From Knowledge to Action: - Ontario Problem Gambling Research
Transcription
From Knowledge to Action: - Ontario Problem Gambling Research
From Knowledge to Action: A Proposal for Building Knowledge Translation and Exchange Capacity about Gambling including its Potential for Harm Prepared by: Ontario Problem Gambling Research Centre 150 Research Lane, Suite 104 Guelph, ON Canada N1G 4T2 Submitted by: Lynda Hessey Chair, Board of Directors Gary O’Connor Chief Executive Officer Date: May 15, 2013 Table of Contents 1 Executive Summary ............................................................................................................ 3 2 Building a Case for Action: Introduction to Gambling Including its Potential for Harm in Ontario ................................................................................................................. 8 3 Ontario Problem Gambling Research Centre ...................................................................12 3.1 The Early Years of OPGRC: 2000-2011 .....................................................................12 3.2 OPGRC Strategic Directions: 2011-2014 ...................................................................13 3.2.1 Conceptual Framework of Harmful Gambling ........................................................15 4 Opportunity for Action: Evolving into a Knowledge Translation and Exchange Centre ..................................................................................................................................16 4.1 Why Knowledge Translation and Exchange Are Important to Gambling Including its Potential for Harm ..................................................................................16 4.2 Who Will Benefit from the Centre’s Knowledge Translation and Exchange Strategy? ......................................................................................................................18 4.3 How does the Centre Define Knowledge Translation and Exchange? ...................19 4.4 Strategies for Successful Knowledge Translation and Exchange ..........................20 5 Vision, Mission and Goals .................................................................................................22 6 A Plan for Action: A Proposed Knowledge Translation and Exchange Program Model ...................................................................................................................................23 6.1 The Knowledge Translation Program and Exchange Model: Strategies and Activities ....................................................................................................................25 6.1.1 Knowledge Repository. ............................................................................................25 6.1.2 Knowledge Products. ...............................................................................................25 6.1.3 Evidence-informed Advice.......................................................................................25 6.1.4 Facilitate Learning. ...................................................................................................26 6.1.5 Knowledge Inquiry. ..................................................................................................27 6.1.6 Monitor, Evaluate, Adjust.........................................................................................27 6.2 Features of the Knowledge Translation and Exchange Program Model…………............................................................................................................28 6.3 Benefits and Positive Impacts of the KTE Program ……………………………….......30 7 Challenges and Risks .......................................................................................................31 8 Communication and Marketing ........................................................................................32 9 The Action Plan: A 3 Year Transition Plan ......................................................................33 10 Financial Plan ...................................................................................................................33 11 Measuring Successful Action........................................................................................33 11.1 Evaluation plan ........................................................................................................34 12 Summary...........................................................................................................................36 13 Appendices.......................................................................................................................41 1 Executive Summary Background The rate of problem gambling in Ontario is likely to increase as a result of Ontario’s lottery and gaming “modernization” plan which will increase access to land-based and internet gambling opportunities. Problem gambling can have negative effects on physical health and well-being, mental health and addiction, family relations, personal finances and delinquency. These problems burden the health care system, tie up the courts and ultimately prove costly to the Ontario government and taxpayers. Now, more than ever, Ontario must respond to the growing need for effective prevention and treatment practices to minimize the harms from gambling. What little evidence exists is being under-utilized by those who can bring about change in the health system and the gambling industry. The new role for OPGRC OPGRC has been recognized for its leadership as an objective, independent problem gambling research centre in Canada and around the world. Our leadership has guided major research initiatives and has supported evidence-informed decision making in policy and practice. In doing so, OPGRC has formed highly effective provincial, interprovincial and international partnerships for collaborating and exchanging knowledge across government, the gambling industry, prevention and treatment providers/organizations, and academic researchers. After 12 years of operation, OPGRC is in a strong position to transition to a comprehensive knowledge translation and exchange (KTE) centre. After extensive discussion with the Ministry of Health and Long-Term Care (MOHLTC), gambling industry leaders, researchers and other stakeholders, a KTE strategy was designed to promote the use of evidence-based knowledge in practice and policy. Objectives To translate and exchange cutting edge knowledge by providing innovative strategies for our partners and stakeholders; To scan and monitor the environment, thereby enabling the Centre and its partners to anticipate, adapt, and respond to emerging gambling issues at an early stage; and To provide leadership in guiding research initiatives and to support evidence-based decision making in gambling-related policy and practice. Our vision is to eliminate harm from gambling. Our mission is to create and translate knowledge to support evidence-based decision making about gambling including its potential for harm. Page 3 Methods and Design of Knowledge Translation and Exchange Strategies The Centre’s KTE program will be comprised of six complementary activities. 1. Knowledge Repository. The Centre will scan, gather, maintain, and distribute gambling-related materials and information from a variety of sources and make them accessible in various forms. Specifically, the Centre will: • Create an online storehouse and provide access to knowledge products and databases • Form partnerships with adjunct research scientists and prevention/treatment experts 2. Knowledge Products. The Centre will create a wide range of tailored knowledge products that reflect the state of knowledge and the needs of the knowledge users. Specifically, the Centre will create: • Tailored knowledge products for target audiences • A system in which stakeholders can seek out or receive knowledge products • Synopses of scientific research and grey literature related to gambling • Comprehensive review/conceptual documents including the Conceptual Framework of Harmful Gambling and Problem Gambling Research Framework 3. Evidence-Informed Advice. The Centre will provide decision makers with current, reliable knowledge and establish dialogue between stakeholders. Specifically, the Centre will: • Prepare policy briefs and other rapid response products at the request of stakeholders • Create literature reviews at the request of stakeholders or for broad dissemination • Establish and facilitate decision making panels/forums and briefings to exchange information about knowledge gaps to inform research agendas • Facilitate the establishment of standards/best practices for gambling practice and policies and share this information with decision makers 4. Facilitate Learning. The Centre will create learning and problem solving opportunities for its stakeholders. Specifically, the Centre will: • Host and participate in education workshops, conferences and webinars • Provide learning opportunities for cooperative education and graduate students • Host and participate in the international Think Tank on Gambling Research, Policy and Practice • Establish a platform for stakeholders to identify and share their learning needs 5. Knowledge Inquiry. The Centre will build on its expertise in coordinating strategic problem gambling research to produce research evidence that can be applied to reduce the harm from gambling and improve outcomes for gamblers and their families. Specifically, the Centre will: • Perform secondary data analysis of data contained in OPGRC’s databases to address gaps in knowledge Page 4 • • Offer knowledge translation and exchange awards to address KTE research gaps or facilitate knowledge uptake Address knowledge questions posed by stakeholders 6. Monitor, Evaluate, Adjust. The Centre will monitor and evaluate whether research was used and how it was used, assess stakeholders’ changing KTE needs, adjust the products/services provided as needed, and develop innovative strategies to facilitate knowledge use. Specifically, the Centre will: • Assess stakeholders’ awareness of, satisfaction with, and use of KTE products/services • Assess barriers and facilitators of knowledge use • Develop program assessment and evaluation tools • Assess the impact of its KTE products/services • Adjust services and products to meet needs of knowledge users and the changing environment • Monitor the changing gambling environment Capacity Building OPGRC’s knowledge translation and exchange strategy will build capacity by: increasing gambling knowledge, awareness, and responsiveness among health care providers, policy makers, and communities by providing current and relevant information about research, prevention/treatment programs, and best practices; appointing adjunct research scientists and partnering with treatment providers and other experts; providing professional development for staff and creating new KTE-focused staff positions; creating student placements to develop interest and skills in KTE and problem gambling; working with allied organizations including the Responsible Gambling Council (RGC) and the Centre for Addiction and Mental Health (CAMH) on projects and initiatives to maximize prevention, treatment and KTE efforts in Ontario. Knowledge users who might benefit from having access to comprehensible, applicable and time-saving products and services include: Ontario Ministries such as the MOHLTC, Ministry of Finance, Ministry of the Attorney General, Ministry of Tourism, Culture and Sport, and the Ministry of Education; Ontario government agencies such as Alcohol and Gaming Commission of Ontario (AGCO) and crown corporations such as Ontario Lottery and Gaming Corporation (OLG); Organizations specifically concerned with problem gambling including RGC and CAMH; Ontario public health departments, community mental health and addiction agencies and community health centres; First responders in the community such as treatment centre providers, general practitioners, and clergy; Page 5 Organizations that provide financial/debt consultation; and Researchers and students. Benefits, Impacts and Practical Importance Knowledge translation and exchange helps decision makers and those who support them to do their job better or more efficiently – namely to find and use research evidence to support policy making in the health system and gambling industry. A KTE strategy will increase the return to society from investments in research by promoting the use of valuable knowledge in practice and policy. Ultimately, the Centre’s KTE strategy will eliminate harm from gambling and save the Ontario government and taxpayers money. OPGRC’s knowledge translation and exchange strategy will facilitate: evaluating and comparing prevention and treatment programs to improve them; identifying strategies to encourage provision and use of effective health and community services for gamblers; identifying strategies to promote the integration of evidence into policy and program decisions; and identifying problems to be considered for applied innovative solutions OPGRC’s KTE strategy will have short- and long-term beneficial impacts. The strategy will: increase awareness of the harmful effects of gambling; the complexities related to problem gambling; the gaps in gambling research that can be used to drive MOHLTC research agendas (e.g., applied health research questions (AHRQs), Ontario Problem Gambling Strategy); and the resources available for prevention and treatment of gambling problems; facilitate the development of strong partnerships with stakeholders; increase awareness of harmful gambling as a health and social-economic concern in Ontario; increase the use of evidence in decision making including prevention/treatment programs and policy; and increase support for gambling related research to better inform health care practices, best practices for gambling operators, and policy. Putting it all together The logic model below provides a summary of the Centre’s goals, products/services, resource requirements, and anticipated outcomes by operating as a knowledge translation and exchange centre. Page 6 Page 7 OPGRC KTE Detailed Proposal 2 Building a Case for Action: Introduction to Gambling Including its Potential for Harm in Ontario Lottery and gaming have been a part of Ontario’s entertainment and tourism industries for decades and are now considered an acceptable leisure option. In 2011, it was estimated that a total of 8 million Ontario adults (80%) played the lottery at least once, and 2.7 million (27%) visited gaming sites. The Ontario Lottery and Gaming Corporation (OLG) is the largest gaming organization (and jurisdiction) in North America, with 33 gaming sites and 10,000 lottery points of sale. Lottery and gaming are not only here to stay, but they continue to expand in the number and types of gambling opportunities. OLG is currently responsible for 23,000 slot machines and more than 500 games tables in Ontario, as well as 27 gaming facilities and more than 10,000 lottery terminals. The Government of Ontario recognizes, however, that the long-term sustainability of the gambling industry has been threatened by advances in technology, changes to shopping patterns, aging demographics, and declining visits from tourists. Based on the 2010 OLG Strategic Business Review (2) the Government of Ontario gave OLG direction to “modernize” gambling in Ontario by: 1. expanding charitable gaming; 2. launching internet gaming by developing a complete internet gaming platform, including peer-to-peer games; 3. increasing the number of venues for selling lottery tickets; and 4. developing a process for private sector vendors to deliver internet gaming. OLG intends to launch provincially controlled internet gambling in 2013 and increase operation to 29 gaming facilities during the next decade. This modernization initiative is intended to “be responsive to customers” and “broaden the player base by becoming more appealing, not increasing the amount that current customers gamble” (2). However, the plan is concerning since internet gambling will likely appeal to youth while other vulnerable populations will be exposed to land-based gaming facilities in targeted large urban centres and tourist areas. The Ontario modernization plan will involve substantial