in their conclusions along with their methodological differences and limitations may create interpretative difficulties, mistaken beliefs, or confusion among all professionals who turn to this literature for guidance, this paper addresses the best available scientific evidence on the topic, by providing a systematic review of the several reviews that have investigated the literature on the effects of child sexual abuse. Seven databases were searched, supplemented with hand-search of reference lists from retrieved papers. The author and a psychiatrist independently evaluated the eligibility of all studies identified, abstracted data, and assessed study quality. Disagreements were resolved by consensus. Fourteen reviews, including more than 270,000 subjects from 587 studies, were analyzed. There is evidence that survivors of childhood sexual abuse are significantly at risk of a wide range of medical, psychological, behavioral, and sexual disorders. Relationships are small to medium in magnitudes and moderated by sample source and size. Child sexual abuse should be considered as a general, nonspecific risk factor for psychopathology. The implications for research, treatment, and health policy are discussed.
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                Author and article information

                Contributors
                jmacgre9@uwo.ca
                nwathen@uwo.ca
                akothari@uwo.ca
                phundal3@uwo.ca
                anaimi4@uwo.ca
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                21 August 2014
                21 August 2014
                2014
                : 14
                : 1
                : 862
                Affiliations
                [ ]Faculty of Information & Media Studies, The University of Western Ontario, North Campus Building, Room 240, 1151 Richmond St, London, ON N6A 5B7 Canada
                [ ]Faculty of Health Sciences, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 222, 1151 Richmond St, London, ON N6A 5B9 Canada
                [ ]Schulich Interfaculty Program in Public Health, The University of Western Ontario, The Western Centre for Public Health and Family Medicine, 1465 Richmond St., 4th Floor, London, ON N6G 2M1 Canada
                [ ]Lab for Knowledge Translation in Health, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 403, 1151 Richmond St, London, ON N6A 5B9 Canada
                Article
                6991
                10.1186/1471-2458-14-862
                4152574
                25146253
                4a49b885-655b-4c01-a3a3-7b29f15907d4
                © MacGregor et al.; licensee BioMed Central Ltd. 2014

                This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 29 April 2014
                : 24 July 2014
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2014

                Public health
                intimate partner violence,child maltreatment,knowledge translation,integrative review,evidence-based

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