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Conducting conservation research and establishing protected areas (PAs) based on research results are critical to biodiversity conservation. However, the effect of research and PAs on conservation of threatened species has rarely been evaluated simultaneously. We collected data on PAs from 2000 for 2021 and determined the number of publications on global primates (published from 1950 to 2021) to assess the effect of PAs, research, and biological and socioeconomic factors on the current International Union for Conservation of Nature endangered status and change in status. We used the MCMCglmm package to conduct a phylogenetic comparative analysis to control the phylogenetic relationship of primate species. The status of 24.6% (82 of 333) of species assessed at least twice declined. Only the black lion tamarin (Leontopithecus chrysopygus) had an improved status. Species with status declines mostly occurred on the south coast of West Africa and in Madagascar. PAs covered 22.1% of each species' range. Forest loss in PAs (5.5%) was significantly lower than forest loss within 5 km outside PAs (13.8%), suggesting PAs effectively mitigated forest loss. Both the median number of total publications and conservation publications on critically endangered species were higher than those of other categories. Models showed that PA coverage and number of publications or conservation-focused publications were not related to current status or change in status over time. A decline in status was not related to creation of PAs or increase of research since the last assessment. Our results suggest that current PAs and research are not reversing the extinction crisis of global primates. Doing more conservation-oriented research, strengthening management of current PAs, and expanding PAs will be needed to protect primates globally.

Efectos de la cobertura e investigación de áreas protegidas sobre el estado de conservación de los primates a nivel mundial Resumen La investigación para la conservación y la creación de áreas protegidas (AP) con base en sus resultados son de suma importancia para conservar la biodiversidad. Sin embargo, pocas veces se ha analizado de forma simultánea el efecto de la investigación y las AP sobre la conservación de especies amenazadas. Recolectamos datos sobre las AP entre el 2000 y el 2021 y determinamos el número de artículos sobre primates publicados entre 1950 y 2021 para evaluar el efecto de las AP, la investigación y los factores biológicos y socioeconómicos sobre el estado actual de en peligro y de cambio de estatus de la Unión Internacional para la Conservación de la Naturaleza. Usamos el paquete MCMCglmm para realizar un estudio filogenético comparativo para analizar la relación filogenética del estado de las especies y del cambio de estatus de primates. El estatus del 24.6% (82 de 333) de las especies analizadas declinó al menos dos veces. Solamente el tití leoncito (Leontopithecus chrysopygus) tuvo una mejoraría en su estado. Las especies con declinación en su estado se ubicaron principalmente en la costa sur del Oeste de África y en Madagascar. Las AP cubrieron el 22.1% de la distribución de cada especie. La pérdida de bosques en las AP (5.5%) fue mucho menor que la pérdida dentro de los primeros 5 km fuera de las AP (13.8%), lo que sugiere que las AP mitigan eficientemente la pérdida de bosque. Tanto el número medio de publicaciones totales como el de publicaciones sobre la conservación de especies en peligro crítico fue mayor que aquellos de cualquier otra categoría. Los modelos mostraron que la cobertura de AP y el número de publicaciones o de publicaciones enfocadas en la conservación no estaban relacionados con el estado actual o el cambio de estado. La declinación del estado no estuvo relacionada con la creación de AP o el incremento en la investigación desde nuestro último análisis. Nuestros resultados sugieren que la investigación y las AP actuales no están revirtiendo la crisis mundial de extinción de primates. Para proteger a los primates se necesitará realizar más investigación orientada a la conservación, fortalecer el manejo actual de las AP, así como expandirlas.

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Advancing equity as a priority is increasingly declared in response to decades of evidence showing the association between poorer health outcomes and the unfair distribution of resources, power, and wealth across all levels of society. Quandries present, however, through incongruence, vagueness and disparate interpretations of the meaning of equity dilute and fragment efforts across research, policy and practice. Progress on reducing health inequities is, in this context, unsurprisingly irresolute. In this article, we make a case for equity science that reimagines the ways in which we (as researchers, as systems leaders, as teachers and mentors, and as citizens in society) engage in this work. We offer a definition of equity, its determinants, and the paradigmatic foundations of equity science, including the assumptions, values, and processes., and methods of this science. We argue for an equity science that can more meaningfully promote coherent alignment between intention, knowledge and action within and beyond the health sciences to spark a more equitable future.

