Grant: Fellowship - Priority Announcement: Knowledge Translation

Background: Minor head injuries in children result in over 650,000 emergency department visits annually. Computed tomography (CT) scan is the most effective method for detecting a life-threatening intracranial hematoma. However, only 5% of children presenting with minor head injury have acute injury on CT. While there is variation in the use of CT scans for children who present with minor head injury in pediatric emergency departments, the overall trend is rising. The number of CT scans for this population has increased from 15% to 53% in the past 10 years with approximately 95% of the scans being negative. Radiology studies suggest that pediatric CTs result in an increased lifetime radiation risk and an increased lifetime cancer mortality risk. The Canadian Assessment of Tomography for Childhood Head Injury (CATCH) Rule was derived from a study of 3867 children and is currently being validated in a Canada wide multicentre cohort study. The CATCH rule will improve diagnostic and therapeutic decision making for children presenting with minor head injury. However, failure to translate research findings into routine practice is a common finding in the health services literature, therefore widespread uptake of the rule will require an effective implementation strategy. Aim: Development of an evidence based knowledge translation (KT) strategy for the CATCH Rule. Methods: This project will be conducted in three phases. First, we will explore clinician non-adherence to the rule in a previously conducted adult CT Head Rule trial. Second, we will identify barriers to the uptake of the CATCH rule with a sample of rural and urban emergency clinicians. Finally, intervention mapping will guide selection of appropriate behavior change techniques to address identified barriers. Feasability testing will also be carried out with a cohort of emergency clinicians in Ontario. This evidence based KT strategy will inform design of a multicentre trial for implementation of the CATCH rule.