benefits. Legalized gambling yields significant tax revenue for governments; OLG reports that it contributes $1.7 to $2 billion in net profit to the provincial government each year. Undoubtedly, gambling results in increased economic activity and significantly greater contributions to the Provincial treasury which, in turn, have been used to support health care, education, and infrastructure development. While most adults gamble responsibly, in 2007-2008, the estimated rate of problem gambling in Ontario was 0.8%; this rate increased to 1.2% by 2011 (1), an increase of 50%, and this number is likely to rise still further as a result of increased access to land-based and internet gaming opportunities (2). Page 8 Nonetheless, recent rapid and prolific expansion of new forms of legalized gambling has been associated with considerable harmful effects for individuals, their families, the local economy and society at large (3, 4). Studies have demonstrated a link between the availability of casinos and increases in problem gambling. A study in Niagara Falls found that rates of pathological gambling increased from 2.5% to 4.4% of the population in the one-year period after the first casino opened (5). Other communities in Ontario have reported similar increases following casinos openings, including Sarnia, Sault Ste. Marie, Brantford, and Thunder Bay (6). The increased accessibility, convenience and anonymity that will come with internet gambling is projected to further increase gambling problems during the next wave of gambling expansion in Ontario (7). In its 2012 report, Toronto Public Health commented on the harmful implications of gambling expansion (6). As summarized in this report, Table 1 identifies negative impacts that gambling can have on health, mental health, substance use and dependence, familial relations, society and the local economy. While the cost of problem gambling is difficult to quantify, these problems burden the health care system, tie up the courts and, ultimately, prove costly to taxpayers since the community is called upon to cover the costs associated with problem gambling, including additional costs of health care, problem gambling treatment, bankruptcy losses, absenteeism, civil and criminal court proceedings, policing, incarceration and security. A decade ago, these incremental costs were on average $56,000 per problem gambler (8). It is not surprising that, problem gambling has been framed as a major health concern by the Toronto Board of Health and by other public health scholars (9). It is also not surprising that it has become increasingly important to demonstrate the benefits of investment of taxpayer dollars in health research by moving research into policy, programs and practice.1 Now, more than ever, Ontario must respond to the growing need for effective prevention and treatment practices for gamblers and their families: this can only be achieved by using evidence to inform policy and practice. 1 1 http://www.cihr-irsc.gc.ca/e/39033.html, retrieved December 6, 2012. Page 9 Table 1. Health, social and economic impacts associated with problem gambling. Impact References General Health Lower self-reported general health and well-being (10-13) Colds and influenza (14) Headaches, including migraines (12, 15) Fatigue and sleep problems (14, 16, 17) Chronic health problems (e.g., bronchitis, fibromyalgia) (12-15) Miscellaneous health symptoms which might be stressrelated (e.g., cardiovascular, gastrointestinal, heart burn, obesity, backache) (18, 19) Mental Health Stress (11, 20, 21) Depression (11, 15, 21-23) Anxiety and mood disorders (11, 22, 23) Suicide (11, 24-26) Co-dependencies Alcohol, tobacco and drug use (15, 21, 27, 28) Substance abuse/addiction (15, 21) Familial impacts Divorce/separation and alienation (10, 15, 29, 30) Partner violence (31, 32) Child abuse and neglect (30) Social and economic impacts Delinquency and crime (33-35) Fatigue and alcohol-related traffic fatalities (36, 37) Use of chronic and costly forms of medical care (18, 38, 39) Poor job performance, absenteeism, job loss (19, 29, 40) Financial problems including debt and bankruptcy (10, 15, 41) Deterioration of previously established local or regional businesses (42) Adapted from the Toronto Public Health Technical Report (2012) (6). Page 10 It has been difficult to respond to harmful gambling in a manner that makes effective use of the state of knowledge. In particular, the uptake of research-based knowledge by health, government and gambling industry decision makers is both unpredictable and slow, thereby diminishing the return to society from investments in research. The federal and provincial governments’ increased focus on research governance and accountability has made it increasingly important to “demonstrate the benefits of investment of taxpayer dollars in health research by moving research into policy, programs and practice”.2 As outlined in Ontario’s Action Plan for Health, “It’s about getting the greatest value for patients from the system, allowing evidence to inform how scarce health care dollars are best invested and ensuring people receive the care they need”.3 Currently, there is a dearth of information on which problem gambling prevention and treatment programs are actually effective and under what circumstances. Moreover, what little evidence exists is being under-utilized by those who can bring about change (43). Accordingly, the Ontario Government support of problem gambling research is placing greater emphasis on “knowledge translation and exchange” (KTE). In particular, the Ministry of Health and Long-Term Care (MOHLTC) has invited the Ontario Problem Gambling Research Centre (OPGRC) to realign its strategic objectives to focus on knowledge translation and exchange related to problem gambling. This invitation has led OPGRC to develop a KTE strategy designed to promote the use of evidence-based knowledge in policy and practice. Knowledge translation and exchange “helps policy makers and those who support them to do their job better or more efficiently – namely to find and use research evidence to support health and gambling industry policy making” (44). A KTE strategy will increase the benefits from investments in gambling research and, more importantly, enhance prevention strategies, treatment approaches, clientcare, and reduce the harm from gambling. “Even the greatest discovery in the world will go unheeded if it is unheard. For research [and more generally, knowledge] to matter, it must be heard and understood by people in a position to bring about change” (45). After 12 years of operation, OPGRC is in a strong position to transition from its role as a research broker to that of a knowledge broker, evolving into a comprehensive knowledge translation and exchange organization. OPGRC has a deep understanding of the potential harms from gambling, risk factors and consequences of problem gambling, and the effective policy and programmatic responses to problem gambling. OPGRC has developed strong partnerships with researchers, treatment providers and gambling operators, and the Centre is dedicated to putting knowledge into the hands of those who should and can make use of it. 2 3 http://www.cihr-irsc.gc.ca/e/39033.html, retrieved December 6, 2012. http://www.health.gov.on.ca/en/ms/ecfa/healthy_change/docs/rep_healthychange.pdf, retrieved April 12, 2013. Page 11 3 Ontario Problem Gambling Research Centre 3.1 The Early Years of OPGRC: 2000-2011 In 1996, during a decade of rapid gambling expansion, the Government of Ontario approved the development of a comprehensive Problem Gambling Strategy for the prevention, treatment and research of problem gambling in Ontario. The Ministry of Health and Long-Term Care (MOHLTC) was given responsibility for developing and managing the Strategy. In 2000, OPGRC was established as an independent non-profit organization. As part of the Problem Gambling Strategy, OPGRC was funded by a portion of the 2% gross revenue from slot machines at racetracks and OLG casinos. OPGRC was established with a mandate to put distance between the Ontario government and problem gambling research to ensure research was conducted free from bias of government, gambling operators, and other vested interests. The Centre coordinated competitive problem gambling research to examine prevalence and risk factors, prevention and treatment program evaluation, as well as the individual, familial, societal and economic effects of gambling. This research addressed important questions to better serve the population of problem gamblers, their families, and society in Ontario and worldwide. Since its inception, OPGRC’s mandate developed to include support for professional capacity development among Ontario researchers and students, and dissemination of research findings derived from OPGRC-funded and independent research. While pursuing this mandate over a period of 12 years, OPGRC invested more than $47 million of government funding into problem gambling research, research capacity building and knowledge dissemination, resulting in: more than 360 research awards addressing the scope of problem gambling in Ontario, tools to measure problem gambling, support for prevention and treatment providers, and guidance related to the development of problem gambling policies by Ontario ministries (e.g., MOHLTC, Finance, and Attorney General), as well as the Alcohol and Gaming Commission of Ontario (AGCO), and Ontario Lottery and Gaming Corporation (OLG); increased capacity among Ontario problem gambling researchers by the provision of studentships, research teams, research school, and researcher workshops; and translation and dissemination of research results in accessible forms (e.g., research summaries and briefs) for use by decision makers (e.g., government Ministries, AGCO, OLG, gaming operators) and practitioners in treatment and prevention settings. OPGRC has been recognized for its leadership in problem gambling in Canada and around the world. Our leadership has guided major research initiatives and has supported evidence-informed decision making in policy and practice. In this, OPGRC has provided what has been referred to as thought leadership; that is, serving as “an authority on relevant topics by delivering the answers to the biggest questions on the minds of your target audiences; intriguing, challenging, and inspiring; starting Page 12 relationships where none exist, and enhancing existing relationships”.4 In doing so, OPGRC has formed highly effective inter-provincial and international partnerships for collaboration, information dialogue exchange among researchers, government, gambling operators, treatment providers and prevention organizations. OPGRC investments in research are the means to a more important end: reducing potential harm from gambling and improving the lives of people with gambling problems. To ensure research findings are used to drive programs and policies in the health system and gambling industry, we must share findings and engage the people who will use the knowledge from research.5 3.2 OPGRC Strategic Directions: 2011-2014 Since its inception in 2000, OPGRC has been committed to building new knowledge, translating and exchanging knowledge for practical and beneficial application. We understand that research must be strategic, forward-looking, long-term, and “translated” in a way that is likely to inform improvements in policy and practice. To reinforce its commitment to this mission, in 2011, the OPGRC developed a Strategic Framework looking to the future, namely, 2011-2014. The journey to develop its three-year Strategic Framework began with a clear understanding of its context. OPGRC: set out to understand the gambling environment, the gambling industry, and political and regulatory trends; analysed the mandates, goals, key initiatives and needs of gambling and problem gambling stakeholders and the ways in which these relate to OPGRC mandate and mission; reviewed the impact of 10 years of OPGRC-funded research on the field of problem gambling; examined evolving expectations regarding the benefits of publicly funded research. OPGRC then directly engaged its stakeholders to identify their expectations and perceptions of OPGRC, and their perceived knowledge needs. OPGRC met with more than 16 organizations and 65 individuals representing provincial, Canadian and international policy makers, treatment providers, educators, researchers, gambling operators and regulators. 4 http://www.forbes.com/sites/sap/2013/01/30/what-is-thought-leadership-5-steps-to-get-it-right/, retrieved March 8, 2013. 5 Adapted from the Ontario HIV Treatment Network (OHTN) Strategic Plan to 2010 Page 13 As a result of this stakeholder engagement: OPGRC learned that it was delivering strong results in some areas and not meeting key needs of some of our stakeholders in other areas. Of special importance was OPGRC’s meeting stakeholders’ knowledge translation needs; that is providing easily accessible and relevant knowledge translated from gambling research studies. OPGRC’s stakeholders identified the need for a strategic, focused, research agenda that would build on existing knowledge, address emerging needs and invest in research that would have optimal impact on responding to the challenges of problem gambling. OPGRC Strategic Themes: 2011-2014 Based on these stakeholder discussions, OPGRC embraced four strategic themes designed to: 1. 2. 3. 4. ensure relevance with respect to stakeholders’ needs; engage and collaborate with stakeholders; invest in research strategically; and develop its leadership role with respect to promoting problem gambling research A review of the Centre’s strategic directions provided a wide array of evidence of its impact on the problem gambling field, including: OPGRC continued to foster and support relevant research designed to understand the interactions between gamblers and the changing gambling environment. For example, the Centre sponsored research to investigate prevalence rates before and after the introduction of internet gambling and new Ontario casinos; the influence of social media and mobile technology on gambling; and the effectiveness of online gambling assessment and treatment tools. OPGRC invested in problem gambling prevention and harm minimization through grants to develop educational online learning modules, educational animations for slot machines/video lottery terminals, and problem gambling assessment and screening tools. OPGRC continued to inform stakeholders of relevant research findings by providing online access to synopses of published gambling research; disseminating research summaries of OPGRC-funded projects to government and the gambling industry; synthesizing new evidence into reviews and fact sheets; and creating policy briefs to inform deliberations and providing consultation for government and gambling operators. OPGRC engaged Ontario and international researchers by co-hosting an internet gambling workshop and hosting a student gambling workshop. OPGRC engaged local and international partners through participation in an exclusive international Think Tank on Gambling Research, Policy and Practice, Page 14 hosted educational workshops, and facilitated the collaborative development of and presentations on the Conceptual Framework of Harmful Gambling. 