Introdução: A Translação do Conhecimento (TC) consiste em uma teoria do conhecimento para a ação que visa à redução das lacunas entre a produção do conhecimento e sua aplicação em boas práticas profissionais e em políticas públicas que promovem melhorias na saúde e nas condições de vida da população. A extensão universitária, articulada ao ensino e à pesquisa, representa uma oportunidade para a TC nas Instituições de Ensino Superior (IES). Contudo, a exiguidade de indicadores de extensão dificulta a avaliação da indissociabilidade dessa tríade acadêmica. Objetivos: 1. Identificar a incorporação dos conteúdos inovadores relacionados à Promoção do Desenvolvimento Infantil (PDI) no ensino, na pesquisa e na extensão, antes e depois de dois anos da participação das IES em projetos de intervenção local (PIL) em municípios paulistas; 2. Elaborar mapas conceituais (MC) para a síntese do processo translacional ocorrido em cursos de graduação de saúde e de educação; 3. Propor indicadores de extensão inovadora; 4. Construir um modelo de avaliação fundamentado no processo de TC. Método: pesquisa exploratória e descritiva, por meio de estudo de casos múltiplos, baseado na triangulação de técnicas qualitativas. Os sujeitos da pesquisa foram sete coordenadores e três professoras de três IES envolvidas nos PIL. Foram coletados dados em duas etapas: I. a) Análise de ementas e planos de ensino de 2009 dos cursos de graduação em Enfermagem, Educação Física, Fisioterapia, Pedagogia, Psicologia e Terapia Ocupacional; b) Entrevistas com informantes-chave sobre o ensino, a pesquisa e a extensão relacionados à PDI; c) Reaplicação das duas fases anteriores com base no ano letivo de 2011; II. Construção de mapas conceituais (MC) para evidenciar a TC em núcleos acadêmicos das IES selecionadas. A análise temática dos documentos e das entrevistas, a síntese cruzada dos casos e o mapeamento conceitual por meio do Cmap Tools®, versão 5.05.01, foram adotados para avaliação dos dados. Desenvolveu-se um esquema analítico com base na ausência ou na presença de oito conteúdos inovadores relacionados à PDI no ensino, na pesquisa e na extensão, a saber: 1. Ausente, 2. Incipiente (apenas no ensino), 3. Regular (no ensino e na pesquisa), 4. Relevante (no ensino e na extensão) e 5. Completa. Resultados: após dois anos de parceria das IES nos projetos, destacaram-se as mudanças ocorridas nos seguintes cursos de graduação: Enfermagem passa de incipiente (75%) para relevante (87,5%) e Psicologia de ausente (87,5%) para relevante (75%) em Centro Universitário Comunitário; no curso de Terapia Ocupacional a classificação ausente (75%) torna-se relevante (75%) e completa (25%) em Universidade Pública Federal; houve a criação de duas disciplinas nos currículos de Pedagogia e Psicologia em Fundação Educacional Privada. Os MC ilustraram o processo de TC ocorrido nas três IES e contribuíram para a elaboração do modelo teórico de Avaliação Translacional de Extensão em Núcleos Acadêmicos (ATENA) composto por 12 indicadores de extensão inovadora. Conclusões: o modelo de ATENA verifica a aplicabilidade das evidências científicas e inovações tecnológicas nas ações de ensino, pesquisa e extensão na interação dos representantes das IES com atores sociais relevantes dos serviços locais e da comunidade a fim de promover a formação profissional, crítica, reflexiva e cidadã. / Introduction: Knowledge Translation (KT) is a theory to action that aims to reduce the gap between knowledge production and application into best practices and public policies in order to improve health and live conditions. Extension in Universities, regardless teaching and research, depicts an opportunity to KT in Higher Education Institutions (HEI). However, there is a lack of extension indicators that complicate evaluation of inextricableness of extension, teaching and research. Objectives: 1. Identifying the incorporation of innovative contents on Early Childhood Promotion (ECP) in teaching, research and extension, before and after two years local intervention-based projects (LIP) at inner state of Sao Paulo, Brazil; 2. Creating concept maps (CM) to synthetize the KT process occurred in Health and Education undergraduate courses; 3. Proposing innovative extension indicators; 4. Building evaluative model with a KT underpinning. Method: it is an exploratory and descriptive research, based on multiple cases study and qualitative triangulation. Subjects were seven coordinators and three teachers from three HEI that have been participating on LIP. Data were collected in two stages: I. a) Analysis of syllabi and study plans until 2009 related to Nursing, Physical Education, Physiotherapy, Pedagogy, Psychology and Occupational Therapy undergraduate courses; b) Key-informants interviews about teaching, research and extension activities about ECP; c) Reapplication of a and b phases based on 2011 school year; II. Creating CM to evince KT in HEIs academic centers. Thematic analysis of documents and transcripted interviews, cross-case synthesis and concept mapping by Cmap Tools® 5.05.01 were adopted to evaluate data. We have developed an analytical scheme based on absence or presence of eight innovative contents on ECP in teaching, research and extension, namely: 1. Absent, 2. Incipient (only in teaching), 3. Regular (in teaching and research), 4. Relevant (in teaching and extension) and 5. Complete. Results: after two-years HEI and LIP partnership, we have highlighted changes occured in the following undergraduate courses: Nursing that was incipient (75%) and has become relevant (87,5%), Psychology from absent (87,5%) to relevant (75%) in a Community College; Occupational Therapy that was absent (75%) has turned into relevant (75%) and complete (25%) in a Public University; there was a creation of two disciplines focused on ECP in Private College Pedagogy and Psychology curricula. CM have illustrated KT process occurred in HEI and contributed to elaborate a theoretical model of Translational Evaluation on Extension in Academic Centers composed by 12 innovative extension indicators. Conclusions: this model verifies evidence and innovation applicability into teaching, research and extension activities and interaction among HEI faculty and students and local services and community stakeholders in order to achieve a professional, critical, reflexive and citizen formation.