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A pragmatic informatics approach was developed to create knowledge tools for co-design of a new model of mental healthcare in cardiac surgery The real-world evidence generation leverages existing technological platforms and routine data collections plus tailored brief tools, surveys and qualitative data.

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BACKGROUND: The burden of emergency general surgery (EGS) is higher compared to elective surgery. Acute appendicitis (AA) is one of the most frequent diseases and its management is dictated by published international clinical practice guidelines (CPG). Adherence to CPG has been reported as heterogeneous. Barriers to clinical implementation were not studied. This study explored barriers to adherence to CPG and the clinico-economic impact of poor compliance. METHODS: Data were extracted from the three-year data lock of the REsiDENT-1 registry, a prospective resident-led multicenter trial. We identified 7 items from CPG published from the European Association of Endoscopic Surgery (EAES) and the World Society of Emergency Surgery (WSES). We applied our classification proposal and used a five-point Likert scale (Ls) to assess laparoscopic appendectomy (LA) difficulty. Descriptive analyses were performed to explore compliance and group comparisons to assess the impact on outcomes and related costs. We ran logistic regressions to identify barriers and facilitators to implementation of CPG. RESULTS: From 2019 to 2022, 653 LA were included from 24 centers. 69 residents performed and coordinated data collection. We identified low compliance with recommendations on peritoneal irrigation (PI) (25.73%), abdominal drains (AD) (34.68%), and antibiotic stewardship (34.17%). Poor compliance on PI and AD was associated to higher infectious complications in uncomplicated AA. Hospitalizations were significantly longer in non-compliance except for PI in uncomplicated AA, and costs significantly higher, exception made for antibiotic stewardship in complicated AA. The strongest barriers to CPG implementation were complicated AA and technically challenging LA for PI and AD. Longer operative times and the use of PI negatively affected antibiotic stewardship in uncomplicated AA. Compliance was higher in teaching hospitals and in emergency surgery units. CONCLUSIONS: We confirmed low compliance with standardized items influenced by environmental factors and non-evidence-based practices in complex LA. Antibiotic stewardship is sub-optimal. Not following CPG may not influence clinical complications but has an impact in terms of logistics, costs and on the non-measurable magnitude of antibiotic resistance. Structured educational interventions and institutional bundles are required.

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AIM: This paper focuses on the co-creation approach to develop culturally and linguistically appropriate educational interventions to promote the uptake of skin-to-skin contact. BACKGROUND: Skin-to-skin contact is beneficial to mothers and newborns, but it is rarely practised in Saudi Arabia. Co-creation involving service users to develop evidence-based resources about skin-to-skin contact relevant to the target population is an approach increasingly used to improve health outcomes. METHOD: A three-step method was used to develop the educational intervention including: (1) a systematic scoping review to identify the evidence-based information for education regarding skin-to-skin contact between mother and baby post-birth; (2) Co-creation of the resources using the Knowledge to Action Framework. The resource was developed collaboratively with academic staff from Australia and health care staff from Saudi hospital; and (3) Finalisation of the educational materials through a consensus development conference and Implementation. FINDINGS: The systematic scoping review generated useful information about the gaps in knowledge and barriers to skin-to-skin practice. Information was tailored and translated according to the needs of the Saudi population. A variety of educational materials including pamphlets, a PowerPoint presentation and a short video were co-created with the help of the stakeholders. Consensus was reached when 93% (87-100%) of the participants agreed about the mode of delivery and appropriateness of the PowerPoint and 100% agreed on the e-pamphlets and video. DISCUSSION: The skin-to-skin online educational resource was created by integrating co-creation principles and the Knowledge to Action framework with the aim of developing and customizing a culturally appropriate intervention using the best available evidence. By engaging in co-creation stakeholders gained a sense of ownership and were more willing to adopt and implement the intervention.

