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Knowledge Translation through Tool-Supported Practices in Health Care: Production and Use of Self-Management Tools in Chronic Disease. The case of Diabetes

English title Knowledge Translation through Tool-Supported Practices in Health Care: Production and Use of Self-Management Tools in Chronic Disease
Applicant Grossen Michèle
Number 156509
Funding scheme Project funding (Div. I-III)
Research institution Institut de psychologie Faculté des sciences sociales et politiques Université de Lausanne
Institution of higher education University of Lausanne - LA
Main discipline Psychology
Start/End 01.09.2015 - 31.10.2019
Approved amount 541'702.00
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All Disciplines (3)

Discipline
Psychology
Sociology
Metabolic Disorders

Keywords (11)

Actor-Network theory; diabetes; self-care management; evidence-based healthcare; situated knowledge; sociocultural psychology; healthcare practitioners; tool-supported practices; chronic disease; knowledge translation in medicine; social interactions

Lay Summary (French)

Lead
Le transfert de connaissances de la recherche clinique aux pratiques médicales est extrêmement important pour assurer la qualité de nos systèmes de soin et la sécurité des patients. Toutefois, face à l’énorme quantité de connaissances nouvelles, les professionnels de la santé peinent à se tenir à jour, ce qui peut donner lieu à des écarts entre les résultats de la recherche clinique et les pratiques de soin effectives.
Lay summary

Croisant la psychologie, la sociologie et la médecine, ce projet porte sur le transfert de connaissances dans le domaine du diabète. Il se centre sur l’usage des outils qui servent à gérer la maladie (notamment ceux qui mesurent le taux de sucre) et étudie les fonctions de ces outils dans la gestion de la maladie. Considérant que l’étude de ces écarts est un bon moyen de comprendre les difficultés qui surgissent dans le transfert de connaissances, il porte sur les écarts entre : (1) les usages prévus par les concepteurs de ces outils et les usages effectifs qu’en font les professionnels de la santé ; (2) les usages des professionnels de la santé et ceux des patients.

Le projet comprend trois études. La première étudie l’usage de ces outils auprès de six professions différentes de la santé impliquées dans la prise en charge du diabète. La deuxième étudie la manière dont deux groupes de patients diabétiques (des « nouveaux » ou des « anciens » diabétiques) apprennent à utiliser ces outils et à gérer leur diabète. La troisième porte sur la fabrication de ces outils par des concepteurs professionnels ou par des professionnels de la santé qui en bricolent pour répondre à des problèmes très concrets issus de leur pratique quotidienne. Ces études recourent à différentes méthodes : entretiens semi-directifs, une méthode originale dite d’ « instruction au sosie » et des observations ethnographiques menées dans un camp de sport pour jeunes souffrant de diabète.

Prenant le cas du diabète comme une manière de comprendre le transfert de connaissances de manière plus générale, ces études ont pour but de contribuer à une meilleure compréhension des éléments qui favorisent, ou au contraire freinent, le transfert de connaissances dans les pratiques de santé.

Direct link to Lay Summary Last update: 31.10.2014

Responsible applicant and co-applicants

Employees

Publications

Publication
Meeting physicians’ needs: A bottom-up approach for improving the implementation of medical knowledge into practice
Pidoux V., Burnand B. (2016), Meeting physicians’ needs: A bottom-up approach for improving the implementation of medical knowledge into practice, in Health Research Policy and Systems, , 14(49), 1-14.
L'accompagnement thérapeutique et l'autogestion des prises alimentaires chez des personnes vivant avec un diabète: une prise en charge complexe
Danesi G. (2016), L'accompagnement thérapeutique et l'autogestion des prises alimentaires chez des personnes vivant avec un diabète: une prise en charge complexe, in Hugol-Gential C. (ed.), L’Harmattan, Paris, 117-134.
Swiss family physicians' perceptions and attitudes towards knowledge translation practices
Schlegel S., Burnand B. (2015), Swiss family physicians' perceptions and attitudes towards knowledge translation practices, in BMC Family Practice, 16(177), 1-12.
Embodiment and agency through self-tracking practices of people living with diabetes”,
, Embodiment and agency through self-tracking practices of people living with diabetes”,, in Ajana B. (ed.), inconnu, inconnu, 0-0.

