The fallacy of amelioration: Thinking through knowledge translation in sport and exercise medicine
- Bekker, Sheree, Paliadelis, Penny, Finch, Caroline
- Authors: Bekker, Sheree , Paliadelis, Penny , Finch, Caroline
- Date: 2018
- Type: Text , Journal article
- Relation: Translational sports medicine Vol. 1, no. 4 (2018), p. 166-171
- Full Text: false
- Reviewed:
- Description: Knowledge Translation, as a component of implementation science, has seen extensive popularization in Sport and Exercise Medicine (SEM) over recent years. However, in seeking better and more influential outcomes, much of SEM appears to be following Knowledge Translation fashion and fad, over ensuring function and form. This has meant that key concepts in Knowledge Translation have been conflated, the work oversimplified, and potential outcomes overhyped. In this manuscript, Knowledge Translation is, first, defined as a process. Next, we show how oversimplified versions of Knowledge Translation rely on the “fallacy of amelioration,” with problematic consequences and unintended outcomes. Finally, we move to rethinking Knowledge Translation in SEM by showing how the field can move forward through embracing Knowledge Translation as a complex process to maximize the influence and impact of its work.
Sources of practice knowledge among Australian fitness trainers
- Bennie, Jason, Wiesner, Glen, van Uffelen, Jannique, Harvey, Jack, Biddle, Stuart
- Authors: Bennie, Jason , Wiesner, Glen , van Uffelen, Jannique , Harvey, Jack , Biddle, Stuart
- Date: 2017
- Type: Text , Journal article
- Relation: Translational Behavioral Medicine Vol. , no. (2017), p. 1-10
- Full Text: false
- Reviewed:
- Description: Few studies have examined the sources of practice knowledge fitness trainers use to inform their training methods and update knowledge. This study aims to describe sources of practice knowledge among Australian fitness trainers. In July 2014, 9100 Australian fitness trainers were invited to complete an online survey. Respondents reported the frequency of use of eight sources of practice knowledge (e.g. fitness magazines, academic texts). In a separate survey, exercise science experts (n = 27) ranked each source as either (1) 'high-quality' or (2) 'low-quality'. Proportions of users of 'high-quality' sources were calculated across demographic (age, sex) and fitness industry-related characteristics (qualification, setting, role). A multivariate logistic regression analysis assessed the odds of being classified as a user of high-quality sources, adjusting for demographic and fitness industry-related factors. Out of 1185 fitness trainers (response rate = 13.0%), aged 17-72 years, 47.6% (95% CI, 44.7-50.4%) were classified as frequent users of high-quality sources of practice knowledge. In the adjusted analysis, compared to trainers aged 17-26 years, those aged >/=61 years (OR, 2.15; 95% CI, 1.05-4.38) and 40-50 years (OR, 1.54; 95% CI, 1.02-2.31) were more likely to be classified as a user of high-quality sources. When compared to trainers working in large centres, those working in outdoor settings (OR, 1.81; 95% CI, 1.23-2.65) and medium centres (OR, 1.59; 95% CI, 1.12-2.29) were more likely to be classified as users of high-quality sources. Our findings suggest that efforts should be made to improve the quality of knowledge acquisition among Australian fitness trainers.
The translation of sports injury prevention and safety promotion knowledge : Insights from key intermediary organisations
- Bekker, Sheree, Paliadelis, Penny, Finch, Caroline
- Authors: Bekker, Sheree , Paliadelis, Penny , Finch, Caroline
- Date: 2017
- Type: Text , Journal article
- Relation: Health Research Policy and Systems Vol. 15, no. 1 (2017), p. 1-9
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Reviewed:
- Description: Background: A recognised research-to-practice gap exists in the health research field of sports injury prevention and safety promotion. There is a need for improved insight into increasing the relevancy, accessibility and legitimacy of injury prevention and safety promotion research knowledge for sport settings. The role of key organisations as intermediaries in the process of health knowledge translation for sports settings remains under-explored, and this paper aims to determine, and describe, the processes of knowledge translation undertaken by a set of key organisations in developing and distributing injury prevention and safety promotion resources. Methods: The National Guidance for Australian Football Partnerships and Safety (NoGAPS) project provided the context for this study. Representatives from five key NoGAPS organisations participated in individual face-to-face interviews about organisational processes of knowledge translation. A qualitative descriptive methodology was used to analyse participants' descriptions of knowledge translation activities undertaken at their respective organisations. Results: Several themes emerged around health knowledge translation processes and considerations, including (1) identifying a need for knowledge translation, (2) developing and disseminating resources, and (3) barriers and enablers to knowledge translation. Conclusions: This study provides insight into the processes that key organisations employ when developing and disseminating injury prevention and safety promotion resources within sport settings. The relevancy, accessibility and legitimacy of health research knowledge is foregrounded, with a view to increasing the influence of research on the development of health-related resources suitable for community sport settings. © 2017 The Author(s).
