SCIENCE MEETS: Shusmita Rashid
Shusmita Rashid discusses knowledge mobilization
In recent years, granting agencies have stressed the importance of ‘knowledge mobilization’ in evaluating research applications. After all, science is more impactful if others know about the work and can build off of it, or otherwise use it to inform their research or practice in some way. But, what exactly is knowledge mobilization (KM) and how do we go about achieving it? And what does a career in KM look like?
To tackle these questions, I recently had a chat with Shusmita Rashid, who is the Senior Manager of Knowledge Mobilization at the Centre for Aging and Brain Health Innovations (CABHI). CABHI’s mission is to “help innovators develop, disseminate, scale, and promote adoption of promising innovations in the aging and brain health sector”, and it was recently announced that the Public Health Agency of Canada would allocate $30million over 3 years to support CABHI’s efforts. Using KM is critical for solution accelerators like CABHI to help ensure innovations move from promising idea to real-world uptake and impact. Shusmita also has a dual role within the Rotman Research Institute (RRI) as Associate Director, Scientific and Academic Affairs, and it was in that role that Shusmita and I worked together to develop a multi-layered KM strategy, as well as sets of Objectives and Key Results (OKRs) to advance RRI’s strategic plan. Shusmita is one of those people who is an absolute gem to work with, and brainstorming with her leaves you feeling invigorated for the rest of the day. So much so that it still boggles my mind that despite working together closely over the past two years, due the pandemic, we actually have yet to meet in person.
JDR: How would you define KM? And why is it so important?
SR: You can think of KM as a spectrum that spans across dissemination and implementation activities. The focus of dissemination is to raise awareness: share the right information at the right time, with the right people. Ideally this is done in a bi-directional way, where there is an exchange of information between the knowledge users and the knowledge producers. The focus of implementation, on the other hand, is to go beyond raising awareness to influencing a change in practice or behaviour: use deliberate strategies to motivate relevant stakeholders to apply the information and do something different than what they were doing before. I am passionate about applying dissemination and implementation science to move research and innovation into practice so they can improve people’s health and well-being.
JDR: How is KM different from, say, marketing?
SR: There is a lot of overlap between KM and marketing in that they often use similar strategies, but KM is unique in that it starts from evidence. If we are promoting something through KM, it has to be backed by research evidence.
JDR: What is involved in the KM process? How do you decide to tailor the KM activities for different organizations or individuals?
SR: The KM process itself is also grounded in theory and evidence. There are different theories and frameworks that we draw from to understand the barriers and enablers to implementing change. For instance, to assess these factors at an individual level we might use the COM-B model of behavior change that states that to influence individual behaviour change, we need to consider 3 things: capacity, motivation, and opportunity. To understand barriers and enablers at an organizational level, we might use the Consolidated Framework for Implementation Research (CFIR) to understand the contextual factors (e.g., learning climate, leadership support, readiness, access to resources etc.) that enable change. Once we assess these barriers and enablers, we then use specific strategies that have been shown to be effective in targeting these factors to promote change.
I’ve found this KM process to be useful and applicable to my work across different stakeholder groups and disciplines, from working with UNICEF and government stakeholders to enhance education and social supports for children with developmental disabilities in Bangladesh, to supporting policy-makers and clinicians with WHO maternal health guideline implementation in Uganda and Ethiopia, to supporting primary care providers in delivering preventive health care, as recommended by the Canadian Task Force for Preventive Healthcare. This process continues to be relevant for my current work at RRI and CABHI, where I support researchers and innovators with the dissemination and uptake of their research and/or innovative product, program, or service, so they can ultimately enhance the quality of care and quality of life of older adults.
Whether the goal is to promote the uptake of an evidence-based guideline or deploy an innovative program in a target setting, my favorite question to ask is, ‘In order for this change to happen, who needs to do what differently, when and how often?’ I then try to understand why the different stakeholders involved may or may not want to adopt the change, what are the barriers and opportunities, what do they care about and prioritize, and what strategies could we use to demonstrate that the proposed practice or program directly supports their priorities? For example, an organizational leader might need to see how a new program leads to cost-savings or staff retention, a health care provider might need to see how the program fits within their existing workflow and enables them to do their job better, quicker, more efficiently, a client may need to see how the program aligns with their own needs and preferences for receiving care etc. The KM processes uses this type of multi-layered and strategic approach to not only introduce a new practice or program but ensure that it is sustained beyond the initial introduction. I remember how this was pointed out to me after I had delivered a KM workshop in Uganda, when a clinician from the audience came up to me and reflected on how, “Sometimes we think that if we just get information and evidence out to people they will start using it, but it sounds like instead of rolling the dice and expecting change to happen, KM is like a game of chess, where you need to use strategy to make real change happen.”
JDR: How do you get people or organizations to do this deep dive with you?
