Implementing Intervention Research into Public Policy-the "I3-Approach"

Developing criteria for research translation decision-making in community settings: a systematic review and thematic analysis informed by the Knowledge to Action Framework and community input

Background

There is a pressing need to translate empirically supported interventions, products, and policies into practice to prevent and control prevalent chronic diseases. According to the Knowledge to Action (K2A) Framework, only those interventions deemed “ready” for translation are likely to be disseminated, adopted, implemented, and ultimately institutionalized. Yet, this pivotal step has not received adequate study. The purpose of this paper was to create a list of criteria that can be used by researchers, in collaboration with community partners, to help evaluate intervention readiness for translation into community and/or organizational settings.

Methods

The identification and selection of criteria involved reviewing the K2A Framework questions from the “decision to translate” stage, conducting a systematic review to identify characteristics important for research translation in community settings, using thematic analysis to select unique research translation decision criteria, and incorporating researcher and community advisory board feedback.

Results

The review identified 46 published articles that described potential criteria to decide if an intervention appears ready for translation into community settings. In total, 17 unique research translation decision criteria were identified. Of the 8 themes from the K2A Framework that were used to inform the thematic analysis, all 8 were included in the final criteria list after research supported their importance for research translation decision-making. Overall, the criteria identified through our review highlighted the importance of an intervention’s public health, cultural, and community relevance. Not only are intervention characteristics (e.g., evidence base, comparative effectiveness, acceptability, adaptability, sustainability, cost) necessary to consider when contemplating introducing an intervention to the “real world,” it is also important to consider characteristics of the target setting and/or population (e.g., presence of supporting structure, support or buy-in, changing sociopolitical landscape).

Conclusions

Our research translation decision criteria provide a holistic list for identifying important barriers and facilitators for research translation that should be considered before introducing an empirically supported intervention into community settings. These criteria can be used for research translation decision-making on the individual and organizational level to ensure resources are not wasted on interventions that cannot be effectively translated in community settings to yield desired outcomes.

An exposition of the constructive research approach: a tactical treatise for addressing methodological and practical issues in organisational research

Purpose

This paper aims to provide an exposition of the constructive research approach (CRA) to show the potential utility of CRA in transcending or mitigating the methodological and practical issues involved in researching organisations.

Design/methodology/approach

The paper is a literature review, and resulting thematic discussion of methodological and practical issues involves in action research (AR) in organisations through the lens of the CRA approach.

Findings

The paper identifies that CRA has benefits in orientation to a practical outcome grounded in a theoretical domain but with leeway to facilitate creativity, which can also potentially improve the quality of the collaborative relationships. The centrality of the construction within the method provides a “vantage point” to manage the emic (inside) and etic (outside) positionality concerns of action researchers working within organisational settings.

Practical implications

CRA has multiple practical benefits for action researchers and their collaborators in terms of time, risk and collaborative commitment.

Originality/value

The paper develops a useful tactical framework for discussing the practical and methodological issues when considering AR in organisations and highlights how CRA can be used in wider organisational scholarship outside its roots in management accounting.

Cyberbullying and Cyber Victimization as Online Risks for Children and Adolescents

Abstract. Cyberbullying is one example of a psychosocial developmental phenomenon caused by mediatization, a meta-process that increasingly shapes everyday practices and social relationships via mediating technologies and media organizations. Research on cyberbullying started less than two decades ago and has grown exponentially during the last few years. Despite the large body of evidence, the research field still is in its “forming” phase, and there are still major topics of debate. The main goal of this paper is to discuss some of the major challenges, identify major research gaps, and give some directions for future research. Summarizing the main findings from meta-analyses and systematic reviews, topics like definition and measurement, theoretical perspectives, risk and protective factors, developmental patterns, as well as prevention and intervention of cyberbullying and cyber victimization are discussed, and promising avenues for future research are outlined.

Applying systems thinking to knowledge mobilisation in public health

CONTEXT

Knowledge mobilisation (KM) is a vital strategy in efforts to improve public health policy and practice. Linear models describing knowledge transfer and translation have moved towards multi-directional and complexity-attuned approaches where knowledge is produced and becomes meaningful through social processes. There are calls for systems approaches to KM but little guidance on how this can be operationalised. This paper describes the contribution that systems thinking can make to KM and provides guidance about how to put it into action.

