Knowledge Translation Interventions for Youth Health Care Transitions: Protocol for a Realist Review

Supporting youth and their caregivers during the transition from pediatric to adult health care is a priority across Canada. Many transition in care (TiC) innovations exist, yet these innovations often fail to be effectively implemented and/or sustained. Knowledge translation (KT) interventions, such as developing educational materials and identifying champions, are used to promote the uptake of innovations into clinical practice. However, there is limited information on what, when, and how these KT interventions are used to implement and sustain TiC innovations.

This paper presents the protocol for a realist review aiming to understand what KT interventions work, how they work, for whom, and under what circumstances to support the implementation and sustainability of TiC innovations for youth moving from pediatric to adult health care. The objectives are to (1) identify and map KT interventions and (2) develop initial program theories.

We will follow Pawson's 5 iterative steps for realist reviews, integrating aspects of rapid realist review methodology. We will adhere to the RAMESES (Realist and Meta-narrative Evidence Syntheses-Evolving Standards) quality standards for realist synthesis. Using an integrated KT approach, we will leverage the lived and professional expertise of a team of knowledge users and researchers.

This project has received funding from Canadian Institutes of Health Research, starting in January 2026. A research partner team of 24 people with lived and professional expertise in transition has been assembled, as well as a team of 18 scientific members. Step 1 of the review is underway. The review is anticipated to be completed within 12 months.

Using a theory-driven approach, this realist review will result in initial program theories about the underlying mechanisms, contextual factors, and processes within KT interventions that influence implementation and sustainability outcomes of TiC innovations for youth and their caregivers. A subsequent explanatory mixed methods realist evaluation with a multiple comparative case study design will test and refine initial theories. This research will be important to inform future TiC innovations for diverse health contexts across Canada and beyond.