RE-AIMing conferences: a reach, effectiveness, and maintenance evaluation of the Rick Hansen Institute’s Praxis 2016

RE-AIMing conferences: a reach, effectiveness, and maintenance evaluation of the Rick Hansen... Abstract This article reported on the reach, effectiveness, and maintenance dimensions of a RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) analysis to evaluate Praxis 2016, a conference aimed to develop solutions to overcome challenges to translating research into practice in the spinal cord injury (SCI) community. Reach indicators were collected from the Praxis 2016 organizing committee. For effectiveness and maintenance, attendees (n = 106) completed a questionnaire pre-, post-, and 9-month post-Praxis 2016 assessing (a) capability (e.g., knowledge), (b) motivation, (c) opportunities, and (d) the groups they currently, need to, and/or plan to work with to develop solutions to overcome the challenges of translating SCI research into practice. They also reported their satisfaction with Praxis 2016. Qualitative interviews with attendees and organizers post-Praxis 2016 were conducted. Praxis 2016 reached 28% of their intended audience. For effectiveness, attendees’ knowledge significantly increased (t(59)= 3.83, p < .001), they reported a greater need to work with members within the SCI community from pre- to post-Praxis 2016, and were generally satisfied with Praxis 2016. Regarding maintenance, more attendees reported needing to work with researchers, clinicians and SCI community organizations at 9-month post-Praxis 2016. The interviewees reported increased knowledge and capacity to network with the SCI community, but highlighted concerns for the long-term impact of Praxis 2016. Praxis 2016 was an effective approach to create short-term change in knowledge, and to expand knowledge translation networks. Further efforts could build on Praxis 2016 to foster long-term success in overcoming the challenges in translating SCI research into practice. Implications Practice: In addition to delivering information, large-scale knowledge translation initiatives should provide knowledge translation tools and strategies to help attendees bridge the knowledge translation gap post-initiative. Policy: Funding large-scale knowledge translation initiative is a first step, but additional resources are needed post-initiative to move forward any resulting action plans. Research: Future research is needed to determine the most effective strategies to change knowledge translation behavior over the long-term. Individuals living with a spinal cord injury (SCI) often report lower quality of life than individuals not living with SCI [1]. An SCI can lead to loss of motor and/or sensory functions and result in a number of secondary complications, such as pressure injuries, pain, and fatigue [2]. Unfortunately, scientific research that could enhance the lives of people with SCI is often not applied in practice. Approximately 14% of scientific health discoveries enter clinical practice, and when they are applied the uptake is slow, as there is an estimated 17- to 20-year gap between health discovery and clinical implementation practice [3, 4]. Given the same delay exists in the SCI field, researchers within the SCI community have identified two areas where innovations are slowly or rarely transferred into practice. The first is when SCI research innovations in basic research and discovery sciences are not translated into clinical research and development. The second valley is when clinical research does not get implemented to optimize health care services [5]. To close these gaps, the Rick Hansen Institute (RHI), members of the program advisory committee, and facilitators from a professional consulting company designed and organized an innovative 3-day conference called Praxis 2016. This conference brought together the SCI community (adults living with SCI, researchers, clinicians, funders, regulators, policy makers, and industry representatives) to develop practical solutions to overcome challenges to translating research into practice. The goals of Praxis 2016 were to (a) create a common understanding and synergy regarding knowledge translation in SCI; (b) promote the exchange of real-world experience among attendees; and (c) determine actions or solutions to overcome the barriers and challenges to achieve knowledge translation in SCI. To understand the impact of Praxis 2016, an independent evaluation was conducted. The evaluation was guided by the RE-AIM framework which aims to capture five factors associated with an initiative’s impact: Reach, Effectiveness, Adoption, Implementation, and Maintenance [6]. Reach and effectiveness focuses on individual level data while adoption and implementation on setting/organizational data. However, maintenance includes both individual and setting level data. This article reports on the individual level data (i.e., Praxis 2016 attendee data), thus the reach, effectiveness, and maintenance components of RE-AIM. Reach refers to the extent to which Praxis 2016 attracted attendees and the representativeness of the attendees. Effectiveness represents the positive and/or negative impact of Praxis 2016 on attendees. Maintenance refers to the long-term effects (6 months or longer) of Praxis 2016 on attendees. A separate article presented the data collected at the setting level to evaluate Praxis 2016 on the adoption, implementation, and setting/organizational maintenance components of RE-AIM [7]. The RE-AIM framework has been utilized and shown to be effective across a variety of contexts [8]. In the SCI domain, the RE-AIM framework has been adopted to evaluate initiatives from a community-university partnership aimed to promote physical activity among adults with SCI [9]. Further, RE-AIM was applied to evaluate the feasibility and effectiveness of a knowledge translation initiative aimed to promote physical activity guidelines for people with SCI that was delivered by a community organization [10]. Given RE-AIM was used to successfully evaluate knowledge translation initiatives in SCI, it is a viable framework to evaluate Praxis 2016. At the effectiveness and maintenance levels, we sought to understand the role of Praxis 2016 in changing attendees’ knowledge translation cognitions and behaviors. We grounded the effectiveness and maintenance evaluations in Michie, Van Stralen and West’s COM-B model, which was developed from a review of 19 frameworks for behavior change [11]. COM-B is the starting point for understanding behaviors in the context where they occur. According to the COM-B model, the three conditions—capability, opportunity, and motivation (COM)—are essential for behavioral enactment [11]. The COM-B model has been used in implementation research to study the adoption of evidence-based behaviors [12]. Therefore, attendees’ capability, opportunity, and motivation to develop solutions to overcome the challenges in translating SCI research into practice were assessed to align with this model. As another goal of Praxis 2016 was to promote the sharing of experiences by bringing people together, we measured effectiveness as attendees’ growth of knowledge translation networks. This growth in network metric was defined as the increase in attendees’ (a) need to collaborate, (b) plans to collaborate, and (c) current collaborations with groups in the SCI community. Previous research has shown that collaborative knowledge translation networks may be an indicator of adopting new evidence and practices [10]. Therefore, the purpose of this article was to report on the Praxis 2016 evaluation on the attendee level dimensions of RE-AIM: reach, effectiveness, and maintenance. METHODS Praxis 2016 Praxis 2016 was held on April 25 to 27, 2016 and focused on four key topics: (a) product development and delivery; (b) preclinical and clinical trials of regeneration and repair in SCI; (c) bringing knowledge into clinical practices; (d) financial viability. Praxis 2016 took a different approach to conferences by moving beyond only expert presentations to include interactive panels and working table discussions. A Praxis 2016 Conference Report was sent to attendees in November 2016 and the Praxis 2016 Action Plan was released in September 2017. Description of Praxis 2016 is available on the RHI website (http://www.rickhanseninstitute.org/). Design A detailed methodology section can be found in Supplementary Appendix A. Cross-sectional data from attendees and the organizational committee were collected for reach and satisfaction indicators. A three-wave prospective design was used for effectiveness and maintenance dimensions of RE-AIM. A generic qualitative approach was used by conducting one-time individual interviews with attendees and organizing committee members to provide additional data on reach, effectiveness, and maintenance. Participants and procedures Two groups of participants—Praxis 2016 attendees and organizers (i.e., RHI staff and the Praxis 2016 Program Advisory Committee)—provided data by completing an online questionnaire or individual interviews. Given this project was a program evaluation, ethics was not required. However, at each time point of the questionnaire and before the interviews, we informed attendees and organizers of the purpose of the evaluation, that their responses remained confidential, provided a contact name of the research team, and asked for consent before data collection. Praxis 2016 attendees’ responded to a questionnaire before the start (pre-Praxis 2016), within 2 weeks after (post-Praxis 2016), and 9 months after Praxis 2016 (9-month post-Praxis 2016). For pre-Praxis 2016 assessments, participants completed the questionnaire online via a link sent by email or on laptop computers at the registration desk. For post-Praxis 2016 data, attendees completed an online questionnaire sent by email the day following Praxis 2016 with reminders 5 and 7 days later. The 9-month post-Praxis 2016 questionnaire (i.e., maintenance) was sent to attendees approximately 1 month after the conference report, with three reminders emails. Interviews with attendees and organizers were conducted to gather qualitative data for reach, effectiveness, and attendee-level maintenance. Within 3 months post-Praxis 2016, J.B. conducted qualitative interviews with attendees who indicated interest on the questionnaire. J.B. randomly contacted interested individuals from various groups (e.g., adults with SCI, researchers) represented at the conference. S.N.S. and H.L.G. conducted interviews with Praxis 2016 conference organizers within 2 months of the release of Praxis 2016 action plan. Interviews were conducted with semi-structured interview guides grounded in RE-AIM (Supplementary Appendix B), audio recorded and transcribed verbatim. Reach In the questionnaire, we collected data on the number of individuals on the mailing list of Praxis 2016 as of April 1, 2016, the number of registered Praxis 2016 attendees, and the number of attendees who responded to the online questionnaire. For representativeness, attendees provided demographic information (e.g., the group they identify with the most, age, sex; (Table 1) and reported whether they felt any groups were not present or underrepresented at Praxis 2016. In the interviews, we asked interviewees about Reach elements such as their perception of the representativeness of Praxis attendees. Table 1 Demographic variables of Praxis 2016 attendees collected from the questionnaire Continuous variables Mean (SD) Age (years) 46.1 (12.61) Categorical variables n (%) Sex: women, men, no response 57 (53.8), 37 (34.9), 12 (11.3) Primary affiliation group of Praxis 2016 attendees  Researcher 20 (31.3)  Clinicians or other health care provider 9 (14.1)  Funding agency representative 7 (10.9)  Knowledge translation leaders/consultant 6 (9.4)  Representative of SCI consumer associations, organizations, or advocacy groups 5 (7.8)   Industry representative 4 (6.3)  Individual with SCI 3 (4.7)  Health care decision or policy maker 3 (4.7)  SCI family members or supporter 2 (3.1)  Representative of non-SCI consumer associations, organizations, or advocacy groups 1 (3.1)  Representative of public or private insurers; other groups 1 (1.6); 2 (3.1) Education  College, CEGEP, some university studies 6 (5.8)  Bachelor’s degree 21 (19.8)  Master’s degree 21 (19.8)  Medical degree 29 (8.5)  Doctorate/PhD 37 (34.9)  No response 12 (11.3) Employment  Full time; part time, student 78 (73.6); 10 (9.4); 5(4.7)  Self-employed; semi-retired; no response 1(0.9); 1(0.9); 11 (10.4) Place of residency  Canada; United States of America 69 (65.1); 20 (18.9)  Australia; New Zealand; Switzerland 2(1.9); 1(0.9); 1(0.9)  No response 13 (12.3) Praxis 2016 attendee role  Standard delegate; invited guest 47 (44.3); 48 (45.3)  Part of a panel/speaker, chairing a session 12 (11.3), 2 (1.9)  Output lead 4 (3.8)  Program Advisory Committee; RHI Board Member of Staff 7 (6.6); 18 (17) Did Praxis 2016 meet your expectations?  Yes, no, no response 81 (73.6), 12 (10.9), 17 (15.5) Continuous variables Mean (SD) Age (years) 46.1 (12.61) Categorical variables n (%) Sex: women, men, no response 57 (53.8), 37 (34.9), 12 (11.3) Primary affiliation group of Praxis 2016 attendees  Researcher 20 (31.3)  Clinicians or other health care provider 9 (14.1)  Funding agency representative 7 (10.9)  Knowledge translation leaders/consultant 6 (9.4)  Representative of SCI consumer associations, organizations, or advocacy groups 5 (7.8)   Industry representative 4 (6.3)  Individual with SCI 3 (4.7)  Health care decision or policy maker 3 (4.7)  SCI family members or supporter 2 (3.1)  Representative of non-SCI consumer associations, organizations, or advocacy groups 1 (3.1)  Representative of public or private insurers; other groups 1 (1.6); 2 (3.1) Education  College, CEGEP, some university studies 6 (5.8)  Bachelor’s degree 21 (19.8)  Master’s degree 21 (19.8)  Medical degree 29 (8.5)  Doctorate/PhD 37 (34.9)  No response 12 (11.3) Employment  Full time; part time, student 78 (73.6); 10 (9.4); 5(4.7)  Self-employed; semi-retired; no response 1(0.9); 1(0.9); 11 (10.4) Place of residency  Canada; United States of America 69 (65.1); 20 (18.9)  Australia; New Zealand; Switzerland 2(1.9); 1(0.9); 1(0.9)  No response 13 (12.3) Praxis 2016 attendee role  Standard delegate; invited guest 47 (44.3); 48 (45.3)  Part of a panel/speaker, chairing a session 12 (11.3), 2 (1.9)  Output lead 4 (3.8)  Program Advisory Committee; RHI Board Member of Staff 7 (6.6); 18 (17) Did Praxis 2016 meet your expectations?  Yes, no, no response 81 (73.6), 12 (10.9), 17 (15.5) View Large Table 1 Demographic variables of Praxis 2016 attendees collected from the questionnaire Continuous variables Mean (SD) Age (years) 46.1 (12.61) Categorical variables n (%) Sex: women, men, no response 57 (53.8), 37 (34.9), 12 (11.3) Primary affiliation group of Praxis 2016 attendees  Researcher 20 (31.3)  Clinicians or other health care provider 9 (14.1)  Funding agency representative 7 (10.9)  Knowledge translation leaders/consultant 6 (9.4)  Representative of SCI consumer associations, organizations, or advocacy groups 5 (7.8)   Industry representative 4 (6.3)  Individual with SCI 3 (4.7)  Health care decision or policy maker 3 (4.7)  SCI family members or supporter 2 (3.1)  Representative of non-SCI consumer associations, organizations, or advocacy groups 1 (3.1)  Representative of public or private insurers; other groups 1 (1.6); 2 (3.1) Education  College, CEGEP, some university studies 6 (5.8)  Bachelor’s degree 21 (19.8)  Master’s degree 21 (19.8)  Medical degree 29 (8.5)  Doctorate/PhD 37 (34.9)  No response 12 (11.3) Employment  Full time; part time, student 78 (73.6); 10 (9.4); 5(4.7)  Self-employed; semi-retired; no response 1(0.9); 1(0.9); 11 (10.4) Place of residency  Canada; United States of America 69 (65.1); 20 (18.9)  Australia; New Zealand; Switzerland 2(1.9); 1(0.9); 1(0.9)  No response 13 (12.3) Praxis 2016 attendee role  Standard delegate; invited guest 47 (44.3); 48 (45.3)  Part of a panel/speaker, chairing a session 12 (11.3), 2 (1.9)  Output lead 4 (3.8)  Program Advisory Committee; RHI Board Member of Staff 7 (6.6); 18 (17) Did Praxis 2016 meet your expectations?  Yes, no, no response 81 (73.6), 12 (10.9), 17 (15.5) Continuous variables Mean (SD) Age (years) 46.1 (12.61) Categorical variables n (%) Sex: women, men, no response 57 (53.8), 37 (34.9), 12 (11.3) Primary affiliation group of Praxis 2016 attendees  Researcher 20 (31.3)  Clinicians or other health care provider 9 (14.1)  Funding agency representative 7 (10.9)  Knowledge translation leaders/consultant 6 (9.4)  Representative of SCI consumer associations, organizations, or advocacy groups 5 (7.8)   Industry representative 4 (6.3)  Individual with SCI 3 (4.7)  Health care decision or policy maker 3 (4.7)  SCI family members or supporter 2 (3.1)  Representative of non-SCI consumer associations, organizations, or advocacy groups 1 (3.1)  Representative of public or private insurers; other groups 1 (1.6); 2 (3.1) Education  College, CEGEP, some university studies 6 (5.8)  Bachelor’s degree 21 (19.8)  Master’s degree 21 (19.8)  Medical degree 29 (8.5)  Doctorate/PhD 37 (34.9)  No response 12 (11.3) Employment  Full time; part time, student 78 (73.6); 10 (9.4); 5(4.7)  Self-employed; semi-retired; no response 1(0.9); 1(0.9); 11 (10.4) Place of residency  Canada; United States of America 69 (65.1); 20 (18.9)  Australia; New Zealand; Switzerland 2(1.9); 1(0.9); 1(0.9)  No response 13 (12.3) Praxis 2016 attendee role  Standard delegate; invited guest 47 (44.3); 48 (45.3)  Part of a panel/speaker, chairing a session 12 (11.3), 2 (1.9)  Output lead 4 (3.8)  Program Advisory Committee; RHI Board Member of Staff 7 (6.6); 18 (17) Did Praxis 2016 meet your expectations?  Yes, no, no response 81 (73.6), 12 (10.9), 17 (15.5) View Large Effectiveness and maintenance To align the measures of the questionnaire with the goals of the Praxis 2016 conference, the phrase “…develop (or developing) solutions to overcome the challenges in translating SCI research into practice” was added after each item assessing COM-B, value, and importance. Using a 7-point scale ranging from 1 (strongly disagree) to 7 (strongly agree), attendees responded to 2–3 items for each element of COM-B which were modified from Michie, Atkins, and West [13]. They also answered items on the value and importance of Praxis 2016. See Table 2 for the items and inter-item correlations or Cronbach’s alpha. Knowledge translation networks were assessed by asking attendees to select all groups they (a) currently work with, (b) need to work with, and/or (c) plan to work with to develop solutions to overcome the challenges in translating SCI research into practice (Table 2). Attendees’ satisfaction was measured regarding their satisfaction with (a) the Praxis 2016 conference overall and (b) specific conference sessions (Table 3). Attendees also selected any of the four Praxis 2016 goals they perceived were achieved to measure perceptions of Praxis 2016 goal achievement: (a) overview of the current state of the affairs; (b) met/networked with individuals they had not previously met/networked; (c) learned from a diverse group of stakeholders; and (d) actively participated in developing solutions. In the interviews, we asked attendees and organizers to discuss the impact of Praxis 2016 and probed for further details when topics mentioned were related to COM-B and knowledge translation networks. Table 2. Effectiveness and maintenance measures for evaluating Praxis 2016 and t-tests across the three time points. Measures Pre- and Post-Praxis 2016 (n=62) Pre- and 9-months Post-Praxis 2016 (n=28) Post and 9-months Post Praxis 2016 (n=33) Pre-Praxis 2016 Post-Praxis 2016 Pre-Praxis 2016 9-months Post-Praxis 2016 Post-Praxis 2016 9-months Post-Praxis 2016 Mean SD Mean SD t-test Mean SD Mean SD t-test Mean SD Mean SD t-test Knowledge (as 
capability in COM-B) 5.08 1.13 5.54 .88 3.83* 5.30 1.21 5.63 .91 1.50 5.83 0.69 5.48 .93 2.17*  Items 2 items, rinter-item = .48, I know the challenges in translating...; I know about some solutions… Capability (COM-B) 4.80 1.35 4.83 1.20 .24 5.11 1.21 5.07 1.10 -.20 5.18 1.19 5.15 1.08 .18  Items 2 items, rinter-item = .78, I have the capability to…; and I have the knowledge and skills to… Opportunity (COM-B) 5.03 1.37 5.11 1.04 .53 5.23 1.49 5.32 1.12 .42 5.52 1.06 5.20 1.00 1.63  Items (a) Physical (1 item; I have the resources (e.g., time and money) to…); (b) Social (2 items; rinter-item = .45; I have support from others (e.g., colleagues, friends, own organization, etc.) to…; I have the working relationships necessary to… Motivation (COM-B) 6.04 .94 5.93 .95 -1.04 6.07 .99 6.09 .78 1.02 6.35 .86 6.25 .73 .63  Items 2 items; rinter-item = .71; I want to…; I am willing to… Behaviour (COM-B) 4.49 1.49 4.57 1.28 .54 4.54 1.55 4.76 1.32 .90 4.77 1.28 4.70 1.27 .34  Items 3 items; Cronbach’s alpha = .78; I have contributed towards…; I have a plan to …; I have implemented a plan to… Value 6.37 .82 6.32 .77 -.45 6.50 .75 6.54 .64 .37 6.60 .56 6.60 .56 0.00  Item I think there is value in bringing the SCI community together to … Importance 6.52 .68 6.60 .64 1.15 6.46 .74 6.46 .74 .00 6.80 .41 6.57 .63 2.04  Item I feel it is important to… Knowledge translation networks  Listed groups (a) Individuals with SCI, (b) SCI family members or supporters, (c) Researchers, (d) Clinicians or other health care providers, (d) SCI consumer associations, organizations or advocacy groups, (e) Non-SCI consumer associations, organizations or advocacy groups, (f) Knowledge translation leaders/consultants, (g) Health care decision or policy maker, (h) Regulatory agencies, (i) Funding agencies, (j) Public or private insurers, (k) Industries, and (l) Investors. Measures Pre- and Post-Praxis 2016 (n=62) Pre- and 9-months Post-Praxis 2016 (n=28) Post and 9-months Post Praxis 2016 (n=33) Pre-Praxis 2016 Post-Praxis 2016 Pre-Praxis 2016 9-months Post-Praxis 2016 Post-Praxis 2016 9-months Post-Praxis 2016 Mean SD Mean SD t-test Mean SD Mean SD t-test Mean SD Mean SD t-test Knowledge (as 
capability in COM-B) 5.08 1.13 5.54 .88 3.83* 5.30 1.21 5.63 .91 1.50 5.83 0.69 5.48 .93 2.17*  Items 2 items, rinter-item = .48, I know the challenges in translating...; I know about some solutions… Capability (COM-B) 4.80 1.35 4.83 1.20 .24 5.11 1.21 5.07 1.10 -.20 5.18 1.19 5.15 1.08 .18  Items 2 items, rinter-item = .78, I have the capability to…; and I have the knowledge and skills to… Opportunity (COM-B) 5.03 1.37 5.11 1.04 .53 5.23 1.49 5.32 1.12 .42 5.52 1.06 5.20 1.00 1.63  Items (a) Physical (1 item; I have the resources (e.g., time and money) to…); (b) Social (2 items; rinter-item = .45; I have support from others (e.g., colleagues, friends, own organization, etc.) to…; I have the working relationships necessary to… Motivation (COM-B) 6.04 .94 5.93 .95 -1.04 6.07 .99 6.09 .78 1.02 6.35 .86 6.25 .73 .63  Items 2 items; rinter-item = .71; I want to…; I am willing to… Behaviour (COM-B) 4.49 1.49 4.57 1.28 .54 4.54 1.55 4.76 1.32 .90 4.77 1.28 4.70 1.27 .34  Items 3 items; Cronbach’s alpha = .78; I have contributed towards…; I have a plan to …; I have implemented a plan to… Value 6.37 .82 6.32 .77 -.45 6.50 .75 6.54 .64 .37 6.60 .56 6.60 .56 0.00  Item I think there is value in bringing the SCI community together to … Importance 6.52 .68 6.60 .64 1.15 6.46 .74 6.46 .74 .00 6.80 .41 6.57 .63 2.04  Item I feel it is important to… Knowledge translation networks  Listed groups (a) Individuals with SCI, (b) SCI family members or supporters, (c) Researchers, (d) Clinicians or other health care providers, (d) SCI consumer associations, organizations or advocacy groups, (e) Non-SCI consumer associations, organizations or advocacy groups, (f) Knowledge translation leaders/consultants, (g) Health care decision or policy maker, (h) Regulatory agencies, (i) Funding agencies, (j) Public or private insurers, (k) Industries, and (l) Investors. Note: *p < .05. Means changes due to the number of participants that responded across both time points. Each example item was followed by the phrase “……develop (or developing) solutions to overcome the challenges in translating SCI research into practice”. View Large Table 2. Effectiveness and maintenance measures for evaluating Praxis 2016 and t-tests across the three time points. Measures Pre- and Post-Praxis 2016 (n=62) Pre- and 9-months Post-Praxis 2016 (n=28) Post and 9-months Post Praxis 2016 (n=33) Pre-Praxis 2016 Post-Praxis 2016 Pre-Praxis 2016 9-months Post-Praxis 2016 Post-Praxis 2016 9-months Post-Praxis 2016 Mean SD Mean SD t-test Mean SD Mean SD t-test Mean SD Mean SD t-test Knowledge (as 
capability in COM-B) 5.08 1.13 5.54 .88 3.83* 5.30 1.21 5.63 .91 1.50 5.83 0.69 5.48 .93 2.17*  Items 2 items, rinter-item = .48, I know the challenges in translating...; I know about some solutions… Capability (COM-B) 4.80 1.35 4.83 1.20 .24 5.11 1.21 5.07 1.10 -.20 5.18 1.19 5.15 1.08 .18  Items 2 items, rinter-item = .78, I have the capability to…; and I have the knowledge and skills to… Opportunity (COM-B) 5.03 1.37 5.11 1.04 .53 5.23 1.49 5.32 1.12 .42 5.52 1.06 5.20 1.00 1.63  Items (a) Physical (1 item; I have the resources (e.g., time and money) to…); (b) Social (2 items; rinter-item = .45; I have support from others (e.g., colleagues, friends, own organization, etc.) to…; I have the working relationships necessary to… Motivation (COM-B) 6.04 .94 5.93 .95 -1.04 6.07 .99 6.09 .78 1.02 6.35 .86 6.25 .73 .63  Items 2 items; rinter-item = .71; I want to…; I am willing to… Behaviour (COM-B) 4.49 1.49 4.57 1.28 .54 4.54 1.55 4.76 1.32 .90 4.77 1.28 4.70 1.27 .34  Items 3 items; Cronbach’s alpha = .78; I have contributed towards…; I have a plan to …; I have implemented a plan to… Value 6.37 .82 6.32 .77 -.45 6.50 .75 6.54 .64 .37 6.60 .56 6.60 .56 0.00  Item I think there is value in bringing the SCI community together to … Importance 6.52 .68 6.60 .64 1.15 6.46 .74 6.46 .74 .00 6.80 .41 6.57 .63 2.04  Item I feel it is important to… Knowledge translation networks  Listed groups (a) Individuals with SCI, (b) SCI family members or supporters, (c) Researchers, (d) Clinicians or other health care providers, (d) SCI consumer associations, organizations or advocacy groups, (e) Non-SCI consumer associations, organizations or advocacy groups, (f) Knowledge translation leaders/consultants, (g) Health care decision or policy maker, (h) Regulatory agencies, (i) Funding agencies, (j) Public or private insurers, (k) Industries, and (l) Investors. Measures Pre- and Post-Praxis 2016 (n=62) Pre- and 9-months Post-Praxis 2016 (n=28) Post and 9-months Post Praxis 2016 (n=33) Pre-Praxis 2016 Post-Praxis 2016 Pre-Praxis 2016 9-months Post-Praxis 2016 Post-Praxis 2016 9-months Post-Praxis 2016 Mean SD Mean SD t-test Mean SD Mean SD t-test Mean SD Mean SD t-test Knowledge (as 
