Innovations to the ECHO model to enhance reach and network-building among addiction clinicians in Western Canada.

Background: Building capacity for evidence-based treatment and support for people with substance use disorders (SUD) is an urgent priority in the context of the toxic drug poisoning crisis. We implemented the first substance use-focused Project Extension for Community Healthcare Outcomes (ECHO) in Western Canada for health care providers, to enhance their clinical addiction skills and knowledge, facilitate practice change, and foster a supportive community of practice. The aims of this article are to describe our innovations to the Project ECHO model in British Columbia (BC) and Yukon, and present key program outcomes.

Realist process evaluation of the knowledge translation programme of a patient-oriented research network.

Rationale: The Knowledge Translation (KT) Programme of a pan-Canadian strategic patient-oriented research network focused on brain-based developmental disabilities aimed to mobilize knowledge relevant to the network members. The programme also promotes and studies integrated Knowledge Translation (iKT) approaches involving different interested parties, such as researchers, patient-partners and decision-makers, in all parts of the knowledge creation process.

Aims And Objectives: The objective of this study is to advance research programme evaluation methods through a realist evaluation of the process of implementing iKT activities.

Community-Engaged Research Ethics Training (CERET): developing accessible and relevant research ethics training for community-based participatory research with people with lived and living experience using illicit drugs and harm reduction workers.

Background: Community-based participatory research (CBPR) can directly involve non-academic community members in the research process. Existing resources for research ethics training can be inaccessible to team members without an academic background and do not attend to the full spectrum of ethical issues that arise through community-engaged research practices. We detail an approach to capacity building and training in research ethics in the context of CBPR with people who use(d) illicit drugs and harm reduction workers in Vancouver's Downtown Eastside neighborhood.

The changing landscape of pharmaceutical alternatives to the unregulated drug supply during COVID-19.

Background: The dual COVID-19 and overdose emergencies amplified strain on healthcare systems tasked with responding to both. One downstream consequence of the pandemic in the USA and Canada was a surge in drug overdoses resulting from public health-restricted access to services and an increasingly toxic unregulated drug supply. This study aimed to describe changes implemented by programs prescribing pharmaceutical alternatives to the drug supply during the early stages of the COVID-19 pandemic.

"COVID just kind of opened a can of whoop-ass": The rapid growth of safer supply prescribing during the pandemic documented through an environmental scan of addiction and harm reduction services in Canada.

Objectives: In the context of the ongoing overdose crisis, a stark increase in toxic drug deaths from the unregulated street supply accompanied the onset of the COVID-19 pandemic. Injectable opioid agonist treatment (iOAT - hydromorphone or medical-grade heroin), tablet-based iOAT (TiOAT), and safer supply prescribing are emerging interventions used to address this crisis in Canada. Given rapid clinical guidance and policy change to enable their local adoption, our objectives were to describe the state of these interventions before the pandemic, and to document and explain changes in implementation during the early pandemic response (March-May 2020).

Organizational supports for knowledge translation in paediatric health centres and research institutes: insights from a Canadian environmental scan.

Background: Organizational supports are thought to help address wide-ranging barriers to evidence-informed health care (EIHC) and knowledge translation (KT). However, little is known about the nature of the resources and services that exist within paediatric health care and research settings across Canada to facilitate evidence use in health care delivery. This survey examined existing supports for EIHC/KT within these organizations to inform the design of similar EIHC/KT support programmes.

Service delivery models for injectable opioid agonist treatment in Canada: 2 sequential environmental scans.

Background: Injectable opioid agonist treatment (iOAT) is an emerging evidence-based option in the continuum of care for opioid use disorder in parts of Canada. Our study objective was to identify and describe iOAT programs operating during the ongoing opioid overdose crisis.

Methods: We conducted 2 sequential environmental scans.

End-user involvement in rehabilitation virtual reality implementation research.

Purpose: Despite increasing evidence for the effectiveness of off-the-shelf and rehabilitation-specific active video games (AVGs) and virtual reality (VR) systems for rehabilitation, clinical uptake remains poor. A better match between VR/AVG system capabilities and client/therapist needs, through improved end-user involvement (UI) in VR/AVG implementation research, may increase uptake of this technology. The purpose of this paper is to review four case examples from the authors' collective experience of including end users in VR/AVG research to identify common benefits, challenges and lessons learned.

