title: Translating a health service intervention into a rural setting: lessons learned.
abstract: BACKGROUND
  Limited research exists on the process of applying knowledge translation (KT) methodology to a rural-based population health intervention.
  
  
  METHODS
  This study reports on the implementation and translational stages of a previously described Co-creating KT (Co-KT) framework in the rural town of Port Lincoln, South Australia (population: 14,000). The Co-KT framework involves five steps: (i) collecting local data; (ii) building stakeholder relationships; (iii) designing an evidence-based intervention incorporating local knowledge; (iv) implementation and evaluation of the intervention; and (v) translating the research into policy and practice. Barriers and enablers to the overall Co-KT implementation process were identified. Our intervention focused on musculoskeletal (MSK) conditions.
  
  
  RESULTS
  Although the Co-KT framework was valuable in engaging with the community, translating the final intervention into daily clinical practice was prevented by a lack of an accessible policy or financial framework to anchor the appropriate intervention, a lack of continued engagement with stakeholders, access problems to general practitioners (GPs) and Allied Health Professionals; and the paucity of referrals from GPs to Allied Health Professionals. Consequently, while many aspects of the intervention were successful, including the improvement of both function and pain in study participants, the full implementation of the Co-KT framework was not possible.
  
  
  CONCLUSIONS
  This study implemented and evaluated a Co-KT framework for a population with MSK conditions, linking locally generated health care system knowledge with academic input. Further policy, health system changes, and on-the-ground support are needed to overcome the identified implementation challenges in order to create sustainable and effective system change.
authors.affiliation: Discipline of Public Health, School of Public Health, The University of Adelaide, South Australia, Australia. e.dent@uq.edu.au.|Centre for Research in Geriatric Medicine, The University of Queensland, Queensland, Australia. e.dent@uq.edu.au.
authors.forename: Elsa
authors.initials: E
authors.lastname: Dent
authors.affiliation: Discipline of Public Health, School of Public Health, The University of Adelaide, South Australia, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hoon
authors.affiliation: School of Nursing, The University of Adelaide, South Australia, Australia.
authors.forename: Alison
authors.initials: A
authors.lastname: Kitson
authors.affiliation: Discipline of Public Health, School of Public Health, The University of Adelaide, South Australia, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Karnon
authors.affiliation: Discipline of Rural Health, School of Medicine, The University of Adelaide, South Australia, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Newbury
authors.affiliation: School of Nursing, The University of Adelaide, South Australia, Australia.
authors.forename: Gillian
authors.initials: G
authors.lastname: Harvey
authors.affiliation: Discipline of Medicine, School of Medicine, The University of Adelaide, South Australia, Australia.
authors.forename: Tiffany K
authors.initials: TK
authors.lastname: Gill
authors.affiliation: Discipline of Public Health, School of Public Health, The University of Adelaide, South Australia, Australia.
authors.forename: Lauren
authors.initials: L
authors.lastname: Gillis
authors.affiliation: Discipline of Public Health, School of Public Health, The University of Adelaide, South Australia, Australia.|Vice Chancellor, Torrens University, Victoria Square, Adelaide, South Australia, Australia.
authors.forename: Justin
authors.initials: J
authors.lastname: Beilby
mesh_terms: D000328:Adult; D003695:Delivery of Health Care / Q000458:organization & administration / Q000592:standards; D055317:Evidence-Based Practice / Q000458:organization & administration / Q000592:standards; D005260:Female; D058006:General Practice / Q000458:organization & administration / Q000592:standards; D018166:Health Care Reform / Q000458:organization & administration / Q000592:standards; D006291:Health Policy; D006297:Health Services Accessibility / Q000458:organization & administration / Q000592:standards; D006801:Humans; D007400:Interprofessional Relations; D008137:Longitudinal Studies; D008297:Male; D009140:Musculoskeletal Diseases / Q000628:therapy*; D019035:Rural Health Services / Q000458:organization & administration* / Q000592:standards; D013021:South Australia; D057170:Translational Research, Biomedical