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INTRODUCTION: Medical students historically receive little to no preclinical exposure to surgery and surgical subspecialties. As a result, by the time they reach their clinical clerkship time, students often have already found interest in other specialties. The goal of this study is to utilize the knowledge to action (KTA) implementation framework to design and refine a clinical immersion experience during the second year of medical school. METHODS: A total of 94 second-year Harvard Medical School students underwent the surgical immersion experience between 2019 and 2022 (the program was postponed in 2020 due to COVID). The development and refinement of the curriculum were nicely modeled by the KTA implementation framework. We identified a gap in medical student preclinical education, adapted a curriculum for preclinical medical students at Massachusetts General Hospital , selected the curriculum components to provide a high-level overview of surgery, monitored the student experience, and evaluated outcomes using the student surveys. Based on the survey results, inductive thematic analysis was utilized to identify prominent positive and negative themes. The feedback was then used to tailor subsequent iterations of the immersion experience. RESULTS: Eighty-eight medical students completed the survey (RR = 93.6%), and 85% rated the immersion experience as "excellent", 11% "very good", 4% "good", and 0% "fair" or "poor". There was no significant difference in ratings between sessions. Several key themes were identified, including changed perceptions, diversity of surgical fields, teamwork, surgery clerkship preparedness, and the need for more preclinical exposure. CONCLUSIONS: Preclinical medical students gave overwhelmingly positive reviews of the surgical immersion experience. A half-day intervention is sufficient to begin changing students' views toward surgery, disproving stereotypes, and even inspiring some to consider a surgical field themselves. In addition, the KTA implementation framework is a useful model for the development and refinement of medical education curricula.

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BACKGROUND:  Literature supports the mismatch between empirical evidence and service delivery. Given this knowledge gap, it is important that research undertaken has a theoretical foundation, considers the context and stakeholders to confirm its need and that it can be feasibly implemented and sustained. OBJECTIVES:  The study aimed to facilitate knowledge translation in oral care using the knowledge-to-action (K2A) process model among nurses. METHOD:  The study was completed in an acute hospital in South Africa. A qualitative design with ethnography incorporating video-recordings and semi-structured interviews were used. A total of 139 nurses were recruited using random purposive sampling and received training on oral care, which was monitored. Inductive thematic analysis was completed. RESULTS:  The model facilitated information transfer and implementation of oral care by nurses. CONCLUSION:  With clear directions for use and theoretical underpinning, the K2A model was well-suited to the needs of the study and stakeholders, and the complexity of the context. For challenging contexts such as public healthcare institutions in South Africa, this was ideal and critical to the success of the intervention.Contribution: When nursing managers show interest and recognise nurses for their role in implementation of interventions, the buy-in, support and sustained use of that intervention is enhanced. A model such as the K2A promotes involvement of all stakeholders (e.g. nurses and their managers) in the design and planning for implementation of an intervention, and these are critical for the successful and feasible use of the intervention.

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To improve the dissemination and actionability of mental health research, many mental health professionals have developed online informational resources to increase the general public's awareness of mental health difficulties and available treatments. Yet, limited information exists on the quality and scope of these resources. This study aimed to explore the scope and quantity of online, free, evidence-based mental health resources. Fifty-two mental health professionals nominated 178 resources, which predominantly consisted of homepages and links to more information. When reviewing the original nominations, our team identified an additional 290 resources (e.g., fact sheets linked from a nominated homepage). Of the 468 total nominated resources, 72 were screened out due to not meeting the inclusion criteria of being free (inter-screener reliability = 95%), evidence-based (inter-screener reliability = 94%), and online (inter-screener reliability = 96%). Nominated resources most commonly covered anxiety and obsessive-compulsive disorder (n = 67) and suicide (n = 60). Resources providing information about the mental health problem were most common (n = 210) and resources providing information about immediate help (e.g., hotline) were least common (n = 57). Our findings indicate many free, online, evidence-based resources are available and raise questions of whether efforts to disseminate mental health research are recreating the issue of information overload. Other considerations and future directions for improving the utilization and synthesizing of available resources are discussed.