capability in COM-B) 5.08 1.13 5.54 .88 3.83* 5.30 1.21 5.63 .91 1.50 5.83 0.69 5.48 .93 2.17*  Items 2 items, rinter-item = .48, I know the challenges in translating...; I know about some solutions… Capability (COM-B) 4.80 1.35 4.83 1.20 .24 5.11 1.21 5.07 1.10 -.20 5.18 1.19 5.15 1.08 .18  Items 2 items, rinter-item = .78, I have the capability to…; and I have the knowledge and skills to… Opportunity (COM-B) 5.03 1.37 5.11 1.04 .53 5.23 1.49 5.32 1.12 .42 5.52 1.06 5.20 1.00 1.63  Items (a) Physical (1 item; I have the resources (e.g., time and money) to…); (b) Social (2 items; rinter-item = .45; I have support from others (e.g., colleagues, friends, own organization, etc.) to…; I have the working relationships necessary to… Motivation (COM-B) 6.04 .94 5.93 .95 -1.04 6.07 .99 6.09 .78 1.02 6.35 .86 6.25 .73 .63  Items 2 items; rinter-item = .71; I want to…; I am willing to… Behaviour (COM-B) 4.49 1.49 4.57 1.28 .54 4.54 1.55 4.76 1.32 .90 4.77 1.28 4.70 1.27 .34  Items 3 items; Cronbach’s alpha = .78; I have contributed towards…; I have a plan to …; I have implemented a plan to… Value 6.37 .82 6.32 .77 -.45 6.50 .75 6.54 .64 .37 6.60 .56 6.60 .56 0.00  Item I think there is value in bringing the SCI community together to … Importance 6.52 .68 6.60 .64 1.15 6.46 .74 6.46 .74 .00 6.80 .41 6.57 .63 2.04  Item I feel it is important to… Knowledge translation networks  Listed groups (a) Individuals with SCI, (b) SCI family members or supporters, (c) Researchers, (d) Clinicians or other health care providers, (d) SCI consumer associations, organizations or advocacy groups, (e) Non-SCI consumer associations, organizations or advocacy groups, (f) Knowledge translation leaders/consultants, (g) Health care decision or policy maker, (h) Regulatory agencies, (i) Funding agencies, (j) Public or private insurers, (k) Industries, and (l) Investors. Note: *p < .05. Means changes due to the number of participants that responded across both time points. Each example item was followed by the phrase “……develop (or developing) solutions to overcome the challenges in translating SCI research into practice”. View Large Table 3 Satisfaction of Praxis 2016 as an effectiveness evaluation Measures Scale anchors Example items Mean (SD) Overall measures Satisfaction overall 1 (very unsatisfied) to 7 (very satisfied) To what extent are you satisfied overall with… • The Praxis 2016 conference • The solutions proposed during the Praxis 2016 conference 5.68 (1.13) Accessibility 1 (strongly disagree) to 7 (strongly agree) To what extent do you agree that the conference venue was accessible for all participants? 5.28 (1.53) Engaged in conference working table sessions 1 (strongly disagree) to 7 (strongly agree) During the working table discussions, overall, I felt that… • views were respected 6.29 (0.73) • views listened to 6.19 (0.82) • engaged in the discussions 6.14 (0.83) • the table discussions led to concrete solutions 4.54 (1.36) Length 1 (far too short) to 5 (far too long) Overall, the length of the panel sessions were… 3.20 (0.50) Overall, the length of the working sessions were… 2.73 (0.67) Session specific measures Opening plenary 1 (strongly disagree) to 7 (strongly agree) • Speakers opened the conversation on developing solutions to overcome the challenges in translating SCI research into practice 5.53 (1.15) • Valuable session in the conference 5.51 (1.34) General evaluation of sessions 1 (strongly disagree) to 7 (strongly agree) • Valuable first step to developing solutions Session 1 5.40 (1.16) Session 2 5.69 (0.90) Session 3 5.67 (1.11) Session 4 5.40 (1.20) Panel of speakers of Sessions 1, 2, 3, 4a 1 (strongly disagree) to 7 (strongly agree) • Learned something new in the session Session 1 5.75 (1.02) Session 2 5.86 (1.04) Session 3 5.67 (1.19) Session 4 5.70 (1.17) • The solutions proposed were relevant to the session topic Session 1 5.45 (0.98) Session 2 5.65 (0.90) • The presentations were relevant to the session topic Session 3 5.84 (1.02) Session 4 5.50 (1.28) • The speakers’ presentations facilitated the working table discussion Session 1 5.46 (1.10) Session 2 5.69 (1.01) Session 3 5.80 (1.06) • The panel interaction and question and answer period after the presentations facilitated the working table discussion that followed Session 1 5.62 (0.96) Session 2 5.62 (1.09) Session 3 5.76 (1.13) Working tables of Sessions 1, 2, 3 1 (strongly disagree) to 7 (strongly agree) • Helped stimulate discussion on the intended topic of the session (e.g., Session 1: developing solutions to overcome the challenges in product development and delivery) Session 1 5.62 (1.10) Session 2 5.55 (1.07) Session 3 5.44 (1.11) • The table discussion activity (e.g., selecting and discussing up to two challenges) was the appropriate format to develop solutions regarding the intended topic of the session Session 1 5.15 (1.31) Session 2 5.34 (1.28) Session 3 5.44 (1.19) Poster 1 (strongly disagree) to 7 (strongly agree) • A valuable session 5.50 (1.35) • The poster content was relevant to the purpose of the conference 5.57 (1.15) Closing plenary 1 (strongly disagree) to 7 (strongly agree) • A valuable session 4.72 (1.37) • A clear overview of the solutions brought forward 4.57 (1.45) Measures Scale anchors Example items Mean (SD) Overall measures Satisfaction overall 1 (very unsatisfied) to 7 (very satisfied) To what extent are you satisfied overall with… • The Praxis 2016 conference • The solutions proposed during the Praxis 2016 conference 5.68 (1.13) Accessibility 1 (strongly disagree) to 7 (strongly agree) To what extent do you agree that the conference venue was accessible for all participants? 5.28 (1.53) Engaged in conference working table sessions 1 (strongly disagree) to 7 (strongly agree) During the working table discussions, overall, I felt that… • views were respected 6.29 (0.73) • views listened to 6.19 (0.82) • engaged in the discussions 6.14 (0.83) • the table discussions led to concrete solutions 4.54 (1.36) Length 1 (far too short) to 5 (far too long) Overall, the length of the panel sessions were… 3.20 (0.50) Overall, the length of the working sessions were… 2.73 (0.67) Session specific measures Opening plenary 1 (strongly disagree) to 7 (strongly agree) • Speakers opened the conversation on developing solutions to overcome the challenges in translating SCI research into practice 5.53 (1.15) • Valuable session in the conference 5.51 (1.34) General evaluation of sessions 1 (strongly disagree) to 7 (strongly agree) • Valuable first step to developing solutions Session 1 5.40 (1.16) Session 2 5.69 (0.90) Session 3 5.67 (1.11) Session 4 5.40 (1.20) Panel of speakers of Sessions 1, 2, 3, 4a 1 (strongly disagree) to 7 (strongly agree) • Learned something new in the session Session 1 5.75 (1.02) Session 2 5.86 (1.04) Session 3 5.67 (1.19) Session 4 5.70 (1.17) • The solutions proposed were relevant to the session topic Session 1 5.45 (0.98) Session 2 5.65 (0.90) • The presentations were relevant to the session topic Session 3 5.84 (1.02) Session 4 5.50 (1.28) • The speakers’ presentations facilitated the working table discussion Session 1 5.46 (1.10) Session 2 5.69 (1.01) Session 3 5.80 (1.06) • The panel interaction and question and answer period after the presentations facilitated the working table discussion that followed Session 1 5.62 (0.96) Session 2 5.62 (1.09) Session 3 5.76 (1.13) Working tables of Sessions 1, 2, 3 1 (strongly disagree) to 7 (strongly agree) • Helped stimulate discussion on the intended topic of the session (e.g., Session 1: developing solutions to overcome the challenges in product development and delivery) Session 1 5.62 (1.10) Session 2 5.55 (1.07) Session 3 5.44 (1.11) • The table discussion activity (e.g., selecting and discussing up to two challenges) was the appropriate format to develop solutions regarding the intended topic of the session Session 1 5.15 (1.31) Session 2 5.34 (1.28) Session 3 5.44 (1.19) Poster 1 (strongly disagree) to 7 (strongly agree) • A valuable session 5.50 (1.35) • The poster content was relevant to the purpose of the conference 5.57 (1.15) Closing plenary 1 (strongly disagree) to 7 (strongly agree) • A valuable session 4.72 (1.37) • A clear overview of the solutions brought forward 4.57 (1.45) aThere was only a panel for Session 4; 74%, 71%, 76%, and 66% of respondents (n = 110) attended Sessions 1, 2, 3, and 4, respectively. View Large Table 3 Satisfaction of Praxis 2016 as an effectiveness evaluation Measures Scale anchors Example items Mean (SD) Overall measures Satisfaction overall 1 (very unsatisfied) to 7 (very satisfied) To what extent are you satisfied overall with… • The Praxis 2016 conference • The solutions proposed during the Praxis 2016 conference 5.68 (1.13) Accessibility 1 (strongly disagree) to 7 (strongly agree) To what extent do you agree that the conference venue was accessible for all participants? 5.28 (1.53) Engaged in conference working table sessions 1 (strongly disagree) to 7 (strongly agree) During the working table discussions, overall, I felt that… • views were respected 6.29 (0.73) • views listened to 6.19 (0.82) • engaged in the discussions 6.14 (0.83) • the table discussions led to concrete solutions 4.54 (1.36) Length 1 (far too short) to 5 (far too long) Overall, the length of the panel sessions were… 3.20 (0.50) Overall, the length of the working sessions were… 2.73 (0.67) Session specific measures Opening plenary 1 (strongly disagree) to 7 (strongly agree) • Speakers opened the conversation on developing solutions to overcome the challenges in translating SCI research into practice 5.53 (1.15) • Valuable session in the conference 5.51 (1.34) General evaluation of sessions 1 (strongly disagree) to 7 (strongly agree) • Valuable first step to developing solutions Session 1 5.40 (1.16) Session 2 5.69 (0.90) Session 3 5.67 (1.11) Session 4 5.40 (1.20) Panel of speakers of Sessions 1, 2, 3, 4a 1 (strongly disagree) to 7 (strongly agree) • Learned something new in the session Session 1 5.75 (1.02) Session 2 5.86 (1.04) Session 3 5.67 (1.19) Session 4 5.70 (1.17) • The solutions proposed were relevant to the session topic Session 1 5.45 (0.98) Session 2 5.65 (0.90) • The presentations were relevant to the session topic Session 3 5.84 (1.02) Session 4 5.50 (1.28) • The speakers’ presentations facilitated the working table discussion Session 1 5.46 (1.10) Session 2 5.69 (1.01) Session 3 5.80 (1.06) • The panel interaction and question and answer period after the presentations facilitated the working table discussion that followed Session 1 5.62 (0.96) Session 2 5.62 (1.09) Session 3 5.76 (1.13) Working tables of Sessions 1, 2, 3 1 (strongly disagree) to 7 (strongly agree) • Helped stimulate discussion on the intended topic of the session (e.g., Session 1: developing solutions to overcome the challenges in product development and delivery) Session 1 5.62 (1.10) Session 2 5.55 (1.07) Session 3 5.44 (1.11) • The table discussion activity (e.g., selecting and discussing up to two challenges) was the appropriate format to develop solutions regarding the intended topic of the session Session 1 5.15 (1.31) Session 2 5.34 (1.28) Session 3 5.44 (1.19) Poster 1 (strongly disagree) to 7 (strongly agree) • A valuable session 5.50 (1.35) • The poster content was relevant to the purpose of the conference 5.57 (1.15) Closing plenary 1 (strongly disagree) to 7 (strongly agree) • A valuable session 4.72 (1.37) • A clear overview of the solutions brought forward 4.57 (1.45) Measures Scale anchors Example items Mean (SD) Overall measures Satisfaction overall 1 (very unsatisfied) to 7 (very satisfied) To what extent are you satisfied overall with… • The Praxis 2016 conference • The solutions proposed during the Praxis 2016 conference 5.68 (1.13) Accessibility 1 (strongly disagree) to 7 (strongly agree) To what extent do you agree that the conference venue was accessible for all participants? 5.28 (1.53) Engaged in conference working table sessions 1 (strongly disagree) to 7 (strongly agree) During the working table discussions, overall, I felt that… • views were respected 6.29 (0.73) • views listened to 6.19 (0.82) • engaged in the discussions 6.14 (0.83) • the table discussions led to concrete solutions 4.54 (1.36) Length 1 (far too short) to 5 (far too long) Overall, the length of the panel sessions were… 3.20 (0.50) Overall, the length of the working sessions were… 2.73 (0.67) Session specific measures Opening plenary 1 (strongly disagree) to 7 (strongly agree) • Speakers opened the conversation on developing solutions to overcome the challenges in translating SCI research into practice 5.53 (1.15) • Valuable session in the conference 5.51 (1.34) General evaluation of sessions 1 (strongly disagree) to 7 (strongly agree) • Valuable first step to developing solutions Session 1 5.40 (1.16) Session 2 5.69 (0.90) Session 3 5.67 (1.11) Session 4 5.40 (1.20) Panel of speakers of Sessions 1, 2, 3, 4a 1 (strongly disagree) to 7 (strongly agree) • Learned something new in the session Session 1 5.75 (1.02) Session 2 5.86 (1.04) Session 3 5.67 (1.19) Session 4 5.70 (1.17) • The solutions proposed were relevant to the session topic Session 1 5.45 (0.98) Session 2 5.65 (0.90) • The presentations were relevant to the session topic Session 3 5.84 (1.02) Session 4 5.50 (1.28) • The speakers’ presentations facilitated the working table discussion Session 1 5.46 (1.10) Session 2 5.69 (1.01) Session 3 5.80 (1.06) • The panel interaction and question and answer period after the presentations facilitated the working table discussion that followed Session 1 5.62 (0.96) Session 2 5.62 (1.09) Session 3 5.76 (1.13) Working tables of Sessions 1, 2, 3 1 (strongly disagree) to 7 (strongly agree) • Helped stimulate discussion on the intended topic of the session (e.g., Session 1: developing solutions to overcome the challenges in product development and delivery) Session 1 5.62 (1.10) Session 2 5.55 (1.07) Session 3 5.44 (1.11) • The table discussion activity (e.g., selecting and discussing up to two challenges) was the appropriate format to develop solutions regarding the intended topic of the session Session 1 5.15 (1.31) Session 2 5.34 (1.28) Session 3 5.44 (1.19) Poster 1 (strongly disagree) to 7 (strongly agree) • A valuable session 5.50 (1.35) • The poster content was relevant to the purpose of the conference 5.57 (1.15) Closing plenary 1 (strongly disagree) to 7 (strongly agree) • A valuable session 4.72 (1.37) • A clear overview of the solutions brought forward 4.57 (1.45) aThere was only a panel for Session 4; 74%, 71%, 76%, and 66% of respondents (n = 110) attended Sessions 1, 2, 3, and 4, respectively. View Large Data analyses Reach To calculate reach, we computed a percentage by dividing (a) the number of Praxis 2016 attendees by the number of people on the Praxis 2016 email list and (b) the number of attendees who responded to the questionnaire at pre-Praxis 2016, post-Praxis 2016, and 9-month post-Praxis 2016 by the number of Praxis 2016 attendees. Descriptive analyses were used for representativeness (Table 1). We calculated the frequencies of individuals who, post-Praxis 2016, reported certain groups were missing or underrepresented at Praxis 2016. For the qualitative data, we conducted separate deductive content analyses guided by RE-AIM for the attendees (N = 13) and organizers (N = 9) using a similar process outlined by Braun and Clarke’s step by step guide to conduct inductive thematic analysis [14, 15]. Specifically, K.B. first identified and marked any content from the transcripts that related to Reach. Content that represented the same or similar idea were then labeled and categorized into themes within the broader Reach category (e.g., Representativeness). Each theme was then defined and relevant quotes were selected. S.N.S., E.M., and H.L.G. met to discuss and debate the names and definitions of each theme to ensure the themes reflected the interview data. For reach, effectiveness, and maintenance, the themes were debated over the course of seven meetings (~13 hours). Effectiveness and maintenance Data from attendees who responded to the pre- and post-Praxis 2016 questionnaire (n = 62) and post- and 9-month post-Praxis 2016 (n = 33) were analyzed for effectiveness and maintenance, respectively. Paired samples t-tests were used to compare change in competence, opportunity, motivation, importance, and value (effectiveness: change from pre- to post-Praxis 2016; maintenance: change from post- to and 9-month post-Praxis 2016), behavior (effectiveness only: change from pre- to 9-month post-Praxis 2016), and perceptions of Praxis 2016 goal achievement (maintenance only: change from post- to 9-month post-Praxis 2016). For knowledge translation networks, McNemar’s chi-squared tests were conducted to compare the nominal data. For effectiveness, the groups that individuals reported they needed to work with were compared pre- to post-Praxis 2016 and the groups that individuals reported currently working with pre-Praxis 2016 were compared with groups that individuals planned to work with post-Praxis 2016. For maintenance, the groups that individuals indicated they needed to work post- to 9-month post-Praxis 2016 were compared along with the groups that individuals planned to work with post-Praxis 2016 and the groups that they currently worked with at 9-month post-Praxis 2016. We used descriptive statistics to report Praxis 2016 satisfaction data (effectiveness). The qualitative analysis for effectiveness and maintenance were the same and occurred simultaneously as the Reach data. RESULTS Reach From the questionnaire data, Praxis 2016 reached 28% of individuals on the Praxis 2016 mailing list (243 attendees/864). Of the attendees, 44% completed the questionnaire pre-Praxis 2016 (n = 106), 45% post-Praxis 2016 (n = 110), and 25% 9-month post-Praxis 2016 (n = 62). In terms of representativeness, 31% were researchers and 14% were health care providers/clinicians with 5% being adults with SCI (Table 1). Attendees indicated that SCI family members or supporters were underrepresented at Praxis 2016 (34%), followed by regulatory agencies (29%), health care decision or policy makers (28%), and investors (28%; Supplementary Appendix C). In the interviews, attendees (mean age = 48 ± 15 years, six men, seven women, two individuals with SCI, two knowledge translation specialists, three researchers; one industry partner, three members of the SCI community, one policy maker and one clinician) indicated that other groups (e.g., non-SCI fields) would have increased the representativeness of Praxis 2016 (Table 4). Organizers (three men, six women, mean age = 52 ± 9.7 years, five RHI staff and four members of the Program Advisory Committee) noted that they went through a thoughtful process in determining their invitation list, but acknowledged the challenges in creating the list (Table 5). Table 4 Reach, effectiveness, and maintenance themes and subthemes derived from interviews with Praxis 2016 attendees Reach: Themes and definitions Subthemes and definitions Quotes Representativeness: Attendees discussed a need for greater representation of stakeholder groups. Not all groups were adequately represented. N/A • “…the conference would have benefited from bringing in more people from other medical fields [beyond SCI] that have experienced the same type of challenges.”—Researcher Reasons for attending: Attendees discussed why they wanted to attend the conference Purpose of conference creating appeal: The topics discussed at the conference were interesting to attendees • “It seemed like a conference that bridged lots of my interests [e.g. research, clinical practice, spinal cord injury, knowledge translation].”—Clinician • “That’s why I was attracted to the conference, is it seemed like something that was going to be producing tangible results.”—Clinician Providing an environment to learn: The conference seemed like an environment where attendees could learn more about SCI • “I was just curious as to what is out there [e.g. SCI technology]. What challenges are in research because I’m not a researcher, so I’m not aware of those [e.g. getting technology out into the field].”—SCI community member • “And when you, yourself registered for praxis, what were your specific reasons for attending?” “I was hoping to have more insight on what others were experiencing when they did not succeed in implementing or changing practice … to have some sense of solutions, I guess, in terms of bridging that gap.”—Researcher Effectiveness Themes and definitions Subthemes and definitions Quotes New connections: Attendees networked and established new collaborative relationships at the conference N/A • “As per further collaboration, I met two physicians from [an insurance company who] talked about research possibilities inside [work place]. You know, maybe following a case study of somebody who comes in.”—SCI community member • “We have a working document between a group of us since the conference [looking at helping the community understand SCI and understanding the larger research economy in the SCI field].”—SCI community member Increase in knowledge: Attendees’ knowledge expanded following the conference Understanding challenges faced in SCI research: Attendees left the conference with an increased understanding of the challenges faced by different areas in the SCI field • “It gave me a different sort of perspective from a researcher’s standpoint.” “…a better understanding of what goes on in the research world?” “Yes, yeah.” [Continues to speak of being encouraged and enlightened that there is more going on in the background that they didn’t know about before]—SCI community member • “I learned more about the gaps, and the obstacles and barriers of fundamental science which is really far from what I have in my clinical life.”—Researcher Understanding the importance of engaging the SCI community: Attendees left the conference with either a strengthened or new understanding of the importance of meaningfully involving the SCI community in SCI work • “I think that there was an understanding that there needs to be more real involvement of people with spinal cord injury.”—Researcher • “What effect would you say praxis had on you, if any?” “…it’s more to place the [SCI community members] in every aspect of our work.”—Clinician Change in the way one works: Attendees were inspired post-Praxis to work in a way that results in a positive change in the SCI field N/A •“So, there are a few things [e.g. encouraging patients to take part in research, listing research projects on website] that I’ve actually changed in my clinical practice and my work … and a few things that have got me thinking about what I can do to make change.”—Clinician •“…give us a better understanding of why we do what we do everyday. You know, cause every once in a while, you’re in the lab too much, you forget that there are actual patients involved.”—Researcher Uniqueness: Attendees affirmed that the conference was different from other conferences The diversity of the conference: The conference was unique in the way it brought together different stakeholders •“…bring different people from different perspectives and angles … that was kind of a very unique experience for me.”—Researcher •“…I think it was a good first attempt at taking people who really do not speak [and putting them together and having the discussions].”—Researcher Enjoyed the engaging format: The conference was less didactic and attendees felt that their input was important for creating solutions •“…instead of information that’s being provided we were asked for input back, so that there could be an action plan to go forward.”—Clinician •“I think it definitely was. It was kind of, like it wasn’t speeches basically. The other conferences I’ve been to are mainly about the speeches…. It was more engaging.”—SCI community member Unsatisfied with engagement of SCI Community member: Attendees expressed being unsatisfied with the way the conference engaged SCI community member N/A •“And I think there was a missed opportunity at the conference … but that’s kind of the core message … there is an intent and a willingness to engage people with SCI, but it’s not the level of sophistication and respect and value that needs to be there”—SCI community member •“I was sorely disappointed that people living with SCI were not actively involved in a meaningful way with the design, leadership, and operation of the conference … it felt more like a token engagement.”—SCI community member Maintenance Themes and definitions Subthemes and definitions Quotes Concerns about impact: Attendees were skeptical that there would be no real change over the long term N/A •“…I think it needs to be a lot of things happening from a lot of different angles to make changes happen. So, conferences aren’t a bad thing, but in of themselves it wouldn’t be enough.”—SCI community member •“I think the conference highlighted a number of challenges, but I didn’t actually hear solutions to the challenges or new approaches to solving the problem.”—Researcher Reach: Themes and definitions Subthemes and definitions Quotes Representativeness: Attendees discussed a need for greater representation of stakeholder groups. Not all groups were adequately represented. N/A • “…the conference would have benefited from bringing in more people from other medical fields [beyond SCI] that have experienced the same type of challenges.”—Researcher Reasons for attending: Attendees discussed why they wanted to attend the conference Purpose of conference creating appeal: The topics discussed at the conference were interesting to attendees • “It seemed like a conference that bridged lots of my interests [e.g. research, clinical practice, spinal cord injury, knowledge translation].”—Clinician • “That’s why I was attracted to the conference, is it seemed like something that was going to be producing tangible results.”—Clinician Providing an environment to learn: The conference seemed like an environment where attendees could learn more about SCI • “I was just curious as to what is out there [e.g. SCI technology]. What challenges are in research because I’m not a researcher, so I’m not aware of those [e.g. getting technology out into the field].”