SR: You have to try to understand the stakeholders; what do each of them value? What are their motivations? It helps in prioritizing activities while recognizing that you may not make everyone happy. There is also a focus on building trust in a way that is equity-based; why should people listen to you? If you want to be successful, you have to build relationships where people feel comfortable enough to be real and share the challenges, the barriers, the struggles. They can’t only highlight positive examples; they have to do post-mortems around why implementation didn’t work – what happened and what went wrong. And how can we learn from those mistakes so we can do better next time?
JDR: What role does organizational culture play in KM?
SR: Culture plays one of the biggest roles. It’s also how you decide which organizations you want to work with first, based on their level of readiness to adopt change. Using frameworks like CFIR you can do a formal context assessment or just have informal discussions asking folks key questions to determine how open are they to new ideas, do they have a feedback process with good communication between staff and leadership, do they have a learning environment where staff have opportunities to try and fail? The red flags are if there isn’t talk across teams, or teams aren’t aware of what other teams are doing, or if leadership says something is a priority but it’s really not. These are some signs that the organization is not ready for change.
JDR: If the organization isn’t quite ready for change, what do you do?
SR: There are a couple things you can do to help them get ready for change. You can interview, separately and together, the stakeholders who are open to feedback, and see what’s the closest to consensus you can get to in determining what their shared priorities are, and a commitment to work together to support these priorities. You won’t get 100% buy-in, but at that point, you can say, let’s implement it, let’s try it and use the experience and learnings to make a decision. When engaging these stakeholders, it is also critical to highlight realistic outcomes the change intends to achieve, and how these will be sustained. You need to plan for sustainability from the beginning, because if you don’t have a sustainability plan, then it becomes a de-motivator when people don’t see their good efforts sustained.
JDR: How did you get into this field? What attracted you to this work?
SR: I did my undergraduate work at the University of Toronto; I majored in Human Biology and minored in Bioethics and Zoology. In my second year I worked in a Botany lab but couldn’t see myself working in a lab environment. I’m a people-person and wanted to connect with people, hear their experiences and pain points, and try to problem-solve. I was especially interested in global health and in working with underprivileged communities. My family is from Bangladesh, and every Brown family’s dream is for their kid to go to med school, which is why I enrolled in the Life Sciences Program. However, when visiting a family member who was in the hospital with a serious condition, I knew I couldn’t deal with seeing people in this kind of situation - at the worst time of their life - on a daily basis. So, I had to think about what else I could do with my life sciences training and found myself being drawn to public health as I wanted to be in an area of making change and influencing policy to improve health. I pursued a Masters in Public Health at the University of Manchester with a focus on global health, health promotion, and disease prevention. When I finished my Masters, I worked in Bangladesh with government stakeholders, policy-makers, and local communities to identify ways to increase health, educational, and social supports for children with autism and developmental disabilities. We also launched a national campaign with UNICEF to raise public awareness and reduce the stigma associated with autism. As part of this work, I got all of the stakeholders together – parents, community members, teachers, educators, social workers, healthcare professionals, and policy-makers – to identify gaps and come up with creative solutions to address these gaps. It was only when I came back to Canada to work at the Knowledge Translation Program at St. Michael’s Hospital, I realized that I had been unknowingly using KM in my work in Bangladesh. I was introduced to KM and realized there was a whole field of KM research and implementation science that provides guidance on the best ways to engage people, assess needs, barriers, and enablers, and use deliberate strategies to implement change - and I fell in love! I learned the frameworks and theories of how to do KM well; I gained an understanding of the theoretical reasons behind influencing behavior change and how to apply it in practice. At St. Mike’s, I worked on a number of global and national health service research projects and provided implementation support on how to implement, evaluate, and sustain evidence-based programs. Now at CABHI, I provide support to innovators and organizations so innovations can get into the hands of their intended end-users.
JDR: How does someone pursue a career in KM?
SR: A science degree helps – the KM field focuses on the question, ‘how do we get research evidence into practice?’, but science is not a requirement. KM requires a lot of analysis: analytical skills, understanding and interpreting and applying data, and monitoring and evaluating to determine what actually works, what can be sustained, how etc. There are core competencies for people who do KM including stakeholder engagement, listening skills, reading the room, reading the evidence etc. There’s also knowing what not to do; sharing educational materials only leads to 2% of behavioral change, but it’s one of the most common things people do when they are trying to implement change. There are a lot of other ways to effectively implement change and those in the field work with stakeholders to determine what actually motivates people to try a new practice or program.
JDR: What are your own goals for this space?
SR: I know what excites me – being part of change initiatives, and sustaining the change. Having people gain an appreciation that change is not simple, it’s not going to happen overnight, but using strategy and being thoughtful in our approach to change can lead to good outcomes. I enjoy working with stakeholders and building relationships; I want to continue building that with the collaborators and organizations I work with and expand my learning of the best ways to support or drive change across diverse stakeholder groups, disciplines, and fields.
To learn more about Shusmita Rashid and her work, follow her on Twitter , LinkedIn and at CABHI.
To see photos from Shusmita’s work in Bangladesh, head over to our Instagram
