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Amplifying the role of knowledge translation platforms in the COVID-19 pandemic response

Abstract

Abstract The COVID-19 pandemic presents the worst public health crisis in recent history. The response to the COVID-19 pandemic has been challenged by many factors, including scientific uncertainties, scarcity of relevant research, proliferation of misinformation and fake news, poor access to actionable evidence, time constraints, and weak collaborations among relevant stakeholders. Knowledge translation (KT) platforms, composed of organisations, initiatives and networks supporting evidence-informed policy-making, can play an important role in providing relevant and timely evidence to inform pandemic responses and bridge the gap between science, policy, practice and politics. In this Commentary, we highlight the emerging roles of KT platforms in light of the COVID-19 pandemic. We also reflect on the lessons learned from the efforts of a KT platform in a middle-income country to inform decision-making and practice during the COVID-19 pandemic. The lessons learned can be integrated into strengthening the role, structures and mandates of KT platforms as hubs for trustworthy evidence that can inform policies and practice during public health crises and in promoting their integration and institutionalisation within the policy-making processes.
C O M M E N T A R Y Open Access
Amplifying the role of knowledge
translation platforms in the COVID-19
pandemic response
Fadi El-Jardali
1,2,3*
, Lama Bou-Karroum
1,2
and Racha Fadlallah
1,2
Abstract
The COVID-19 pandemic presents the worst public health crisis in recent history. The response to the COVID-19
pandemic has been challenged by many factors, including scientific uncertainties, scarcity of relevant research,
proliferation of misinformation and fake news, poor access to actionable evidence, time constraints, and weak
collaborations among relevant stakeholders. Knowledge translation (KT) platforms, composed of organisations,
initiatives and networks supporting evidence-informed policy-making, can play an important role in providing
relevant and timely evidence to inform pandemic responses and bridge the gap between science, policy, practice
and politics. In this Commentary, we highlight the emerging roles of KT platforms in light of the COVID-19
pandemic. We also reflect on the lessons learned from the efforts of a KT platform in a middle-income country to
inform decision-making and practice during the COVID-19 pandemic. The lessons learned can be integrated into
strengthening the role, structures and mandates of KT platforms as hubs for trustworthy evidence that can inform
policies and practice during public health crises and in promoting their integration and institutionalisation within
the policy-making processes.
Keywords: COVID-19 pandemic, knowledge translation, evidence-informed policy-making, evidence, research, data
Background
The world is facing the worst public health crisis in re-
cent history. The coronavirus disease (COVID-19) pan-
demic has directly and indirectly affected more than
four million people across the globe, disrupting health
systems and economies [1]. It has placed unprecedented
pressure on decision-makers at all levels to make rapid
decisions, oftentimes in the face of uncertainty and with
long-term consequences on the lives of millions of
people [1,2].
Using the best available research evidence and data to
guide public health and health systems decisions is inte-
gral to an effective and efficient response in public
health emergencies [24]. In crises of such devastating
scale and intensity, this could make the difference be-
tween life and death [5]. Despite the breadth of available
research evidence on epidemic preparedness and on dif-
ferent preventive measures, such as travel restriction [6],
school closures [7], disease surveillance networks [8] and
quarantine [9], this evidence was inconsistently used in
informing decisions [10]. Even in countries where public
health expertise was available, governments did not le-
verage this expertise to better mitigate trade-offs and
guide the policy response in the face of uncertainties
[11]. Instead, many governments reverted to a top-down
approach to decision-making with political and eco-
nomic considerations and other contextual factors taking
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* Correspondence: fe08@aub.edu.lb
Lama Bou-Karroum and Racha Fadlallah contributed equally to this work.
1
Department of Health Management and Policy, Faculty of Health Sciences,
American University of Beirut, Beirut, Lebanon
2
Knowledge to Policy (K2P) Center, Faculty of Health Sciences, American
University of Beirut, Beirut, Lebanon
Full list of author information is available at the end of the article
El-Jardali et al. Health Research Policy and Systems (2020) 18:58
https://doi.org/10.1186/s12961-020-00576-y
precedence over research and health directives, further
exposing populations to risks [10,12].
Organisations, initiatives and networks that support
evidence-informedpolicy-making can play an important
role in providing relevant and timely evidence to inform
pandemic responses and bridge the gap between science,
policy and politics. An organised form of these afore-
mentioned entities, known as knowledge translation
(KT) platforms, brings decision-makers, researchers,
practitioners, civil society groups and other stakeholders
together to facilitate the process of translating evidence
into policy and action by aligning research topics with
policy priorities, responding to pressing issues through
developing policy briefs, rapid responses and evidence
summaries, and convening dialogues to guide policy for-
mulation and implementation, taking into consideration
local and political context [1315].
The role of KT platforms in pandemic responses is
more important than ever, particularly in low- and
middle-income countries, where public health and
health systems are already overburdened and under-
resourced, thus posing additional challenges to effective
response. In this Commentary, we highlight the emer-
ging roles of KT platforms in light of the COVID-19
pandemic. We also reflect on the lessons learned from a
KT platform effort in a middle-income country to in-
form decision-making and practice during the COVID-
19 pandemic. Lessons learned can be integrated into
strengthening the role, structures and mandates of KT
platforms as hubs for trustworthy evidence that can in-
form policies and practice during public health crises.
Emerging roles of KT platforms in pandemic
response
KT platforms are uniquely positioned to help facilitate a
rapid evidence-informed response during public health
crises in different ways, as outlined below.
Engaging decision-makers and stakeholders in setting
priorities
A key starting point to inform decision-making pro-
cesses is to identify policy- and practice-relevant prior-
ities. Engaging decision-makers in priority-setting can
increase the acceptability of evidence and foster its util-
isation in the decision-making process [16]. KT plat-
forms can play an important role in prioritising relevant
issues, mapping knowledge gaps, and aligning research
and evidence synthesis topics with policy needs during a
public health crisis. Providing decision-makers and prac-
titioners with policy- and practice-relevant evidence can
help inform critical decisions and contribute to strength-
ening health systems and improving population health.
It can also help overcome the scarcity of resources by
pursuing and acting upon high priority issues that are
likely to have a significant impact on knowledge, policy
or practice [17,18].
