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Systematic reviews and knowledge translation Tugwell P; Robinson V; Grimshaw J; Santesso NBull World Health Organ 2006[Aug]; 84 (8): 643-51Proven effective interventions exist that would enable all countries to meet the Millennium Development Goals. However, uptake and use of these interventions in the poorest populations is at least 50% less than in the richest populations within each country. Also, we have recently shown that community effectiveness of interventions is lower for the poorest populations due to a "staircase" effect of lower coverage/access, worse diagnostic accuracy, less provider compliance and less consumer adherence. We propose an evidence-based framework for equity-oriented knowledge translation to enhance community effectiveness and health equity. This framework is represented as a cascade of steps to assess and prioritize barriers and thus choose effective knowledge translation interventions that are tailored for relevant audiences (public, patient, practitioner, policy-maker, press and private sector), as well as the evaluation, monitoring and sharing of these strategies. We have used two examples of effective interventions (insecticide-treated bednets to prevent malaria and childhood immunization) to illustrate how this framework can provide a systematic method for decision-makers to ensure the application of evidence-based knowledge in disadvantaged populations. Future work to empirically validate and evaluate the usefulness of this framework is needed. We invite researchers and implementers to use the cascade for equity-oriented knowledge translation as a guide when planning implementation strategies for proven effective interventions. We also encourage policy-makers and health-care managers to use this framework when deciding how effective interventions can be implemented in their own settings.|*Knowledge[MESH]|*Review Literature as Topic[MESH]|Developed Countries[MESH]|Developing Countries[MESH]|Global Health[MESH]|Health Policy[MESH]|Health Services Accessibility/*organization & administration[MESH]|Humans[MESH]|Immunization Programs/organization & administration[MESH]|Information Dissemination/*methods[MESH]|Insecticides[MESH]|Malaria/prevention & control[MESH] |
