Introduction
Outcomes analysis
Process analysis
Methods
Identification of studies
Selection and evaluation
Data extraction
Final data analyses
Results
References | Journal | Countries | Design | KT | Strategies | Use | Results |
---|---|---|---|---|---|---|---|
Abuya et al. (2009) | American Journal of Tropical Medicine and Hygiene | Kenya | 2 | O | T, Dm, Pd | I, C | Users showed a significant increase in knowledge about recommended doses and appropriate practices |
Abuya et al. (2010) | PLoS One | Kenya | 3 | O | T, Dm | I, C | Users showed a significant increase in knowledge about recommended doses and appropriate practices |
Ahmed and Zerihun (2010) | PLoS One | Uganda | 3 | O | T, Dm, Pd, F, R | I, C | The population studied showed limited knowledge about the results transmitted regarding the disease treatment and transmission and the preventive behaviours that should be adopted. Results on the possession and use of distributed products were not very encouraging. There were marked differences among regions |
Ayieko et al. (2011) | PLoS Medicine | Kenya | 2 | O | T, Dm, S, G, V | I | The authors found a significant increase in the practices recommended in the practice guidelines and improved performance in terms of admission assessments |
Bagamoyo College of Arts et al. (2002) | Evaluation and Program Planning | Tanzania | 1 | O, P | T, Pd, A, F | I, C | Artistic performances and discussions with participants helped break the silence on taboo subjects. The authors noted increases in the sense of collective responsibility, in motivation to adopt new behaviours, and in the capacity to analyse problems and find solutions. They also noted an increase in the use of recommended products and services |
Blanton et al. (2010) | American Journal of Tropical Medicine and Hygiene | Kenya | 3 | O* | T, Dm, V, F | I, C | Users, both direct and indirect, were significantly more aware of the treatments implemented and the products available. They also showed significant increases in the knowledge transferred, the recommended health behaviours and the use of distributed products. Results were not attributable to the sociodemographic data measured |
Dagenais et al. (2013b) | Global Health Promotion | Burkina Faso | 1 | O, P | Dm, Pd, P | I, C, P | Users appeared to be more familiar with the research process. Few consulted the published written documents. Users said they preferred workshops, even if, for these to be effective, intermediary agents had to subsequently retransmit the information into their own settings. The authors also noted changes in users’ behaviours and attitudes |
Delva et al. (2010) | Tropical Medicine and International Health | Kenya | 3 | O* | T, Pd, R, S | I | The authors did not observe the desired improvements in health indicators. They considered that awareness raising and mobilization activities had limited effects. The frequency and timing of visits were not improved as recommended, although more prenatal services were provided |
Dynes et al. (2011) | Midwifery | Bangladesh | 5 | O, P | T, Dm, V, F, G | I, C | Results suggested rapid integration of the program, significant improvement in performance post-training, and a high level of satisfaction with the training among participants and transfer agents |
English et al. (2011) | Implementation Science | Kenya | 5 | O, P | T, Dm, V, G, S | I, C | The authors emphasized that the normative-educational approach and the sustained efforts exerted throughout the research project were determining factors for performance |
Friend and Chertok (2009) | Public Health Nursing | Kenya | 3 | O* | T, Dm, V, F | I, C | Practical demonstrations significantly improved users’ skills, and the use of images was shown to be culturally effective. Overall, users’ practical knowledge was significantly improved |
Gazi et al. (2005) | Journal of Health, Population and Nutrition | Bangladesh | 3 | O, P | T, F, S | I, C | Users demonstrated better knowledge of the services and used them more often. Their use of recommended products also increased. The results showed that local facilitators transferred knowledge, provided services and directed users toward clinics |
Kaseje et al. (2010) | Global Public Health | Kenya | 5 | O, P | T, P | I | Results showed a marked improvement in governance committees and better practices related to the management of data and services. There was also significant improvement in the coverage of many services |
Kidala et al. (2000) | Public Health Nutrition | Tanzania | 2 | O | T, Dm, Pd, F, L | I, C | Significant increases were seen in knowledge regarding the possession and use of distributed products and in the frequency of recommended practices |
Lemay et al. (2012) | Journal of Health Communication | Malawi | 5 | O, P | T, Dm | I | The strategy used was costly and more effective for obtaining rapid feedback than were transitional strategies. Because of that, there was improvement noted in the quality of health services provided |