—SCI community member • “And when you, yourself registered for praxis, what were your specific reasons for attending?” “I was hoping to have more insight on what others were experiencing when they did not succeed in implementing or changing practice … to have some sense of solutions, I guess, in terms of bridging that gap.”—Researcher Effectiveness Themes and definitions Subthemes and definitions Quotes New connections: Attendees networked and established new collaborative relationships at the conference N/A • “As per further collaboration, I met two physicians from [an insurance company who] talked about research possibilities inside [work place]. You know, maybe following a case study of somebody who comes in.”—SCI community member • “We have a working document between a group of us since the conference [looking at helping the community understand SCI and understanding the larger research economy in the SCI field].”—SCI community member Increase in knowledge: Attendees’ knowledge expanded following the conference Understanding challenges faced in SCI research: Attendees left the conference with an increased understanding of the challenges faced by different areas in the SCI field • “It gave me a different sort of perspective from a researcher’s standpoint.” “…a better understanding of what goes on in the research world?” “Yes, yeah.” [Continues to speak of being encouraged and enlightened that there is more going on in the background that they didn’t know about before]—SCI community member • “I learned more about the gaps, and the obstacles and barriers of fundamental science which is really far from what I have in my clinical life.”—Researcher Understanding the importance of engaging the SCI community: Attendees left the conference with either a strengthened or new understanding of the importance of meaningfully involving the SCI community in SCI work • “I think that there was an understanding that there needs to be more real involvement of people with spinal cord injury.”—Researcher • “What effect would you say praxis had on you, if any?” “…it’s more to place the [SCI community members] in every aspect of our work.”—Clinician Change in the way one works: Attendees were inspired post-Praxis to work in a way that results in a positive change in the SCI field N/A •“So, there are a few things [e.g. encouraging patients to take part in research, listing research projects on website] that I’ve actually changed in my clinical practice and my work … and a few things that have got me thinking about what I can do to make change.”—Clinician •“…give us a better understanding of why we do what we do everyday. You know, cause every once in a while, you’re in the lab too much, you forget that there are actual patients involved.”—Researcher Uniqueness: Attendees affirmed that the conference was different from other conferences The diversity of the conference: The conference was unique in the way it brought together different stakeholders •“…bring different people from different perspectives and angles … that was kind of a very unique experience for me.”—Researcher •“…I think it was a good first attempt at taking people who really do not speak [and putting them together and having the discussions].”—Researcher Enjoyed the engaging format: The conference was less didactic and attendees felt that their input was important for creating solutions •“…instead of information that’s being provided we were asked for input back, so that there could be an action plan to go forward.”—Clinician •“I think it definitely was. It was kind of, like it wasn’t speeches basically. The other conferences I’ve been to are mainly about the speeches…. It was more engaging.”—SCI community member Unsatisfied with engagement of SCI Community member: Attendees expressed being unsatisfied with the way the conference engaged SCI community member N/A •“And I think there was a missed opportunity at the conference … but that’s kind of the core message … there is an intent and a willingness to engage people with SCI, but it’s not the level of sophistication and respect and value that needs to be there”—SCI community member •“I was sorely disappointed that people living with SCI were not actively involved in a meaningful way with the design, leadership, and operation of the conference … it felt more like a token engagement.”—SCI community member Maintenance Themes and definitions Subthemes and definitions Quotes Concerns about impact: Attendees were skeptical that there would be no real change over the long term N/A •“…I think it needs to be a lot of things happening from a lot of different angles to make changes happen. So, conferences aren’t a bad thing, but in of themselves it wouldn’t be enough.”—SCI community member •“I think the conference highlighted a number of challenges, but I didn’t actually hear solutions to the challenges or new approaches to solving the problem.”—Researcher N/A not applicable; SCI spinal cord injury. View Large Table 4 Reach, effectiveness, and maintenance themes and subthemes derived from interviews with Praxis 2016 attendees Reach: Themes and definitions Subthemes and definitions Quotes Representativeness: Attendees discussed a need for greater representation of stakeholder groups. Not all groups were adequately represented. N/A • “…the conference would have benefited from bringing in more people from other medical fields [beyond SCI] that have experienced the same type of challenges.”—Researcher Reasons for attending: Attendees discussed why they wanted to attend the conference Purpose of conference creating appeal: The topics discussed at the conference were interesting to attendees • “It seemed like a conference that bridged lots of my interests [e.g. research, clinical practice, spinal cord injury, knowledge translation].”—Clinician • “That’s why I was attracted to the conference, is it seemed like something that was going to be producing tangible results.”—Clinician Providing an environment to learn: The conference seemed like an environment where attendees could learn more about SCI • “I was just curious as to what is out there [e.g. SCI technology]. What challenges are in research because I’m not a researcher, so I’m not aware of those [e.g. getting technology out into the field].”—SCI community member • “And when you, yourself registered for praxis, what were your specific reasons for attending?” “I was hoping to have more insight on what others were experiencing when they did not succeed in implementing or changing practice … to have some sense of solutions, I guess, in terms of bridging that gap.”—Researcher Effectiveness Themes and definitions Subthemes and definitions Quotes New connections: Attendees networked and established new collaborative relationships at the conference N/A • “As per further collaboration, I met two physicians from [an insurance company who] talked about research possibilities inside [work place]. You know, maybe following a case study of somebody who comes in.”—SCI community member • “We have a working document between a group of us since the conference [looking at helping the community understand SCI and understanding the larger research economy in the SCI field].”—SCI community member Increase in knowledge: Attendees’ knowledge expanded following the conference Understanding challenges faced in SCI research: Attendees left the conference with an increased understanding of the challenges faced by different areas in the SCI field • “It gave me a different sort of perspective from a researcher’s standpoint.” “…a better understanding of what goes on in the research world?” “Yes, yeah.” [Continues to speak of being encouraged and enlightened that there is more going on in the background that they didn’t know about before]—SCI community member • “I learned more about the gaps, and the obstacles and barriers of fundamental science which is really far from what I have in my clinical life.”—Researcher Understanding the importance of engaging the SCI community: Attendees left the conference with either a strengthened or new understanding of the importance of meaningfully involving the SCI community in SCI work • “I think that there was an understanding that there needs to be more real involvement of people with spinal cord injury.”—Researcher • “What effect would you say praxis had on you, if any?” “…it’s more to place the [SCI community members] in every aspect of our work.”—Clinician Change in the way one works: Attendees were inspired post-Praxis to work in a way that results in a positive change in the SCI field N/A •“So, there are a few things [e.g. encouraging patients to take part in research, listing research projects on website] that I’ve actually changed in my clinical practice and my work … and a few things that have got me thinking about what I can do to make change.”—Clinician •“…give us a better understanding of why we do what we do everyday. You know, cause every once in a while, you’re in the lab too much, you forget that there are actual patients involved.”—Researcher Uniqueness: Attendees affirmed that the conference was different from other conferences The diversity of the conference: The conference was unique in the way it brought together different stakeholders •“…bring different people from different perspectives and angles … that was kind of a very unique experience for me.”—Researcher •“…I think it was a good first attempt at taking people who really do not speak [and putting them together and having the discussions].”—Researcher Enjoyed the engaging format: The conference was less didactic and attendees felt that their input was important for creating solutions •“…instead of information that’s being provided we were asked for input back, so that there could be an action plan to go forward.”—Clinician •“I think it definitely was. It was kind of, like it wasn’t speeches basically. The other conferences I’ve been to are mainly about the speeches…. It was more engaging.”—SCI community member Unsatisfied with engagement of SCI Community member: Attendees expressed being unsatisfied with the way the conference engaged SCI community member N/A •“And I think there was a missed opportunity at the conference … but that’s kind of the core message … there is an intent and a willingness to engage people with SCI, but it’s not the level of sophistication and respect and value that needs to be there”—SCI community member •“I was sorely disappointed that people living with SCI were not actively involved in a meaningful way with the design, leadership, and operation of the conference … it felt more like a token engagement.”—SCI community member Maintenance Themes and definitions Subthemes and definitions Quotes Concerns about impact: Attendees were skeptical that there would be no real change over the long term N/A •“…I think it needs to be a lot of things happening from a lot of different angles to make changes happen. So, conferences aren’t a bad thing, but in of themselves it wouldn’t be enough.”—SCI community member •“I think the conference highlighted a number of challenges, but I didn’t actually hear solutions to the challenges or new approaches to solving the problem.”—Researcher Reach: Themes and definitions Subthemes and definitions Quotes Representativeness: Attendees discussed a need for greater representation of stakeholder groups. Not all groups were adequately represented. N/A • “…the conference would have benefited from bringing in more people from other medical fields [beyond SCI] that have experienced the same type of challenges.”—Researcher Reasons for attending: Attendees discussed why they wanted to attend the conference Purpose of conference creating appeal: The topics discussed at the conference were interesting to attendees • “It seemed like a conference that bridged lots of my interests [e.g. research, clinical practice, spinal cord injury, knowledge translation].”—Clinician • “That’s why I was attracted to the conference, is it seemed like something that was going to be producing tangible results.”—Clinician Providing an environment to learn: The conference seemed like an environment where attendees could learn more about SCI • “I was just curious as to what is out there [e.g. SCI technology]. What challenges are in research because I’m not a researcher, so I’m not aware of those [e.g. getting technology out into the field].”—SCI community member • “And when you, yourself registered for praxis, what were your specific reasons for attending?” “I was hoping to have more insight on what others were experiencing when they did not succeed in implementing or changing practice … to have some sense of solutions, I guess, in terms of bridging that gap.”—Researcher Effectiveness Themes and definitions Subthemes and definitions Quotes New connections: Attendees networked and established new collaborative relationships at the conference N/A • “As per further collaboration, I met two physicians from [an insurance company who] talked about research possibilities inside [work place]. You know, maybe following a case study of somebody who comes in.”—SCI community member • “We have a working document between a group of us since the conference [looking at helping the community understand SCI and understanding the larger research economy in the SCI field].”—SCI community member Increase in knowledge: Attendees’ knowledge expanded following the conference Understanding challenges faced in SCI research: Attendees left the conference with an increased understanding of the challenges faced by different areas in the SCI field • “It gave me a different sort of perspective from a researcher’s standpoint.” “…a better understanding of what goes on in the research world?” “Yes, yeah.” [Continues to speak of being encouraged and enlightened that there is more going on in the background that they didn’t know about before]—SCI community member • “I learned more about the gaps, and the obstacles and barriers of fundamental science which is really far from what I have in my clinical life.”—Researcher Understanding the importance of engaging the SCI community: Attendees left the conference with either a strengthened or new understanding of the importance of meaningfully involving the SCI community in SCI work • “I think that there was an understanding that there needs to be more real involvement of people with spinal cord injury.”—Researcher • “What effect would you say praxis had on you, if any?” “…it’s more to place the [SCI community members] in every aspect of our work.”—Clinician Change in the way one works: Attendees were inspired post-Praxis to work in a way that results in a positive change in the SCI field N/A •“So, there are a few things [e.g. encouraging patients to take part in research, listing research projects on website] that I’ve actually changed in my clinical practice and my work … and a few things that have got me thinking about what I can do to make change.”—Clinician •“…give us a better understanding of why we do what we do everyday. You know, cause every once in a while, you’re in the lab too much, you forget that there are actual patients involved.”—Researcher Uniqueness: Attendees affirmed that the conference was different from other conferences The diversity of the conference: The conference was unique in the way it brought together different stakeholders •“…bring different people from different perspectives and angles … that was kind of a very unique experience for me.”—Researcher •“…I think it was a good first attempt at taking people who really do not speak [and putting them together and having the discussions].”—Researcher Enjoyed the engaging format: The conference was less didactic and attendees felt that their input was important for creating solutions •“…instead of information that’s being provided we were asked for input back, so that there could be an action plan to go forward.”—Clinician •“I think it definitely was. It was kind of, like it wasn’t speeches basically. The other conferences I’ve been to are mainly about the speeches…. It was more engaging.”—SCI community member Unsatisfied with engagement of SCI Community member: Attendees expressed being unsatisfied with the way the conference engaged SCI community member N/A •“And I think there was a missed opportunity at the conference … but that’s kind of the core message … there is an intent and a willingness to engage people with SCI, but it’s not the level of sophistication and respect and value that needs to be there”—SCI community member •“I was sorely disappointed that people living with SCI were not actively involved in a meaningful way with the design, leadership, and operation of the conference … it felt more like a token engagement.”—SCI community member Maintenance Themes and definitions Subthemes and definitions Quotes Concerns about impact: Attendees were skeptical that there would be no real change over the long term N/A •“…I think it needs to be a lot of things happening from a lot of different angles to make changes happen. So, conferences aren’t a bad thing, but in of themselves it wouldn’t be enough.”—SCI community member •“I think the conference highlighted a number of challenges, but I didn’t actually hear solutions to the challenges or new approaches to solving the problem.”—Researcher N/A not applicable; SCI spinal cord injury. View Large Table 5 Reach and effectiveness themes and sub-themes derived from interviews with RHI Staff and Program Advisory Committee members (i.e., organizers) Reach Themes and definitions Subthemes and definitions Quotes Invitation challenges: Organizers described the difficulties of determining an invite list for a new conference N/A • “And then the other piece was, how do we then now start to involve some of the people that we do not normally involve? And that list was, honestly, a little difficult to pull together because I think the field’s been doing things one way for a long time. So, who are those people that we need to involve?” • “I think maybe we do not know who the right decision makers are is the challenge. And if we were to do this again, I would like to do environmental scan and find out who’s actually making these decisions.” Careful consideration of invite list: Organizers describe the thoughtful process to ensure the right individuals were invited to the conference N/A • “The original invitation list probably changed, not 360 but at least 180 degrees between September and April. Because as the process evolved and as more people came on board, people were dumped off the train, other people were invited on.” • “I think in part of the planning we identified you know, we really had a lot of discussion about ensuring that the right individuals were in attendance… We really pushed forward to ensure that the right individuals were in the room.” Effectiveness Themes and definitions Subthemes and definitions Quotes New connections: Organizers described how Praxis fostered discussions between diverse groups N/A • “I liked the idea of bringing together a very diverse community and a conference around a very diverse community from pre-clinical studies, clinical trials, rehabilitation, quality care and knowledge translation.” • “Here’s the thing that I think is exciting. In the 20 years I’ve been hanging out in the [inaudible] community, this is the first time that this collection of stakeholders was in the same place at the same time.” Increase in knowledge: The conference expanded the knowledge of those who attended N/A • “Okay, so shifting how people see … an issue, problem, question, challenge. I think some people are able to see that there are commonalities across the continuum in a lot of the challenges and then to also appreciate a bit more their individual challenges that were unique to where they are in the continuum, or what environment they practice in, or whatever.” • “I think my involvement in Praxis was a huge learning opportunity for myself. And I do think that personally, it helped me identify some of the needs in the SCI research and care community. And I think in the work that I’m doing now, I think it will help tailor some of that work.” Uniqueness: Organizers affirmed that the conference was different from other conferences N/A • “I do not think most of them had actually been in a conference that was very solution-oriented. And where at the end you come up with an action plan, so that was a novelty. The second thing that I was told that people found very unique was the diverse types of stakeholders who were at the meeting.” • “We do not always have all four [broad areas of SCI research together] in the same place. And that I thought was actually quite unique.” Satisfaction with consumer engagement: Organizers expressed being satisfied with the way the conference engaged consumers N/A • “It’s certainly brought forward, I mean it’s all the different people that were bringing up consumer engagement at Praxis, it wasn’t just me and it wasn’t just other people with spinal cord injury. I think it opened up people’s ears in a way that was I think hopefully more impactful than future or previous things.” • “I think, you know, the first time I’ve been to a meeting such as that where I actually heard researchers stand up with a microphone and say to consumers that, “we need you to be a part of the conversation more”. So, that was a pretty big [thing] to accomplish.” Reach Themes and definitions Subthemes and definitions Quotes Invitation challenges: Organizers described the difficulties of determining an invite list for a new conference N/A • “And then the other piece was, how do we then now start to involve some of the people that we do not normally involve? And that list was, honestly, a little difficult to pull together because I think the field’s been doing things one way for a long time. So, who are those people that we need to involve?” • “I think maybe we do not know who the right decision makers are is the challenge. And if we were to do this again, I would like to do environmental scan and find out who’s actually making these decisions.” Careful consideration of invite list: Organizers describe the thoughtful process to ensure the right individuals were invited to the conference N/A • “The original invitation list probably changed, not 360 but at least 180 degrees between September and April. Because as the process evolved and as more people came on board, people were dumped off the train, other people were invited on.” • “I think in part of the planning we identified you know, we really had a lot of discussion about ensuring that the right individuals were in attendance… We really pushed forward to ensure that the right individuals were in the room.” Effectiveness Themes and definitions Subthemes and definitions Quotes New connections: Organizers described how Praxis fostered discussions between diverse groups N/A • “I liked the idea of bringing together a very diverse community and a conference around a very diverse community from pre-clinical studies, clinical trials, rehabilitation, quality care and knowledge translation.” • “Here’s the thing that I think is exciting. In the 20 years I’ve been hanging out in the [inaudible] community, this is the first time that this collection of stakeholders was in the same place at the same time.” Increase in knowledge: The conference expanded the knowledge of those who attended N/A • “Okay, so shifting how people see … an issue, problem, question, challenge. I think some people are able to see that there are commonalities across the continuum in a lot of the challenges and then to also appreciate a bit more their individual challenges that were unique to where they are in the continuum, or what environment they practice in, or whatever.” • “I think my involvement in Praxis was a huge learning opportunity for myself. And I do think that personally, it helped me identify some of the needs in the SCI research and care community. And I think in the work that I’m doing now, I think it will help tailor some of that work.” Uniqueness: Organizers affirmed that the conference was different from other conferences N/A • “I do not think most of them had actually been in a conference that was very solution-oriented. And where at the end you come up with an action plan, so that was a novelty. The second thing that I was told that people found very unique was the diverse types of stakeholders who were at the meeting.” • “We do not always have all four [broad areas of SCI research together] in the same place. And that I thought was actually quite unique.” Satisfaction with consumer engagement: Organizers expressed being satisfied with the way the conference engaged consumers N/A • “It’s certainly brought forward, I mean it’s all the different people that were bringing up consumer engagement at Praxis, it wasn’t just me and it wasn’t just other people with spinal cord injury. I think it opened up people’s ears in a way that was I think hopefully more impactful than future or previous things.” • “I think, you know, the first time I’ve been to a meeting such as that where I actually heard researchers stand up with a microphone and say to consumers that, “we need you to be a part of the conversation more”. So, that was a pretty big [thing] to accomplish.” RE-AIMing conferences: A reach, effectiveness, and maintenance evaluation of the Rick Hansen Institute’s Praxis 2016 (Part 1). N/A not applicable; SCI spinal cord injury. View Large Table 5 Reach and effectiveness themes and sub-themes derived from interviews with RHI Staff and Program Advisory Committee members (i.e., organizers) Reach Themes and definitions Subthemes and definitions Quotes Invitation challenges: Organizers described the difficulties of determining an invite list for a new conference N/A • “And then the other piece was, how do we then now start to involve some of the people that we do not normally involve? And that list was, honestly, a little difficult to pull together because I think the field’s been doing things one way for a long time. So, who are those people that we need to involve?” • “I think maybe we do not know who the right decision makers are is the challenge. And if we were to do this again, I would like to do environmental scan and find out who’s actually making these decisions.” Careful consideration of invite list: Organizers describe the thoughtful process to ensure the right individuals were invited to the conference N/A • “The original invitation list probably changed, not 360 but at least 180 degrees between September and April. Because as the process evolved and as more people came on board, people were dumped off the train, other people were