Synthesising the best available evidence: separating the
wheat from the chaff
With the rapid spread of COVID-19 around the globe,
decision-makers and practitioners are also required to
mount a rapid response. This necessitates timely and
relevant evidence to inform prevention, control and
mitigation measures. Evidence includes not only findings
from research but also other forms of knowledge such as
local data, surveillance data, guidelines, national and
international agency reports as well as media reports
[19]. However, the speed with which the information is
being generated during the public health crisis is unpre-
cedented decision-makers and practitioners are
swamped with a tsunami of information, both reliable
and unreliable, making it challenging to remain abreast
of the rapidly evolving evidence base and to filter the
type and structure of evidence that would be of most
value to inform decision-making and practice.
Acknowledging the tension between rigor and speed,
KT platforms can harness this large body of knowledge
through synthesis to inform policy and practice. Specific-
ally, they can filter current best available evidence from
unsubstantiated or non-scientifically supervised sources
and combine the results of multiple relevant studies
while taking into consideration the quality of studies and
biases in the existing evidence base. In doing so, they
can provide decision-makers and practitioners with rele-
vant, reliable and accessible evidence syntheses that ad-
dress priority issues in a timely and transparent manner.
Contextualising and disseminating actionable evidence to
target audience: turning the noise into music
The availability of evidence is a necessary but insufficient
condition for evidence-informed response during public
health crisis; evidence must reach people in policy and
operational positions in an actionable form and with
minimal time lag and, when used, should be applied ef-
fectively [20]. Often, relevant evidence exists but
decision-makers are unaware or unable to interpret or
apply it to their own context [21]. Beyond evidence from
research, decision-makers are also influenced by numer-
ous forces, including institutional constraints, political
context, interest group pressures, personal convictions
and values, and external factors such as economic
recession.
KT platforms recognise that a one-size-fits-allap-
proach for responding to public health crises may not be
appropriate and, therefore, they provide context-specific
and actionable evidence to enable countries to adapt glo-
bal solutions to local needs and realities. Specifically,
they can produce a range of KT products by combining
El-Jardali et al. Health Research Policy and Systems (2020) 18:58 Page 2 of 7
insights from multiple sources (systematic/rapid reviews,
primary studies, local date and tacit knowledge) in a
user-friendly format and plain language and tailoring the
findings to local context. To further foster the use of evi-
dence in policies and practice, they can leverage a range
of uptake activities to disseminate the products to target
audience and support the use of that evidence to its full
potential. Additionally, they can maintain repositories of
product pipelines that can serve as a one-stop shop
freely accessible by the different stakeholders to support
evidence use in a timely manner.
Promoting trust and countering misinformation
Were not just fighting an epidemic; were fighting
an infodemic”–Dr. Tedros Adhanom Ghebreyesus,
WHO Director General, 15 February 2020.
While infodemics (or overflow of information) are not
a novel phenomenon, the speed and reach of the
COVID-19 infodemic and fake news has been unprece-
dented [22]. This makes it challenging for people to find
trustworthy sources and reliable information to guide
them when they need it. It can also hamper the effective-
ness of a pandemic response [5]. KT platforms are
uniquely positioned to serve as a credible hub that pro-
vides trustworthy evidence that can be acted upon by
policy-makers, stakeholders, citizens and media in times
of crisis.
Providing platforms for cross-sectoral dialogue: breaking
down silos
The scope and intensity of public health crisis means
that no single agency can work alone to effectively con-
trol and mitigate its impact. Governments need to col-
laborate and shape the collective response through
multi-sectoral actions that involve the public, private
and civil society sectors [23].
KT platforms can facilitate the coordinated and multi-
disciplinary approach needed to inform policy and prac-
tice during a public health crisis. They can provide a
platform (physical or web-enabled, depending on the cri-
sis) that brings together the different stakeholders (e.g.
policy-makers, researchers, practitioners, civil society or-
ganisations) from different sectors (e.g. health, educa-
tion, social, economy) to shape policy problems, increase
mutual understanding of challenges faced, deliberate
about policy and practice solutions (including their ben-
efits, potential harms, costs and uncertainties), and dis-
cuss implementation considerations. They can also serve
as a neutral communication channel for real-time ex-
change of relevant information, ideas, concerns and best
practices as the crisis unfolds. In doing so, they enable
stakeholder group interaction, redistribution of power
resources and evidence-informed deliberations alongside
contextual factors, such as values, beliefs, interests or
political goals, and the strategies of the different stake-
holders [24]. Importantly, they can ensure that the
voices of those who are most affected by a public health
crisis are meaningfully included in the decision-making
process.
Monitoring and evaluating policy response
During the 2009 H1N1 influenza pandemic, evaluations
of implemented response measures were hindered by
the lack of planning for this activity, political sensitivities
and legal issues. Additionally, little attention was paid to
the recovery phase and to the transition to seasonal in-
fluenza [25]. This posed a missed opportunity to learn
what worked for whom and in what circumstances in
order to generate valuable lessons for informing future
pandemics like COVID-19. KT platforms can help in
monitoring the effectiveness of prevention and mitiga-
tion measures during a crisis and in assessing the impact
on different population groups to guide a response effort
that is more inclusive, equitable and responsive to the
contextual needs. In doing so, they can play an import-
ant role in assessing the immediate and longer-term
health, social and economic effects of the pandemic,
which is critical to inform the transition to the post-
pandemic phase.
Lessons learned from a KT platform
Below, we reflect on the experience and lessons learned
so far from the Knowledge to Policy (K2P) Center, a
WHO Collaborating Centre for Evidence-Informed Pol-
icymaking and Practice. Established within a university
setting in Lebanon (a middle-income country), K2P Cen-
ter seeks to bridge the gap between science, policy and
politics by making research evidence more accessible to
a broader range of stakeholders, building institutional
capacities for evidence-informedpolicy-making and seiz-
ing opportunities to advocate and influence policy out-
comes. The Centers response to COVID-19 builds on
years of work in raising the awareness of policy-makers,
stakeholders, civil society organisations and media on
the importance of evidence in informing decision-
making, developing their capacities in accessing and
using evidence, raising demand for evidence, building
trust and establishing critical linkages. With the pan-
demic still unfolding, new lessons will likely emerge,
making this a learning platform and an evolving living
experience.