3.2.1 Conceptual Framework of Harmful Gambling During the strategic planning phase, OPGRC undertook a major initiative to develop a Conceptual Framework of Harmful Gambling (46). A team of international and interdisciplinary experts were engaged to create a comprehensive framework for understanding factors that influence gambling and the harmful effects gambling can have on individuals, their families, and the community (see Appendix 1). Harmful gambling is considered any type of gambling that leads to recurring negative consequences for the individual, their family, social network, and the community. Harmful gambling encompasses all degrees of severity and frequency. The Framework is intended to create a common language among a variety of stakeholders – including researchers, treatment providers, operators, policy makers – with which to exchange knowledge about the possible causes and consequences of harmful gambling and resources to minimize gambling harm. The Framework is a “living document” that will be updated annually as new knowledge becomes available. It is designed to: 1. reflect the state of knowledge as it relates to factors influencing harmful gambling and the inter-relationships among these factors; 2. assist policy makers, regulators, service providers, and the public in better understanding the complex dynamics involved in harmful gambling; and 3. act as a strategic map to identify gaps in gambling-related knowledge and guide the development of strategic research programs. Publication and dissemination of the Framework at international conferences and on the Centre’s website (http://opgrc.org/conceptualframework/) demonstrate OPGRC’s stature as a thought leader on issues related to problem gambling. It demonstrates how strong OPGRC’s partnerships are throughout Ontario, across Canada, and internationally. Finally, the Framework demonstrates the OPGRC’s success in identifying, synthesizing and communicating the findings of more than a decade of international problem gambling research to help our stakeholders make better informed decisions in health care, policy and governance, and strategic research agendas, including the Ontario Problem Gambling Strategy. The Conceptual Framework of Harmful Gambling provides a foundation for realigning OPGRC’s objective to evolve as a leader in knowledge translation related to gambling. Page 15 4 Opportunity for Action: Evolving into a Knowledge Translation and Exchange Centre In 2012, the Ontario Government launched an Action Plan to transform the health care system to ensure families get the best health care where and when they need it, while ensuring all Ontarians get better value for their health dollars. As part of the Action Plan, the Ontario government had to make decisions regarding funding priorities and ensure funding shifted to areas where we get the best value. “It’s about getting the greatest value for patients from the system, allowing evidence to inform how scarce health care dollars are best invested and ensuring people receive the care they need….Evidence will drive our decisions and it will drive our funding.”6 Also in 2012, the Ontario Government instituted changes in the way in which it supports problem gambling research in the province. The MOHLTC has invited OPGRC to realign its strategic objectives to focus on knowledge translation and exchange related to problem gambling. A KTE strategy will increase the return to society from investments in research by promoting the use of valuable knowledge in health practice and policy. OPGRC embraces the opportunity to evolve into a knowledge translation and exchange Centre. This opportunity for action will build upon the successes achieved when we implemented the Strategic Direction for 2011-14 (see Section 3.2, above), and will allow the Centre to better serve the population of gamblers, problem gamblers, and their families in Ontario. The Centre’s role will go beyond supporting research; we will ensure that information developed through research activities is used to improve care and treatment for people with gambling problems. As part of its commitment to shape both practice and policy, the Centre will actively support knowledge translation and exchange strategies designed to ensure that knowledge is shared and used to improve prevention, treatment and care services, and to shape policy. 4.1 Why Knowledge Translation and Exchange are Important to Gambling including its Potential for Harm It is now widely recognized that a significant gap exists between the creation of knowledge and the use of knowledge in health-related policy and practice, including gambling (47, 48). Failure to use knowledge to inform decision making has been documented across all decision making groups, including policy makers, health care providers, gambling operators, community agencies, and clients who use treatment services. This failure has recently been characterized as a knowledge-to-action gap (46). 6 http://www.health.gov.on.ca/en/ms/ecfa/healthy_change/docs/rep_healthychange.pdf, retrieved April 12, 2013. Page 16 This gap between knowledge creation and its use has been attributed to the fact that researchers, policy makers, and treatment providers inhabit “different worlds” (49, 50). This concept, known as the “two-communities” theory (51), states that receiving knowledge does not necessarily lead to acting on it, especially if there is no common focus, language, or research agenda among parties (52, 53). The world in which the knowledge is developed (e.g., by researchers) must be synchronized with the needs and practices of the world occupied by decision makers. Gambling in Ontario provides an excellent example of the two-communities phenomenon. On the one hand, governments stand to profit economically from gambling expansion, and are likely to make decisions based on limited research, other than evidence related to economic and political benefits. On the other hand, gambling researchers stand to “profit” from securing funding and publishing in academic journals, even though this dissemination medium has limited effectiveness in contributing to evidence-based policy and health program decision-making. The growing concern about the research-to-practice knowledge gap, coupled with the recent emphasis on evidence-based, cost-effective and accountable health care, has stimulated interest in knowledge translation and exchange initiatives as a way to minimize the knowledge-to-action gap (47). The purpose of knowledge translation and exchange is for “knowledge to be applied or used to improve the health outcomes of individuals or groups or improvements in the function of services associated with health and illness” (54). The gap between what is known and what is done contributes to poor health outcomes and, ultimately, results in wasted time and money. Any discovery will go unheeded if it is unheard. For research and, more generally knowledge, to have influence, it must be heard and understood by those in positions to bring about change (45). Thus efforts must be made to close knowledge-to-action gaps related to harmful gambling through the development of effective knowledge translation and exchange initiatives. Optimally, development of such strategies will minimize the harmful effects of gambling, thereby improving the health of the general population, gamblers and particularly the health of problem gamblers (43). A knowledge translation and exchange strategy will facilitate7: developing evidence-based prevention and treatment programs appropriate for the population and setting; comparing multiple problem gambling prevention and treatment programs; identifying strategies to encourage provision and use of effective services for problem gamblers; identifying strategies to promote the integration of evidence into policy and program decisions; 7 http://www.fic.nih.gov/News/Events/implementation-science/Pages/faqs.aspx, retrieved April 16, 2013. Page 17 bringing identified problems forward to the political arena and helping thinking about problems and solutions related to gambling differently; and developing innovative approaches to improve health care delivery for problem gamblers. To move forward as a leader in understanding and responding to gambling and its potential for harm, OPGRC strongly supports restructuring the organization (OPGRC) as a comprehensive knowledge translation and exchange centre. 4.2 Who Will Benefit from the Centre’s Knowledge Translation and Exchange Strategy? Reorienting OPGRC’s strategic objectives to focus on knowledge translation and exchange related to problem gambling represents a shift in the organization’s roles and relationships with stakeholders. In its new role, the Centre will serve the many target audiences with whom we already have strong relationships; other relationships will be built and strengthened as we transition to a KTE organization. Target Audiences A variety of stakeholders are key players in decision making processes in prevention/ treatment services for problem gambling, mental health policy, gambling policy, and research. Knowledge users who might benefit from having access to comprehensible, applicable and time-saving products and services might include: • • • • • • • A variety of Ontario Ministries play a major role in policy making and funding gambling–related research, including the Ministry of Health and Long-Term Care (MOHLTC), Ministry of Finance, the Ministry of the Attorney General, the Ministry of Tourism, Culture and Sport; and the Ministry of Education Ontario government agencies such as the Alcohol and Gaming Commission of Ontario (AGCO) and crown corporations such as the Ontario Lottery and Gaming Corporation (OLG) Organizations concerned with problem gambling including the Responsible Gambling Council (RGC) and the Centre for Addiction and Mental Health (CAMH) First responders in the community such as treatment centre providers, general practitioners and clergy The scientific community, including research institutes (including CAMH), researchers and students Community organizations including financial/debt consultants Human Resources centres who handle absenteeism, etc. Page 18 4.3 How does the Centre Define Knowledge Translation and Exchange? The Centre will adopt the Canadian Institutes of Health Research (CIHR) model of knowledge translation (KT), which currently represents the “gold standard” of knowledge translation thinking and practice in Canada and elsewhere (e.g., World Health Organization, National Center for the Dissemination of Disability Research) (47, 55). CIHR acknowledges that: 1. “The creation of new knowledge often does not on its own lead to widespread implementation or impacts on health.” 2. “With the increased focus on research governance and accountability from the federal and provincial governments, as well as from the public, it becomes increasingly important to demonstrate the benefits of investment of taxpayer dollars in health research by moving research into policy, programs and practice.”8 CIHR provides the following definition of knowledge translation: “Knowledge Translation is a dynamic and iterative process…. [KT] is the exchange, synthesis and ethically-sound application of knowledge – within a complex system of interactions among researchers and users – to accelerate the capture of the benefits of research for Canadians through improved health, more effective services and products, and a strengthened health care system.”9 Inherent in the definition is the notion of exchange: "Knowledge exchange involves collaborative problem-solving between researchers and decision makers that happens through linkage and exchange. Effective knowledge exchange involves interaction between knowledge users and researchers and results in mutual learning through the process of planning, producing, disseminating, and applying existing or new research in decision-making."10 CIHR has adopted Graham’s knowledge-to-action process as a model for promoting the application of research and as a conceptual framework for the KT processes (47) (see Figure 1). This framework helps identify and understand the complexities of knowledge translation, that is, the dynamic relationships between knowledge “creation” and “action”. Graham’s model includes multiple phases between the creation of new 8 http://www.cihr-irsc.gc.ca/e/39033.html, retrieved December 6, 2012. Canadian Institutes of Health Research http://www.cihr-irsc.gc.ca/e/29418.html; http://www.cihrirsc.gc.ca/e/26574.html#defining, retrieved December 6, 2012. 10 Canadian Institutes of Health Research http://www.cihr-irsc.gc.ca/e/39033.html#Exchange, retrieved May 7, 2013. 9 Page 19 knowledge, knowledge synthesis, the tailored translation of research into accessible forms, its real-world utilization and, finally, the evaluation of knowledge use. Inherent in the model is a non-linear and active two-way exchange of information between those who create new knowledge and the various stakeholders who might use it. The Centre recognizes that knowledge can be viewed as either explicit or tacit. Explicit knowledge is information that can be readily transmitted to others (e.g., research and data). Tacit knowledge is generated through experience and insight, for example, frontline treatment providers’ experiences with clients; this knowledge must first be systematically captured through some level of personal contact; before it can become explicit and shared. 4.4 Strategies for Successful Knowledge Translation and Exchange Push, pull and exchange models are the most used knowledge translation dialogues (56). In the push model, producers of knowledge plan and implement approaches to push or disseminate knowledge while decision makers are the receivers of information on a particular topic. Knowledge is made more accessible through the use of products (e.g., summaries, briefs, workshops). In contrast, in the pull model, decision makers seek out or ask for the information they think they need. User pull often involves providing “one-stop shopping” for summaries, reviews, rapid response products and continuing education programs. Finally, the exchange model is an interactive process involving mutually beneficial partnerships among decision makers, prevention and treatment service providers and researchers. Partners might work in networks or communities on priority-setting exercises, collaborative projects, and even work together to create useful databases (49, 56). To minimize the potential harm from gambling, the Centre will give careful consideration to (i) involving a number of forms of knowledge, which can be either tacit or explicit; (ii) the most appropriate fit of push, pull and/or exchange methods for that knowledge; (iii) the message that should be disseminated or exchanged; and (iv) the target audiences or stakeholders who will benefit most from the knowledge translation and exchange strategy. This process requires ongoing assessment of stakeholder needs, involvement of stakeholders in the development of products and services, and establishing a system in which knowledge can be received, actively sought out, or exchanged. Page 20 Figure 1. The knowledge-to-action process. (Adapted from Graham et al., 2006) Page 21 OPGRC KTE Detailed Proposal 5 Vision, Mission and Goals The Centre will have the following Vision and Mission statements: Vision Statement To eliminate harm from gambling. Mission Statement To create and translate knowledge to support evidence-based decision making about gambling including its potential for harm. As a knowledge translation and exchange centre, the Centre’s goals will be: 1. To translate and exchange cutting edge knowledge by providing innovative strategies for our partners and stakeholders; 2. To scan and monitor the environment, thereby enabling the Centre and its partners to anticipate, adapt, and respond to emerging gambling issues at an early stage; and 3. To provide leadership in guiding research initiatives and to support evidencebased decision making in gambling-related policy and practice. Page 22 OPGRC KTE Detailed Proposal 6 A Plan for Action: A Proposed Knowledge Translation and Exchange Program Model The current opportunity for action to bridge the harmful gambling knowledge-to-action gap calls for restructuring OPGRC’s operations and activities. To this end, OPGRC consulted KTE experts, gambling industry leaders, and researchers (see Appendix 2) in developing a comprehensive structured KTE program comprised of related, complementary activities. Through these consultations, OPGRC has addressed the key elements required when planning a structured KTE program, namely identifying multiple target audiences, how knowledge will be “packaged” for effective use, how activities will be implemented and evaluated, and the anticipated beneficial outcomes of the KTE program (57, 58). The Centre’s KTE program will grow and evolve with the development of the knowledge translation field, techniques and tools. As illustrated in Figure 2 and described below, the Centre will operate with six KTE initiatives that may occur either sequentially or simultaneously as a result of work undertaken by a variety of staff and stakeholders (47). The activities are intended to help treatment providers, researchers, and gambling industry and government policy makers do their jobs more efficiently – namely, to find and use research evidence to support their practices and decisions. 