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Barreto JOM, de Melo RC, da Silva LALB, de Araújo BC, de Freitas Oliveira C, Toma TS, de Bortoli MC, Demaio PN, Kuchenmüller T. Research evidence communication for policy-makers: a rapid scoping review on frameworks, guidance and tools, and barriers and facilitators. Health Res Policy Syst 2024; 22:99. [PMID: 39118156 PMCID: PMC11312384 DOI: 10.1186/s12961-024-01169-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/23/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Communication is a multifaceted process, ranging from linear, one-way approaches, such as transmitting a simple message, to continuous exchanges and feedback loops among stakeholders. In particular the COVID-19 pandemic underscored the critical need for timely, effective and credible evidence communication to increase awareness, levels of trust, and evidence uptake in policy and practice. However, whether to improve policy responses in crises or address more commonplace societal challenges, comprehensive guidance on evidence communication to decision-makers in health policies and systems remains limited. Our objective was to identify and systematize the global evidence on frameworks, guidance and tools supporting effective communication of research evidence to facilitate knowledge translation and evidence-informed policy-making processes, while also addressing barriers and facilitators. METHODS We conducted a rapid scoping review following the Joanna Briggs Manual. Literature searches were performed across eight indexed databases and two sources of grey literature, without language or time restrictions. The methodological quality of included studies was assessed, and a narrative-interpretative synthesis was applied to present the findings. RESULTS We identified 16 documents presenting either complete frameworks or framework components, including guidance and tools, aimed at supporting evidence communication for policy development. These frameworks outlined strategies, theoretical models, barriers and facilitators, as well as insights into policy-makers' perspectives, communication needs, and preferences. Three primary evidence communication strategies, comprising eleven sub-strategies, emerged: "Health information packaging", "Targeting and tailoring messages to the audience", and "Combined communication strategies". Based on the documented barriers and facilitators at micro, meso and macro levels, critical factors for successful communication of evidence to policy-makers were identified. CONCLUSIONS Effective communication is indispensable for facilitating knowledge translation and evidence-informed policy-making. Nonetheless gaps persist in frameworks designed to enhance research communication to policy-makers, particularly regarding the effectiveness of multiple communication strategies. To advance in this field, the development of comprehensive frameworks incorporating implementation strategies is warranted. Additionally, barriers and facilitators to implementing effective communication must be recognized and addressed taking diverse contexts into consideration. Registration https://zenodo.org/record/5578550.
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Affiliation(s)
| | | | | | | | | | | | | | - Peter Nichols Demaio
- McMaster Health Forum, Hamilton, Canada
- Department of Health, Aging and Society, McMaster University, Hamilton, Canada
| | - Tanja Kuchenmüller
- Evidence to Policy and Impact, Research for Health, Science Division, World Health Organization, Geneva, Switzerland
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Wolfenden L, Hall A, Bauman A, Milat A, Hodder R, Webb E, Mooney K, Yoong S, Sutherland R, McCrabb S. Research outcomes informing the selection of public health interventions and strategies to implement them: A cross-sectional survey of Australian policy-maker and practitioner preferences. Health Res Policy Syst 2024; 22:58. [PMID: 38745326 PMCID: PMC11095011 DOI: 10.1186/s12961-024-01144-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 04/19/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND A key role of public health policy-makers and practitioners is to ensure beneficial interventions are implemented effectively enough to yield improvements in public health. The use of evidence to guide public health decision-making to achieve this is recommended. However, few studies have examined the relative value, as reported by policy-makers and practitioners, of different broad research outcomes (that is, measures of cost, acceptability, and effectiveness). To guide the conduct of research and better inform public health policy and practice, this study aimed at describing the research outcomes that Australian policy-makers and practitioners consider important for their decision-making when selecting: (a) public health interventions; (b) strategies to support their implementation; and (c) to assess the differences in research outcome preferences between policy-makers and practitioners. METHOD An online value-weighting survey was conducted with Australian public health policy-makers and practitioners working in the field of non-communicable disease prevention. Participants were presented with a list of research outcomes and were asked to select up to five they considered most critical to their decision-making. They then allocated 100 points across these - allocating more points to outcomes perceived as more important. Outcome lists were derived from a review and consolidation of evaluation and outcome frameworks in the fields of public health knowledge translation and implementation. We used descriptive statistics to report relative preferences overall and for policy-makers and practitioners separately. RESULTS Of the 186 participants; 90 primarily identified as policy-makers and 96 as public health prevention practitioners. Overall, research outcomes of effectiveness, equity, feasibility, and sustainability were identified as the four most important outcomes when considering either interventions or strategies to implement them. Scores were similar for most outcomes between policy-makers and practitioners. CONCLUSION For Australian policy-makers and practitioners working in the field of non-communicable disease prevention, outcomes related to effectiveness, equity, feasibility, and sustainability appear particularly important to their decisions about the interventions they select and the strategies they employ to implement them. The findings suggest researchers should seek to meet these information needs and prioritize the inclusion of such outcomes in their research and dissemination activities. The extent to which these outcomes are critical to informing the decision of policy-makers and practitioners working in other jurisdictions or contexts warrants further investigation.
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Affiliation(s)
- Luke Wolfenden
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia.
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia.
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia.
| | - Alix Hall
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia
| | - Adrian Bauman
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia
- Prevention Research Collaboration, Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- The Australian Prevention Partnership Centre, Sydney, NSW, Australia
| | - Andrew Milat
- School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Epidemiology and Evidence, NSW Ministry of Health, Sydney, Australia
| | - Rebecca Hodder
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia
| | - Emily Webb
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia
| | - Kaitlin Mooney
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia
| | - Serene Yoong
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia
- School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, 3122, Australia
- Global Nutrition and Preventive Health, Institute of Health Transformation, School of Health and Social Development, Deakin University, Burwood, VIC, Australia
| | - Rachel Sutherland
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia
| | - Sam McCrabb
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2318, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia
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Hedayatipour M, Etemadi S, Hekmat SN, Moosavi A. Challenges of using evidence in managerial decision-making of the primary health care system. BMC Health Serv Res 2024; 24:38. [PMID: 38183009 PMCID: PMC10770934 DOI: 10.1186/s12913-023-10409-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 11/30/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Managerial Evidence-Based Decision-Making [EBDM] in the primary is a systematic approach that directs the decision-maker in a conscientious, explicit, and judicious utilization of reliable and best evidence based on the professional experiences and preferences of stakeholders and patients from various sources. This study aimed to investigate the challenges primary healthcare managers encounter while undertaking decision-making processes. METHOD A systematic review was conducted in 2022 with the aim of identifying and collecting all qualitative articles pertaining to evidence-based decision-making in the primary healthcare system. To achieve this, a meticulous search was conducted using the relevant keywords, including primary health care and evidence-based decision making, as well as their corresponding synonyms, across the databases Web of Science, Scopus, and Pubmed. Importantly, there were no limitations imposed on the timeframe for the search. To carefully analyze and consolidate the findings of this systematic review, the meta-synthesis approach was employed. RESULTS A total of 22 articles were assessed in this systematic review study. The results revealed the main categories including evidence nature, EBDM barriers, utilizing evidence, decision-makers ability, organizational structure, evidence-based, EBDM support, communication for EBDM, evidence sides, EBDM skill development, public health promotion, and health system performance improvement. CONCLUSION The primary healthcare system is crucial in improving health outcomes and ensuring access to healthcare services for all individuals. This study explored the utilization of evidence-based EBDM within the primary healthcare system. We identified five key dimensions: causal, contextual, and intervening conditions, strategies, and consequences of EBDM as a core phenomenon. The findings will help policymakers and administrators comprehend the importance of evidence-based decision-making, ultimately leading to enhanced decision quality, community well-being, and efficiency within the healthcare system. EBDM entails considering the best reliable evidence, and incorporating community preferences while also exploiting the professional expertise and experiences of decision-makers. This systematic review has the potential to provide guidance for future reforms and enhance the quality of decision-making at the managerial level in primary healthcare.
