(017) Use of Knowledge Translation Methodology to Incorporate Research Results into Clinical Practice: Bringing Mindfulness and Cognitive Behavioural Therapy into a local prostate cancer program
Bibliographic record
Abstract
Abstract Introduction There is an unmet need for psychological therapies that address sex-related distress in couples after prostate cancer (PCa) beyond pharmaceuticals and device aids. We recently completed a clinical trial that found both mindfulness and cognitive behavioural therapy (CBT) improved couples’ sexual health after prostate cancer (PCa). Given the benefits of these therapies to patients yet the poor translation of research into routine clinical care, we sought to use evidence-informed methods of knowledge translation to make this transition. Objective This was a knowledge translation (KT) and implementation science project. We aimed to share information about the efficacy of these therapies to PCa patients and their partners in a local prostate cancer program by creating and implementing KT tools in a format that was accessible, affirming, and effective. Methods We utilized two KT frameworks: the Knowledge to Action (KTA) cycle and the Consolidated Framework for Implementation Research (CFIR), and collaborated with knowledge partners (prostate cancer program clinical leader partnerships, patient partner consultations, and a focus group of the program staff analyzed using the CFIR framework) to guide implementation. Results We used the first four stages of the KTA cycle, informed by our knowledge partners, to create our KT tools. The first stage involved clarifying the knowledge gap. We then included the evidence-based mindfulness and CBT approaches to various existing time points of patient education in the local program's context. Next, we conducted our focus group to identify potential barriers and facilitators to implementation, and modified our implementation plan accordingly. We created an information card that explained CBT and mindfulness using terminology appropriate for the patient population. The card contained a link to a patient education video we created that instructed patients on how to practice these skills at home. This link was hosted on a webpage with external CBT and mindfulness resource links. Implementation is currently underway. Eligible patients receive the information card at clinical appointments with a registered sexual health nurse and access the education video, which then guides them on how to practice these therapies at home. A questionnaire has been developed to evaluate patient use of these tools, ease of use of the tools, and whether the tools were helpful with respect to improving sexual intimacy and mental health. Data collection is in progress. Conclusions By creating three KT tools to implement mindfulness and CBT patient education materials, we incorporated research findings into routine clinic flow of a local prostate cancer program. These tools have large implications for the current patient population: we filled a gap of a lack of psychosocial education for sexual intimacy for couples after prostate cancer to practice. To the best of our knowledge, this is the first study to use KTA methodology to apply results from a clinical trial directly into clinical practice. This methodology should be incorporated into research funding mechanisms in order to encourage more widespread adoption of bringing research findings into practice. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific, Coloplast, Sustained Therapeutics, AstraZeneca, Astellas, Genetech, Lantheus Merck, Sharp & Dohme, Myovant, Menarini, Tolmar, Vaccitech, Verity
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.148 | 0.135 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.006 | 0.003 |
| Open science | 0.002 | 0.009 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".