title: Development of a measure of knowledge use by stakeholders in rehabilitation technology.
abstract: OBJECTIVE
  Uptake of new knowledge by diverse and diffuse stakeholders of health-care technology innovations has been a persistent challenge, as has been measurement of this uptake. This article describes the development of the Level of Knowledge Use Survey instrument, a web-based measure of self-reported knowledge use.
  
  
  METHODS
  The Level of Knowledge Use Survey instrument was developed in the context of assessing effectiveness of knowledge communication strategies in rehabilitation technology. It was validated on samples representing five stakeholder types: researchers, manufacturers, clinician-practitioners, knowledge brokers, and consumers. Its structure is broadly based on Rogers' stages of innovation adoption. Its item generation was initially guided by Hall et al's Levels of Use framework. Item selection was based on content validity indices computed from expert ratings (n 1 = 4; n 2 = 3). Five representative stakeholders established usability of the web version. The version included 47 items (content validity index for individual items >0.78; content validity index for a scale or set of items >0.90) in self-reporting format. Psychometrics were then established for the version.
  
  
  RESULTS
  Analyses of data from small (n = 69) and large (n = 215) samples using the Level of Knowledge Use Survey instrument suggested a conceptual model of four levels of knowledge use-Non-awareness, Awareness, Interest, and Use. The levels covered eight dimensions and six user action categories. The sequential nature of levels was inconclusive due to low cell frequencies. The Level of Knowledge Use Survey instrument showed adequate content validity (≈ 0.88; n = 3) and excellent test-retest reliability (1.0; n = 69). It also demonstrated good construct validity (n = 215) for differentiating among new knowledge outputs (p < 0.001) and among stakeholder types (0.001 < p ≤ 0.013). It showed strong responsiveness to change between baseline and follow-up testing (0.001 < p ≤ 0.002; n = 215).
  
  
  CONCLUSIONS
  The Level of Knowledge Use Survey instrument is valid and reliable for measuring uptake of innovations across diffuse stakeholders of rehabilitation technologies and therefore also for tracking changes in knowledge use.
authors.affiliation: Center for Assistive Technology, University at Buffalo, Amherst, NY, USA.
authors.forename: Vathsala I
authors.initials: VI
authors.lastname: Stone
authors.affiliation: Center for Assistive Technology, University at Buffalo, Amherst, NY, USA; Western New York Independent Living, Inc., Buffalo, NY, USA.
authors.forename: Amanda R
authors.initials: AR
authors.lastname: Nobrega
authors.affiliation: Center for Assistive Technology, University at Buffalo, Amherst, NY, USA.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Lane
authors.affiliation: Department of Rehabilitation Science, University at Buffalo, Buffalo, NY, USA.
authors.forename: Machiko R
authors.initials: MR
authors.lastname: Tomita
authors.affiliation: Western New York Independent Living, Inc., Buffalo, NY, USA.
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Usiak
authors.affiliation: Western New York Independent Living, Inc., Buffalo, NY, USA.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Lockett
keywords: Knowledge translation; health and function; knowledge use; rehabilitation technology; research evaluation