Examining the process of knowledge exchange and uptake (KEU) involved collaborating with a current decision-maker to determine what knowledge would be examined to increase the understanding why evidence is accepted or rejected as evidence for decision-making. The knowledge selected were the organizational values of a Regional Health Authority from a managerial perspective. The uptake was how the values informed decision-making. The secondary attributes were identified as the conditions and characteristics that enable or challenge using values. As decision-makers prefer usable tools as a research deliverable, a Continuous Improvement Model and Logic Model were populated with the results of a mixed method inquiry. The actionable recommendations are intended to counter challenges and encourage best practices, and provide evaluation indicators. This dissertation will add to the growing literature on how to influence the uptake of evidence through collaboration and effective knowledge transfer plans that aid in bridging the know-do gap.

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Objective: The objective of this study was to understand school administrators’ experience using the Youth Smoking Survey (YSS) school smoking profile to inform and improve future knowledge exchange strategies with schools. Methods: This study employed a two-phase, sequential explanatory mixed method approach. Phase One consisted of a close-ended mail-out questionnaire to 111 school administrators who had not viewed their schools’ feedback report. Phase Two consisted of telephone interviews with consenting questionnaire participants. Results: Of the 111 eligible schools, 71% (N=79) responded to the questionnaire; 29 school administrators participated in the follow-up interviews. Overall, questionnaire respondents rated the feedback report’s layout very positively in terms of clarity and relevancy, but somewhat less positively on timeliness and level of detail (too much). The majority of school administrators (82%) plan to use the feedback report when planning programs, curriculum, or events, and would primarily discuss the report with teachers, students, and parents. While interview participants provided positive feedback regarding the communication quality, relevance, timeliness, and content of the smoking profile, further investigation revealed a weak relationship between these information characteristics and knowledge use (conceptual and instrumental). The weak association could be attributed to the small sample (N=29), the fact that participants had not previously viewed their feedback reports, and did not have adequate time to incorporate the findings into their practice. Conclusions: The findings have contributed to our understanding of the knowledge utilization process of school administrators. Specifically, it examined how end users perceived source and information characteristics in school smoking profile, and the extent conceptual and instrumental knowledge use are associated with the these characteristics. Findings will guide profile revisions and process.

This study employs classic grounded theory methodology to produce a theory of rehumanising knowledge work through fluctuating support networks in the knowledge workplace. Data consisted of field notes and transcripts from personal interviews and focus groups. Participants were drawn from the public and private sectors and a variety of professional fields under the general rubric of knowledge work. Data were analysed using the full complement of procedures that comprise classic grounded theory methodology, including theoretical sensitivity, core emergence, constant comparison of empirical indicators to theoretical saturation and hand sorting of conceptual memos to achieve theoretical integration. The thesis explains the basic social structural process of fluctuating support networks through which knowledge workers self-organise to overcome dehumanised work environments, consequent of a rapidly changing workplace context. Such networks operate outside the formal organisation. They are epiphenomenal - self-emerging, self-organising, and self-sustaining. Participation is voluntary and intuitive. The core variable of the theory is the basic social psychological process of rehumanising. Through fluctuating support networks, knowledge workers rehumanise their work and work environments. Rehumanising gives meaning to work while sustaining energy and commitment. Rehumanising is characterised by authenticity, depth and meaning, recognition and respect, safety and healing and kindred sharing. Network relationships offer validation and support. Network members pursue shared interests and passions. Network activities are characterised by challenge, experimentation, creativity and learning, providing members with renewed energy and learning. The resultant sense of achievement builds confidence and passion for sustained network engagement. The contributions of the thesis to knowledge centre on the role of informal networks in the knowledge workplace and relate to theories of organisation, social networking, motivation and social learning. Knowledge of fluctuating support networks will enable managers to understand their functionality as psychological infrastructure for resolving workers’ concerns and needs in coping with change in the knowledge workplace

Objective: The objective of this study was to understand school administrators’ experience using the Youth Smoking Survey (YSS) school smoking profile to inform and improve future knowledge exchange strategies with schools. Methods: This study employed a two-phase, sequential explanatory mixed method approach. Phase One consisted of a close-ended mail-out questionnaire to 111 school administrators who had not viewed their schools’ feedback report. Phase Two consisted of telephone interviews with consenting questionnaire participants. Results: Of the 111 eligible schools, 71% (N=79) responded to the questionnaire; 29 school administrators participated in the follow-up interviews. Overall, questionnaire respondents rated the feedback report’s layout very positively in terms of clarity and relevancy, but somewhat less positively on timeliness and level of detail (too much). The majority of school administrators (82%) plan to use the feedback report when planning programs, curriculum, or events, and would primarily discuss the report with teachers, students, and parents. While interview participants provided positive feedback regarding the communication quality, relevance, timeliness, and content of the smoking profile, further investigation revealed a weak relationship between these information characteristics and knowledge use (conceptual and instrumental). The weak association could be attributed to the small sample (N=29), the fact that participants had not previously viewed their feedback reports, and did not have adequate time to incorporate the findings into their practice. Conclusions: The findings have contributed to our understanding of the knowledge utilization process of school administrators. Specifically, it examined how end users perceived source and information characteristics in school smoking profile, and the extent conceptual and instrumental knowledge use are associated with the these characteristics. Findings will guide profile revisions and process.