invited on.” • “I think in part of the planning we identified you know, we really had a lot of discussion about ensuring that the right individuals were in attendance… We really pushed forward to ensure that the right individuals were in the room.” Effectiveness Themes and definitions Subthemes and definitions Quotes New connections: Organizers described how Praxis fostered discussions between diverse groups N/A • “I liked the idea of bringing together a very diverse community and a conference around a very diverse community from pre-clinical studies, clinical trials, rehabilitation, quality care and knowledge translation.” • “Here’s the thing that I think is exciting. In the 20 years I’ve been hanging out in the [inaudible] community, this is the first time that this collection of stakeholders was in the same place at the same time.” Increase in knowledge: The conference expanded the knowledge of those who attended N/A • “Okay, so shifting how people see … an issue, problem, question, challenge. I think some people are able to see that there are commonalities across the continuum in a lot of the challenges and then to also appreciate a bit more their individual challenges that were unique to where they are in the continuum, or what environment they practice in, or whatever.” • “I think my involvement in Praxis was a huge learning opportunity for myself. And I do think that personally, it helped me identify some of the needs in the SCI research and care community. And I think in the work that I’m doing now, I think it will help tailor some of that work.” Uniqueness: Organizers affirmed that the conference was different from other conferences N/A • “I do not think most of them had actually been in a conference that was very solution-oriented. And where at the end you come up with an action plan, so that was a novelty. The second thing that I was told that people found very unique was the diverse types of stakeholders who were at the meeting.” • “We do not always have all four [broad areas of SCI research together] in the same place. And that I thought was actually quite unique.” Satisfaction with consumer engagement: Organizers expressed being satisfied with the way the conference engaged consumers N/A • “It’s certainly brought forward, I mean it’s all the different people that were bringing up consumer engagement at Praxis, it wasn’t just me and it wasn’t just other people with spinal cord injury. I think it opened up people’s ears in a way that was I think hopefully more impactful than future or previous things.” • “I think, you know, the first time I’ve been to a meeting such as that where I actually heard researchers stand up with a microphone and say to consumers that, “we need you to be a part of the conversation more”. So, that was a pretty big [thing] to accomplish.” Reach Themes and definitions Subthemes and definitions Quotes Invitation challenges: Organizers described the difficulties of determining an invite list for a new conference N/A • “And then the other piece was, how do we then now start to involve some of the people that we do not normally involve? And that list was, honestly, a little difficult to pull together because I think the field’s been doing things one way for a long time. So, who are those people that we need to involve?” • “I think maybe we do not know who the right decision makers are is the challenge. And if we were to do this again, I would like to do environmental scan and find out who’s actually making these decisions.” Careful consideration of invite list: Organizers describe the thoughtful process to ensure the right individuals were invited to the conference N/A • “The original invitation list probably changed, not 360 but at least 180 degrees between September and April. Because as the process evolved and as more people came on board, people were dumped off the train, other people were invited on.” • “I think in part of the planning we identified you know, we really had a lot of discussion about ensuring that the right individuals were in attendance… We really pushed forward to ensure that the right individuals were in the room.” Effectiveness Themes and definitions Subthemes and definitions Quotes New connections: Organizers described how Praxis fostered discussions between diverse groups N/A • “I liked the idea of bringing together a very diverse community and a conference around a very diverse community from pre-clinical studies, clinical trials, rehabilitation, quality care and knowledge translation.” • “Here’s the thing that I think is exciting. In the 20 years I’ve been hanging out in the [inaudible] community, this is the first time that this collection of stakeholders was in the same place at the same time.” Increase in knowledge: The conference expanded the knowledge of those who attended N/A • “Okay, so shifting how people see … an issue, problem, question, challenge. I think some people are able to see that there are commonalities across the continuum in a lot of the challenges and then to also appreciate a bit more their individual challenges that were unique to where they are in the continuum, or what environment they practice in, or whatever.” • “I think my involvement in Praxis was a huge learning opportunity for myself. And I do think that personally, it helped me identify some of the needs in the SCI research and care community. And I think in the work that I’m doing now, I think it will help tailor some of that work.” Uniqueness: Organizers affirmed that the conference was different from other conferences N/A • “I do not think most of them had actually been in a conference that was very solution-oriented. And where at the end you come up with an action plan, so that was a novelty. The second thing that I was told that people found very unique was the diverse types of stakeholders who were at the meeting.” • “We do not always have all four [broad areas of SCI research together] in the same place. And that I thought was actually quite unique.” Satisfaction with consumer engagement: Organizers expressed being satisfied with the way the conference engaged consumers N/A • “It’s certainly brought forward, I mean it’s all the different people that were bringing up consumer engagement at Praxis, it wasn’t just me and it wasn’t just other people with spinal cord injury. I think it opened up people’s ears in a way that was I think hopefully more impactful than future or previous things.” • “I think, you know, the first time I’ve been to a meeting such as that where I actually heard researchers stand up with a microphone and say to consumers that, “we need you to be a part of the conversation more”. So, that was a pretty big [thing] to accomplish.” RE-AIMing conferences: A reach, effectiveness, and maintenance evaluation of the Rick Hansen Institute’s Praxis 2016 (Part 1). N/A not applicable; SCI spinal cord injury. View Large Effectiveness From the questionnaire data, only attendees’ knowledge (capability of COM-B) significantly increased from pre- to post-Praxis 2016 (t(59) = 3.83, p < .001; Table 2). In the interview data, attendees highlighted that they gained knowledge in understanding of SCI research and the importance of engaging with the SCI community. Similarly, organizers reported that Praxis 2016 expanded their knowledge, especially around understanding the need of the SCI community (Tables 4 and 5). Regarding knowledge translation networks, attendees reported, in the questionnaire, a change in needing to work with: individuals with SCI [χ2(1) = 7.11, p =.004], SCI family members or supporters [χ2(1) = 4.05, p = .04], researchers [χ2(1) = 28.66, p < .001], clinicians or other health care providers [χ2(1) = 24.32, p < .001], SCI community associations, organizations, or advocacy groups [χ2(1) = 4.32, p = .04], knowledge translation leaders/consultants [χ2(1) = 5.04, p = .02], and funding agencies [χ2(1)= 4.32, p = .04] post-Praxis 2016 compared with pre-Praxis 2016 (Supplementary Appendix D). Both attendees and organizers discussed in the interviews that Praxis 2016 enabled people to make new connections and the importance of having people across the entire SCI network (Tables 4 and 5). From the questionnaire, the groups that individuals reported currently working with pre-Praxis 2016 and who they planned on working with post-Praxis 2016 only differed for clinicians or other health care providers group [χ2(1) = 7.58, p = .004; Supplementary Appendix E]. Qualitative data from attendees provided additional insight beyond the quantitative data. They discussed that attending Praxis 2016 inspired them to work differently, specifically taking the time to discuss their work with adults with SCI (Table 4). Satisfaction Questionnaire data indicated that attendees were satisfied with Praxis 2016 and felt that they were generally respected (M = 6.29), listened to (M = 6.19), and engaged (M = 6.14), that the venue was relatively accessible (M = 5.28), and were generally satisfied with the specific panel sessions (M > 5.45, Table 3). The majority of attendees reported that Praxis 2016 met their expectation (87%, n = 93) and 80% would attend a future Praxis-type conference (n = 91). Attendees felt the working group sessions could have been longer and neither agreed nor disagreed that the closing session provided a clear overview of solutions to bridge the gap (Table 3). A large majority of attendees agreed that Praxis 2016 achieved its goal to: (a) provide an overview of the current state of the affairs (75%); (b) enable networking (81%); and (c) facilitate learning from a diverse group of stakeholders (72%). However, only 58% of attendees indicated actively participating in developing solutions. Across both sets of interviews, individuals reported that Praxis 2016 was a unique conference due to the diversity of attendees and the engaging format (i.e., discussions and working tables) of the conference (Tables 4 and 5). However, attendees and organizers had diverging views and satisfaction regarding the role of adults with SCI in the conference. Some attendees mentioned that there was a missed opportunity to engage adults with SCI as members of the conference and the planning committee (Table 4). Organizers felt satisfied with the engagement of adults with SCI because they felt the voices of adults with SCI were heard at the conference (Table 5). Maintenance From the questionnaire, no significant differences between any of the COM measures, the importance, and value were found when examining change pre- to 9-month post-Praxis 2016 and post-to 9-month post-Praxis 2016 (Table 2). In the interviews, only attendees discussed topics related to maintenance and expressed concerns about Praxis 2016 resulting in any behavior changes over the long-term. This concern was raised because the solutions to overcome the knowledge translation challenges were not clear immediately after Praxis 2016 (Table 4). Comparing change in knowledge translation networks from post- to 9-month post-Praxis 2016, the questionnaire data informed that more attendees reported a change to needing to work with researchers, clinicians and SCI community associations 9-month post-Praxis 2016 (Supplementary Appendix D). Specifically, 11 individuals changed from not needing to work with researchers post-Praxis 2016 to reporting needing to work with this group at 9-month post-Praxis 2016 [χ2(1) = 4.92, p = .02]. The same trend was found for clinicians and SCI community associations. No differences were found between the groups that attendees planned to work with post-Praxis and those they worked with 9-month post-Praxis 2016, except for SCI family members or supporters [χ2(1) = 4.08, p = .04; Supplementary Appendix E]. Ten attendees who did not plan to work with SCI family members/supporters post-Praxis 2016 were working with them 9-month post-Praxis 2016. DISCUSSION The purpose of this work was to report on the reach, effectiveness, and maintenance evaluation of the Praxis 2016 conference. Praxis 2016 was able to reach over a quarter of their intended audience, increase and maintain attendees’ knowledge about developing practical solutions for overcoming challenges, and expand and maintain attendees’ knowledge translation networks. The attendees were generally satisfied with Praxis 2016. This evaluation provides evidence that a large-scale SCI knowledge translation initiative aimed to overcome the challenges in translating research into practice in the SCI field can have a positive impact on the field, while highlighting elements that could improve future large scale interventions. Regarding Reach, Praxis 2016 reached 28% of its intended audience which aligns with rates from other knowledge mobilization initiatives in SCI. For example, Gainforth et al. [10] reached 21% of their intended audience in a physical activity guidelines knowledge translation initiative for adults with SCI. These reach indicators could be smaller if we were to consider all members of the SCI community rather than only individuals on the Praxis 2016 mailing list. In fact, the organizers highlighted in their interviews the difficulty of including individuals not already involved with RHI or members of the planning committee. These difficulties might explain why some attendees felt representation from other members of SCI community was low such as adults with SCI, SCI family members, health care decision or policy makers, regulatory agencies, investors, and public or private insurers. Having a broader representation is important because knowledge translation stakeholders are best equipped to fill the roles they are in a position to act upon [16]. Thus, a diverse group of stakeholders with different expertize has the potential to develop more effective knowledge translation strategies by allowing individuals to work within their skill set. Future large scale knowledge translation initiatives should consider inviting a balanced representation of groups involved in the entire research, translation, and uptake process. Praxis 2016 successfully changed two effectiveness and maintenance metrics. First, Praxis 2016 changed attendees’ knowledge about developing practical solutions for overcoming challenges pre-post Praxis 2016, which was maintained 9-month post-Praxis 2016. This increase and maintenance of knowledge is likely due to the presentations, questions and answer periods, and the working table sessions. Previous knowledge translation activities using similar formats have also found an increase in knowledge [10, 17, 18]. Attendees reported relatively low levels of capability, opportunity, and behavior pre-Praxis 2016, which did not change post- or 9-month post-Praxis 2016. To increase these outcomes, future initiatives might benefit from providing attendees with tools and strategies to overcome the challenges of translating SCI research into practice. The Behaviour Change Wheel outlines strategies to enhance capability (e.g., modeling: providing examples of individuals within the SCI community who have overcame these knowledge translation challenges) and social opportunity (e.g., environmental restructuring: provide networking best-practice strategies to facilitate exchanges at SCI events) [13]. Attendees reported the need to work with various groups from pre- to post-Praxis 2016 and this need was maintained 9-month post-Praxis 2016 for some specific groups (e.g., researchers, SCI community organizations). The qualitative data supported that Praxis 2016 was successful at bringing people together, and emphasized the need to involve more adults with SCI in research and knowledge translation initiatives. Although attendees expressed a need to work with many groups post-Praxis 2016, attendees did not seem to maintain or change from expressing a need to actually working with some groups 9-month post-Praxis 2016. As outlined in the Praxis 2016 action plan, one strategy to build knowledge translation networks is the creation of a secure web-based platform that allows for communication and document sharing. However, as outlined in the AIM evaluation of Praxis 2016 [7]), little resources were put in place after Praxis 2016 to create the action plan and strategies on how to move these plans forward. It is therefore critical that future efforts ensure that proper resources are allocated to move the action plans forward post-conference, such as the creation of a collaborative online platform. In terms of satisfaction, attendees found Praxis 2016 to be a valuable experience and were generally satisfied with the content and format. However, they wished the working table sessions could have been longer. This finding hints that attendees may want to be more actively engaged in developing solutions. Salter and Kothari have debated that knowledge translation/evidence-based practice interventions need to move away from linear, passive mode of knowledge sharing to a collaborative and engaged enterprise [19]. Thus, the Praxis 2016 working tables may have been an informative (and possibly transformative) process for the attendees given the active learning and experiential knowledge sharing process that likely happened in these working tables. Future organizers of knowledge translation initiatives, such as Praxis 2016, may want to explore a variety of active learning methods, such as having attendees’ critically reflect on the topic and/or embark in shared conversation through working tables, to maximize experiential [19]. Similarly, future organizers may want to consider re-thinking the closing plenary session given attendees were not as satisfied with this session. Using this session to provide attendees with time and resources to develop knowledge translation skills (e.g., a training session on how to advocate for practice change within an organization) may facilitate the translation of SCI research into practice. Limitations and future research A limitation of this evaluation was that less than half of attendees answered the survey and one-third answered the 9-month post-Praxis 2016 survey. However, these response rates were similar to previous event-based knowledge translation initiatives [10, 20]. Further, these results pertain to one knowledge mobilization initiative in SCI, which may not be comparable to other types of initiatives in other populations. Attendees were motivated by and interested in Praxis 2016 as evidenced by high motivation and interest scores. These ceiling effects may explain why no significant changes were found in these variables. Further, the low response rate at 9-month post-Praxis 2016 further limits our ability to understand how such an initiative can maintain or change motivation, capability, and opportunity to develop solutions to overcome the challenges in SCI knowledge translation. Future evaluations of knowledge translation initiatives may need to identify the best incentives (e.g., donations to charities or SCI organizations) to increase the response rates to evaluation assessments. CONCLUSION Praxis 2016 was a knowledge translation intervention that was successful at increasing attendees’ knowledge and need to increase their knowledge translation networks to develop solutions to overcome the knowledge translation gap in SCI research. Further initiatives are necessary to translate this knowledge and need into action among attendees. Praxis 2016’s action plan (http://www.rickhanseninstitute.org/work/praxis/action-plan) may be a step forward to guide the SCI field into reducing the knowledge translation gap. Other research areas could utilize knowledge translation initiatives such as Praxis 2016 to address knowledge translation gaps. Such initiatives may want to develop strategies to enhance capability and social opportunity to facilitate the transfer of knowledge to action and provide knowledge translation tools to their attendees. Compliance with Ethical Standards Conflict of Interest: The authors have no competing financial interests. The evaluation team received a grant to conduct an independent evaluation of Praxis. While RHI was consulted throughout the evaluation process, final methods, analyses, and reporting were done independently of RHI. Author Contributions: S.N.S. and H.L.G. developed and led the evaluation implementation and analyses, and conducted the interviews with organizer. E.M. informed the development of the evaluation methods and led the quantitative data analysis. K.B. led the qualitative analysis with assistance from S.S. and H.G. J.B. informed the development of the evaluation methods and conducted the interviews with attendees. S.N.S. drafted the initial article and all authors provided feedback and approved the article. Ethical Approval: Given this project is a program evaluation, ethics was not required. Informed Consent: At each time point of the questionnaire and before the interviews, we informed attendees and organizers of the purpose of the evaluation, that their responses remained confidential, provided a contact name of the research team, and asked for consent before data collection. Welfare of Animals: This article does not contain any studies with animals performed by any of the authors. Acknowledgments We would like to acknowledge Rhyann McKay and Jena Shank for their help with data collection during the Praxis 2016 meeting. Emily Giroux and Brianna Tsui are also acknowledged for their assistance with transcription. This project was funded by Rick Hansen Institute (G2016-25). The evaluation was independent and the Rick Hansen Institute did not influence the findings reported in this article. References 1. Post MWM , van Leeuwen CMC . Psychosocial issues in spinal cord injury: A review . Spinal Cord . 2012 ; 50 : 382 – 389 . Google Scholar Crossref Search ADS PubMed 2. Noreau L , Noonan VK , Cobb J , Leblond J , Dumont FS . Spinal cord injury community survey: A national, comprehensive study to portray the lives of canadians with spinal cord injury . Top Spinal Cord Inj Rehabil. 2014 ; 20 ( 4 ): 249 – 264 . Google Scholar Crossref Search ADS PubMed 3. Morris ZS , Wooding S , Grant J . The answer is 17 years, what is the question: Understanding time lags in translational research . J R Soc Med. 2011 ; 104 ( 12 ): 510 – 520 . Google Scholar Crossref Search ADS PubMed 4. Noonan VK , Wolfe DL , Thorogood NP , Park SE , Hsieh JT , Eng JJ ; SCIRE Research Team. Knowledge translation and implementation in spinal cord injury: A systematic review . Spinal Cord. 2014 ; 52 ( 8 ): 578 – 587 . Google Scholar Crossref Search ADS PubMed 5. Barrable B , Thorogood N , Noonan V , et al. Model for bridging the translational “valleys of death” in spinal cord injury research . J Health Care Leadership . 2014 ; 2014 : 15 – 37 . 6. Glasgow RE , Vogt TM , Boles SM . Evaluating the public health impact of health promotion interventions: The RE-AIM framework . Am J Public Health. 1999 ; 89 ( 9 ): 1322 – 1327 . Google Scholar Crossref Search ADS PubMed 7. Gainforth, H. L., Baxter, K., Baron, J., Michalovic, E., Caron, J. G., & Sweet, S. N. (submitted). RE-AIMing conferences: Evaluating the adoption, implementation and maintenance of the Rick Hansen Institute’s Praxis 2016. 8. Gaglio B , Shoup JA , Glasgow RE . The RE-AIM framework: A systematic review of use over time . Am J Public Health. 2013 ; 103 ( 6 ): e38 – e46 . Google Scholar Crossref Search ADS PubMed 9. Sweet SN , Martin Ginis KA , Estabrooks PA , Latimer-Cheung AE . Operationalizing the RE-AIM framework to evaluate the impact of multi-sector partnerships . Implement Sci. 2014 ; 9 : 74 . Google Scholar Crossref Search ADS PubMed 10. Gainforth HL , Latimer-Cheung AE , Athanasopoulos P , Martin Ginis KA . Examining the feasibility and effectiveness of a community-based organization implementing an event-based knowledge mobilization initiative to promote physical activity guidelines for people with spinal cord injury among support personnel . Health Promot Pract. 2015 ; 16 ( 1 ): 55 – 62 . Google Scholar Crossref Search ADS PubMed 11. Michie S , van Stralen MM , West R . The behaviour change wheel: A new method for characterising and designing behaviour change interventions . Implement Sci. 2011 ; 6 : 42 . Google Scholar Crossref Search ADS PubMed 12. Thompson LM , Diaz-Artiga A , Weinstein JR , Handley MA . Designing a behavioral intervention using the COM-B model and the theoretical domains framework to promote gas stove use in rural Guatemala: A formative research study . BMC Public Health. 2018 ; 18 ( 1 ): 253 . Google Scholar Crossref Search ADS PubMed 13. Michie S , Atkins L , West R. The Behaviour Change Wheel: A Guide to Designing Interventions . Great Britain : Silverback Publishing ; 2014 . 14. Braun V , Clarke V . Using thematic analysis in psychology . Qual Res Psychol . 2006 ; 3 : 77 – 101 . Google Scholar Crossref Search ADS 15. Braun V , Clarke V. Successful Qualitative Research: A Practical Guide for Beginners . London, UK : Sage ; 2013 . 16. Nabyonga Orem J , Marchal B , Mafigiri D , et al. Perspectives on the role of stakeholders in knowledge translation in health policy development in Uganda . BMC Health Serv Res. 2013 ; 13 : 324 . Google Scholar Crossref Search ADS PubMed 17. Gainforth HL , Latimer-Cheung AE , Athanasopoulos P , Martin Ginis KA . Examining the effectiveness of a knowledge mobilization initiative for disseminating the physical activity guidelines for people with spinal cord injury . Disabil Health J. 2013 ; 6 ( 3 ): 260 – 265 . Google Scholar Crossref Search ADS PubMed 18. Schreiber J , Marchetti GF , Racicot B , Kaminski E . The use of a knowledge translation program to increase use of standardized outcome measures in an outpatient pediatric physical therapy clinic: Administrative case report . Phys Ther. 2015 ; 95 ( 4 ): 613 – 629 . Google Scholar Crossref Search ADS PubMed 19. Salter KL , Kothari A . Knowledge ‘translation’ as social learning: Negotiating the uptake of research-based knowledge in practice . BMC Med Educ. 2016 ; 16 : 76 . Google Scholar Crossref Search ADS PubMed 20. Tomasone JR , Martin Ginis KA , Estabrooks PA , Domenicucci L . ‘Changing minds’: Determining the effectiveness and key ingredients of an educational intervention to enhance healthcare professionals’ intentions to prescribe physical activity to patients with physical disabilities . Implement Sci. 2014 ; 9 : 30 . Google Scholar Crossref Search ADS PubMed © Society of Behavioral Medicine 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Translational Behavioral Medicine Oxford University Press

RE-AIMing conferences: a reach, effectiveness, and maintenance evaluation of the Rick Hansen Institute’s Praxis 2016

Loading next page...