METHODS

We apply a model of systems thinking (which focuses on leveraging change in complex systems) to eight KM practices empirically identified by others. We describe how these models interact and draw out some key learnings for applying systems thinking practically to KM in public health policy and practice. Examples of empirical studies, tools and targeted strategies are provided.

FINDINGS

Systems thinking can enhance and fundamentally transform KM. It upholds a pluralistic view of knowledge as informed by multiple parts of the system and reconstituted through use. Mobilisation is conceived as a situated, non-prescriptive and potentially destabilising practice, no longer conceptualised as a discrete piece of work within wider efforts to strengthen public health but as integral to and in continual dialogue with those efforts. A systems approach to KM relies on contextual understanding, collaborative practices, addressing power imbalances and adaptive learning that responds to changing interactions between mobilisation activities and context.

CONCLUSION

Systems thinking offers valuable perspectives, tools and strategies to better understand complex problems in their settings and for strengthening KM practice. We make four suggestions for further developing empirical evidence and debate about how systems thinking can enhance our capacity to mobilise knowledge for solving complex problems - (1) be specific about what is meant by 'systems thinking', (2) describe counterfactual KM scenarios so the added value of systems thinking is clearer, (3) widen conceptualisations of impact when evaluating KM, and (4) use methods that can track how and where knowledge is mobilised in complex systems.

Moving beyond the ivory tower – why researchers from the field of education should go ahead

Abstract. Since the beginning of the 21st century universities are increasingly requested to use the results produced by their first (teaching) and second mission (research) to help resolve the growing challenges societies and local communities are faced with. This obligation has been codified as the Third Mission of universities. However, research and its results often seem to remain in the so-called ivory tower and realization of successful transfer often failed. Empirical research clearly shows that the key factor for successful transfer is to involve an intensive cooperation between researchers, policymakers, and practitioners within a mutually respectful, collaborative process. However, the establishment of a high quality and fruitful cooperation among these different groups is difficult. In the paper, possible reasons for poor transfer of research findings on part of researchers, practitioners, and policymakers are discussed as well as demands for successful transfer. A systematic six-step procedure for policy impact from research is presented, which summarizes the most relevant actions to be taken and issues to be considered on the part of (individual) researchers for realizing successful transfer. Universities can provide a supportive environment through the development of a distinct Third Mission profile including criteria and incentives for transfer activities of single researchers. It is the intention of this paper to convince researchers from the field of education to go ahead in moving beyond the ivory tower and to engage in transfer of scientific knowledge. One reason is the high importance of education for society. Another reason is that the competences and experiences necessary for successful transfer of research to the wider field of policy and practice are core competences and experiences of researchers from the field of education.

Contextualizing and pilot testing the Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) to primary healthcare workers in Kilifi, Kenya

BACKGROUND

Little data exists about the methodology of contextualizing version two of the Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) in resource-poor settings. This paper describes the contextualisation and pilot testing of the guide in Kilifi, Kenya.

METHODS

Contextualisation was conducted as a collaboration between the KEMRI-Wellcome Trust Research Programme (KWTRP) and Kilifi County Government's Department of Health (KCGH) between 2016 and 2018. It adapted a mixed-method design and involved a situational analysis, stakeholder engagement, local adaptation and pilot testing of the adapted guide. Qualitative data were analysed using content analysis to identify key facilitators and barriers to the implementation process. Pre- and post-training scores of the adapted guide were compared using the Wilcoxon signed-rank test.

RESULTS

Human resource for mental health in Kilifi is strained with limited infrastructure and outdated legislation. Barriers to implementation included few specialists for referral, unreliable drug supply, difficulty in translating the guide to Kiswahili language, lack of clarity of the roles of KWTRP and KCGH in the implementation process and the unwillingness of the biomedical practitioners to collaborate with traditional health practitioners to enhance referrals to hospital. In the adaptation process, stakeholders recommended the exclusion of child and adolescent mental and behavioural problems, as well as dementia modules from the final version of the guide. Pilot testing of the adapted guide showed a significant improvement in the post-training scores: 66.3% (95% CI 62.4-70.8) v. 76.6% (95% CI 71.6-79.2) (p < 0.001).

