Table 1 Overview of how systems-focused strategies and intervention points intersect with knowledge mobilisation practices^a

1. Producing and disseminating knowledge

Knowledge producers must first reconcile their own paradigms with a ‘systems lens’, using methods for analysing and responding to complexity [14, 24, 25]

Complex problems are multifaceted: embrace methodological and disciplinary pluralism [24, 26]

Critique what knowledge is valued and most fit-for-purpose. An evidence-base for systems change is crafted differently to an evidence-base for biomedical interventions [2, 27, 28]

Question universal hierarchies of evidence [28]: do not automatically privilege a particular interpretation of rigour if it is at the expense of “ecological fit” (local relevance and applicability) [29, 30]

Use co-production to build in relevance, applicability and knowledge translation. It helps participants’ reflect on worldviews and frames of reference [28, 31]

Articulate the goals of collaborative knowledge production as part of wider mobilisation efforts. Including whether and how they fit with the goals of the system – leaders are in the strongest position to make this impactful [32]

Consider “multisolving” approaches (also known as double-duty or triple-duty actions) that produce knowledge targeting two or more systems problems simultaneously [33,34,35]

From the outset, strive to make research useful to policymakers and/or practitioners. Many argue that research is not ‘lost in translation’ but ‘lost before translation’ [36]. Researchers need to understand policy/practice challenges before trying to produce knowledge that influences them [37]

Develop structural and governance supports for cross-sector collaboration, co-production and engaged scholarship which includes those who are affected by the problem and those who are in a position to do something about it: this will produce more relevant and applicable knowledge [14, 38,39,40] [41]

Embed accountability structures such as data-sharing agreements, explicit and flexible roles and deliverables, group decision-making, and distributed governance [42, 43].

Fund knowledge production that tackles problems systemically and uses systems-sensitive methods [44,45,46]

Be conscious of what levels of the system you are targeting and shape knowledge production accordingly [45, 47, 48]

Ask whose knowledge is being privileged and with what impacts. Addressing power may require broadening the boundaries of participation and using methods such as co-production and participatory and action research [49, 50]

Develop inclusive mechanisms for deliberation with extra support for those who are structurally disadvantaged [50,51,52,53]. Mechanisms can function at all level so consider how to support individuals, but also how structures and processes can be changed to optimise inclusion. Models for evaluating public involvement in research may help assess how stakeholders are involved in and influence co-produced knowledge [28]

Provide clear and accessible preliminary findings to participants and incorporate their views in final papers and reports [39] Explain any views that are at variance with researchers’ findings

Collaboration to resolve complex problems involves iterative action, reflection and deliberation, sharing ideas and experiences as well as formal knowledge: build this into your process goals and timeline [28, 51]

Engage stakeholders in interpreting and strategically communicating knowledge, e.g. blend community stories with epidemiological data to educate the media and other stakeholders about human costs and contextual realities [20, 33, 54, 55].

Direct resources to facilitate systems learning, capacity development and co-production [56, 57]

Use creative strategies to communicate with and build systems thinking capacity among community partners and other stakeholders [58]

Learn about and from the knowledge context [14, 59] : techniques include concept (or systems) mapping [60, 61], user journey mapping [54], participative dynamic systems modelling [62, 63], and social network analysis [24, 25, 64]

2. Brokering one’s own research

and

3. Brokering bodies of research

Ideally, brokering will focus on syntheses (integrated bodies of knowledge) rather than individual studies thus, in practice, Archetype 2 should be embedded in Archetype 3.

Treat brokering as a long-term, relational process, not a ‘stage’ that follows knowledge production [65]

Broaden the concept of ‘evidence’ in brokered syntheses to include diverse information and ideas, including from local contexts, that can shed light on problems and possible solutions [4, 66]

Start with what matters to end users: knowledge is imbued with social meaning and its value depends on these meanings [27, 67]

Brokering should not focus on transferring knowledge products, it is a form of change agency [68]

Shift the KM goals from bridging gaps to blurring the boundaries between groups and bringing them together [69]

Knowledge brokers need to understand and find a ‘fit’ with organisational culture and goals. They must become credible insiders [70] [68]

Aim to facilitate experiential learning and goal-orientated engagement with research rather than disseminating research products [71]

Embed knowledge facilitators within organisations to support engagement with research, collaboration, capacity development and organisational change [72]

Create cross-sector training opportunities and secondments for researchers, practitioners and policymakers [72]

Brokers should be embedded in organisations with strong support from leaders and adequate flexibility and resources [68]

Develop & resource credible trustworthy local champions who can influence how people engage with different forms of knowledge [17].

