Overview

A grant from the US National Cancer Institute was recently awarded to the Arizona Cancer Center at The University of Arizona, to work with NAQC to better understand the communication mechanisms by which NAQC members interact, share new evidence, make decisions on how and when to implement new knowledge, and actually adopt practices that they believe will improve quitline outcomes. The goal of the study is to strengthen the NAQC network in order to improve dissemination, adoption and implementation of best practices. The study will be conducted over five years, with opportunities for NAQC members to become involved throughout the research process.

Objectives

KIQNIC has five main objectives:

1. To investigate the structure of the social network of tobacco quitlines in the US and Canada.

2. To investigate the role of social networks on the dissemination and implementation of evidence-based and newly created practices on tobacco quitlines.

3. To identify what moderating role decision-making practices within quitlines may have on the relationship between social networks and adoption of evidence-based practices.

4. To evaluate the impact of information and normative influence on decision-making within quitlines.

5. To describe the task characteristics and structural features of the quitlines that affect decision-making within quitlines.

Components of the Study

There are three theory and research components to KIQNIC: social network analysis, decision-making, and knowledge integration.

Social network analysis (SNA): A critical mechanism for the adoption of new ideas is through the network of connections maintained by individuals and organizations immersed in a field of study and practice. SNA investigates how the involvement of an individual or organization in a network affects its actions and outcomes, as well as how overall network structures and processes affect network-level actions and outcomes in general.

KIQNIC will use SNA to analyze data on the adoption and implementation of evidence-based practices and practice innovations. Some of the key structural issues that will be examined include the following:

  • Centrality –Which organizations occupy a central or a more peripheral position in the network and how does this affect adoption of best practices?
  • Multiplexity – What is the strength of the relationship between an organization and its various network partners?
  • Density – What is the overall level of connectedness among organizations in the network? And how much density is beneficial, versus a “looser” network?

The SNA component of KIQNIC will help NAQC members understand how their organizations fit into the network on a variety of levels, and will help to identify what types of connections and relationships are most likely to facilitate the flow of information and ideas about best practices, thereby optimizing member and client benefits.

Decision-Making:While network characteristics influence the quality and quantity of information disseminated among the quitlines, such information is likely to have differential weight for key decision-makers within quitlines. Most quitlines lack the resources to implement every potential practice, information is often unclear about which options are best suited for a particular quitline, and decision-makers are sometimes forced to choose one practice from among several supportable options.

The decision-making framework used by KIQNIC is based on information sharing and influence in small groups. It recognizes informational influences on decision-making, such as data and arguments presented during discussion[i], and the normative influences of social factors like status or professional position[ii], the influential role of a decision-maker’s colleagues’ behaviors and beliefs, and real-world constraints like budgets and staffing.

The decision-making component of KIQNIC aims to help NAQC members understand the conditions under which informational influence, rather than normative influence, guides decision-making in quitlines. The findings will also help to identify the relative impact of decision influences versus network relationships on the adoption of best practices.

Knowledge Integration: More and more, people are recognizing that putting evidence into action requires careful attention to how the new knowledge can be integrated with local context and systemsThe concept of knowledge integration views the dissemination and implementation process through a systems lens, recognizing that knowledge exchange and uptake activities are embedded in relationships, that are in turn embedded in networks, and part of continually evolving complex adaptive systems. Reflective learning and the adaptation of implementation and evaluation processes are involved throughout the knowledge-to-action process.

KIQNIC values the applied research environment of NAQC and aims to use the powerful roles of organizations, systems, and networks in achieving evidence-based policies and practices. Building on recent work on knowledge integration and drawing heavily on current tobacco control practice and research, KIQNIC will develop specific measures of best practices and innovations that will then be utilized as the primary “outcome” variable for the research. Through this approach, KIQNIC will be able to assess the ways in which NAQC’s networks can be enhanced to maximize the adoption and implementation of best practices and innovations.

How will NAQC members be involved?

As a NAQC member, you have a vested interest in getting the most out of this project! Over 40 quitlines provided letters of support for this study when the proposal was submitted in 2006, and the research team takes pride in sharing ownership with NAQC. A key activity for this first year is to build a healthy collaborative relationship between the researchers and NAQC members. Because KIQNIC is a participatory research project, there are opportunities for members to contribute at each step of the way, including these critical first year activities:

  • Contributing to, or reviewing conceptual models developed for KIQNIC,
  • Helping to identify dependent and independent variables to be measured in the study,
  • Providing a sounding board for methods development,
  • Reviewing and aiding in the development of survey instruments.

Years two, three and four will focus on data collection, and preliminary analyses to provide feedback and help the NAQC membership integrate the knowledge generated into practice. The fifth year of the study will focus on final analyses and writing up the results. The research team will distribute quarterly updates on the project to NAQC members, to keep them apprised of activities, findings, and opportunities to participate.

The KIQNIC Research Team

  • Scott Leischow (Principal Investigator), Professor, Department of Family and Community Medicine, University of Arizona, Deputy Director, Arizona Cancer Center
  • Linda Bailey (Co-Investigator), President and CEO, North American Quitline Consortium
  • Allan Best (Co-Investigator), Managing Partner, InSource Research Group, Clinical Professor, School of Population and Public Health, University of British Columbia
  • Joseph Bonito (Co-Investigator), Associate Professor, Department of Communication, University of Arizona
  • Keith Provan (Co-Investigator), McClelland Professor of Public Administration & Policy, Eller College of Management, University of Arizona
  • Michele Walsh (Co-Investigator), Associate Director, Evaluation, Research and Development Unit, University of Arizona

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[i]Meyers, R. A., Seibold, D. R. (1990). Perspectives on group argument: A critical review of persuasive arguments theory and an alternative structurational view. In J. Anderson (Ed.), Communication Yearbook 13 (pp. 268-302). Newbury Park, CA: Sage.

[ii]Ibid.