Sociological aspects of knowledge translation

Problematising knowledge translation

Knowledge translation – the ubiquity of this term extends to policy, scholarship, and practice, internationally. This ubiquity is particularly the case in healthcare. Consider the efforts of several international bodies to promote knowledge translation – these bodies include the Canadian Institutes of Health Research (2015, n.d.), the National Health and Medical Research Council (n.d.) in Australia, and the National Health Service in the United Kingdom (Stansfield & South, 2018). Thus, this special issue on the sociological aspects of knowledge translation is important, timely, and particularly relevant to the sociology of health, illness, and medicine. This is for four key reasons. First, given different (if not heightened) societal expectations, many government bodies and international organisations now expect different knowledges to be represented in research about health(care). Second, the processes through which different knowledges coalesce demonstrate the myriad interactions between society and health. Third, knowledge translation requires sociologically informed scholarship that accounts for how social interactions and political processes influence health, illness, and medicine. And fourth, First Nations Peoples have emphasised that knowledge translation should be grounded in respect for diverse knowledges and that it should operate relationally rather than uni-directionally. Furthermore, making knowledge translation foundational to research design and communication provides an opportunity to demonstrate respect for First Nations People’s enduring connections to Country, intergenerational responsibilities, and knowledge of communities (Williams & Marlin, 2022).

This special issue represents a complement of formative and thought-provoking articles that collectively advance the sociological aspects of knowledge translation. Reflecting a sociology of knowledge translation (Kitto et al., 2012), the authors of each contribution recognise knowledge translation as the processes through which different knowledge coalesce to inform how we feel, think, and behave. These knowledges include (but are not limited to) evidence born from research, lived experiences, cultural values, and spiritual awareness.

The articles that collectively represent this special issue offer several astute contributions. For instance, they demonstrate some of the many forms of knowledge translation. They reveal how knowledge translation can helpfully problematise historical and contemporary social issues. They highlight the methodologies and research methods that can helpfully advance the scholarship of knowledge translation. They verify the importance of collaboration in approaches to knowledge translation. And they establish how knowledge translation research can prompt and sustain change.

For instance, Heinsch and colleagues (2023) consider the ‘dense and intricate relationships, values, politics, and interests that determine whose knowledge counts, who gets to speak, who is spoken for, and with what consequences, in the translation and implementation of scientific knowledge’. They problematise the assumption that there is one objective science and argue that implementation science has a key role in ensuring that the traditional dominance of particular voices and institutional structures is critiqued.

Complementing this contribution are several articles that highlight innovative arts-based methods to address and advance the science of knowledge translation. Consider, for instance, Cooke and colleagues (2023), who describe the use of the ‘depart radically in academic writing’ (DRAW) model (Mackinlay, 2022). They use data poetry and two case studies based on semi-structured interviews with mothers, fathers, and siblings about their experiences of having a child or sibling with Down syndrome. They demonstrate that writing with creative criticality contributes to an embodied and affective understanding of research participants’ stories, which are largely lacking in the academic literature in the sociology of health and illness field. They argue that DRAWing can impact audiences, emotionally and intellectually, with significant knowledge translation implications for healthcare professionals and these families.

Similarly, Watson and colleagues (2023) describe a collaborative study that involved the creation of an exhibition titled, ‘Creative approaches to health information ecologies’. The collaboration involved a multidisciplinary research team and an Australian health consumer organisation. Creative workshops explored how people learn, think, and feel about their bodies and health states and attended to the importance of communities, places, spaces, objects, and other living things – what the authors refer to as ‘ecologies’ of health information. An interactive exhibition of materials was designed for public engagement.

Also using a participatory approach, Hor and colleagues (2023) examine knowledge translation as both an empirical focus and a research methodology. From practice theory and critical pedagogy underpinnings, they describe knowledge translation as a situated and social process of transformative learning, enabled by reflexive dialogue about practice and supported by care. They illustrate five studies across two countries, demonstrating that this process can be mediated by researchers, using the methodology of video-reflexive ethnography (VRE). The importance (and features) of care in VRE that creates psychological safety for transformative learning are described. The authors argue that attempts to transform and improve healthcare must account for sustained and reciprocal care, both for and between those made vulnerable in the process. Knowledge translation should be undertaken as a process of capacity strengthening, with care as a core principle and practice.

