Table 1.

Barriers to KTE identified in the literature are also cited by ADI key informants

Barriers identified in the literature*	Comments from respondents
Individual level Including:	"I am not sure we have a good system for really gauging relativity of importance and so I am not sure we always put the attention on the things that actually are the most important" (P3)
• Lack of experience and capacity for assessing evidence	"There is no doubt [a] barrier is 'we do everything right and I don't know why you're telling me anyway, because I know. Okay?' [laughter]" (P4)
• Mutual mistrust	"If the people who are going to enact what is recommended, are not ready to do that, then that individual's work is really moot. It made no change" (P5)
• Negative attitude toward change
Organizational level Including:	"Until, I think, it comes from the top ... and there's an expectation and there's opportunities and there's people hired to do these things specifically, they just don't truly change significantly" (P5)
• Unsupportive culture	"a major problem or a barrier is the protection of interests, and these interests are generally protected by individuals who have got a particular professional orientation or they have got an income stake in the way that things are done" (P1)
• Competing interests	"you don't get rewarded as a research person for any of these kinds of ongoing exchanges or plain language summaries" (P2)
• Researcher incentive system
• Frequent staff turnover
Related to communication Including:	"In this day and age, you're inundated with so many different ... getting information isn't a problem. Getting information you need is more the problem" (P9)
• Poor choice of messenger	"[A] big barrier for effective knowledge transfer would be use of appropriate language.... You really have to come up with appropriate language that is customized for the specific audience that you are dealing with" (P1)
• Information overload	"Part of any kind of knowledge transfer is in fact, probably taking a position.... For effective knowledge transfer up, we need to at least say: 'Well, we've got one or two or three options that we're recommending"' (P8)
• Traditional, academic language	"Policy makers want to do something but they would like to have some kind of advice on what do you want me to do, not only present me the finding, the statistics, and then say we need more research to be more sure. You must also provide me with some advice, at least in some direction" (P13)
• No actionable messages (information on what needs to be done and the implications)
Related to time or timing Including:	"I think the research arena and their processes are also a challenge and their time frames because that whole process is so different from service delivery timelines and processes" (P3)
• Differences in decision makers' and researchers' time frames	"One of the things that really drives the policies is a lot of the times when things become issues for us, things need to be done quickly....I've often had this said to me: 'Surely you want the best evidence.' And my response back is: 'I want whatever you can give me because you do understand that whether you provide the evidence or not, the decision might be made tomorrow'." (P14)
• Limited time to make decisions

*Source: Reference [5].