- Authors: Bekker, Sheree , Paliadelis, Penny , Finch, Caroline
- Date: 2017
- Type: Text , Journal article
- Relation: Health Research Policy and Systems Vol. 15, no. 1 (2017), p. 1-9
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text:
- Reviewed:
- Description: Background: A recognised research-to-practice gap exists in the health research field of sports injury prevention and safety promotion. There is a need for improved insight into increasing the relevancy, accessibility and legitimacy of injury prevention and safety promotion research knowledge for sport settings. The role of key organisations as intermediaries in the process of health knowledge translation for sports settings remains under-explored, and this paper aims to determine, and describe, the processes of knowledge translation undertaken by a set of key organisations in developing and distributing injury prevention and safety promotion resources. Methods: The National Guidance for Australian Football Partnerships and Safety (NoGAPS) project provided the context for this study. Representatives from five key NoGAPS organisations participated in individual face-to-face interviews about organisational processes of knowledge translation. A qualitative descriptive methodology was used to analyse participants' descriptions of knowledge translation activities undertaken at their respective organisations. Results: Several themes emerged around health knowledge translation processes and considerations, including (1) identifying a need for knowledge translation, (2) developing and disseminating resources, and (3) barriers and enablers to knowledge translation. Conclusions: This study provides insight into the processes that key organisations employ when developing and disseminating injury prevention and safety promotion resources within sport settings. The relevancy, accessibility and legitimacy of health research knowledge is foregrounded, with a view to increasing the influence of research on the development of health-related resources suitable for community sport settings. © 2017 The Author(s).
- Granger, Catherine, Denehy, Linda, Remedios, Louisa, Retica, Sarah, Phongpagdi, Pimsiri, Hart, Nicholas, Parry, Selina
- Authors: Granger, Catherine , Denehy, Linda , Remedios, Louisa , Retica, Sarah , Phongpagdi, Pimsiri , Hart, Nicholas , Parry, Selina
- Date: 2016
- Type: Text , Journal article
- Relation: Annals of the American Thoracic Society Vol. 13, no. 12 (2016), p. 2215-2222
- Full Text: false
- Reviewed:
- Description: Rationale: Evidence-based clinical practice guidelines recommend physical activity for people with lung cancer, however evidence has not translated into clinical practice and the majority of patients do not meet recommended activity levels. Objectives: To identify factors (barriers and enablers) that influence clinicians' translation of the physical activity guidelines into practice. Methods: Qualitative study involving 17 participants (three respiratory physicians, two thoracic surgeons, two oncologists, two nurses, and eight physical therapists) who were recruited using purposive sampling from five hospitals in Melbourne, Victoria, Australia. Nine semistructured interviews and a focus group were conducted, transcribed verbatim, and independently crosschecked by a second researcher. Thematic analysis was used to analyze data. Measurements and Main Results: Five consistent themes emerged: (1) the clinicians perception of patient-related physical and psychological influences (including symptoms and comorbidities) that impact on patient's ability to perform regular physical activity; (2) the influence of the patient's past physical activity behavior and their perceived relevance and knowledge about physical activity; (3) the clinicians own knowledge and beliefs about physical activity; (4) workplace culture supporting or hindering physical activity; and (5) environmental and structural influences in the healthcare system (included clinicians time, staffing, protocols and services). Clinicians described potential strategies, including: (1) the opportunity for nurse practitioners to act as champions of regular physical activity and triage referrals for physical activity services; (2) opportunistically using the time when patients are in hospital after surgery to discuss physical activity; and (3) for all members of the multidisciplinary team to provide consistent messages to patients about the importance of physical activity. Conclusions: Key barriers to implementation of the physical activity guidelines in lung cancer are diverse and include both clinician- and healthcare system-related factors. A combined approach to target a number of these factors should be used to inform research, improve clinical services, and develop policies aiming to increase physical activity and improve survivorship outcomes for patients with lung cancer. © Copyright 2016 by the American Thoracic Society.
