Knowledge acquisition and research evidence in autism: Researcher and practitioner perspectives and engagement

adds? This study presents the ﬁrst evidence of similarities and differences between researchers and practitioners in the methods they use to gain research knowledge of autism. In a novel questionnaire completed by over 600 researchers and practitioners, individuals were asked to indicate the methods that they used to keep up-to-date with research as well as methods that they felt would be beneﬁcial in increasing practitioners’ access to research evidence. They were also asked to what extent they engaged with the other group.

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Introduction
Government policy and national practice guidelines have highlighted an increasing need for professionals working in autism services to adopt an evidence-based approach in the delivery of diagnostic methods and clinical and educational interventions.However, a gap continues to exist between research knowledge and its application in practice (Parsons et al., 2013;Reichow, Volkmar, & Cicchetti, 2008).One factor that may contribute to this gap is a difference between academic and non-academic professional groups in their approach to acquiring knowledge of autism research.
Practitioners' views about what counts as a credible knowledge source is historically influenced by their training and experience (Rycroft-Malone et al., 2004).They may, therefore, routinely use different methods from those used by researchers when updating their specialist professional knowledge and have different views about how they could potentially benefit from research evidence in the future.Greater understanding of these perspectives is therefore important for researchers who are aiming to adapt scientific evidence to meet the needs of the wider, non-academic community (Lemay & Sa ´, 2014).
Effective knowledge translation into practice depends on effective facilitation by researchers (Kitson, Harvey, & McKormack, 1998;Rycroft-Malone et al., 2004), a goal that has been heightened by government policy in recent years by the impact assessment of academic research (e.g.Research Excellence Framework, 2014;http://www.ref.ac.uk/).It has been argued that attempts to bridge the research-practice gap need to involve greater collaboration between autism researchers and research-users, such that both communities are engaged in the research process from the beginning (Parsons et al., 2013).Such collaborative activity, or engagement, can facilitate co-participation in the development of research design and method through reciprocal exchange of knowledge.Engagement between researchers and the people who use research is a central component of interactive models of knowledge translation in health policy (Jacobson, Butterill, & Goering, 2003) and a key facilitator of effective knowledge translation (Huberman, 1990).It enables the researcher to orient towards the needs of the user group, provides opportunities for discussion about the values and interpretation of evidence, and helps to facilitate trust and collaboration between researchers and research-users (Milton, 2014;Parsons et al., 2013).
Recent research studies in the field of autism have highlighted the importance of developing a research agenda that is oriented towards the research-user.This work has identified topic areas that research-users prioritize as important areas for future research (Pellicano, Dinsmore, & Charman, 2013;Pellicano, Dinsmore, & Charman, 2014a).Results showed that although researchers and research-users agreed on some of the priorities for future research in autism, there was also a mismatch in priorities for other areas.This research also reported a mismatch in the level of engagement reported by researchers and research-users in the field of autism (Pellicano et al., 2013;Pellicano, Dinsmore, & Charman, 2014b).While academic researchers perceive themselves to be engaging with non-researchers, the same view is not held by non-research users of research.
The findings above emphasize that research should focus on priority areas that meet the needs of the research-user community, a goal more likely to be fulfilled by improved engagement between researchers and non-researchers.The focus of the current study was not on priorities for what should be researched, as previously studied, but on the process of knowledge acquisition.To investigate this, similarities and differences in the methods and preferences for acquiring knowledge used by researchers and research-users were examined, targeting individuals from one sector of the autism research-user community: professional practitioners working in clinical, educational and policy settings.In this respect our definition of 'research-user' is consistent with the definition used by Lemay and Sa ´(2014) in a study of the translation of research evidence into professional practice.If methods of knowledge acquisition differ, and researchers present evidence in ways that are incompatible with the preferences of practitioners, communication will be inhibited and the translation of research evidence impeded.Therefore, greater understanding of the gap between research and practitioner groups in both their current practice and future preferences will facilitate conditions for collaborative engagement that starts from a more common ground and enable reciprocal exchange.
The current questionnaire study formed part of the development work for an online web-based initiative being designed for the purpose of connecting research, practice, and policy communities.In a set of three questions, researchers and professionals working in practice communities were asked about how they use research information.First, both groups were asked how they currently keep up to date with information in the field of autism.Second, both groups were asked which methods they thought would be beneficial to increase research access and research knowledge for research-users.This question necessarily focuses on the translation of information from researchers to research-users, to help explore issues about the inadequacy of the communication of research evidence to non-research professionals.Finally, researchers and practitioners were asked to report on their current level of engagement with the other community.This question was intended as a general measure of the extent to which each group felt that they had any form of active involvement with the other community and was intentionally non-specific, to capture any form of interaction or engagement.
