Objective: Significant investments to address childhood obesity require that we understand the factors that facilitate the use of research among public health practitioners in order to support evidence-informed strategies. Therefore the objective of this study is to understand the role of the interactive support of the SHAPES-Ontario Knowledge Exchange Extension (KE Extension) on evidence-informed knowledge use concerning youth physical activity in public health. The interactive support is defined according to three components: 1) Collaborative Partnership, 2) Community of Practice, and 3) Knowledge Broker. Methods: Two different groups of Public Health Organisations were selected. The Intervention group consisted of two Ontario Public Health Units from the SHAPES-Ontario KE Extension. The Comparison group consisted of one Ontario Public Health Unit and one Manitoba Regional Health Authority. The Comparison organisations did not have the intervention of the KE Extension. Semi-structured interviews were conducted with approximately four to five staff from each organisation. Qualitative analysis identified instances of evidence-informed knowledge use, interactive processes and other factors that influenced knowledge use related to youth physical activity in public health program planning and decision-making. This resulted in comprehensive case studies for each organisation. Cross case analysis identified the dominant similarities and difference in the factors that influence evidence-informed knowledge use across the organisations and how they inter-relate. Results: The cross case analysis indicated that having access to local youth physical activity surveillance data (e.g., SHAPES data) was the most important facilitator of evidence-informed practice. Interactive processes, specifically working groups, partnerships, and knowledge brokers, were found to be an important factor across the fours organisations. These interactive processes were found to have a reciprocal relationship with the information source and the context for sue, further facilitating evidence-informed knowledge use. The specific interactive mechanisms of the KE Extension did not emerge from the data, as the intervention was not intensive enough compared to the other activities within the Intervention organisations. Conclusions: Providing public health practitioners with access to local and relevant research evidence, coupled with intensive, sustained, and consistent interactive support for planning and decision-making may be effective at encouraging evidence-informed practice related to youth physical activity.

Objective: Significant investments to address childhood obesity require that we understand the factors that facilitate the use of research among public health practitioners in order to support evidence-informed strategies. Therefore the objective of this study is to understand the role of the interactive support of the SHAPES-Ontario Knowledge Exchange Extension (KE Extension) on evidence-informed knowledge use concerning youth physical activity in public health. The interactive support is defined according to three components: 1) Collaborative Partnership, 2) Community of Practice, and 3) Knowledge Broker. Methods: Two different groups of Public Health Organisations were selected. The Intervention group consisted of two Ontario Public Health Units from the SHAPES-Ontario KE Extension. The Comparison group consisted of one Ontario Public Health Unit and one Manitoba Regional Health Authority. The Comparison organisations did not have the intervention of the KE Extension. Semi-structured interviews were conducted with approximately four to five staff from each organisation. Qualitative analysis identified instances of evidence-informed knowledge use, interactive processes and other factors that influenced knowledge use related to youth physical activity in public health program planning and decision-making. This resulted in comprehensive case studies for each organisation. Cross case analysis identified the dominant similarities and difference in the factors that influence evidence-informed knowledge use across the organisations and how they inter-relate. Results: The cross case analysis indicated that having access to local youth physical activity surveillance data (e.g., SHAPES data) was the most important facilitator of evidence-informed practice. Interactive processes, specifically working groups, partnerships, and knowledge brokers, were found to be an important factor across the fours organisations. These interactive processes were found to have a reciprocal relationship with the information source and the context for sue, further facilitating evidence-informed knowledge use. The specific interactive mechanisms of the KE Extension did not emerge from the data, as the intervention was not intensive enough compared to the other activities within the Intervention organisations. Conclusions: Providing public health practitioners with access to local and relevant research evidence, coupled with intensive, sustained, and consistent interactive support for planning and decision-making may be effective at encouraging evidence-informed practice related to youth physical activity.