1. Knowledge Repository 2. Knowledge Products 3. Evidence-informed Advice 4. Facilitated Learning 5. Knowledge Inquiry 6. Monitor, Evaluate, Adjust Page 23 OPGRC KTE Detailed Proposal Figure 2. The Knowledge Translation and Exchange Program Model Page 24 6.1 The Knowledge Translation and Exchange Program Model: Strategies and Activities Below we provide a description of each initiative of the Centre’s Knowledge Translation and Exchange Program Model together with examples of activities for each initiative. Appendix 3 provides a complete description of the example activities, and Table 2 provides a timeline for implementing the activities in fiscal years 2013-2016. 6.1.5 Knowledge Repository Stakeholders are often unaware of the kinds of evidence that exist and how to access them. Moreover, it is difficult to remain current with the volume of gambling-related research evidence and “grey” literature. By gathering, storing, analyzing and understanding the range of problem gambling research literature, the Centre will be positioned to identify gaps and needs in gambling-related knowledge, and share this knowledge with all health care providers, policy makers and researchers. This repository will be a combination of Centre-owned and non-owned data, materials and information that will provide a vehicle for placing evidence into the hands of those who should and can make use of it. The Centre will gather and store gambling-related knowledge; it will scan, gather, analyze, and distribute materials and information from a variety of sources and make them accessible in various forms. Specifically, the Centre will: • Create an online storehouse and provide access to knowledge products and databases • Form partnerships with adjunct research scientists and partnerships with treatment provider experts • Invite stakeholders to contribute to the repository and establish a system to allow them to access it 6.1.6 Knowledge Products Evidence often has different meanings and uses for researchers, gambling operators, client care providers and policymakers. To be useful, the Centre will interpret and synthesize gambling-related knowledge to meet the specific needs of these and other users (45). The Centre will create a wide range of tailored, thorough knowledge products that reflect the state of knowledge and the needs of the knowledge users. Specifically, the Centre will: • Develop synopses of scientific research and grey literature • Develop and provide comprehensive review/conceptual documents, including the Conceptual Framework of Harmful Gambling and Problem Gambling Research Framework Page 25 • • Create tailored knowledge products and tools for target audiences through forums and needs assessment Create a system in which stakeholders can seek products from us or products can be received 6.13 Evidence-informed Advice Gambling-related decision-making in health care and policy is becoming increasingly complex, involving input of knowledge from multiple sources including researchers, treatment providers, front-line community agency staff, gambling operators and staff, clients and the public. These stakeholders face many barriers to using knowledge including time constraints; inability to access knowledge from multiple inputs; inability to understand the language of the research and/or critically appraise the research and recommended options; and agreement regarding what constitutes evidence. These stakeholders require access to reliable, timely, and comprehensive evidence to assess complex gambling-related issues to guide policy decisions. Researchers, health care providers and policymakers will also benefit from ongoing exchange of information concerning their needs and motives related to the use of evidence. The Centre will provide decision makers with current, reliable knowledge and establish dialogue between stakeholders. Specifically, the Centre will: • Prepare policy briefs and other rapid response products at the request of stakeholders • Create literature reviews at the request of stakeholders or for general dissemination • Establish and facilitate decision making panels/forums and briefings to exchange information about knowledge gaps, research needs for prevention and treatment • Facilitate the establishment of standards/best practices for gambling practice and policies and share this information with decision makers during panels/forums 6.1.4. Facilitate learning Many Canadians have a limited understanding of the factors affecting health, individual risk factors for problem gambling, and the harmful effects gambling can have on individuals, their families and society. There is a dearth of skills required to critically appraise and understand the implications of research findings in relation to prevention and treatment services and policy decisions. Moreover, the environment for collaborative problem solving with regard to harmful gambling is weak. All of our stakeholders can benefit from education on issues in health care, research, and gambling policy to be applied or used to minimize the harms from gambling and improve the outcomes of problem gamblers, their families and society. The Centre will create learning opportunities for its stakeholders. and problem solving Page 26 Specifically, the Centre will: • Host and participate in education workshops, conferences and webinars • Provide learning opportunities for cooperative education and graduate students • Host and participate in the international Think Tank on Gambling Research, Policy and Practice • Establish a platform for stakeholders to identify and share their learning needs 6.15 Knowledge Inquiry Putting knowledge into action includes the multiple steps between knowledge creation and its real-world application. On the one hand it can be argued that the creation of new knowledge rarely leads to its widespread use and, hence, rarely has a significant impact on health. However, on the other hand, knowledge translation and exchange is impossible without the creation of new and relevant knowledge. Strategic research (based on the Centre’s analysis of where the research is most needed) can provide new evidence to enhance gambling prevention/treatment programs, and gambling industry standards and policy. The Centre will build on its expertise in coordinating strategic problem gambling research to produce research evidence that can be applied to reduce the harm from gambling and improve outcomes for gamblers and their families. Specifically, the Centre will: • Perform secondary analysis of research data contained in OPGRC’s databases to address gaps in knowledge • Offer knowledge translation and exchange awards to address a KTE research gap or to facilitate knowledge uptake • Address knowledge questions posed by stakeholders 6.16 Monitor, Evaluate, Adjust The Centre is committed to providing value for resources invested, continually improving our programs and exceeding expectations. We are accountable to our funder for the use of resources and to all of our stakeholders for the effectiveness and relevance of our activities to improve health care for gamblers, and drive health care and gambling industry policy change. The Centre will put in place an ongoing mechanism for the objective and systematic evaluation of all of the activities of the Centre to ensure that they meet and/or exceed expectations of the funder and our major stakeholder groups. Determining whether the Centre’s Knowledge Translation and Exchange Program Model is successful, and why and in what context it is successful, is critical for ensuring sustained knowledge-use with regard to policy and practice decisions (59). We recognize that knowledge may be utilized in different ways, and take different forms, depending on the context (60). The Centre will encourage sustained implementation of its Knowledge Translation and Exchange Program Model by remaining relevant with Page 27 respect to research developments involving problem gambling; identifying current stakeholder attitudes, motivations and needs with regard to their use of evidence; and identifying new networks of collaborators. This monitoring, evaluation and adjustment function is embedded in all KTE phases and functions. The Centre will monitor and evaluate whether research was used, how it was used, and assess stakeholders’ changing KTE needs and adjust activities to facilitate knowledge use. Specifically, the Centre will: • Perform knowledge audits to take stock of resources and knowledge flow • Assess stakeholders’ awareness and use of, and satisfaction with KTE products/services • Assess barriers and facilitators of knowledge use • Develop program assessment and evaluation tools • Assess the impact of its KTE products/services • Monitor the changing gambling environment 6.2 Features of the Knowledge Translation and Exchange Program Model The Centre’s proposed model builds on OPGRC’s strength – our knowledge base. The foundation for our transition into a KTE organization is the knowledge and thought leadership that OPGRC has developed over the past 12 years by guiding research initiatives, building capacity for Ontario researchers and students, and strengthening translation and dissemination of knowledge to stakeholders in Ontario, across Canada, and around the world. From this foundation, we have formed highly effective partnerships to develop the Conceptual Framework of Harmful Gambling and identified research needs through the development of the Problem Gambling Research Framework. OPGRC is now in a strong position to become a leader in gambling-related knowledge translation and exchange. We have thoughtfully considered the KTE proposed program model comprised of core activities. These activities will provide guidance for evidence-informed decisions in policy and gambling regulation, and develop best practices for treatment and prevention. Figure 3 below provides an illustration of our leadership and natural evolution to a knowledge translation and exchange organization. Page 28 Figure 3. Building on our knowledge base to deliver a KTE program. Other significant features of the Centre’s KTE strategy are: It has widespread relevance. The evidence we synthesize and transfer can inform policies, support health systems (client-care, prevention/treatment programs), and drive strategic research agendas for stakeholders (e.g., Applied health research questions (AHRQs), Ontario’s Problem Gambling Strategy). It is unique and collaborative. The Centre will not duplicate or undermine the work of allied organizations, including the Responsible Gambling Council (RGC) and the Problem Gambling Institute of Ontario (located at CAMH). The Centre’s KTE strategy is unique and collaborative. No other Ontario organization possesses a combination of: independence and objectivity; gambling-related knowledge, as synthesized in its Conceptual and Research Framework; strong provincial, Canadian and international partnerships with researchers, treatment providers, and gambling industry leaders; and capacity to foster and support research and knowledge translation and exchange initiatives. Although other organizations offer some knowledge translation and exchange activities related to responsible gambling or treatment (for the gambling industry, the public, and treatment services), a gap remains between connecting and bridging those knowledge bases to support evidence-based health care and policy making. The Centre will collaborate with these organizations on Page 29 projects/initiatives (e.g., Discovery Conference, Centre for the Development of Best Practices, CAMH webinars and listserv community) to promote the transfer and exchange of all relevant knowledge. 6.3 Benefits and Positive Impacts of the KTE Program Knowledge translation and exchange help decision makers and those who support them to do their job better or more efficiently – namely to find and use research evidence to support policy making in the health system and gambling industry. A KTE strategy will increase the return to society from investments in research by promoting the use of valuable knowledge in practice and policy. Ultimately, the Centre’s KTE strategy will eliminate harm from gambling and save the Ontario government and taxpayers money. OPGRC’s KTE strategy will have short- and long-term beneficial effects. The strategy will: increase awareness of the harmful effects of gambling; the complexities related to problem gambling; the gaps in gambling research that can be used to drive MOHLTC research agendas (Applied health research questions (AHRQs), Ontario Problem Gambling Strategy); and the resources available for prevention and treatment of gambling problems; facilitate the development of strong partnerships with stakeholders; increase awareness of harmful gambling as a health and social-economic concern in Ontario; increase the use of evidence in decision making including prevention/treatment programs and policy; and increase support for gambling-related research to better inform health care practices, best practices for gambling operators, and policy. The Centre’s KTE strategy will build capacity in knowledge translation and exchange with regard to harmful gambling by: increasing knowledge awareness, and responsiveness about harmful gambling among health care providers, policy makers, and communities by providing current and relevant information about gambling research, prevention/treatment programs, and best practices; supporting KTE initiatives by other organizations such as RGC and CAMH thereby increasing province-wide efficiency; appointing researchers and treatment providers as associates with whom we will maintain ongoing and mutually beneficial relationships; creating student cooperative education placements; developing staff skills in knowledge translation and exchange, policy and problem gambling research through the use of workshops and conferences; and creating new staff positions for knowledge translation and exchange and communication specialists. Page 30 7 Challenges and Risks Since 2000, one of OPGRC’s mandates was to gather and disseminate research findings related to the prevention and treatment of problem gambling, and other gambling-related topics. This role has provided a platform for its current evolution into a comprehensive KTE organization. Based upon prior experience, the Centre acknowledges it will face challenges during the transition, including the following four major challenges and risks: 1. Complexity of KTE. KTE is extraordinarily wide-ranging and complex. A plethora of processes and tools are involved in executing an effective KTE program. And, even though there are many strategies for KTE, it currently is not clear which ones should be used in which contexts (49). The Centre will manage this risk by having ongoing consultations and partnerships with KTE experts (e.g., National Collaborating Centre for Methods and Tools (NCCMT), Institute for Clinical Evaluative Sciences). The Centre is consulting with KTE experts during its strategic planning stage, and undertaking a KTE needs assessment. The Centre will continue to seek expert advice and train staff in KTE science. 2. Establishing KTE credibility. Establishing the Centre’s credibility as a KTE organization, as it transitions from its current function as a research centre, will take time. The Centre’s credibility will depend on successful partnerships/collaborations with knowledge translation and exchange experts, and educating staff in KTE science. As noted above, we are developing relationships with KTE experts and training staff in KTE science. 