Strategies to promote knowledge translation in primary health care: scoping review

Schneider, Luana Roberta; Rodrigues Junior, Sinval Adalberto

doi:10.1590/1983-1447.2022.20220107.en

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Revista Gaúcha de Enfermagem

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Sumário

Scoping Review - Knowledge translation and advances in health and nursing practices • Rev. Gaúcha Enferm. 43 (spe) • 2022 • https://doi.org/10.1590/1983-1447.2022.20220107.en copy

Strategies to promote knowledge translation in primary health care: scoping review

Estrategias para promover la traducción del conocimiento en la atención primaria de salud: revisión de alcance

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To map the strategies used by health professionals to promote knowledge translation in Primary Health Care and to identify barriers and facilitators for the use of scientific evidence.

Method:

Scoping review with search in PubMed, EMBASE, CINAHL, Web of Science, Scopus, LILACS, and gray literature, in April 2022, using the terms “translational medical research”, “knowledge translation”, “primary health care”. The PRISMA-ScR was used to report the review.

Results:

56 studies included. Several strategies were identified and grouped into: educational material, training, websites, educational outreach, knowledge translation networks, local facilitators, feedback and public promotion. High demand for services and content without practical information represented barriers, while assessing the context, involving stakeholders and the presence of local facilitators ease theuse of evidence.

Conclusion:

The most used strategies were educational material and training. Overcoming barriers is essential to bridging the gap between evidence and practice.

Keywords:
Primary health care; Translational research; biomedical; Health services

