Ian Graham

University of Ottawa · School of Nursing

Background Maternal-newborn care does not always align with the best available evidence. Applying implementation science to change initiatives can help move evidence-informed practices into clinical settings. However, it remains unknown to what extent current implementation practices in maternal-newborn care align with recommendations from implemen...

Background Scaling is typically discussed as a way to amplify or expand a health innovation. However, there is limited knowledge about the specific techniques that can enhance access to or improve the quality of innovations, aiming to increase their positive impacts for the public good. We sought to identify, compare, and contrast scaling framework...

Background Health guideline developers engage with interested people and groups to ensure that guidelines and their recommendations are relevant and useful to those who will be affected by them. These ‘interest‐holders’ include patients, payers/purchasers of health services, payers of health research, peer review editors, product makers, programme...

This is the protocol for a Campbell systematic review. The objectives are as follows. The objective of this review is to identify and synthesize empirical research on the impacts of interest‐holder engagement on the guideline development process and content. Our research questions are as follows: (1) What are the empirical examples of impact on the...

Aim The aim of this paper is to provide insights into conducting an implementation needs assessment using a case example in a less-research-intensive setting. Design and methods In the case example, an implementation needs assessment was conducted, including ¹ an environmental scan of the organization's website and preliminary discussions with key...

Aneurysmal subarachnoid haemorrhage (aSAH) is a devastating condition with high mortality and morbidity. The outcome measures used in aSAH clinical research vary making it challenging to compare and combine different studies. Additionally, there may be a mismatch between the outcomes prioritized by patients, caregivers, and health care providers an...

Introduction Since its first publication, the Cochrane Review of Patient Decision Aids team has been committed to collaborating with knowledge users (e.g. patients/health consumers, caregivers) as research team members. Little is known about knowledge users’ involvement in the conduct of systematic reviews. During its most recent update, we evaluat...

Background The impact of social frailty on older adults is profound including mortality risk, functional decline, falls, and disability. However, effective strategies that respond to the needs of socially frail older adults are lacking and few studies have unpacked how social determinants operate or how interventions can be adapted during periods r...

Background Co-production is a collaborative approach to prepare, plan, conduct, and apply research with those who will use or be impacted by research (knowledge users). Our team of knowledge users and researchers sought to conduct and evaluate co-production of a systematic review on decision coaching. Methods We conducted a mixed-methods case stud...

Background Unit nurse managers hold essential positions that can facilitate implementation of evidence-based practice. Studies showed that nurse managers in China lacked competencies and behaviours necessary to lead evidence-based practice implementation. The aim of the current study was to develop a context-fit training program prototype to enhanc...

Knowledge translation and implementation science have made many advances in the last two decades. However, research is still not making expedient differences to practice, policy, and service delivery. It is time to evolve our approach to knowledge production and implementation. In this editorial we advance research coproduction as a neglected pathw...

PURPOSE Functional problems such as incontinence and sexual dysfunction after radical prostatectomy (RP) are important outcomes to evaluate surgical quality in prostate cancer (PC) care. Differences in survival after RP between countries are known, but differences in functional outcomes after RP between providers from different countries are not we...

Background Recruiting participants to clinical trials is an ongoing challenge, and relatively little is known about what recruitment strategies lead to better recruitment. Recruitment interventions can be considered complex interventions, often involving multiple components, targeting a variety of groups, and tailoring to different groups. We used...

Introduction and aims This study examined critical care nurses’, physicians’, and allied health professionals’ perceptions of factors that support, inhibit, or limit the use of sedation interruption (SI) to improve the use of this integral component of care for mechanically ventilated patients. Method We conducted a theory-based, descriptive quali...

Introduction International guidelines recommend that adults with peripheral artery disease (PAD) be prescribed antiplatelet, statin and antihypertensive medications. However, it is unclear how often people with PAD are underprescribed these drugs, which characteristics predict clinician underprescription of and patient non-adherence to guideline-re...

Aims To explore youth, caregiver and staff perspectives on their vision of trauma‐informed care, and to identify and understand potential considerations for the implementation of a trauma‐informed care programme in an inpatient mental health unit within a paediatric hospital. Design and Methods We applied the Interpretive Description approach, gui...