Facilitating the Implementation of Virtual Reality-Based Therapies in Pediatric Rehabilitation.

Evaluate the impact of a multifaceted knowledge translation (KT) strategy for the implementation of virtual reality (VR) intervention by rehabilitation clinicians in a pediatric hospital setting. Eleven therapists were recruited and completed a questionnaire on perceptions on VR usage. A multifaceted KT strategy was implemented over five months.

Mixed methods study exploring parent engagement in child health research in British Columbia.

Objectives: The objective of this study was to explore parent perspectives of and interest in an interactive knowledge translation platform called Child-Sized KT that proposes to catalyse the collaboration of patients, families, practitioners and researchers in patient-oriented research at British Columbia Children's Hospital (BCCH).

Methods: An explanatory sequential mixed methods design was used over 1 year. Over 500 parents across BC completed an online survey, including a subsample of 102 parents who had accessed care at BCCH within the past 2 years.

How the study of networks informs knowledge translation and implementation: a scoping review.

Background: To date, implementation science has focused largely on identifying the individual and organizational barriers, processes, and outcomes of knowledge translation (KT) (including implementation efforts). Social network analysis (SNA) has the potential to augment our understanding of KT success by applying a network lens that examines the influence of relationships and social structures on research use and intervention acceptability by health professionals. The purpose of this review was to comprehensively map the ways in which SNA methodologies have been applied to the study of KT with respect to health professional networks.

Barriers, Facilitators and Interventions to Support Virtual Reality Implementation in Rehabilitation: A Scoping Review.

Virtual reality and active video games (VR/AVGs) are promising rehabilitation tools because of their potential to facilitate abundant, motivating, and feedback-rich practice. However, clinical adoption remains low despite a growing evidence base and the recent development of clinically accessible and rehabilitation-specific VR/AVG systems. Given clinicians' eagerness for resources to support VR/AVG use, a critical need exists for knowledge translation (KT) interventions to facilitate VR/AVG integration into clinical practice.

A visual management tool for program planning, project management and evaluation in paediatric health care.

This article describes the development and implementation of a custom-designed Excel-based visual management tool. The tool's purpose was to support program planning and evaluation by our resource support team within a paediatric health care setting. Our aims in developing it were to 1) establish a streamlined process and supporting tools to efficiently plan and prioritize program directions and activities; 2) track progress; and 3) evaluate and report on our performance, outputs and outcomes.

Facilitating Interviews in Qualitative Research With Visual Tools: A Typology.

Visual methods are gaining traction in qualitative research to support data generation, data analysis, and research dissemination. In this article, I propose a preliminary typology that categorizes five identified purposes of applying visual methods in qualitative interviews: to (a) enable communication, (b) represent the data, (c) enhance data quality and validity, (d) facilitate the relationship, and (e) effect change. Examples of visual tools are presented to demonstrate their utility in addressing these five aims.

Core knowledge translation competencies: a scoping review.

Background: Knowledge translation (KT) is the broad range of activities aimed at supporting the use of research findings leading to evidence-based practice (EBP) and policy. Recommendations have been made that capacity building efforts be established to support individuals to enact KT. In this study, we summarized existing knowledge on KT competencies to provide a foundation for such capacity building efforts and to inform policy and research.

Application of Commercial Games for Home-Based Rehabilitation for People with Hemiparesis: Challenges and Lessons Learned.

Objective: To identify the factors that influence the use of an at-home virtual rehabilitation gaming system from the perspective of therapists, engineers, and adults and adolescents with hemiparesis secondary to stroke, brain injury, and cerebral palsy.

Materials And Methods: This study reports on qualitative findings from a study, involving seven adults (two female; mean age: 65 ± 8 years) and three adolescents (one female; mean age: 15 ± 2 years) with hemiparesis, evaluating the feasibility and clinical effectiveness of a home-based custom-designed virtual rehabilitation system over 2 months. Thematic analysis was used to analyze qualitative data from therapists' weekly telephone interview notes, research team documentation regarding issues raised during technical support interactions, and the transcript of a poststudy debriefing session involving research team members and collaborators.