First author (year) Country of origin	Objective(s)	Study design	Single/Multiple intervention	KT strategy(ies)
Wensing (1994) Netherlands1818. Wensing M, Grol R. Single and combined strategies for implementing changes in primary care: a literature review. Int J Qual Health Care. 1994;6(2):115-32. doi: https://doi.org/10.1093/intqhc/6.2.115 https://doi.org/10.1093/intqhc/6.2.115...	To evaluate the effectiveness of different strategies, applied single or combined, to implement changes in primary care practice.	Systematic review	Multiple	Educational Material, Training and Feedback
Swinglehurst (2001) United Kingdom1919. Swinglehurst DA, Pierce M, Fuller JCA. A clinical informaticist to support primary care decision making. Qual Health Care. 2001;10(4):245-9. doi: https://doi.org/10.1136/qhc.0100245 https://doi.org/10.1136/qhc.0100245...	To develop and evaluate an information service.	Descriptive study	Single	Educational outreach
Forsetlund (2003) Norway2020. Forsetlund L, Bradley P, Forsen L, Nordheim L, Jamtvedt G, Bjorndal A. Randomised controlled trial of a theoretically grounded tailored intervention to diffuse evidence-based public health practice. BMC Med Educ. 2003;3:2. doi: https://doi.org/10.1186/1472-6920-3-2 https://doi.org/10.1186/1472-6920-3-2...	To evaluate whether a theory-based, multifaceted, intervention increased the integration of research into the decision-making of public health physicians.	Randomized controlled trial	Multiple	Training, Educational outreach, Educational material andWebsite
Lindbloom (2004) USA2121. Lindbloom EJ, Ewigman BG, Hickner JM. Practice-based research networks: the laboratories of primary care research. Med Care. 2004;42(4 Suppl):45-9.	To describe the organization and work of networks of practice-based research.	Descriptive study	Single	KT Networks
Stevenson (2006) United Kingdom2222. Stevenson K, Lewis M, Hay E. Does physiotherapy management of low back pain change as a result of an evidence-based educational programme? J EvalClinPract. 2006;12(3):365-75. doi: https://doi.org/10.1111/j.1365-2753.2006.00565.x https://doi.org/10.1111/j.1365-2753.2006...	To investigate whether physical therapists’ clinical management of patients with low back pain would change after an evidence-based education programme.	Randomized controlled trial	Single	Local facilitators
Dobbins (2009) Canada2323. Dobbins M, Robeson P, Ciliska D, Hanna S, Cameron R, O'Mara L, et al. A description of a knowledge broker role implemented as part of a randomized controlled trial evaluating three knowledge translation strategies. Implement Sci. 2009;4:23. doi: https://doi.org/10.1186/1748-5908-4-23 https://doi.org/10.1186/1748-5908-4-23...	To describe the intervention of the knowledge mediator and reflect on the future development of the role in public health, as well as in other health settings.	Randomized controlled trial	Single	Local facilitators
McGowan (2010) Canada2424. McGowan J, Hogg W, Rader T, Salzwedel D, Worster D, Cogo E, et al. A rapid evidence-based service by librarians provided information to answer primary care clinical questions. Health Info Libr J. 2010;27(1):11-21.doi: https://doi.org/10.1111/j.1471-1842.2009.00861.x https://doi.org/10.1111/j.1471-1842.2009...	To describe the process and lessons learned from developing and operating a rapid response library consultation service for primary care physician.	Qualitative study - interviews	Single	Educational outreach
Armstrong (2010) Australia2525. Armstrong K, Kendall E. Translating knowledge into practice and policy: the role of knowledge networks in primary health care. Health Inf Manag. 2010;39(2):9-17. doi: https://doi.org/10.1177/183335831003900203 https://doi.org/10.1177/1833358310039002...	To describe how interdisciplinary Knowledge Networks can support knowledge translation into practice.	Descriptive study	Single	KT Networks
Goldman (2010) Canada2626. Goldman J, Meuser J, Lawrie L, Rogers J, Reeves S. Interprofessional primary care protocols: a strategy to promote an evidence-based approach to teamwork and the delivery of care. J Interprof Care. 2010;24(6):653-65. doi: https://doi.org/10.3109/13561820903550697 https://doi.org/10.3109/1356182090355069...	To examine the interprofessional protocol development process and pilot implementation.	Exploratory case study	Single	Educational material
Labrecque (2010) Canada2727. Labrecque M, Lafortune V, Lajeunesse J, Lambert-Perrault AM, Manrique H, Blais J, et al. Do continuing medical education articles foster shared decision making? J Contin Educ Health Prof. 2010;30(1):44-50. doi: https://doi.org/10.1002/chp.20055 https://doi.org/10.1002/chp.20055...	To evaluate continuing medical education articles for mention of evidence-based information about benefits and harms of available treatment and/or preventive options.	Cross-sectional study	Single	Educational material
Dolor (2011) USA2828. Dolor RJ, Greene SM, Thompson E, Baldwin LM, Neale AV. Partnership-driven Resources to Improve and Enhance Research (PRIMER): a survey of community-engaged researchers and creation of an online toolkit. Clin Transl Sci. 2011;4(4):259-65. doi: https://doi.org/10.1111/j.1752-8062.2011.00310.x https://doi.org/10.1111/j.1752-8062.2011...	To develop an open access website that provides adaptable resources to facilitate best practices.	Cross-sectional study	Single	Website
Estrada (2011) USA2929. Estrada CA, Safford MM, Salanitro AH, Houston TK, Curry W, Williams JH, et al. A web-based diabetes intervention for physician: a cluster-randomized effectiveness trial. Int J Qual Health Care. 2011;23(6):682-9. doi: https://doi.org/10.1093/intqhc/mzr053 https://doi.org/10.1093/intqhc/mzr053...	To determine the effectiveness of a web-based education and implementation intervention to improve diabetes control.	Cluster randomized trial	Multiple	Training and feedback