 
/lp/oxford-university-press/re-aiming-conferences-a-reach-effectiveness-and-maintenance-evaluation-qerH8XpczK
Copyright
© Society of Behavioral Medicine 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
ISSN
1869-6716
eISSN
1613-9860
D.O.I.
10.1093/tbm/ibz002
Publisher site
See Article on Publisher Site

Abstract

Abstract This article reported on the reach, effectiveness, and maintenance dimensions of a RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) analysis to evaluate Praxis 2016, a conference aimed to develop solutions to overcome challenges to translating research into practice in the spinal cord injury (SCI) community. Reach indicators were collected from the Praxis 2016 organizing committee. For effectiveness and maintenance, attendees (n = 106) completed a questionnaire pre-, post-, and 9-month post-Praxis 2016 assessing (a) capability (e.g., knowledge), (b) motivation, (c) opportunities, and (d) the groups they currently, need to, and/or plan to work with to develop solutions to overcome the challenges of translating SCI research into practice. They also reported their satisfaction with Praxis 2016. Qualitative interviews with attendees and organizers post-Praxis 2016 were conducted. Praxis 2016 reached 28% of their intended audience. For effectiveness, attendees’ knowledge significantly increased (t(59)= 3.83, p < .001), they reported a greater need to work with members within the SCI community from pre- to post-Praxis 2016, and were generally satisfied with Praxis 2016. Regarding maintenance, more attendees reported needing to work with researchers, clinicians and SCI community organizations at 9-month post-Praxis 2016. The interviewees reported increased knowledge and capacity to network with the SCI community, but highlighted concerns for the long-term impact of Praxis 2016. Praxis 2016 was an effective approach to create short-term change in knowledge, and to expand knowledge translation networks. Further efforts could build on Praxis 2016 to foster long-term success in overcoming the challenges in translating SCI research into practice. Implications Practice: In addition to delivering information, large-scale knowledge translation initiatives should provide knowledge translation tools and strategies to help attendees bridge the knowledge translation gap post-initiative. Policy: Funding large-scale knowledge translation initiative is a first step, but additional resources are needed post-initiative to move forward any resulting action plans. Research: Future research is needed to determine the most effective strategies to change knowledge translation behavior over the long-term. Individuals living with a spinal cord injury (SCI) often report lower quality of life than individuals not living with SCI [1]. An SCI can lead to loss of motor and/or sensory functions and result in a number of secondary complications, such as pressure injuries, pain, and fatigue [2]. Unfortunately, scientific research that could enhance the lives of people with SCI is often not applied in practice. Approximately 14% of scientific health discoveries enter clinical practice, and when they are applied the uptake is slow, as there is an estimated 17- to 20-year gap between health discovery and clinical implementation practice [3, 4]. Given the same delay exists in the SCI field, researchers within the SCI community have identified two areas where innovations are slowly or rarely transferred into practice. The first is when SCI research innovations in basic research and discovery sciences are not translated into clinical research and development. The second valley is when clinical research does not get implemented to optimize health care services [5]. To close these gaps, the Rick Hansen Institute (RHI), members of the program advisory committee, and facilitators from a professional consulting company designed and organized an innovative 3-day conference called Praxis 2016. This conference brought together the SCI community (adults living with SCI, researchers, clinicians, funders, regulators, policy makers, and industry representatives) to develop practical solutions to overcome challenges to translating research into practice. The goals of Praxis 2016 were to (a) create a common understanding and synergy regarding knowledge translation in SCI; (b) promote the exchange of real-world experience among attendees; and (c) determine actions or solutions to overcome the barriers and challenges to achieve knowledge translation in SCI. To understand the impact of Praxis 2016, an independent evaluation was conducted. The evaluation was guided by the RE-AIM framework which aims to capture five factors associated with an initiative’s impact: Reach, Effectiveness, Adoption, Implementation, and Maintenance [6]. Reach and effectiveness focuses on individual level data while adoption and implementation on setting/organizational data. However, maintenance includes both individual and setting level data. This article reports on the individual level data (i.e., Praxis 2016 attendee data), thus the reach, effectiveness, and maintenance components of RE-AIM. Reach refers to the extent to which Praxis 2016 attracted attendees and the representativeness of the attendees. Effectiveness represents the positive and/or negative impact of Praxis 2016 on attendees. Maintenance refers to the long-term effects (6 months or longer) of Praxis 2016 on attendees. A separate article presented the data collected at the setting level to evaluate Praxis 2016 on the adoption, implementation, and setting/organizational maintenance components of RE-AIM [7]. The RE-AIM framework has been utilized and shown to be effective across a variety of contexts [8]. In the SCI domain, the RE-AIM framework has been adopted to evaluate initiatives from a community-university partnership aimed to promote physical activity among adults with SCI [9]. Further, RE-AIM was applied to evaluate the feasibility and effectiveness of a knowledge translation initiative aimed to promote physical activity guidelines for people with SCI that was delivered by a community organization [10]. Given RE-AIM was used to successfully evaluate knowledge translation initiatives in SCI, it is a viable framework to evaluate Praxis 2016. At the effectiveness and maintenance levels, we sought to understand the role of Praxis 2016 in changing attendees’ knowledge translation cognitions and behaviors. We grounded the effectiveness and maintenance evaluations in Michie, Van Stralen and West’s COM-B model, which was developed from a review of 19 frameworks for behavior change [11]. COM-B is the starting point for understanding behaviors in the context where they occur. According to the COM-B model, the three conditions—capability, opportunity, and motivation (COM)—are essential for behavioral enactment [11]. The COM-B model has been used in implementation research to study the adoption of evidence-based behaviors [12]. Therefore, attendees’ capability, opportunity, and motivation to develop solutions to overcome the challenges in translating SCI research into practice were assessed to align with this model. As another goal of Praxis 2016 was to promote the sharing of experiences by bringing people together, we measured effectiveness as attendees’ growth of knowledge translation networks. This growth in network metric was defined as the increase in attendees’ (a) need to collaborate, (b) plans to collaborate, and (c) current collaborations with groups in the SCI community. Previous research has shown that collaborative knowledge translation networks may be an indicator of adopting new evidence and practices [10]. Therefore, the purpose of this article was to report on the Praxis 2016 evaluation on the attendee level dimensions of RE-AIM: reach, effectiveness, and maintenance. METHODS Praxis 2016 Praxis 2016 was held on April 25 to 27, 2016 and focused on four key topics: (a) product development and delivery; (b) preclinical and clinical trials of regeneration and repair in SCI; (c) bringing knowledge into clinical practices; (d) financial viability. Praxis 2016 took a different approach to conferences by moving beyond only expert presentations to include interactive panels and working table discussions. A Praxis 2016 Conference Report was sent to attendees in November 2016 and the Praxis 2016 Action Plan was released in September 2017. Description of Praxis 2016 is available on the RHI website (http://www.rickhanseninstitute.org/). Design A detailed methodology section can be found in Supplementary Appendix A. Cross-sectional data from attendees and the organizational committee were collected for reach and satisfaction indicators. A three-wave prospective design was used for effectiveness and maintenance dimensions of RE-AIM. A generic qualitative approach was used by conducting one-time individual interviews with attendees and organizing committee members to provide additional data on reach, effectiveness, and maintenance. Participants and procedures Two groups of participants—Praxis 2016 attendees and organizers (i.e., RHI staff and the Praxis 2016 Program Advisory Committee)—provided data by completing an online questionnaire or individual interviews. Given this project was a program evaluation, ethics was not required. However, at each time point of the questionnaire and before the interviews, we informed attendees and organizers of the purpose of the evaluation, that their responses remained confidential, provided a contact name of the research team, and asked for consent before data collection. Praxis 2016 attendees’ responded to a questionnaire before the start (pre-Praxis 2016), within 2 weeks after (post-Praxis 2016), and 9 months after Praxis 2016 (9-month post-Praxis 2016). For pre-Praxis 2016 assessments, participants completed the questionnaire online via a link sent by email or on laptop computers at the registration desk. For post-Praxis 2016 data, attendees completed an online questionnaire sent by email the day following Praxis 2016 with reminders 5 and 7 days later. The 9-month post-Praxis 2016 questionnaire (i.e., maintenance) was sent to attendees approximately 1 month after the conference report, with three reminders emails. Interviews with attendees and organizers were conducted to gather qualitative data for reach, effectiveness, and attendee-level maintenance. Within 3 months post-Praxis 2016, J.B. conducted qualitative interviews with attendees who indicated interest on the questionnaire. J.B. randomly contacted interested individuals from various groups (e.g., adults with SCI, researchers) represented at the conference. S.N.S. and H.L.G. conducted interviews with Praxis 2016 conference organizers within 2 months of the release of Praxis 2016 action plan. Interviews were conducted with semi-structured interview guides grounded in RE-AIM (Supplementary Appendix B), audio recorded and transcribed verbatim. Reach In the questionnaire, we collected data on the number of individuals on the mailing list of Praxis 2016 as of April 1, 2016, the number of registered Praxis 2016 attendees, and the number of attendees who responded to the online questionnaire. For representativeness, attendees provided demographic information (e.g., the group they identify with the most, age, sex; (Table 1) and reported whether they felt any groups were not present or underrepresented at Praxis 2016. In the interviews, we asked interviewees about Reach elements such as their perception of the representativeness of Praxis attendees. Table 1 Demographic variables of Praxis 2016 attendees collected from the questionnaire Continuous variables Mean (SD) Age (years) 46.1 (12.61) Categorical variables n (%) Sex: women, men, no response 57 (53.8), 37 (34.9), 12 (11.3) Primary affiliation group of Praxis 2016 attendees  Researcher 20 (31.3)  Clinicians or other health care provider 9 (14.1)  Funding agency representative 7 (10.9)  Knowledge translation leaders/consultant 6 (9.4)  Representative of SCI consumer associations, organizations, or advocacy groups 5 (7.8)   Industry representative 4 (6.3)  Individual with SCI 3 (4.7)  Health care decision or policy maker 3 (4.7)  SCI family members or supporter 2 (3.1)  Representative of non-SCI consumer associations, organizations, or advocacy groups 1 (3.1)  Representative of public or private insurers; other groups 1 (1.6); 2 (3.1) Education  College, CEGEP, some university studies 6 (5.8)  Bachelor’s degree 21 (19.8)  Master’s degree 21 (19.8)  Medical degree 29 (8.5)  Doctorate/PhD 37 (34.9)  No response 12 (11.3) Employment  Full time; part time, student 78 (73.6); 10 (9.4); 5(4.7)  Self-employed; semi-retired; no response 1(0.9); 1(0.9); 11 (10.4) Place of residency  Canada; United States of America 69 (65.1); 20 (18.9)  Australia; New Zealand; Switzerland 2(1.9); 1(0.9); 1(0.9)  No response 13 (12.3) Praxis 2016 attendee role  Standard delegate; invited guest 47 (44.3); 48 (45.3)  Part of a panel/speaker, chairing a session 12 (11.3), 2 (1.9)  Output lead 4 (3.8)  Program Advisory Committee; RHI Board Member of Staff 7 (6.6); 18 (17) Did Praxis 2016 meet your expectations?  Yes, no, no response 81 (73.6), 12 (10.9), 17 (15.5) Continuous variables Mean (SD) Age (years) 46.1 (12.61) Categorical variables n (%) Sex: women, men, no response 57 (53.8), 37 (34.9), 12 (11.3) Primary affiliation group of Praxis 2016 attendees  Researcher 20 (31.3)  Clinicians or other health care provider 9 (14.1)  Funding agency representative 7 (10.9)  Knowledge translation leaders/consultant 6 (9.4)  Representative of SCI consumer associations, organizations, or advocacy groups 5 (7.8)   Industry representative 4 (6.3)  Individual with SCI 3 (4.7)  Health care decision or policy maker 3 (4.7)  SCI family members or supporter 2 (3.1)  Representative of non-SCI consumer associations, organizations, or advocacy groups 1 (3.1)  Representative of public or private insurers; other groups 1 (1.6); 2 (3.1) Education  College, CEGEP, some university studies 6 (5.8)  Bachelor’s degree 21 (19.8)  Master’s degree 21 (19.8)  Medical degree 29 (8.5)  Doctorate/PhD 37 (34.9)  No response 12 (11.3) Employment  Full time; part time, student 78 (73.6); 10 (9.4); 5(4.7)  Self-employed; semi-retired; no response 1(0.9); 1(0.9); 11 (10.4) Place of residency  Canada; United States of America 69 (65.1); 20 (18.9)  Australia; New Zealand; Switzerland 2(1.9); 1(0.9); 1(0.9)  No response 13 (12.3) Praxis 2016 attendee role  Standard delegate; invited guest 47 (44.3); 48 (45.3)  Part of a panel/speaker, chairing a session 12 (11.3), 2 (1.9)  Output lead 4 (3.8)  Program Advisory Committee; RHI Board Member of Staff 7 (6.6); 18 (17) Did Praxis 2016 meet your expectations?  Yes, no, no response 81 (73.6), 12 (10.9), 17 (15.5) View Large Table 1 Demographic variables of Praxis 2016 attendees collected from the questionnaire Continuous variables Mean (SD) Age (years) 46.1 (12.61) Categorical variables n (%) Sex: women, men, no response 57 (53.8), 37 (34.9), 12 (11.3) Primary affiliation group of Praxis 2016 attendees  Researcher 20 (31.3)  Clinicians or other health care provider 9 (14.1)  Funding agency representative 7 (10.9)  Knowledge translation leaders/consultant 6 (9.4)  Representative of SCI consumer associations, organizations, or advocacy groups 5 (7.8)   Industry representative 4 (6.3)  Individual with SCI 3 (4.7)  Health care decision or policy maker 3 (4.7)  SCI family members or supporter 2 (3.1)  Representative of non-SCI consumer associations, organizations, or advocacy groups 1 (3.1)  Representative of public or private insurers; other groups 1 (1.6); 2 (3.1) Education  College, CEGEP, some university studies 6 (5.8)  Bachelor’s degree 21 (19.8)  Master’s degree 21 (19.8)  Medical degree 29 (8.5)  Doctorate/PhD 37 (34.9)  No response 12 (11.3) Employment  Full time; part time, student 78 (73.6); 10 (9.4); 5(4.7)  Self-employed; semi-retired; no response 1(0.9); 1(0.9); 11 (10.4) Place of residency  Canada; United States of America 69 (65.1); 20 (18.9)  Australia; New Zealand; Switzerland 2(1.9); 1(0.9); 1(0.9)  No response 13 (12.3) Praxis 2016 attendee role  Standard delegate; invited guest 47 (44.3); 48 (45.3)  Part of a panel/speaker, chairing a session 12 (11.3), 2 (1.9)  Output lead 4 (3.8)  Program Advisory Committee; RHI Board Member of Staff 7 (6.6); 18 (17) Did Praxis 2016 meet your expectations?  Yes, no, no response 81 (73.6), 12 (10.9), 17 (15.5) Continuous variables Mean (SD) Age (years) 46.1 (12.61) Categorical variables n (%) Sex: women, men, no response 57 (53.8), 37 (34.9), 12 (11.3) Primary affiliation group of Praxis 2016 attendees  Researcher 20 (31.3)  Clinicians or other health care provider 9 (14.1)  Funding agency representative 7 (10.9)  Knowledge translation leaders/consultant 6 (9.4)  Representative of SCI consumer associations, organizations, or advocacy groups 5 (7.8)   Industry representative 4 (6.3)  Individual with SCI 3 (4.7)  Health care decision or policy maker 3 (4.7)  SCI family members or supporter 2 (3.1)  Representative of non-SCI consumer associations, organizations, or advocacy groups 1 (3.1)  Representative of public or private insurers; other groups 1 (1.6); 2 (3.1) Education  College, CEGEP, some university studies 6 (5.8)  Bachelor’s degree 21 (19.8)  Master’s degree 21 (19.8)  Medical degree 29 (8.5)  Doctorate/PhD 37 (34.9)  No response 12 (11.3) Employment  Full time; part time, student 78 (73.6); 10 (9.4); 5(4.7)  Self-employed; semi-retired; no response 1(0.9); 1(0.9); 11 (10.4) Place of residency  Canada; United States of America 69 (65.1); 20 (18.9)  Australia; New Zealand; Switzerland 2(1.9); 1(0.9); 1(0.9)  No response 13 (12.3) Praxis 2016 attendee role  Standard delegate; invited guest 47 (44.3); 48 (45.3)  Part of a panel/speaker, chairing a session 12 (11.3), 2 (1.9)  Output lead 4 (3.8)  Program Advisory Committee; RHI Board Member of Staff 7 (6.6); 18 (17) Did Praxis 2016 meet your expectations?  Yes, no, no response 81 (73.6), 12 (10.9), 17 (15.5) View Large Effectiveness and maintenance To align the measures of the questionnaire with the goals of the Praxis 2016 conference, the phrase “…develop (or developing) solutions to overcome the challenges in translating SCI research into practice” was added after each item assessing COM-B, value, and importance. Using a 7-point scale ranging from 1 (strongly disagree) to 7 (strongly agree), attendees responded to 2–3 items for each element of COM-B which were modified from Michie, Atkins, and West [13]. They also answered items on the value and importance of Praxis 2016. See Table 2 for the items and inter-item correlations or Cronbach’s alpha. Knowledge translation networks were assessed by asking attendees to select all groups they (a) currently work with, (b) need to work with, and/or (c) plan to work with to develop solutions to overcome the challenges in translating SCI research into practice (Table 2). Attendees’ satisfaction was measured regarding their satisfaction with (a) the Praxis 2016 conference overall and (b) specific conference sessions (Table 3). Attendees also selected any of the four Praxis 2016 goals they perceived were achieved to measure perceptions of Praxis 2016 goal achievement: (a) overview of the current state of the affairs; (b) met/networked with individuals they had not previously met/networked; (c) learned from a diverse group of stakeholders; and (d) actively participated in developing solutions. In the interviews, we asked attendees and organizers to discuss the impact of Praxis 2016 and probed for further details when topics mentioned were related to COM-B and knowledge translation networks. Table 2. Effectiveness and maintenance measures for evaluating Praxis 2016 and t-tests across the three time points. Measures Pre- and Post-Praxis 2016 (n=62) Pre- and 9-months Post-Praxis 2016 (n=28) Post and 9-months Post Praxis 2016 (n=33) Pre-Praxis 2016 Post-Praxis 2016 Pre-Praxis 2016 9-months Post-Praxis 2016 Post-Praxis 2016 9-months Post-Praxis 2016 Mean SD Mean SD t-test Mean SD Mean SD t-test Mean SD Mean SD t-test Knowledge (as 
capability in COM-B) 5.08 1.13 5.54 .88 3.83* 5.30 1.21 5.63 .91 1.50 5.83 0.69 5.48 .93 2.17*  Items 2 items, rinter-item = .48, I know the challenges in translating...; I know about some solutions… Capability (COM-B) 4.80 1.35 4.83 1.20 .24 5.11 1.21 5.07 1.10 -.20 5.18 1.19 5.15 1.08 .18  Items 2 items, rinter-item = .78, I have the capability to…; and I have the knowledge and skills to… Opportunity (COM-B) 5.03 1.37 5.11 1.04 .53 5.23 1.49 5.32 1.12 .42 5.52 1.06 5.20 1.00 1.63  Items (a) Physical (1 item; I have the resources (e.g., time and money) to…); (b) Social (2 items; rinter-item = .45; I have support from others (e.g., colleagues, friends, own organization, etc.) to…; I have the working relationships necessary to… Motivation (COM-B) 6.04 .94 5.93 .95 -1.04 6.07 .99 6.09 .78 1.02 6.35 .86 6.25 .73 .63  Items 2 items; rinter-item = .71; I want to…; I am willing to… Behaviour (COM-B) 4.49 1.49 4.57 1.28 .54 4.54 1.55 4.76 1.32 .90 4.77 1.28 4.70 1.27 .34  Items 3 items; Cronbach’s alpha = .78; I have contributed towards…; I have a plan to …; I have implemented a plan to… Value 6.37 .82 6.32 .77 -.45 6.50 .75 6.54 .64 .37 6.60 .56 6.60 .56 0.00  Item I think there is value in bringing the SCI community together to … Importance 6.52 .68 6.60 .64 1.15 6.46 .74 6.46 .74 .00 6.80 .41 6.57 .63 2.04  Item I feel it is important to… Knowledge translation networks  Listed groups (a) Individuals with SCI, (b) SCI family members or supporters, (c) Researchers, (d) Clinicians or other health care providers, (d) SCI consumer associations, organizations or advocacy groups, (e) Non-SCI consumer associations, organizations or advocacy groups, (f) Knowledge translation leaders/consultants, (g) Health care decision or policy maker, (h) Regulatory agencies, (i) Funding agencies, (j) Public or private insurers, (k) Industries, and (l) Investors. Measures Pre- and Post-Praxis 2016 (n=62) Pre- and 9-months Post-Praxis 2016 (n=28) Post and 9-months Post Praxis 2016 (n=33) Pre-Praxis 2016 Post-Praxis 2016 Pre-Praxis 2016 9-months Post-Praxis 2016 Post-Praxis 2016 9-months Post-Praxis 2016 Mean SD Mean SD t-test Mean SD Mean SD t-test Mean SD Mean SD t-test Knowledge (as 
capability in COM-B) 5.08 1.13 5.54 .88 3.83* 5.30 1.21 5.63 .91 1.50 5.83 0.69 5.48 .93 2.17*  Items 2 items, rinter-item = .48, I know the challenges in translating...; I know about some solutions… Capability (COM-B) 4.80 1.35 4.83 1.20 .24 5.11 1.21 5.07 1.10 -.20 5.18 1.19 5.15 1.08 .18  Items 2 items, rinter-item = .78, I have the capability to…; and I have the knowledge and skills to… Opportunity (COM-B) 5.03 1.37 5.11 1.04 .53 5.23 1.49 5.32 1.12 .42 5.52 1.06 5.20 1.00 1.63  Items (a) Physical (1 item; I have the resources (e.g., time and money) to…); (b) Social (2 items; rinter-item = .45; I have support from others (e.g., colleagues, friends, own organization, etc.) to…; I have the working relationships necessary to… Motivation (COM-B) 6.04 .94 5.93 .95 -1.04 6.07 .99 6.09 .78 1.02 6.35 .86 6.25 .73 .63  Items 2 items; rinter-item = .71; I want to…; I am willing to… Behaviour (COM-B) 4.49 1.49 4.57 1.28 .54 4.54 1.55 4.76 1.32 .90 4.77 1.28 4.70 1.27 .34  Items 3 items; Cronbach’s alpha = .78; I have contributed towards…; I have a plan to …; I have implemented a plan to… Value 6.37 .82 6.32 .77 -.45 6.50 .75 6.54 .64 .37 6.60 .56 6.60 .56 0.00  Item I think there is value in bringing the SCI community together to … Importance 6.52 .68 6.60 .64 1.15 6.46 .74 6.46 .74 .00 6.80 .41 6.57 .63 2.04  Item I feel it is important to… Knowledge translation networks  Listed groups (a) Individuals with SCI, (b) SCI family members or supporters, (c) Researchers, (d) Clinicians or other health care providers, (d) SCI consumer associations, organizations or advocacy groups, (e) Non-SCI consumer associations, organizations or advocacy groups, (f) Knowledge translation leaders/consultants, (g) Health care decision or policy maker, (h) Regulatory agencies, (i) Funding agencies, (j) Public or private insurers, (k) Industries, and (l) Investors. Note: *p < .05. Means changes due to the number of participants that responded across both time points. Each example item was followed by the phrase “……develop (or developing) solutions to overcome the challenges in translating SCI research into practice”. View Large Table 2. Effectiveness and maintenance measures for evaluating Praxis 2016 and t-tests across the three time points. Measures Pre- and Post-Praxis 2016 (n=62) Pre- and 9-months Post-Praxis 2016 (n=28) Post and 9-months Post Praxis 2016 (n=33) Pre-Praxis 2016 Post-Praxis 2016 Pre-Praxis 2016 9-months Post-Praxis 2016 Post-Praxis 2016 9-months Post-Praxis 2016 Mean SD Mean SD t-test Mean SD Mean SD t-test Mean SD Mean SD t-test Knowledge (as 
capability in COM-B) 5.08 1.13 5.54 .88 3.83* 5.30 1.21 5.63 .91 1.50 5.83 0.69 5.48 .93 2.17*  Items 2 items, rinter-item = .48, I know the challenges in translating...; I know about some solutions… Capability (COM-B) 4.80 1.35 4.83 1.20 .24 5.11 1.21 5.07 1.10 -.20 5.18 1.19 5.15 1.08 .18  Items 2 items, rinter-item = .78, I have the capability to…; and I have the knowledge and skills to… Opportunity (COM-B) 5.03 1.37 5.11 1.04 .53 5.23 1.49 5.32 1.12 .42 5.52 1.06 5.20 1.00 1.63  Items (a) Physical (1 item; I have the resources (e.g., time and money) to…); (b) Social (2 items; rinter-item = .45; I have support from others (e.g., colleagues, friends, own organization, etc.) to…; I have the working relationships necessary to… Motivation (COM-B) 6.04 .94 5.93 .95 -1.04 6.07 .99 6.09 .78 1.02 6.35 .86 6.25 .73 .63  Items 2 items; rinter-item = .71; I want to…; I am willing to… Behaviour (COM-B) 4.49 1.49 4.57 1.28 .54 4.54 1.55 4.76 1.32 .90 4.77 1.28 4.70 1.27 .34  Items 3 items; Cronbach’s alpha = .78; I have contributed towards…; I have a plan to …; I have implemented a plan to… Value 6.37 .82 6.32 .77 -.45 6.50 .75 6.54 .64 .37 6.60 .56 6.60 .56 0.00  Item I think there is value in bringing the SCI community together to … Importance 6.52 .68 6.60 .64 1.15 6.46 .74 6.46 .74 .00 6.80 .41 6.57 .63 2.04  Item I feel it is important to… Knowledge translation networks  Listed groups (a) Individuals with SCI, (b) SCI family members or supporters, (c) Researchers, (d) Clinicians or other health care providers, (d) SCI consumer associations, organizations or advocacy groups, (e) Non-SCI consumer associations, organizations or advocacy groups, (f) Knowledge translation leaders/consultants, (g) Health care decision or policy maker, (h) Regulatory agencies, (i) Funding agencies, (j) Public or private insurers, (k) Industries, and (l) Investors. Measures Pre- and Post-Praxis 2016 (n=62) Pre- and 9-months Post-Praxis 2016 (n=28) Post and 9-months Post Praxis 2016 (n=33) Pre-Praxis 2016 Post-Praxis 2016 Pre-Praxis 2016 9-months Post-Praxis 2016 Post-Praxis 2016 9-months Post-Praxis 2016 Mean SD Mean SD t-test Mean SD Mean SD t-test Mean SD Mean SD t-test Knowledge (as 