Collaboration

Group / person Country
Types of collaboration
I-KnoT research group (Improving Health Knowledge Translation) Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Prof. Pierre Pluye, McGill University, Montreal Canada (North America)
- in-depth/constructive exchanges on approaches, methods or results
Maryse Bournel Bosson, University of Franche Comté France (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Prof. Katia Kostulski, Centre National des Arts et Métiers (CNAM) Paris France (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Prof. D. Vinck, UNIL Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Prof. Ludivine Soguel Alexander HES Geneva Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Dr Juan Ruiz, UNIL, CHUV Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Prof. A. Salazar Orvig, University Sorbonne Nouvelle – Sorbonne Paris Cité, Paris III France (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Laure Kloetzer, University of Neuchâtel Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Prof. Roland Grad, McGill University, Montreal Canada (North America)
- in-depth/constructive exchanges on approaches, methods or results
Prof. Marie-Pierre Gagnon, University Laval, Québec Canada (North America)
- in-depth/constructive exchanges on approaches, methods or results
Group of reading and revisions of the Recommandations of Good Practices of the PcD Canton of Vaud Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Research Infrastructure
Ayo Wahlberg, Department of Anthropology, University of Copenhagen Denmark (Europe)
- in-depth/constructive exchanges on approaches, methods or results
IUHMSP Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
British Sociological Association. Medical Sociology Group Annual Conference Talk given at a conference Trajectories, boundaries and negotiations in the (self-)management of diabetes risks: multiple actors, knowledge and tools at work, 13.09.2017 York, Great Britain and Northern Ireland Pidoux Vincent; Danesi Giada; Pralong Mélody;
15th Congress of the Swiss Psychological Society Talk given at a conference Bridging the gap between clinic, home and school: an ethnographic approach of diabetes management in the school setting 05.09.2017 Lausanne, Switzerland Pralong Mélody;
Annual Meeting of the Society for Social Studies of Science (4S 2017 Conference), Talk given at a conference Learning Through the Sensibilities of Chronic Self-Care: STS and Diabetes Management 30.08.2017 Boston, United States of America Pidoux Vincent;
4th workhop of the HSS-GPG (Société Suisse d’Histoire de la Santé et des Soins Infirmiers), Talk given at a conference Intégrer, autonomiser, contrôler. Une approche socio-technique de l’auto-gestion du diabète 16.06.2017 Berne, Switzerland Pidoux Vincent;
8th Medical Anthropology Young Scholars (MAYS) Annual Meeting Talk given at a conference Building bridges: diabetes healthcare management in the school setting 15.06.2017 Edinburgh, Great Britain and Northern Ireland Pralong Mélody;
International Conference “Metric Culture: The Quantified Self and Beyond” Talk given at a conference Self-monitoring practices of people living with diabetes as forms of embodiment and agency 07.06.2017 Aarhus, Denmark Pidoux Vincent;
Conference “Knowledge translation and self-management in chronic diseases: contexts, tools and practices”, Talk given at a conference Learning to manage diabetes risks in school 18.05.2017 Lausanne, Switzerland Pralong Mélody;
Conference "Knowledge translation and self-management in chronic diseases: contexts, tools and practices” Talk given at a conference An ethnographic approach to the ®Freestyle Libre: Accounts of the uses in context 18.05.2017 Lausanne, Switzerland Danesi Giada;
Conference “Knowledge translation and self-management in chronic diseases: contexts, tools and practices”, Talk given at a conference Technologies of diabetes management: A short historical overview 18.05.2017 Lausanne, Switzerland Pidoux Vincent;
3ème Forum de l'Institut Universitaire d'Histoire de la Médecine et de la Santé Publique (IUMSP) Talk given at a conference Quelle agentivité du patient dans la prise en charge du diabète ?, 17.11.2016 Lausanne, Switzerland Danesi Giada; Pralong Mélody;
European Association for Learning and Instruction (EARLI) Special Interest Group (SIG) Conference Talk given at a conference Reframing knowledge transfer in medicine from the double standpoint of sociocultural psychology and science & technology studies 28.08.2016 Tartu, Estonia Panese Francesco; Grossen Michèle; Burnand Bernard;
Conference of the European Society for Health and Medical Sociology (ESHMS), Talk given at a conference Diabetes as challenging lifestyle. Technologies, experiences, and the duty to be & do well 28.06.2016 Geneva, Switzerland Pidoux Vincent;
Journée d'étude “Le repas en etablissement de sante : des realites physiologiques au mieux-etre du patient" Talk given at a conference L'accompagnement thérapeutique et l'autogestion des prises alimentaires chez des personnes vivant avec un diabète: une prise en charge complexe 16.06.2016 Dijon, France Danesi Giada;
Meeting of the Centre for Innovative Research AGILE, European Association for Learning and Instruction (EARLI) Talk given at a conference Knowledge translation, artefacts and management of everyday life 28.04.2016 Leuven, Belgium Grossen Michèle;
Ateliers Lausannois d'Ethnographie « La preuve ethnographique » Talk given at a conference L’approche ethnographique au contact des professionnel-le-s de la santé : le cas des pratiques de soin dans la (auto-)gestion du diabète 18.03.2016 Lausanne, Switzerland Pidoux Vincent; Danesi Giada;
International Symposium “Health information: challenges and strategies Talk given at a conference Knowledge transfer and translation: the viewpoint of sociocultural psychology 05.11.2015 Lausanne, Switzerland Grossen Michèle;
International Symposium “Health information: Challenges and strategies Talk given at a conference What is the evidence about knowledge translation and implementation sciences? 05.11.2015 Lausanne, Switzerland Pidoux Vincent;
nternational Symposium “Health information: Challenges and strategies Talk given at a conference Self-health quantifying and big data in medicine, 05.11.2015 Lausanne, Switzerland Panese Francesco;
Société Suisse des Podologues Individual talk Figures du patient et relations de soin. Réflexion à partir des sciences humaines et sociales 30.10.2015 Lausanne, Switzerland Panese Francesco;
Swiss Public Health Conference Talk given at a conference Sources of information and attitudes towards evidence-based healthcare: A survey of Swiss Physicians 17.09.2015 Genève, Switzerland Grossen Michèle; Burnand Bernard; Pidoux Vincent; Panese Francesco;