CONCLUSION

The adapted mhGAP-IG version two can be used across coastal Kenya to train primary healthcare providers. However, successful implementation in Kilifi will require a review of new evidence on the burden of disease, improvements in the mental health system and sustained dialogue among stakeholders.

Programme zur Förderung kognitiver Fähigkeiten in Vorschule und Schule: Wie effektiv sind sie, und wie gut sind die Verfahren praktisch implementiert?

Zusammenfassung. Der Beitrag beschäftigt sich mit neueren Trends bei der Entwicklung und Evaluation von kognitiven Trainingsprogrammen sowie ihrer Implementation in die pädagogisch-psychologische Praxis. Es wird konstatiert, dass die Fortschritte der letzten Jahrzehnte weniger in der theoretischen Weiterentwicklung basaler Konzepte als vielmehr in methodologischen Verbesserungen zu sehen sind. Im Hinblick auf die Trainingsinhalte finden sich unterschiedliche Ergebnistrends. Im Hinblick auf die Förderung von Gedächtnisstrategien ergaben sich mehrfach positive Effekte, leider jedoch keine Übertragung in publizierte Programme. Neue Studien fokussierten auf das Training des Arbeitsgedächtnisses, zeigten dabei kaum nennenswerte Effekte und wurden von daher auch selten als Programme publiziert. Die Situation im Hinblick auf das Training induktiven Denkens, der phonologischen Bewusstheit und der Lesekompetenz stellt sich im Vergleich deutlich positiver dar. Die Nachhaltigkeit der publizierten Programme konnte in allen genannten Bereich wiederholt demonstriert werden, wobei sich im Hinblick auf die Lesekompetenz besonders deutliche Auswirkungen für Lesestrategien zeigten. Nach wie vor zeigen sich jedoch Probleme bei dem Transfer wirksamer Programme in die pädagogisch-psychologische Praxis. Da nicht davon auszugehen ist, dass nachhaltig wirksame Fördermaßnahmen ohne weiteren Aufwand in die pädagogische Praxis übertragen werden können, werden sinnvolle Implementationsstrategien diskutiert. Es werden Empfehlungen für Vorgehensweisen gegeben, die eine enge Zusammenarbeit zwischen den Programmentwicklern, den jeweils involvierten Bildungsinstitutionen und den Personen (z. B. pädagogische Fachkräfte in Kindergärten und Schulen) implizieren. Diese sollten den nachhaltigen Einsatz effektiver Förderprogramme in pädagogischen Kontexten wahrscheinlicher machen.

Innovation and Integrity: Desiderata and Future Directions for Prevention and Intervention Science

This article summarizes essential implications of the papers within this special issue and discusses directions for future prevention and intervention research on conceptual issues, methodological and transfer-related challenges and opportunities. We identify a need to move from programs to principles in intervention research and encourage the implementation of research on potential mechanisms underlying intervention effectiveness. In addition, current methodological issues in intervention research are highlighted, including advancements in methodology and statistical procedures, extended outcome assessments, replication studies, and a thorough examination of potential biases. We further discuss transfer-related issues, for example the need for more research on the flexibility and adaptability of programs and intervention approaches as well as more general problems in knowledge translation reasoning the need for enhanced communication between practitioners, policy makers, and researchers. Finally, we briefly touch on the need to discuss the relation between single intervention programs, the mental health system, and changes of contextual conditions at the macro level.

Innovation and Integrity in Intervention Research: Conceptual Issues, Methodology, and Knowledge Translation

In this article, we introduce the special issue entitled Innovation and Integrity in Intervention Science. Its focus is on essential problems and prospects for intervention research examining two related topics, i.e., methodological issues and research integrity, and challenges in the transfer of research knowledge into practice and policy. The main aims are to identify how to advance methodology in order to improve research quality, examine scientific integrity in the field of intervention science, and discuss future steps to enhance the transfer of knowledge about evidence-based intervention principles into sustained practice, routine activities, and policy decisions. Themes of the special issue are twofold. The first includes questions about research methodology in intervention science, both in terms of research design and methods, as well as data analyses and the reporting of findings. Second, the issue tackles questions surrounding the types of knowledge translation frameworks that might be beneficial to mobilize the transfer of research-based knowledge into practice and public policies. The issue argues that innovations in methodology and thoughtful approaches to knowledge translation can enable transparency, quality, and sustainability of intervention research.