17 General introduction 1 Challenge five: disconnection between evidence and application in practice The generation and application of evidence is essential for the adoption of eHealth and its impact on healthcare and society. However, there is often a disconnection between the generation of evidence and its application in practice, leading to a ‘knowledge-to-action’ gap (54). This gap has been recognized as one of the significant challenges of our time and has prompted a global call for knowledge translation, which involves ‘the synthesis, dissemination, exchange, and application of knowledge in an effort to improve health services and products and strengthen the healthcare system’ (55). The Knowledge-to-Action (KtA) framework offers a conceptual framework to aid in knowledge translation and the use of this evidence by healthcare professionals in their decision making regarding the adoption of health policies, practices, or programs (56). This framework consists of two interconnected components: the Action Cycle and the Knowledge Creation funnel. The Action Cycle encompasses the activities required to apply evidence-based knowledge into practice. It involves tailoring interventions to suit the local context, identifying and evaluating barriers and facilitators to implementation, and ensuring the effective application of evidence-based practices (57). On the other hand, the Knowledge Creation funnel represents the simultaneous process of generating tools and key messages that support the Action Cycle. It involves a funnel-like process translating scientific results into core messages that are actionable and easily understandable by stakeholders and decision-makers. Principles of science communication and data visualization play a valuable role in this knowledge creation process. However, there is currently a lack of guidance on how to practically implement the knowledge creation funnel (58). Building bridges – why this dissertation To conclude, while eHealth is promising in facing current healthcare challenges, measures should be undertaken to bridge the gaps that challenge the development, implementation, and evaluation. Addressing these gaps is crucial for the development of meaningful eHealth solutions that align with user needs, promote user engagement and adherence and ensure equal access to eHealth. In addition, to reach its full potential effort should be directed at generating evidence on effectiveness, and facilitating knowledge translation and dissemination, thereby bridging the gap between research and practice and strengthening the wide-spread adoption and implementation of eHealth. Outline of this dissertation This dissertation addresses the above-mentioned challenges in eHealth development, evaluation, and implementation. Through real-world examples and case studies it demonstrates how these challenges can be addressed and metaphorical gaps can be bridged.
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