3. Core capabilities. Successful implementation of OPGRC’s transition plan will be dependent on its core capabilities; many of its new functions and activities will require new skills. OPGRC has analyzed the impact that its Knowledge Translation and Exchange Program Model will have on individual jobs, and on the workflow that forms the basis of its three-year plan (e.g., staff loss, professional development). OPGRC has identified the following core capabilities, some of which will involve training of current staff and/or the hiring of personnel with specialized skills. Staff who can serve as “knowledge brokers” will be requires. This involves operating as a communication channel, representative and mediator between the Centre and its stakeholders. Broker training might include: critical appraisal of research, research methodology, policy development, adult education, communications, and mediation11. As OPGRC moves forward, staff understanding of the political environment, policy issues, and media/communications skills will be essential. Knowledge translation and exchange skills for designing effective KTE activities, monitoring and evaluating program implementation and program success, adjusting KTE activities, and managing knowledge translation awards. We will consult with KTE experts and train/hire staff specializing in KTE. 11 http://www.cfhi-fcass.ca/migrated/pdf/event_reports/brokers_final_e.pdf, retrieved December 4, 2012. Page 31 Critical research appraisal skills to complete literature reviews, provide recommendations for AHRQs, and update (and present) the Conceptual Framework and Research Framework. Strong communication, information technology skills, web design/management, and database management skills. “Customer” focused mindset. 4. Communication with stakeholders. Evolving into a KTE organization will elevate the Centre’s communication needs. OPGRC will need to inform key stakeholders about its transition plan, and seek ongoing feedback from key stakeholders (i.e., OLG, AGCO, RGC, CAMH, and researchers) using consistent messaging. We must reassure currently funded researchers that ongoing projects will continue to be funded but there will be organizational changes in the future. This task requires ongoing consultation with communications experts who understand the everchanging political environment and the sensitivities of OPGRC-funded researchers who face changes in research support and capacity. We are currently working with experts to develop an integrated communication plan. 8 Communication and Marketing Effective strategic communication is the key to successfully implementing OPGRC’s strategic and organizational initiatives. Communication is the glue that binds internal and external stakeholders to a shared vision, mission and activities related to OPGRC’s future KTE direction. It is essential that the Centre provide its stakeholders with timely, consistent, high quality information about its proposed strategic and organizational changes. It is equally important to listen to stakeholders and actively solicit their feedback, and then respond constructively. We have developed a communication plan that specifies the nature, flow, format, media and timing of this information. In March 2013, OPGRC launched a communication plan to engage key stakeholders in providing support and feedback regarding its evolution into a KTE organization. In order, these meetings included the Ministry of Finance, OLG and AGCO; RGC and CAMH; and Ontario gambling researchers. From these meetings, there were clear indications that OPGRC was regarded as a leader in objective research and capacity building, and that there is a growing need for applied research to inform best practices for gambling operations and health services available to problem gamblers and their families. The Centre can be a leader in knowledge translation and exchange for gambling including its potential for harm in Ontario, across Canada and worldwide. Communication planning might also involve marketing; the Centre’s KTE initiatives and activities will be successful only if its users are aware of them. We will therefore launch a marketing strategy directed to all stakeholders that might consist of formal and informal communication with stakeholders using multi-media and social media. Page 32 9 The Action Plan: A Three-Year Transition Plan OPGRC developed a transition plan designed to show how it intends to increase knowledge translation and exchange initiatives and activities for fiscal years 2013-2016. Adequate development of some products and services will require resources and time, resulting in the three-year phased progression. Appendix 4 provides a detailed list of the Centre’s objectives, activities we intend to implement to achieve those objectives, and the date to be achieved. Many of our activities are ongoing and are indicated as such in the Appendix. 10 Financial Plan A budget for fiscal year 2013-14 to 2015-16 is provided in Appendix 6. As outlined in the budget summary, resources allocated for ongoing research awards (i.e., investigatordriven research) will decrease as resources for knowledge inquiry (i.e., AHRQs, KT awards, secondary data analysis) and other knowledge translation and exchange activities (i.e., all other activities in the program model) will increase each year as OPGRC evolves into a fully functioning and comprehensive knowledge translation and exchange centre. 11 Measuring Successful Action Unlike the business world, non-profit organizations do not have a clear bottom line to determine how well they are achieving their mission. Research has shown that a program's success is significantly affected by how well organizational processes work in carrying out its mission. OPGRC has addressed the organizational elements often identified as significant contributors to non-profit organizational effectiveness including (61): A well-organized Board with able, involved members; the Centre will operate with its own charter and Board of Directors. Its Board members have extensive experience in various health sectors, health research, addictions and psychology. Board members with KTE expertise will be recruited. A clear Vision and Mission for the organization that is regularly reviewed by the Board. Strong leadership and management systems to provide ongoing support, motivation, and regular employee performance evaluations. Stable finances (see the three-year financial plan). Two key knowledge translation success indicators are the engagement of the target audiences (including interaction), and the use or application of knowledge (54). To achieve success, the Centre will need to decide whether its past programs, functions and activities fit its new Knowledge Translation and Exchange Program Model. This will include decisions about the optimal use of time and resources; determining whether the program is meeting stakeholder needs; identifying ways of improving programs; and demonstrating the effectiveness of programs to stakeholders. Page 33 11.1 Evaluation plan Decisions will be based on structured formal evaluations rather than on potentially biased informal feedback from stakeholders and other observations. Program evaluation requires a structured approach in the form of “the systematic gathering, analysis and reporting of data about a program to assist in decision making” (Ontario Ministry of Health, Public Health Branch, 1996). Public Health Ontario (62) and the NCCMT National Registry of Methods and Tools12, have produced workbooks to support health research program evaluation (including knowledge translation and exchange). With ongoing evaluation, we are confident the Centre will impact gambling-related health concerns and be accountable to its stakeholders, including government, gambling operators, treatment providers, researchers and communities. As OPGRC transitions into its new role, the implementation of new programs will need to be evaluated. A three-stage program evaluation process is recommended to fulfill this requirement; these stages build on one another, with the end goal being to evaluate short-and long-term program impacts (62). Figure 4 illustrates the three evaluation stages, and identifies example activities or questions involved in evaluating success. This evaluation strategy enhances the Centre’s Monitor, Evaluate; Adjust activities described earlier. Appendix 5 provides a list of performance measures, potential risks and evaluation criteria per activity. Formative evaluation. Formative evaluation focuses on programs that are under development. OPGRC is currently planning its KTE program to ensure its program development is based on its stakeholders’ needs, and that programs are using effective and appropriate materials and procedures. Specifically, the Centre will: • Define objectives and goals; • Identify target audiences; • Identify knowledge translation and exchange needs; • Document and understand the political and research context; • Take stock of available resources; • Design program strategies; and • Assess which factors will influence levels of participation and program success; Process evaluation. Process evaluation focuses on programs that are already underway; its goal is to assess procedures and tasks involved in providing a program. Specifically, the Centre will: • Track the quantity and description of people who are reached by our program; • Track the quantity and types of services provided; • Provide descriptions of how services are provided; 12 National Collaborating Centre for Methods and Tools (2012). Evaluation module: CIHR resource. Hamilton, ON: McMaster University. Retrieved from http://www.nccmt.ca/registry/view/eng/149.html, February 25, 2013. Page 34 • • Describe what actually occurs while providing services, and the quality of services provided; and Implement evaluations of short term outcomes Summative evaluation. Summative evaluation focuses on programs that are already underway or completed: its goal is to assess a program’s outcomes and impacts Specifically, the Centre will: • Evaluate changes in attitudes, knowledge and/or behaviours; • Evaluate changes in negative impacts of gambling on those participating in gambling; • Evaluate efficiency; • Assess the impact of changes in policies and practices; and • Perform short- and long-term impact assessments. Figure 4. Stages in program evaluation. Adapted from Jacobs (1988) (63). Page 35 12 Summary Ontario lottery and gaming are not only here to stay, but they continue to expand in the number and types of gambling opportunities. With these changes, Ontario can expect an increase in gambling problems for individuals, their families, and the community. Now more than ever, Ontario must respond to the growing need for effective, evidencebased decision making in client care, prevention, treatment, and policy. OPGRC has demonstrated leadership in understanding gambling-related knowledge, creating partnerships and coordinating independent research in Ontario, across Canada, and worldwide. OPGRC is in a strong position to put relevant knowledge in the hands of those who should and can bring about change. OPGRC’s proposal to evolve into a knowledge translation and exchange centre will better serve the population of gamblers and problem gamblers; reduce the harms from gaming modernization; and help decision makers find and use evidence to support their practices and decisions. Page 36 References 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. WILLIAMS, R. J., VOLBERG, R. A. & STEVENS, R. (2012) The population prevalence of problem gambling: Methodological influences, standardized, rates, jurisdictional differences, and worldwide trends. Report for the Ontario Problem Gambling Research Centre and the Ontario Ministry of Health and Long Term Care. ONTARIO LOTTERY AND GAMING CORPORATION (OLG) (2012) Modernizing Gaming and Lottery in Ontario: Strategic business review/Advice to government. COX, B. J., YU, N., AFIFI, T. O. & LADOUCEUR, R. (2005) A national survey of gambling problems in Canada, Canadian Journal of Psychiatry, 50, 213-217. VOLBERG, R. (2001) When the chips are down: Problem Gambling in America. (New York, The Century Foundation Press). ROOM, R., TURNER, N. E. & IALOMITEANU, A. (1999) Community effects of the opening of the Niagara Casino, Addiction Theory and Research, 94, 1449-1466. DALTON, A., STOVER, A., VANDERLINDEN, L. & TURNER, N. E. (2012) Toronto Public Health. The Health Impacts of Gambling Expansion in Toronto – Technical Report. WOOD, R. T. & W ILLIAMS, R. (2009) Internet gambling: Prevalence, patterns, problems, and policy options. Final report prepared for the Ontario Problem Gambling Research Centre. NATIONAL COUNCIL OF WELFARE (1996) Gambling in Canada. KORN, D. A. & SHAFFER, H. J. (1999) Gambling and the health of the public: Adopting a public health perspective, J Gambl Stud, 15, 289-365. WILLIAMS, R. J., REHM, J. & STEVENS, R. (2011) The social and economic impacts of gambling. Final Report for the Canadian Consortium for Gambling Research. WILLIAMS, R. J., BELANGER, Y. D. & ARTHUR, J. N. (2011) Gambling in Alberta: History, current status, and socioeconomic impacts. Final report to the Alberta Gaming Research Institute. AFIFI, T. O., COX, B. J., MARTENS, P. J., SAREEN, J. & ENNS, M. W. (2010) The relationship between problem gambling and mental and physical health correlates among a nationally representative sample of Canadian women, Can J Public Health, 101, 171-5. PASTERNAK, A. V. T. & FLEMING, M. F. (1999) Prevalence of gambling disorders in a primary care setting, Arch Fam Med, 8, 515-20. BERGH, C. & KFIHLHORN, E. (1994) Social, psychological and physical consequences of pathological gambling in Sweden, Journal of Gambling Studies, 10, 275-285. PRODUCTIVITY COMMISSION (1999) Australia's gambling industries. Report No. 10, AusInfo, Canberra. PARHAMI, I., SIANI, A., ROSENTHAL, R. J. & FONG, T. W. (2012) Pathological Gambling, Problem Gambling and Sleep Complaints: An Analysis of the National Comorbidity Survey: Replication (NCS-R), J Gambl Stud. PARHAMI, I., SIANI, A., ROSENTHAL, R. J. et al. (2012) Sleep and gambling severity in a community sample of gamblers, J Addict Dis, 31, 67-79. Page 37 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. BLACK, D. W., SHAW , M., MCCORMICK, B. & ALLEN, J. (2012) Pathological gambling: relationship to obesity, self-reported chronic medical conditions, poor lifestyle choices, and impaired quality of life, Compr Psychiatry, 54, 97-104. POTENZA, M. N., FIELLIN, D. A., HENINGER, G. R., ROUNSAVILLE, B. J. & MAZURE, C. M. (2002) Gambling: an addictive behavior with health and primary care implications, J Gen Intern Med, 17, 721-32. NEW ZEALAND MINISTRY OF HEALTH (2008) Raising the odds? Gambling behaviour and neighbourhood access to gambling venues in New Zealand. (Wellington: Ministry of Health). LORAINS, F. K., COWLISHAW , S. & THOMAS, S. A. (2011) Prevalence of comorbid disorders in problem and pathological gambling: systematic review and metaanalysis of population surveys, Addiction, 106, 490-8. CROCKFORD, D. N. & EL-GUEBALY, N. (1998) Psychiatric comorbidity in pathological gambling: a critical review, Can J Psychiatry, 43, 43-50. PETRY, N. (2005) Comorbidity of disordered gambling and other psychiatric disorders, in: Petry, N. (Ed.) Pathological Gambling: Etiology, Comorbidity and Treatment (Washington, DC, American Psychological Association). HODGINS, D. C., MANSLEY, C. & THYGESEN, K. (2006) Risk factors for suicide ideation and attempts among pathological gamblers, Am J Addict, 15, 303-10. SEGUIN, M., BOYER, R., LESAGE, A. et al. (2010) Suicide and gambling: psychopathology and treatment-seeking, Psychol Addict Behav, 24, 541-7. PHILLIPS, D. P., W ELTY, W. R. & SMITH, M. M. (1997) Elevated suicide levels associated with legalized gambling., Suicide & Life-Threatening Behavior 27, 373-378. MCGRATH, D. S., BARRETT, S. P., STEWART, S. H. & MCGRATH, P. R. (2012) A comparison of gambling behavior, problem gambling indices, and reasons for gambling among smokers and nonsmokers who gamble: evidence from a provincial gambling prevalence study, Nicotine Tob Res, 14, 833-9. MOMPER, S. L., DELVA, J., GROGAN-KAYLOR, A., SANCHEZ, N. & VOLBERG, R. A. (2010) The association of at-risk, problem, and pathological gambling with substance use, depression, and arrest history. , Journal of Gambling Issues, 732. OLIVEIRA, M. P., SILVEIRA, D. X. & SILVA, M. T. (2008) [Pathological gambling and its consequences for public health], Rev Saude Publica, 42, 542-9. BLACK, D. W., SHAW , M. C., MCCORMICK, B. A. & ALLEN, J. (2012) Marital status, childhood maltreatment, and family dysfunction: a controlled study of pathological gambling, J Clin Psychiatry, 73, 1293-7. AFIFI, T. O., BROWNRIDGE, D. A., MACMILLAN, H. & SAREEN, J. (2010) The relationship of gambling to intimate