capability in COM-B) 5.08 1.13 5.54 .88 3.83* 5.30 1.21 5.63 .91 1.50 5.83 0.69 5.48 .93 2.17*  Items 2 items, rinter-item = .48, I know the challenges in translating...; I know about some solutions… Capability (COM-B) 4.80 1.35 4.83 1.20 .24 5.11 1.21 5.07 1.10 -.20 5.18 1.19 5.15 1.08 .18  Items 2 items, rinter-item = .78, I have the capability to…; and I have the knowledge and skills to… Opportunity (COM-B) 5.03 1.37 5.11 1.04 .53 5.23 1.49 5.32 1.12 .42 5.52 1.06 5.20 1.00 1.63  Items (a) Physical (1 item; I have the resources (e.g., time and money) to…); (b) Social (2 items; rinter-item = .45; I have support from others (e.g., colleagues, friends, own organization, etc.) to…; I have the working relationships necessary to… Motivation (COM-B) 6.04 .94 5.93 .95 -1.04 6.07 .99 6.09 .78 1.02 6.35 .86 6.25 .73 .63  Items 2 items; rinter-item = .71; I want to…; I am willing to… Behaviour (COM-B) 4.49 1.49 4.57 1.28 .54 4.54 1.55 4.76 1.32 .90 4.77 1.28 4.70 1.27 .34  Items 3 items; Cronbach’s alpha = .78; I have contributed towards…; I have a plan to …; I have implemented a plan to… Value 6.37 .82 6.32 .77 -.45 6.50 .75 6.54 .64 .37 6.60 .56 6.60 .56 0.00  Item I think there is value in bringing the SCI community together to … Importance 6.52 .68 6.60 .64 1.15 6.46 .74 6.46 .74 .00 6.80 .41 6.57 .63 2.04  Item I feel it is important to… Knowledge translation networks  Listed groups (a) Individuals with SCI, (b) SCI family members or supporters, (c) Researchers, (d) Clinicians or other health care providers, (d) SCI consumer associations, organizations or advocacy groups, (e) Non-SCI consumer associations, organizations or advocacy groups, (f) Knowledge translation leaders/consultants, (g) Health care decision or policy maker, (h) Regulatory agencies, (i) Funding agencies, (j) Public or private insurers, (k) Industries, and (l) Investors. Note: *p < .05. Means changes due to the number of participants that responded across both time points. Each example item was followed by the phrase “……develop (or developing) solutions to overcome the challenges in translating SCI research into practice”. View Large Table 3 Satisfaction of Praxis 2016 as an effectiveness evaluation Measures Scale anchors Example items Mean (SD) Overall measures Satisfaction overall 1 (very unsatisfied) to 7 (very satisfied) To what extent are you satisfied overall with… • The Praxis 2016 conference • The solutions proposed during the Praxis 2016 conference 5.68 (1.13) Accessibility 1 (strongly disagree) to 7 (strongly agree) To what extent do you agree that the conference venue was accessible for all participants? 5.28 (1.53) Engaged in conference working table sessions 1 (strongly disagree) to 7 (strongly agree) During the working table discussions, overall, I felt that… • views were respected 6.29 (0.73) • views listened to 6.19 (0.82) • engaged in the discussions 6.14 (0.83) • the table discussions led to concrete solutions 4.54 (1.36) Length 1 (far too short) to 5 (far too long) Overall, the length of the panel sessions were… 3.20 (0.50) Overall, the length of the working sessions were… 2.73 (0.67) Session specific measures Opening plenary 1 (strongly disagree) to 7 (strongly agree) • Speakers opened the conversation on developing solutions to overcome the challenges in translating SCI research into practice 5.53 (1.15) • Valuable session in the conference 5.51 (1.34) General evaluation of sessions 1 (strongly disagree) to 7 (strongly agree) • Valuable first step to developing solutions Session 1 5.40 (1.16) Session 2 5.69 (0.90) Session 3 5.67 (1.11) Session 4 5.40 (1.20) Panel of speakers of Sessions 1, 2, 3, 4a 1 (strongly disagree) to 7 (strongly agree) • Learned something new in the session Session 1 5.75 (1.02) Session 2 5.86 (1.04) Session 3 5.67 (1.19) Session 4 5.70 (1.17) • The solutions proposed were relevant to the session topic Session 1 5.45 (0.98) Session 2 5.65 (0.90) • The presentations were relevant to the session topic Session 3 5.84 (1.02) Session 4 5.50 (1.28) • The speakers’ presentations facilitated the working table discussion Session 1 5.46 (1.10) Session 2 5.69 (1.01) Session 3 5.80 (1.06) • The panel interaction and question and answer period after the presentations facilitated the working table discussion that followed Session 1 5.62 (0.96) Session 2 5.62 (1.09) Session 3 5.76 (1.13) Working tables of Sessions 1, 2, 3 1 (strongly disagree) to 7 (strongly agree) • Helped stimulate discussion on the intended topic of the session (e.g., Session 1: developing solutions to overcome the challenges in product development and delivery) Session 1 5.62 (1.10) Session 2 5.55 (1.07) Session 3 5.44 (1.11) • The table discussion activity (e.g., selecting and discussing up to two challenges) was the appropriate format to develop solutions regarding the intended topic of the session Session 1 5.15 (1.31) Session 2 5.34 (1.28) Session 3 5.44 (1.19) Poster 1 (strongly disagree) to 7 (strongly agree) • A valuable session 5.50 (1.35) • The poster content was relevant to the purpose of the conference 5.57 (1.15) Closing plenary 1 (strongly disagree) to 7 (strongly agree) • A valuable session 4.72 (1.37) • A clear overview of the solutions brought forward 4.57 (1.45) Measures Scale anchors Example items Mean (SD) Overall measures Satisfaction overall 1 (very unsatisfied) to 7 (very satisfied) To what extent are you satisfied overall with… • The Praxis 2016 conference • The solutions proposed during the Praxis 2016 conference 5.68 (1.13) Accessibility 1 (strongly disagree) to 7 (strongly agree) To what extent do you agree that the conference venue was accessible for all participants? 5.28 (1.53) Engaged in conference working table sessions 1 (strongly disagree) to 7 (strongly agree) During the working table discussions, overall, I felt that… • views were respected 6.29 (0.73) • views listened to 6.19 (0.82) • engaged in the discussions 6.14 (0.83) • the table discussions led to concrete solutions 4.54 (1.36) Length 1 (far too short) to 5 (far too long) Overall, the length of the panel sessions were… 3.20 (0.50) Overall, the length of the working sessions were… 2.73 (0.67) Session specific measures Opening plenary 1 (strongly disagree) to 7 (strongly agree) • Speakers opened the conversation on developing solutions to overcome the challenges in translating SCI research into practice 5.53 (1.15) • Valuable session in the conference 5.51 (1.34) General evaluation of sessions 1 (strongly disagree) to 7 (strongly agree) • Valuable first step to developing solutions Session 1 5.40 (1.16) Session 2 5.69 (0.90) Session 3 5.67 (1.11) Session 4 5.40 (1.20) Panel of speakers of Sessions 1, 2, 3, 4a 1 (strongly disagree) to 7 (strongly agree) • Learned something new in the session Session 1 5.75 (1.02) Session 2 5.86 (1.04) Session 3 5.67 (1.19) Session 4 5.70 (1.17) • The solutions proposed were relevant to the session topic Session 1 5.45 (0.98) Session 2 5.65 (0.90) • The presentations were relevant to the session topic Session 3 5.84 (1.02) Session 4 5.50 (1.28) • The speakers’ presentations facilitated the working table discussion Session 1 5.46 (1.10) Session 2 5.69 (1.01) Session 3 5.80 (1.06) • The panel interaction and question and answer period after the presentations facilitated the working table discussion that followed Session 1 5.62 (0.96) Session 2 5.62 (1.09) Session 3 5.76 (1.13) Working tables of Sessions 1, 2, 3 1 (strongly disagree) to 7 (strongly agree) • Helped stimulate discussion on the intended topic of the session (e.g., Session 1: developing solutions to overcome the challenges in product development and delivery) Session 1 5.62 (1.10) Session 2 5.55 (1.07) Session 3 5.44 (1.11) • The table discussion activity (e.g., selecting and discussing up to two challenges) was the appropriate format to develop solutions regarding the intended topic of the session Session 1 5.15 (1.31) Session 2 5.34 (1.28) Session 3 5.44 (1.19) Poster 1 (strongly disagree) to 7 (strongly agree) • A valuable session 5.50 (1.35) • The poster content was relevant to the purpose of the conference 5.57 (1.15) Closing plenary 1 (strongly disagree) to 7 (strongly agree) • A valuable session 4.72 (1.37) • A clear overview of the solutions brought forward 4.57 (1.45) aThere was only a panel for Session 4; 74%, 71%, 76%, and 66% of respondents (n = 110) attended Sessions 1, 2, 3, and 4, respectively. View Large Table 3 Satisfaction of Praxis 2016 as an effectiveness evaluation Measures Scale anchors Example items Mean (SD) Overall measures Satisfaction overall 1 (very unsatisfied) to 7 (very satisfied) To what extent are you satisfied overall with… • The Praxis 2016 conference • The solutions proposed during the Praxis 2016 conference 5.68 (1.13) Accessibility 1 (strongly disagree) to 7 (strongly agree) To what extent do you agree that the conference venue was accessible for all participants? 5.28 (1.53) Engaged in conference working table sessions 1 (strongly disagree) to 7 (strongly agree) During the working table discussions, overall, I felt that… • views were respected 6.29 (0.73) • views listened to 6.19 (0.82) • engaged in the discussions 6.14 (0.83) • the table discussions led to concrete solutions 4.54 (1.36) Length 1 (far too short) to 5 (far too long) Overall, the length of the panel sessions were… 3.20 (0.50) Overall, the length of the working sessions were… 2.73 (0.67) Session specific measures Opening plenary 1 (strongly disagree) to 7 (strongly agree) • Speakers opened the conversation on developing solutions to overcome the challenges in translating SCI research into practice 5.53 (1.15) • Valuable session in the conference 5.51 (1.34) General evaluation of sessions 1 (strongly disagree) to 7 (strongly agree) • Valuable first step to developing solutions Session 1 5.40 (1.16) Session 2 5.69 (0.90) Session 3 5.67 (1.11) Session 4 5.40 (1.20) Panel of speakers of Sessions 1, 2, 3, 4a 1 (strongly disagree) to 7 (strongly agree) • Learned something new in the session Session 1 5.75 (1.02) Session 2 5.86 (1.04) Session 3 5.67 (1.19) Session 4 5.70 (1.17) • The solutions proposed were relevant to the session topic Session 1 5.45 (0.98) Session 2 5.65 (0.90) • The presentations were relevant to the session topic Session 3 5.84 (1.02) Session 4 5.50 (1.28) • The speakers’ presentations facilitated the working table discussion Session 1 5.46 (1.10) Session 2 5.69 (1.01) Session 3 5.80 (1.06) • The panel interaction and question and answer period after the presentations facilitated the working table discussion that followed Session 1 5.62 (0.96) Session 2 5.62 (1.09) Session 3 5.76 (1.13) Working tables of Sessions 1, 2, 3 1 (strongly disagree) to 7 (strongly agree) • Helped stimulate discussion on the intended topic of the session (e.g., Session 1: developing solutions to overcome the challenges in product development and delivery) Session 1 5.62 (1.10) Session 2 5.55 (1.07) Session 3 5.44 (1.11) • The table discussion activity (e.g., selecting and discussing up to two challenges) was the appropriate format to develop solutions regarding the intended topic of the session Session 1 5.15 (1.31) Session 2 5.34 (1.28) Session 3 5.44 (1.19) Poster 1 (strongly disagree) to 7 (strongly agree) • A valuable session 5.50 (1.35) • The poster content was relevant to the purpose of the conference 5.57 (1.15) Closing plenary 1 (strongly disagree) to 7 (strongly agree) • A valuable session 4.72 (1.37) • A clear overview of the solutions brought forward 4.57 (1.45) Measures Scale anchors Example items Mean (SD) Overall measures Satisfaction overall 1 (very unsatisfied) to 7 (very satisfied) To what extent are you satisfied overall with… • The Praxis 2016 conference • The solutions proposed during the Praxis 2016 conference 5.68 (1.13) Accessibility 1 (strongly disagree) to 7 (strongly agree) To what extent do you agree that the conference venue was accessible for all participants? 5.28 (1.53) Engaged in conference working table sessions 1 (strongly disagree) to 7 (strongly agree) During the working table discussions, overall, I felt that… • views were respected 6.29 (0.73) • views listened to 6.19 (0.82) • engaged in the discussions 6.14 (0.83) • the table discussions led to concrete solutions 4.54 (1.36) Length 1 (far too short) to 5 (far too long) Overall, the length of the panel sessions were… 3.20 (0.50) Overall, the length of the working sessions were… 2.73 (0.67) Session specific measures Opening plenary 1 (strongly disagree) to 7 (strongly agree) • Speakers opened the conversation on developing solutions to overcome the challenges in translating SCI research into practice 5.53 (1.15) • Valuable session in the conference 5.51 (1.34) General evaluation of sessions 1 (strongly disagree) to 7 (strongly agree) • Valuable first step to developing solutions Session 1 5.40 (1.16) Session 2 5.69 (0.90) Session 3 5.67 (1.11) Session 4 5.40 (1.20) Panel of speakers of Sessions 1, 2, 3, 4a 1 (strongly disagree) to 7 (strongly agree) • Learned something new in the session Session 1 5.75 (1.02) Session 2 5.86 (1.04) Session 3 5.67 (1.19) Session 4 5.70 (1.17) • The solutions proposed were relevant to the session topic Session 1 5.45 (0.98) Session 2 5.65 (0.90) • The presentations were relevant to the session topic Session 3 5.84 (1.02) Session 4 5.50 (1.28) • The speakers’ presentations facilitated the working table discussion Session 1 5.46 (1.10) Session 2 5.69 (1.01) Session 3 5.80 (1.06) • The panel interaction and question and answer period after the presentations facilitated the working table discussion that followed Session 1 5.62 (0.96) Session 2 5.62 (1.09) Session 3 5.76 (1.13) Working tables of Sessions 1, 2, 3 1 (strongly disagree) to 7 (strongly agree) • Helped stimulate discussion on the intended topic of the session (e.g., Session 1: developing solutions to overcome the challenges in product development and delivery) Session 1 5.62 (1.10) Session 2 5.55 (1.07) Session 3 5.44 (1.11) • The table discussion activity (e.g., selecting and discussing up to two challenges) was the appropriate format to develop solutions regarding the intended topic of the session Session 1 5.15 (1.31) Session 2 5.34 (1.28) Session 3 5.44 (1.19) Poster 1 (strongly disagree) to 7 (strongly agree) • A valuable session 5.50 (1.35) • The poster content was relevant to the purpose of the conference 5.57 (1.15) Closing plenary 1 (strongly disagree) to 7 (strongly agree) • A valuable session 4.72 (1.37) • A clear overview of the solutions brought forward 4.57 (1.45) aThere was only a panel for Session 4; 74%, 71%, 76%, and 66% of respondents (n = 110) attended Sessions 1, 2, 3, and 4, respectively. View Large Data analyses Reach To calculate reach, we computed a percentage by dividing (a) the number of Praxis 2016 attendees by the number of people on the Praxis 2016 email list and (b) the number of attendees who responded to the questionnaire at pre-Praxis 2016, post-Praxis 2016, and 9-month post-Praxis 2016 by the number of Praxis 2016 attendees. Descriptive analyses were used for representativeness (Table 1). We calculated the frequencies of individuals who, post-Praxis 2016, reported certain groups were missing or underrepresented at Praxis 2016. For the qualitative data, we conducted separate deductive content analyses guided by RE-AIM for the attendees (N = 13) and organizers (N = 9) using a similar process outlined by Braun and Clarke’s step by step guide to conduct inductive thematic analysis [14, 15]. Specifically, K.B. first identified and marked any content from the transcripts that related to Reach. Content that represented the same or similar idea were then labeled and categorized into themes within the broader Reach category (e.g., Representativeness). Each theme was then defined and relevant quotes were selected. S.N.S., E.M., and H.L.G. met to discuss and debate the names and definitions of each theme to ensure the themes reflected the interview data. For reach, effectiveness, and maintenance, the themes were debated over the course of seven meetings (~13 hours). Effectiveness and maintenance Data from attendees who responded to the pre- and post-Praxis 2016 questionnaire (n = 62) and post- and 9-month post-Praxis 2016 (n = 33) were analyzed for effectiveness and maintenance, respectively. Paired samples t-tests were used to compare change in competence, opportunity, motivation, importance, and value (effectiveness: change from pre- to post-Praxis 2016; maintenance: change from post- to and 9-month post-Praxis 2016), behavior (effectiveness only: change from pre- to 9-month post-Praxis 2016), and perceptions of Praxis 2016 goal achievement (maintenance only: change from post- to 9-month post-Praxis 2016). For knowledge translation networks, McNemar’s chi-squared tests were conducted to compare the nominal data. For effectiveness, the groups that individuals reported they needed to work with were compared pre- to post-Praxis 2016 and the groups that individuals reported currently working with pre-Praxis 2016 were compared with groups that individuals planned to work with post-Praxis 2016. For maintenance, the groups that individuals indicated they needed to work post- to 9-month post-Praxis 2016 were compared along with the groups that individuals planned to work with post-Praxis 2016 and the groups that they currently worked with at 9-month post-Praxis 2016. We used descriptive statistics to report Praxis 2016 satisfaction data (effectiveness). The qualitative analysis for effectiveness and maintenance were the same and occurred simultaneously as the Reach data. RESULTS Reach From the questionnaire data, Praxis 2016 reached 28% of individuals on the Praxis 2016 mailing list (243 attendees/864). Of the attendees, 44% completed the questionnaire pre-Praxis 2016 (n = 106), 45% post-Praxis 2016 (n = 110), and 25% 9-month post-Praxis 2016 (n = 62). In terms of representativeness, 31% were researchers and 14% were health care providers/clinicians with 5% being adults with SCI (Table 1). Attendees indicated that SCI family members or supporters were underrepresented at Praxis 2016 (34%), followed by regulatory agencies (29%), health care decision or policy makers (28%), and investors (28%; Supplementary Appendix C). In the interviews, attendees (mean age = 48 ± 15 years, six men, seven women, two individuals with SCI, two knowledge translation specialists, three researchers; one industry partner, three members of the SCI community, one policy maker and one clinician) indicated that other groups (e.g., non-SCI fields) would have increased the representativeness of Praxis 2016 (Table 4). Organizers (three men, six women, mean age = 52 ± 9.7 years, five RHI staff and four members of the Program Advisory Committee) noted that they went through a thoughtful process in determining their invitation list, but acknowledged the challenges in creating the list (Table 5). Table 4 Reach, effectiveness, and maintenance themes and subthemes derived from interviews with Praxis 2016 attendees Reach: Themes and definitions Subthemes and definitions Quotes Representativeness: Attendees discussed a need for greater representation of stakeholder groups. Not all groups were adequately represented. N/A • “…the conference would have benefited from bringing in more people from other medical fields [beyond SCI] that have experienced the same type of challenges.”—Researcher Reasons for attending: Attendees discussed why they wanted to attend the conference Purpose of conference creating appeal: The topics discussed at the conference were interesting to attendees • “It seemed like a conference that bridged lots of my interests [e.g. research, clinical practice, spinal cord injury, knowledge translation].”—Clinician • “That’s why I was attracted to the conference, is it seemed like something that was going to be producing tangible results.”—Clinician Providing an environment to learn: The conference seemed like an environment where attendees could learn more about SCI • “I was just curious as to what is out there [e.g. SCI technology]. What challenges are in research because I’m not a researcher, so I’m not aware of those [e.g. getting technology out into the field].”—SCI community member • “And when you, yourself registered for praxis, what were your specific reasons for attending?” “I was hoping to have more insight on what others were experiencing when they did not succeed in implementing or changing practice … to have some sense of solutions, I guess, in terms of bridging that gap.”—Researcher Effectiveness Themes and definitions Subthemes and definitions Quotes New connections: Attendees networked and established new collaborative relationships at the conference N/A • “As per further collaboration, I met two physicians from [an insurance company who] talked about research possibilities inside [work place]. You know, maybe following a case study of somebody who comes in.”—SCI community member • “We have a working document between a group of us since the conference [looking at helping the community understand SCI and understanding the larger research economy in the SCI field].”—SCI community member Increase in knowledge: Attendees’ knowledge expanded following the conference Understanding challenges faced in SCI research: Attendees left the conference with an increased understanding of the challenges faced by different areas in the SCI field • “It gave me a different sort of perspective from a researcher’s standpoint.” “…a better understanding of what goes on in the research world?” “Yes, yeah.” [Continues to speak of being encouraged and enlightened that there is more going on in the background that they didn’t know about before]—SCI community member • “I learned more about the gaps, and the obstacles and barriers of fundamental science which is really far from what I have in my clinical life.”—Researcher Understanding the importance of engaging the SCI community: Attendees left the conference with either a strengthened or new understanding of the importance of meaningfully involving the SCI community in SCI work • “I think that there was an understanding that there needs to be more real involvement of people with spinal cord injury.”—Researcher • “What effect would you say praxis had on you, if any?” “…it’s more to place the [SCI community members] in every aspect of our work.”—Clinician Change in the way one works: Attendees were inspired post-Praxis to work in a way that results in a positive change in the SCI field N/A •“So, there are a few things [e.g. encouraging patients to take part in research, listing research projects on website] that I’ve actually changed in my clinical practice and my work … and a few things that have got me thinking about what I can do to make change.”—Clinician •“…give us a better understanding of why we do what we do everyday. You know, cause every once in a while, you’re in the lab too much, you forget that there are actual patients involved.”—Researcher Uniqueness: Attendees affirmed that the conference was different from other conferences The diversity of the conference: The conference was unique in the way it brought together different stakeholders •“…bring different people from different perspectives and angles … that was kind of a very unique experience for me.”—Researcher •“…I think it was a good first attempt at taking people who really do not speak [and putting them together and having the discussions].”—Researcher Enjoyed the engaging format: The conference was less didactic and attendees felt that their input was important for creating solutions •“…instead of information that’s being provided we were asked for input back, so that there could be an action plan to go forward.”—Clinician •“I think it definitely was. It was kind of, like it wasn’t speeches basically. The other conferences I’ve been to are mainly about the speeches…. It was more engaging.”—SCI community member Unsatisfied with engagement of SCI Community member: Attendees expressed being unsatisfied with the way the conference engaged SCI community member N/A •“And I think there was a missed opportunity at the conference … but that’s kind of the core message … there is an intent and a willingness to engage people with SCI, but it’s not the level of sophistication and respect and value that needs to be there”—SCI community member •“I was sorely disappointed that people living with SCI were not actively involved in a meaningful way with the design, leadership, and operation of the conference … it felt more like a token engagement.”—SCI community member Maintenance Themes and definitions Subthemes and definitions Quotes Concerns about impact: Attendees were skeptical that there would be no real change over the long term N/A •“…I think it needs to be a lot of things happening from a lot of different angles to make changes happen. So, conferences aren’t a bad thing, but in of themselves it wouldn’t be enough.”—SCI community member •“I think the conference highlighted a number of challenges, but I didn’t actually hear solutions to the challenges or new approaches to solving the problem.”—Researcher Reach: Themes and definitions Subthemes and definitions Quotes Representativeness: Attendees discussed a need for greater representation of stakeholder groups. Not all groups were adequately represented. N/A • “…the conference would have benefited from bringing in more people from other medical fields [beyond SCI] that have experienced the same type of challenges.”—Researcher Reasons for attending: Attendees discussed why they wanted to attend the conference Purpose of conference creating appeal: The topics discussed at the conference were interesting to attendees • “It seemed like a conference that bridged lots of my interests [e.g. research, clinical practice, spinal cord injury, knowledge translation].”—Clinician • “That’s why I was attracted to the conference, is it seemed like something that was going to be producing tangible results.”—Clinician Providing an environment to learn: The conference seemed like an environment where attendees could learn more about SCI • “I was just curious as to what is out there [e.g. SCI technology]. What challenges are in research because I’m not a researcher, so I’m not aware of those [e.g. getting technology out into the field].”