<p>Increasingly, informal caregivers are providing hospice palliative care and support to dying friends and family members. These individuals must often negotiate multiple roles and responsibilities as a result of being caregivers and members of the paid labour force. Canada’s federal government has recognized the burden placed on informal caregivers, and legislated the Compassionate Care Benefit (CCB) in 2004. The CCB allows informal caregivers providing hospice palliative care six paid weeks off work to alleviate some of the role strain in the provision of care. Evaluations of the CCB have recognized that the low program uptake has been primarily the result of a lack of awareness. As such, knowledge translation campaigns about the CCB are needed. Stakeholders interviewed, including family caregivers, front-line palliative providers, and employers, have suggested that Canadian social workers are the primary group in need of a targeted knowledge campaign. This research presents the results of the development of a two-stage knowledge translation intervention for social workers. First, the development of appropriate interventions are explored through a qualitative messaging survey (<em>n</em>=16), a focus group (<em>n</em>=8) and key informant interviews (<em>n</em>=3). Preferred intervention formats and messages are identified, and draft knowledge tools are created. Secondly, draft knowledge tools are piloted in workplaces by social workers (<em>n</em>=8), the results of which are captured through participant interviews. The refinement period suggested some of the constraints of space and time on knowledge translation about the CCB and tool use. Hägerstrand’s time geography is explored in relation to tool use and knowledge translation. The research presented herein is relevant to policy makers, program planners, clinicians and researchers working with the fields of hospice palliative care, social work and knowledge translation. This research makes contributions to the knowledge translation and intervention development literatures through the presentation of novel methodologies and the application of time geography.</p> / Master of Arts (MA)

<p><strong>Introduction: </strong>eHealth Ontario and the Ministry of Health and Long Term Care (MOHLTC), with funding from Canada Health Infoway, are considering introducing a Drug Information System (DIS). This system will introduce and integrate ePrescribing, eDispensing and electronic data interchange (two-way electronic order communication between physicians via electronic medical records (EMR) systems and pharmacists via pharmacy management systems (PMS) regarding medications).</p> <p><strong>Objectives: </strong>To gather perceptions of family physicians, community pharmacists and patients on the DIS being implemented in Ontario. Before such an expensive large-scale system is implemented, areas of concerns should be identified to maximize utilization of the system.</p> <p><strong>Study Design: </strong>Three different group-specific electronic and paper questionnaires</p> <p><strong>Setting: </strong>Family physicians, community pharmacists and patients. The aim was to receive <strong>35</strong> questionnaire responses from each group from Waterloo, Hamilton, Guelph and the Greater Toronto Area in Ontario. <strong></strong></p> <p><strong>Methods: </strong>A<strong> </strong>Literature search was conducted to study the current two-way electronic order communication systems and perceptions of prescribers, dispensers and patients on ePrescribing or eDispensing within primary care. Group-specific questionnaires, used with consent from a Scottish study, were altered and tailored for Ontarians, and distributed to all 3 groups via convenience and snowball sampling. Study findings were compared to the same Scottish study.</p> <p><strong>Results: </strong>The ‘adjusted’ response rates were 82% (patients), 72% (community pharmacists) and 60% (family physicians). All three groups were in favour of DIS being implemented in Ontario. Generally only the pharmacist group had any knowledge of DIS before this survey. Most respondents agreed that patient care would improve with the implementation of DIS.</p> <p><strong>Conclusion: </strong>Implementation of the DIS in Ontario is perceived as a good idea amongst all pharmacists, family physicians and patients. However, eHealth Ontario and MOHLTC need to increase awareness amongst all three, but mostly consumer and prescriber groups of the potential benefits of the DIS in order for them to accept and adapt to this new system. <strong> </strong></p> / Master of Science (MSc)