Activate rapid response services
During a public health crisis, decision-makers are under
tremendous pressure to respond urgently to demon-
strate capability and meet public health needs. The time
El-Jardali et al. Health Research Policy and Systems (2020) 18:58 Page 3 of 7
limitation is a critical barrier to evidence use during a
crisis, thus necessitating the provision of evidence in a
timely manner to decision-makers. In this regard, the
rapid response service presents a key element in the re-
sponse to the COVID-19 pandemic. It can respond to
urgent requests from decision-makers and stakeholders
by delivering relevant and high-quality evidence in short
periods of time, ranging from 3 to 30 days. Rapid re-
sponse products use systematic and transparent methods
to search, synthesise and appraise the existing evidence
base (giving precedence to existing systematic/rapid re-
views when possible) while tailoring the implications to
local context in order to support policy and systems de-
cisions. They also utilise user-friendly formats and plain
language to facilitate the uptake of evidence in decision-
making.
KT platforms should have the capability and flexibility
to switch to rapid response mode during a crisis and
tailor their suite of services to address the various as-
pects of the response. Operationalising the rapid re-
sponse service is facilitated by the presence of Standard
Operating Procedures and templates for preparing and
disseminating rapid response products, the availability of
a team with appropriate sets of skills and expertise, ac-
cess to relevant databases, and flexibility in funding to
re-orient human, financial and material resources to re-
spond to the pandemic.
Position the KT platform as a credible source of evidence
during a pandemic
At the time of crisis, KT platforms must rapidly position
themselves as credible hubs that provide trustworthy evi-
dence to policy-makers, stakeholders, citizens and media.
This can be achieved by actively demonstrating the value
of the platform early on rather than taking a back seat
and waiting for people to turn to them for information.
When the crisis hit Lebanon, the K2P Center launched
the K2P COVID-19 Series Initiative and the first policy-
relevant document produced in that series cemented
and reinforced K2Ps role as a trusted reference centre
for evidence and guidance related to COVID-19. At the
downstream level, the K2P Center activated the
K2Peopleinitiative to educate and raise awareness of
citizens and media about the virus and its mode of
transmission as well as to address scepticisms and mis-
conceptions through social media platforms. As part of
the K2Peopleinitiative, we sought to target vulnerable
groups that are mostly affected by the COVID-19 pan-
demic such as smokers, cancer patients, elderly popula-
tion, refugees and low socio-economic workers. We also
tackled mental health problems affecting adults as well
as children as a result of the COVID-19 pandemic. The
abovementioned two initiatives also provided a clear
portal for communicating COVID-19 information, which
can be accessed for free by all relevant and interested
stakeholders.
Importantly, KT platforms must maintain their cred-
ibility throughout the crisis by demonstrating a high de-
gree of responsiveness to priorities and needs, remaining
objective, truthful and politically neutral, and ensuring
transparency in the evidence and recommendations gen-
erated. This is particularly relevant for KT platforms
established independently or within an academic institu-
tion where trust is a pre-requisite to interacting with
such platforms.
Remain alert and responsive to changing priorities and
needs, both upstream and downstream
Decision-makersneeds for evidence can vary, depending
on the context, type of stakeholder, resource availability,
or the specific phase of the pandemic cycle in a given
country [19]. To improve the translation of evidence
into policy and practice, it is important for KT platforms
to identify context-specific knowledge gaps, priorities
and needs and to subsequently address them through a
corresponding product (e.g. rapid evidence summary,
guidance document, evidence brief, media bite) tailored
to the target audience.
Moreover, given the high level of uncertainty associ-
ated with such a pandemic, there is a huge appetite for
evidence to guide decision-making at all levels. This pre-
sents a critical opportunity for KT platforms to not only
respond to decision-makerspriorities and needs, but to
also proactively shape the policy agenda by bringing im-
portant (often overlooked) issues to the attention of
decision-makers. This requires KT platforms to remain
vigilant of changes in the health system, closely monitor
social media (e.g. through real-time content analysis of
tweets) and keep abreast of how the COVID-19 situation
is unfolding at the international level. Anticipating the
types of needed decisions can help KT platforms priori-
tise and prepare ahead of time in order to ensure a more
timely response to emerging priorities.
Furthermore, given the scale and breadth of COVID-
19, a top-down approach will likely fail to achieve the
desired impact; organisations, initiatives and networks
that support evidence-informedpolicy-making can help
balance top-down with bottom-up approaches by cater-
ing to the needs not only of governments and policy-
makers but also of policy implementers, including muni-
cipalities, healthcare providers, civil society organisations
and communities. For the latter groups, the lack of clar-
ity on their roles and responsibilities may hinder their
involvement in the pandemic response. To overcome
this, the K2P Center produced a number of evidence-
based guidance documents specifying the roles of the
different actors and the link to the national pandemic re-
sponse. These guidance documents played a role in
El-Jardali et al. Health Research Policy and Systems (2020) 18:58 Page 4 of 7
empowering the different actors and prompted govern-
ment to strengthen its stewardship function for a more
effective and efficient response.
Search for evidence beyond conventionaltypes and
sources
During pandemics, evidence-informeddecision-making
may be challenged by scientific uncertainties and scarcity
of research, especially during the early phases of the cri-
sis. Conventionally, systematic reviews and randomised
controlled trials are considered the gold standards for
informing decisions on what works. However, in crisis
situations, evidence is needed to address a broad range
of questions beyond what works. Moreover, the best
evidence, i.e. the most valid and reliable evidence, may
not be available, yet decisions have to be made fast and
under great uncertainty. In many instances, there may
only be a single case study or an observational study
available, rendering these the best available evidence.
Furthermore, indirect evidence becomes particularly
valuable during the early phases of the pandemic when
there is limited research directly addressing COVID-19.
Under such circumstances, turning to indirect evidence
from closely related viruses like influenza, SARS (severe
acute respiratory syndrome) or Ebola virus may be ne-
cessary to inform policy response. As such, KT platforms
should aim for the best available evidence while acknow-
ledging the tension between rigor and speed; waiting
until more research and better data become available
may risk decisions being made with no evidence at all
due to time constraints.