However, it is through a systematic scoping review of academic literature that we learn that knowledge translation might also have unintended negative consequences (Dadich et al., 2023). Although knowledge translation is hailed as important and a worthy pursuit, seldom are efforts to promote knowledge translation critiqued. This is demonstrated by the fact that, of the 9,598 articles that were screened, only six reported evidence of unintended negative consequences. The most dominant was emotional labour – the negative emotional or psychological sequelae, including depression, anxiety, powerlessness, and frustration. These consequences were experienced by knowledge translation brokers, knowledge translation recipients, and knowledge translation producers. Strategies to manage or mitigate these unintended negative consequences included co-design, collaboration, and supported dialogue. There is considerable opportunity to identify, address, and avert these unintended consequences of knowledge translation, particularly given the limited research on this topic.

Furthering this theme of problematising knowledge translation, Fitts and colleagues (2023) note that mainstream research with First Nations Peoples often fails to address culturally relevant, meaningful, contextual, or decolonising knowledge. Drawing on the work of Indigenous scholars, they offer a better understanding of knowledge translation in disability research with First Nations Peoples. Using a case study, they explore the needs and priorities of First Nations women in Australia who have experienced a traumatic brain injury as a result of domestic and family violence. They suggest that two-way community-knowledge feedback loops support the integration of data collection and knowledge translation, simultaneously. By engaging knowledge users in all phases of the research production process, the authors argue that research can produce knowledge translation that is relevant and timely for knowledge users.

Similarly, a team of intercultural researchers explicates Aboriginal participatory action research, particularly its ethical focus and capacity to decolonise scholarship (Wright et al., 2023, original italics). This is demonstrated with reference to a research program, ‘where Aboriginal Elders as cultural guides hold the research through storying and cultural experiences that have deepened relationships between services and the local Aboriginal community'. Through this account, the team confirms the transformative potential of scholarship that ‘facilitates shared storying, engages non-Indigenous and Indigenous people together in On Country and culturally immersive activities, and sets a space for co-design to occur’.

From this suite of articles are three key lessons. First, knowledge translation comes in many guises, partly due to the myriad forms and sources of knowledge that can and should be recognised when informing feelings, thoughts, and behaviours. Second, despite the ubiquity of knowledge translation, there is still much terrain yet to be explored. Third, and relatedly, participatory and creative methodologies are likely to be helpful in advancing the science of knowledge translation.

These lessons have considerable implications for anyone with an interest in ‘the synthesis, exchange, and application of knowledge … to … improv[e] … health’ (Regional Office for the Americas of the World Health Organization, n.d.). For instance, for scholars, there is an opportunity to problematise knowledge translation through the use of ‘assumption-challenging approaches’ (Alvesson & Sandberg, 2011; Sandberg & Alvesson, 2011). Rather than rely on prevailing values and suppositions to inform knowledge translation efforts, critical and creative approaches can help to disrupt scholarship, troubling traditional ways of examining, and furthering knowledge translation scholarship and theory. For those who deliver and manage health services, this special issue underscores the importance of meaningful participatory approaches to knowledge translation. This might include strategies that involve different stakeholders in the translation of research evidence into clinical practice to promote quality healthcare – these stakeholders might include those who deliver, manage, or receive healthcare. However, if these strategies are to be effective, the conceptual and practical challenges experienced by these stakeholders must be addressed. For policymakers, this special issue suggests that knowledge translation requires engagement with different stakeholders via different and flexible strategies (Lawrence et al., 2019). And for community members, this special issue highlights the creative approaches that have shown promise in terms of communicating complex health information in embodied, lay-friendly, and accessible ways (Boydell, 2019). As a platform for future scholarship, we trust that this special issue advances knowledge translation, enabling colleagues to respond to these calls.