CBR Musings: Is what we do informed by what we know?

Knowledge mobilization.  Knowledge transfer. Knowledge translation. Knowledge exchange.

These are some of the buzzwords that have remained popular in Canadian research circles over the past few years as the goal of making sure that research findings get “put to work” has been high on the lists of research funders, universities, and community stakeholders alike.

Knowledge translation has been defined as “closing the know-do gap” – it’s about making sure what we do is informed by what we know. I read a statistic recently that 35% to 40% of patients do not get treatments of proven effectiveness. This is staggering, right? Whether or not this statistic is completely on the mark, it is telling us something. It is saying that although we are swimming in medical and health “evidence” there’s an important cog between the machines of research and of practice, one that is not necessarily well oiled.

In the early days of HIV/AIDS research, this know-do gap was closed fairly quickly because it was a time when delaying putting research into action by even one week literally meant that many lives would miss being saved. Activism and advocacy played important roles in ensuring that findings were moved quickly into practice (and, to a lesser extent, policy).

Thirty years after the discovery of the virus that causes AIDS, here in British Columbia we are very fortunate that much of this evidence has been translated into effective and accessible prevention and treatment. At International AIDS Society’s 2012 conference, these advances were celebrated and the hopeful messages that we are nearing the “end of AIDS” or that there could be an “AIDS-free generation” in the near future were broadcasted loudly.

And as always, amidst the optimism, voices were present to offer a healthy dose of reality. The fact is that much of the evidence we have now is not being implemented globally. For example, we how to prevent mother-to-child transmission and we know that unrestricted availability of sterile needles in a community leads to decreased HIV transmission, yet universal access to these prevention technologies is still far from being achieved.

It is this reality that highlights the complexities of knowledge mobilization.

While it seems simple to take evidence and integrate it into programs and policies, when we bring research findings back to communities, they need to be “translated” to fit the local geographical, cultural and political landscapes of each community. To mobilize research knowledge, an exchange has to happen where the research evidence meets the local knowledge and it becomes transformed into a solution that fits for that community. And in many cases, as we have seen with HIV, this may mean long years of advocacy to move the evidence past layers of politics, stigma, and social inequities.

It’s not a simple process, yet it can be an incredibly powerful one. By gathering local knowledge and using the best available evidence to compliment it, innovative solutions can be found and put into practice. This is why successful knowledge translation and exchange strategies are built on relationships where all knowledge is valued, and where advocacy is seen not simply as a challenge to the status quo, but as one part of the intricate workings of a democratic and just society. Over the course of the AIDS movement, we have seen communities combat homophobia, implement harm reduction, and use science to challenge stigma around HIV/AIDS and the people affected by it.

So whether you call it knowledge translation or knowledge mobilization or something else, it’s the heart of the concept that matters most – the act of building relationships and working together to use research to create positive social change. There may be bumps along the road when it feels a bit uncomfortable to be along for the ride, or like we may never make it over that hill, but as history has taught us, mobilizing knowledge is one tool that we have in transforming local and global responses to HIV and AIDS.

To learn more about the “how” of knowledge translation and exchange (KTE), visit the newly updated KTE section of the PAN’s CBR Toolkit here.

Andrea Langlois
Community-Based Research Manager