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Affiliation(s)
- Marjan Hedayatipour
- Department of Healthcare Management, Policy and Economics, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Sina Etemadi
- Department of Healthcare Management, Policy and Economics, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Somayeh Noori Hekmat
- Department of Healthcare Management, Policy and Economics, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran.
| | - Alisadat Moosavi
- Department of Medical Library & Information Sciences, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
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Shato T, Kepper MM, McLoughlin GM, Tabak RG, Glasgow RE, Brownson RC. Designing for dissemination among public health and clinical practitioners in the USA. J Clin Transl Sci 2023; 8:e8. [PMID: 38384897 PMCID: PMC10877519 DOI: 10.1017/cts.2023.695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/07/2023] [Accepted: 12/03/2023] [Indexed: 02/23/2024] Open
Abstract
Introduction The slow adoption of evidence-based interventions reflects gaps in effective dissemination of research evidence. Existing studies examining designing for dissemination (D4D), a process that ensures interventions and implementation strategies consider adopters' contexts, have focused primarily on researchers, with limited perspectives of practitioners. To address these gaps, this study examined D4D practice among public health and clinical practitioners in the USA. Methods We conducted a cross-sectional study among public health and primary care practitioners in April to June 2022 (analyzed in July 2022 to December 2022). Both groups were recruited through national-level rosters. The survey was informed by previous D4D studies and pretested using cognitive interviewing. Results Among 577 respondents, 45% were public health and 55% primary care practitioners, with an overall survey response rate of 5.5%. The most commonly ranked sources of research evidence were email announcements for public health practitioners (43.7%) and reading academic journals for clinical practitioners (37.9%). Practitioners used research findings to promote health equity (67%) and evaluate programs/services (66%). A higher proportion of clinical compared to public health practitioners strongly agreed/agreed that within their work setting they had adequate financial resources (36% vs. 23%, p < 0.001) and adequate staffing (36% vs. 24%, p = 0.001) to implement research findings. Only 20% of all practitioners reported having a designated individual or team responsible for finding and disseminating research evidence. Conclusions Addressing both individual and modifiable barriers, including organizational capacity to access and use research evidence, may better align the efforts of researchers with priorities and resources of practitioners.
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Affiliation(s)
- Thembekile Shato
- Prevention Research Center, Brown School, Washington
University in St. Louis, St. Louis, MO,
USA
- Department of Surgery (Division of Public Health Sciences), Washington
University School of Medicine, Washington University in St.
Louis, St. Louis, MO, USA
| | - Maura M. Kepper
- Prevention Research Center, Brown School, Washington
University in St. Louis, St. Louis, MO,
USA
| | - Gabriella M. McLoughlin
- College of Public Health, Temple University,
Philadelphia, PA, USA
- Implementation Science Center for Cancer Control, Brown School and School
of Medicine, Washington University in St. Louis, St.
Louis, MO, USA
| | - Rachel G. Tabak
- Prevention Research Center, Brown School, Washington
University in St. Louis, St. Louis, MO,
USA
| | - Russell E. Glasgow
- Department of Family Medicine and ACCORDS Research Center,
University of Colorado Anschutz Medical Campus,
Aurora, CO, USA
| | - Ross C. Brownson
- Prevention Research Center, Brown School, Washington
University in St. Louis, St. Louis, MO,
USA
- Department of Surgery (Division of Public Health Sciences), Washington
University School of Medicine, Washington University in St.
Louis, St. Louis, MO, USA
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McCrabb S, Hall A, Milat A, Bauman A, Hodder R, Mooney K, Webb E, Barnes C, Yoong S, Sutherland R, Wolfenden L. Disseminating health research to public health policy-makers and practitioners: a survey of source, message content and delivery modality preferences. Health Res Policy Syst 2023; 21:121. [PMID: 38012773 PMCID: PMC10680334 DOI: 10.1186/s12961-023-01066-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 10/29/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Understanding the views of policy-makers and practitioners regarding how best to communicate research evidence is important to support research use in their decision-making. AIM To quantify and describe public health policy-makers and practitioners' views regarding the source, content and form of messages describing public health research findings to inform their decision-making. We also sought to examine differences in preferences between public health policy-makers and practitioners. METHODS A cross sectional, value-weighting survey of policy-makers and practitioners was conducted. Participants were asked to allocate a proportion of 100 points across different (i) sources of research evidence, (ii) message content and (iii) the form in which evidence is presented. Points were allocated based on their rating of influence, usefulness and preference when making decisions about health policy or practice. RESULTS A total of 186 survey responses were received from 90 policy-makers and 96 practitioners. Researchers and government department agencies were the most influential source of research evidence based on mean allocation of points, followed by knowledge brokers, professional peers and associations. Mean point allocation for perceived usefulness of message content was highest for simple summary of key findings and implications, and then evidence-based recommendations and data and statistical summaries. Finally, based on mean scores, policy-makers and practitioners preferred to receive research evidence in the form of peer-reviewed publications, reports, evidence briefs and plain language summaries. There were few differences in scores between policy-makers and practitioners across source, message content or form assessments or those with experience in different behavioural areas. CONCLUSIONS The findings should provide a basis for the future development and optimization of dissemination strategies to this important stakeholder group.
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Affiliation(s)
- Sam McCrabb
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia.
