Knowledge Translation Research to Promote Behavior Changes in Rehabilitation: Use of Theoretical Frameworks and Tailored Interventions: A Scoping Review

Objective To describe knowledge translation (KT) research as a means of changing practice behaviors in rehabilitation. We specifically aimed to explore how theories, models and frameworks (TMFs) are used to guide KT, methods to tailor KT interventions, and to evaluate outcomes. We hypothesized these methods would increase over the past 10 years. Data Sources Articles were identified through searches conducted using databases CINAHL, MEDLINE, PubMed, Academic Search Premier, and previous reviews from January 2000 to April 2020. Search terms included physical therapy, occupational therapy, speech language pathology, knowledge translation and knowledge-to-action. Study Selection Titles, abstracts, and full-text articles were screened independently by two authors. Studies were included if behavior change of rehabilitation practitioners was measured. Systematic reviews, protocols and capacity building interventions were excluded. Data Extraction Information on study design, theoretical frameworks, intervention strategies and outcome evaluation were extracted by three authors. Data Synthesis Fifty-six studies were included in the review. Sixteen (29%) reported the use of a theoretical framework to guide the KT process. Since 2013, the Knowledge-to-Action framework was used 35% of the time. Twenty-two studies (39%) reported barrier assessments to tailor interventions and 82% were published after 2013. However, barrier assessment in the local context was only conducted 64% of the time. Outcomes of tailored interventions were most frequently measured using chart audits (50%) and questionnaires (41%). Further, the link between KT theory, specific barriers, and selection of intervention strategies was not consistently described. Conclusions Over the past 7 years, there has been an increase in the use of KT TMFs and tailored interventions. Recommendations for future research include the use of TMFs to guide local barrier assessment, KT strategy selection, intervention development, and the overall KT process and mapping barriers to selected intervention strategies