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BACKGROUND: Collective agreement about the importance of centering equity in health research, practice, and policy is growing. Yet, responsibility for advancing equity is often situated as belonging to a vague group of 'others', or delegated to the leadership of 'equity-seeking' or 'equity-deserving' groups who are tasked to lead systems transformation while simultaneously navigating the violence and harms of oppression within those same systems. Equity efforts also often overlook the breadth of equity scholarship. Harnessing the potential of current interests in advancing equity requires systematic, evidence-guided, theoretically rigorous ways for people to embrace their own agency and influence over the systems in which they are situated. ln this article, we introduce and describe the Systematic Equity Action-Analysis (SEA) Framework as a tool that translates equity scholarship and evidence into a structured process that leaders, teams, and communities can use to advance equity in their own settings. METHODS: This framework was derived through a dialogic, critically reflective and scholarly process of integrating methodological insights garnered over years of equity-centred research and practice. Each author, in a variety of ways, brought engaged equity perspectives to the dialogue, bringing practical and lived experience to conversation and writing. Our scholarly dialogue was grounded in critical and relational lenses, and involved synthesis of theory and practice from a broad range of applications and cases. RESULTS: The SEA Framework balances practices of agency, humility, critically reflective dialogue, and systems thinking. The framework guides users through four elements of analysis (worldview, coherence, potential, and accountability) to systematically interrogate how and where equity is integrated in a setting or object of action-analysis. Because equity issues are present in virtually all aspects of society, the kinds of 'things' the framework could be applied to is only limited by the imagination of its users. It can inform retrospective or prospective work, by groups external to a policy or practice setting (e.g., using public documents to assess a research funding policy landscape); or internal to a system, policy, or practice setting (e.g., faculty engaging in a critically reflective examination of equity in the undergraduate program they deliver). CONCLUSIONS: While not a panacea, this unique contribution to the science of health equity equips people to explicitly recognize and interrupt their own entanglements in the intersecting systems of oppression and injustice that produce and uphold inequities.

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Background: Familial hypercholesterolemia (FH) is vastly underdiagnosed and causes an increased risk for sudden cardiac death. Cardiology providers (CHCPs) are in an ideal position to care for FH patients. This research aimed to understand the practice behaviors of CHCPs in the screening, diagnosis, and management of FH. Methods: Adaptation of an existing FH knowledge tool guided survey development. The results of the quantitative survey guided development of the interview protocol. CHCPs were recruited in the Division of Cardiology at Columbia University Irving Medical Center (CUIMC). A review of the educational materials offered by the Division of Cardiology was conducted to identify FH knowledge domains presented. Results: CHCPs with MDs, at CUIMC for 6-10 years, in clinical practice for 1-5 years, and in inpatient services had the highest average total knowledge scores. CHCPs with RNs, at CUIMC for less than 1 year, in clinical practice for 6-10 years, and in Cath Lab had the lowest average knowledge scores. Four themes emerged - variability in FH care; issues related to addressing FH at institutional, practice setting, and individual levels; importance of identifying FH early; and intervention approaches to overcome barriers to caring for FH patients in cardiology. CHCPs with MDs or with experiential FH knowledge described FH care beyond screening. The document review revealed that only MDs were provided lectures pertaining to FH. Conclusions: Future interventions should increase didactic and experiential FH knowledge incorporating institutional, local, and national FH resources. Improving FH care can reduce FH-related morbidity and mortality, as well as improve FH health outcomes.

