The Canadian secret is two-fold: They have integrated knowledge translation into the earliest stages of health research grant-writing and grantmaking, and; they have integrated the philosophy of "exchange" into their research and dissemination work. By exchange, we mean seeking the input and guidance of research stakeholders and end-users at every juncture in the research, analysis, publication, and dissemination process. In contrast, American knowledge translation practices are usually an afterthought, underfunded or unfunded, and they are heavily siloed within a variety of institutions and organizations. This presentation will examine the strengths and weaknesses of Canadian and American knowledge translation practices, and explore ways to integrate the best aspects of both.