Background When people who can use or benefit from research findings are engaged as partners on study teams, the quality and impact of findings are better. These people can include patients/consumers and clinicians who do not identify as researchers. They are referred to as “knowledge users”. This partnered approach is called integrated knowledge t...

Background: Patient decision aids are interventions designed to support people making health decisions. At a minimum, patient decision aids make the decision explicit, provide evidence-based information about the options and associated benefits/harms, and help clarify personal values for features of options. This is an update of a Cochrane review...

Aim To explore the prospective acceptability of an implementation leadership training programme prototype for nurse managers in China to implement evidence‐based practices, from the perspectives of potential programme participants and deliverers. Design A qualitative descriptive study was conducted in Spring 2022 at three tertiary hospitals in Hun...

Background Health research partnership approaches have grown in popularity over the past decade, but the systematic evaluation of their outcomes and impacts has not kept equal pace. Identifying partnership assessment tools and key partnership characteristics is needed to advance partnerships, partnership measurement, and the assessment of their out...

Background Knowledge translation (KT) strategies are widely used to facilitate the implementation of EBIs into healthcare practices. However, it is unknown what and how KT strategies are used to facilitate the sustainability of EBIs in institutional healthcare settings. Objectives This scoping review aimed to consolidate the current evidence on (i...

Background Applying the knowledge gained through implementation science can support the uptake of research evidence into practice; however, those doing and supporting implementation (implementation practitioners) may face barriers to applying implementation science in their work. One strategy to enhance individuals’ and teams’ ability to apply impl...

Background Moving evidence into practice is complex, and pregnant and birthing people and their infants do not always receive care that aligns with the best available evidence. Implementation science can inform how to effectively move evidence into practice. While there are a growing number of examples of implementation science being studied in mat...

Trauma-informed care (TIC) is an approach to care emerging in research and in practice that involves addressing the needs of individuals with histories of trauma. The aim of this scoping review was to examine the current literature relating to TIC interventions used in pediatric mental health inpatient and residential settings. We sought to answer...

BACKGROUND Virtual healthcare is changing healthcare delivery with consequent effects on how both patients and providers experience clinical encounters. OBJECTIVE The objective of our analysis was to identify themes of change in how patients and providers in a geographically dispersed renal service discussed their experiences with virtual care, in...

Background Virtual health care has transformed health care delivery, with its use dramatically increasing since the COVID-19 pandemic. While it has been quickly adopted for its convenience and efficiency, there has been a relative lack of in-depth exploration of its human impact, specifically how both patients and providers experience clinical enco...

Background and Aims Involving research users in collaborative research approaches may increase the relevance and utility of research findings. Our primary objectives were to (i) identify and describe characteristics of Canadian federally and provincially funded health research projects that included research users and were funded between 2011 and 2...

Background: We know little about knowledge users’ involvement in the conduct of systematic reviews. We aimed to evaluate team members’ degree of meaningful engagement and their perceptions of having used an integrated knowledge translation (IKT) approach when updating the Cochrane Review of Patient Decision Aids. Methods: We conducted a pre-post mi...

BACKGROUND Normal saline (NS) and Ringer’s lactate (RL) are the most common crystalloids given to hospitalised patients. Despite concern about possible harm associated with NS (e.g., hyperchloremic metabolic acidosis, impaired kidney function, and death), few large multi-centre randomised trials focused on critically ill patients have compared thes...

Background Normal saline (NS) and Ringer’s lactate (RL) are the most common crystalloids given to hospitalized patients. Despite concern about possible harm associated with NS (eg, hyperchloremic metabolic acidosis, impaired kidney function, and death), few large multicenter randomized trials focused on critically ill patients have compared these f...

Background There is growing evidence that context mediates the effects of implementation interventions intended to increase healthcare professionals’ use of research evidence in clinical practice. However, conceptual clarity about what comprises context is elusive. The purpose of this study was to advance conceptual clarity on context by developing...

Background Involving collaborators and partners in research may increase relevance and uptake, while reducing health and social inequities. Collaborators and partners include people and groups interested in health research: health care providers, patients and caregivers, payers of health research, payers of health services, publishers, policymakers...

