NEXUS Spring Institute

From knowledge to action: Knowledge translation in the “real world” of clinical psychiatry Johnson, Joy; Malchy, Syd; Baines, Katie


Tobacco use disproportionately affects the wellbeing of individuals with severe and persistent mental illness. There are cultural norms regarding smoking in psychiatric settings where cigarette smoking is often viewed as a point of therapeutic connection between clients and providers and used to modify clients’ behaviour. Practitioners are often ambivalent about their clients’ tobacco use and may minimize tobacco’s harms. Given these culturally embedded behaviours, how can we develop and introduce effective, evidence-informed smoking cessation interventions into these institutional settings? To date, much of the knowledge translation (KT) literature has ignored the difficult question of how to support organizational change. In this presentation, we use the CACTUS project as a case study in KT. We begin by examining a commonly used KT framework: the CIHR Knowledge to Action Process. This macro level model describes the iterative steps one moves through when planning and implementing KT. We describe several challenges in using the CIHR framework, focusing on the lack of prescriptive steps within the implementation of interventions stage. We discuss two novel approaches that provided us with much needed direction for engagement with the practice communities. The first approach is Appreciative Inquiry (AI). Rather than being deficit based, AI is a generative process that asks us to consider what might be possible, or what we want more of. The other approach we found helpful is Motivational Interviewing (MI). The principles of MI helped us to think about how to meaningfully engage with practice groups in a positive way. AI and MI complement each other because they both use affirmative approaches to encourage behaviour change.

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