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia.
| | - Alix Hall
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
| | - Andrew Milat
- School of Public Health, University of Sydney, Sydney, NSW, Australia
- Centre for Epidemiology and Evidence, NSW Ministry of Health, Sydney, Australia
| | - Adrian Bauman
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Prevention Research Collaboration, Charles Perkins Centre, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- The Australian Prevention Partnership Centre, Sydney, NSW, Australia
| | - Rebecca Hodder
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
| | - Kaitlin Mooney
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Emily Webb
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Courtney Barnes
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
| | - Serene Yoong
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
- School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, 3122, Australia
- Global Nutrition and Preventive Health, Institute of Health Transformation, School of Health and Social Development, Deakin University, Burwood, Australia
| | - Rachel Sutherland
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, Newcastle, NSW, 2305, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
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Klepac B, Krahe M, Spaaij R, Craike M. Six Public Policy Recommendations to Increase the Translation and Utilization of Research Evidence in Public Health Practice. Public Health Rep 2023; 138:715-720. [PMID: 36239490 PMCID: PMC10467493 DOI: 10.1177/00333549221129355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Bojana Klepac
- Mitchell Institute for Education and Health Policy, Victoria University, Melbourne, Australia
| | | | - Ramon Spaaij
- Institute for Health and Sport, Victoria University, Melbourne, Australia
- School of Governance, Utrecht University, Utrecht, The Netherlands
| | - Melinda Craike
- Mitchell Institute for Education and Health Policy, Victoria University, Melbourne, Australia
- Institute for Health and Sport, Victoria University, Melbourne, Australia
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Turon H, Wolfenden L, Finch M, McCrabb S, Naughton S, O'Connor SR, Renda A, Webb E, Doherty E, Howse E, Harrison CL, Love P, Smith N, Sutherland R, Yoong SL. Dissemination of public health research to prevent non-communicable diseases: a scoping review. BMC Public Health 2023; 23:757. [PMID: 37095484 PMCID: PMC10123991 DOI: 10.1186/s12889-023-15622-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 04/06/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Dissemination is a critical element of the knowledge translation pathway, and a necessary step to ensure research evidence is adopted and implemented by key end users in order to improve health outcomes. However, evidence-based guidance to inform dissemination activities in research is limited. This scoping review aimed to identify and describe the scientific literature examining strategies to disseminate public health evidence related to the prevention of non-communicable diseases. METHODS Medline, PsycInfo and EBSCO Search Ultimate were searched in May 2021 for studies published between January 2000 and the search date that reported on the dissemination of evidence to end users of public health evidence, within the context of the prevention of non-communicable diseases. Studies were synthesised according to the four components of Brownson and colleagues' Model for Dissemination of Research (source, message, channel and audience), as well as by study design. RESULTS Of the 107 included studies, only 14% (n = 15) directly tested dissemination strategies using experimental designs. The remainder primarily reported on dissemination preferences of different populations, or outcomes such as awareness, knowledge and intentions to adopt following evidence dissemination. Evidence related to diet, physical activity and/or obesity prevention was the most disseminated topic. Researchers were the source of disseminated evidence in over half the studies, and study findings/knowledge summaries were more frequently disseminated as the message compared to guidelines or an evidence-based program/intervention. A broad range of dissemination channels were utilised, although peer-reviewed publications/conferences and presentations/workshops predominated. Practitioners were the most commonly reported target audience. CONCLUSIONS There is a significant gap in the peer reviewed literature, with few experimental studies published that analyse and evaluate the effect of different sources, messages and target audiences on the determinants of uptake of public health evidence for prevention. Such studies are important as they can help inform and improve the effectiveness of current and future dissemination practices in public health contexts.
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Affiliation(s)
- Heidi Turon
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia.
| | - Luke Wolfenden
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
| | - Meghan Finch
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
| | - Sam McCrabb
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Shaan Naughton
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, 3220, Australia
| | - Sean R O'Connor
- School of Psychology, Queen's University Belfast, Malone Road, Belfast, BT9 5BN, Northern Ireland
| | - Ana Renda
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Population Health, Sydney Local Health District, Camperdown, NSW, 2050, Australia
| | - Emily Webb
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
| | - Emma Doherty
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
| | - Eloise Howse
- The Australian Prevention Partnership Centre, Sax Institute, Glebe, NSW, 2037, Australia
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, 3168, Australia
| | - Penelope Love
- Faculty of Health, School of Exercise and Nutrition Sciences (SENS), Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, VIC, Australia
| | - Natasha Smith
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia
| | - Rachel Sutherland
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
| | - Sze Lin Yoong
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, 3220, Australia
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Becerril-Montekio V, García-Bello LA, Torres-Pereda P, Alcalde-Rabanal J, Reveiz L, Langlois EV. Collaboration between health system decision makers and professional researchers to coproduce knowledge, a scoping review. Int J Health Plann Manage 2022; 37 Suppl 1:45-58. [PMID: 35643849 DOI: 10.1002/hpm.3513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 05/10/2022] [Accepted: 05/17/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Recent literature uses different terms and approaches to the collaboration between researchers and health system decision-makers in the research process. In 2012, the World Health Organisation proposed to "Embed research within decision-making processes". Yet, important contributions use other terms and perspectives for the same issue. This scoping review aimed to identify these terms, approaches, their application and eventual influence on the utilization of evidence. METHODS We searched papers published between January 2000 and February 2019 in English, Spanish, French and Portuguese in the databases of PubMed, Scielo, Google Scholar and EBSCOhost, thus accessing MedicLatina, MEDLINE Complete and eBook Collection. Our main inclusion criterion was the participation of health personnel in non-clinical research activities. We considered three domains for in depth analysis: Definition, name and description of the participation of decision makers and health staff; Forms of collaboration and actual/effective participation of health staff in research; Eventual influence on the utilization of research results. RESULTS We identified 607 articles and selected 74 for full text analysis. Nineteen different terms are currently used in twelve countries to describe the participation of health decision-makers and staff in research activities. Most publications refer to Integrated Knowledge Translation or Embedded Research, and were published in Canada and the United Kingdom. Forty-five papers discuss the participation of health staff in research activities; 20 leading the whole process and 21 as collaborators. CONCLUSIONS The identification of the different terms and approaches to the close collaboration of health staff and decision-makers with professional researchers is essential to promote its effective application and influence on the utilization of evidence. Yet, it is also necessary to insist in their co-participation throughout the whole investigation process as a relevant way to improve research results uptake, strengthen health systems and advance towards universal health coverage.
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Affiliation(s)
| | | | | | | | - Ludovic Reveiz
- Department of Evidence and Intelligence for Action in Health, Pan American Health Organization, Washington, Columbia, USA
| | - Etienne V Langlois
- Partnership for Maternal, Newborn & Child Health (PMNCH), World Health Organization (WHO), Geneva, Switzerland
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Tobin R, Crawford G, Hallett J, Maycock B, Lobo R. Utilizing Causal Loop Diagramming to Explore a Research and Evaluation Capacity Building Partnership. Front Public Health 2022; 10:857918. [PMID: 35712267 PMCID: PMC9194391 DOI: 10.3389/fpubh.2022.857918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/12/2022] [Indexed: 11/13/2022] Open
Abstract
The capacity to engage in research, evaluation and evidence-informed decision-making supports effective public health policy and practice. Little is known about partnership-based approaches that aim to build capacity across a system or how to evaluate them. This study examines the impacts of a research and evaluation capacity building partnership called the Western Australian Sexual Health and Blood-borne Virus Applied Research and Evaluation Network (hereafter, SiREN). SiREN aims to strengthen capacity across a system of clinical and medical services and government and non-government organizations. These organizations are connected through their shared aim of preventing and managing sexually transmissible infections and blood-borne viruses. To examine SiREN, systems concepts and methods were used. Data were collected from SiREN organizational documents (n = 42), a survey tool (n = 104), in-depth interviews (n = 17), a workshop and three meetings with SiREN stakeholders and used to develop two causal loop diagrams. Findings show engagement with SiREN was influenced by a complex interplay of contextual (e.g., organizational capacity) and process (e.g., presence of trusting relationships) factors. SiREN contributed to system level changes, including increased resources for research and evaluation, the development of networks and partnerships that led to more efficient responses to emerging health issues, evidence sharing, and sustainable research and evaluation practice. The use of causal loop diagrams enabled the identification of key leverage points that SiREN can use for continuous improvement or evaluation. The focus on how contextual factors influenced SiREN's ability to create change provides valuable information for researchers, policymakers or practitioners seeking to develop a similar partnership.
