Challenges in Knowledge Translation: The Early Years of Cancer Care Ontario’s Program in Evidence-Based Care

Background: Cancer Care Ontario’s Program in Evidence-Based Care (pebc) was formalized in 1997 to produce clinical practice guidelines for cancer management for the Province of Ontario. At the time, the gap between guideline development and implementation was beginning to be acknowledged. The Program implemented strategies to promote use of guidelines. Methods: The program had to overcome numerous social challenges to survive. (1) Prospective strategies useful to practitioners—including participation, transparent communication, a methodological vision, and methodology skills development offerings—were used to create a culture of research-informed oncology practice within a broad community of practitioners. (2) Reactive strategies ensured the survival of the program in the early years, when some within the influential academic community and among decision-makers were skeptical about the feasibility of a rigorous methodologic approach meeting the fast turnaround times necessary for policy. Results: The paper details the pebc strategies within the context of what was known about knowledge translation (kt) at the time, and it tries to identify key success factors. Conclusions: Many of the barriers faced in the implementation of kt—and the strategies for overcoming them—are unavailable in the public domain because the relevant reporting does not fit the traditional paradigm for publication. Telling the “stories behind the story” should be encouraged to enhance the practice of kt beyond the science.