Background: Despite the increasing popularity of using social media to disseminate and translate knowledge, there remains a lack of theoretical understanding of how social media can work for healthcare providers’ knowledge use. The purpose of this thesis was to understand how and under what circumstances social media supports healthcare providers’ use of knowledge in clinical practice. Methods: Drawing on the tenets of scientific realism and the context (C) + mechanism (M) = outcome (O) (CMO) heuristic, a three-phase multi-method study was conducted to build a progressive theoretical understanding of how social media supports healthcare providers’ use of knowledge: 1) theory gleaning by a narrative review of five social media initiatives, five theories, and 58 empirical studies; 2) theory refining by a realist review of 32 articles; and 3) theory consolidation by a realist-informed qualitative study with 11 participants. Results: The Social Media for ImpLementing Evidence (SMILE) framework was developed in the theory gleaning phase. In the theory refining phase, two causal explanations were identified: 1) the rationality-driven approach that primarily uses open social media platforms (eight CMOs), and 2) the relationality-driven approach that primarily uses closed social media platforms (six CMOs). In the theory consolidation phase, the program theory developed for open social media platforms from the realist review was refined to ten CMOs, of which four confirmed the original CMOs, four refined the original CMOs, and two were new CMO propositions. The key mechanisms included content developers’ capabilities and capacities, along with healthcare providers’ increased attention; fulfillment of information needs; access to social influence and support; perception of message value and implementability; behaviour capabilities, self-efficacy, intention, and awareness; and ability to exercise professional autonomy. Conclusions: Through a three-phase realist theory development process, a theoretical understanding of how social media supports healthcare providers’ knowledge use in clinical practice was built. Future research is necessary to further develop this framework and investigate the synergistic effects of the rationality and relationality-driven approaches.

A great deal of evaluations are commissioned and conducted every year in social work, but research reports a lack of use of the evaluation results. This may depend on how the evaluations are conducted, but it may also depend on how social workers use evaluation results. The aim of this thesis is to explore and analyse evaluation practice in social work from an empirical, normative, and constructive perspective. The objectives are partly to increase the understanding of how we can produce relevant and useful knowledge for social work using evaluation results and partly, to give concrete suggestions on improvements on how to conduct evaluations. The empirical data has been organised as four cases, which are evaluations of temporary programmes in social work. The source materials are documents and interviews. The results show that findings from evaluations of temporary programmes are sparingly used in social work. Evaluations seem to have unclear intentions with less relevance for learning and improvement. In contrast, the evaluators themselves are using the data for new purposes. These empirical findings are elaborated further by using the knowledge form phronesis, which can be translated into practical wisdom. The overall conclusion is that social work is in need of knowledge that social workers find relevant and useful in practice. In order to meet these needs, researchers and evaluators must broaden their knowledge view and begin to include practical knowledge instead of solely relying on scientific knowledge when conducting evaluations. Finally, a new evaluation model is suggested. It is called phronesis-based evaluation and is argued to have great potential to address and include professionals’ praxis-based knowledge. It advocates a view that takes social work’s dynamic context into serious consideration and acknowledges values and power as important components of the evaluation process.

Objective: The effectiveness and efficiency of health promotion programs and policies relies on evidence to inform and guide these practices in an age of increased cost-efficiency and accountability. To achieve impact and continuous improvement requires the application of evidence to inform and guide population and public health decisions. To facilitate the broader use of knowledge derived from research and evaluation, we must identify the factors that facilitate or impede the use of such evidence among pubic health professionals. At the individual level, we have developed considerable understanding of these factors; however, at the organisational level this understanding lags. The purpose of this study was to examine how the organisational context of Ontario health units influences evidence-informed public health practice. Methods: The study employed a multiple case study design. Data sources included interviews, internal health unit documents and correspondence from three health units (reflecting high, moderate and low use of evidence) participating in the SHAPES-Ontario Knowledge Exchange Extension Project. Qualitative analyses using constant comparative methods intended to maximize trustworthiness identified macro-, meso- and micro-environmental level factors related to the use of local tobacco and physical activity data in public health program planning and evaluation. Individual and cross-case analyses determined the extent of each factor’s influence, how the factors inter-related and identified similarities and differences between sites. Results: Several internal contextual factors were directly and indirectly influential on knowledge use. The most directly influential factors were commitment/receptiveness to use evidence, and the leadership and internal co-ordinated action given to facilitate uptake and use. The degree of each of these factors directly influenced the level of knowledge use. Other internal contextual factors were also influential on utilisation however, through a less direct route. This included organisational mandates/priorities as well as previous experiences with knowledge use which were influential on the other contextual factors, as a result indirectly influencing knowledge use. Overall, it appears the more extensive the contextual factor the more extensive the influence, directly or indirectly, on knowledge use. Additionally, several external factors influential on the internal context and knowledge use within health units were identified, including external relationships, external processes and procedures, external mandates and priorities as well as external resources. The need to adapt to these external contextual factors was necessary in order for health units to have a strong working relationship with external parties (i.e., schools and school boards). As a result of this relationship, health units conformed and adapted to external contexts such as the processes/procedures, priorities and resources of schools. In turn, this adaptation process influenced the type of information utilised by health units as well as how the information was used and to what degree. At this point, the inter-relation between external contextual factors as well as direct connections to internal contextual factors was not entirely clear and requires further examination. Conclusions/Implications: Studying these cases has illuminated the processes and structures that contribute or impede evidence-informed practice. The findings and interpretations of this study help to identify organisational supports that facilitate the use of population health intervention research, in turn, contributing to more effective and efficient health programs and policies aimed at improving population health.