Unfortunately, evidence at time of crisis is scattered
around different databases, journals, websites and in the
grey literature [26]. Therefore, the search for the best
available evidence should not be restricted to peer-
reviewed journals and electronic databases but also to
other sources of information such as reports by national
and international agencies, governmental websites, social
media platforms (e.g. Twitter), media websites, email
subscriptions and blogs, and direct correspondence with
senior decision-makers and health professionals in the
field. This non-traditional way of searching for evidence
may be necessary in a context of rapid evolution and
complexity with knowledge constantly changing and
evolving. Thus, what constitutes evidence in a crisis set-
ting is often broader than the research generated
through the scientific method. The key is to exercise
transparency and be explicit about the sources of evi-
dence informing a policy response and acknowledge any
limitations and uncertainties in the evidence base.
The emergence of international initiatives like the
COVID-19 Evidence Network to support Decision-
making (COVID-END) partners, which are compiling
COVID-related evidence from partners around the
world in one repository, is a much needed step in ad-
dressing the fragmentation of the evidence base and re-
ducing the duplication of efforts. Establishing similar
initiatives at the country level is much warranted.
Harness the strength of complementary evidence
networks
The highly dynamic trajectory of the COVID-19 pan-
demic and the large number of intertwined health, social
and economic factors associated with it mean that no
single entity can provide all the needed support for a
comprehensive response to the pandemic. Researchers,
public health specialists, guideline developers, epidemiol-
ogists, data analysts and evaluation experts from both
health and non-health sectors are all generating relevant
and timely evidence to inform the various aspects of the
pandemic from controlling the spread of virus to
assessing the effectiveness of public health and social in-
terventions to evaluating the impact on health and the
economy. Yet, the absence of a mechanism to bridge the
different entities can result in ad hoc, fragmented and
delayed engagement, which can undermine the efficiency
and effectiveness of the pandemic response.
The COVID-19 pandemic has exposed the deficiencies
of siloed approaches to informing decision-making pro-
cesses and re-enforced the need to build bridges to the
organisations, institutions and networks working in
complementary areas to inform decision-making related
to different aspects of the pandemic. Moving forward, it
is critical to establish mechanisms for coordinating and
integrating research, data and expertise across stake-
holders and sectors in transparent ways for a more ef-
fective policy response during pandemics.
Leverage multiple dissemination channels tailored to
different audiences
Dissemination of the evidence to target the right audi-
ence is crucial to achieve the desirable impact. In a time
of pandemic, where conventional dissemination methods
like policy dialogues may not be feasible, it is critical for
KT platforms to innovate and leverage multiple dissem-
ination channels suited to the context and audience at
the right time.
Social media is an increasingly important platform to
disseminate evidence from research and knowledge
translation products during pandemics [27]. KT plat-
forms should invest in developing a robust social media
presence and should establish relationships with key
journalists that they can leverage to help disseminate the
evidence to a wide range of audiences, including policy-
makers, healthcare professionals, non-governmental or-
ganisations and the general public. Therefore, KT plat-
forms should have a communication strategy set in place
to allow a timely response in times of crisis and
El-Jardali et al. Health Research Policy and Systems (2020) 18:58 Page 5 of 7
emergencies. In addition, media messages, including
Twitter and other social media platforms, should be
evidence-based yet concise and simple, utilising videos,
visuals and infographics whenever possible in order to
engage lay people and decision-makers. Television/radio
interviews, podcasts and online webinars constitute
other ways to disseminate relevant evidence to decision-
makers, practitioners and the public during pandemics.
Conclusions
The response to the COVID-19 pandemic has been
challenged by many factors, including scientific uncer-
tainties, scarcity of relevant research, proliferation of
misinformation and fake news, poor access to action-
able evidence, time constraints, and weak collabor-
ation among relevant stakeholders. This Commentary
highlighted the emerging roles of KT platforms in
light of the COVID-19 pandemic. The COVID-19 ex-
perience is an opportunity to amplify the roles of KT
platforms and position them as the go-to hubs for
trustworthy evidence that can inform policies and
practice during public health crises. The lessons
learned reflected in this Commentary can be inte-
grated into strengthening the role, structures and
mandates of KT platforms.
In the post COVID-19 era, it is expected that much
of the global and national efforts will focus on
strengthening public health systems. Organisations,
initiatives and networks supporting evidence-
informedpolicy-making are an integral and indispens-
able component of strengthening public health sys-
tems and preparedness response; therefore, one of the
best investments in the future is to invest in strength-
ening these entities to support a more proactive and
swift response to public health crises that utilises the
best available research evidence and data in a timely
manner. This calls for countries, governments, science
communities and funders to start investing in KT
platforms in different regions through securing ad-
equate resources and supporting capacity-building in
KT through education and training programmes and,
more importantly, promoting their integration and
institutionalisation within the policy-making processes.
This is particularly relevant in the context of low-
and middle-income countries, where the utilisation of
evidence in decision-making is still limited and chal-
lenged by the lack of importance given to evidence,
the poor communication between researchers and
decision-makers, corruption, insufficient training, in-
stitutional constraints and weak mechanisms to sup-
port evidence-informeddecision-making [28,29].
Abbreviations
COVID-19: coronavirus disease; KT: knowledge translation; K2P
Center: Knowledge to Policy (K2P) Center
Acknowledgements
Not applicable.
Authorscontributions
FEJ, LBK and RF were involved in the conceptualisation, writing and revision
of the manuscript. All authors read and approved the final manuscript. LBK
and RF contributed equally to this manuscript.
Availability of data and materials
Not applicable.
Ethics approval and consent to participate
Not applicable.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
Author details
1
Department of Health Management and Policy, Faculty of Health Sciences,
American University of Beirut, Beirut, Lebanon.
2
Knowledge to Policy (K2P)
Center, Faculty of Health Sciences, American University of Beirut, Beirut,
Lebanon.
3
Department of Health Research Methods, Evidence, and Impact,
McMaster University, Hamilton, Ontario, Canada.
Received: 5 May 2020 Accepted: 14 May 2020
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... T he coronavirus disease (COVID-19) pandemic illustrates a broader global need for the rapid translation of knowledge into policy and practice. 1,2 Policy makers and practitioners need to respond quickly to global health problems and issues despite a paucity of contextualized knowledge. 1,3,4 Knowledge platforms can play an important role in prioritizing relevant issues, mapping knowledge gaps, and developing evidence-based policy and practice. ...