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The 1616 Program is a newly developed and evidence-informed story-based positive youth development (PYD) program for young ice hockey players (10-12 years of age) in North America. The program uses elite ice hockey players as role models-through story-telling-to serve as inspirational figures to engage youth athletes and important social agents (i.e., parents, coaches) with evidence-informed PYD concepts. The objective of this study was to use a Proof-of-Concept evaluation to assess whether the 1616 Program 'worked' in enhancing PYD outcomes and to determine if the concepts were engaging and enjoyable for youth, their parents, and coaches. The 5 week Proof-of-Concept evaluation was conducted with 11 ice hockey teams (n = 160 youths, 93 parents, and 11 coaches), encompassing both qualitative (e.g., focus groups) and quantitative (e.g., retrospective pretest-posttest questionnaires) processes and outcome assessments. Results showed that the program was well received by participants and positively impacted the intended outcomes. Overall, the data presented in this Proof-of-Concept evaluation was deemed to support the development and implementation of the full-scale 1616 Program for a more comprehensive evaluation.

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The use of communities of practice (CoP) to support the application of knowledge in improved geriatric care practice is not widely understood. This case study's aim was to gain a deeper understanding of the knowledge-to-action (KTA) processes of a CoP focused on environmental design, to improve how persons with dementia find their way around in long-term care (LTC) homes. Qualitative data were collected (key informant interviews, observations, and document review), and analysed using emergent coding. CoP members contributed extensive knowledge to the KTA process characterized by the following themes: team dynamics, employing a structured process, technology use, varied forms of knowledge, and a clear initiative. The study's CoP effectively synthesized and translated knowledge into practical tools to inform changes in practice, programs, and policy on dementia care. More research is needed on how to involve patients and caregivers in the KTA processes, and to ensure that practical application of knowledge has financial and policy support.

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PURPOSE: Employment participation offers benefits including income, sense of accomplishment, social engagement, and meaningful contribution to society. Rates of competitive employment of youth with disabilities are amongst the lowest in society, despite having capacity and motivation to participate in the workplace. The marginalization of young workers with disability presents a lost opportunity for youth, potential employers, and social care systems. In order to engage young people with disabilities in employment, we present an integrated, community-based model for employment participation preparation. MATERIALS AND METHODS: The employment participation pathway model is based on best available evidence and 15 years of program delivery for youth with disabilities preparing to transition out of school and into employment in the Canadian context. It was conceptualized using the Knowledge to Action framework and presented for consideration in the current paper. RESULTS: Starting early, taking a person-directed approach to planning, and considering the individual and our systems contribute to effective and comprehensive transition to employment. CONCLUSIONS: The employment participation model provides evidence and examples for service providers to consider integrating into their repertoire and begin to construct similar pathways to equip their clients and families with skills, capacities, and knowledge as they journey towards workplace participation.IMPLICATIONS FOR REHABILITATIONEmployment for individuals with disabilities is lower than the national average, with rates being even lower for young people (ages 15-25) with disabilities.Low workplace participation for individuals with disabilities is particularly troubling due to the myriad social and health benefits of engagement in employment.Programs that start early (during high school) and provide ongoing, community-integrated support are reported to be most beneficial to the eventual job attainment and retention for young job seekers with disabilities.The presented employment participation pathway model that was developed using the Knowledge to Action Framework integrates evidence and best practices to support service providers in facilitating progressive workplace participation for clients and families.

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PURPOSE: Whilst anyone can be scammed, individuals with acquired brain injury (ABI) may have unique risk factors to cyberscams for which tailored interventions are required. To address this, a co-design approach was utilised to develop cybersafety resources with people with living experience of ABI and scams. This study aimed to evaluate the co-design experience to inform future utilisation of co-design methods. METHOD: Semi-structured qualitative interviews explored perceived benefits and challenges, level of support and the co-design process for people with ABI (n= 7) and an attendant care worker (ACW) (n= 1). Transcripts were analysed using a six-stage reflexive thematic analysis. RESULTS: Five themes were identified: "An Intervention Addressing Shame"; "Feeling Validated and Valued"; "Experiencing a 'Profound Change Amongst a Group of Peers'"; 'Gaining Stronger Scam Awareness'; and 'Taking Ownership'. Adjustments to support communication, memory impairments and fatigue in the co-design process were recommended. CONCLUSIONS: Participant reflections on the co-design process extended beyond resource design and highlighted therapeutic benefits of increased insight and emotional recovery from shame. Likely mechanisms underpinning these benefits were the peer group format and opportunities to make meaningful contributions. Despite identified challenges in facilitating co-design projects, the practical and emotional benefits reported by participants underscore the value of co-design with people with ABI. Implications for rehabilitationIndividuals with acquired brain injury (ABI) may be at increased risk of cyberscams due to cognitive impairments, for which tailored cyberscam interventions are required.Using a co-design approach maximises the relevance of training resources for individuals with ABI.Using a collaborative co-design approach to developing cybersafety training resources may facilitate scam awareness and peer support.Support for communication, memory impairments and fatigue may be necessary in co-design efforts with people with ABI.