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Affiliation(s)
- Rochelle Tobin
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA, Australia
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA, Australia
| | - Jonathan Hallett
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA, Australia
| | - Bruce Maycock
- European Centre for Environment and Human Health, College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Roanna Lobo
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA, Australia
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Guleid FH, Njeru A, Kiptim J, Kamuya DM, Okiro E, Tsofa B, English M, Molyneux S, Kariuki D, Barasa E. Experience of Kenyan researchers and policy-makers with knowledge translation during COVID-19: a qualitative interview study. BMJ Open 2022; 12:e059501. [PMID: 35649617 PMCID: PMC9160583 DOI: 10.1136/bmjopen-2021-059501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 05/17/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Researchers at the KEMRI-Wellcome Trust Research Programme (KWTRP) carried out knowledge translation (KT) activities to support policy-makers as the Kenyan Government responded to the COVID-19 pandemic. We assessed the usefulness of these activities to identify the facilitators and barriers to KT and suggest actions that facilitate KT in similar settings. DESIGN The study adopted a qualitative interview study design. SETTING AND PARTICIPANTS Researchers at KWTRP in Kenya who were involved in KT activities during the COVID-19 pandemic (n=6) were selected to participate in key informant interviews to describe their experience. In addition, the policy-makers with whom these researchers engaged were invited to participate (n=11). Data were collected from March 2021 to August 2021. ANALYSIS A thematic analysis approach was adopted using a predetermined framework to develop a coding structure consisting of the core thematic areas. Any other theme that emerged in the coding process was included. RESULTS Both groups reported that the KT activities increased evidence availability and accessibility, enhanced policy-makers' motivation to use evidence, improved capacity to use research evidence and strengthened relationships. Policy-makers shared that a key facilitator of this was the knowledge products shared and the regular interaction with researchers. Both groups mentioned that a key barrier was the timeliness of generating evidence, which was exacerbated by the pandemic. They felt it was important to institutionalise KT to improve readiness to respond to public health emergencies. CONCLUSION This study provides a real-world example of the use of KT during a public health crisis. It further highlights the need to institutionalise KT in research and policy institutions in African countries to respond readily to public health emergencies.
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Affiliation(s)
- Fatuma Hassan Guleid
- Policy Engagement & Knowledge Translation Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - Alex Njeru
- Policy Engagement & Knowledge Translation Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - Joy Kiptim
- Policy Engagement & Knowledge Translation Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - Dorcas Mwikali Kamuya
- Health Systems and Research Ethics, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
| | - Emelda Okiro
- Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
- Population Health, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - Benjamin Tsofa
- Health Policy and Systems Research, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Mike English
- Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
- Health Services Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - Sassy Molyneux
- Health Systems and Research Ethics, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
| | - David Kariuki
- Department of Health Policy and Research, Ministry of Health, Nairobi, Kenya
| | - Edwine Barasa
- Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
- Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
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Shafaghat T, Bastani P, Nasab MHI, Bahrami MA, Montazer MRA, Zarchi MKR, Edirippulige S. A framework of evidence-based decision-making in health system management: a best-fit framework synthesis. Arch Public Health 2022; 80:96. [PMID: 35351210 PMCID: PMC8961960 DOI: 10.1186/s13690-022-00843-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 03/08/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Scientific evidence is the basis for improving public health; decision-making without sufficient attention to evidence may lead to unpleasant consequences. Despite efforts to create comprehensive guidelines and models for evidence-based decision-making (EBDM), there isn`t any to make the best decisions concerning scarce resources and unlimited needs. The present study aimed to develop a comprehensive applied framework for EBDM. METHODS This was a Best-Fit Framework (BFF) synthesis conducted in 2020. A comprehensive systematic review was done via six main databases including PUBMED, Scopus, Web of Science, Science Direct, EMBASE, and ProQuest using related keywords. After the evidence quality appraisal, data were extracted and analyzed via thematic analysis. Results of the thematic analysis and the concepts generated by the research team were then synthesized to achieve the best-fit framework applying Carroll et al. (2013) approach. RESULTS Four thousand six hundred thirteen studies were retrieved, and due to the full-text screening of the studies, 17 final articles were selected for extracting the components and steps of EBDM in Health System Management (HSM). After collecting, synthesizing, and categorizing key information, the framework of EBDM in HSM was developed in the form of four general scopes. These comprised inquiring, inspecting, implementing, and integrating, which included 10 main steps and 47 sub-steps. CONCLUSIONS The present framework provided a comprehensive guideline that can be well adapted for implementing EBDM in health systems and related organizations especially in underdeveloped and developing countries where there is usually a lag in updating and applying evidence in their decision-making process. In addition, this framework by providing a complete, well-detailed, and the sequential process can be tested in the organizational decision-making process by developed countries to improve their EBDM cycle.
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Affiliation(s)
- Tahereh Shafaghat
- School of Management and Medical Informatics, Health Human Recourses Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Health Care Management, School of Public Health, Health Policy and Management Research Center, Shahid Saoughi University of Medical Sciences, Yazd, Iran
| | - Peivand Bastani
- School of Management and Medical Informatics, Health Human Recourses Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
- Faculty of Health and Behavioral Sciences, School of Dentistry, University of Queensland, QLD, 4072, Brisbane, Australia.
| | - Mohammad Hasan Imani Nasab
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mohammad Amin Bahrami
- School of Management and Medical Informatics, Health Human Recourses Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahsa Roozrokh Arshadi Montazer
- Student Research Committee, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Kazem Rahimi Zarchi
- Department of Health Care Management, School of Public Health, Health Policy and Management Research Center, Shahid Saoughi University of Medical Sciences, Yazd, Iran
| | - Sisira Edirippulige
- Faculty of Medicine, Center for Health Services Research, The University of Queensland, Brisbane, Australia
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Thissen M, Seeling S, Achterberg P, Fehr A, Palmieri L, Tijhuis MJ, Unim B, Ziese T. Overview of national health reporting in the EU and quality criteria for public health reports - results of the Joint Action InfAct. Arch Public Health 2021; 79:229. [PMID: 34933687 PMCID: PMC8692080 DOI: 10.1186/s13690-021-00753-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/07/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Health reporting shall provide up-to-date health-related data to inform policy-makers, researchers and the public. To this end, health reporting formats should be tailored to the needs and competencies of the target groups and provide comparable and high-quality information. Within the Joint Action on Health Information 'InfAct', we aimed at gaining an overview of health reporting practices in the EU Member States and associated countries, and developed quality criteria for the preparation of public health reports. The results are intended to facilitate making health information adequately available while reducing inequalities in health reporting across the EU. METHODS A web-based desk research was conducted among EU Member States and associated countries to generate an overview of different formats of national health reporting and their respective target groups. To identify possible quality criteria for public health reports, an exploratory literature review was performed and earlier projects were analysed. The final set of criteria was developed in exchange with experts from the InfAct consortium. RESULTS The web-based desk research showed that public health reports are the most frequently used format across countries (94%), most often addressed to scientists and researchers (51%), politicians and decision-makers (41%). However, across all reporting formats, the general public is the most frequently addressed target group. With regards to quality criteria for public health reports, the literature review has yielded few results. Therefore, two earlier projects served as main sources: the 'Evaluation of National and Regional Public Health Reports' and the guideline 'Good Practice in Health Reporting'from Germany. In collaboration with experts, quality criteria were identified and grouped into eight categories, ranging from topic selection to presentation of results, and compiled in a checklist for easy reference. CONCLUSION Health reporting practices in the EU are heterogeneous across Member States. The assembled quality criteria are intended to facilitate the preparation, dissemination and access to better comparable high-quality public health reports as a basis for evidence-based decision-making. A comprehensive conceptual and integrative approach that incorporates the policy perspective would be useful to investigate which dissemination strategies are the most suitable for specific requirements of the targeted groups.