Purpose: Exome and genome sequencing have rapidly transitioned from research methods to widely used clinical tests for diagnosing rare genetic diseases. We sought to synthesize the topics covered and appraise the development processes of clinical guidance documents generated by genetics professional organizations. Methods: We conducted a scoping...

Background Chronic disease management (CDM) through sustained knowledge translation (KT) interventions ensures long-term, high-quality care. We assessed implementation of KT interventions for supporting CDM and their efficacy when sustained in older adults. Methods Design: Systematic review with meta-analysis engaging 17 knowledge users using inte...

The saying “horses for courses” refers to the idea that different people and things possess different skills or qualities that are appropriate in different situations. In this paper, we apply the analogy of “horses for courses” to stimulate a debate about how and why we need to get better at selecting appropriate implementation research methods tha...

Background Co-production is an umbrella term used to describe the process of generating knowledge through partnerships between researchers and those who will use or benefit from research. Multiple advantages of research co-production have been hypothesized, and in some cases documented, in both the academic and practice record. However, there are s...

Background To date, little attention has focused on what the determinants are and how evidence-based practices (EBPs) are sustained in tertiary settings (i.e., acute care hospitals). Current literature reveals several frameworks designed for implementation of EBPs (0–2 years), yet fewer exist for the sustainment of EBPs (>2 years) in clinical pract...

Introduction and aims: Interaction and collaboration between researchers, patients/public, clinicians, managers and policy-makers are necessary to enhance the relevance and use of research, improve planning, and optimize healthcare delivery and outcomes. The Integrated Knowledge Translation Research Network (IKTRN) published four casebooks from 20...

Objectives To describe our experience with using a methodological outcomes measurement search filter (precise and sensitive versions of a filter designed to locate articles that report on psychometric properties of measurement tools) and citation searches to locate psychometric articles for tools that can be used to measure context attributes. To c...

Background An enduring challenge remains about how to effectively implement programs, services, or practices. Too often, implementation does not achieve its intended effectiveness, fidelity, and sustainability, even when frameworks or theories determine implementation strategies and actions. A different approach is needed. This scoping review joine...

Background Community-based exercise programs delivered through healthcare-community partnerships (CBEP-HCPs) are beneficial to individuals with balance and mobility limitations. For the community to benefit, however, these programs must be sustained over time. Purpose To identify conditions influencing the sustainability of CBEP-HCPs for people wi...

Objectives Normal saline (NS) and Ringer’s lactate (RL) are the most common crystalloids used for fluid therapy. Despite evidence of possible harm associated with NS (eg, hyperchloremic metabolic acidosis, impaired kidney function and death), few large multi-centre randomised trials have evaluated the effect of these fluids on clinically important...

Objective To identify and assess the globally available valid, reliable and acceptable tools for assessing health research partnership outcomes and impacts. Methods We searched Ovid MEDLINE, Embase, CINAHL Plus and PsycINFO from origin to 2 June 2021, without limits, using an a priori strategy and registered protocol. We screened citations indepen...

Background Accurate, consistent assessment of outcomes and impacts is challenging in the health research partnerships domain. Increased focus on tool quality, including conceptual, psychometric and pragmatic characteristics, could improve the quantification, measurement and reporting partnership outcomes and impacts. This cascading review was under...

Objective The objectives of the review were to (i) assess the methodological quality of all accessible and published guidelines and care bundles that offer a recommendation related to sedation interruptions, using the AGREE-II instrument, to (ii) determine what is the recommended best practice for sedation interruptions from the available guideline...

Category Sports; Trauma Introduction/Purpose Uncertainty exists regarding the best treatment for acute Achilles tendon ruptures. Simultaneous comparison of the multiple treatment options using traditional study designs is problematic; multiarm clinical trials often are logistically constrained to small sample sizes, and traditional meta-analyses a...

Background Co-production is an umbrella term used to describe the process of generating knowledge by bringing together researchers and those who will use research to work in partnership. Multiple benefits of research co-production have been hypothesized, and in some cases documented, in the academic and practice record. However, there are significa...