Souza (2011) Canada3030. Souza NM, Sebaldt RJ, Mackay JA, Prorok JC, Weise-Kelly L, Navarro T, et al. Computerized clinical decision support systems for primary preventive care: a decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes. Implement Sci. 2011;6:87. doi: https://doi.org/10.1186/1748-5908-6-87 https://doi.org/10.1186/1748-5908-6-87...	To review randomized clinical trials evaluating the effects of computerized clinical decision support systems for primary preventive care.	Systematic review	Single	Website
Tieman (2012) Australia3131. Tieman JJ. Filters and hubs: shortening the distance to palliative care evidence. Aust J Prim Health. 2012;18(4):268-73. doi: https://doi.org/10.1071/PY11103 https://doi.org/10.1071/PY11103...	To describe two strategies used to assist those who work in primary care in the care for their patients who have palliative care needs.	Descriptive study	Multiple	Website
Hofmeyer (2012) Canada3232. Hofmeyer A, Scott C, Lagendyk L. Researcher-decision-maker partnerships in health services research: practical challenges, guiding principles. BMC Health Serv Res. 2012;12:280. doi: https://doi.org/10.1186/1472-6963-12-280 https://doi.org/10.1186/1472-6963-12-280...	To discuss a decision-maker-researcher partnership that investigated practice in primary care networks in Alberta.	Descriptive study	Single	KT Networks
LaRocca (2012) Canada3333. LaRocca R, Yost J, Dobbins M, Ciliska D, Butt M. The effectiveness of knowledge translation strategies used in public health: a systematic review. BMC Public Health. 2012;12:751. doi: https://doi.org/10.1186/1471-2458-12-751 https://doi.org/10.1186/1471-2458-12-751...	To identify the effectiveness of knowledge translation strategies used to promote evidence-informed decision making among public health decision makers.	Systematic review	Multiple	Website and Educational material
Bailie (2013) Australia3434. Bailie R, Matthews V, Brands J, Schierhout G. A systems-based partnership learning model for strengthening primary healthcare. Implement Sci. 2013;8:143. doi: https://doi.org/10.1186/1748-5908-8-143 https://doi.org/10.1186/1748-5908-8-143...	To describe the Partnership Learning Model in Primary Care and the successes and challenges in its application.	Descriptive study	Single	KT Networks
Liddy (2013) Canada3535. Liddy C, Laferriere D, Baskerville B, Dahrouge S, Knox L, Hogg W. An overview of practice facilitation programs in Canada: current perspectives and future directions. Healthc Policy. 2013;8(3):58-67. doi: https://doi.org/10.12927/hcpol.2013.23177 https://doi.org/10.12927/hcpol.2013.2317...	To provide an overview on practice facilitators.	Descriptive study	Single	Local facilitators
Barreto (2013) Brazil11. Barreto JOM, Souza NM. Avançando no uso de políticas e práticas de saúde informadas por evidências: a experiência de Piripiri-Piauí. Cien Saude Colet. 2013;18(1):25-34. doi: https://doi.org/10.1590/S1413-81232013000100004 https://doi.org/10.1590/S1413-8123201300...	To describe the experience of the Nucleus of Evidence in Health.	Descriptive study	Single	Educational material
Dadich (2013) Australia3636. Dadich A, Hosseinzadeh H. Healthcare reform: implications for knowledge translation in primary care. BMC Health Serv Res. 2013;13:490. doi: https://doi.org/10.1186/1472-6963-13-490 https://doi.org/10.1186/1472-6963-13-490...	To determine what works to facilitate evidence-based sexual health in the primary care unit.	Cross-sectional study	Multiple	Educational material and Training
Ryan (2013) Canada3737. Ryan D, Barnett R, Cott C, Dalziel W, Gutmanis I, Jewell D, et al. Geriatrics, interprofessional practice, and interorganizational collaboration: a knowledge-to-practice intervention for primary care teams. J ContinEduc Health Prof. 2013;33(3):180-9. doi: https://doi.org/10.1002/chp.21183 https://doi.org/10.1002/chp.21183...	To use a knowledge-to-practice intervention for primary care teams to help professionals develop their capacity to care for frail elderly people.	Non-randomized intervention trial	Multiple	Website, Educational material and Local facilitators
Armstrong (2013) Australia3838. Armstrong R, Waters E, Dobbins M, Anderson L, Moore L, Petticrew M, et al. Knowledge translation strategies to improve the use of evidence in public health decision making in local government: intervention design and implementation plan. Implement Sci. 2013;8:121. doi: https://doi.org/10.1186/1748-5908-8-121 https://doi.org/10.1186/1748-5908-8-121...	To describe the design and implementation plan of a knowledge translation intervention for public health decision-making.	Cluster randomized controlled trial	Multiple	Educational material and Training
Bernhardsson (2014) Sweden3939. Bernhardsson S, Larsson MEH, Eggertsen R, Olsén MF, Johansson K, Nilsen P, et al. Evaluation of a tailored, multi-component intervention for implementation of evidence-based clinical practice guidelines in primary care physical therapy: a non-randomized controlled trial. BMC Health Serv Res. 2014;14:105. doi: https://doi.org/10.1186/1472-6963-14-105 https://doi.org/10.1186/1472-6963-14-105...	To evaluate the effect of a intervention for implementation in primary care physical therapy in western Sweden.	Non-randomized intervention trial	Multiple	Websiteand Educational material