Objective: The effectiveness and efficiency of health promotion programs and policies relies on evidence to inform and guide these practices in an age of increased cost-efficiency and accountability. To achieve impact and continuous improvement requires the application of evidence to inform and guide population and public health decisions. To facilitate the broader use of knowledge derived from research and evaluation, we must identify the factors that facilitate or impede the use of such evidence among pubic health professionals. At the individual level, we have developed considerable understanding of these factors; however, at the organisational level this understanding lags. The purpose of this study was to examine how the organisational context of Ontario health units influences evidence-informed public health practice. Methods: The study employed a multiple case study design. Data sources included interviews, internal health unit documents and correspondence from three health units (reflecting high, moderate and low use of evidence) participating in the SHAPES-Ontario Knowledge Exchange Extension Project. Qualitative analyses using constant comparative methods intended to maximize trustworthiness identified macro-, meso- and micro-environmental level factors related to the use of local tobacco and physical activity data in public health program planning and evaluation. Individual and cross-case analyses determined the extent of each factor’s influence, how the factors inter-related and identified similarities and differences between sites. Results: Several internal contextual factors were directly and indirectly influential on knowledge use. The most directly influential factors were commitment/receptiveness to use evidence, and the leadership and internal co-ordinated action given to facilitate uptake and use. The degree of each of these factors directly influenced the level of knowledge use. Other internal contextual factors were also influential on utilisation however, through a less direct route. This included organisational mandates/priorities as well as previous experiences with knowledge use which were influential on the other contextual factors, as a result indirectly influencing knowledge use. Overall, it appears the more extensive the contextual factor the more extensive the influence, directly or indirectly, on knowledge use. Additionally, several external factors influential on the internal context and knowledge use within health units were identified, including external relationships, external processes and procedures, external mandates and priorities as well as external resources. The need to adapt to these external contextual factors was necessary in order for health units to have a strong working relationship with external parties (i.e., schools and school boards). As a result of this relationship, health units conformed and adapted to external contexts such as the processes/procedures, priorities and resources of schools. In turn, this adaptation process influenced the type of information utilised by health units as well as how the information was used and to what degree. At this point, the inter-relation between external contextual factors as well as direct connections to internal contextual factors was not entirely clear and requires further examination. Conclusions/Implications: Studying these cases has illuminated the processes and structures that contribute or impede evidence-informed practice. The findings and interpretations of this study help to identify organisational supports that facilitate the use of population health intervention research, in turn, contributing to more effective and efficient health programs and policies aimed at improving population health.