The integrative chapter of this thesis explains how the nominated papers, when combined, meet the University of Exeter’s assessment criteria for the award of PhD by Publication. It argues that a coherent contribution to knowledge emerges from the three strands of research discussed, namely: (i) examinations of research and innovation policy, notably via the work of tourism academics and the knowledge exchange practices of practitioners; (ii) investigations into the practices of small businesses in tourism, particularly in relation to their articulation with public policy at a local level; (iii) an assessment of the professionalization of tourism, via the conceptual lens of corporate professionalization. Collectively, these publications explain important aspects of business, notably small business, dynamics in tourism; my contribution has been to provide new conceptualisations of tourism organisations and explanations for their behaviour that advance existing academic accounts. The theoretical contributions made offer public policy-makers greater scope for developing interventions to more effectively influence business behaviour than at present. The chapter also reviews, briefly, the range of methods of enquiry used in my research and my philosophical position in relation to knowledge construction. Finally, the limitations of my work and my current research agenda are discussed.

Background: The process of shared decision making (SDM), a key component of interprofessional (IP) practice, provides an opportunity for the separate and shared knowledge and skills of care providers to synergistically influence the client / patient care provided. The aim of this study was to understand how different professional groups perceive IPSDM, their role as effective participants in the process and how they ensure their voices are heard. Methods: A sequential explanatory mixed methods design was used consisting of a realist review of the literature about IPSDM in intensive care, a survey of the IP team (n=96; RR-81.4%) about collaboration and satisfaction with the decision making process in NICU, semi-structured interviews with a sample of team members (n=22) working in NICU, and observation of team decision making interactions during morning rounds over a two week period. A tertiary care NICU in Canada was the study setting. Findings: The study revealed a number of key findings that are important to our increased understanding of IPSDM. Healthcare professionals’ (HCP) views differ about what constitutes IPSDM. The nature of the decision (triage, chronic condition, values sensitive) is an important influencing factor for IPSDM. Four key roles were identified as essential to the IPSDM process: professional expert, leader, synthesizer and parent. IPSDM involves collaboration, sharing, weighing and building consensus to overcome diversity. HCPs use persuasive knowledge exchange strategies to ensure their voices are heard during IPSDM. Buffering power differentials and increasing agreement about best options lead to well-informed decisions. A model was developed to illustrate the relationships among these concepts. Conclusions: Findings from this study improve understanding of how different members of the team participate in the IPSDM process, and highlight effective strategies to ensure professional voices are heard, understood and considered during deliberations.

Background: The process of shared decision making (SDM), a key component of interprofessional (IP) practice, provides an opportunity for the separate and shared knowledge and skills of care providers to synergistically influence the client / patient care provided. The aim of this study was to understand how different professional groups perceive IPSDM, their role as effective participants in the process and how they ensure their voices are heard. Methods: A sequential explanatory mixed methods design was used consisting of a realist review of the literature about IPSDM in intensive care, a survey of the IP team (n=96; RR-81.4%) about collaboration and satisfaction with the decision making process in NICU, semi-structured interviews with a sample of team members (n=22) working in NICU, and observation of team decision making interactions during morning rounds over a two week period. A tertiary care NICU in Canada was the study setting. Findings: The study revealed a number of key findings that are important to our increased understanding of IPSDM. Healthcare professionals’ (HCP) views differ about what constitutes IPSDM. The nature of the decision (triage, chronic condition, values sensitive) is an important influencing factor for IPSDM. Four key roles were identified as essential to the IPSDM process: professional expert, leader, synthesizer and parent. IPSDM involves collaboration, sharing, weighing and building consensus to overcome diversity. HCPs use persuasive knowledge exchange strategies to ensure their voices are heard during IPSDM. Buffering power differentials and increasing agreement about best options lead to well-informed decisions. A model was developed to illustrate the relationships among these concepts. Conclusions: Findings from this study improve understanding of how different members of the team participate in the IPSDM process, and highlight effective strategies to ensure professional voices are heard, understood and considered during deliberations.

The NEXUS Portal provides an in-depth profile of the research and achievements of NEXUS on a quarterly basis. This special issue is dedicated to knowledge exchange.

Objective: The primary goal of this study is to understand what factors contribute to teachers and administrators involved in these projects viewing the YSS feedback reports as effective and useable in order to continue improving the design and content of the reports to encourage knowledge utilization and integration at the school level. Methods: This study employed a mixed methods approach that included both qualitative and quantitative methods of data analysis. Specifically this study employed a concurrent nested design wherein quantitative data analysis was performed concurrently within a predominantly qualitative study. The qualitative portion consisted of telephone interviews with YSS participants that had viewed their School Profile. The quantitative portion was a secondary data analysis that examined the relationship between a downloading behaviour outcome and various school characteristics and contextual factors. Results: Of the 57 eligible participants that were identified from the 2010-11 YSS sample, 8 participated in telephone interviews; in the quantitative analysis data from 448 of the schools that participated in the 2010-11 YSS were used. Overall interview respondents rated the School Profile as a valuable and utile KTA tool for them and their school communities. Aspects of the profile that contributed to its value were the tailored and quantitative information it provides; the clarity and readability of its design; the ease of accessing and sharing the profile in an electronic format; and the broad range of health topics covered in the Profile. Participants were also asked to discuss their use and sharing of the profile with almost all respondents indicating that they had shared the profile within their school and/or community. Instrumental and conceptual knowledge use were the most common forms described by participants. Participants also commonly expressed a desire for more resources to support the continued use and uptake of the Profile in their school and community. The quantitative analysis revealed a statistical relationship between location in certain provinces and downloading behaviour but no other predictor variables proved significant in the full logistic model. Conclusion: The findings have contributed to understanding what facets of the School Profile contribute to its value as perceived by the individuals using it and point to a few avenues of further investigation regarding the Profile and its function within the YSS. The positive response by interview participants indicates that the Profile in its current state is a valuable and useful tool, however the use of additional strategies to support its uptake and utilization could be improved. The findings that location in certain provinces, some of which have collaborative projects with the YSS, may influence Profile downloading and health outcomes within schools is a potentially important avenue for further investigation and refinement of YSS KE systems.