title: Knowledge to action for solving complex problems: insights from a review of nine international cases.
abstract: BACKGROUND
  Solving complex problems such as preventing chronic diseases introduces unique challenges for the creation and application of knowledge, or knowledge to action (KTA). KTA approaches that apply principles of systems thinking are thought to hold promise, but practical strategies for their application are not well understood. In this paper we report the results of a scan of systems approaches to KTA with a goal to identify how to optimize their implementation and impact.
  
  
  METHODS
  A 5-person advisory group purposefully selected 9 initiatives to achieve diversity on issues addressed and organizational forms. Information on each case was gathered from documents and through telephone interviews with primary contacts within each organization. Following verification of case descriptions, an inductive analysis was conducted within and across cases.
  
  
  RESULTS
  The cases revealed 5 guidelines for moving from conceiving KTA systems to implementing them: (1) establish and nurture relationships, (2) co-produce and curate knowledge, (3) create feedback loops, (4) frame as systems interventions rather than projects, and (5) consider variations across time and place.
  
  
  CONCLUSIONS
  Results from the environmental scan are a modest start to translating systems concepts for KTA into practice. Use of the strategies revealed in the scan may improve KTA for solving complex public health problems. The strategies themselves will benefit from the development of a science that aims to understand adaptation and ongoing learning from policy and practice interventions, strengthens enduring relationships, and fills system gaps in addition to evidence gaps. Systems approaches to KTA will also benefit from robust evaluations.
authors.affiliation: Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: B L
authors.initials: BL
authors.lastname: Riley
authors.affiliation: Public Health Agency of Canada, Ottawa, Ontario, Canada.
authors.forename: K L
authors.initials: KL
authors.lastname: Robinson
authors.affiliation: Imprint Consulting, Hampton, New Brunswick, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Gamble
authors.affiliation: Simon Fraser University, Burnaby, British Columbia, Canada.
authors.forename: D T
authors.initials: DT
authors.lastname: Finegood
authors.affiliation: Public Health Agency of Canada, Ottawa, Ontario, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Sheppard
authors.affiliation: Cambridge University, Cambridge, United Kingdom.
authors.forename: T L
authors.initials: TL
authors.lastname: Penney
authors.affiliation: InSource Research Group, Vancouver, British Columbia, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Best
mesh_terms: D005246:Feedback; D006801:Humans; D033183:Interdisciplinary Communication; D007400:Interprofessional Relations; D019359:Knowledge; D011340:Problem Solving; D016730:Program Development / Q000379:methods*; D011634:Public Health; D013597:Systems Analysis; D018511:Systems Integration
keywords: intervention studies; knowledge transfer; public health; systems approach