September 15-16, 2005

Executive Summary

The purpose of the Knowledge Translation (KT) Symposium was to bring stakeholders in all jurisdictions into a forum of discussion to find pathways and gateways of translating scientific research knowledge on immigrant health into practice including community actions, programs and policies. In order to be cohesive we limited our attention to the social determinants of immigrant health.

With the establishment of five Metropolis Centres across Canada, immigrant health research in Canada is steadily flourishing i.e. the number of scientific papers and graduate theses is increasing in the area of immigrant health. The Metropolis Project of Citizenship and Immigration Canada provides "an international forum for comparative research and public policy development about population migration, cultural diversity and the challenges of immigrant integration in cities in Canada and around the world' (Metropolis Canada). The Metropolis forum of research consists of a spectrum of stakeholders including all levels of government and community-based organizations, in addition to academic researchers. All stakeholders in Health Domains across all five Canadian Centres of Metropolis work towards the common goal of the enhancement of immigrant's health across the lifespan. They bring forward diverse needs and share varied expertise.

Even in this context of increased research activity, the policy makers and program planners report barriers to accessing and utilizing research-based evidence. Valuable research findings can end up buried in scientific literature. The language or mode of communication can hinder the incorporation of scientific literature into community action. Some methodologies used in non-academic research may lack scientific rigor, in which case the research does not yield strong recommendations. And other pieces of research, while meeting standards for scientific rigor, simply do not include policy and program implications. This entire scenario is further complicated because immigrant health knowledge producers (mainly academics and some community groups) and the consumers of this knowledge (the immigration and health government sector) hold contrasting views due to the challenges in translation from producers to the consumers. These barriers need to be addresses as a major step towards improving immigrant's health.

The major components addressed in this policy forum were the identification of key players, platforms, research priorities and languages of research communication in knowledge translation. The symposium focused on the unique needs of immigrant health research, policy and programs in Atlantic Canada, while still paying attention to other Canadian research to fill the gaps. The event was designed to enable knowledge exchange between stakeholders and thereby provided opportunities for networking and partnership building which strengthen communication exchange between different sectors involved in knowledge translation.

The structure of the symposium allowed participants to learn from each other and also learn from experts in the KT field. Existing knowledge on social determinants of immigrant health with an Atlantic focus was synthesized prior to the symposium and was presented to the participants in three separate concept paper, each consisting of research-based knowledge on social determinants of health for youth, adults and seniors. National experts in the field made presentations that defined knowledge translation and provided direction on how to transfer research knowledge to policy, program and practice. The presentation also included a section on how to integrate KT into the design of future research.

Factors promoting and hindering KT were discussed at three different structured round table discussions, where the highlights of the discussion were reported to the whole group at the end, allowing ideas to flow around the further comments. In the first session participants from a mixture of sectors (NGO, government and academics) at each table discussed success stories of KT, while exploring the importance of partnerships at all levels. At the second discussion session, each sector (NGO, government and academia) gathered around three separate tables to discuss concerns and issues faced by their sector and how the other sectors can contribute to make a difference. The last set of round table discussions were devoted to a discussion of knowledge mobilization, specifically around immigrant youth, adult and senior social determinants of health. Building inter-sectoral partnerships was a general them that emerged from the discussions. Ways of linking academics to grass root communities for successful knowledge mobilization was explored. Knowledge mobilization was considered as a two-way process of transferring grass roots community concerns and needs to researchers, and then transferring research findings back into communities to impact program and policy decisions. In that respect, research knowledge was considered as the compiled knowledge of the grass roots community and therefore the necessity of giving the knowledge back to them was emphasized.

The discussions during the symposium also brought to light that paradigm shifts are needed in the role played by government and research grant agencies in facilitating KT. Mutual mentoring and internships emerged as two essential components that strengthen inter-sectoral collaborative knowledge transfer activities. The review process and budget criteria of the granting agencies need to be flexible to accommodate not only the KT activities in general, but also the additional resources required to overcome immigrant specific linguistic and cultural difficulties, as well as financial aid and social barriers. In addition, the academic, NGO and government, institutional cooperate-culture needs some adaptations to facilitate and value KT to grass roots immigrant communities.

Also, a top-down and a bottom-up approaches of KT models for immigrant communities were the main outcomes of the symposium; however, future work in this area needs to explore both of these models further to overcome the pitfalls of knowledge leakage and to develop knowledge uptake assessment tools. We discovered there are considerable gaps in the existing Canadian knowledge regarding determinants of health for immigrant youth, men and seniors.