Virtual Rehabilitation with Children: Challenges for Clinical Adoption [From the Field].

Virtual, augmented, and mixed reality environments are increasingly being developed and used to address functional rehabilitation goals related to physical, cognitive, social, and psychological impairments. For example, a child with an acquired brain injury may participate in virtual rehabilitation to address impairments in balance, attention, turn taking, and engagement in therapy. The trend toward virtual rehabilitation first gained momentum with the adoption of commercial off-the-shelf active video gaming consoles (e.

Virtual Reality and Active Videogame-Based Practice, Learning Needs, and Preferences: A Cross-Canada Survey of Physical Therapists and Occupational Therapists.

Objective: Describe the clinical use of virtual reality (VR)/active videogaming (AVG) by physical therapists (PTs) and occupational therapists (OTs) in Canada, identify usage barriers and facilitators, evaluate factors that predict intention to use VR/AVGs, and determine therapists' learning needs.

Design: Cross-sectional survey.

Materials And Methods: Online survey of therapists in Canada who were members of 1 of 26 professional PT or OT colleges or associations using the Assessing Determinants Of Prospective Take-up of Virtual Reality (ADOPT-VR2) Instrument.

Evaluating change in virtual reality adoption for brain injury rehabilitation following knowledge translation.

Purpose: To evaluate the impact of knowledge translation (KT) on factors influencing virtual reality (VR) adoption and to identify support needs of therapists.

Hypotheses: Intervention will be associated with improvements in therapists' perceived ease of use and self-efficacy, and an associated increase in intentions to use VR.

Method: Single group mixed-methods pre-test-post-test evaluation of convenience sample of physical, occupational and rehabilitation therapists (n=37) from two brain injury rehabilitation centres.

Protocol of a scoping review on knowledge translation competencies.

Background: Knowledge translation (KT) activities can reduce the gap between "what is known" and "what is done". Several factors hinder or facilitate KT activities including individual characteristics and organizational attributes; we will focus on individual healthcare professional modifiable characteristics. The purpose of this scoping review is to summarize knowledge on KT competencies for knowledge users, knowledge brokers, and knowledge producers/researchers to support evidence-based practice (EBP) and inform policy and research in health.

Promoting Therapists' Use of Motor Learning Strategies within Virtual Reality-Based Stroke Rehabilitation.

Purpose: Therapists use motor learning strategies (MLSs) to structure practice conditions within stroke rehabilitation. Virtual reality (VR)-based rehabilitation is an MLS-oriented stroke intervention, yet little support exists to assist therapists in integrating MLSs with VR system use.

Method: A pre-post design evaluated a knowledge translation (KT) intervention incorporating interactive e-learning and practice, in which 11 therapists learned how to integrate MLSs within VR-based therapy.

Trunk Compensation During Bimanual Reaching at Different Heights by Healthy and Hemiparetic Adults.

The authors explored how trunk compensation and hand symmetry in stroke survivors and healthy controls were affected by the distance and height of virtual targets during a bimanual reaching task. Participants were asked to reach to 4 different virtual targets set at: 90% of their arm length at shoulder, xiphoid process, and knee height, and 50% of their arm length at xiphoid process height. For the stroke group, for all targets, the hands' movements were more asymmetrical than those of the healthy group, with more asymmetry observed in the direction of gravity, and trunk forward displacement values were larger and more variable.

A knowledge translation intervention to enhance clinical application of a virtual reality system in stroke rehabilitation.

Background: Despite increasing evidence for the effectiveness of virtual reality (VR)-based therapy in stroke rehabilitation, few knowledge translation (KT) resources exist to support clinical integration. KT interventions addressing known barriers and facilitators to VR use are required. When environmental barriers to VR integration are less amenable to change, KT interventions can target modifiable barriers related to therapist knowledge and skills.

Role Domains of Knowledge Brokering: A Model for the Health Care Setting.

Knowledge brokering is a strategy to support collaborations and partnerships within and across clinical, research, and policy worlds to improve the generation and use of research knowledge. Knowledge brokers function in multiple roles to facilitate the use of evidence by leveraging the power of these partnerships. The application of theory can provide clarity in understanding the processes, influences, expected mechanisms of action, and desired outcomes of knowledge brokering.