... 1,2 Policy makers and practitioners need to respond quickly to global health problems and issues despite a paucity of contextualized knowledge. 1,3,4 Knowledge platforms can play an important role in prioritizing relevant issues, mapping knowledge gaps, and developing evidence-based policy and practice. 1,5 In this article, we use the Canadian Institutes of Health Research's 6 definition of knowledge translation: ...
... 1,3,4 Knowledge platforms can play an important role in prioritizing relevant issues, mapping knowledge gaps, and developing evidence-based policy and practice. 1,5 In this article, we use the Canadian Institutes of Health Research's 6 definition of knowledge translation: ...
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Introduction: Translation of knowledge into policy and practice is important to prevent sexual reproductive health and rights (SRHR)-related morbidity and mortality and ensure access to rights. Existing approaches to knowledge translation are often relatively rigid and implicitly assume linear processes, leading to time-consuming processes that are not tailored to countries' needs. Approach: SRHR knowledge platforms designed and implemented a collaborative rapid improvement model for knowledge translation (CRIM-KT) in Burundi, Bangladesh, Indonesia, and Jordan. The approach consisted of learning sessions and action periods aimed at improving policies and practices addressing the prevention of child marriage and teenage pregnancies. To evaluate the approach, a participatory action learning process took place throughout the implementation (September 2017 and January 2019). An end evaluation was conducted using a desk review of project documentation, in-depth interviews, and a focus group discussion to document the process, outcomes, and lessons learned. Achievements: In Indonesia, a local government policy was changed that aims to prevent child marriage by avoiding misinterpretation of a local cultural practice. In Jordan, the cabinet endorsed a national action plan to prevent child marriage and changes in practice took place. In Burundi, no tangible changes in policy and practice in SRHR were observed. In Bangladesh, practice changed by strengthening coordination for collaboration and exchange among stakeholders to prevent child marriage. In all countries, the approach considerably strengthened participants' knowledge translation capacities. Conclusion: The CRIM-KT led to improvements in policy and practice in a relatively short time frame and different contexts. This can be explained by the systematic, structured, and participatory approach, allowing for contextual adaptation and involvement of stakeholders, as well as the cross-learning on 2 levels (international and country collaboration teams). The principles of the CRIM-KT may be further developed and applied in other fields in global health to strengthen knowledge translation processes.
... Finally, the need for evidence-based insights to inform government responses is recognized as being more acute during the global COVID-19 pandemic, with the important role of knowledge translation platforms being emphasized [28,29]. ...
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WHO promotes the use of research in policy-making to drive improvements in health, including in achieving Sustainable Development Goals such as tobacco control. The European Union’s new €95 billion Horizon Europe research framework programme parallels these aims, and also includes commitments to fund economic evaluations. However, researchers often express frustration at the perceived lack of attention to scientific evidence during policy-making. For example, some researchers claim that evidence regarding the return on investment from optimal implementation of evidence-based policies is frequently overlooked. An increasingly large body of literature acknowledges inevitable barriers to research use, but also analyses facilitators encouraging such use. This opinion piece describes how some research is integrated into policy-making. It highlights two recent reviews. One examines impact assessments of 36 multi-project research programmes and identifies three characteristics of projects more likely to influence policy-making. These include a focus on healthcare system needs, engagement of stakeholders, and research conducted for organizations supported by structures to receive and use evidence. The second review suggests that such characteristics are likely to occur as part of a comprehensive national health research system strategy, especially one integrated into the healthcare system. We also describe two policy-informing economic evaluations conducted in Spain. These examined the most cost-effective package of evidence-based tobacco control interventions and the cost-effectiveness of different strategies to increase screening coverage for cervical cancer. Both projects focused on issues of healthcare concern and involved considerable stakeholder engagement. The Spanish examples reinforce some lessons from the global literature and, therefore, could help demonstrate to authorities in Spain the value of developing comprehensive health research systems, possibly following the interfaces and receptor model. The aim of this would be to integrate needs assessment and stakeholder engagement with structures spanning the research and health systems. In such structures, economic evaluation evidence could be collated, analysed by experts in relation to healthcare needs, and fed into both policy-making as appropriate, and future research calls. The increasingly large local and global evidence base on research utilization could inform detailed implementation of this approach once accepted as politically desirable. Given the COVID-19 pandemic, increasing the cost-effectiveness of healthcare systems and return on investment of public health interventions becomes even more important.
... OR OR (95% CI) P For several reasons, this unprecedented speed in the production of information has proved to be a challenge for all involved in fighting the pandemic. [38] The first is the phenomenon known as information overload, [39] which may lead to misinterpretation of information, delay in the processing of information, acceptance of low-quality information and withdrawal of appropriate and necessary information from the search. [40] Another phenomenon experienced by health professionals [41] and that has been worrying the WHO, because it can cause individuals to stop seeking information on COVID-19, is pandemic fatigue. ...
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Health care professional's knowledge is essential to contain epidemics. This research aimed to evaluate the knowledge of Brazilian health care professionals regarding COVID-19 to analyze whether there is a difference in knowledge between professionals in Primary Health Care and those in other levels of care or not; and to identify factors associated with knowledge. This is a cross-sectional study, including 716 participants who answered an online questionnaire between April and May 2020. Descriptive statistics, difference tests between groups, and logistic regression models were used to analyze the data. The average knowledge score was 12.42 points (out of a possible total of 15). There was no significant difference between professionals in Primary Health Care and those in other levels of care. Knowledge was associated with age, profession, perception regarding media's information quality, and hours exposed to information on COVID-19. Participants showed adequate knowledge, despite some specific gaps. Continuing education actions should prioritize younger nonmedical professionals.
... Furthermore, despite some exceptions where false information has been transmitted through Wikipedia, the general accuracy of Wikipedia has been shown to be good [17,61]. Wikipedia's ability to swiftly update online information might also prevent the spread of misinformation seen in other social media platforms (e.g., YouTube, Facebook, and Twitter) perceived as sources of a social media infodemic [91,92]. ...
