Knowledge Translation to Improve Research and Decision-making in Child Health

  • Author / Creator
    Hamm, Michele P
  • Background: Bias is a significant concern in pediatric randomized controlled trials (RCTs), but while there have been numerous calls for improvement in trial conduct, traditional means of education and dissemination of methodological principles have not had a substantial effect on the quality of published research. Objective: To investigate the use of knowledge translation to address the gap between what is known about clinical trial methodology and how pediatric RCTs are designed and conducted in practice. Methods: This study was conducted in four phases. To obtain a descriptive overview of the quality of pediatric RCTs, 300 studies published in 2007 were assessed for methodological quality and reporting. A mixed methods study was then conducted with pediatric trialists to identify the barriers and facilitators in conducting methodologically rigorous RCTs. Corresponding authors of 690 pediatric RCTs published in 2008 and 2009 were surveyed and 13 trialists identified through the Maternal Infant Child and Youth Research Network were interviewed. The feedback from the survey and interviews, and a scoping review on the uses of social media by health care professionals led to the development of a wiki-based educational tool. The wiki was pilot tested for usability by conducting interviews with 15 trialists and methodologists. Results: Most trials from our 2007 sample were at high (59.3%) or unclear (33.0%) risk of bias. Barriers related to conducting methodologically rigorous trials included a lack of knowledge of bias and a negative research culture; facilitators included supportive colleagues and collaborative working relationships. Ninety six studies were identified in the scoping review, highlighting the prominence of social media in health care education. The use of a wiki as an online resource for providing guidance on minimizing bias was viewed favourably by participants, particularly components that put methodological principles into an applied context, such as case studies and examples. Conclusions: While methodological limitations in pediatric RCTs persist, a wiki developed to provide guidance on minimizing bias is a promising knowledge translation intervention to increase the quality of research in child health.

  • Subjects / Keywords
  • Graduation date
  • Type of Item
  • Degree
    Doctor of Philosophy
  • DOI
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
  • Language
  • Institution
    University of Alberta
  • Degree level
  • Department
    • Medical Sciences-Paediatrics
  • Supervisor / co-supervisor and their department(s)
    • Klassen, Terry (Pediatrics)
    • Hartling, Lisa (Pediatrics)
  • Examining committee members and their departments
    • Scott, Shannon (Nursing)
    • Moher, David (Epidemiology and Community Medicine)
    • Forgie, Sarah (Pediatrics)
    • Jones, Allyson (Physical Therapy)
    • Ciliska, Donna (Nursing)
    • Persad, Sujata (Pediatrics)