—SCI community member • “And when you, yourself registered for praxis, what were your specific reasons for attending?” “I was hoping to have more insight on what others were experiencing when they did not succeed in implementing or changing practice … to have some sense of solutions, I guess, in terms of bridging that gap.”—Researcher Effectiveness Themes and definitions Subthemes and definitions Quotes New connections: Attendees networked and established new collaborative relationships at the conference N/A • “As per further collaboration, I met two physicians from [an insurance company who] talked about research possibilities inside [work place]. You know, maybe following a case study of somebody who comes in.”—SCI community member • “We have a working document between a group of us since the conference [looking at helping the community understand SCI and understanding the larger research economy in the SCI field].”—SCI community member Increase in knowledge: Attendees’ knowledge expanded following the conference Understanding challenges faced in SCI research: Attendees left the conference with an increased understanding of the challenges faced by different areas in the SCI field • “It gave me a different sort of perspective from a researcher’s standpoint.” “…a better understanding of what goes on in the research world?” “Yes, yeah.” [Continues to speak of being encouraged and enlightened that there is more going on in the background that they didn’t know about before]—SCI community member • “I learned more about the gaps, and the obstacles and barriers of fundamental science which is really far from what I have in my clinical life.”—Researcher Understanding the importance of engaging the SCI community: Attendees left the conference with either a strengthened or new understanding of the importance of meaningfully involving the SCI community in SCI work • “I think that there was an understanding that there needs to be more real involvement of people with spinal cord injury.”—Researcher • “What effect would you say praxis had on you, if any?” “…it’s more to place the [SCI community members] in every aspect of our work.”—Clinician Change in the way one works: Attendees were inspired post-Praxis to work in a way that results in a positive change in the SCI field N/A •“So, there are a few things [e.g. encouraging patients to take part in research, listing research projects on website] that I’ve actually changed in my clinical practice and my work … and a few things that have got me thinking about what I can do to make change.”—Clinician •“…give us a better understanding of why we do what we do everyday. You know, cause every once in a while, you’re in the lab too much, you forget that there are actual patients involved.”—Researcher Uniqueness: Attendees affirmed that the conference was different from other conferences The diversity of the conference: The conference was unique in the way it brought together different stakeholders •“…bring different people from different perspectives and angles … that was kind of a very unique experience for me.”—Researcher •“…I think it was a good first attempt at taking people who really do not speak [and putting them together and having the discussions].”—Researcher Enjoyed the engaging format: The conference was less didactic and attendees felt that their input was important for creating solutions •“…instead of information that’s being provided we were asked for input back, so that there could be an action plan to go forward.”—Clinician •“I think it definitely was. It was kind of, like it wasn’t speeches basically. The other conferences I’ve been to are mainly about the speeches…. It was more engaging.”—SCI community member Unsatisfied with engagement of SCI Community member: Attendees expressed being unsatisfied with the way the conference engaged SCI community member N/A •“And I think there was a missed opportunity at the conference … but that’s kind of the core message … there is an intent and a willingness to engage people with SCI, but it’s not the level of sophistication and respect and value that needs to be there”—SCI community member •“I was sorely disappointed that people living with SCI were not actively involved in a meaningful way with the design, leadership, and operation of the conference … it felt more like a token engagement.”—SCI community member Maintenance Themes and definitions Subthemes and definitions Quotes Concerns about impact: Attendees were skeptical that there would be no real change over the long term N/A •“…I think it needs to be a lot of things happening from a lot of different angles to make changes happen. So, conferences aren’t a bad thing, but in of themselves it wouldn’t be enough.”—SCI community member •“I think the conference highlighted a number of challenges, but I didn’t actually hear solutions to the challenges or new approaches to solving the problem.”—Researcher N/A not applicable; SCI spinal cord injury. View Large Table 4 Reach, effectiveness, and maintenance themes and subthemes derived from interviews with Praxis 2016 attendees Reach: Themes and definitions Subthemes and definitions Quotes Representativeness: Attendees discussed a need for greater representation of stakeholder groups. Not all groups were adequately represented. N/A • “…the conference would have benefited from bringing in more people from other medical fields [beyond SCI] that have experienced the same type of challenges.”—Researcher Reasons for attending: Attendees discussed why they wanted to attend the conference Purpose of conference creating appeal: The topics discussed at the conference were interesting to attendees • “It seemed like a conference that bridged lots of my interests [e.g. research, clinical practice, spinal cord injury, knowledge translation].”—Clinician • “That’s why I was attracted to the conference, is it seemed like something that was going to be producing tangible results.”—Clinician Providing an environment to learn: The conference seemed like an environment where attendees could learn more about SCI • “I was just curious as to what is out there [e.g. SCI technology]. What challenges are in research because I’m not a researcher, so I’m not aware of those [e.g. getting technology out into the field].”—SCI community member • “And when you, yourself registered for praxis, what were your specific reasons for attending?” “I was hoping to have more insight on what others were experiencing when they did not succeed in implementing or changing practice … to have some sense of solutions, I guess, in terms of bridging that gap.”—Researcher Effectiveness Themes and definitions Subthemes and definitions Quotes New connections: Attendees networked and established new collaborative relationships at the conference N/A • “As per further collaboration, I met two physicians from [an insurance company who] talked about research possibilities inside [work place]. You know, maybe following a case study of somebody who comes in.”—SCI community member • “We have a working document between a group of us since the conference [looking at helping the community understand SCI and understanding the larger research economy in the SCI field].”—SCI community member Increase in knowledge: Attendees’ knowledge expanded following the conference Understanding challenges faced in SCI research: Attendees left the conference with an increased understanding of the challenges faced by different areas in the SCI field • “It gave me a different sort of perspective from a researcher’s standpoint.” “…a better understanding of what goes on in the research world?” “Yes, yeah.” [Continues to speak of being encouraged and enlightened that there is more going on in the background that they didn’t know about before]—SCI community member • “I learned more about the gaps, and the obstacles and barriers of fundamental science which is really far from what I have in my clinical life.”—Researcher Understanding the importance of engaging the SCI community: Attendees left the conference with either a strengthened or new understanding of the importance of meaningfully involving the SCI community in SCI work • “I think that there was an understanding that there needs to be more real involvement of people with spinal cord injury.”—Researcher • “What effect would you say praxis had on you, if any?” “…it’s more to place the [SCI community members] in every aspect of our work.”—Clinician Change in the way one works: Attendees were inspired post-Praxis to work in a way that results in a positive change in the SCI field N/A •“So, there are a few things [e.g. encouraging patients to take part in research, listing research projects on website] that I’ve actually changed in my clinical practice and my work … and a few things that have got me thinking about what I can do to make change.”—Clinician •“…give us a better understanding of why we do what we do everyday. You know, cause every once in a while, you’re in the lab too much, you forget that there are actual patients involved.”—Researcher Uniqueness: Attendees affirmed that the conference was different from other conferences The diversity of the conference: The conference was unique in the way it brought together different stakeholders •“…bring different people from different perspectives and angles … that was kind of a very unique experience for me.”—Researcher •“…I think it was a good first attempt at taking people who really do not speak [and putting them together and having the discussions].”—Researcher Enjoyed the engaging format: The conference was less didactic and attendees felt that their input was important for creating solutions •“…instead of information that’s being provided we were asked for input back, so that there could be an action plan to go forward.”—Clinician •“I think it definitely was. It was kind of, like it wasn’t speeches basically. The other conferences I’ve been to are mainly about the speeches…. It was more engaging.”—SCI community member Unsatisfied with engagement of SCI Community member: Attendees expressed being unsatisfied with the way the conference engaged SCI community member N/A •“And I think there was a missed opportunity at the conference … but that’s kind of the core message … there is an intent and a willingness to engage people with SCI, but it’s not the level of sophistication and respect and value that needs to be there”—SCI community member •“I was sorely disappointed that people living with SCI were not actively involved in a meaningful way with the design, leadership, and operation of the conference … it felt more like a token engagement.”—SCI community member Maintenance Themes and definitions Subthemes and definitions Quotes Concerns about impact: Attendees were skeptical that there would be no real change over the long term N/A •“…I think it needs to be a lot of things happening from a lot of different angles to make changes happen. So, conferences aren’t a bad thing, but in of themselves it wouldn’t be enough.”—SCI community member •“I think the conference highlighted a number of challenges, but I didn’t actually hear solutions to the challenges or new approaches to solving the problem.”—Researcher Reach: Themes and definitions Subthemes and definitions Quotes Representativeness: Attendees discussed a need for greater representation of stakeholder groups. Not all groups were adequately represented. N/A • “…the conference would have benefited from bringing in more people from other medical fields [beyond SCI] that have experienced the same type of challenges.”—Researcher Reasons for attending: Attendees discussed why they wanted to attend the conference Purpose of conference creating appeal: The topics discussed at the conference were interesting to attendees • “It seemed like a conference that bridged lots of my interests [e.g. research, clinical practice, spinal cord injury, knowledge translation].”—Clinician • “That’s why I was attracted to the conference, is it seemed like something that was going to be producing tangible results.”—Clinician Providing an environment to learn: The conference seemed like an environment where attendees could learn more about SCI • “I was just curious as to what is out there [e.g. SCI technology]. What challenges are in research because I’m not a researcher, so I’m not aware of those [e.g. getting technology out into the field].”—SCI community member • “And when you, yourself registered for praxis, what were your specific reasons for attending?” “I was hoping to have more insight on what others were experiencing when they did not succeed in implementing or changing practice … to have some sense of solutions, I guess, in terms of bridging that gap.”—Researcher Effectiveness Themes and definitions Subthemes and definitions Quotes New connections: Attendees networked and established new collaborative relationships at the conference N/A • “As per further collaboration, I met two physicians from [an insurance company who] talked about research possibilities inside [work place]. You know, maybe following a case study of somebody who comes in.”—SCI community member • “We have a working document between a group of us since the conference [looking at helping the community understand SCI and understanding the larger research economy in the SCI field].”—SCI community member Increase in knowledge: Attendees’ knowledge expanded following the conference Understanding challenges faced in SCI research: Attendees left the conference with an increased understanding of the challenges faced by different areas in the SCI field • “It gave me a different sort of perspective from a researcher’s standpoint.” “…a better understanding of what goes on in the research world?” “Yes, yeah.” [Continues to speak of being encouraged and enlightened that there is more going on in the background that they didn’t know about before]—SCI community member • “I learned more about the gaps, and the obstacles and barriers of fundamental science which is really far from what I have in my clinical life.”—Researcher Understanding the importance of engaging the SCI community: Attendees left the conference with either a strengthened or new understanding of the importance of meaningfully involving the SCI community in SCI work • “I think that there was an understanding that there needs to be more real involvement of people with spinal cord injury.”—Researcher • “What effect would you say praxis had on you, if any?” “…it’s more to place the [SCI community members] in every aspect of our work.”—Clinician Change in the way one works: Attendees were inspired post-Praxis to work in a way that results in a positive change in the SCI field N/A •“So, there are a few things [e.g. encouraging patients to take part in research, listing research projects on website] that I’ve actually changed in my clinical practice and my work … and a few things that have got me thinking about what I can do to make change.”—Clinician •“…give us a better understanding of why we do what we do everyday. You know, cause every once in a while, you’re in the lab too much, you forget that there are actual patients involved.”—Researcher Uniqueness: Attendees affirmed that the conference was different from other conferences The diversity of the conference: The conference was unique in the way it brought together different stakeholders •“…bring different people from different perspectives and angles … that was kind of a very unique experience for me.”—Researcher •“…I think it was a good first attempt at taking people who really do not speak [and putting them together and having the discussions].”—Researcher Enjoyed the engaging format: The conference was less didactic and attendees felt that their input was important for creating solutions •“…instead of information that’s being provided we were asked for input back, so that there could be an action plan to go forward.”—Clinician •“I think it definitely was. It was kind of, like it wasn’t speeches basically. The other conferences I’ve been to are mainly about the speeches…. It was more engaging.”—SCI community member Unsatisfied with engagement of SCI Community member: Attendees expressed being unsatisfied with the way the conference engaged SCI community member N/A •“And I think there was a missed opportunity at the conference … but that’s kind of the core message … there is an intent and a willingness to engage people with SCI, but it’s not the level of sophistication and respect and value that needs to be there”—SCI community member •“I was sorely disappointed that people living with SCI were not actively involved in a meaningful way with the design, leadership, and operation of the conference … it felt more like a token engagement.”—SCI community member Maintenance Themes and definitions Subthemes and definitions Quotes Concerns about impact: Attendees were skeptical that there would be no real change over the long term N/A •“…I think it needs to be a lot of things happening from a lot of different angles to make changes happen. So, conferences aren’t a bad thing, but in of themselves it wouldn’t be enough.”—SCI community member •“I think the conference highlighted a number of challenges, but I didn’t actually hear solutions to the challenges or new approaches to solving the problem.”—Researcher N/A not applicable; SCI spinal cord injury. View Large Table 5 Reach and effectiveness themes and sub-themes derived from interviews with RHI Staff and Program Advisory Committee members (i.e., organizers) Reach Themes and definitions Subthemes and definitions Quotes Invitation challenges: Organizers described the difficulties of determining an invite list for a new conference N/A • “And then the other piece was, how do we then now start to involve some of the people that we do not normally involve? And that list was, honestly, a little difficult to pull together because I think the field’s been doing things one way for a long time. So, who are those people that we need to involve?” • “I think maybe we do not know who the right decision makers are is the challenge. And if we were to do this again, I would like to do environmental scan and find out who’s actually making these decisions.” Careful consideration of invite list: Organizers describe the thoughtful process to ensure the right individuals were invited to the conference N/A • “The original invitation list probably changed, not 360 but at least 180 degrees between September and April. Because as the process evolved and as more people came on board, people were dumped off the train, other people were invited on.” • “I think in part of the planning we identified you know, we really had a lot of discussion about ensuring that the right individuals were in attendance… We really pushed forward to ensure that the right individuals were in the room.” Effectiveness Themes and definitions Subthemes and definitions Quotes New connections: Organizers described how Praxis fostered discussions between diverse groups N/A • “I liked the idea of bringing together a very diverse community and a conference around a very diverse community from pre-clinical studies, clinical trials, rehabilitation, quality care and knowledge translation.” • “Here’s the thing that I think is exciting. In the 20 years I’ve been hanging out in the [inaudible] community, this is the first time that this collection of stakeholders was in the same place at the same time.” Increase in knowledge: The conference expanded the knowledge of those who attended N/A • “Okay, so shifting how people see … an issue, problem, question, challenge. I think some people are able to see that there are commonalities across the continuum in a lot of the challenges and then to also appreciate a bit more their individual challenges that were unique to where they are in the continuum, or what environment they practice in, or whatever.” • “I think my involvement in Praxis was a huge learning opportunity for myself. And I do think that personally, it helped me identify some of the needs in the SCI research and care community. And I think in the work that I’m doing now, I think it will help tailor some of that work.” Uniqueness: Organizers affirmed that the conference was different from other conferences N/A • “I do not think most of them had actually been in a conference that was very solution-oriented. And where at the end you come up with an action plan, so that was a novelty. The second thing that I was told that people found very unique was the diverse types of stakeholders who were at the meeting.” • “We do not always have all four [broad areas of SCI research together] in the same place. And that I thought was actually quite unique.” Satisfaction with consumer engagement: Organizers expressed being satisfied with the way the conference engaged consumers N/A • “It’s certainly brought forward, I mean it’s all the different people that were bringing up consumer engagement at Praxis, it wasn’t just me and it wasn’t just other people with spinal cord injury. I think it opened up people’s ears in a way that was I think hopefully more impactful than future or previous things.” • “I think, you know, the first time I’ve been to a meeting such as that where I actually heard researchers stand up with a microphone and say to consumers that, “we need you to be a part of the conversation more”. So, that was a pretty big [thing] to accomplish.” Reach Themes and definitions Subthemes and definitions Quotes Invitation challenges: Organizers described the difficulties of determining an invite list for a new conference N/A • “And then the other piece was, how do we then now start to involve some of the people that we do not normally involve? And that list was, honestly, a little difficult to pull together because I think the field’s been doing things one way for a long time. So, who are those people that we need to involve?” • “I think maybe we do not know who the right decision makers are is the challenge. And if we were to do this again, I would like to do environmental scan and find out who’s actually making these decisions.” Careful consideration of invite list: Organizers describe the thoughtful process to ensure the right individuals were invited to the conference N/A • “The original invitation list probably changed, not 360 but at least 180 degrees between September and April. Because as the process evolved and as more people came on board, people were dumped off the train, other people were invited on.” • “I think in part of the planning we identified you know, we really had a lot of discussion about ensuring that the right individuals were in attendance… We really pushed forward to ensure that the right individuals were in the room.” Effectiveness Themes and definitions Subthemes and definitions Quotes New connections: Organizers described how Praxis fostered discussions between diverse groups N/A • “I liked the idea of bringing together a very diverse community and a conference around a very diverse community from pre-clinical studies, clinical trials, rehabilitation, quality care and knowledge translation.” • “Here’s the thing that I think is exciting. In the 20 years I’ve been hanging out in the [inaudible] community, this is the first time that this collection of stakeholders was in the same place at the same time.” Increase in knowledge: The conference expanded the knowledge of those who attended N/A • “Okay, so shifting how people see … an issue, problem, question, challenge. I think some people are able to see that there are commonalities across the continuum in a lot of the challenges and then to also appreciate a bit more their individual challenges that were unique to where they are in the continuum, or what environment they practice in, or whatever.” • “I think my involvement in Praxis was a huge learning opportunity for myself. And I do think that personally, it helped me identify some of the needs in the SCI research and care community. And I think in the work that I’m doing now, I think it will help tailor some of that work.” Uniqueness: Organizers affirmed that the conference was different from other conferences N/A • “I do not think most of them had actually been in a conference that was very solution-oriented. And where at the end you come up with an action plan, so that was a novelty. The second thing that I was told that people found very unique was the diverse types of stakeholders who were at the meeting.” • “We do not always have all four [broad areas of SCI research together] in the same place. And that I thought was actually quite unique.” Satisfaction with consumer engagement: Organizers expressed being satisfied with the way the conference engaged consumers N/A • “It’s certainly brought forward, I mean it’s all the different people that were bringing up consumer engagement at Praxis, it wasn’t just me and it wasn’t just other people with spinal cord injury. I think it opened up people’s ears in a way that was I think hopefully more impactful than future or previous things.” • “I think, you know, the first time I’ve been to a meeting such as that where I actually heard researchers stand up with a microphone and say to consumers that, “we need you to be a part of the conversation more”. So, that was a pretty big [thing] to accomplish.” RE-AIMing conferences: A reach, effectiveness, and maintenance evaluation of the Rick Hansen Institute’s Praxis 2016 (Part 1). N/A not applicable; SCI spinal cord injury. View Large Table 5 Reach and effectiveness themes and sub-themes derived from interviews with RHI Staff and Program Advisory Committee members (i.e., organizers) Reach Themes and definitions Subthemes and definitions Quotes Invitation challenges: Organizers described the difficulties of determining an invite list for a new conference N/A • “And then the other piece was, how do we then now start to involve some of the people that we do not normally involve? And that list was, honestly, a little difficult to pull together because I think the field’s been doing things one way for a long time. So, who are those people that we need to involve?” • “I think maybe we do not know who the right decision makers are is the challenge. And if we were to do this again, I would like to do environmental scan and find out who’s actually making these decisions.” Careful consideration of invite list: Organizers describe the thoughtful process to ensure the right individuals were invited to the conference N/A • “The original invitation list probably changed, not 360 but at least 180 degrees between September and April. Because as the process evolved and as more people came on board, people were dumped off the train, other people were invited on.” • “I think in