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The knowledge produced by conservation scientists must be actionable in order to address urgent conservation challenges. To understand the process of creating actionable science, we interviewed 71 conservation scientists who had participated in 1 of 3 fellowship programs focused on training scientists to become agents of change. Using a grounded theory approach, we identified 16 activities that these researchers employed to make their scientific products more actionable. Some activities were more common than others and, arguably, more foundational. We organized these activities into 3 nested categories (motivations, strategies, and tactics). Using a co-occurrence matrix, we found that most activities were positively correlated. These correlations allowed us to identify 5 approaches, framed as profiles, to actionable science: the discloser, focused on open access; the educator, focused on science communication; the networker, focused on user needs and building relationships; the collaborator, focused on boundary spanning; and the pluralist, focused on knowledge coproduction resulting in valuable outcomes for all parties. These profiles build on one another in a hierarchy determined by their complexity and level of engagement, their potential to support actionable science, and their proximity to ideal coproduction with knowledge users. Our results provide clear guidance for conservation scientists to generate actionable science to address the global biodiversity conservation challenge.

Cinco estrategias para producir ciencia práctica en la conservación Resumen El conocimiento producido por los científicos de la conservación debe ser práctico para poder abordar los obstáculos urgentes que enfrenta la conservación. Entrevistamos a 71 científicos de la conservación que participaron en uno de los tres programas de becas enfocados en la formación de científicos como agentes de cambio para entender el proceso de creación de la ciencia práctica. Usamos una estrategia de teoría fundamentada para identificar 16 actividades empleadas por estos investigadores para hacer más prácticos sus productos científicos. Algunas actividades fueron más comunes que otras y, probablemente, más fundamentales. Organizamos estas actividades en tres categorías anidadas: motivaciones, estrategias y tácticas. Con una matriz de co-ocurrencia, encontramos que la mayoría de las actividades estaban correlacionadas positivamente. Estas correlaciones nos permitieron identificar cinco estrategias, encuadradas como perfiles, para la ciencia práctica: la reveladora, enfocada en el acceso abierto; la educativa, enfocada en la comunicación de la ciencia; la interconectora, enfocada en las necesidades del usuario y en construir relaciones; la colaborativa, enfocada en la expansión de las fronteras; y la pluralista, enfocada en la coproducción del conocimiento como el origen de resultados valiosos para todas las partes. Estas estrategias se apoyan entre sí en una jerarquía determinada por su complejidad y el nivel de compromiso, su potencial para apoyar la ciencia práctica y su proximidad a la coproducción ideal con los usuarios del conocimiento. Nuestros resultados proporcionan directrices claras para que los científicos de la conservación generen ciencia práctica para abordar los retos de conservación que enfrenta la biodiversidad mundial.

