Disseminating a Pediatric Oncology Critical Care Intervention in Latin America and Spain: An Integrated-Knowledge-Translation Approach

PROACTIVE (Pediatric Oncology Capacity Assessment Tool for Intensive Care) is a quality improvement (QI) intervention that assist pediatric onco-critical care teams identify institutional strengths and gaps, but language barriers have limited its global uptake. This study aimed to evaluate the translation, refinement, and dissemination of Spanish-PROACTIVE guided by an integrated knowledge translation (IKT) approach. We conducted a four-phase mixed-methods study including: (1) translating and piloting Spanish-PROACTIVE in 22 centers across 12 countries in Latin America and Spain, (2) identifying institutional and regional pediatric onco-critical care challenges and QI priorities, (3) assessing barriers to disseminating results, and (4) co-developing dissemination tools. The professionally translated and refined Spanish-PROACTIVE identified key institutional and common regional pediatric onco-critical care challenges including lack of multidisciplinary rounds (only 14% availability). Institutional barriers to disseminating results included limited time and resources, gaps in dissemination knowledge and skill, and lack of mentorship. These findings informed the co-development of tailored dissemination tools, including a leadership-focused slide deck and a clinical-staff-targeted infographic to support internal dissemination. Applying an IKT approach effectively addressed language and dissemination barriers, and improved accessibility and local relevance of PROACTIVE. Spanish-PROACTIVE supports consistent multilingual data collection, and its contextually tailored dissemination tools may enhance internal communication and uptake of findings across Spanish-speaking institutions. This approach offers a practical model for strengthening dissemination and accelerating uptake of intervention results in linguistically diverse, resource-constrained settings, supporting global efforts to improve outcomes for children with cancer.

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Publication Details

Journal
Global Implementation Research and Applications
Published
2026-03-12
DOI
https://doi.org/10.1007/s43477-026-00218-5
Primary Topic
Neonatal Respiratory Health Research
Type
article
Field-Weighted Citation Impact
0.00

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article

Disseminating a Pediatric Oncology Critical Care Intervention in Latin America and Spain: An Integrated-Knowledge-Translation Approach

Maria Rosaria Lamia, Janet Middlekauff, Yefry Andrés Aragón-Joya, Yvania Alfonso et al.
Global Implementation Research and Applications
Neonatal Respiratory Health Research
article

Disseminating a Pediatric Oncology Critical Care Intervention in Latin America and Spain: An Integrated-Knowledge-Translation Approach

Maria Rosaria Lamia, Janet Middlekauff, Yefry Andrés Aragón-Joya, Yvania Alfonso, Rodrigo Pérez-Morales, Norma Araceli López Facundo, Ligia Fu-Carrasco, Javier Godoy-Cordobés, Scheybi Miralda, Eliana López, Sara M. Malone, Ritwik Budhiraja, Claudia María De León Gutiérrez, Rosa León-Paredes, Magdalena Cerdá, Erika E. Blasco-Arriaga, María Eugenia Costa, Jocelyn Becerril Becerril, Renée Alce, Ángela M. Puerto-Torres, Arturo G. Estrada-López, Alejandra Calderon, Paola Arias-Prado, Catherine Grisales-Salamanca, Yichen Chen, Asya Agulnik, María González-Pedroza, Zuley Dominguez, Rubén E. Lasso-Palomino, Mauricio Mesa-Rincón, Margarita M. Torres-Baquero, María Sánchez-Martín, Romina Corona, Estuardo Pineda-Urquilla, David Garay-Barbosa, Silvio F. Torres, Rosario Montilva, Carlos Acuña, Anita V. Arias
article en

Abstract

PROACTIVE (Pediatric Oncology Capacity Assessment Tool for Intensive Care) is a quality improvement (QI) intervention that assist pediatric onco-critical care teams identify institutional strengths and gaps, but language barriers have limited its global uptake. This study aimed to evaluate the translation, refinement, and dissemination of Spanish-PROACTIVE guided by an integrated knowledge translation (IKT) approach. We conducted a four-phase mixed-methods study including: (1) translating and piloting Spanish-PROACTIVE in 22 centers across 12 countries in Latin America and Spain, (2) identifying institutional and regional pediatric onco-critical care challenges and QI priorities, (3) assessing barriers to disseminating results, and (4) co-developing dissemination tools. The professionally translated and refined Spanish-PROACTIVE identified key institutional and common regional pediatric onco-critical care challenges including lack of multidisciplinary rounds (only 14% availability). Institutional barriers to disseminating results included limited time and resources, gaps in dissemination knowledge and skill, and lack of mentorship. These findings informed the co-development of tailored dissemination tools, including a leadership-focused slide deck and a clinical-staff-targeted infographic to support internal dissemination. Applying an IKT approach effectively addressed language and dissemination barriers, and improved accessibility and local relevance of PROACTIVE. Spanish-PROACTIVE supports consistent multilingual data collection, and its contextually tailored dissemination tools may enhance internal communication and uptake of findings across Spanish-speaking institutions. This approach offers a practical model for strengthening dissemination and accelerating uptake of intervention results in linguistically diverse, resource-constrained settings, supporting global efforts to improve outcomes for children with cancer.

Global Implementation Research and Applications
St. Jude Children's Research Hospital (US), Universidad Autónoma del Estado de México (MX), Hospital Universitario La Paz (ES), National University of Santiago del Estero (AR), Universidad de Antioquia (CO), Cleveland Clinic Lerner College of Medicine (US), Clínica Girona (ES), Fundación Valle del Lili (CO), Hospital Universitario Austral (AR), Hospital Universitario de Maracaibo (VE), Instituto Nacional de Salud del Niño (PE), Hospital Luis Calvo Mackenna (CL), Hospital Pablo Tobon Uribe (CO), Hospital Nacional de Niños Bloom (SV), Instituto Nacional de Cancerología (CO), Universidad Metropolitana de Honduras (HN), Liga Nacional Contra el Cáncer (GT), Hospital Materno-Infantil (ES), Fundación Santa Fe de Bogotá (CO), Unidad de Cirugía Cardiovascular de Guatemala (GT), Hospital de Especialidades (MX), Gheskio Centers (HT), Hospital Regional de Alta Especialidad del Bajío (MX), Hospital de Niños de la Santísima Trinidad (AR), Instituto de Salud del Estado de México (MX), Foscal Hospital (CO), Saint Louis University (US), Universidad Autónoma de Madrid (ES), Icesi University (CO)
American Lebanese Syrian Associated Charities, National Cancer Institute
Quality Education
Openalex Percentile: Top 24%
Neonatal Respiratory Health Research
DOIOpen Access PDFOpenAlex
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