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Affiliation(s)
- Martin Thissen
- Unit 24 - Health Reporting, Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101, Berlin, Germany.
| | - Stefanie Seeling
- Unit 24 - Health Reporting, Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101, Berlin, Germany
| | - Peter Achterberg
- Centre for Health Knowledge Integration, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Angela Fehr
- Unit 24 - Health Reporting, Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101, Berlin, Germany
- ZIG 1 - Information Centre for International Health Protection (INIG), Centre for International Health Protection (ZIG), Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
| | - Mariken J Tijhuis
- Centre for Health Knowledge Integration, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Brigid Unim
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
| | - Thomas Ziese
- Unit 24 - Health Reporting, Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101, Berlin, Germany
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Dhaliwal B, Neil-Sztramko SE, Boston-Fisher N, Buckeridge DL, Dobbins M. Assessing the Electronic Evidence System Needs of Canadian Public Health Professionals: Cross-sectional Study. JMIR Public Health Surveill 2021; 7:e26503. [PMID: 34491205 PMCID: PMC8456326 DOI: 10.2196/26503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/26/2021] [Accepted: 06/02/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND True evidence-informed decision-making in public health relies on incorporating evidence from a number of sources in addition to traditional scientific evidence. Lack of access to these types of data as well as ease of use and interpretability of scientific evidence contribute to limited uptake of evidence-informed decision-making in practice. An electronic evidence system that includes multiple sources of evidence and potentially novel computational processing approaches or artificial intelligence holds promise as a solution to overcoming barriers to evidence-informed decision-making in public health. OBJECTIVE This study aims to understand the needs and preferences for an electronic evidence system among public health professionals in Canada. METHODS An invitation to participate in an anonymous web-based survey was distributed via listservs of 2 Canadian public health organizations in February 2019. Eligible participants were English- or French-speaking individuals currently working in public health. The survey contained both multiple-choice and open-ended questions about the needs and preferences relevant to an electronic evidence system. Quantitative responses were analyzed to explore differences by public health role. Inductive and deductive analysis methods were used to code and interpret the qualitative data. Ethics review was not required by the host institution. RESULTS Respondents (N=371) were heterogeneous, spanning organizations, positions, and areas of practice within public health. Nearly all (364/371, 98.1%) respondents indicated that an electronic evidence system would support their work. Respondents had high preferences for local contextual data, research and intervention evidence, and information about human and financial resources. Qualitative analyses identified several concerns, needs, and suggestions for the development of such a system. Concerns ranged from the personal use of such a system to the ability of their organization to use such a system. Recognized needs spanned the different sources of evidence, including local context, research and intervention evidence, and resources and tools. Additional suggestions were identified to improve system usability. CONCLUSIONS Canadian public health professionals have positive perceptions toward an electronic evidence system that would bring together evidence from the local context, scientific research, and resources. Elements were also identified to increase the usability of an electronic evidence system.
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Affiliation(s)
- Bandna Dhaliwal
- National Collaborating Centre for Methods and Tools, McMaster University, Hamilton, ON, Canada
| | - Sarah E Neil-Sztramko
- National Collaborating Centre for Methods and Tools, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | | | - David L Buckeridge
- School of Population and Global Health, McGill University, Montreal, QC, Canada
| | - Maureen Dobbins
- National Collaborating Centre for Methods and Tools, McMaster University, Hamilton, ON, Canada
- School of Nursing, McMaster University, Hamilton, ON, Canada
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Levy M, Cohen DA, Arnon S, Levkovich I. The decision-making and learning roles of a professional social network: The case of a family physicians' network. Int J Med Inform 2021; 153:104515. [PMID: 34139620 DOI: 10.1016/j.ijmedinf.2021.104515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 11/07/2020] [Accepted: 06/02/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This research was aimed at studying the evolution and roles of the Israeli physicians' professional social network as perceived by the members of the network. METHODOLOGY The research examined a case study of RAMBAM/KEHILA professional networks, applying both qualitative and quantitative methods for establishing a grounded theory. FINDINGS Physicians want to be part of their professional community and consider the network as a place where the "wisdom of the crowd" exists. They seek approval for their initial line of reasoning regarding their clinical cases but will consider other approaches if such are suggested by persons of professional repute or if answers are based on evidence-based medicine. The evolved network constitutes an a-political space which has gained the trust of the community and enables physicians of various ranks to share experiences and thoughts. Moreover, the network fosters learning opportunities and the network dynamics have impact on physicians' professional development. DISCUSSION This unique ten-year longitudinal research examined the evolution of a professional social network. The research findings have practical and social implications. Practically, the study shows the values of professional network as an instrument for clinicians' lifelong learning and professional development. Socially, the study presents the professional network social role in facilitating social interactions when the network participants are involved in determining its roles and gain trust by avoiding any political or commercial interference.
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Affiliation(s)
- Meira Levy
- School of Industrial Engineering and Management, Shenkar College of Engineering and Design, Ramat-Gan, Israel.