part of the planning we identified you know, we really had a lot of discussion about ensuring that the right individuals were in attendance… We really pushed forward to ensure that the right individuals were in the room.” Effectiveness Themes and definitions Subthemes and definitions Quotes New connections: Organizers described how Praxis fostered discussions between diverse groups N/A • “I liked the idea of bringing together a very diverse community and a conference around a very diverse community from pre-clinical studies, clinical trials, rehabilitation, quality care and knowledge translation.” • “Here’s the thing that I think is exciting. In the 20 years I’ve been hanging out in the [inaudible] community, this is the first time that this collection of stakeholders was in the same place at the same time.” Increase in knowledge: The conference expanded the knowledge of those who attended N/A • “Okay, so shifting how people see … an issue, problem, question, challenge. I think some people are able to see that there are commonalities across the continuum in a lot of the challenges and then to also appreciate a bit more their individual challenges that were unique to where they are in the continuum, or what environment they practice in, or whatever.” • “I think my involvement in Praxis was a huge learning opportunity for myself. And I do think that personally, it helped me identify some of the needs in the SCI research and care community. And I think in the work that I’m doing now, I think it will help tailor some of that work.” Uniqueness: Organizers affirmed that the conference was different from other conferences N/A • “I do not think most of them had actually been in a conference that was very solution-oriented. And where at the end you come up with an action plan, so that was a novelty. The second thing that I was told that people found very unique was the diverse types of stakeholders who were at the meeting.” • “We do not always have all four [broad areas of SCI research together] in the same place. And that I thought was actually quite unique.” Satisfaction with consumer engagement: Organizers expressed being satisfied with the way the conference engaged consumers N/A • “It’s certainly brought forward, I mean it’s all the different people that were bringing up consumer engagement at Praxis, it wasn’t just me and it wasn’t just other people with spinal cord injury. I think it opened up people’s ears in a way that was I think hopefully more impactful than future or previous things.” • “I think, you know, the first time I’ve been to a meeting such as that where I actually heard researchers stand up with a microphone and say to consumers that, “we need you to be a part of the conversation more”. So, that was a pretty big [thing] to accomplish.” Reach Themes and definitions Subthemes and definitions Quotes Invitation challenges: Organizers described the difficulties of determining an invite list for a new conference N/A • “And then the other piece was, how do we then now start to involve some of the people that we do not normally involve? And that list was, honestly, a little difficult to pull together because I think the field’s been doing things one way for a long time. So, who are those people that we need to involve?” • “I think maybe we do not know who the right decision makers are is the challenge. And if we were to do this again, I would like to do environmental scan and find out who’s actually making these decisions.” Careful consideration of invite list: Organizers describe the thoughtful process to ensure the right individuals were invited to the conference N/A • “The original invitation list probably changed, not 360 but at least 180 degrees between September and April. Because as the process evolved and as more people came on board, people were dumped off the train, other people were invited on.” • “I think in part of the planning we identified you know, we really had a lot of discussion about ensuring that the right individuals were in attendance… We really pushed forward to ensure that the right individuals were in the room.” Effectiveness Themes and definitions Subthemes and definitions Quotes New connections: Organizers described how Praxis fostered discussions between diverse groups N/A • “I liked the idea of bringing together a very diverse community and a conference around a very diverse community from pre-clinical studies, clinical trials, rehabilitation, quality care and knowledge translation.” • “Here’s the thing that I think is exciting. In the 20 years I’ve been hanging out in the [inaudible] community, this is the first time that this collection of stakeholders was in the same place at the same time.” Increase in knowledge: The conference expanded the knowledge of those who attended N/A • “Okay, so shifting how people see … an issue, problem, question, challenge. I think some people are able to see that there are commonalities across the continuum in a lot of the challenges and then to also appreciate a bit more their individual challenges that were unique to where they are in the continuum, or what environment they practice in, or whatever.” • “I think my involvement in Praxis was a huge learning opportunity for myself. And I do think that personally, it helped me identify some of the needs in the SCI research and care community. And I think in the work that I’m doing now, I think it will help tailor some of that work.” Uniqueness: Organizers affirmed that the conference was different from other conferences N/A • “I do not think most of them had actually been in a conference that was very solution-oriented. And where at the end you come up with an action plan, so that was a novelty. The second thing that I was told that people found very unique was the diverse types of stakeholders who were at the meeting.” • “We do not always have all four [broad areas of SCI research together] in the same place. And that I thought was actually quite unique.” Satisfaction with consumer engagement: Organizers expressed being satisfied with the way the conference engaged consumers N/A • “It’s certainly brought forward, I mean it’s all the different people that were bringing up consumer engagement at Praxis, it wasn’t just me and it wasn’t just other people with spinal cord injury. I think it opened up people’s ears in a way that was I think hopefully more impactful than future or previous things.” • “I think, you know, the first time I’ve been to a meeting such as that where I actually heard researchers stand up with a microphone and say to consumers that, “we need you to be a part of the conversation more”. So, that was a pretty big [thing] to accomplish.” RE-AIMing conferences: A reach, effectiveness, and maintenance evaluation of the Rick Hansen Institute’s Praxis 2016 (Part 1). N/A not applicable; SCI spinal cord injury. View Large Effectiveness From the questionnaire data, only attendees’ knowledge (capability of COM-B) significantly increased from pre- to post-Praxis 2016 (t(59) = 3.83, p < .001; Table 2). In the interview data, attendees highlighted that they gained knowledge in understanding of SCI research and the importance of engaging with the SCI community. Similarly, organizers reported that Praxis 2016 expanded their knowledge, especially around understanding the need of the SCI community (Tables 4 and 5). Regarding knowledge translation networks, attendees reported, in the questionnaire, a change in needing to work with: individuals with SCI [χ2(1) = 7.11, p =.004], SCI family members or supporters [χ2(1) = 4.05, p = .04], researchers [χ2(1) = 28.66, p < .001], clinicians or other health care providers [χ2(1) = 24.32, p < .001], SCI community associations, organizations, or advocacy groups [χ2(1) = 4.32, p = .04], knowledge translation leaders/consultants [χ2(1) = 5.04, p = .02], and funding agencies [χ2(1)= 4.32, p = .04] post-Praxis 2016 compared with pre-Praxis 2016 (Supplementary Appendix D). Both attendees and organizers discussed in the interviews that Praxis 2016 enabled people to make new connections and the importance of having people across the entire SCI network (Tables 4 and 5). From the questionnaire, the groups that individuals reported currently working with pre-Praxis 2016 and who they planned on working with post-Praxis 2016 only differed for clinicians or other health care providers group [χ2(1) = 7.58, p = .004; Supplementary Appendix E]. Qualitative data from attendees provided additional insight beyond the quantitative data. They discussed that attending Praxis 2016 inspired them to work differently, specifically taking the time to discuss their work with adults with SCI (Table 4). Satisfaction Questionnaire data indicated that attendees were satisfied with Praxis 2016 and felt that they were generally respected (M = 6.29), listened to (M = 6.19), and engaged (M = 6.14), that the venue was relatively accessible (M = 5.28), and were generally satisfied with the specific panel sessions (M > 5.45, Table 3). The majority of attendees reported that Praxis 2016 met their expectation (87%, n = 93) and 80% would attend a future Praxis-type conference (n = 91). Attendees felt the working group sessions could have been longer and neither agreed nor disagreed that the closing session provided a clear overview of solutions to bridge the gap (Table 3). A large majority of attendees agreed that Praxis 2016 achieved its goal to: (a) provide an overview of the current state of the affairs (75%); (b) enable networking (81%); and (c) facilitate learning from a diverse group of stakeholders (72%). However, only 58% of attendees indicated actively participating in developing solutions. Across both sets of interviews, individuals reported that Praxis 2016 was a unique conference due to the diversity of attendees and the engaging format (i.e., discussions and working tables) of the conference (Tables 4 and 5). However, attendees and organizers had diverging views and satisfaction regarding the role of adults with SCI in the conference. Some attendees mentioned that there was a missed opportunity to engage adults with SCI as members of the conference and the planning committee (Table 4). Organizers felt satisfied with the engagement of adults with SCI because they felt the voices of adults with SCI were heard at the conference (Table 5). Maintenance From the questionnaire, no significant differences between any of the COM measures, the importance, and value were found when examining change pre- to 9-month post-Praxis 2016 and post-to 9-month post-Praxis 2016 (Table 2). In the interviews, only attendees discussed topics related to maintenance and expressed concerns about Praxis 2016 resulting in any behavior changes over the long-term. This concern was raised because the solutions to overcome the knowledge translation challenges were not clear immediately after Praxis 2016 (Table 4). Comparing change in knowledge translation networks from post- to 9-month post-Praxis 2016, the questionnaire data informed that more attendees reported a change to needing to work with researchers, clinicians and SCI community associations 9-month post-Praxis 2016 (Supplementary Appendix D). Specifically, 11 individuals changed from not needing to work with researchers post-Praxis 2016 to reporting needing to work with this group at 9-month post-Praxis 2016 [χ2(1) = 4.92, p = .02]. The same trend was found for clinicians and SCI community associations. No differences were found between the groups that attendees planned to work with post-Praxis and those they worked with 9-month post-Praxis 2016, except for SCI family members or supporters [χ2(1) = 4.08, p = .04; Supplementary Appendix E]. Ten attendees who did not plan to work with SCI family members/supporters post-Praxis 2016 were working with them 9-month post-Praxis 2016. DISCUSSION The purpose of this work was to report on the reach, effectiveness, and maintenance evaluation of the Praxis 2016 conference. Praxis 2016 was able to reach over a quarter of their intended audience, increase and maintain attendees’ knowledge about developing practical solutions for overcoming challenges, and expand and maintain attendees’ knowledge translation networks. The attendees were generally satisfied with Praxis 2016. This evaluation provides evidence that a large-scale SCI knowledge translation initiative aimed to overcome the challenges in translating research into practice in the SCI field can have a positive impact on the field, while highlighting elements that could improve future large scale interventions. Regarding Reach, Praxis 2016 reached 28% of its intended audience which aligns with rates from other knowledge mobilization initiatives in SCI. For example, Gainforth et al. [10] reached 21% of their intended audience in a physical activity guidelines knowledge translation initiative for adults with SCI. These reach indicators could be smaller if we were to consider all members of the SCI community rather than only individuals on the Praxis 2016 mailing list. In fact, the organizers highlighted in their interviews the difficulty of including individuals not already involved with RHI or members of the planning committee. These difficulties might explain why some attendees felt representation from other members of SCI community was low such as adults with SCI, SCI family members, health care decision or policy makers, regulatory agencies, investors, and public or private insurers. Having a broader representation is important because knowledge translation stakeholders are best equipped to fill the roles they are in a position to act upon [16]. Thus, a diverse group of stakeholders with different expertize has the potential to develop more effective knowledge translation strategies by allowing individuals to work within their skill set. Future large scale knowledge translation initiatives should consider inviting a balanced representation of groups involved in the entire research, translation, and uptake process. Praxis 2016 successfully changed two effectiveness and maintenance metrics. First, Praxis 2016 changed attendees’ knowledge about developing practical solutions for overcoming challenges pre-post Praxis 2016, which was maintained 9-month post-Praxis 2016. This increase and maintenance of knowledge is likely due to the presentations, questions and answer periods, and the working table sessions. Previous knowledge translation activities using similar formats have also found an increase in knowledge [10, 17, 18]. Attendees reported relatively low levels of capability, opportunity, and behavior pre-Praxis 2016, which did not change post- or 9-month post-Praxis 2016. To increase these outcomes, future initiatives might benefit from providing attendees with tools and strategies to overcome the challenges of translating SCI research into practice. The Behaviour Change Wheel outlines strategies to enhance capability (e.g., modeling: providing examples of individuals within the SCI community who have overcame these knowledge translation challenges) and social opportunity (e.g., environmental restructuring: provide networking best-practice strategies to facilitate exchanges at SCI events) [13]. Attendees reported the need to work with various groups from pre- to post-Praxis 2016 and this need was maintained 9-month post-Praxis 2016 for some specific groups (e.g., researchers, SCI community organizations). The qualitative data supported that Praxis 2016 was successful at bringing people together, and emphasized the need to involve more adults with SCI in research and knowledge translation initiatives. Although attendees expressed a need to work with many groups post-Praxis 2016, attendees did not seem to maintain or change from expressing a need to actually working with some groups 9-month post-Praxis 2016. As outlined in the Praxis 2016 action plan, one strategy to build knowledge translation networks is the creation of a secure web-based platform that allows for communication and document sharing. However, as outlined in the AIM evaluation of Praxis 2016 [7]), little resources were put in place after Praxis 2016 to create the action plan and strategies on how to move these plans forward. It is therefore critical that future efforts ensure that proper resources are allocated to move the action plans forward post-conference, such as the creation of a collaborative online platform. In terms of satisfaction, attendees found Praxis 2016 to be a valuable experience and were generally satisfied with the content and format. However, they wished the working table sessions could have been longer. This finding hints that attendees may want to be more actively engaged in developing solutions. Salter and Kothari have debated that knowledge translation/evidence-based practice interventions need to move away from linear, passive mode of knowledge sharing to a collaborative and engaged enterprise [19]. Thus, the Praxis 2016 working tables may have been an informative (and possibly transformative) process for the attendees given the active learning and experiential knowledge sharing process that likely happened in these working tables. Future organizers of knowledge translation initiatives, such as Praxis 2016, may want to explore a variety of active learning methods, such as having attendees’ critically reflect on the topic and/or embark in shared conversation through working tables, to maximize experiential [19]. Similarly, future organizers may want to consider re-thinking the closing plenary session given attendees were not as satisfied with this session. Using this session to provide attendees with time and resources to develop knowledge translation skills (e.g., a training session on how to advocate for practice change within an organization) may facilitate the translation of SCI research into practice. Limitations and future research A limitation of this evaluation was that less than half of attendees answered the survey and one-third answered the 9-month post-Praxis 2016 survey. However, these response rates were similar to previous event-based knowledge translation initiatives [10, 20]. Further, these results pertain to one knowledge mobilization initiative in SCI, which may not be comparable to other types of initiatives in other populations. Attendees were motivated by and interested in Praxis 2016 as evidenced by high motivation and interest scores. These ceiling effects may explain why no significant changes were found in these variables. Further, the low response rate at 9-month post-Praxis 2016 further limits our ability to understand how such an initiative can maintain or change motivation, capability, and opportunity to develop solutions to overcome the challenges in SCI knowledge translation. Future evaluations of knowledge translation initiatives may need to identify the best incentives (e.g., donations to charities or SCI organizations) to increase the response rates to evaluation assessments. CONCLUSION Praxis 2016 was a knowledge translation intervention that was successful at increasing attendees’ knowledge and need to increase their knowledge translation networks to develop solutions to overcome the knowledge translation gap in SCI research. Further initiatives are necessary to translate this knowledge and need into action among attendees. Praxis 2016’s action plan (http://www.rickhanseninstitute.org/work/praxis/action-plan) may be a step forward to guide the SCI field into reducing the knowledge translation gap. Other research areas could utilize knowledge translation initiatives such as Praxis 2016 to address knowledge translation gaps. Such initiatives may want to develop strategies to enhance capability and social opportunity to facilitate the transfer of knowledge to action and provide knowledge translation tools to their attendees. Compliance with Ethical Standards Conflict of Interest: The authors have no competing financial interests. The evaluation team received a grant to conduct an independent evaluation of Praxis. While RHI was consulted throughout the evaluation process, final methods, analyses, and reporting were done independently of RHI. Author Contributions: S.N.S. and H.L.G. developed and led the evaluation implementation and analyses, and conducted the interviews with organizer. E.M. informed the development of the evaluation methods and led the quantitative data analysis. K.B. led the qualitative analysis with assistance from S.S. and H.G. J.B. informed the development of the evaluation methods and conducted the interviews with attendees. S.N.S. drafted the initial article and all authors provided feedback and approved the article. Ethical Approval: Given this project is a program evaluation, ethics was not required. Informed Consent: At each time point of the questionnaire and before the interviews, we informed attendees and organizers of the purpose of the evaluation, that their responses remained confidential, provided a contact name of the research team, and asked for consent before data collection. Welfare of Animals: This article does not contain any studies with animals performed by any of the authors. Acknowledgments We would like to acknowledge Rhyann McKay and Jena Shank for their help with data collection during the Praxis 2016 meeting. Emily Giroux and Brianna Tsui are also acknowledged for their assistance with transcription. This project was funded by Rick Hansen Institute (G2016-25). The evaluation was independent and the Rick Hansen Institute did not influence the findings reported in this article. References 1. Post MWM , van Leeuwen CMC . Psychosocial issues in spinal cord injury: A review . Spinal Cord . 2012 ; 50 : 382 – 389 . Google Scholar Crossref Search ADS PubMed 2. Noreau L , Noonan VK , Cobb J , Leblond J , Dumont FS . Spinal cord injury community survey: A national, comprehensive study to portray the lives of canadians with spinal cord injury . Top Spinal Cord Inj Rehabil. 2014 ; 20 ( 4 ): 249 – 264 . Google Scholar Crossref Search ADS PubMed 3. Morris ZS , Wooding S , Grant J . The answer is 17 years, what is the question: Understanding time lags in translational research . J R Soc Med. 2011 ; 104 ( 12 ): 510 – 520 . Google Scholar Crossref Search ADS PubMed 4. Noonan VK , Wolfe DL , Thorogood NP , Park SE , Hsieh JT , Eng JJ ; SCIRE Research Team. Knowledge translation and implementation in spinal cord injury: A systematic review . Spinal Cord. 2014 ; 52 ( 8 ): 578 – 587 . Google Scholar Crossref Search ADS PubMed 5. Barrable B , Thorogood N , Noonan V , et al. Model for bridging the translational “valleys of death” in spinal cord injury research . J Health Care Leadership . 2014 ; 2014 : 15 – 37 . 6. Glasgow RE , Vogt TM , Boles SM . Evaluating the public health impact of health promotion interventions: The RE-AIM framework . Am J Public Health. 1999 ; 89 ( 9 ): 1322 – 1327 . Google Scholar Crossref Search ADS PubMed 7. Gainforth, H. L., Baxter, K., Baron, J., Michalovic, E., Caron, J. G., & Sweet, S. N. (submitted). RE-AIMing conferences: Evaluating the adoption, implementation and maintenance of the Rick Hansen Institute’s Praxis 2016. 8. Gaglio B , Shoup JA , Glasgow RE . The RE-AIM framework: A systematic review of use over time . Am J Public Health. 2013 ; 103 ( 6 ): e38 – e46 . Google Scholar Crossref Search ADS PubMed 9. Sweet SN , Martin Ginis KA , Estabrooks PA , Latimer-Cheung AE . Operationalizing the RE-AIM framework to evaluate the impact of multi-sector partnerships . Implement Sci. 2014 ; 9 : 74 . Google Scholar Crossref Search ADS PubMed 10. Gainforth HL , Latimer-Cheung AE , Athanasopoulos P , Martin Ginis KA . Examining the feasibility and effectiveness of a community-based organization implementing an event-based knowledge mobilization initiative to promote physical activity guidelines for people with spinal cord injury among support personnel . Health Promot Pract. 2015 ; 16 ( 1 ): 55 – 62 . Google Scholar Crossref Search ADS PubMed 11. Michie S , van Stralen MM , West R . The behaviour change wheel: A new method for characterising and designing behaviour change interventions . Implement Sci. 2011 ; 6 : 42 . Google Scholar Crossref Search ADS PubMed 12. Thompson LM , Diaz-Artiga A , Weinstein JR , Handley MA . Designing a behavioral intervention using the COM-B model and the theoretical domains framework to promote gas stove use in rural Guatemala: A formative research study . BMC Public Health. 2018 ; 18 ( 1 ): 253 . Google Scholar Crossref Search ADS PubMed 13. Michie S , Atkins L , West R. The Behaviour Change Wheel: A Guide to Designing Interventions . Great Britain : Silverback Publishing ; 2014 . 14. Braun V , Clarke V . Using thematic analysis in psychology . Qual Res Psychol . 2006 ; 3 : 77 – 101 . Google Scholar Crossref Search ADS 15. Braun V , Clarke V. Successful Qualitative Research: A Practical Guide for Beginners . London, UK : Sage ; 2013 . 16. Nabyonga Orem J , Marchal B , Mafigiri D , et al. Perspectives on the role of stakeholders in knowledge translation in health policy development in Uganda . BMC Health Serv Res. 2013 ; 13 : 324 . Google Scholar Crossref Search ADS PubMed 17. Gainforth HL , Latimer-Cheung AE , Athanasopoulos P , Martin Ginis KA . Examining the effectiveness of a knowledge mobilization initiative for disseminating the physical activity guidelines for people with spinal cord injury . Disabil Health J. 2013 ; 6 ( 3 ): 260 – 265 . Google Scholar Crossref Search ADS PubMed 18. Schreiber J , Marchetti GF , Racicot B , Kaminski E . The use of a knowledge translation program to increase use of standardized outcome measures in an outpatient pediatric physical therapy clinic: Administrative case report . Phys Ther. 2015 ; 95 ( 4 ): 613 – 629 . Google Scholar Crossref Search ADS PubMed 19. Salter KL , Kothari A . Knowledge ‘translation’ as social learning: Negotiating the uptake of research-based knowledge in practice . BMC Med Educ. 2016 ; 16 : 76 . Google Scholar Crossref Search ADS PubMed 20. Tomasone JR , Martin Ginis KA , Estabrooks PA , Domenicucci L . ‘Changing minds’: Determining the effectiveness and key ingredients of an educational intervention to enhance healthcare professionals’ intentions to prescribe physical activity to patients with physical disabilities . Implement Sci. 2014 ; 9 : 30 . Google Scholar Crossref Search ADS PubMed © Society of Behavioral Medicine 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Journal

Translational Behavioral MedicineOxford University Press

Published: Feb 12, 2019

References

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create folders to
organize your research

Export folders, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off