B Mechanism of OL and KB Mechanism was classified into four categories including 1 theories and theoretical background 2 roles and activities 3 types of KT interventions associated with OL and KB and 4 parameters for OL and KB interventions Table 8 and 9 summarize the mechanism data for every study 1 Theories and Theoretical background Most of the studies used OL based on positive results of OL in previous studies 57 62 64 without referring to any theory or theoretical framework that support OL intervention while one study 63 relied on Social Learning Theory 97 which supposes that individuals who have credibility trusted and likeable are likely to be convincing agents of behavioral change Likewise most of studies used KB relied on positive results of KB in previous studies 84 86 89 as well as relied 84 88 90 92 on the knowledge to action KTA framework 6 Figure 7 while one study 91 used the Promoting Action on Research in Health Sciences PARiHS 98 to analysis KB roles Figure 8 2 Roles and activities of OL and KB Roles and activities were classified according to Role Domains Model for Knowledge Brokering 90 Figure 9 that aims to outline role domains of KB in healthcare Since there are significant mutual roles between OL and KB this model was considered as the most appropriate model to report roles of both OL and KB This model consists of five role domains including information manager linking agent capacity builder facilitator and evaluator a Capacity builder was the most common role for both OL and KB n 15 Capacity builder role included delivering and guiding educational meetings 57 60 62 64 84 86 88 89 providing relevant information such as articles evidence based materials or useful websites 84 86 88 89 91 tailoring KT intervention based on their context s needs 84 86 89 directing patients to specific behavior assuming that practitioners will follow them by adopting the same behavior 92 or administrating work to assist
KT activities such as organizing educational seminars 61 Capacity builder role was performed formally during workshops or informally during the clinic lunchtime 63 b Information manager was the most second common role for both OL and KB n 9 Information manager role included performing self learning and research activities 57 61 63 84 86 91 developing resources based on their context s needs 57 61 63 84 86 89 representing their peers beliefs and views based on which the intervention can be tailored 57 61 63 or preparing resource binders and additional materials developing online toolkit with other stakeholders 90 c Linking agent role was occasionally performed by OL and KB to act as a liaison among various stakeholders n 7 OL act as linking agent by reaching out relevant stakeholders by different means via email or conference calls 63 64 connecting the frontline administrators with the research team to facilitate operational changes 63 or discussing practitioners improvement with clinic directors 63 However KB act as a linking agent in a wider range not only reaching targeted practitioners but also reaching other individuals outside of the research project such as administrators board members community members patients caregivers other health care professionals education staff and government 84 86 91 92 d Facilitator was a role performed by KB only n 7 this included facilitating workshops follow up sessions individuals and group discussions 84 88 90 91
promoting knowledge share among practitioners encouraging reflective thinking 91 guiding an online discussion board 87 guiding ongoing collaborative learning throughout study period 90 and organizing schedules for educational meetings during the workday 84 87 Lastly e Evaluator was a role performed also by KB only n 6 this included a number of evaluative tasks throughout study duration such as assessing local context s barriers 84 86 89 90 and identifying knowledge and skill gaps 90 in the beginning of the research project performing ongoing evaluation throughout intervention period and evaluating intervention outcomes at the end of the study 92 3 Types of KT interventions associated with OL and KB A variety of KT interventions were associated with OL or KB interventions these KT interventions were classified according to the Cochrane Effective Practice and Organisation of Care Review Group EPOC taxonomy 99 this taxonomy is currently used by the Cochrane Collaboration and widely used by other researchers Appendix 4 Following EPOC taxonomy educational meetings is the most common type of professional interventions associated with both OL 57 62 64 and KB 87 91 which included various educational strategies such as teaching interactive discussion reflective thinking practical application peer group teaching brainstorming for identifying barriers and developing strategies to overcome those identified barriers The second common intervention was distribution of educational materials 57 60 61 64 87 88 followed by providing online resources 63 84 88 90 91 and reminders 64 87 respectively However outreach visits 57 60 audit and feedback 64 and mass media 57 were associated with OL only While one study used KB alone without any other KT interventions 92 4 Parameters for OL and KB interventions OL and KB parameters were categorized into frequency duration and format a Frequency of educational meetings facilitated by KB ranged from 2 to 6 times while the ones that guided by OL ranged from 1 to 2 times b Duration of educational meeting facilitated by KB ranged 1 2 hours while the ones guided by OL ranged 1 8 hours Also KB performed additional brokering activities 1 4 hours week during the study duration c Format Most of OL and KB performed their activities through face to face group meeting 57 62 64 84 88 90 92 while KB 84 87 90 91 and OL 63 often performed their activities via an online platform Tables 7 8 9 and 10 and Figure 10 11 and 12 presents details of KB and OL mechanism for each study
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