It was expected that the two groups would use different sources of information to keep up to date with professional knowledge, with researchers relying more on primary evidence sources and practitioner research-users relying on alternative evidence sources.However, it was not known if views would differ about the best methods for increasing research knowledge in the non-academic community.Better understanding of potential differences between these groups may identify mechanisms by which knowledge sharing could be improved.Finally, based on previous findings, it was expected that practitioners would report lower levels of engagement with researchers than vice versa.
A total number of 683 respondents answered at least one of the three questions.Two hundred and sixty one respondents described themselves as working in the area of practice or policy.When asked to specify their occupation, of these 261, the two largest occupational groups represented were professionals working in schools (teachers or teaching/learning assistants; n = 55), and psychologists, including educational, clinical and occupational psychologists (n = 47).Other occupational groups included speech and language therapists (n = 21), psychiatrists (n = 5), nurses (n = 3), support workers (n = 16) and social workers (n = 6).Nine respondents stated that their occupation included both ''policy work'' and practice roles, with a further two indicating that their primary occupation was ''policy work''.Eighty-two respondents selected ''Other'' and a further 26 did not respond to this question.The title of 'practitioner' group was therefore assigned, to include a range of professionals working in clinical, educational, and policy-based practice.
In the research professional group (n = 422), the majority described themselves as either established career researchers (including completed a PhD, working in research; n = 256) or early career researchers (including post-graduate, research assistant or associate, or PhD student; n = 143).A minority (n = 17) selected ''Other'', which included retired or freelance/ independent researcher, and six gave no response.Researchers were also asked in which country they worked.1 [ 2 _ T D $ D I F F ] There were 147 researcher responses from North America, 137 from Australia/New Zealand, and a further 108 from elsewhere in the UK.The remaining respondents (n = 30) came from a range of countries including Serbia, Japan, South Korea, Argentina, South Africa, Columbia and Singapore.
[ 5 _ T D $ D I F F ] 2.2.Design and procedure The survey questions were first designed for practitioners and trialled on a first 'wave' set of 54 local professionals from clinical, educational and policy sectors recruited through professional contacts in two neighbouring regions of Wales (UK), in order to identify potential problems.Concurrent with this initial trial of the survey, a separate sample of eight local autism professionals from teaching, occupational therapy, speech and language therapy, care work and educational psychology professions were recruited through professional contacts to take part in 40 minute telephone/face-to-face interviews using a semi-structured, open-ended interview format.The interviews focused on the topics of evidence-based practice, research colleagues, and collaboration.Responses from these interviews revealed broad themes that were consistent with the online survey questions and response options.The survey was then distributed to the researcher group in addition to the geographically wider practitioner community without alterations.The survey was written and distributed only in English.
The data for the main survey were collected via Google Survey over a period of three weeks in August 2013.The online survey was also sent to UK professionals and two international email lists made up of both practitioners and researchers who attended face-to-face or online professional conferences.Consistent with previous online surveys of this type (e.g.Pellicano et al., 2014aPellicano et al., , 2014b)), a snowball method of sampling was used.The link was shared extensively via national and international email contact lists and social media, and recipients were encouraged to forward it to colleagues, resulting in a 'cascade' distribution.Emails were sent out three times inviting people to respond.The survey was shared on Twitter and Facebook weekly.The written introduction to the survey explained that the questions formed part of the planning and design stage for a new knowledge hub initiative aiming to improve connections between autism researchers and non-academic professionals, and that the survey aimed to compare the needs and views of different professional groups.Ethical approval was obtained from the University's School of Psychology Ethics Committee.All participants gave informed consent on the first online page of the questionnaire prior to participating.
Participants were first asked to indicate if they were a researcher or a professional working in practice or policy.Both groups were asked about the methods they use to access information: ''At the moment, how do you keep up to date with current information in the area of autism?''Respondents were asked to select their top three options out of a possible ten (see Fig. 1 for summarized response options).In a separate question, respondents were asked to identify methods that they perceived would be beneficial for increasing research access and research knowledge (see Fig. 2 for response options).Non-academic professionals were asked ''Of the options below, which would help you benefit most from research knowledge and evidence in your specialist area of autism?''Respondents were asked to select their top three options out of a possible nine.The researcher version of the questionnaire asked a similar question, which aimed to elicit researchers' views of what would help most to promote engagement, research awareness and knowledge translation in practice and policy communities: ''The [online initiative] aims to engage researchers with non-academic professionals, promote awareness of research and create opportunities to translate research knowledge.Which options below do you think would help achieve this aim?Tick your top three''.The identical response options for both groups are shown in Fig. 2. Both questions included an 'other' option.Finally, both groups were also asked about their level of engagement with research or non-research professionals: either ''As a practitioner or working in policy in autism, do you currently engage with researchers?''or ''As a researcher in autism, do you currently engage with practitioners or those working in policy?''To reduce the potential carry-over effect of responses, the questionnaire design presented the following fixed order: (1) methods for improving research knowledge question, (2) methods for updating of current information question, (3) engagement with the other professional group question.