Practitioners use caregiver coaching in early intervention services, but coaching principles and practices are not well understood in the context of listening and spoken language (LSL) services with families of children who are deaf or hard of hearing. The purpose of this study was to examine practitioners’ experiences with coaching, including defi...

BACKGROUND During the COVID-19 pandemic, Canadians faced difficult health-related decisions. It is important to identify their decision making needs to provide person-centred care, to improve health outcomes, and to inform future pandemic preparedness. OBJECTIVE We sought to identify their decisions and decisional needs. METHODS Our study was co-...

Background: Never before the COVID-19 pandemic, Canadians had faced making health-related decisions in a context of significant uncertainty. However, little is known about which type of decisions and the types of difficulties that they faced. Objective: We sought to identify the health-related decisions and decisional needs of Canadians. Method...

Aim: This study aimed to synthesize evidence on interventions to improve leadership competencies of managers supervising nurses. Background: In recent years, numerous interventions have been developed to improve the leadership competencies of managers supervising nurses. However, researchers and nursing leaders are unclear about what aspects of...

Objective The objective of this scoping review is to identify and characterize relevant knowledge translation methods tools (those that provide guidance for optimized knowledge translation practice) to uncover candidate quality indicators to inform a future quality assessment tool for knowledge translation strategies. Introduction Knowledge transl...

Background: Under-recruitment regularly impedes clinical trials, leading to wasted resources and opportunity costs. Methods for designing trial participation strategies rarely consider behavior change theory. Objective: Informed by the Theoretical Domains Framework, we identified factors important to participating in Huntington's disease researc...

Objectives To share a concept analysis of social movement aimed at advancing its application to evidence uptake and sustainability in health-care. Methods We applied Avant and Walker's method to clarify the concept of social movement in the context of knowledge uptake and sustainability. Peer-reviewed and grey literature databases were systematica...

Background Traditionally, economic evaluations have engaged clinicians and policymakers; however, patients and their caregivers have insight that can ensure that the economic evaluation process appropriately reflects disease consequences and adequately addresses their priorities related to treatment.Objective We aimed to identify patient priorities...

Background To improve patient outcomes many healthcare organizations have undertaken a number of steps to enhance the quality of care, including the use of evidence-based practices (EBPs) such as clinical practice guidelines. However, there is little empirical understanding of the longer-term use of guideline-based practices and how to ensure their...

Background Models, theories, and frameworks (MTFs) provide the foundation for a cumulative science of implementation, reflecting a shared, evolving understanding of various facets of implementation. One under-represented aspect in implementation MTFs is how intersecting social factors and systems of power and oppression can shape implementation. Th...

Background The Stroke Recovery in Motion Implementation Planner guides teams through the process of planning for the implementation of community-based exercise programs for people with stroke, in alignment with implementation science frameworks. Objective The purpose of this study was to conduct a field test with end users to describe how teams us...

Background As more people are surviving stroke, there is a growing need for services and programs that support the long-term needs of people living with the effects of stroke. Exercise has many benefits; however, most people with stroke do not have access to specialized exercise programs that meet their needs in their communities. To catalyze the i...

Background Champions have been documented in the literature as an important strategy for implementation, yet their effectiveness has not been well synthesized in the health care literature. The aim of this systematic review was to determine whether champions, tested in isolation from other implementation strategies, are effective at improving innov...

Background The field of knowledge translation (KT) has been criticized for neglecting contextual and social considerations that influence health equity. Intersectionality, a concept introduced by Black feminist scholars, emphasizes how human experience is shaped by combinations of social factors (e.g., ethnicity, gender) embedded in systemic power...

Background In 2018, the Heart and Stroke Foundation of Canada transformed its approach to organizational strategic planning and priority-setting. The goal was to generate impact from bench to bedside to community, to improve the health of Canadians. It engaged researchers, clinician scientists, health systems leaders, and community members includin...

Caregiver coaching is utilized in early intervention services with families of children who are deaf or hard of hearing to increase caregivers’ skills and confidence in supporting their child’s language development, but few studies have examined coaching from the perspective of the caregivers. The purpose of this study was to increase understanding...