Knowledge brokers can support organisational knowledge orthodoxy or disrupt it: lessen constraints by placing brokers in senior roles, forming multidisciplinary brokerage teams, and linking brokers across different levels and parts of a system [73, 74]

Ideas often have more impact than formal knowledge products [75]. This requires dialogue and relationships. Establish mechanisms to build trust and rapport between stakeholders [65]

Build a learning organisation that is engaged in continuous dialogue about how different forms of knowledge should be valued and used [17, 76]

Create channels for communication and forums for networking and collaboration [77]

Demonstrate that you are listening and learning, and changing your practice accordingly. Model reflective practice [2, 31, 45]

Build shared vocabularies using local terms [62, 78]

Build capacity of individuals and organisations (via coaching, mentoring and interactive and applied learning) to produce, critique and use knowledge [2, 43, 57]

Co-develop models and maps that can act as ‘boundary objects’ in stakeholder dialogues [58, 62, 79]

Forge alliances with leaders who can influence the ways that knowledge is used in their organisations and networks [68]

4. Advocating research

Identify current mental models and ‘frame’ communications strategically to target them. Where appropriate, work to challenge mental models using narrative approaches that reframe concepts (i.e. shift blame or reconceptualise legitimacy) for greater impact [45, 80]

Consider which beliefs are ‘core’ and which may be more amenable to change [81]

Leverage ‘shocks’ or windows of opportunity in which societal foci, attitudes and values can be more malleable [80, 82]

Seek to understand and influence the outcomes that matter to key players in the system [31, 81, 83]

Articulate a compelling vision of change for advocacy allies [80, 81, 84]

Consider “multisolving” approaches (see Archetype 1)

Learn about the system: the stakeholders, key roles and organisations; who influences who; and who has power to make what decisions; who gains from different forms of knowledge? Consider what vested interest groups should be worked with, and which should not [45, 85, 86]

Cultivate policy and practice ‘insiders’ who exert gentle persuasion with colleagues and ‘outsiders’ who create external pressure [3, 87]

Identify ‘windows of opportunity’ and engage with real world policymaking rather than planning for a ‘rational’ orderly process [83]

Forge strategic alliances between communities, policymakers, not-for-profits & researchers to generate political pressure [53, 81]. Develop “policy entrepreneurs” who can navigate policy terrains, attract resources & influence powerful decision-makers [82]

Consider ‘Who can act on this knowledge?’ & ‘Who can influence those who can act?’ [88]

Call out & counter the influence of vested interests (& problem framings) that perpetuate social injustice & inertia [14, 85, 89]

Strengthen civil society, support social movements and help marginalised groups have a voice [87]

Engage in “policy learning”: monitor shifts in the policy landscape and adapt accordingly, especially during implementation when policy contributes to positive or unintended outcomes [81]

Develop media expertise and forge working relationships with on-side journalists who can reach mass audiences and impact public opinion [90] [87, 91]

Use stories, metaphors, symbols and images to communicate findings powerfully and engage others in discussion [63, 82, 87]

Educate health researchers and practitioners in systems-informed advocacy techniques and position advocacy as a legitimate (vital) aspect of public health KM [80]

“Mobilise troops”: engage members of the public in political activism and fund raising [81]

Draw on different forms of knowledge strategically for different audiences and at different times [87]

5. Getting research into practice (implementation)

and

6. Researching in practice

(local learning and knowledge production as part of implementation)

From a systems perspective, these practices are iterative and entwined: implementation should contribute to and be guided by local learning and knowledge production.

‘Diagnose’ the context you are dealing with so you can select appropriate intervention and implementation strategies [92]

Recognise that knowledge is not objective or universal: it evolves, and must be understood, within the context of practice [27]

Systems interventions are not discrete projects: focus on emergent change rather than tangible short-term outputs [93]

Move away from prescriptive practice models towards empowerment models [94]

Complex problems may be shifted but are seldom fully ‘solved’ [95]: Forego the search for ultimate solutions and invest in a ‘positive error culture’. Outcomes and theories of change should be responsive. Trial and error learning and adaptation is key [44]

Allow sufficient time to establish community-based interventions so that the knowledge being generated is easier to appreciate. Systems change takes time to embed and show meaningful results [96]

Consider how the system’s dynamics and history of change shape the current change trajectory [14, 16, 97]

Find ways to tap into what drives people in this system. Focus on measures and outcomes that reflect local stakeholders’ interests [44]

Develop shared goals and support practitioners to modify their practice so that they can own them: “if people cannot take care of a problem, they won’t see a problem” [94].