Increasing research knowledge
Each participant was asked to select the three methods that they considered most beneficial for increasing research access and knowledge (their top three).The question to practitioners asked which methods would most benefit their own research knowledge and evidence in their specialist area of autism (top three choices), while the question to researchers asked which would help promote research awareness and opportunities for knowledge translation in non-academic professionals.Eleven respondents (all of whom were researchers) did not endorse any items and were excluded.Of the remaining participants 228 practitioners (87%) and 389 researchers (95%) endorsed three choices.Fig. 2 compares the choices of the respondents who selected three choices.As above, 2Â2 Chi square analyses were computed to compare groups for each option, with alpha level set at .006 using Bonferroni adjustment for multiple comparisons.
The following options were selected significantly more frequently by practitioners than researchers: connect directly to research articles to read original research: x 2 [ 8 _ T D $ D I F F ] (1) = 29.09,p < .001(58% practitioners, 36% researchers); access to practice based articles that have been based on reliable research: x 2 (1) = 11.47,p < .001(61% practitioners, 47% researchers).In contrast, the following options were selected more frequently by researchers: speak to a researcher to ask questions about specific research findings: x 2 (1) = 27.59,p < .001(35% researchers, 15% practitioners); access a large directory of researchers to find out about research and/or develop opportunities for collaborating: x 2 (1) = 8.72, p < .005(45% researchers, 33% practitioners).The most frequently endorsed option for practitioners was access to practice-based articles based on research (61%), followed by connect directly to research articles (58%) and then learn to apply evidence-based research methods (45%).For researchers the most frequently endorsed option was non-technical one-page lay summaries (50%), followed by access to practice-based articles based on research (47%) and access a large directory of researchers (45%).No group differences were found for researchers' blogs (16% practitioners, 23% researchers), non-technical one-page summaries (43% practitioners, 50% researchers), Twitter or news updates (26% practitioners, 23% researchers) or apply evidence-based research methods to use in practice and policy (45% practitioners, 40% researchers).Analyses were re-run to include all those participants who did not endorse the full three choices; the results were identical.

Engagement with the other professional group
Eight practitioners and one researcher did not respond to this question.Table 1 shows the current level of inter-group engagement reported by the remaining practitioners (n = 253) and researchers (n = 421).Researchers reported significantly higher levels of engagement with practitioners than practitioners reported for their level of engagement with researchers (x 2 [ 9 _ T D $ D I F F ] (3) = 87.03p < 0.001); the majority of researchers (56.3%) indicated that they had either ''a lot'' or ''quite a bit'' of engagement with practitioners, while the majority of practitioners (79.1%) reported that they only ''occasionally'' had engagement with researchers, if at all.

[ 1 0 _ T D $ D I F F ] 4. Discussion
This study presents the first evidence of similarities and differences between researchers and practitioners working in autism in their preferred methods for acquiring up-to-date information and gaining research knowledge.The focus on a professional practitioner research-user group in the current study specifically aimed to facilitate greater understanding of the incompatibility in preferred methods used by researchers and professional practitioners.By identifying gaps in the way that researchers communicate research evidence it may be possibly to highlight potential targets for evidence-based approaches in clinical, educational and policy-based practice.
Multi-dimensional approaches to knowledge translation (Kitson et al., 1998;Rycroft-Malone et al., 2004) have emphasized the importance of the nature and accessibility of the research evidence to be translated.In the current study we examined the evidence sources that practitioners prefer to use when updating their knowledge and the methods that they consider would help them benefit from research knowledge and evidence.Previous work on knowledge translation in areas of health and education indicates that practitioners can be resistant to learning about and accepting research evidence (Parsons et al., 2013;Russell, Greenhalgh, Boynton, & Rigby, 2004;Rycroft-Malone et al., 2004), and indicate preferences for accessible, practitioner-relevant and non-technical sources of evidence information (Graham, Tetroe, & Gagnon, 2013).Specific work in the area of autism has also emphasized practitioners' priorities for accessing practitioner-oriented methods in the area of intervention (Reichow et al., 2008).
When both researchers and practitioners were asked about how they keep up to date with current information, their responses showed that the preferred current sources of information for practitioners were conferences and continuing professional development (CPD).There was also evidence that practitioners relied more than researchers on publicly accessible sources of knowledge such as news media and campaigns, as well as on non-academic journals.In general, however, more accessible methods of updating current information, such as social media, Google searches and news/TV, were of relatively low priority for practitioners.Researchers differed from practitioners in their methods for keeping up to date with current information due to their highly frequent use of academic journals compared with practitioners.However they were similar in their low priority for social media and other accessible evidence sources.The results from the current study support a recommendation to provide access to a range of research-based information in the development of an online knowledge platform, from non-technical summaries to access to original research articles.Our findings also point to the need for improved engagement and communication, and continual review of user needs and the barriers to research implementation in practice.However, it is essential that future work should more fully characterize a range of potential factors that hinder knowledge sharing and translation in order to best integrate research and practice in autism.

Fig. 1 .
Fig. 1.Percentage of practitioners and researchers selecting each type of method as one they use to keep up to date with current information.CPD = Continuing Professional Development.*denotes a significant group difference (p < .005following Bonferroni correction for multiple comparisons).

Fig. 2 .
Fig. 2. Percentage of practitioners and researchers selecting each type of method as beneficial for increasing research knowledge.*denotes a significant group difference (p < .005following Bonferroni correction for multiple comparisons).

Table 1
Percentage of practitioners reporting current engagement with researchers, and percentage of researchers reporting current engagement with practitioners.