Pluye (2014) Canada4040. Pluye P, Grad R, Repchinsky C, Jovaisas B, Lewis D, Tang DL, et al. "Better-than-best" evidence? using family physicians' feedback for 2-way knowledge translation. Can Fam Physician. 2014 [cited 2022 May 10];60(5):415-7. Available from: https://www.cfp.ca/content/60/5/415.long https://www.cfp.ca/content/60/5/415.long...	To explore whether stimulated family physicians’ feedback could further optimize research-based information delivered via email.	Cross-sectional study	Single	Feedback
Giguere (2014) Canada4141. Giguere AMC, Labrecque M, Haynes RB, Grad R, Pluye P, Légaré F, et al. Evidence summaries (decision boxes) to prepare clinicians for shared decision-making with patients: a mixed methods implementation study. Implement Sci. 2014;9:144.doi: https://doi.org/10.1186/s13012-014-0144-6 https://doi.org/10.1186/s13012-014-0144-...	To measure the value and intent of using decision boxes in practice and describe barriers and facilitators to their use.	Mixed methods implementation study	Single	Educational material
McColl (2015) Canada4242. McColl MA, Aiken A, Smith K, McColl A, Green M, Godwin M, et al. Actionable nuggets: knowledge translation tool for the needs of patients with spinal cord injury. Can Fam Physician. 2015 [cited 2022 May 10];61(5):e240-8. Available from: https://www.cfp.ca/content/61/5/e240.long https://www.cfp.ca/content/61/5/e240.lon...	To design and test an innovative methodology to translate the latest and best evidence on spinal cord injury for family physician to use in practice.	Mixed methods	Single	Educational material
Badran (2015) Canada4343. Badran H, Pluye P, Grad R. Advantages and disadvantages of educational email alerts for family physicians: viewpoint. J Med Internet Res. 2015;17(2):e49. doi: https://doi.org/10.2196/jmir.3773 https://doi.org/10.2196/jmir.3773...	To explore the advantages and disadvantages of educational email alerts.	Qualitative descriptive study	Single	Educational material
Redaèlli (2015) Germany4444. Redaèlli M, Vollmar HC, Simic D, Maly-Schürer C, Löscher S, Koneczny N. Guideline implementation study on asthma: Results of a pragmatic implementation approach. Z Evid Fortbild Qual Gesundhwes. 2015;109(2):124-31. doi: https://doi.org/10.1016/j.zefq.2015.04.015 https://doi.org/10.1016/j.zefq.2015.04.0...	Identify the best strategies for implementing an asthma guideline.	Non-randomized controlled study	Single	Training
Clark (2015) Canada4545. Clark AJ, Taenzer P, Drummond N, Spanswick CC, Montgomery LS, Findlay T, et al. Physician-to-physician telephone consultations for chronic pain patients: a pragmatic randomized trial. Pain Res Manag. 2015;20(6):288-92. doi: https://doi.org/10.1155/2015/345432 https://doi.org/10.1155/2015/345432...	To assess the impact of telephone consultations between pain specialists and primary care physicians in the care of patients with chronic pain.	Pragmatic randomized trial	Single	Educational outreach
Naik (2015) USA4646. Naik AD, Lawrence B, Kiefer L, Ramos K, Utech A, Masozera N, et al. Building a primary care/research partnership: lessons learned from a telehealth intervention for diabetes and depression. Fam Pract. 2015;32(2):216-23. doi: https://doi.org/10.1093/fampra/cmu084 https://doi.org/10.1093/fampra/cmu084...	To describe the process of building a partnership between a research team and a community of primary care providers.	Community-based participatory research	Single	KT Networks
Siron (2015) Canada4747. Siron S, Dagenais C, Ridde V. What research tells us about knowledge transfer strategies to improve public health in low-income countries: a scoping review. Int J Public Health. 2015;60(7):849-63. doi: https://doi.org/10.1007/s00038-015-0716-5 https://doi.org/10.1007/s00038-015-0716-...	To describe the current state of research on knowledge transfer strategies to improve public health in low-income countries.	Scoping review	Multiple	Training, Educational material and Local facilitators
Perrier (2015) Canada4848. Perrier L. The development and pilot test of a shortened systematic review format for use by physicians [Thesis]. Toronto: The University of Toronto; 2015 [cited 2022 May 10]. Available from: https://hdl.handle.net/1807/69471 https://hdl.handle.net/1807/69471...	To describe the development and pilot testing of an shortened systematic review format for use by physicians.	Mixed methods study	Single	Educational material
McIntyre (2016) Australia4949. McIntyre E, Erny-Albrecht K, Hagger C, Bywood P, Brown L, Oliver-Baxter J. The contribution of a knowledge exchange organisation in primary healthcare. AustFam Physician. 2016 [cited 2022 May 10];45(9):684-7. Available from: https://www.racgp.org.au/afp/2016/september/the-contribution-of-a-knowledge-exchange-organisation-in-primary-healthcare/ https://www.racgp.org.au/afp/2016/septem...	To report how the Primary Health Care Research and Information Service operates to accelerate the use of research and evidence in primary healthcare policy and practice.	Descriptive study	Single	Website
Carroll (2016) Canada5050. Carroll JC, Grad R, Allanson JE, Pluye P, Permaul JA, Pimlott N, et al. The gene messenger impact project: an innovative genetics continuing education strategy for primary care providers. J Contin Educ Health Prof. 2016;36(3)178-85. doi: https://doi.org/10.1097/CEH.0000000000000079 https://doi.org/10.1097/CEH.000000000000...	To determine the value of Gene Messengers as a continuing education strategy in genomic medicine for family physicians	Non-randomized study of interventions	Single	Educational material
