Innoversity in knowledge-for-action and adaptation to climate change: the first steps of an ‘evidence-based climatic health’ transfrontier training program

Abstract

It has become increasingly clear to the international scientific community that climate change is real and has important consequences for human health. To meet these new challenges, the World Health Organization recommends reinforcing the adaptive capacity of health systems. One of the possible avenues in this respect is to promote awareness and knowledge translation in climatic health, at both the local and global scales. Within such perspective, two major themes have emerged in the field of public health research: 1) the development of advanced training adapted to ‘global environment’ change and to the specific needs of various groups of actors (doctors, nurses, public health practitioners, health care managers, public service managers, local communities, etc) and 2) the development of strategies for implementing research results and applying various types of evidence to the management of public health issues affected by climate change. Progress on these two fronts will depend on maximum innovation in transdisciplinary and transsectoral collaborations. The general purpose of this article is to present the program of a new research and learning chair designed for this double set of developmental objectives – a chair that emphasizes ‘innoversity’ (the dynamic relationship between innovation and diversity) and ‘transfrontier ecolearning for adaptive actions’. The Écoapprentissages, santé mentale et climat collaborative research chair (University of Montreal and Quebec National Public Health Institute) based in Montreal is a center for ‘transdisciplinary research’ on the transfrontier knowledge-for-action that can aid adaptation of the public health sector, the public mental health sector, and the public service sector to climate change, as well as a center for complex collaborations on evidence-based climatic health ‘training’. This program-focused article comprises two main sections. The first section presents the ‘general’ and ‘specific contexts’ in which the chair emerged. The ‘general context’ pertains to the health-related challenge of finding ways to integrate, transfer, and implement knowledge, a particularly pointed challenge in Canada. The ‘specific context’ refers to the emerging research field of adaptation of public health to climate change. In the second section, the characteristics of the research chair are more extensively detailed (the vision of ‘innoversity’ and ‘ transfrontier knowledge-for-action,’ the approach of shared responsibility and complex collaboration, objectives, and major axes of research). We conclude with a call for complex collaboration toward knowledge-for-action in public health services/mental health services/public services’ adaptation to climate change: this call is aimed at individual and institutional actors in the North and South/West and East concerned by these issues.

Keywords:

• global changing environment
• climatic health
• adaptation to climate change
• adaptive capacity
• innoversity
• diversity
• complex collaboration
• transdisciplinary knowledge-for-action
• transfrontier training
• andragogy
• continuing education
• ecocompetency
• public health
• mental health
• health professional
• public service manager
• knowledge translation
• implementation science
• ecolearning
• ecomanagement
• eco-decision-making

Acknowledgments

Funding has been provided by the Fonds vert du gouvernement québécois (Ministère de la Santé et des Services sociaux du Québec: Thème 6 de l’Action 21 du Plan d’action 2006–2012 sur les changements climatiques).

Disclosure

The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Quebec Ministry of Health and Social Services, the Quebec National Public Health Institute, the Canadian Consortium OURANOS (Consortium on Regional Climatology and Adaptation to Climate Change), the Fernand-Seguin Research Center (and the Fonds de recherche en santé du Québec), the University of Montreal (Department of Psychiatry, Faculty of Medicine), or the Laval University (Faculty of Nursing).

Notes

a Knowledge-to-action (KT) is an interactive, dynamic, and complex process.^123,168,169 It is interactive in the sense that it occurs within a system of exchanges among producers and users of knowledge, and oftentimes includes other actors. It is dynamic in the sense that it involves a range of actions such as adoption, integration, mobilization, and use of knowledge in order to transform or concretely apply knowledge toward better practice and exemplary actions. Finally, KT is complex, implying as it does: 1) identification of the know-do gap within each problem area, and identification of existing knowledge and knowledge needs for various targeted groups; 2) examination of knowledge in order to adapt it to local needs; 3) acquaintance with all actors involved, and an understanding of their interactions; 4) familiarity with the local context within which knowledge will be used, shared, or transformed; 5) identification of obstacles and facilitating factors to KT; 6) development of strategies as well as professional activities through which knowledge can be assimilated and integrated by concerned local actors, leading ultimately to modified perceptions and practices; and 7) evaluation of the results of the KT process: was the transferred knowledge accessible, understood, and used? Did the targeted group demonstrate changes in understanding, attitudes, and professional practice? Did the KT process demonstrate sustainability, innovation, and did it lead to complex collaboration?^170,171

b 1) Knowledge synthesis (to identify the knowledge for KT); 2) Research into the evolution of and critical discourse around research evidence; 3) Research into knowledge retrieval, evaluation, and knowledge management infrastructure; 4) Identification of knowledge to action gaps; 5) Development of methods to assess barriers and facilitators to KT; 6) Development of methods for optimizing KT strategies; 7) Evaluations of the effectiveness and efficiency of KT strategies; 8) Development of KT theory; and 9) Development of KT research methods.¹⁶⁸

c In Canada, today, existing theoretical models are classified into two general approaches: 1) the ‘classical’ models’ approach often seen today as too descriptive and prescriptive, historically inspired by psychological theories of cognitive change, educational theories, organizational theories, and theories of ‘quality improvement;’ and 2) the ‘planned action’ approach, currently favored in Canada by authors such as Graham and Tetroe²⁰¹ and considered as an approach that ‘causes change’.

d These measures take many distinct forms, and can include behavioral changes, operational modifications, technological interventions, legislation, updating of professional practice, and investment planning.²³³

e In terms of the United Nations Framework Convention on Climate Change, participating nations must facilitate adaptation by attenuating ongoing impacts, reducing sensitivity and exposure to climate dangers, and increasing resistance to stressful climatic and nonclimatic factors (strengthening adaptive capacity).

f On the basis of the best-known available data, climate change is estimated to have caused 150,000 deaths and 5.5 million DALY (disability-adjusted life years) in the year 2000.

g There are several types of adaptation.²³⁴ Adaptive capacity includes anticipatory or preventive measures (before observed impacts) and reactive or corrective measures (after impacts). Both can be planned (products of political decision), but reactive measures can also be unplanned, spontaneous, after-the-fact. Planned adaptation consists of four phases: 1) information gathering and awareness raising; 2) conception and planning; 3) putting into practice; and 4) surveillance and evaluation.²⁵⁵

h Université de Montréal (Département de psychiatrie; Centre de recherche Fernand-Seguin de l’Hôpital Louis-H Lafontaine) and Institut national de santé publique du Québec (Canada).

i Transdisciplinarity as a form of knowledge translation research is driven by the need to solve problems of the lifeworld. By transcending disciplinary paradigms, transdisciplinary knowledge translation research is challenged by the following requirements: to grasp the complexity of the problems, to take into account the diversity of scientific and societal views of these problems, to link abstract and case-specific knowledge, and to constitute knowledge with a focus on problem solving for what is perceived to be the common good. (p. 19)²⁷⁴