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BACKGROUND: When a new guideline is published there is a need to understand how its recommendations can best be implemented in real-world practice. Yet, guidelines are often published with little to no roadmap for organizations to follow to promote adherence to their recommendations. The purpose of this study was to evaluate the impact of using a common process model to implement a single clinical practice guideline across multiple physical therapy clinical settings. METHODS: Five organizationally distinct sites with physical therapy services for patients with peripheral vestibular hypofunction participated. The Knowledge to Action model served as the foundation for implementation of a newly published guideline. Site leaders conducted preliminary gap surveys and face-to-face meetings to guide physical therapist stakeholders' identification of target-behaviors for improved guideline adherence. A 6-month multimodal implementation intervention included local opinion leaders, audit and feedback, fatigue-resistant reminders, and communities of practice. Therapist adherence to target-behaviors for the 6 months before and after the intervention was the primary outcome for behavior change. RESULTS: Therapist participants at all sites indicated readiness for change and commitment to the project. Four sites with more experienced therapists selected similar target behaviors while the fifth, with more inexperienced therapists, identified different goals. Adherence to target behaviors was mixed. Among four sites with similar target behaviors, three had multiple areas of statistically significantly improved adherence and one site had limited improvement. Success was most common with behaviors related to documentation and offering patients low technology resources to support home exercise. A fifth site showed a trend toward improved therapist self-efficacy and therapist behavior change in one provider location. CONCLUSIONS: The Knowledge to Action model provided a common process model for sites with diverse structures and needs to implement a guideline in practice. Multimodal, active interventions, with a focus on auditing adherence to therapist-selected target behaviors, feedback in collaborative monthly meetings, fatigue-resistant reminders, and developing communities of practice was associated with long-term improvement in adherence. Local rather than external opinion leaders, therapist availability for community building meetings, and rate of provider turnover likely impacted success in this model. TRIAL REGISTRATION: This study does not report the results of a health care intervention on human participants.

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BACKGROUND: Patient Reported Outcome Measures (PROMs) have been shown to be valid and reliable indicators of health status and treatment outcomes, however, the current knowledge, understanding, and utilisation of PROMs within the Australian Chiropractic profession is limited. This study used the New World Kirkpatrick Model (NWKM) to evaluate whether an online PROM education package could improve knowledge, confidence, attitude, and utilisation of PROMs by chiropractors in Australia. METHODS: A longitudinal cohort interventional study of chiropractors in Australia. The recruitment phase and data collection period occurred from November 2020 - May 2021. Participants completed three online surveys two weeks before, four weeks after, and 12 weeks after receiving an online education package that included ten evidence-based region-specific modules on PROMs. Survey questions were grouped into five subthemes for analysis according to the NWKM levels: (1) Reaction; (2) Learning - knowledge; (3) Learning - confidence; (4) Behaviour - attitude; (5) and Behaviour - utilisation). RESULTS: Of the 116 participants that enrolled in the study, 43 completed all three survey and were included in the analysis. There was very positive reaction to the education package with mean response scores (1-5 Likert scale) for the reaction questions ranging from 3.75 to 4.43. There was a small, but significant, increase in knowledge (out of 32) at four weeks (24.3 ± 6.1) and 12 weeks after receiving the education package (27.2 ± 5.5), compared to baseline (27.4 ± 5.1). There was no effect of the intervention on clinician confidence or attitude towards PROMs. Utilisation of function- and pain-related PROMs did not change after the intervention. There was a small and significant (p < 0.05) increase in utilisation of health-related PROMs 12 weeks after the intervention. CONCLUSION: Despite modest improvements in knowledge, which were retained 12 weeks after the educational package was provided, there was no evidence that participant confidence, attitude, or utilisation of PROMs changed because of the intervention. While the respondents' have positive attitudes and beliefs regarding PROMs use, further education surrounding the clinical translation process into clinical practice is required. Caution is advised when interpreting these findings due to the low participant response and completion rate with the potential for selection bias and the inability to generalise the results.