This study is about a social workers’ knowledge of shame. Shame in this context is the embarrassment and humiliation that many people feel when they have to apply for financial assistance which equates to approximately half a million people each year in Sweden. The aim of this study is to understand if and how social workers in this field become acquainted with shame, and how it is exposed and then handled by the social workers in the meeting and work with clients. In order to achieve the purpose of the study, we also to some extent, need to study knowledge and how social workers obtain knowledge in social work. To analyse the results and to answer the aim of the qualitative study, the study relied on the concepts of knowledge and embarrassment. Informal interviews were conducted with both managers and social workers at two smaller social offices. Results showed that respondents, as previous research shows, think it is important to use new knowledge and new science in their daily work, but contend that there is a lack of time that makes it difficult for them to assimilate these things. There were different opinions among the social workers and the managers as to what information and research was being communicated. The study showed that none of the respondents knew any research of shame or about how clients perceive the visit to the social services office. The social workers indicated that there was shame clearly evident in the meetings, but that it differs between different categories of people. Remarkably, the respondents stated that they believed that immigrants do not feel shame, while previous research shows that immigrants belong to the group of people that feel most ashamed of having to apply for financial help. How social workers handle shame in meetings with clients differs, and the development of knowledge occurs in different ways. The study concluded that there is a substantial sort of knowledge, and that this takes place along with needs and interests. / Den här studien handlar om handläggares kunskap om skam. Den skam många människor känner som är tvungna att ansöka om ekonomiskt bistånd, vilket cirka en halv miljon människor är i Sverige varje år. Studiens syfte är att förstå om och hur handläggare inom ekonomiskt bistånd får kunskap om skam, hur den eventuellt märks och i så fall hanteras av handläggarna i mötet och arbetet med klienter. För att kunna nå studiens syfte måste vi även i viss mån studera kunskap och hur handläggare får kunskap i det sociala arbetet. För att analysera resultaten och kunna besvara den kvalitativa studiens syfte har studien utgått ifrån begreppen kunskap och skam, och informella intervjuer har genomförts med både handläggare och chefer på två mindre socialkontor. Resultaten visade att respondenterna, enligt vad tidigare forskning visar, anser att det är viktigt med ny kunskap och forskning, men menar att det råder en tidsbrist på arbetsplatserna som gör att de har svårt att tillgodogöra sig detta. Det visade sig råda delade meningar mellan handläggare och chefer när det gäller vilken information och forskning som förmedlas. Studien visade vidare att ingen av respondenterna kände till någon forskning om skam, eller om hur klienter upplever besöket på socialkontoret. Handläggarna uppgav dock att skammen tydligt visar sig i mötet, men att den skiljer sig mellan olika kategorier av människor. Anmärkningsvärt var att respondenterna uppgav att de inte tror att utlandsfödda känner skam, medan tidigare forskning visar att just utlandsfödda tillhör den grupp som känner mest skam över att behöva ansöka om ekonomisk hjälp. Hur handläggarna hanterar skam i mötet med klienter skiljer sig åt, och utvecklandet av kunskap sker på olika sätt utefter erfarenhet. Studien visade vidare att det sker en kraftig sortering av kunskap, och att denna sker utefter behov och intresse.

The aim of this study was to examine what knowledge social workers express about home visits in child welfare investigations and how they know what to do. Sixteen social workers who work with social investigations concerning children were asked to discuss the topic home visit in three focus group interviews in three different municipalities in southern Sweden. The social workers in our focus group interviews mainly discussed the purpose of the home visit, what social workers do during home visits and furthermore their opinions about guidelines and policy documents regarding the home visit.  To get an understanding of what type of knowledge is the basis for social workers use of the home visit, we used Polanyi's concept of 'tacit knowing' as well as the Aristotelian theory of knowledge containing three forms of knowledge, that is, episteme, techne and fronesis. We found that the displaying of ‘tacit knowing’ was a consistent feature in all groups, as they had difficulty expressing their knowledge use. This may be considered as an effect of their knowledge being deeply incorporated into them as social workers. Our observations also indicate that the social workers mostly use the form of knowledge fronesis which is aimed at the common sense and the practical wisdom. Evidence for this was found in how respondents frequently described how they observe the interpersonal interaction, and that they sense the home's atmosphere to get a picture of the child's situation.