partner violence and child maltreatment in a nationally representative sample, J Psychiatr Res, 44, 331-7. MUELLEMAN, R. L., DENOTTER, T., W ADMAN, M. C., TRAN, T. P. & ANDERSON, J. (2002) Problem gambling in the partner of the emergency department patient as a risk factor for intimate partner violence, J Emerg Med, 23, 307-12. BELLRINGER, M., ABBOTT, M., COOMBES, R. et al. (2009) Problem gambling Formative investigation of the links between gambling (including problem Page 38 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. gambling) and crime in New Zealand (Final report prepared for Ministry of Health, New Zealand). WILLIAMS, R. J., ROYSTON, J. & HAGEN, B. F. (2005) Gambling and problem gambling within forensic populations, Criminal Justice and Behavior, 32, 665689. POTENZA, M. N., STEINBERG, M. A., MCLAUGHLIN, S. D., ROUNSAVILLE, B. J. & O'MALLEY, S. S. (2000) Illegal behaviors in problem gambling: analysis of data from a gambling helpline, J Am Acad Psychiatry Law, 28, 389-403. COTTI, C. D. & W ALKER, D. M. (2010) The impact of casinos on fatal alcoholrelated traffic accidents in the United States., Journal of Health Economics, 788796. SPECTRUM GAMING GROUP (2009) Gambling in Connecticut: Analyzing the economic and social impacts, pp. 193-197. HONG, S. I., SACCO, P. & CUNNINGHAM-W ILLIAMS, R. M. (2009) An empirical typology of lifetime and current gambling behaviors: association with health status of older adults, Aging Ment Health, 13, 265-73. MORASCO, B. J. & PETRY, N. M. (2006) Gambling problems and health functioning in individuals receiving disability, Disabil Rehabil, 28, 619-23. FONG, T. W. (2005) The biopsychosocial consequences of pathological gambling, Psychiatry (Edgmont), 2, 22-30. GRANT, J. E., SCHREIBER, L., ODLAUG, B. L. & KIM, S. W. (2010) Pathologic gambling and bankruptcy, Compr Psychiatry, 51, 115-20. EADINGTON, W. R. (2003) Measuring costs from permitted gaming: concepts and categories in evaluating gambling's consequences, J Gambl Stud, 19, 185-213. STRAUS, S. E., TETROE, J. & GRAHAM, I. (2009) Knowledge Translation in Health Care : Moving from Evidence to Practice. (Wiley-Blackwell). LAVIS, J. N., OXMAN, A. D., LEWIN, S. & FRETHEIM, A. (2009) SUPPORT Tools for evidence-informed health Policymaking (STP), Health Res Policy Syst, 7 Suppl 1, I1. BENNET, G. & JESSANI, N. (2011) The Knowledge Translation Toolkit: Bridging the Know-Do Gap: A Resource for Researchers. (Sage India, IDRC). ABBOTT, M., BINDE, P., HODGINS, D. et al. (2012) Conceptual Framework for Harmful Gambling: An International Collaboration. The Ontario Problem Gambling Research Centre (OPGRC), Guelph, Ontario, Canada. GRAHAM, I. D., LOGAN, J., HARRISON, M. B. et al. (2006) Lost in knowledge translation: time for a map?, J Contin Educ Health Prof, 26, 13-24. DOBBINS, M., HANNA, S. E., CILISKA, D. et al. (2009) A randomized controlled trial evaluating the impact of knowledge translation and exchange strategies, Implement Sci, 4, 61. LAVIS, J. N., ROBERTSON, D., W OODSIDE, J. M., MCLEOD, C. B. & ABELSON, J. (2003) How can research organizations more effectively transfer research knowledge to decision makers?, Milbank Q, 81, 221-48, 171-2. LOMAS, J. (1993) Diffusion, dissemination and implementation: Who should do what? , Annals of the New York Academy of Sciences, 703, 226-235. CAPLAN, N. (1979) The two-communities theory and knowledge utilization., American Behavioral Scientist, 22, 459-470. Page 39 52. 53. 54. 55. 56. 57. 58. 59. 60. 61. 62. 63. 64. 65. 66. JACOBSON, N., BUTTERILL, D. & GOERING, P. (2003) Development of a framework for knowledge translation: understanding user context, J Health Serv Res Policy, 8, 94-9. KING, L., HAWE, P. & WISE, M. (1998) Making dissemination a two way process. , Health Promotion International, 13, 237-244. DAVISON, C. M. (2009) Knowledge translation: Implications for evaluation., in: Ottoson, J. M. & Hawe, P. (Eds.) Knowledge utilization, diffusion, implementation, transfer, and translation: Implications for evaluation. New Directions for Evaluation, pp. 75-87 (San Francisco, Wiley Subscription Services at Jossey-Bass). STRAUS, S. E., TETROE, J. & GRAHAM, I. (2009) Defining knowledge translation, CMAJ, 181, 165-8. LAVIS, J. N. (2006) Research, public policymaking, and knowledge-translation processes: Canadian efforts to build bridges, J Contin Educ Health Prof, 26, 3745. ABERNATHY, T., COUTTS, J., ROYCE, D. et al. (2000) Knowledge transfer: Looking beyond health. Report on the conference held in Toronto, October 26-27, 2000. (Canadian Foundation for Healthcare Improvement). ZARINPOUSH, F., VON SYCHOWSKI, S. & SPERLING, J. (2007) Effective Knowledge Transfer and Exchange for Nonprofit Organizations: A Framework (Imagine Canada). LAVIS, J., ROSS, S., MCLEOD, C. & GILDINER, A. (2003) Measuring the impact of health research. , Journal of Health Services Research & Policy, 8, 165-170. LARSEN, J. K. (1980) Knowledge utilization: What is it?, Knowledge: Creation, Diffusion, Utilization, 1, 421-442. INNOVATION NETWORK INC. (1999) Nonprofit Organizational Effectiveness: A Literature Review. (The Learning Circles Project). PUBLIC HEALTH ONTARIO (2008) Evaluting Health Promotion Programs Workbook, The Heatlh Communication Unit, University of Toronto, Ontario. JACOBS, F. (1988) The five-tiered approach to evaluation, in: Weiss, H. B. (Ed.) Evaluating Family Programs. (New York., Aldine Publishers). GOODSTADT, M. S. & SANTESSO, D. L. (2012) Developing a research program to address problem gambling: A background paper for the Ontario Problem Gambling Research Centre (OPGRC), Guelph, Ontario, Canada. . LAVIS, J., DAVIES, H., OXMAN, A. et al. (2005) Towards systematic reviews that inform health care management and policy-making, J Health Serv Res Policy, 10 Suppl 1, 35-48. LAVIS, J. N., POSADA, F. B., HAINES, A. & OSEI, E. (2004) Use of research to inform public policymaking, Lancet, 364, 1615-21. Page 40 13 Appendices Page 41 OPGRC KTE Detailed Proposal Appendix 1 Conceptual Framework of Harmful Gambling Page 42 OPGRC KTE Detailed Proposal Appendix 2 Expert consultations and stakeholder discussions Consultant Institution/Organization Dr. Onil Battacharyya Keenan Research Center of the Li Ka Shing Research Knowledge Institute Dr. Maureen Dobbins National Collaborating Centre for Methods and Tools (NCCMT) Barry Goodwin Assistant Deputy to the Minister of Finance Dr. Jon Kelly Chief Executive Officer, RGC Dr. John Lavis McMaster University Health Forum Jean Major Chief Executive Officer, AGCO Martha Otton Chief Strategy Officer, AGCO Paul Pellizarri Executive Director - Policy & Social Responsibility, OLG Dr. Sean Rourke Scientific and Executive Director, Ontario HIV Treatment Network (OHTN) Nina Littman-Sharp Manager, Problem Gambling Service for CAMH Wayne Skinner Deputy Director, CAMH Addictions Program Page 43 Appendix 3 OPGRC Knowledge Translation Program Model example activities Knowledge Repository • Maintain a user-friendly searchable and up-to-date online storehouse for journal article abstracts and synopses; grey literature including opinion papers on policy issues, press releases, newspaper articles; minutes from publically available Ministry meetings regarding gambling-related policy issues. Grey literature will also include student theses/dissertations and evaluation reports from treatment and community agencies. In spring 2013 OPGRC will begin to solicit agencies to gather this grey literature. OPGCR currently scans, gathers and summarizes research literature and these materials are available online. We currently also post presentations from OPGRC workshops/conferences; and OPGRC-funded educational animations. • After a decade of operation, OPGRC has developed study databases from which secondary data analyses can be performed to address new and relevant research questions. Databases will be gathered and consolidated, and researchers will have contractual access to databases for secondary data analyses. • OPGRC will create new and maintain existing partnerships on three levels: 1. Strategic level – We will obtain formal agreements to store and circulate information about researchers’ work in progress, to notify knowledge users of their participation in media/scientific community events, and finally disseminate completed research findings (in the form of journal abstract, synopsis, and open-access journal articles). 2. Adjunct scientist level – Through capacity building, we will appoint researchers and treatment providers as adjunct scientists with whom we will maintain ongoing, mutually beneficial relationships. 3. Network level – We will create extended partnerships, provincially, nationally, internationally to gain broader perspectives on gambling issues. Our partners’ biography, area of expertise, laboratory website link and contact information will be made available on the OPGRC website so that all stakeholders will be able to discover the “who?”, “what?” and “where?” regarding gambling issues. These partnerships will be mutually beneficial: the Centre will build strong working relationships with gambling researchers; researchers (and their work) will gain exposure outside of the scientific community and their own KTE activities – an essential factor in the research funding process – will be supported. Page 44 Knowledge Products • OPGRC already has an online repository of over 550 searchable synopses. Each synopsis provides a one page lay language summary of a gambling research article published in a peer-reviewed journal. Synopses will be expanded to include grey literature such as newspaper articles and opinion papers. • OPGRC’s Conceptual Framework for Harmful Gambling was created by an international and interdisciplinary team of experts on gambling and problem gambling (46). The Framework comprehensively addresses problem gambling factors related to population risk and consolidates theoretical understanding. The Framework will be updated annually based on emerging research. In spring 2013, the Conceptual Framework will be linked to supporting and/or relevant synopses, articles and OPGRC-funded projects within the storehouse. • OPGRC has also created a strategic review and theoretical document Problem Gambling Research Framework (64). The document is a comprehensive literature review of problem gambling risk factors, social-economic consequences of gambling, and prevention/intervention strategies. This Framework highlights gaps in gambling research to facilitate strategic programs of research. Importantly, this document also offers a framework for understanding the problems and solutions for problem gambling. The document will be available online and updated annually. Page 45 Evidence-informed Advice • Policy briefs are most likely to be read first in policy-making circles (45). The brief highlights a project's policy-relevant findings in non-technical language to articulate the policy implications of the work and recommendations. • Literature reviews that address complex political issues are time efficient for public policymakers because the research literature has already been identified, selected, appraised, and synthesized in a systematic and transparent way (56, 65, 66). • OPGRC will develop an evidence-based process for identifying best practices for land- and internetbased gambling following reviews of the literature and past and present practices and standards. OPGRC will create an evaluation framework for making best practice recommendations on the basis of assessment of a practice’s potential impact and the strength of evidence. The results will be valuable to gambling operators and government decision makers. • To the extent that funding allows, OPGRC will hold policy panels and briefing sessions in order to create face-to-face dialogue between policymakers, researchers and other stakeholders when there is policy debate. Page 46 Facilitated Learning • OPGRC will continue to offer stakeholders continuing education workshops that provide a platform for dissemination and debate on “hot topics” in gambling research and effective knowledge translation strategies in the gambling field. Workshops will teach participants how to critically appraise research evidence and how to put this knowledge into action or practice (such as treatment program development). We envision engaging research and knowledge translation partners (e.g., National Collaborating Centre for Methods and Tools at McMaster University; NCCMT) to lead these workshops. The continuing education workshop provides an excellent opportunity for stakeholders to come together to discuss and debate ways to improve gambling research and knowledge translation while providing all stakeholders with a platform for networking. • OPGRC will offer student placements within the organization which will provide students with experiential learning related to KTE, project management, technology and website design, and gambling issues. • OPGRC participation at international conferences will increase visibility of the Centre and provide an appropriate environment for presenting the Conceptual Framework and research findings completed in-house. • OPGRC will participate in and host the invitation-only international Think Tank on Gambling Research, Policy and Practice organized for intensive gambling research discussion and problem solving. The think tank brings people together with a variety of expertise and experience to tackle an issue by discovering what we know, where we are and how to move forward. Page 47 Knowledge Inquiry • OPGRC’s will continue to address knowledge questions posed by its stakeholders. This might include Applied Health Research Questions (AHRQ) posed by the Ontario Government. An AHRQ is a question posed by a health system policy maker or provider in order to obtain research evidence to 13 inform planning, policy and program development that will benefit the entire Ontario health system. • After a decade of operation, OPGRC has developed study databases from which secondary data analyses can be performed to address new and relevant research questions by researchers and/or OPGRC staff. • OPGRC will continue to offer knowledge translation awards (e.g., “Take-it-to-the-Finish Award”) first introduced in 2012. The awards are designed to encourage researchers to bridge the knowledge-toaction gap by examining users’ practice of measures, interventions, responsible gambling tools, and other research results. • To the extent that funding allows, OPGRC will identify gaps in gambling research. Through this exercise, OPGRC will be in the position to address questions posed by stakeholders in areas of greatest need (e.g., sex differences, ethno-cultural influences). 13 http://www.health.gov.on.ca/en/pro/ministry/research/ahrq.aspx Page 48 Monitor, Evaluate, Adjust • Monitor the knowledge-to-action gaps by systematically assessing stakeholders’ changing knowledge translation needs (e.g., what knowledge product or facilitated learning would be useful to them) and assess the barriers and facilitators to knowledge use. In spring 2013, OPGRC will engage knowledge translation experts to assess stakeholders’ needs using key informant interviews and surveys. • If we do not know what knowledge we already have, what our knowledge gaps are, and how that knowledge flows within our organization, we cannot assess and improve our activities and practices. As such, OPGCR will undertake knowledge audits to assess and list knowledge resources, assets and flows. • Measure the most effective ways to promote knowledge use in the decision making process by developing assessment and evaluation tools with partners at the NCCMT who have developed tools for various health sectors. • Monitor policy debate and policy implementation to assess the impact of OPGRC functions in evidence-informed decision making. • Evaluate stakeholders’ awareness of, satisfaction with and actual use of knowledge products and facilitated learning opportunities in practice through online tracking, surveys or key informant interviews. The NCCMT provides methods to organize this activity (e.g., guidelines, forums) and tools or instruments to carry out this activity. • Identify the Zeitgeist, or dominant school of thought, characterizing and influencing general attitudes towards gambling and complex policy issues at any period in time. This is critical to providing timely and relevant knowledge products and facilitated learning services. Page 49 OPGRC KTE Detailed Proposal Appendix 4 Timeline of KTE activities for fiscal year 2013-16 Fiscal Year 2013-14 Objective 1 Date to be Achieved/ indicate if ongoing Knowledge Repository 1.1 Strengthen capacity to gather, store and disseminate knowledge products and deliver services. 