Leow et al. (2011) | Journal of Surgical Education | Sierra Leone | 4 | O | T, Dm | I, C | Participants found the training helpful. More than 90 % of them reported that their expectations had been met, that the content was well explained and that the practical sessions were useful. They felt confident about being able to teach the skills they had learned to others in their own settings. Subsequent workshops led by the participants demonstrated the effectiveness of the strategy of developing participants’ autonomy |
Libamba et al. (2007) | Bulletin of the WHO | Malawi | 4 | O* | T, G, S | I | Service coverage was increased |
Manzi et al. (2009) | Transactions of the Royal Society of Tropical Medicine and Hygiene | Tanzania | 5 | O, P | T, Dm, Pd, P, S, G, V | I | After 2 months, 92 % of the health centres had implemented the use of WaterGuard. The main barrier at the start of the project was the product’s unavailability, but the supply increased as the project progressed. After 9 months, users reported they had no major problems integrating the product into their routine care practices |
Nyagero et al. (2012) | Pan African Medical Journal | Kenya | 3 | O, P | T, Dm | I, C | Users demonstrated good practices in terms of behaviour change. These changes were associated with several sociodemographic data, in some cases significantly |
Nzinga et al. (2009) | Implementation Science | Kenya | 1 | P | T, Dm | I | The authors identified 10 themes that could impede implementation of the transfer process |
Perez et al. (2009) | BMC International Health and Human Rights | Mali | 3 | O, P | T, Dm, Pd, F | I, C | Results suggested the positive influence of agent users through significant increases in possession and use of distributed products and adoption of certain health behaviours. The continuation of certain non-recommended behaviours was also noted |
Puchalski Ritchie et al. (2012) | International Journal of Tuberculosis and Lung Disease | Malawi | 1 | O, P | T, Dm, F, S | I | Local facilitators pointed out several barriers preventing them from carrying out their role and integrating knowledge into their practice. This resulted in conflicting messages, documentation errors and poor interactions with users |
Shrestha et al. (2006) | Tropical Medicine & International Health | Nepal | 2 | O | T, Dm, F, G, V | I | Implementation of practice guidelines led to a significant reduction in multiple prescriptions. The results, although not significant, suggest that recommended practices increased and average costs of wastage decreased |
Shrestha (2002) | Journal of Health, Population and Nutrition | Nepal | 3 | O, P | T, Dm, V, F, S | I, C | The use of visual supports was helpful and users demonstrated better knowledge after training. Group sessions allowed local facilitators to approach users and better understand their concerns, and also saved time. Six months later, significant change was noted in care-seeking behaviours |
Sodhi et al. (2011) | BMC International Health and Human Rights | Malawi | 5 | O, P | T, Dm, F, G | I, C | Practice guidelines gave participants a greater sense of autonomy in providing appropriate health care. Participants recommended this approach because it presented several conditions that favoured implementation of the transfer process, but they also pointed out certain barriers to knowledge use |
Ssengooba et al. (2011) | BMC International Health and Human Rights | Uganda | 1 | P | P, Pd, G, P | I | This study identified factors that facilitated absorption of knowledge and implementation of policies. Certain barriers were also pointed out |
Wanyama et al. (2012) | Journal of Acquired Immune Deficiency Syndromes | Uganda | 2 | O, P | A, F, T | C | Users in the intervention group obtained significantly higher scores on the knowledge questionnaires. Overall, participants in the intervention group felt they had benefited from it and recommended this method. These participants and the transfer agents pointed out particular features that supported the tool |
Willms et al. (2011) | Sexually Transmitted Infections | Malawi | 1 | O, P | P, A, L | I, C | The authors observed changes in users’ behaviours and attitudes. They describe the creation of a discussion forum, press releases and documents supporting knowledge emanating from research |
Source and year of publication
Research setting
Low-income countries
Health issue(s) addressed
Research designs
Qualitative designs (n = 6, 21.4 %) |
+ Descriptions of data collection methods, formats and results took into account the research context |
− Very little information was provided on the researcher’s influence on the interpretation of results |
− Descriptions of participant selection or exclusion criteria were sometimes missing |
Qualitative designs without random selection (n = 9, 32.1 %) |
+ Recruitment methods helped reduce the biases associated with participant selection |