| | - Dikla Agur Cohen
- The Bruce Rappaport Faculty of Medicine, The Technion, Institute of Technology, Haifa, Israel
| | - Shahar Arnon
- School of Industrial Engineering and Management, Shenkar College of Engineering and Design, Ramat-Gan, Israel
| | - Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College of Education, Tivon, Israel
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15
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Shafaghat T, Imani Nasab MH, Bahrami MA, Kavosi Z, Roozrokh Arshadi Montazer M, Rahimi Zarchi MK, Bastani P. A mapping of facilitators and barriers to evidence-based management in health systems: a scoping review study. Syst Rev 2021; 10:42. [PMID: 33516269 PMCID: PMC7847165 DOI: 10.1186/s13643-021-01595-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 01/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Healthcare settings are complex, and the decision-making process is usually complicated, too. Precise use of best evidence from different sources for increasing the desired outcomes is the result of EBM. Therefore, this study aimed to map the potential facilitators and barriers to EBM in health systems to help the healthcare managers to better implement EBM in their organizations. METHODS The present study was a scoping review (SR) conducted in 2020 based on the integration of the frameworks presented by Arksey and O'Malley (2005) and Levac et al. (2010) considering the Joanna Briggs Institute guideline (2015). These frameworks consist of 6 steps. After finalizing the search strategy, 7 databases were searched, and the PRISMA-ScR was used to manage the retrieval and inclusion of the evidence. Microsoft Excel 2013 was used to extract the data, and the graphic description was presented. The summative analysis approach was used applying MAXQDA10. RESULTS According to the systematic search, 4815 studies were retrieved after eliminating duplicates and unrelated articles, 49 articles remained to extract EBM facilitators and barriers. Six main aspects attitude toward EBM, external factors, contextual factors, resources, policies and procedures, and research capacity and data availability were summarized as EBM facilitators. The barriers to EBM were similarly summarized as attitude toward EBM, external factors, contextual factors, policies and procedures, limited resources, and research capacity and data availability. The streamgraphs describe that the international attention to the sub-aspects of facilitators and barriers of EBM has been increased since 2011. CONCLUSIONS The importance of decision-making regarding complex health systems, especially in terms of resource constraints and uncertainty conditions, requires EBM in the health system as much as possible. Identifying the factors that facilitate the use of evidence, as well as its barriers to management and decision-making in the organization, can play an important role in making systematic and reliable decisions that can be defended by the officials and ultimately lead to greater savings in organization resources and prevent them from being wasted.
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Affiliation(s)
- Tahereh Shafaghat
- Student Research Committee, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hasan Imani Nasab
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mohammad Amin Bahrami
- Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Kavosi
- Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahsa Roozrokh Arshadi Montazer
- Student Research Committee, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Kazem Rahimi Zarchi
- Health Policy and Management Research Center, Department of Health Care Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Peivand Bastani
- Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran.
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Skalitzky E, Joyner H, Weymouth L. Local Data for Action: Statewide Dissemination of School Wellness Policy Evaluations in Wisconsin. Health Promot Pract 2020; 23:118-127. [PMID: 33225753 DOI: 10.1177/1524839920973650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
School settings can influence child health, including physical activity and diet, through the promotion of high-quality wellness policies. Many studies have analyzed the quality of school wellness policies, but evidence is lacking regarding the dissemination of the policy evaluation results to school districts. This study describes the process the Wisconsin Health Atlas followed to disseminate tailored school wellness policy data reports and interactive dashboards to school districts throughout the state and the results of the statewide dissemination efforts. Prioritizing the translation of research to practice, the process included collaborating with key stakeholders and partners to provide formative feedback on the dissemination activities. The electronic and hard copy reports were disseminated to 232 districts through email and U.S. mail. Each district received a tailored report featuring an executive summary, local data for action, personalized policy recommendations, best practices, and a unique code to enter into interactive data dashboards to explore additional local, regional, and state-level data. In the utilization follow-up survey (20.3% response rate), respondents indicated that the report will help their district to improve the quality of their school wellness policy. Additionally, respondents who had used the report specified they used the data to identify areas for policy improvement and to support their triennial assessment, suggesting that districts value the technical support. To support school districts in improving the quality of school wellness policies, we recommend researchers prioritize collaborative dissemination efforts and provide actionable policy data when conducting school wellness policy evaluations.
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Keay S, Sargeant JM, O'Connor A, Friendship R, O'Sullivan T, Poljak Z. Veterinarian barriers to knowledge translation (KT) within the context of swine infectious disease research: an international survey of swine veterinarians. BMC Vet Res 2020; 16:416. [PMID: 33138811 PMCID: PMC7607664 DOI: 10.1186/s12917-020-02617-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 10/09/2020] [Indexed: 11/12/2022] Open
Abstract
Background Food animal veterinarians face commodity specific and urgent global challenges yet conditions preventing use of best available knowledge have been sparsely studied. The American Association of Swine Veterinarians (AASV) membership (N = 1289) was surveyed online to benchmark their information priorities and their motivations and sources for keeping current with infectious disease research, and to describe their reported time, skill, access, and process as barriers to knowledge translation (KT). Results Respondents (n = 80) were mostly from Canada (n = 40) and the U.S.A (n = 31) and demographics approximated the AASV’s. Colleagues are the first choice for information on difficult cases (49%, 95%CI: 38–61). Half of respondents (53%, 95%CI: 41–64) spend an hour or less per week keeping up with infectious disease research. The majority reported moderate or less than moderate efficiency (62%, 95%CI: 51–72), and moderate or greater stress (59%, 95%CI: 48–70) with their process for keeping up. Journal article methods sections are commonly not read, almost a third (32%, 95% CI: 22–43) reported either they do not evaluate statistical methods or that they had poor confidence to do so, and half (52, 95%CI: 41–63) could not explain ‘confounding bias’. Approximately half (55%, 95%CI: 41-69) with direct oversight of swine herds had full access to 2 or fewer academic journals. Approximately a third of respondents (34%, 95%CI: 24–46) selected only formats involving single research studies (either full text or summaries) as preferred reading materials for keeping current over expert summaries of the body of evidence. Conclusion KT barriers are considerable and a source of stress for many swine veterinarians. Sub-optimal efficiency with keeping up and low confidence to appraise aspects of research are concerns. Results are consistent with previous literature and illustrate need for improved KT infrastructure and for additional training in statistical methods and interpretation of primary research. Further evaluation is warranted of why approximately a third of veterinarians in this study, for the purpose of keeping up, preferentially choose to review individual research studies over choices that would include an expert summary of the body of evidence. Consideration of reasons for this preference will be important in the planning of KT infrastructure improvements. Supplementary information Supplementary information accompanies this paper at 10.1186/s12917-020-02617-8.
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Affiliation(s)
- Sheila Keay
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Canada.
| | - Jan M Sargeant
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Canada.,Centre for Public Health and Zoonoses, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | - Annette O'Connor
- Department of Large Animal Clincal Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Robert Friendship
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | - Terri O'Sullivan
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | - Zvonimir Poljak
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Canada
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Garritty C, Hersi M, Hamel C, Stevens A, Monfaredi Z, Butler C, Tricco AC, Hartling L, Stewart LA, Welch V, Thavorn K, Cheng W, Moher D. Assessing the format and content of journal published and non-journal published rapid review reports: A comparative study. PLoS One 2020; 15:e0238025. [PMID: 32845906 PMCID: PMC7449464 DOI: 10.1371/journal.pone.0238025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 08/08/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND As production of rapid reviews (RRs) increases in healthcare, knowing how to efficiently convey RR evidence to various end-users is important given they are often intended to directly inform decision-making. Little is known about how often RRs are produced in the published or unpublished domains, and what and how information is structured. OBJECTIVES To compare and contrast report format and content features of journal-published (JP) and non-journal published (NJP) RRs. METHODS JP RRs were identified from key databases, and NJP RRs were identified from a grey literature search of 148 RR producing organizations and were sampled proportionate to cluster size by organization and product type to match the JP RR group. We extracted and formally compared 'how' (i.e., visual arrangement) and 'what' information was presented. RESULTS We identified 103 RRs (52 JP and 51 NJP) from 2016. A higher percentage of certain features were observed in JP RRs compared to NJP RRs (e.g., reporting authors; use of a traditional journal article structure; section headers including abstract, methods, discussion, conclusions, acknowledgments, conflict of interests, and author contributions; and use of figures (e.g., Study Flow Diagram) in the main document). For NJP RRs, a higher percentage of features were observed (e.g., use non-traditional report structures; bannering of executive summary sections and appendices; use of typographic cues; and including outcome tables). NJP RRs were more than double in length versus JP RRs. Including key messages was uncommon in both groups. CONCLUSIONS This comparative study highlights differences between JP and NJP RRs. Both groups may benefit from better use of plain language, and more clear and concise design. Alternative innovative formats and end-user preferences for content and layout should be studied further with thought given to other considerations to ensure better packaging of RR results to facilitate uptake into policy and practice. STUDY REGISTRATION The full protocol is available at: https://osf.io/29xvk/.
