The role of bias in knowledge translation: Lessons learned from a dissemination of best practices in maternal opioid use

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Meredith Gringle (Creator)
Tracy R. Nichols, Associate Professor and Doctoral Program Coordinator (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:

Abstract: Introduction: Increases in opioid use during pregnancy fueled concerns among reproductive health advocates, policy makers, and providers in North Carolina, United States. A stakeholder group designed a set of knowledge translation (KT) interventions to increase the use of evidence-based practices across relevant health care and social service arenas. Efforts to decrease stigma was included as a best practice. Understanding the process and the contexts in which KT intervention activities occur can help increase their effectiveness. Toward that end, this study examined how stigma was addressed and how audiences responded to evidence-based messages. Methods: Data were collected over a seven-year period and included observations of KT activities (conferences, workshops, and community meetings), focus groups and interviews conducted with providers, and a review of publicly available documents, including KT intervention materials. Clarke's situational mapping was initially applied, and stigma emerged as a critical contextual element. Data were then analyzed to identify how stigma was addressed and how evidence-based messages were received. Results: Despite direct stigma-reduction messages, biases against maternal drug use and ambivalence toward evidence-based recommendations of harm reduction principles were found in audience responses. Findings also revealed tensions around the interpretation of knowledge and the appropriate implementation of best practices between “experts” and among practitioners. Discussion: Stigma and professional biases may serve as significant barriers to KT activities. Results suggest that even under the best of circumstances, evidence-based practices for highly stigmatized and controversial issues are difficult to disseminate and may require unique approaches.

Additional Information

Journal of Continuing Education in the Health Professions, 40(3), 169-175
Language: English
Date: 2020
stigma, knowledge translation, evidence-based practice, perinatal substance use

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