+ Data were sufficiently complete to support the results |
+ Measurement instruments and variables studied were generally well described |
− Psychometric properties of the instruments used were poorly documented |
Qualitative designs with random selection (n = 5, 17.9 %) |
+ Sampling procedures were well explained and presented low rates of exclusion and drop-out |
− Procedures for blinding were presented in only half the studies |
Descriptive qualitative designs (n = 2, 7.1 %) |
− Little information was presented on participant selection method |
− No information was presented on sample representativeness |
− Relevance of measurements used was mixed |
Mixed designs (n = 6, 21.4 %) |
+ Research design selected and integration of qualitative and quantitative data appear appropriate for responding to the study’s objectives |
− Very little information was presented on the limitations of this integration |
Evaluation objectives
Knowledge transfer strategies
Training program (n = 26) |
Demonstrations and practical activities; seminars and workshops; supervision and feedback; refresh sessions; peer teaching; follow-up meetings; discussion sessions |
Distribution of materials (n = 20) |
For implementation: bicycles, cellular telephones, practice guidelines and training manuals, teaching tools, wall posters in points of service |
For use: medications, condoms, water containers, water purification sachets, seeds and seedlings, mosquito nets, health kits |
Tailored materials: Comics, picture books, diagrams, photographs |
Local facilitators (n = 13) |
Health professionals; community members |
Public dissemination (n = 9) |
Awareness-raising activities; information sessions at points of service; health kiosks at markets; home visits; educational messages on health transmitted through the media and social networks; distribution of T-shirts with logos; scientific communications; policy briefs; press conferences |
Partnership activities (n = 5) |
Digital platform; discussion forums and exchange network for partners; workshops |
Artistic performances and games (n = 3) |
Theatre, dance, song, poetry; board games |
Opinion leaders (n = 2) |
Religious leaders; village chiefs |
Transfer agents involved
Target users
Results reported
Outcomes of transfer strategies
Process analysis
Conditions facilitating research results use | Conditions inhibiting research results use |
---|---|
A strategy that… | |
Uses a participative approach | Does not involve continuing education sessions |
Facilitates communication between agents and users, and among the different partners | Provides training that is too brief or too intensive |
Involves local leaders | Does not promote communication among the different partners, agents and users, nor with those in charge of the implementation |
Has low costs | |
Makes it possible to get rapid feedback | |
Is accessible (transportation) and flexible (schedule) | |
Involves a method of supervision | |
A transfer agent who… | |
Is highly devoted and committed to the population | Is not sufficiently knowledgeable |
Makes him/herself available to users | Lacks communication skills |
Receives payment commensurate with the workload | Does not have the resources needed to carry out tasks (limited means of transportation) |
Is too poorly paid | |
Users who… | |
See the benefits of using the knowledge that is transferred | Do not believe they need the knowledge being transferred |
Present sufficient and accurate knowledge in relation to the evidence provided | Lack knowledge on the different aspects of the disease |
Recognize the value of the evidence presented | Have financial constraints and are not ready to pay the price for essential products |
Have transportation constraints that make it difficult for them to access services | |
Have beliefs and cultural practices that are in contradiction with the recommendations | |
Are resistant to change | |
Lack motivation | |
An organizational setting that… | |
Facilitates the delegation of tasks among professionals | Lacks the necessary resources: space, products, and teaching materials |
Fosters communication among partners, agents, and organizers of the strategies | Provides inadequate services and incomplete information and education |
Value transfer activities and support agents in their activities (social acceptability) | Does not understand the community’s involvement and participation in the transfer process |
Is able to receive and absorb user demands to deliver products recommended by evidence (condoms, vaccinations, primary care services, etc.) | Has a high staff turnover rate |
Does not provide the support required for supervision | |
Does not enable users to access the essential products recommended by research results | |
Knowledge that… | |
Is tailored to the context | Is too complicated to understand |
Is transmitted in ways that respect users’ level of education | Is not available |
Is available |