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Objectives This study aimed to : (1) Map existing evidence about the use of collaborative writing applications (CWAs) during pandemics; (2) Describe CWAs’ positive and negative effects on knowledge translation (KT) and knowledge management (KM) during pandemics; and (3) Inventory the barriers and facilitators that affect CWAs’ use to support KT and KM during pandemics. Materials and Methods Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews, we conducted a scoping review of the literature reporting the use of CWAs during pandemics published between 2001 and 2021. Two reviewers undertook the screening, study selection and qualitative thematic analysis. Results We identified a total of 46 studies. CWAs were used for the following two purposes: KT and KM (23 of 46) and disease surveillance and infodemiology (20 of 46). Three studies addressed both purposes. Influenza was the focus of most studies (15 of 46), followed by COVID-19 (10 of 46). We identified and classified 24 barriers and 66 facilitators into four categories (factors related to the CWAs, users’ knowledge and attitude towards CWAs, human environment, and organizational environment). We also found 74 positive and 7 negative effects that were classified into processes and outcomes. Conclusion CWAs offer the potential to accelerate KT and KM during pandemics. Their scalability and adaptability to different contexts makes them well suited to support the urgent KT and KM needed in the context of rapidly changing knowledge during pandemics. While their speed and cost as disease surveillance systems compare favorably with existing surveillance systems, the primary challenge is to ensure the accuracy of information shared.
... Consiste en la reunión de las partes involucradas en un problema de salud para abordar la evidencia sobre las soluciones (18). Precisamente, durante la pandemia de COVID-19 se ha reclamado una diseminación rápida de evidencia, que se acompañe del trabajo integrado entre organizaciones de diversa índole para coordinar la investigación y la experiencia individual (19). ...
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Objective. To contextualize a synthesis of evidence on interventions in student mental health during the COVID-19 pandemic through a deliberative dialogue with Ibero-American universities. Methods. An evidence synthesis and synchronous dialogues were previously conducted, consisting of sub-group discussions about the design and implementation of mental health interventions. An analysis of dialogic data was conducted, then organized by topic. Results. Fifty-seven representatives of 17 public and private Ibero-American universities participated in the meeting. In terms of the design of interventions, mental health is perceived as neglected, although its profile was raised by the pandemic. Interventions are guided by detection of needs; scientific evidence is rarely used to design them. Importance was given to forming an interdisciplinary team with continuous training in order to design a specific program that also covers families and teaching/administrative staff. In terms of implementa-tion, problems include saturation of services due to high demand and lack of basic resources among students. Regarding the provision of resources, the influence of the broader context, including the institutional context, is undeniable. The dialogues were perceived as an opportunity to build a new set of interventions. Conclusions. These dialogues enriched the description of interventions already described in the literature on student mental health during the COVID-19 pandemic. However, implementing such interventions in the region means addressing previous neglect and a high level of unmet basic needs.
... There are many tools and strategies used by public health officials to make quick and effective decisions. Professionals have expertise in these decision-making strategies, specifically in evidencebased research, which is commonly used in response to an infectious disease outbreak [18,19]. Since professionals are trained in evidence-based research, they play a key role in facilitating evidence-based decisions in the development of health policy. ...
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Background: The COVID-19 pandemic has highlighted the important role of professionals in designing and communicating effective policies. The purpose of this study was to evaluate the level of trust in the COVID-19 national public health policy among public health professionals in Israel and its correlates during the first wave of the pandemic. Methods: A purposive sampling of public health professionals in Israel, through professional and academic public health networks (N = 112). The survey was distributed online during May 2020. Level of trust was measured by the mean of 18 related statements using a 5-point Likert scale, where 1 means not at all and 5 means to a very high extent, and grouped as low and high trust by median (2.75). Results: A moderate level of trust in policy was found among professionals (Mean: 2.84, 95% Cl: [2.70, 2.98]). The level of trust among public health physicians was somewhat lower than among researchers and other health professionals (Mean: 2.66 vs. 2.81 and 2.96, respectively, p = 0.286), with a higher proportion expressing low trust (70% vs. 51% and 38%, respectively, p < 0.05). Participants with a low compared to high level of trust in policy were less supportive of the use of Israel Security Agency tools for contact tracing (Mean = 2.21 vs. 3.17, p < 0.01), and reported lower levels of trust in the Ministry of Health (Mean = 2.52 vs. 3.91, p < 0.01). A strong positive correlation was found between the level of trust in policy and the level of trust in the Ministry of Health (rs = 0.782, p < 0.01). Most professionals (77%) rated their involvement in decision making as low or not at all, and they reported a lower level of trust in policy than those with high involvement (Mean = 2.76 vs. 3.12, p < 0.05). Regarding trust in the ability of agencies to deal with the COVID-19 crisis, respondents reported high levels of trust in the Association of Public Health Physicians (80%) and in hospitals (79%), but very low levels of trust in the Minister of Health (5%). Conclusions: This study shows that Israeli public health professionals exhibited moderate levels of trust in COVID-19 national public health policy and varied levels of trust in government agencies during the first wave of COVID-19. The level of trust in policy was lower among most of the participants who were not involved in decision making. The level of trust found is worrisome and should be monitored, because it may harm cooperation, professional response, and public trust. Professionals' trust in policy-making during early stages of emergencies is important, and preemptive measures should be considered, such as involving professionals in the decision-making process, maintaining transparency of the process, and basing policy on scientific and epidemiological evidence.
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Objectives Researchers at the KEMRI-Wellcome Trust Research Programme (KWTRP) carried out knowledge translation (KT) activities to support policy-makers as the Kenyan Government responded to the COVID-19 pandemic. We assessed the usefulness of these activities to identify the facilitators and barriers to KT and suggest actions that facilitate KT in similar settings. Design The study adopted a qualitative interview study design. Setting and participants Researchers at KWTRP in Kenya who were involved in KT activities during the COVID-19 pandemic (n=6) were selected to participate in key informant interviews to describe their experience. In addition, the policy-makers with whom these researchers engaged were invited to participate (n=11). Data were collected from March 2021 to August 2021. Analysis A thematic analysis approach was adopted using a predetermined framework to develop a coding structure consisting of the core thematic areas. Any other theme that emerged in the coding process was included. Results Both groups reported that the KT activities increased evidence availability and accessibility, enhanced policy-makers’ motivation to use evidence, improved capacity to use research evidence and strengthened relationships. Policy-makers shared that a key facilitator of this was the knowledge products shared and the regular interaction with researchers. Both groups mentioned that a key barrier was the timeliness of generating evidence, which was exacerbated by the pandemic. They felt it was important to institutionalise KT to improve readiness to respond to public health emergencies. Conclusion This study provides a real-world example of the use of KT during a public health crisis. It further highlights the need to institutionalise KT in research and policy institutions in African countries to respond readily to public health emergencies.