<p>For more information contact: Susan Strong, <a href="mailto:sstrong@stjoes.ca">sstrong@stjoes.ca</a>; St Joseph's Healthcare Hamilton, West 5th Campus, Schizophrenia & Community Integration Service, 100 West 5th St., Hamilton, ON L8N3K7</p> / <p><strong>Introduction</strong></p> <p>Despite international pressure to implement self-management support for individuals living with chronic illnesses, little direction is available for integration into specialized mental health services. The premise of the dissertation is that self-management support can be provided and be beneficial within a recovery framework for individuals living with serious mental illnesses.</p> <p><strong>Methods</strong></p> <p>A large regional service was studied as an exemplar of specialized service delivery. Using a van Manen phenomenological study through an occupational therapist lens, the meaning of clients’ experiences with self-management learning events in a diverse sample was examined. Conditions shaping clinicians’ experiences and actions enabling self-management across eight varied settings were identified in a Yin case study with embedded units. Provider triads (occupational therapist-nurse-social worker) from each setting, allowed an examination of patterns by individual, discipline and practice environment. With an integrated knowledge translation approach, both studies informed the strategic creation of an innovation and implementation plan for organizational change.</p> <p><strong>Results</strong></p> <p>Findings created a rich picture of clients’ lifeworlds learning self-management and conditions and mechanisms influencing clinician self-management support practices. Client self-management needs were not routinely addressed by services. Clients experienced eight tasks shaped by contextual structures represented in a model of the work of learning self-management. Self-management was enmeshed in recovery and a personal resource for self-determination and living well. Another model illustrated the complex dynamic relationships underpinning clinicians’ intentions and actions, and key features of clinicians enabling client self-management. A structured approach to delivering self-management support and a learning and embedding initiative were generated.</p> <p><strong>Conclusions</strong></p> <p>The dominance of practice environments offers an opportunity for organizational change. Direction is given to customize self-management support in a conventional mental health service. The conceptualization of self-management support within a recovery framework may benefit all client groups with long-standing conditions.</p> / Doctor of Philosophy (PhD)

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

L’agression sexuelle (AS) envers les enfants est une problématique majeure affectant les communautés autochtones. Considérant les conséquences à long terme associées à l’AS, il est primordial que les intervenants soient formés adéquatement pour intervenir en cas d’AS puisque que cette problématique compromet le bien-être des enfants, de leur famille et de leur communauté. Le Centre d’expertise Marie-Vincent, en partenariat avec les communautés autochtones, a mis sur pied une formation en matière d’AS spécifiquement adaptée aux besoins des intervenants. De 2013 à 2015, 161 professionnels œuvrant dans les communautés autochtones ont participé à cette formation. Deux phases de collecte de données distinctes ont été menées pour vérifier l’atteinte des objectifs du programme, soit l’amélioration des connaissances et des interventions en matière d’AS des participants. Lors de la première phase, les participants ont répondu à un questionnaire de réactions et à un test de connaissances. Une étude de cas multiples qualitative comportant quatre communautés a été réalisée lors de la deuxième phase. En plus d’un taux d’appréciation élevé, les résultats révèlent une augmentation significative des connaissances, passant de 54 % à 87 % (t(125) = 16,4, p < 0,001, ηp2 = 0,68). L’analyse des entrevues fait état d’une appropriation des contenus de formation dans la pratique professionnelle des participants. Ces derniers affirment avoir modifié la façon dont ils questionnent les enfants et être plus attentifs aux signes et symptômes d’une AS. Des changements sur le plan des attitudes, notamment sur l’importance du signalement, sont également rapportés. Finalement, la formation est considérée comme l’un des éléments déclencheurs d’une meilleure collaboration intersectorielle dans au moins une communauté. / Child sexual abuse (CSA) is a major issue affecting the well-being of indigenous communities. For this reason, the Marie-Vincent Centre of Expertise, in partnership with indigenous stakeholders, has created a training program on the topic of CSA specifically tailored to the needs of Québec’s indigenous communities. From 2013 to 2015, 161 professionals took the training. In order to evaluate this training, two distinct data collection phases were conducted. As part of the first data collection phase, participants completed a reaction questionnaire and a knowledge assessment questionnaire. Interviews with four subgroups of participants were conducted in the second phase of collection. The overall satisfaction with the training was high and the participants’ knowledge level significantly increased from 54% to 87% (t(125) = 16.4, p < 0.001, ηp2= 0.68). Furthermore, interview results show an integration of training contents in the participants’ professional practice. Participants mentioned that the training influenced the way they interrogate children. Being more aware of potential signs and symptoms of CSA was credited to the training. Changes in attitudes were also found, particularly in the importance of reporting abuses. Finally, an improved inter-sectoral collaboration was attributed to the program in at least one community.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Continued documentation of the disproportionate burden of ill health faced by Aboriginal Peoples in Canada raises questions about the gap between what is known and what action is being taken to improve Aboriginal health in Canada. In order to explore this puzzle of knowledge translation (KT), a conceptual framework was developed by synthesizing the KT literature with the Aboriginal health research literature. Using this framework as a guide, this study explored the idea of KT within one Aboriginal health research context – the Network Environments for Aboriginal Research British Columbia (NEARBC). Concepts, ideas, and patterns drawn from the systematic thematic analysis of semi-structured qualitative interviews highlight the complexity of Aboriginal KT and the challenges that lie ahead. The lessons learned from these challenges are reviewed and opportunities for KT to help transform the discourse and practice of Aboriginal health research and policy in Canada discussed.

