How is knowledge translation different from simply publishing research?

Publishing makes findings available, but knowledge translation is concerned with whether and how those findings are actually understood, adapted, and used in practice and policy, which usually requires active exchange and supportive infrastructure rather than passive availability.

What is the know-do gap?

It is the persistent distance between what research evidence shows should be done and what is actually done in routine care and policy; closing it is the central motivation for this area of research.

Knowledge Translation and Dissemination

Knowledge translation and dissemination is the area of health services research concerned with how scientific findings move into routine practice, policy, and public use. It studies the gap between what research shows and what health systems actually do, and the methods, theories, and infrastructure that help close it.

Definition

Knowledge translation and dissemination is the study of the synthesis, exchange, and ethically sound application of knowledge to improve health, strengthen health services, and inform policy, together with the processes by which innovations and evidence spread through health systems.

Scope

This area orients the reader to the field that connects evidence production with evidence use. It spans knowledge translation and transfer, the adoption of evidence-based practice, clinical decision support as a delivery mechanism for synthesized knowledge, and the diffusion of medical innovations across organizations and systems. It treats these as a coherent reference domain within health services research, not as operational instructions for a specific setting.

Sub-topics

Core questions

Why does a gap persist between research evidence and routine clinical and policy practice?
What processes move knowledge from production to application, and where do they break down?
Which strategies and infrastructures most reliably support the uptake of evidence?
How do innovations spread through organizations and across health systems?

Key concepts

Know-do gap
Knowledge-to-action cycle
Implementation science
Dissemination versus diffusion versus implementation
Research utilization
Context and facilitation
Sustainability and scale-up

Mechanisms

The area frames the movement of knowledge as a multi-stage process rather than a single hand-off. Evidence is first synthesized into usable form, then actively exchanged with and adapted by intended users, and finally applied within a particular context whose culture, resources, and incentives shape uptake. Graham and colleagues' knowledge-to-action framework describes this as a cycle linking knowledge creation to a sequence of action steps, while implementation science studies the strategies that promote each transition and the contextual factors that enable or block it.

Clinical relevance

The concepts in this area explain why proven interventions often reach patients slowly and unevenly, and why disseminating a finding is rarely enough to change practice on its own. They describe how health systems generate, spread, and adopt evidence; they are a reference frame for understanding system behaviour and are not a basis for individual diagnostic or treatment decisions.

Evidence & guidelines

Systematic reviews and dedicated journals such as Implementation Science have consolidated this area into a recognized field with shared frameworks and an accumulating evidence base on what supports knowledge uptake. Greenhalgh and colleagues' systematic review of diffusion in service organizations is a frequently cited synthesis that anchors the dissemination side of the field.

History

Concern with the slow uptake of research is long-standing, but the field cohered in the 1990s and 2000s as funders and researchers named the know-do gap and built shared vocabulary. Graham and colleagues' 2006 knowledge-to-action paper and the 2006 launch of the journal Implementation Science marked the consolidation of knowledge translation and implementation science as an identifiable area of health services research.

Debates

Is the field fragmented by too many overlapping terms and frameworks?: Knowledge translation, knowledge mobilization, dissemination, diffusion, and implementation are used inconsistently across countries and disciplines, and commentators debate whether this proliferation of terminology and models aids or hinders cumulative progress.

Key figures

Ian Graham
Sharon Straus
Trisha Greenhalgh
Martin Eccles
Brian Mittman

Seminal works

graham-2006
eccles-2006
greenhalgh-2004

Frequently asked questions

How is knowledge translation different from simply publishing research?: Publishing makes findings available, but knowledge translation is concerned with whether and how those findings are actually understood, adapted, and used in practice and policy, which usually requires active exchange and supportive infrastructure rather than passive availability.
What is the know-do gap?: It is the persistent distance between what research evidence shows should be done and what is actually done in routine care and policy; closing it is the central motivation for this area of research.