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Affiliation(s)
- Chantelle Garritty
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- TRIBE Graduate Program, University of Split School of Medicine, Split, Croatia
| | - Mona Hersi
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Candyce Hamel
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- TRIBE Graduate Program, University of Split School of Medicine, Split, Croatia
| | - Adrienne Stevens
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Zarah Monfaredi
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Claire Butler
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Andrea C. Tricco
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Lesley A. Stewart
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
| | - Vivian Welch
- Methods Centre, Bruyère Research Institute, Ottawa, Canada
| | - Kednapa Thavorn
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Wei Cheng
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - David Moher
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
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Jessani NS, Hendricks L, Nicol L, Young T. University Curricula in Evidence-Informed Decision Making and Knowledge Translation: Integrating Best Practice, Innovation, and Experience for Effective Teaching and Learning. Front Public Health 2019; 7:313. [PMID: 31850294 PMCID: PMC6901672 DOI: 10.3389/fpubh.2019.00313] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/14/2019] [Indexed: 11/30/2022] Open
Abstract
As attention to Evidence Informed Decision Making (EIDM) and Knowledge Translation (KT) in research, policy and practice grows, so does a need for capacity enhancement in amongst evidence producers and evidence users. Recognizing that most researchers enter the professional sphere with little or no appreciation of the importance and power of EIDM, the Centre for Evidence-based Health Care at Stellenbosch University, South Africa, spearheaded the development and accreditation of a foundational course titled Evidence-Informed Decision making: The Art, Science and Complexity of knowledge translation. The curriculum draws on the principles of adult learning and effective teaching that includes integrating seven key aspects: (1) extraction of intuitive and tacit knowledge (2) autonomous knowledge generation (3) diverse perspectives (4) learning by doing (5) peer-support and critique (6) facilitator coaching and (7) constant reflection. In this paper, we reflect on these techniques in enhancing understanding and utilization of KT in advancing EIDM. The in-person short course has been offered 5 times since its launch in September 2017 with attendance by ~85 senior researchers and government officials-each of whom left the workshop with three completed outputs: a stakeholder matrix, an engagement strategy for their chosen stakeholder and a plan for evaluating the impact of their KT strategy. Interest in the course has grown considerably: (a) Requests from local institutes of research for dedicated training to their staff; (b) Incorporation into international program partner capacity enhancing strategies; (c) Publication of a book chapter designed using course content; (d) Adaptation and utilization of the templates and tools as teaching resources (e) Informing organizational stakeholder engagement strategies (f) Adaptation of the modules for conference capacity building workshops. In summary, designing courses that take into consideration adult principles of learning is not a new concept. However, effective delivery of such courses is still nascent. We found that integrating the seven aspects mentioned above, including researchers together with decision-makers in the workshops, and having an experienced facilitator is critical for effective learning. Enhancing knowledge and skills "just in time" rather than "just in case" has demonstrated increased potential for immediate relevance, uptake and sustainability.
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Affiliation(s)
- Nasreen S. Jessani
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Centre for Evidence-Based Health Care, Stellenbosch University, Cape Town, South Africa
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Lynn Hendricks
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Centre for Evidence-Based Health Care, Stellenbosch University, Cape Town, South Africa
- Qualitative Inquiry Group, Faculty of Social Sciences, KU Leuven, Centre for Sociological Research, Leuven, Belgium
| | - Liesl Nicol
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Centre for Evidence-Based Health Care, Stellenbosch University, Cape Town, South Africa
| | - Taryn Young
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Centre for Evidence-Based Health Care, Stellenbosch University, Cape Town, South Africa
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Figure Interpretation Assessment Tool-Health (FIAT-health) 2.0: from a scoring instrument to a critical appraisal tool. BMC Med Res Methodol 2019; 19:160. [PMID: 31337354 PMCID: PMC6647325 DOI: 10.1186/s12874-019-0797-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 07/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Statistics are frequently used in health advocacy to attract attention, but are often misinterpreted. The Figure Interpretation Assessment Tool-Health (FIAT-Health) 1.0 was developed to support systematic assessment of the interpretation of figures on health and health care. This study aimed to test and evaluate the FIAT-Health 1.0 amongst its intended user groups, and further refine the tool based on our results. METHODS Potential users (N = 32) were asked to assess one publicly reported figure using the FIAT-Health 1.0, and to justify their assessments and share their experience in using the FIAT-Health. In total four figures were assessed. For each figure, an expert on the specific topic (N = 4) provided a comparative assessment. The consistency of the answers was calculated, and answers to the evaluation questions were qualitatively analysed. A qualitative comparative analysis of the justifications for assessment by the experts and potential users was made. Based on the results, a new version of the FIAT-Health was developed and tested by employees (N = 27) of the National Institute for Public Health and the Environment (RIVM), and approved by the project's advisory group. In total sixty-three participants contributed. RESULTS Potential users using the FIAT-Health 1.0 and experts gave similar justifications for their assessments. The justifications provided by experts aligned with the items of the FIAT-Health. Seventeen out of twenty-six dichotomous questions were consistently answered by the potential users. Numerical assessment questions showed inconsistencies in how potential users responded. In the evaluation, potential users most frequently mentioned that thanks to its structured approach, the FIAT-Health contributed to their awareness of the main characteristics of the figure (n = 14), but they did find the tool complex (n = 11). The FIAT-Health 1.0 was revised from a scoring instrument into a critical appraisal tool: the FIAT-Health 2.0, which was tested and approved by employees of the RIVM and the advisory group. CONCLUSION The tool was refined according to the results of the test and evaluation, transforming the FIAT-Health from a quantitative scoring instrument into an online qualitative appraisal tool that has the potential to aid the better interpretation and public reporting of statistics on health and healthcare.