Continued documentation of the disproportionate burden of ill health faced by Aboriginal Peoples in Canada raises questions about the gap between what is known and what action is being taken to improve Aboriginal health in Canada. In order to explore this puzzle of knowledge translation (KT), a conceptual framework was developed by synthesizing the KT literature with the Aboriginal health research literature. Using this framework as a guide, this study explored the idea of KT within one Aboriginal health research context – the Network Environments for Aboriginal Research British Columbia (NEARBC). Concepts, ideas, and patterns drawn from the systematic thematic analysis of semi-structured qualitative interviews highlight the complexity of Aboriginal KT and the challenges that lie ahead. The lessons learned from these challenges are reviewed and opportunities for KT to help transform the discourse and practice of Aboriginal health research and policy in Canada discussed.

Objectifs : Explorer les facteurs influençant l’implantation d’un dépistage des difficultés sexuelles (DDS) en réadaptation de l’accident vasculaire cérébral (AVC), les besoins des clients post-AVC et les rôles perçus des cliniciens par rapport à la réadaptation sexuelle. Méthodologie : Un devis mixte a été réalisé au sein d’un hôpital de réadaptation, où le DDS a été implanté durant 4 mois. Le nombre de DDS réalisés et le niveau d’aise des intervenants à aborder la sexualité avant et après l’implantation ont été mesurés. Les perceptions liées aux facteurs influençant l’implantation, aux besoins des clients et aux rôles professionnels en sexualité ont été recueillis par entrevues et groupe de discussions auprès de cinq clients post-AVC, de 15 intervenants et d’un coordonnateur. Résultats : Le DDS a été utilisé 28 fois durant l’étude. Le niveau d’aise des intervenants s’est significativement amélioré (p=0.001) post-implantation. Les facteurs d’influence ont été regroupés parmi 4 thèmes : l’acceptabilité du DDS, les caractéristiques individuelles des personnes concernées, le contexte de l’hôpital de réadaptation et le processus d’implantation. Les besoins des clients étaient variables, certains n’en avaient pas et d’autres voulaient plus d’information sur la sexualité ou un environnement privé pour reprendre leur sexualité. Les intervenants percevaient avoir un rôle en sexualité et privilégiaient l’interdisciplinarité. Conclusion : Plusieurs facteurs, dont certains modifiables, ont influencé l’implantation du DDS. Les besoins de la clientèle et les rôles professionnels ont été clarifiés. Des formations et des ressources spécialisées en sexualité pourraient soutenir les intervenants dans de futures études sur le sujet. / Objectives: Examine the factors that could affect the implementation of a Sexual Difficulty Screening tool (SDS) in stroke rehabilitation, the clients’ needs regarding sexual rehabilitation and related professional roles with clinicians. Methodology: A mixed research design was used in a rehabilitation hospital, where the SDS was implemented for four months. The number of times the SDS was administered and the clinicians' level of comfort in addressing sexuality before and after implementation were measured. The perceived factors influencing the implementation, as well as clients’ needs and professional roles, were gathered through interviews and group discussions with five stroke clients, 15 clinicians and a coordinator. Results: The SDS was used 28 times during the study. The clinicians' level of comfort improved significantly (p = 0.001) post-implementation. The influencing factors were grouped into four themes: the acceptability of the SDS, the individual characteristics of participants, the context of the rehabilitation hospital and the implementation process. Clients’ needs were variable, from the absence of rehabilitation needs to the need for more information regarding sexuality and a safe environment to experiment their own sexuality. Occupational, physical and speech therapists reported they could contribute to sexual rehabilitation post-stroke but emphasized the importance of an interdisciplinary approach. Conclusion: Several types of factors, some of which could be modified, influenced the implementation of the SDS. Clients’ sexual rehabilitation needs and clinicians’ professional contribution have been clarified. Training and access to specialized sexuality resources would be important for supporting clinicians in future studies on the subject.