1.2 Develop and acquire problem gambling research data to be used by the centre and researchers to answer questions about problem gambling. 1.3 Engage experts and combine knowledge. 2 Activity or Milestone Assess how to develop a user-friendly, searchable website and data storage system to disseminate knowledge products and engage stakeholders to seek knowledge. Development of the site/systems might begin. Gather and merge study datasets and develop a process to provide access to data. March 31, 2014 Communicate with and recruit Ontario adjunct research scientists and partner with treatment provider experts. March 31, 2014 Continue to provide access to plain language summaries of peer-reviewed research articles (The Synopsis Project). Ongoing to 2016 Ongoing to 2016 Knowledge Products 2.1 Strengthen dissemination of various forms of knowledge. Page 50 2.2 Promote awareness of the harms of gambling. Engage international panel of experts to jointly author an updated edition of the Conceptual Framework of Harmful Gambling based on new research findings and trends. Ongoing to 2016 Work with KTE communication staff to maximize dissemination of information. 2.3 Provide an annual summary of the key research and policy issues relating to problem gambling. Develop a Problem Gambling Research Framework as a learning tool, advisory/review document of new research findings and trends. Ongoing to 2016 Work with KTE communication staff to maximize dissemination of information. 3 Evidence-informed Advice 3.1 Provide expert advice to stakeholders. Create reviews, summaries and/or policy briefs, and perform literature searches for stakeholders as requested. Ongoing to 2016 Establish methods to discuss gambling issues (e.g., panels/forums/roundtables/webinars). 4 Facilitated Learning 4.1 Provide learning opportunities for research students. 5 Host 1 student-oriented gambling workshop or webinar focused on current learning needs. March 31, 2014 Existing high quality problem gambling research is completed on time and in scope, and a final report is submitted. Ongoing to 2016 Knowledge Inquiry 5.1 Continue funding for committed research projects. Page 51 5.2 Provide expert advice on problem gambling issues. Work with MOHLTC and other Ministries and Government agencies to address their Applied Health Research Questions needs. Ongoing to 2016 5.3 Engage researchers and practitioners in knowledge translation. Develop a model for funding knowledge translation awards to encourage researchers to bridge the knowledge into practice gap by examining users’ practice of measures, interventions, responsible gambling tools, and other research results. Offer one award this fiscal year. Work with a broader stakeholder group to identify relevant themes and gaps in gambling knowledge that merit research resources. March 31, 2014 6.1 Establish and maintain relationships with stakeholders to improve knowledge translation activities. Create a platform for stakeholders to provide feedback and insight into what knowledge translation products and services they need. Ongoing to 2016 6.2 Strengthen our ability to deliver relevant knowledge. Monitor the knowledge use and systematically assess stakeholders’ changing knowledge translation needs (e.g., what knowledge product or facilitated learning is useful to them). Assess barriers to knowledge use. Develop tools to assess program success. Ongoing to 2016 5.4 Strengthen strategic research. 6 Ongoing to 2016 Monitor, Evaluate, Adjust 6.3 Ensure program success. Ongoing to 2016 Page 52 Fiscal Year 2014-15 Objective 1 Activity or Milestone Date to be Achieved/ indicate if ongoing Knowledge Repository 1.1 Continued development and maintenance of the web site and the data storage functions. Continue to develop and maintain the userfriendly, searchable website and data storage system to disseminate knowledge products and engage stakeholders to seek knowledge. Ongoing to 2016 1.2 Integrate new problem gambling research data into datasets as they become available Gather and merge datasets in order to provide for stakeholders March 31, 2015 1.3 Engage experts and combine knowledge. Continue communication with and recruitment of Ontario adjunct research scientists and treatment provider experts as partners. Pilot the provision of access to datasets in order to conduct secondary data analyses. Ongoing to 2016 Continue to engage international panel of experts to jointly author an updated edition of the Conceptual Framework of Harmful Gambling based on new research findings and trends. Ongoing to 2016 1.4 Share a wealth of research data. 2 March 31, 2015 Knowledge Products 2.1 Continue to promote awareness of the harms of gambling. Work with KTE communication staff to maximize dissemination of information. Page 53 2.2 Provide an annual summary of the key research and policy issues relating to problem gambling. Continue to update the Problem Gambling Research Framework with new knowledge as a learning tool, advisory/review document of new research findings and trends. Ongoing to 2016 Work with KTE communication staff to maximize dissemination of information. 2.3 Strengthen dissemination of various forms of knowledge. Provide access to plain language summaries for grey literature in addition to peer-reviewed research studies (The Synopsis Project). Ongoing to 2016 Create reviews, summaries and/or policy briefs, and perform literature searches for stakeholders as requested. Host panels/forums/roundtables to discuss gambling issues for stakeholders to problem solve, set priorities, and/or assess stakeholder needs. Ongoing to 2016 4.1 Provide learning opportunities for students and stakeholders. Host one student- and one stakeholder-oriented gambling workshop or webinar focused on current learning needs. March 31, 2015 4.2 Strengthen dissemination and build presence and networks. Attend and/or present at conferences. Ongoing to 2016 3 Evidence-informed Advice 3.1 Provide expert advice to stakeholders. 3.2 Provide expert advice to decision makers through exchange and dialogue. 4 Ongoing to 2016 Facilitated Learning Page 54 5 Knowledge Inquiry 5.1 Continue funding for committed research projects. Existing high quality problem gambling research is completed on time and in scope, final report submission. Ongoing to 2016 5.2 Provide expert advice on problem gambling issues. Work with MOHLTC and other Ministries and Government agencies to address their Applied Health Research Questions needs. Ongoing to 2016 5.3 Engage researchers and practitioners in knowledge translation research. Offer two knowledge translation awards to encourage researchers to bridge the knowledge into practice gap by examining users’ practice of measures, interventions, responsible gambling tools, and other research results. Ongoing to 2016 5.4 Strengthen strategic research. Work with a broader stakeholder group to identify relevant themes and gaps in gambling knowledge that merit research resources. Ongoing to 2016 Assess short-term outcomes and possible improvements to the KTE program using previously developed tools. Ongoing to 2016 6 Monitor, Evaluate, Adjust 6.1 Ensure program success. Page 55 Fiscal Year 2015-16 Objective Activity or Milestone Date to be Achieved/ indicate if ongoing 1.1 Continued development and maintenance of the web site and the data storage functions. Continue to develop and maintain the userfriendly, searchable website and data storage system to disseminate knowledge products/ engage stakeholders to seek knowledge. Ongoing to 2016 1.2 Engage experts and combine knowledge. Continue communication with and recruitment of Ontario adjunct research scientists and partner with treatment provider experts. Gather and merge datasets as they become available. Ongoing to 2016 Provide researchers, students and staff access to datasets in order to conduct secondary data analyses. Ongoing to 2016 Continue to engage international panel of experts to jointly author an updated edition of the Conceptual Framework of Harmful Gambling based on new research findings and trends. Ongoing to 2016 1 Knowledge Repository 1.3 Integrate new problem gambling research data into datasets as they become available. 1.4 Share a wealth of research data. 2 Ongoing to 2016 Knowledge Products 2.1 Continue to promote awareness of the harms of gambling. Work with KTE communication staff to maximize dissemination of information. Page 56 2.2 Provide an annual summary of the key research and policy issues relating to problem gambling. 2.3 Strengthen dissemination of various forms of knowledge. 3 Continue to update the Problem Gambling Research Framework with new knowledge as a learning tool, advisory/review document of new research findings and trends. Work with KTE communication staff to maximize dissemination of information. Provide access to plain language summaries for grey literature and peer-reviewed research studies (The Synopsis Project). Ongoing to 2016 Ongoing to 2016 Evidence-informed Advice 3.1 Provide expert advice to stakeholders. Create reviews, summaries and/or policy briefs, and perform literature searches for stakeholders as requested. Ongoing to 2016 3.2 Provide expert advice to decision makers through exchange and dialogue. Host panels/forums/roundtables to discuss gambling issues for stakeholders to problem solve, set priorities, and/or assess stakeholder needs. Ongoing to 2016 4.1 Provide learning and networking opportunities for students and stakeholders. Host one stakeholder and two student-oriented gambling workshops or webinars with an expert panel. Ongoing to 2016 4.2 Provide problem solving and networking opportunities for stakeholders. Host the International Think Tank on Gambling Research, Policy and Practice. April 2015 4.3 Strengthen dissemination and build presence and networks. Attend and/or present at conferences. Ongoing to 2016 4 Facilitated Learning Page 57 5 Knowledge Inquiry 5.1 Continue funding for committed research projects. Existing high quality problem gambling research is completed on time and in scope, and a final report submitted. Ongoing to 2016 5.2 Provide expert advice on problem gambling issues. Work with MOHLTC and other Ministries and Government agencies to address their Applied Health Research Questions needs. Ongoing to 2016 5.3 Engage researchers and practitioners in knowledge translation research. Offer four knowledge translation awards to encourage researchers to bridge the knowledge into practice gap by examining users’ practice of measures, interventions, responsible gambling tools, and other research results. Work with a broader stakeholder group to identify relevant themes and gaps in gambling knowledge that merit research resources. Ongoing to 2016 Assess short-term and long-term outcomes and program success using previously developed tools. Ongoing to 2016 5.4 Strengthen strategic research. 6 Ongoing to 2016 Monitor, Evaluate, Adjust 6.1 Ensure program success. Page 58 OPGRC KTE Detailed Proposal Appendix 5 Performance measures and evaluation criteria for KTE activities per fiscal year Fiscal Year 2013-14 Activity or Milestone 1 Performance Measure Potential Risks/ Contingencies Evaluation Criteria Knowledge repository 1.1 Create a user-friendly, searchable website and data storage system to disseminate knowledge products/ engage stakeholders to seek knowledge. Survey stakeholders’ awareness of website and satisfaction with website functions and appeal. Centre lacking the resources to take on this task. We will seek advice from fully functional KTE organizations and by contracting out the design work. How well does the product meet the needs of knowledge users? 1.2 Gather and merge study datasets and develop a system process to provide access to these data. A storage and online data site is flexible to meet transition requirements. Centre lacking the resources to take on this task. Were available data integrated into the database? Was an access system created for users? 1.3 Open communication with and recruit Ontario adjunct research scientists and partner with treatment provider experts. Obtain three to six formal agreements for the new funding period. OPGRC transition may be unappealing to previously funded researchers. How many adjunct research scientists were appointed and partnerships established? Page 59 2 Knowledge Products 2.1 Continue to provide access to plain language summaries of peer-reviewed research articles (The Synopsis Project). Monitor use of synopses. Survey the relevancy and readability of the synopses. Volume of literature; plain language writing is difficult and may require training; reluctance of stakeholders to access synopses; search engine must be flexible. Did stakeholder access the Synopsis Project? How relevant was the synopsis to the stakeholders? 2.2 Survey its relevancy, breadth/depth and readability. Engaging original author panel and/or new authors. How relevant was the Framework to stakeholders? Engage international panel of experts to jointly author an updated edition of the Conceptual Framework of Harmful Gambling based on new research findings and trends. Interest might be low from stakeholders in positions to make decisions and/or set priorities. Work with KTE communication staff to maximize dissemination of information. 2.3 Develop and disseminate the Problem Gambling Research Framework as a learning tool, advisory/review document of new research findings and trends. Monitor the use of the Framework. Problem gambling is complex and the literature large. Interest might be low from stakeholders in positions to make decisions and/or set priorities. How relevant was the Framework to stakeholders? How often was the Framework referenced by stakeholders? Page 60 3 3.1 Evidence-informed Advice Create reviews, summaries and/or policy briefs, and perform literature searches for stakeholders as requested. Obtain feedback on the quality and timeliness of the advice. Establish methods to discuss gambling issues for stakeholders to problem solve, set priorities, and/or assess stakeholder needs (e.g., panels / forums / roundtables/webinars). Assess potential participation by stakeholders. 4 4.1 Were reviews, summaries and/or briefs request by or used by stakeholders? How open are key stakeholders to participating in methods established? Which platform best meets their needs? Facilitated Learning Host one student-oriented gambling workshop or webinar focused on current learning needs. 5 5.1 Timeliness of material is critical; stakeholders may be unaware staff can perform these tasks. Interest might be low from stakeholders in positions to make decisions and/or set priorities. Assess participation, and obtain feedback on the usefulness of the workshop. There are few students involved in gambling research. How many students attended? How well did the workshop meet the students’ learning needs? Knowledge Inquiry Existing problem gambling research is completed on time and in scope, and a final report is submitted. Quality of interim and final research reports and timeliness. Change in OPGRC role away from being a research funder may weaken researchers resolve to deliver against contracts. Did the projects address the research questions? Were research projects completed on time with a report? Page 61 5.2 Work with MOHLTC and other Ministries and Government agencies to address their Applied Health Research Questions needs. Stakeholder satisfaction with OPGRC expert advice. MOHLTC chooses not to fund three-year KTE proposal. Did OPGRC and the stakeholder(s) work collaboratively to develop and address research questions based on needs? 5.3 Develop and offer knowledge translation awards. Monitor submissions and researcher interest. Few gambling researchers are involved in knowledge translation. Interest may be low. OPGRC transition may be unappealing to previously funded researchers. Do the topics address KTE gaps/needs? 