Self-organised

Title Date Place
International Conference “Knowledge translation and self-management in chronic diseases: contexts, tools and practices”, 18.05.2017 Lausanne, Switzerland
Pidoux, V. & Kingod, N. Panel “Embodiment, identity and uncertainty in chronic illness”, 14th European Association of Social Anthropologists Biennial Conference “Anthropological legacies and human futures”, 21.07.2016 Milan, Italy
Danesi G. & Wahlberg A. Panel “The self-management of chronic disease: critical perspectives. 14th European Association of Social Anthropologists (EASA) Biennial Conference 20.07.2016 Milan, Italy
Health information: challenges and strategies 05.11.2015 Lausanne, Switzerland

Associated projects

Number Title Start Funding scheme
180350 Development of Personalized Health in Switzerland: Social Sciences Perpectives 01.01.2019 Sinergia
173568 Knowledge translation and self-management in chronic diseases: contexts, tools and practices 01.05.2017 Scientific Conferences

Abstract

The pace of development of new or updated knowledge has accelerated in modern medicine. As a result, Knowledge Translation in Medicine (KTM) plays an important role in ensuring effective high quality healthcare, as well as patients’ safety. However, the amount of available new information makes it difficult for busy physicians to identify important information. This creates what is referred to as a know-do gap, i.e., a gap between findings in clinical research and actual healthcare practice. The wish to address this scientific, health and social issue in an interdisciplinary perspective is at the origin of the creation of the research group I-KnoT (“Improving health Knowledge Translation”).Assuming that an interdisciplinary approach to KTM may renew our understanding of processes of “knowledge translation”, this research project draws on sociocultural psychology and science and technology studies to reframe mainstream research into KTM. Considering that human cognition is a situated practice, these complementary approaches both focus on the tools that mediate human activity. Our assumption is then that conceiving knowledge as a situated practice mediated by tools enables us to renew the understanding of the processes of “knowledge translation” and possible gaps.Concretely, this research project concerns “know-do-gaps” in the field of diabetes and considers: (a) gaps between professional designers and healthcare practitioners; (b) gaps between healthcare practitioners and patients. We assume that these gaps are good indicators to understand more general processes involved in gaps in “knowledge translation”. Diabetes appeared to be an appropriate research field since the patients’ self-management of diabetes and their relationship with healthcare practitioners heavily rely on the use of various tools which are expected to enhance efficient and effective care and self-care. The production and use of these tools, that we call Diabetes Self-Management Tools (DSMT), are central to this research project. By linking elements from sociocultural psychology and Actor-Network Theory, we propose a provisional conceptualisation of these specific DSMT by identifying four main functions: semiotic, epistemic, relational and boundary. These functions are not given but are developed through their use in context. We provisionally refer to the tools which integrate these four functions by the generic notion of “Semio-Epistemic Transactional Tools” (SETT). Our empirical goal is to grasp the process of knowledge translation (and its possible gaps) by starting from the design of DSMT and then by examining their use in specific contexts. Our question is then: How do Diabetes Self-Management Tools gain semiotic, epistemic, relational and boundary functions pertaining to SETT? Our goal is to put this provisional conceptualisation of SETT to the test and to improve it so as to gain a better and renewed understanding of difficulties in knowledge translation in the (self-)management of chronic diseases in general.The research plan consists of three studies: Study 1 focuses on the use of DSMT by 6 professions of healthcare practitioners involved in diabetes care. Study 2 focuses on the learning of DSMT by two groups of diabetic patients: “newcomers” (Type I diabetic teenagers who started a diabetes in the year preceding the data collection) and “oldtimers” (who started it within two years or more before the data collection). Study 3 concerns the design of DSMT by professional and lay designers. In order to examine situated knowledge and practices, we resort to qualitative methods: semi-directed interviews, an original method called “instruction to a double” and ethnographic observations in a sport camp for teenagers living with diabetes.Through the case of diabetes, this research project intends to contribute to a better understanding of knowledge translation and its implementation, in clinical and healthcare practices in general. Its relevance and originality are scientific, practical and social, since it addresses an issue of high importance in healthcare.
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