Gupta (2016) Canada5151. Gupta S, Moosa D, MacPherson A, Allen C, Tamari IE. Effects of a 12-month multi-faceted mentoring intervention on knowledge, quality, and usage of spirometry in primary care: a before-and-after study. BMC Pulm Med. 2016;16(1):56. doi:https://doi.org/10.1186/s12890-016-0220-6 https://doi.org/10.1186/s12890-016-0220-...	To evaluate a knowledge translation intervention to address both the poor quality of spirometry and the underuse of spirometry in primary care.	Prospective study	Multiple	Training and Educational outreach
Grudniewicz (2016) Canada5252. Grudniewicz A, Bhattacharyya O, McKibbon KA, Straus SE. User-centered design and printed educational materials: a focus group study of primary care physician preferences. J Contin Educ Health Prof. 2016;36(4):249-55. doi: https://doi.org/10.1097/CEH.0000000000000112 https://doi.org/10.1097/CEH.000000000000...	To understand what design and content attributes primary care physicians perceive as key to increase acceptance of printed educational materials and their ease of use.	Qualitative study - focus group	Single	Educational material
Oelke (2016) Canada5353. Oelke ND, Plamondon KM, Mendel D. Using dialogic methods as a participatory knowledge translation approach to promote integration of nurse practitioners in primary healthcare settings. Nurs Leadersh (Tor Ont). 2016;29(3):72-81. doi: https://doi.org/10.12927/cjnl.2016.24894 https://doi.org/10.12927/cjnl.2016.24894...	To describe the use of dialogic methods as a participatory knowledge translation approach to promote integration of nursing professionals in primary healthcare settings.	Intervention study	Single	KT Networks
Davis (2017) USA5454. Davis MM, Howk S, Spurlock M, McGinnis PB, Cohen DJ, Fagnan LJ. A qualitative study of clinic and community member perspectives on intervention toolkits: "unless the toolkit is used it won't help solve the problem". BMC Health Serv Res. 2017;17(1):497. doi: https://doi.org/10.1186/s12913-017-2413-y https://doi.org/10.1186/s12913-017-2413-...	To explore what clinic and community users want from intervention toolkits and identify factors that support application in practice.	Qualitative study - focus group	Single	Educational material
Morténius (2017) Sweden5555. Morténius H, Twetman S. Creating research and development awareness among dental care professionals by use of strategic communication: a 12-year intervention study. BMC Oral Health. 2017;17(1):164. doi: https://doi.org/10.1186/s12903-017-0445-7 https://doi.org/10.1186/s12903-017-0445-...	To analyze the role of strategic communication in raising awareness and interest in research and development among dental professionals and compare findings with primary care professionals.	Intervention study	Multiple	Educational material, WebsiteandPublic promotion
Wang (2017) China5656. Wang Y, Xiao LD, Ullah S, He GP, De Bellis A. Evaluation of a nurse-led dementia education and knowledge translation programme in primary care: a cluster randomized controlled trial. Nurse Educ Today. 2017;49:1-7. doi: https://doi.org/10.1016/j.nedt.2016.10.016 https://doi.org/10.1016/j.nedt.2016.10.0...	To determine the effectiveness of a nurse-led education and knowledge translation programme.	Cluster randomized controlled trial	Single	Training
Cornick (2018) South Africa5757. Cornick R, Picken S, Wattrus C, Awotiwon A, Carkeek E, Hannington J, et al. The Practical Approach to Care Kit (PACK) guide: developing a clinical decision support tool to simplify, standardise and strengthen primary healthcare delivery. BMJ Glob Health. 2018;3(Suppl 5):e000962. doi: https://doi.org/10.1136/bmjgh-2018-000962 https://doi.org/10.1136/bmjgh-2018-00096...	To describe the lessons learned during the development of the Practical Approach to Care Kit (PACK).	Descriptive study	Single	Educational material
Wattrus (2018) Brazil5858. Wattrus C, Zepeda J, Cornick RV, Zonta R, Andrade MP, Fairall L, et al. Using a mentorship model to localise the Practical Approach to Care Kit (PACK): from South Africa to Brazil. BMJ Global Health. 2018;3(Suppl 5):e001016.doi: https://doi.org/10.1136/bmjgh-2018-001016 https://doi.org/10.1136/bmjgh-2018-00101...	To describe the adaptation and implementation of the Practical Approach to Care Kit (PACK) in Brazil.	Descriptive study	Single	Educational material
Vedel (2018) Canada5959. Vedel I, Le Berre M, Sourial N, Arsenault-Lapierre G, Lapointe L. Shedding light on conditions for the successful passive dissemination of recommendations in primary care: a mixed methods study. Implement Sci. 2018;13(1):129. doi: https://doi.org/10.1186/s13012-018-0822-x https://doi.org/10.1186/s13012-018-0822-...	To discover conditions associated with change in primary care practice following passive dissemination of recommendations for the diagnosis and management of Alzheimer’s disease and related dementias.	Mixed methods study	Single	Educational material
Schütze (2018) Australia6060. Schütze H, Shell A, Brodaty H. Development, implementation and evaluation of Australia's first national continuing medical education program for the timely diagnosis and management of dementia in general practice. BMC Med Educ. 2018;18(1):194. doi: https://doi.org/10.1186/s12909-018-1295-y https://doi.org/10.1186/s12909-018-1295-...	To assist primary care physicians and nurses to better understand, diagnosis and management of dementia in primary care.	Cross-sectional study	Multiple	Training
Klaic (2018) Australia6161. Klaic M. Enhancing the uptake of evidence-based practice with allied health professionals: a quasi-experimental study [Thesis]. Melbourne: Monash University; 2018. doi: https://doi.org/10.26180/5b9b2cf23062c https://doi.org/10.26180/5b9b2cf23062c...	To enhance uptake of evidence-based practices with allied health professionals.	Mixed methods study	Single	Training