5.4 Work with a broader stakeholder group to identify relevant themes and gaps in gambling knowledge that merit research resources. Monitor stakeholder engagement to identify themes/gaps in knowledge. Lack of stakeholder interest and support. Lack of resources. Were stakeholders engaged in themes/gaps analysis? Was there uptake on recommendations? 6 6.1 Monitor, Evaluate, Adjust Create a platform for stakeholders to provide feedback and insight into what knowledge translation products and services they need. Monitor use and stakeholder satisfaction with the platform. Engage stakeholders to determine best practice platforms. Was the platform used for discussion and dissemination purposes? How many stakeholders use the platform? Page 62 6.2 6.3 Monitor the knowledge use and systematically assess stakeholders’ changing knowledge translation needs (e.g., what knowledge product or facilitated learning is useful to them). Assess barriers to knowledge use. Develop tools to assess program success. Assess stakeholders’ willingness to provide useful feedback and feasibility of altering products and services. Stakeholders may be uninterested or have time constraints. Stakeholders may not know what they need and/or in what format. Was the assessment performed with various target stakeholders? Were suggested improvements to the KTE activity implemented? Quality of tools developed / adapted from other knowledge translation organizations. Stakeholders may be uninterested in participating in the assessments Were tools to assess program success developed? Page 63 Fiscal Year 2014-15 Activity or Milestone 1 1.1 1.2 Performance Measure Potential Risks/ Contingencies Evaluation Criteria Knowledge Repository Continued development and maintenance of a userfriendly, searchable website and data storage system to disseminate knowledge products/ engage stakeholders to seek knowledge. Gather and merge datasets in order to provide for stakeholders Survey stakeholders’ awareness of website and satisfaction with website functions and appeal. Centre lacking the resources to take on this task. How well does the product meet the needs of knowledge users? Demonstrate successful storing, merging and a system for accessing these data. Maintain linkage with fully functioning data warehouses so we can keep track of current best practices. Were available data integrated into the database and made available to users? Existing problem gambling researchers may migrate to other research interests since there are fewer funds available for investigator driven research. Ethical concerns regarding secondary use of data. Number of adjunct research scientists and partners that remain engaged. Number of new adjunct scientists and partnerships established. Was data accessed and analysed ethically and used to address varied research questions? 1.3 Continue communication with Ontario researchers to become adjunct research scientists and treatment provider experts as partners. Obtain a maximum of six formal agreements for the funding period. 1.4 Provide researchers, students and staff access to datasets in order to conduct secondary data analyses. Monitor access requests and publication of results emerging from the database. Page 64 2 2.1 Knowledge Products Continue to engage international panel of experts to jointly author an updated edition of the Conceptual Framework of Harmful Gambling based on new research findings and trends. Survey its relevancy, breadth/depth and readability. Continue to update the Problem Gambling Research Framework with new knowledge as a learning tool, advisory/review document of new research findings and trends. Monitor the use of the Framework. Provide access to plain language summaries for grey literature in addition to peerreviewed research studies (The Synopsis Project). Problem gambling is complex and the literature large. Interest might be low from stakeholders in positions to make decisions and/or set priorities. Work with a KTE communication staff to maximize dissemination of information. 2.3 How relevant was the Framework to stakeholders? Interest might be low from stakeholders in positions to make decisions and/or set priorities. Work with a KTE communication staff to maximize dissemination of information. 2.2 Engaging original author panel and/or new authors. Monitor use of the Synopsis Project. Survey the relevancy and readability of the synopses. Remaining current and up to date on literature is a challenge. How relevant was the Framework to stakeholders? How often was the Framework referenced by stakeholders? Did stakeholder access the Synopsis Project? How relevant was the synopsis to the stakeholders? Page 65 3 3.1 Evidence-informed Advice Create reviews, summaries and/or policy briefs, and perform literature searches for stakeholders as requested. Obtain feedback on the quality and timeliness of the advice. Assess potential participation by stakeholders. Timeliness of material is critical; stakeholders may be unaware staff can perform these tasks. Were reviews, summaries and/or briefs request by or used by stakeholders? Interest might be low from stakeholders in positions to make decisions and/or set priorities. 3.2 Host panels/forums/ roundtables to discuss gambling issues for stakeholders to problem solve, set priorities, and/or assess stakeholder needs. 4 4.1 Obtain feedback on the quality and timeliness of the advice. Interest might be low from stakeholders in positions to make decisions and/or set priorities. Did key stakeholders to participate in the established exchange method? Did stakeholders find the exchange beneficial regarding advice and problem solving? Facilitated Learning Host one student- and one stakeholder-oriented gambling workshop or webinar focused on current learning needs. Assess participation, and obtain feedback on the usefulness of the discussions. There are few students involved in gambling research. Stakeholder interest might be low. How many students attended? How many stakeholders attended? Did the workshop meet the participants’ learning needs? Page 66 4.2 Attend and/or present at conferences. 5 Positive feedback from participants that the information we disseminated was useful to them. Remaining current and relevant in our presentation is an ever present issue - KT staff will regularly review the priority topics and presentations. How many conferences were attended? Was material/knowledge disseminated at the conference? Knowledge Inquiry 5.1 Existing problem gambling research is completed on time and in scope, final report submission. Quality of interim and final research reports and timeliness. 5.2 Work with MOHLTC and other Ministries and Government agencies to address their Applied Health Research Questions needs. Stakeholder satisfaction with OPGRC expert advice. 5.3 Offer two knowledge translation awards to encourage researchers to bridge the knowledge into practice gap by examining users’ practice of measures, interventions, responsible gambling tools, and other research results. Assess project relevancy and interest from the research and treatment community. Change in OPGRC role away from being a research funder may weaken researchers resolve to deliver against contracts. MOHLTC chooses not to fund three-year KTE proposal. Few gambling researchers are involved in knowledge translation. Interest may be low. OPGRC transition may be unappealing to previously funded researchers. Did the projects address the research questions? Were research projects completed on time with a report? Did OPGRC and the stakeholder(s) work collaboratively to develop and address research questions based on needs? Do the topics address knowledge gaps/needs? Did the award result in quality work? Page 67 5.4 Work with a broader stakeholder group to identify relevant themes and gaps in gambling knowledge that merit research resources. 6 6.1 Monitor stakeholder engagement to identify themes/gaps in knowledge. Lack of stakeholder interest and support. Lack of resources. Were stakeholders engaged in themes/gaps analysis? Was there uptake on recommendations? Monitor, Evaluate, Adjust Assess short-term outcomes and program success using developed tools. Survey awareness, attitude change, use of products and services, policy discussions and OPGRC participation in forums, etc. Assessment tools are complex and assessing impact (e.g., harm reduction) difficult. Were short-term goals or outcomes met or in progress? Were identified improvements implemented? Page 68 Fiscal Year 2015-16 Activity or Milestone 1 1.1 1.2 Performance Measure Potential Risks/ Contingencies Evaluation Criteria Knowledge repository Continued development and maintenance of a userfriendly, searchable website and data storage system to disseminate knowledge products/ engage stakeholders to seek knowledge. Continue communication with Ontario researchers to become adjunct research scientists and treatment provider experts as partners. 1.3 Gather and merge datasets as they become available. 1.4 Provide researchers, students and staff access to datasets in order to conduct secondary data analyses. Survey stakeholders’ awareness of website and satisfaction with website functions and appeal. Centre lacking the resources to take on this task. How well does the product meet the needs of knowledge users? Obtain a maximum of six formal agreements. Existing problem gambling researchers may migrate to other research interests since there are fewer funds available for investigator driven research Demonstrate successful storing, merging and a system for accessing these data. Monitor access requests and publication of results emerging from the database. Maintain linkage with fully functioning data warehouses so we can keep track of current best practices. Ethical concerns regarding secondary use of data. Number of adjunct research scientists and partners that remain engaged. Number of new adjunct research scientists and partnerships established. Were available data integrated into the database and made available to users? Was data accessed and analysed ethically and used to address varied research questions? Page 69 2 2.1 Knowledge Products Continue to engage international panel of experts to jointly author an updated edition of the Conceptual Framework of Harmful Gambling based on new research findings and trends. Survey its relevancy, breadth/depth and readability. 2.3 How relevant was the Framework to stakeholders? Interest might be low from stakeholders in positions to make decisions and/or set priorities. Work with a KTE communication staff to maximize dissemination of information. 2.2 Engaging original author panel and/or new authors. Develop and disseminate the Problem Gambling Research Framework as a learning tool, advisory/review document and of new research findings and trends. Monitor the use of the Framework. Provide access to plain language summaries for grey and peer-reviewed research studies (The Synopsis Project). Survey its relevancy, breadth/depth and readability. Problem gambling is complex and the literature large. Interest might be low from stakeholders in positions to make decisions and/or set priorities. Problem gambling is complex and the literature large. How relevant was the Framework to stakeholders? How often was the Framework referenced by stakeholders? How relevant was the synopsis to the stakeholders? How many stakeholders accessed the Synopsis Project? Page 70 3 Evidence-informed Advice 3.1 Create reviews, summaries and/or policy briefs, and perform literature searches for stakeholders as requested. Obtain feedback on the quality and timeliness of the advice. Assess potential participation by stakeholders. 3.2 Host panels/ forums/ roundtables to discuss gambling issues for stakeholders to problem solve, set priorities, and/or assess stakeholder needs. Obtain feedback on the quality and timeliness of the advice. Timeliness of material is critical; stakeholders may be unaware staff can perform these tasks. Interest might be low from stakeholders in positions to make decisions and/or set priorities. Timeliness of material is critical; stakeholders may be unaware staff can perform these tasks. Interest might be low from stakeholders in positions to make decisions and/or set priorities. 4 4.1 Were reviews, summaries and/or briefs request by or used by stakeholders? Did key stakeholders to participate in the established exchange method? Did stakeholders find the exchange beneficial regarding advice and problem solving? Facilitated Learning Host two student-oriented and one stakeholder gambling workshops or webinars with an expert panel. Assess participation, and obtain feedback on the usefulness of the workshop. There are few students involved in gambling research. How many key stakeholders and students attended? Did the workshop meet their learning needs? Page 71 4.2 Host the Think Tank on Gambling Research, Policy and Practice. Assess participation, and obtain feedback on the usefulness of the discussions. Recruiting international experts to Ontario. How many international gambling research leaders attended? Was the Think Tank relevant? 4.3 Attend and/or present at conferences. Positive feedback from participants that the information we disseminated was useful to them. Remaining current and relevant in our presentation is an ever present issue - KT staff will regularly review the priority topics and presentations. How many conferences were attended? Was material/knowledge disseminated at the conference? 5 Knowledge Inquiry 5.1 Existing problem gambling research is completed on time and in scope, final report submission. Quality of interim and final research reports and timeliness. Change in OPGRC role away from being a research funder may weaken researchers resolve to deliver against contracts. Did the projects address the research questions? Were research projects completed on time with a report? 5.2 Work with MOHLTC and other Ministries and Government agencies to address their Applied Health Research Questions needs. Stakeholder satisfaction with OPGRC expert advice. MOHLTC chooses not to fund three-year KTE proposal. Did OPGRC and the stakeholder(s) work collaboratively to develop and address research questions based on needs? Page 72 5.3 5.4 Offer four knowledge translation awards to encourage researchers to bridge the knowledge into practice gap by examining users’ practice of measures, interventions, responsible gambling tools, and other research results. Work with a broader stakeholder group to identify relevant themes and gaps in gambling knowledge that merit research resources. 6 6.1 Assess project relevancy and interest from the research and treatment community. Monitor stakeholder engagement to identify themes/gaps in knowledge. Few gambling researchers are involved in knowledge translation. Interest may be low. OPGRC transition may be unappealing to previously funded researchers. Lack of stakeholder interest and support. Lack of resources. Do the topics address KTE gaps/needs? Were stakeholders engaged in themes/gaps analysis? Was there uptake on recommendations? Monitor, Evaluate, Adjust Assess short and long-term outcomes and program success using developed tools. Survey awareness, attitude change, use of products and services, policy discussions and OPGRC participation in forums, etc., Assessment tools are complex and assessing impact (e.g., harm reduction) difficult. Were short and longterm goals or outcomes met? Page 73 OPGRC KTE Detailed Proposal Appendix 6 Budget Summary OPGRC Budget 2013-14 to 2015-16 2013-14 2014-15 2015-16 Expenses Salaries and Benefits $ 694,151 $654,019 $662,663 Supplies and Services $155,170 $137,275 $146,273 $95,000 $81,600 $83,232 $970,834 $587,989 $37,699 Research Review $25,000 $25,000 $25,500 Partnership Research (CCGR) $83,000 $ - $ - $183,000 $261,700 $338,434 Knowledge Products $60,000 $61,200 $118,636 Evidence-Informed Advice $30,000 $30,600 $57,222 Facilitated Learning $83,500 $132,120 $330,282 Knowledge Inquiry $402,500 $258,500 $479,770 $35,000 $35,200 $35,404 $1,872,834 $1,392,309 $1,422,947 $291,247 $260,787 $210,711 $3,108,402 $2,525,990 $2,525,827 Travel Programs and Services Ongoing Research Awards Program Knowledge Repository Monitor/Evaluate/Adjust Total Programs and Services Indirect Costs Total Expenses Note: These totals include all sources of funding Page 74