Use tight-loose-tight KM approaches where the purpose of the project and its outcomes are tightly specified, but its design and implementation are participative and loosely specified, so that they can be adapted locally for maximum effect [98,99,100]

Implement strategies flexibility, guided by principles and adherence to ‘form’ rather than fidelity to static rules: “help it happen” not “make it happen” [101,102,103]

In scaling up, focus on adaptation, interdependencies and stakeholder sensemaking, and responsivity to unintended consequences [11, 104]

Leaders should use strategies and facilitate conversations that build organisational learning and foster innovation and positive deviance [92]

Create flexible rules (policies, guidelines) that allow the system to evolve. These usually incorporate learning into the management process [32]

Create opportunities within organisations for people to take on new roles and forge new relationships aimed at mobilising knowledge [64]

Share leadership among a distributed group of champions and influencers at different levels who model desired values and practices [43, 105, 106]

Build ownership through collaboration with service providers. Work with local champions to diffuse ideas, get feedback and adapt knowledge and implementation strategies for local ‘best fit’ [17, 66, 94, 104]

Build on innovations that emerge from service delivery and have been shown to work well for local communities and organisations [29]

Support service users (especially those who are seldom heard) to participate in local knowledge generation (see the ‘Addressing power imbalances’ section of this paper for examples)

Build indicators and accountabilities in collaboration with frontline staff [107]

Help knowledge inform action: use existing feedback loops to promote dialogue and provide updates, and create new feedback channels where needed [93]

Invite discussion and convey feedback in locally meaningful ways [15, 20]. Use stories to surface tacit practice knowledge and explore ambiguities [108]

Use reflexive methods that attend to system dynamics and direct process learning back into change efforts, e.g. ‘learn and adapt’ cycles, continuous improvement, developmental evaluation and researcher-in-residence models [109, 110]. In these approaches learning itself is a feedback loop [44]

Resist “drift to low performance”: promote positive performance feedback and articulate underpinning values [32]

Watch for windows of opportunity in policy implementation and capitalise on shifts in politics and political will [83, 111]

Use research and evaluation methods that capture the views and lived experiences of key stakeholders, e.g. co-production, action research [54, 58, 112]

In many areas of complex policy and practice there is no universal ‘best practice’, only emergent practice [113]. Work towards ‘best fit’ which focuses on optimal adaptation and reach in your context [114]

Direct funding and other resources at learning-orientated implementation [44]. Focus on workforce capabilities (responsive capacities) rather than competence (fixed skills) [115]

Use tools that can visualise non-linear dynamics, including complexity-sensitive logic models [58, 116, 117].

Don’t discard robust behavioural frameworks [118] but note that interventions focused exclusively on individual elements may be less effective in changing systems [119]

7. Fostering networks

Systems-informed KM interventions can impact formal and informal networks. Formal networks are collaborations of people or organisations working for a common purpose. Informal networks are everyday ‘who-knows-who’ relationships.

Deliberately form connections across paradigms, disciplines and epistemic communities [42, 86]

Do not aim for unified consensus but for ways of understanding and bringing together diverse perspectives [27]

Utilise network science and other systems-sensitive methods to map and analyse developments [39, 120]

Both formal and informal networks can influence decision-makers. Employ the communication strategies described in archetype 4, above [85]

Develop and articulate a shared understanding of the underlying goals of any formal network and a clear vision of what they are working towards [43]

Critique the boundaries within which formal network members are identified: are they wide (inclusive) enough to address the network’s goals? [49, 50]

Structural connectivity will affect functional connectivity: agree on structures and systems for supporting formal networks (see no. 1 above) [42, 43], including clear roles and rules for decision-making [16]

Where possible, articulate and address the structural (institutional, epistemological and political) boundaries that impact knowledge sharing and use in formal networks [22]

Consider how networks often sit within and are linked to other networks: can these wider connections be used to maximise KM? [16]

Identify and work with influential connectors to foster and strengthen relationships [42]

Develop mechanisms for inclusivity that give all members a voice [43]

Invest in the quality of relationships as much as project delivery. Mutual trust and respect are fundamental [44]

Build a community of practice that learns together and can influence change in multiple arenas [84, 121]

Effective formal networks continuously improve through reflecting and acting on feedback [16]. Continue to review and amend linkage and governance mechanisms, communication, working processes, and KM strategies and goals [42]

Ensure formal network members are well-informed about early wins in the network’s goals and have a say in how next steps should proceed [43]

Develop capacity building initiatives that can help members to participate fully within a collaboration [42, 122, 123]

Provide platforms for meeting and sharing knowledge (technological and face-to-face), and informal networking [40, 123]

Evaluation strategies suited to capturing the effects of social networks include: interviews, spidergrams, social network analysis (especially useful for studying and visualizing complex structural ties over time [23, 64]), dynamic systems modelling and Photovoice/Videovoice techniques [39].