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Previous studies examined the relationship between intellectual capital and a firm's performance. However, the moderating role of corporate governance—a fundamental factor leading to improved firm performance and increased intellectual capital accumulation—has largely been ignored, particularly in an emerging market such as Vietnam. As such, this study examines the moderating role of corporate governance on the intellectual capital–performance nexus in Vietnam. This study uses a sample of 45 listed firms in Vietnam from 2011 to 2018. The generalized method of moments (GMM) technique is utilized in this paper to enhance the robustness of the findings. The modified value‐added intellectual coefficient (MVAIC) model is used to measure intellectual capital. A firm's performance is proxied by both returns on assets and equity. Our results indicate that intellectual capital components such as capital employed efficiency, human capital efficiency and structural capital efficiency provide a significant and positive effect on a firm's performance. In addition, the results reveal that the inclusion of corporate governance as a moderating factor affects the relationship between intellectual capital and a firm's performance in Vietnam. Findings from this paper provide a valuable framework and implications for executives and policymakers in creating and managing intellectual capital within the Vietnamese context. Besides, improving corporate governance is critical to improving intellectual capital accumulation. To the authors' best knowledge, our literature review indicates that this is the first empirical study that examines the relationship between intellectual capital and a firm's performance using corporate governance as a moderating factor in Vietnam.
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Objectives COVID-19 has been recognised as a global health emergency necessitating collaborative efforts to halt further disease spread. The success of public health interventions and vaccination campaigns is contingent on the knowledge and awareness level of the public. We aim to assess COVID-19 knowledge and attitudes among Lebanese pregnant women and women seeking fertility treatment. Design Cross-sectional study using telehealth administered survey. Setting University-affiliated tertiary care centre. Participants The data of 402-Lebanese women pregnant or seeking fertility treatment aged 20–45 years were analysed. Outcome measures Extent of COVID-19 general knowledge, pregnancy-specific knowledge and attitudes toward COVID-19 practices. Results All participants reported being knowledgeable about COVID-19, 70% of which rated their knowledge as 7 or more on a numerical scale of 0–10. The mean general COVID-19 knowledge was 22.15 (SD 2.44, range 14–27) indicating a high level of knowledge. The mean pregnancy-specific COVID-19 knowledge 6.84 (SD 2.061, range 0–10) indicated poorer pregnancy-specific knowledge compared with general COVID-19 knowledge. A trend towards higher knowledge was noted with higher income status. Reproductive age women with higher pregnancy-specific knowledge had more positive attitudes toward COVID-19 pregnancy practices. Conclusion Our findings suggest a deficiency in pregnancy-specific COVID-19 knowledge stressing the necessity for targeted public health education interventions. It highlights the need for enhancing COVID-19 pregnancy-specific awareness which can serve as a stepping stone in the success of COVID-19 vaccination campaigns and in halting further disease spread.
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Background Infectious disease outbreaks require decision makers to make rapid decisions under time pressure and situations of scientific uncertainty, and yet the role of evidence usage in these contexts is poorly understood. Aims and objectives To define and contextualise the role of scientific evidence in the governance of infectious disease outbreaks and to identify recommendations for overcoming common barriers to evidence-informed decision making. Methods A scoping review and an expert workshop to provide additional input into recommendations on enhancing evidence uptake during infectious disease outbreaks taking place in European settings. Findings Forty-nine records reporting on multiple decision-making processes during infectious disease outbreaks of the past ten years were included in the study. Decision makers prioritise expert advice, epidemiological data and mathematical modelling data for risk characterisation and management, but tend to be challenged by scientific uncertainties, which allow for conflicting interpretations of evidence and for public criticism and contestation of decision-making processes. There are concrete opportunities for optimising evidence usage to improve public health policy and practice through investment in decision-making competencies, relationship building, and promoting transparent decision-making processes. Discussion and conclusions It is not necessarily a disregard of evidence that puts a strain on decision making in health crises, but rather competing interests and the lack of clear, unambiguous and rapidly available evidence for risk characterisation and effectiveness of response measures. The relationship between science and public health decision making is relatively understudied but is deserving of greater attention, so as to ensure that the pursuit of evidence for decision making does not challenge timely and effective crisis management.
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Background: Decision-makers in crisis zones are faced with the challenge of having to make health-related decisions under limited time and resource constraints and in light of the many factors that can influence their decisions, of which research evidence is just one. To address a key gap in the research literature about how best to support the use of research evidence in such situations, we conducted a critical interpretive synthesis approach to develop a conceptual framework that outlines the strategies that leverage the facilitators and address the barriers to evidence use in crisis zones. Methods: We systematically reviewed both empirical and non-empirical literature and used an interpretive analytic approach to synthesise the results and develop the conceptual framework. We used a 'compass' question to create a detailed search strategy and conducted electronic searches in CINAHL, EMBASE, MEDLINE, SSCI and Web of Science. A second reviewer was assigned to a representative sample of articles. We purposively sampled additional papers to fill in conceptual gaps. Results: We identified 21 eligible papers to be analysed and purposively sampled an additional 6 to fill conceptual gaps. The synthesis resulted in a conceptual framework that focuses on evidence use in crisis zones examined through the lens of four systems - political, health, international humanitarian aid and health research. Within each of the four systems, the framework identifies the most actionable strategies that leverage the facilitators and address the barriers to evidence use. Conclusions: This study presents a new conceptual framework that outlines strategies that leverage the facilitators and address the barriers to evidence use in crisis zones within different systems. This study expands on the literature pertaining to evidence-informed decision-making.
