How integrated knowledge translation worked to reduce federal policy barriers to the implementation of medication abortion in Canada: a realist evaluation
Abstract Background Initial Canadian federal regulations for the abortion pill, mifepristone, had the potential to impede safe and equitable access to this medication. To catalyze evidence-based regulatory change, we engaged health policy, health system, and health services decision makers, and heal...
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| Format: | Article |
| Language: | English |
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BMC
2025-02-01
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| Series: | Implementation Science Communications |
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| Online Access: | https://doi.org/10.1186/s43058-025-00694-0 |
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| author | Sarah Munro Kate Wahl Sheila Dunn Courtney Devane Linda C. Li Wendy V. Norman |
| author_facet | Sarah Munro Kate Wahl Sheila Dunn Courtney Devane Linda C. Li Wendy V. Norman |
| author_sort | Sarah Munro |
| collection | DOAJ |
| description | Abstract Background Initial Canadian federal regulations for the abortion pill, mifepristone, had the potential to impede safe and equitable access to this medication. To catalyze evidence-based regulatory change, we engaged health policy, health system, and health services decision makers, and health professional organizations in integrated knowledge translation (iKT), a research approach that engages the users of research as equal partners. Methods We conducted a realist evaluation of what iKT strategies worked, for whom, and in what context to impact federal mifepristone regulations. We constructed initial program theories (if–then statements about how iKT worked). We tested the initial program theories using interviews with researchers and knowledge partners and triangulated with analysis of research programme documents. We configured the evidence in relation to the initial program theories, and refined program theories into causal explanatory configurations. Results We analyzed 38 interviews with researchers, health professional leaders, advocacy group leaders, and administrative government policy makers, as well as 49 program documents. Our results indicated that researcher partnerships with stakeholders had a meaningful impact on the removal of restrictions. We found key components of the causal explanatory configurations included: researcher motivation to move evidence into action, trusted reputations as credible sources of evidence, strategic partnerships, understanding of health policy processes, and researcher roles as a trusted convenor between key groups and decision makers. Conclusions Our study identifies several practical and transferable approaches to impactful iKT. The findings may be of relevance to researchers focused on public health topics subject to stigma. |
| format | Article |
| id | doaj-art-9fa2e0d047e948fb889f663e0b845dc5 |
| institution | Kabale University |
| issn | 2662-2211 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science Communications |
| spelling | doaj-art-9fa2e0d047e948fb889f663e0b845dc52025-02-09T12:39:16ZengBMCImplementation Science Communications2662-22112025-02-016111510.1186/s43058-025-00694-0How integrated knowledge translation worked to reduce federal policy barriers to the implementation of medication abortion in Canada: a realist evaluationSarah Munro0Kate Wahl1Sheila Dunn2Courtney Devane3Linda C. Li4Wendy V. Norman5Department of Health Systems and Population Health, School of Public Health, University of WashingtonContraception and Abortion Research Team, Women’s Health Research Institute, BC Women’s Hospital and Health CentreContraception and Abortion Research Team, Women’s Health Research Institute, BC Women’s Hospital and Health CentreSchool of Nursing, Faculty of Applied Science, University of British ColumbiaDepartment of Physical Therapy, University of British ColumbiaContraception and Abortion Research Team, Women’s Health Research Institute, BC Women’s Hospital and Health CentreAbstract Background Initial Canadian federal regulations for the abortion pill, mifepristone, had the potential to impede safe and equitable access to this medication. To catalyze evidence-based regulatory change, we engaged health policy, health system, and health services decision makers, and health professional organizations in integrated knowledge translation (iKT), a research approach that engages the users of research as equal partners. Methods We conducted a realist evaluation of what iKT strategies worked, for whom, and in what context to impact federal mifepristone regulations. We constructed initial program theories (if–then statements about how iKT worked). We tested the initial program theories using interviews with researchers and knowledge partners and triangulated with analysis of research programme documents. We configured the evidence in relation to the initial program theories, and refined program theories into causal explanatory configurations. Results We analyzed 38 interviews with researchers, health professional leaders, advocacy group leaders, and administrative government policy makers, as well as 49 program documents. Our results indicated that researcher partnerships with stakeholders had a meaningful impact on the removal of restrictions. We found key components of the causal explanatory configurations included: researcher motivation to move evidence into action, trusted reputations as credible sources of evidence, strategic partnerships, understanding of health policy processes, and researcher roles as a trusted convenor between key groups and decision makers. Conclusions Our study identifies several practical and transferable approaches to impactful iKT. The findings may be of relevance to researchers focused on public health topics subject to stigma.https://doi.org/10.1186/s43058-025-00694-0Realist evaluationHealth services research / methodsHealth Policy researchInterprofessional relationsKnowledgeOrganizational innovation |
| spellingShingle | Sarah Munro Kate Wahl Sheila Dunn Courtney Devane Linda C. Li Wendy V. Norman How integrated knowledge translation worked to reduce federal policy barriers to the implementation of medication abortion in Canada: a realist evaluation Implementation Science Communications Realist evaluation Health services research / methods Health Policy research Interprofessional relations Knowledge Organizational innovation |
| title | How integrated knowledge translation worked to reduce federal policy barriers to the implementation of medication abortion in Canada: a realist evaluation |
| title_full | How integrated knowledge translation worked to reduce federal policy barriers to the implementation of medication abortion in Canada: a realist evaluation |
| title_fullStr | How integrated knowledge translation worked to reduce federal policy barriers to the implementation of medication abortion in Canada: a realist evaluation |
| title_full_unstemmed | How integrated knowledge translation worked to reduce federal policy barriers to the implementation of medication abortion in Canada: a realist evaluation |
| title_short | How integrated knowledge translation worked to reduce federal policy barriers to the implementation of medication abortion in Canada: a realist evaluation |
| title_sort | how integrated knowledge translation worked to reduce federal policy barriers to the implementation of medication abortion in canada a realist evaluation |
| topic | Realist evaluation Health services research / methods Health Policy research Interprofessional relations Knowledge Organizational innovation |
| url | https://doi.org/10.1186/s43058-025-00694-0 |
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