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Objectives: To share a concept analysis of social movement aimed at advancing its application to evidence uptake and sustainability in health-care. Methods: We applied Walker and Avant method to clarify the concept of social movement in the context of knowledge uptake and sustainability. Peer-reviewed and grey literature databases were systematically searched for relevant reports that described how social movement action led to evidence-based practice changes in health and community settings. Titles, abstracts and full texts were reviewed independently and in duplicate, resulting in 38 included articles. Results: Social movement action for knowledge uptake and sustainability can be defined as individuals, groups, or organizations that, as voluntary and intrinsically motivated change agents, mobilize around a common cause to improve outcomes through knowledge uptake and sustainability. The 10 defining attributes, three antecedents and three consequences that we identified are dynamic and interrelated, often mutually reinforcing each other to fortify various aspects of the social movement. Examples of defining attributes include an urgent need for action, collective action and collective identity. The concept analysis resulted in the development of the Social Movement Action Framework. Conclusions: Social movement action can provide a lens through which we view implementation science. Collective action and collective identity - concepts less frequently canvassed in implementation science literature - can lend insight into grassroots approaches to uptake and sustainability. Findings can also inform providers and change leaders on the practicalities of harnessing social movement action for real-world change initiatives. By mobilizing individuals, groups, or organizations through social movement approaches, they can engage as powered change agents and teams that impact the individual, organizational and health systems levels to facilitate knowledge uptake and sustainability.

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BACKGROUND: Children's ability to engage in meaningful activities is positively influenced by their ability to move independently. Preliminary evidence in children suggests that wheelchair skills training improves wheelchair skills, which are important for independent mobility. The Wheelchair Skills Training Program is a standardized program to teach wheelchair skills. However, it is underutilized in pediatric rehabilitation settings. To increase its utilization, 3 pediatric-specific Wheelchair Skills Training Program resources related to indoor skills were developed (i.e., a storybook, four instructional posters, and a training workbook). This study aimed to describe occupational therapists' (OTs) and pediatric manual wheelchair users' (PMWUs) perceived satisfaction with the storybook, instructional posters and training workbook, and to explore their perceptions regarding the usability, relevance, and feasibility of these resources in pediatric rehabilitation settings. METHODS: A descriptive qualitative design was used. Convenience samples of OTs and PMWUs were recruited in a rehabilitation center and affiliated schools. A focus group with OTs and semi-structured interviews with PMWUs were conducted by videoconference to obtain participants' feedback on the resource prototypes and suggestions for improvement. Data were deductively analyzed using the Framework method. RESULTS: Eight OTs and 5 PMWUs expressed general satisfaction with the resources, describing them as usable, relevant, and feasible to integrate into wheelchair skills training with novice wheelchair users and younger children. All OTs and 3 PMWUs expressed the desire to use the resources for wheelchair skills training. Two PMWUs perceived the resources were not relevant to them because they already mastered the skills. The participants suggested minor modifications for improving the resources (e.g., more action in the story, increased precision of illustrations related to the characters' position in the wheelchair). CONCLUSION: OTs and PMWUs were satisfied with the resources, perceiving them to be applicable for training wheelchair skills among young children and novice wheelchair users. The resources represent a concrete solution to facilitate the use of the Wheelchair Skills Training Program in pediatric rehabilitation settings. Additional resources are needed to better reach older and more experienced PMWUs (i.e., of intermediate and advanced skill levels).

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The wildlife trade has been characterized as one of the biggest risk factors in the emergence of new infectious diseases. In the shadow of COVID-19, there is growing political and scientific urgency to manage this risk. Existing studies and experiences make it clear that something must be done but are less clear on how to get it done. It is a quite different task to accumulate evidence on the presence of pathogens, their locations in the supply chain, and their spillover to new hosts than to identify effective ways to prevent and mitigate emerging disease under real-world conditions. This study sought peer-reviewed evidence on the effectiveness, acceptability, feasibility, and sustainability of risk reduction interventions for zoonotic and nonzoonotic disease emergence in the wildlife trade. An environmental scan triangulated information from a scoping review following a Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping review protocol, two narrative literature reviews, and key informant interviews of 26 international wildlife health experts. Existing literature has been inattentive to program implementation or evaluation studies. There was insufficient evidence to identify effective and sustainable risk management actions. Studies on the effects of social, epidemiologic, and ecologic context on intervention success was lacking, as was research using a complex systems perspective. The lack of systematic program evaluations or implementation studies leaves decision makers with insufficient evidence to select interventions likely to be acceptable, effective, and sustainable within and across the disparate context of the wildlife trade. This necessitates adaptive risk management and innovations in program implementation and evaluation to ensure evidence-based risk management.

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