Article
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On December 31, 2019, Chinese health officials reported a cluster of cases of acute respiratory illness in persons associated with the Hunan seafood and animal market in the city of Wuhan, Hubei Province, in central China. On January 7, 2020, Chinese health officials confirmed that a novel coronavirus (2019-nCoV) was associated with this initial cluster (1). As of February 4, 2020, a total of 20,471 confirmed cases, including 2,788 (13.6%) with severe illness,* and 425 deaths (2.1%) had been reported by the National Health Commission of China (2). Cases have also been reported in 26 locations outside of mainland China, including documentation of some person-to-person transmission and one death (2). As of February 4, 11 cases had been reported in the United States. On January 30, the World Health Organization (WHO) Director-General declared that the 2019-nCoV outbreak constitutes a Public Health Emergency of International Concern.† On January 31, the U.S. Department of Health and Human Services (HHS) Secretary declared a U.S. public health emergency to respond to 2019-nCoV.§ Also on January 31, the president of the United States signed a "Proclamation on Suspension of Entry as Immigrants and Nonimmigrants of Persons who Pose a Risk of Transmitting 2019 Novel Coronavirus," which limits entry into the United States of persons who traveled to mainland China to U.S. citizens and lawful permanent residents and their families (3). CDC, multiple other federal agencies, state and local health departments, and other partners are implementing aggressive measures to slow transmission of 2019-nCoV in the United States (4,5). These measures require the identification of cases and their contacts in the United States and the appropriate assessment and care of travelers arriving from mainland China to the United States. These measures are being implemented in anticipation of additional 2019-nCoV cases in the United States. Although these measures might not prevent the eventual establishment of ongoing, widespread transmission of the virus in the United States, they are being implemented to 1) slow the spread of illness; 2) provide time to better prepare health care systems and the general public to be ready if widespread transmission with substantial associated illness occurs; and 3) better characterize 2019-nCoV infection to guide public health recommendations and the development of medical countermeasures including diagnostics, therapeutics, and vaccines. Public health authorities are monitoring the situation closely. As more is learned about this novel virus and this outbreak, CDC will rapidly incorporate new knowledge into guidance for action by CDC and state and local health departments.
Preprint
Quality evidence-based decisions and strategies are critical and valuable tools in strengthening health systems policies, strategic priorities action plans and comprehensive care delivery management. Our finding showed that there is scarcity of local/national and internal effective evidence-based and management strategies for informed decision making based on the disease or health epidemics nature, extend, ecological and geo-location of pandemics and epidemics crises burden and impacts. Evidence-based programs or projects are crucial in evolving pandemics and/or (Ebola, meningitis, Cholera and influenza) epidemics persistent morbidity and mortality/ case fatality reduction or prevention; as well as on poverty and inequity alleviation within the vulnerable population and citizenry over time. This paper assesses implications of evidence-based on health systems surveillance and monitoring systems, preparedness and emergency response gaps and needs in improving care delivery uptake and usefulness, coverage and effectiveness in Africa. Furthermore, the article advocates for quality, access to and uptake of knowledge-based policy-decision making and practice improvements in building efficient and standardized surveillance, preparedness and response approaches. Also, in enriching data sharing and inclusiveness through understanding the links between poverty, poor health and inequited related emerging infectious diseases epidemics in Africa. Leveraging on cumulative lessons learnt experiences and innovations in integrating participatory knowledge-based policies and approaches is paramount in fostering vulnerable population awareness and engagement, skills empowerment collaborative productivity and sustainable healthy solutions and measures. Strengthening new partnerships, alliances, and networks requires collaborative and quality evidence policy decisions, appropriate and reliable monitoring and evaluation systems approaches and strategies in improving local preparedness and emergency response capabilities against future emerging infectious diseases epidemics and fast-tracking poverty alleviation knowledge-based livelihoods and health solutions for impact. Furthermore, integrated, participative partnerships and collaborative responsibilities, cost effective and reliable evidence health financing and budget allocation, and targeted capacity development aiming at reducing and averting the burden of poverty related emerging threats and epidemics preparedness and response programs in African countries.
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The evolving coronavirus disease 2019 (COVID‐19) epidemic1 is certainly cause for concern. Proper communication and optimal decision‐making is an ongoing challenge, as data evolve. The challenge is compounded, however, by exaggerated information. This can lead to inappropriate actions. It is important to differentiate promptly the true epidemic from an epidemic of false claims and potentially harmful actions.
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The UK Government asserts that its response to the coronavirus disease 2019 (COVID-19) pandemic is based on evidence and expert modelling. However, different scientists can reach different conclusions based on the same evidence, and small differences in assumptions can lead to large differences in model predictions.
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The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has already taken on pandemic proportions, affecting over 100 countries in a matter of weeks. A global response to prepare health systems worldwide is imperative. Although containment measures in China have reduced new cases by more than 90%, this reduction is not the case elsewhere, and Italy has been particularly affected. There is now grave concern regarding the Italian national health system's capacity to effectively respond to the needs of patients who are infected and require intensive care for SARS-CoV-2 pneumonia. The percentage of patients in intensive care reported daily in Italy between March 1 and March 11, 2020, has consistently been between 9% and 11% of patients who are actively infected. The number of patients infected since Feb 21 in Italy closely follows an exponential trend. If this trend continues for 1 more week, there will be 30 000 infected patients. Intensive care units will then be at maximum capacity; up to 4000 hospital beds will be needed by mid-April, 2020. Our analysis might help political leaders and health authorities to allocate enough resources, including personnel, beds, and intensive care facilities, to manage the situation in the next few days and weeks. If the Italian outbreak follows a similar trend as in Hubei province, China, the number of newly infected patients could start to decrease within 3–4 days, departing from the exponential trend. However, this cannot currently be predicted because of differences between social distancing measures and the capacity to quickly build dedicated facilities in China.
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We discuss challenges to implementing evidence-based practice within the broad field of public health preparedness and response. We discuss the progress of public health preparedness and response in building and translating evidence to practice since the World Trade Center attacks of 9/11/2001. We briefly describe analogies to struggles that other professional disciplines face, and we highlight key factors that facilitate and impede the implementation of evidence-based practice. We recommend a partnership led by funding agencies and closely involving research organizations and professional associations as a means to ensure that the public health preparedness and response field continues to develop an evidence-based culture and practice.