{Ottawa Doula} Research to Action

I sat in on an  interesting presentation at work today about "knowledge translation" - a very basic term describing how research actually gets translated into practice.

She used a great story to kick-off the talk:

In 1497, a ship sailing with 160 sailors discovered that supplementing the men with lemon juice may have helped to ward off/cure scurvy. Guess how long it took for the British government to formally implement the citrus remedy onto every ship setting sail from the country?

368 years.


So for 368 years, more and more researchers discovered (and conducted trials) to assess the applicability of citrus juice in preventing or treating scurvy. But it took until 1865 for the "head honchos" to do anything with the life-saving information. Soon, all ships sailing from Britain used citrus fruits to ward of the impact of scurvy.


Luckily for us modern folks, the gap between research and practice has now shrunk to 17 years. Yikes - still doesn't seem that great, does it?

Let's take a birth-related example. Research for the past several years has shown that delayed cord clamping can have significant benefits for the newborn. However, most hospitals, unless you insist (and you have to be quick - they'll go "snip, snip" before you know it!) will cut the cord immediately after birth.

So why the gap? There are 2 main reasons:

• Researchers don't do enough to pass their findings on to health care practitioners - instead, they focus on publication, which they are bound to do by the institutions they work for ("publish or die" is pretty much the mantra in the research world)
• Doctors don't have time to read hundreds of studies published in medical journals

We're all working on solutions to the problem, mainly by attempting to be better at translating knowledge - by working directly with patients, health care professionals, and other interest groups.

But in the meantime, what's a poor pregnant mama to do? Maybe you've heard of something that could be beneficial to yourself or your baby, but it's not common practice at your institution. Here are some tips for putting your own research into action:

1) Stay really well informed. Avoid wasting time with websites like Baby Centre or books like What to Expect When You're Expecting. These are not sources of good quality evidence. Instead, check out these websites:

MotherRisk

Health Evidence

Cochrane Library

2) If you read something you want to know more about, print off a copy and bring it to your next prenatal appointment. Doctors are time-strapped, but they do appreciate (generally) patients who are well informed.

3) Compromise. Try to come to some agreement with your healthcare practitioner. It's never helpful to become angry, and most doctor's don't respond well to "unruly" patients. Remember that they're working within an institution, which comes along with many rules and regulations - sometimes they want to help, but their hands are tied.

4) Accept when something may not be possible. Despite all of your efforts to convince your doctor that a certain procedure is beneficial, they may be bound by hospital policy.

5) Know your rights. You do have rights as a patient!

6) If you can't change it, go somewhere else! If it's not too late, try to find a practitioner who is more willing to address your needs.