Anderson (2019) Australia6262. Anderson J, O'Moore K, Faraj M, Proudfoot J. Stepped care mental health service in Australian primary care: codesign and feasibility study. Aust Health Rev. 2020;44(6):873-9. doi: https://doi.org/10.1071/AH19078 https://doi.org/10.1071/AH19078...	To report on the development and feasibility study of Stepped Care, a scaled online mental health service.	Cross-sectional study	Single	Educational outreach
Fritz (2019) Sweden6363. Fritz J, Wallin L, Söderlund A, Almqvist L, Sandborgh M. Implementation of a behavioral medicine approach in physiotherapy: a process evaluation of facilitation methods. Implement Sci. 2019;14(1):94. doi: https://doi.org/10.1186/s13012-019-0942-y https://doi.org/10.1186/s13012-019-0942-...	To explore the mechanisms of impact on implementing a behavioral medicine approach in physiotherapy by examining the dose, scope and experiences of participants.	Mixed methods study	Multiple	Educational material, Training andPublic promotion
Brimble (2020) Canada6464. Brimble KS, Boll P, Grill AK, Molnar A, Nash DM, Garg A, et al. Impact of the kidney wise toolkit on chronic kidney disease referral practices in Ontario primary care: a prospective evaluation. BMJ Open. 2020;10(2):e032838. doi: https://doi.org/10.1136/bmjopen-2019-032838 https://doi.org/10.1136/bmjopen-2019-032...	To evaluate the impact of the launch of the Kidney Wise toolkit on the characteristics of primary care nephrology referrals.	Prospective study	Single	Educational material
Barbosa (2020) Portugal6565. Barbosa PM, Martins AC, Santos PC, Dias R, Pereira P, Pinto B, et al. The MOVE.TE falls prevention and management program: lessons learnt in the Portuguese context. J Frailty Sarcopenia Falls. 2020;5(2):42-6. doi: https://doi.org/10.22540/JFSF-05-042 https://doi.org/10.22540/JFSF-05-042...	To describe the development of the Prevention and Management Program.	Descriptive study	Single	Website
Casey (2020) Australia6666. Casey AN, Islam MM, Schütze H, Parkinson A, Yen L, Shell A, et al. GP awareness, practice, knowledge and confidence: evaluation of the first nation-wide dementia-focused continuing medical education program in Australia. BMC Fam Pract. 2020;21(1):104. doi: https://doi.org/10.1186/s12875-020-01178-x https://doi.org/10.1186/s12875-020-01178...	To evaluate the effectiveness of a nation-wide Continuing Medical Education.	Prospective study	Single	Training
Gattellari (2020) Australia6767. Gattellari M, Hayen A, Leung DYC, Zwar NA, Worthington JM. Supporting anticoagulant treatment decision making to optimise stroke prevention in complex patients with atrial fibrillation: a cluster randomised trial. BMC Fam Pract. 2020;21(1):102. doi: https://doi.org/10.1186/s12875-020-01175-0 https://doi.org/10.1186/s12875-020-01175...	To evaluate an intervention to improve anticoagulation uptake in patients with atrial fibrillation.	Randomized controlled trial	Multiple	Training and Feedback
Kjaergaard (2020) Kyrgyzstan and Vietnam6868. Kjærgaard J, Nissen TN, Isaeva E, Quynh NN, Reventlow S, Lund S, et al. No time for change? impact of contextual factors on the effect of training primary care healthcare workers in Kyrgyzstan and Vietnam on how to manage asthma in children - A FRESH AIR implementation study. BMC Health Serv Res. 2020;20(1):1137. doi: https://doi.org/10.1186/s12913-020-05984-y https://doi.org/10.1186/s12913-020-05984...	To evaluate whether carrying out the same training program in two contextually different countries would lead to differences in translating increased knowledge into clinical change.	Prospective study	Single	Training
Stander (2020) South Africa6969. Stander J, Grimmer K, Brink Y. Tailored training for physiotherapists on the use of clinical practice guidelines: a mixed methods study. Physiother Res Int. 2021;26(1):e2174. doi: https://doi.org/10.1002/pri.1883 https://doi.org/10.1002/pri.1883...	To develop and test a tailored training program.	Mixed methods study	Single	Training
Howie (2021) Canada7070. Howie AH, Klar N, Nash DM, Reid JN, Zwarenstein M. Printed educational materials directed at Ontario family physicians do not improve adherence to guideline recommendations for diabetes management: a pragmatic, factorial, cluster randomized controlled trial [ISRCTN72772651]. BMC Fam Pract. 2021;22:243. doi: https://doi.org/10.1186/s12875-021-01592-9 https://doi.org/10.1186/s12875-021-01592...	To test whether printed educational materials improve care on a larger scale within usual primary care clinical practice.	Cluster randomized controlled trial	Single	Educational material
Minian (2021) Canada7171. Minian N, Ahad S, Ivanova A, Veldhuizen S, Zawertailo L, Ravindran A, et al. The effectiveness of generic emails versus a remote knowledge broker to integrate mood management into a smoking cessation programme in team-based primary care: a cluster randomised trial. Implement Sci. 2021;16(1):30. doi: https://doi.org/10.1186/s13012-021-01091-6 https://doi.org/10.1186/s13012-021-01091...	To evaluate the effectiveness of generic and email-only prompts versus a custom remote knowledge broker.	Cluster randomized controlled trial	Single	Educational material
Phillips (2021) USA7272. Phillips WR, Sturgiss E, Yang A, Glasziou P, Olde Hartman T, Orkin A, et al. Clinician use of primary care research reports. J Am Board Fam Med. 2021;34(3):648-60. doi: https://doi.org/10.3122/jabfm.2021.03.200436 https://doi.org/10.3122/jabfm.2021.03.20...	To evaluate how primary care professionals use general health care reports and primary care research and how well the reports provide what they need to inform clinical practice.	Cross-sectional study	Single	Educational material