Abstract This dissertation focuses on the information use in the bachelor’s theses at Finnish Universities of Applied Sciences (UASs, polytechnics). The study was carried out as a multiple case study based on qualitative data consisting of a sample of bachelor’s theses and research literature. The approach is oriented towards theory building. The study was motivated by earlier research findings about the complex and discursively controversial nature of the Finnish UASs. An approach based on structuralist semiotics and a typology of systems was employed to support the qualitative data-driven analyses. The following types were found: (i) structure-driven, (ii) those emphasizing students’ unique situations, and (iii) reflective combinations of the two. Several strategies related to each type were identified. A model including eight levels was formed proceeding from dichotomies in meaning and issues of agency, to the information use typical of the two main genres, research or practice based thesis, and finally, to the means of manifesting them in textual blocks. The model introduced in the dissertation can be applied in the guidance of thesis processes and in thesis-like project approaches. Writing a thesis appears as a unique episode. The insitutional processes appear as recurring loops in the life span of the UAS. The guiding of the thesis process is manifested as case-by-case interventions combining unique making and institutional routines. The problems encountered by the actors of the thesis processes form potential targets for interventions. The results indicate that the present views on the relevant actors related to the thesis process are too narrow, if they only comprise the student, the teacher and the representatives of project partners as recognized actors. The problematic issues in information seeking and use indicate that the personnel of the library should also be included in the actors of thesis processes. / Tiivistelmä Tutkimus tarkastelee tiedonkäyttöä ammattikorkeakoulun opinnäytetöissä ja esittää mallin tiedonkäytön ilmiöiden konteksteista. Tutkimus on toteutettu teoriaa luovana, aineistolähtöisenä laadullisena monitapaustutkimuksena. Kirjallisuutta luetaan tutkimuksessa yhtenä aineistoryhmänä. Tutkimuksessa käytetään aineistolähtöisen lähestymistavan tukena strukturalistisen semiotiikan klassisesta perinteestä täydennettyä generatiivisen kulun mallia. Opinnäytetyötoiminnan lähtökohtia jäsennetään myös kolmijakona objektivistisiin konemaisiin systeemeihin, yksilöllistä tilannetta painottavaan näkemykseen ja näitä yhdistäviin systeemirakenteisiin. Tutkimusta motivoivat osaltaan tulokset ammattikorkeakoulun kompleksisesta ja diskursiivisesti jännitteisestä luonteesta, joka heijastuu opinnäytetyötoimintaan. Tutkimus on yksittäisistä ammattikorkeakouluista ja niiden yhteenliittymistä riippumaton. Aiempi vastaava tutkimus ammattikorkeakoulun opinnäytetyötoiminnasta on ammattikorkeakoulun henkilökunnan tekemää. Aineistosta on tunnistettu tiedonkäytön ilmiöitä, jotka on jaoteltu tiukkarajaisia järjestelmiä tavoitteleviin, kunkin opinnäytetyötilanteen ainutkertaisuutta korostaviin sekä informaatiokäytäntöihin liittymisen dynamiikkaa hyödyntäviin. Tiedonkäytön ilmiöitä mallinnetaan 8-tasoisena rakenteena edeten merkityksen läsnä- tai poissaolon dikotomiasta toimijuuteen, tekstilajin tiedonkäytöllisiin ominaisuuksiin ja näiden tuottamiseen tekstijaksoissa. Mallia voidaan soveltaa opinnäytetöiden ohjauksessa ja hanketoiminnassa. Opinnäytetyön tekeminen ilmenee ainutkertaisena elämäntapahtumana. Teettäminen on ammattikorkeakoululle toistuva rutiini ja tilaajalle ainutkertaista tai rutiinia. Ohjaaminen on tapauskohtaisia interventioita, liittymisiä tekemis- ja teettämistoimintaan. Tiedonkäytön rakenteita ja ongelmia on syytä käsitellä mahdollisina interventiokohteina ammattikorkeakoulun opinnäytetyötoimintaan ja tietokäsityksiin. Tutkimuksessa tunnistetut ongelmat tiedonhankinnassa ja -käytössä osoittavat, että kirjaston henkilökuntakin tulee käsittää opinnäytetyön toimijaksi.

Drawing upon the concept of governance, this dissertation refers to the two most commonly employed mechanisms that ensure high quality knowledge in electronic repositories as expert-governance and community-governance. In three related but distinct essays, the dissertation examines the governance concept, and investigates contributing knowledge to and using knowledge from electronic repositories governed by these two mechanisms. The first essay sets the conceptual foundations of knowledge governance in repositories, and examines the salient aspects of expert- and community-governance that contribute to knowledge quality. The essay adopts an interpretive research methodology and analyzes empirical data collected from a range of organizations using interviews and online questionnaires. Findings suggest that executing governance functions thoroughly, experts' credibility, and experts' ownership of content contribute to knowledge quality in expert-governed repositories; and executing governance functions continuously and by a diverse set of members, and members' involvement in governance contribute to knowledge quality in community-governed repositories. The second essay investigates the factors that influence individuals to make voluntary contributions to expert- and community-governed repositories. This essay employs the same research methodology used in Essay I and suggests that personal benefits is a stronger motivator for contributing to expert-governed, and reciprocity is a stronger motivator for contributing to community-governed repositories when these two repositories are implemented on an individual basis in organizational settings. When the two repositories are implemented simultaneously, two sets of factors influence contribution behaviors: knowledge-based factors include the type, formality, and sensitivity of knowledge; and need-based factors include the need for collaboration, expert validation, and recognition. The third essay investigates knowledge use from expert- and communitygoverned repositories using a positivist perspective. It conducts a controlled experiment drawing upon elaboration likelihood model, and finds that the credibility of a governance mechanism positively affects subjects’ perceptions of knowledge quality as well as their intentions to use knowledge, which in turn affect their actual knowledge use. This essay also conducts within-subject comparisons using repeated measures ANOVA to shed light on subjects’ perceptions of expert- and community-governed knowledge assets.