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Integrated knowledge translation to advance noncommunicable disease policy and practice in South Africa: application of the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework

Authors
  • Jessani, Nasreen S.1, 2
  • Rohwer, Anke1
  • Schmidt, Bey-Marrie3, 4
  • Delobelle, Peter5, 6
  • 1 Stellenbosch University, Cape Town, South Africa , Cape Town (South Africa)
  • 2 Johns Hopkins Bloomberg School of Public Health, Baltimore, USA , Baltimore (United States)
  • 3 Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa , Cape Town (South Africa)
  • 4 University of the Western Cape, Cape Town, South Africa , Cape Town (South Africa)
  • 5 University of Cape Town, Cape Town, South Africa , Cape Town (South Africa)
  • 6 Vrije Universiteit Brussel, Brussels, Belgium , Brussels (Belgium)
Type
Published Article
Journal
Health Research Policy and Systems
Publisher
BioMed Central
Publication Date
May 17, 2021
Volume
19
Issue
1
Identifiers
DOI: 10.1186/s12961-021-00733-x
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundIn response to the “know–do” gap, several initiatives have been implemented to enhance evidence-informed decision-making (EIDM). These include individual training, organizational culture change management, and legislative changes. The importance of relationships and stakeholder engagement in EIDM has led to an evolution of models and approaches including integrated knowledge translation (IKT). IKT has emerged as a key strategy for ensuring that engagement is equitable, demand-driven, and responsive. As a result, the African-German Collaboration for Evidence-Based Healthcare and Public Health in Africa (CEBHA+) incorporated an IKT approach to influence noncommunicable diseases (NCD) policy and practice. We documented the phased process of developing, implementing, and monitoring the IKT approach in South Africa; and explored the appropriateness of using the exploration, preparation, implementation, and sustainment (EPIS) framework for this purpose.MethodsWe mapped the South Africa IKT approach onto the EPIS framework using a framework analysis approach. Notes of team meetings, stakeholder matrices, and engagement strategies were analysed and purposefully plotted against the four phases of the framework in order to populate the different constructs. We discussed and finalized the analysis in a series of online iterations until consensus was reached.ResultsThe mapping exercise revealed an IKT approach that was much more iterative, dynamic, and engaging than initially thought. Several constructs (phase-agnostic) remained important and stable across EPIS phases: stable and supportive funding; committed and competent leadership; skilled and dedicated IKT champions; diverse and established personal networks; a conducive and enabling policy environment; and boundary-spanning intermediaries. Constructs such as “innovations” constantly evolved and adapted to the changing inner and outer contexts (phase-specific).ConclusionsUsing the EPIS framework to interrogate, reflect on, and document our IKT experiences proved extremely relevant and useful. Phase-agnostic constructs proved critical to ensure resilience and agility of NCD deliberations and policies in the face of highly dynamic and changing local contexts, particularly in view of the current coronavirus disease 2019 (COVID-19) pandemic. Bridging IKT with a framework from implementation science helps to reflect on this process and can guide the development and planning of similar interventions and strategies.

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