Facilitators	Barriers
Evidence-based teaching in undergraduate courses2020. Forsetlund L, Bradley P, Forsen L, Nordheim L, Jamtvedt G, Bjorndal A. Randomised controlled trial of a theoretically grounded tailored intervention to diffuse evidence-based public health practice. BMC Med Educ. 2003;3:2. doi: https://doi.org/10.1186/1472-6920-3-2 https://doi.org/10.1186/1472-6920-3-2...	Lack of portable devices or internet access in the workplace2424. McGowan J, Hogg W, Rader T, Salzwedel D, Worster D, Cogo E, et al. A rapid evidence-based service by librarians provided information to answer primary care clinical questions. Health Info Libr J. 2010;27(1):11-21.doi: https://doi.org/10.1111/j.1471-1842.2009.00861.x https://doi.org/10.1111/j.1471-1842.2009...
Research agenda informed by the professional working in PHC2121. Lindbloom EJ, Ewigman BG, Hickner JM. Practice-based research networks: the laboratories of primary care research. Med Care. 2004;42(4 Suppl):45-9.	High demand for healthcare services2929. Estrada CA, Safford MM, Salanitro AH, Houston TK, Curry W, Williams JH, et al. A web-based diabetes intervention for physician: a cluster-randomized effectiveness trial. Int J Qual Health Care. 2011;23(6):682-9. doi: https://doi.org/10.1093/intqhc/mzr053 https://doi.org/10.1093/intqhc/mzr053... ^,3636. Dadich A, Hosseinzadeh H. Healthcare reform: implications for knowledge translation in primary care. BMC Health Serv Res. 2013;13:490. doi: https://doi.org/10.1186/1472-6963-13-490 https://doi.org/10.1186/1472-6963-13-490... ^,6363. Fritz J, Wallin L, Söderlund A, Almqvist L, Sandborgh M. Implementation of a behavioral medicine approach in physiotherapy: a process evaluation of facilitation methods. Implement Sci. 2019;14(1):94. doi: https://doi.org/10.1186/s13012-019-0942-y https://doi.org/10.1186/s13012-019-0942-... ^,6565. Barbosa PM, Martins AC, Santos PC, Dias R, Pereira P, Pinto B, et al. The MOVE.TE falls prevention and management program: lessons learnt in the Portuguese context. J Frailty Sarcopenia Falls. 2020;5(2):42-6. doi: https://doi.org/10.22540/JFSF-05-042 https://doi.org/10.22540/JFSF-05-042...
Research in partnership2525. Armstrong K, Kendall E. Translating knowledge into practice and policy: the role of knowledge networks in primary health care. Health Inf Manag. 2010;39(2):9-17. doi: https://doi.org/10.1177/183335831003900203 https://doi.org/10.1177/1833358310039002... ^,3232. Hofmeyer A, Scott C, Lagendyk L. Researcher-decision-maker partnerships in health services research: practical challenges, guiding principles. BMC Health Serv Res. 2012;12:280. doi: https://doi.org/10.1186/1472-6963-12-280 https://doi.org/10.1186/1472-6963-12-280... ^,4646. Naik AD, Lawrence B, Kiefer L, Ramos K, Utech A, Masozera N, et al. Building a primary care/research partnership: lessons learned from a telehealth intervention for diabetes and depression. Fam Pract. 2015;32(2):216-23. doi: https://doi.org/10.1093/fampra/cmu084 https://doi.org/10.1093/fampra/cmu084... ^,5757. Cornick R, Picken S, Wattrus C, Awotiwon A, Carkeek E, Hannington J, et al. The Practical Approach to Care Kit (PACK) guide: developing a clinical decision support tool to simplify, standardise and strengthen primary healthcare delivery. BMJ Glob Health. 2018;3(Suppl 5):e000962. doi: https://doi.org/10.1136/bmjgh-2018-000962 https://doi.org/10.1136/bmjgh-2018-00096...	Resistance to change2626. Goldman J, Meuser J, Lawrie L, Rogers J, Reeves S. Interprofessional primary care protocols: a strategy to promote an evidence-based approach to teamwork and the delivery of care. J Interprof Care. 2010;24(6):653-65. doi: https://doi.org/10.3109/13561820903550697 https://doi.org/10.3109/1356182090355069...
Local facilitator who adapts the main messages of the research evidence to the local perspective2323. Dobbins M, Robeson P, Ciliska D, Hanna S, Cameron R, O'Mara L, et al. A description of a knowledge broker role implemented as part of a randomized controlled trial evaluating three knowledge translation strategies. Implement Sci. 2009;4:23. doi: https://doi.org/10.1186/1748-5908-4-23 https://doi.org/10.1186/1748-5908-4-23... ^,3535. Liddy C, Laferriere D, Baskerville B, Dahrouge S, Knox L, Hogg W. An overview of practice facilitation programs in Canada: current perspectives and future directions. Healthc Policy. 2013;8(3):58-67. doi: https://doi.org/10.12927/hcpol.2013.23177 https://doi.org/10.12927/hcpol.2013.2317... ^,3737. Ryan D, Barnett R, Cott C, Dalziel W, Gutmanis I, Jewell D, et al. Geriatrics, interprofessional practice, and interorganizational collaboration: a knowledge-to-practice intervention for primary care teams. J ContinEduc Health Prof. 2013;33(3):180-9. doi: https://doi.org/10.1002/chp.21183 https://doi.org/10.1002/chp.21183...	Lack of managerial support6363. Fritz J, Wallin L, Söderlund A, Almqvist L, Sandborgh M. Implementation of a behavioral medicine approach in physiotherapy: a process evaluation of facilitation methods. Implement Sci. 2019;14(1):94. doi: https://doi.org/10.1186/s13012-019-0942-y https://doi.org/10.1186/s13012-019-0942-...
