Background: The process and effectiveness of knowledge translation (KT) interventions targeting policymakers are\nrarely reported. In Cambodia, a low-income country (LIC), an intervention aiming to provide evidence-based knowledge\non pneumonia to health authorities was developed to help update pediatric and adult national clinical guidelines.\nThrough a case study, we assessed the effectiveness of this KT intervention, with the goal of identifying the barriers to KT\nand suggest strategies to facilitate KT in similar settings.\nMethods: An extensive search for all relevant sources of data documenting the processes of updating adult and\npediatric pneumonia guidelines was done. Documents included among others, reports, meeting minutes, and email\ncorrespondences. The study was conducted in successive phases: an appraisal of the content of both adult and pediatric\npneumonia guidelines; an appraisal of the quality of guidelines by independent experts, using the AGREE-II instrument; a\ndescription and modeling of the KT process within the guidelines updating system, using the Unified Modeling\nLanguage (UML) tools 2.2; and the listing of the barriers and facilitators to KT we identified during the study.\nResults: The first appraisal showed that the integration of the KT key messages in pediatric and adult guidelines\nvaried with a better efficiency in the pediatric guidelines. The overall AGREE-II quality assessments scored 37%\nand 44% for adult and pediatric guidelines, respectively. Scores were lowest for the domains of ââ?¬Ë?rigor of developmentââ?¬â?¢\nand ââ?¬Ë?editorial independence.ââ?¬â?¢ The UML analysis highlighted that time frames and constraints of the involved stakeholders\ngreatly differed and that there were several missed opportunities to translate on evidence into the adult pneumonia\nguideline. Seventeen facilitating factors and 18 potential barriers to KT were identified. Main barriers were related to the\nabsence of a clear mandate from the Ministry of Health for the researchers and to a lack of synchronization between\nknowledge production and policy-making.\nConclusions: Study findings suggest that stakeholders, both researchers and policy makers planning to update clinical\nguidelines in LIC may need methodological support to overcome the expected barriers.
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