Evaluation of knowledge translation and workforce development through targeted exercise for falls prevention education programs for exercise physiologists
- Authors: Pascoe, Deborah
- Date: 2015
- Type: Text , Thesis , PhD
- Full Text:
- Description: There is a wealth of evidence supporting the positive effects of exercise for falls prevention. The problem that faces researchers, policy makers, accreditation bodies and higher education providers is how to best translate this information to allied health practitioners to ensure they are providing the best evidence-based practice to their clients. One in three community dwelling older people over the age of 65 years fall every year and this figure increases to one in two people over the age of 80 years. As a profession, exercise physiologists (EPs) are responsible for providing exercise for the prevention, maintenance and treatment of chronic disease and complex medical conditions, including prescribing exercise for falls prevention. The incidence of falls, chronic disease and complex medical conditions increases with age and as Australia moves towards an ever ageing population, the cost burden of health care for older people and falls is exploding. Exercise physiology and exercise science professionals have an opportunity to become champions of exercise for falls prevention and assist in ameliorating the ever increasing burden of falls in Australia. By targeting the exercise physiology profession and providing methods to translate the research evidence, there is great potential to build workforce capacity to deliver falls prevention exercise programs. But how best to target the profession of exercise physiology? Advances can be made by targeting undergraduate and post-graduate university programs or as part of mandated professional continuing education programs which focuses on both the future and current exercise physiology workforce respectively. A scoping study conducted across two States in Australia (New South Wales and Victoria) established that at the time, the current level of knowledge of undergraduate human movement and exercise and sports science students and post graduate exercise rehabilitation/exercise physiology students, was inadequate with regard to falls risk and exercise prescription for fall prevention in older people. These results highlighted the need for the development and widespread implementation of an evidence-based “exercise for falls prevention” curriculum for future exercise professionals. The UniFPEP curriculum was developed to provide evidence-based teaching and learning resource materials to enhance learning beyond current levels by translating the latest research evidence regarding falls risk and exercises for falls prevention to produce a discipline leading curriculum. The curriculum was designed to enhance exercise science and exercise rehabilitation students’ learning outcomes through the provision of online lectures and learning materials to supplement and strengthen the delivery of face-to-face lectures, practical classes and self-directed learning tasks. The UniFPEP curriculum was implemented at the University of Ballarat and following completion students’ knowledge outcomes and self-reported confidence to prescribe exercise for older people and for falls prevention were significantly increased. The results indicated that a significant change in knowledge and confidence can be achieved during a 2-3 week educational period during a normal university semester. More importantly, these changes were retained 13 weeks after completion of the UniFPEP curriculum. Following evaluation of the UniFPEP the curriculum was reviewed and prepared as a workforce continuing education program (CEP) (Fit+Fall=Free). This was implemented and evaluated as a clustered controlled trial to compare two different delivery modes: face-to-face and online, to a control group of exercise physiology professionals. The Fit+Fall=Free CEP showed significant improvements in the knowledge and confidence of EPs in prescribing exercise for older people and exercise prescription for falls prevention for both the face-to-face (F2F) and Online delivery modes. The F2F delivery of the Fit+Fall=Free CEP provided the greatest long-term impact with the increases being maintained at a significant level six months post workshop.
- Description: Doctor of Philosophy
- Authors: Pascoe, Deborah
- Date: 2015
- Type: Text , Thesis , PhD
- Full Text:
- Description: There is a wealth of evidence supporting the positive effects of exercise for falls prevention. The problem that faces researchers, policy makers, accreditation bodies and higher education providers is how to best translate this information to allied health practitioners to ensure they are providing the best evidence-based practice to their clients. One in three community dwelling older people over the age of 65 years fall every year and this figure increases to one in two people over the age of 80 years. As a profession, exercise physiologists (EPs) are responsible for providing exercise for the prevention, maintenance and treatment of chronic disease and complex medical conditions, including prescribing exercise for falls prevention. The incidence of falls, chronic disease and complex medical conditions increases with age and as Australia moves towards an ever ageing population, the cost burden of health care for older people and falls is exploding. Exercise physiology and exercise science professionals have an opportunity to become champions of exercise for falls prevention and assist in ameliorating the ever increasing burden of falls in Australia. By targeting the exercise physiology profession and providing methods to translate the research evidence, there is great potential to build workforce capacity to deliver falls prevention exercise programs. But how best to target the profession of exercise physiology? Advances can be made by targeting undergraduate and post-graduate university programs or as part of mandated professional continuing education programs which focuses on both the future and current exercise physiology workforce respectively. A scoping study conducted across two States in Australia (New South Wales and Victoria) established that at the time, the current level of knowledge of undergraduate human movement and exercise and sports science students and post graduate exercise rehabilitation/exercise physiology students, was inadequate with regard to falls risk and exercise prescription for fall prevention in older people. These results highlighted the need for the development and widespread implementation of an evidence-based “exercise for falls prevention” curriculum for future exercise professionals. The UniFPEP curriculum was developed to provide evidence-based teaching and learning resource materials to enhance learning beyond current levels by translating the latest research evidence regarding falls risk and exercises for falls prevention to produce a discipline leading curriculum. The curriculum was designed to enhance exercise science and exercise rehabilitation students’ learning outcomes through the provision of online lectures and learning materials to supplement and strengthen the delivery of face-to-face lectures, practical classes and self-directed learning tasks. The UniFPEP curriculum was implemented at the University of Ballarat and following completion students’ knowledge outcomes and self-reported confidence to prescribe exercise for older people and for falls prevention were significantly increased. The results indicated that a significant change in knowledge and confidence can be achieved during a 2-3 week educational period during a normal university semester. More importantly, these changes were retained 13 weeks after completion of the UniFPEP curriculum. Following evaluation of the UniFPEP the curriculum was reviewed and prepared as a workforce continuing education program (CEP) (Fit+Fall=Free). This was implemented and evaluated as a clustered controlled trial to compare two different delivery modes: face-to-face and online, to a control group of exercise physiology professionals. The Fit+Fall=Free CEP showed significant improvements in the knowledge and confidence of EPs in prescribing exercise for older people and exercise prescription for falls prevention for both the face-to-face (F2F) and Online delivery modes. The F2F delivery of the Fit+Fall=Free CEP provided the greatest long-term impact with the increases being maintained at a significant level six months post workshop.
- Description: Doctor of Philosophy
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