Bond with the community studied⁽³²⁾	Lack of resources to implement the recommended translation strategies4747. Siron S, Dagenais C, Ridde V. What research tells us about knowledge transfer strategies to improve public health in low-income countries: a scoping review. Int J Public Health. 2015;60(7):849-63. doi: https://doi.org/10.1007/s00038-015-0716-5 https://doi.org/10.1007/s00038-015-0716-... ^,6565. Barbosa PM, Martins AC, Santos PC, Dias R, Pereira P, Pinto B, et al. The MOVE.TE falls prevention and management program: lessons learnt in the Portuguese context. J Frailty Sarcopenia Falls. 2020;5(2):42-6. doi: https://doi.org/10.22540/JFSF-05-042 https://doi.org/10.22540/JFSF-05-042...
Creation of research networks to share information2121. Lindbloom EJ, Ewigman BG, Hickner JM. Practice-based research networks: the laboratories of primary care research. Med Care. 2004;42(4 Suppl):45-9.^,3838. Armstrong R, Waters E, Dobbins M, Anderson L, Moore L, Petticrew M, et al. Knowledge translation strategies to improve the use of evidence in public health decision making in local government: intervention design and implementation plan. Implement Sci. 2013;8:121. doi: https://doi.org/10.1186/1748-5908-8-121 https://doi.org/10.1186/1748-5908-8-121...	Shortened or intensive training courses4747. Siron S, Dagenais C, Ridde V. What research tells us about knowledge transfer strategies to improve public health in low-income countries: a scoping review. Int J Public Health. 2015;60(7):849-63. doi: https://doi.org/10.1007/s00038-015-0716-5 https://doi.org/10.1007/s00038-015-0716-...
Adapt the research according to the context4646. Naik AD, Lawrence B, Kiefer L, Ramos K, Utech A, Masozera N, et al. Building a primary care/research partnership: lessons learned from a telehealth intervention for diabetes and depression. Fam Pract. 2015;32(2):216-23. doi: https://doi.org/10.1093/fampra/cmu084 https://doi.org/10.1093/fampra/cmu084... ^,4747. Siron S, Dagenais C, Ridde V. What research tells us about knowledge transfer strategies to improve public health in low-income countries: a scoping review. Int J Public Health. 2015;60(7):849-63. doi: https://doi.org/10.1007/s00038-015-0716-5 https://doi.org/10.1007/s00038-015-0716-...	Systematic reviews without practical information3333. LaRocca R, Yost J, Dobbins M, Ciliska D, Butt M. The effectiveness of knowledge translation strategies used in public health: a systematic review. BMC Public Health. 2012;12:751. doi: https://doi.org/10.1186/1471-2458-12-751 https://doi.org/10.1186/1471-2458-12-751... ^,4848. Perrier L. The development and pilot test of a shortened systematic review format for use by physicians [Thesis]. Toronto: The University of Toronto; 2015 [cited 2022 May 10]. Available from: https://hdl.handle.net/1807/69471 https://hdl.handle.net/1807/69471...
Shortened recommendation guides4848. Perrier L. The development and pilot test of a shortened systematic review format for use by physicians [Thesis]. Toronto: The University of Toronto; 2015 [cited 2022 May 10]. Available from: https://hdl.handle.net/1807/69471 https://hdl.handle.net/1807/69471... ^,5252. Grudniewicz A, Bhattacharyya O, McKibbon KA, Straus SE. User-centered design and printed educational materials: a focus group study of primary care physician preferences. J Contin Educ Health Prof. 2016;36(4):249-55. doi: https://doi.org/10.1097/CEH.0000000000000112 https://doi.org/10.1097/CEH.000000000000... ^,5454. Davis MM, Howk S, Spurlock M, McGinnis PB, Cohen DJ, Fagnan LJ. A qualitative study of clinic and community member perspectives on intervention toolkits: "unless the toolkit is used it won't help solve the problem". BMC Health Serv Res. 2017;17(1):497. doi: https://doi.org/10.1186/s12913-017-2413-y https://doi.org/10.1186/s12913-017-2413-...

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
E-mail: revista@enf.ufrgs.br

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[1] Corresponding author:
Luana Roberta Schneider E-mail: luanaschneider@unochapeco.edu.br

Educational material (n=28)	1.Multiprofessional protocols, synthesis of evidence, scientific abstracts sent by email, posters and printed leaflets, recommendation guide (guidelines).
Training (n=16)	2.Workshops, online and face-to-face courses, seminars, practical training, peer training, interactive lectures, and case discussions.
Website (n=10)	3.Website (with resources from project design to dissemination), website with customized material, website of the Service of Research and Information on Primary Health Care, automated search in PubMed, computerized systems to support clinical decisions.
Educational outreach (n=6)	4. Assistance to the librarian, telephone consultation with specialist, continuous guidance from specialists (online, e-mail, telephone, or in-person).
Knowledge translation networks (n=6)	5. Creation of networks to connect researchers, service providers, funding bodies and consumers, such as practice-based research networks or research networks.
Local facilitators (n=5)	6. Health practice facilitators.
Feedback (n=3)	7. Performance feedback and constructive feedback on research outcomes.
Public promotion (n=2)	8. Research seminars and promotion visits.