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Laycock AF, Bailie J, Percival NA, Matthews V, Cunningham FC, Harvey G, Copley K, Patel L, Bailie R. Wide-Scale Continuous Quality Improvement: A Study of Stakeholders' Use of Quality of Care Reports at Various System Levels, and Factors Mediating Use. Front Public Health 2019; 6:378. [PMID: 30687690 PMCID: PMC6338065 DOI: 10.3389/fpubh.2018.00378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 12/19/2018] [Indexed: 01/25/2023] Open
Abstract
Introduction: Increasing the use of evidence in healthcare policy and practice requires greater understanding of how stakeholders use evidence to inform policy, refine systems and change practice. Drawing on implementation theory, we have used system-focused participatory research to engage diverse stakeholders in using aggregated continuous quality improvement (CQI) data from Australian Indigenous primary health care settings to identify priority evidence-practice gaps, barriers/enablers and strategies for improvement. This article reports stakeholders' use or intended use of evidence at various levels of the system, and factors mediating use. Material and Methods: Interviews were undertaken with a purposeful sample of 30 healthcare stakeholders in different roles, organization types and settings in one Australian jurisdiction and with national participants, as part of the project's developmental evaluation. Qualitative data were analyzed to identify themes and categories relating to use of evidence. Results: Context-specific aggregated CQI data that were relatable to the diverse professional roles and practices provided an effective starting point for sharing perspectives, generating practice-based evidence and mobilizing evidence-use. Interviewees perceived the co-produced findings as applicable at different levels and useful for planning, policy development, supporting best practice and reflection, capacity strengthening and developing new research. Factors mediating use were commitment to best practice; the credibility of the evidence and its perceived relevance to work roles, contexts and decision needs; report format and language; facilitation and communication; competing work pressures and the organizational environment for change. Conclusions: This study found that primary health care stakeholders used evidence on quality of care for a variety of purposes. This could be linked to the interactive research processes used to engage stakeholders in different roles and settings in interpreting data, sharing and generating knowledge. Findings indicate that system-based participatory research using CQI data and iterative, interactive and systematic CQI-based methods can be applied at scale to support concurrent action for healthcare improvement at different system levels. Factors known to influence implementation should be addressed within the research design to optimize evidence use. Further research is needed to explore the utility of interactive dissemination for engaging healthcare stakeholders in informing policy and system change.
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Affiliation(s)
- Alison F Laycock
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Sydney, NSW, Australia
| | - Nikki A Percival
- The Australian Centre for Public and Population Health Research, University of Technology Sydney, Sydney, NSW, Australia
| | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, Sydney, NSW, Australia
| | - Frances C Cunningham
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Gillian Harvey
- Adelaide Nursing School, The University of Adelaide, Adelaide, SA, Australia
| | - Kerry Copley
- Aboriginal Medical Services Alliance Northern Territory, Darwin, NT, Australia
| | - Louise Patel
- Aboriginal Medical Services Alliance Northern Territory, Darwin, NT, Australia
| | - Ross Bailie
- University Centre for Rural Health, The University of Sydney, Sydney, NSW, Australia
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Greaves NS, Tull J, Hassell T, Samuels TA. Communication strategy to disseminate the results of the evaluation of the Port-of-Spain Declaration (POSDEVAL) across multiple audiences in the Caribbean. Rev Panam Salud Publica 2018; 42:e186. [PMID: 31093214 PMCID: PMC6385851 DOI: 10.26633/rpsp.2018.186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 08/22/2018] [Indexed: 11/24/2022] Open
Abstract
Like many nations in the Americas, the countries of the Caribbean are facing increasing morbidity and mortality associated with noncommunicable diseases (NCDs). In 2007, based on advocacy by Sir George Alleyne and others, the Caribbean Community (CARICOM) convened the first in the world Heads of Government NCDs Summit. This summit issued the Port of Spain Declaration that served not only as a rallying point to accelerate the regional NCDs response, but also as a catalyst for the first United Nations high-level meeting on NCDs in September 2011. In 2014, seven years after the CARICOM NCDs Summit, a formal evaluation of the Port of Spain Declaration (POSDEVAL) was conducted to investigate its impact and learn lessons to support and further accelerate its implementation. One mechanism was to review successes and challenges in the NCDs response and effectively communicate findings to stakeholders and the public. The results of the evaluation and the implementation of the Port of Spain Declaration are presented by other papers in this supplement. The present paper describes the communication and social information process used for sharing POSDEVAL findings across multiple layers of social influence in the Caribbean, primarily in 2016 – 2017. The main steps of the communication process are shared as a possible strategy for disseminating NCDs research information and accelerating control and policy adoption in other Small Island Developing States and middle-income countries.
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Affiliation(s)
- Natalie S Greaves
- Faculty of Medical Sciences, the University of the West Indies, Bridgetown, Barbados
| | - Joan Tull
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, the University of the West Indies, Bridgetown, Barbados
| | | | - T Alafia Samuels
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, the University of the West Indies, Bridgetown, Barbados
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Benedetti A, Wu Y, Levis B, Wilchesky M, Boruff J, Ioannidis JPA, Patten SB, Cuijpers P, Shrier I, Gilbody S, Ismail Z, McMillan D, Mitchell N, Ziegelstein RC, Thombs BD. Diagnostic accuracy of the Geriatric Depression Scale-30, Geriatric Depression Scale-15, Geriatric Depression Scale-5 and Geriatric Depression Scale-4 for detecting major depression: protocol for a systematic review and individual participant data meta-analysis. BMJ Open 2018; 8:e026598. [PMID: 30518594 PMCID: PMC6286470 DOI: 10.1136/bmjopen-2018-026598] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION The 30-item Geriatric Depression Scale (GDS-30) and the shorter GDS-15, GDS-5 and GDS-4 are recommended as depression screening tools for elderly individuals. Existing meta-analyses on the diagnostic accuracy of the GDS have not been able to conduct subgroup analyses, have included patients already identified as depressed who would not be screened in practice and have not accounted for possible bias due to selective reporting of results from only better-performing cut-offs in primary studies. Individual participant data meta-analysis (IPDMA), which involves a standard systematic review, then a synthesis of individual participant data, rather than summary results, could address these limitations. The objective of our IPDMA is to generate accuracy estimates to detect major depression for all possible cut-offs of each version of the GDS among studies using different reference standards, separately and among participant subgroups based on age, sex, dementia diagnosis and care settings. In addition, we will use a modelling approach to generate individual participant probabilities for major depression based on GDS scores (rather than a dichotomous cut-off) and participant characteristics (eg, sex, age, dementia status, care setting). METHODS AND ANALYSIS Individual participant data comparing GDS scores to a major depression diagnosis based on a validated structured or semistructured diagnostic interview will be sought via a systematic review. Data sources will include Medline, Medline In-Process & Other Non-Indexed Citations, PsycINFO and Web of Science. Bivariate random-effects models will be used to estimate diagnostic accuracy parameters for each cut-off of the different versions of the GDS. Prespecified subgroup analyses will be conducted. Risk of bias will be assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. ETHICS AND DISSEMINATION The findings of this study will be of interest to stakeholders involved in research, clinical practice and policy. PROSPERO REGISTRATION NUMBER CRD42018104329.
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Affiliation(s)
- Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Yin Wu
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Brooke Levis
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Machelle Wilchesky
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Jill Boruff
- Schulich Library of Science and Engineering, McGill University, Montreal, Quebec, Canada
| | - John P A Ioannidis
- Stanford Prevention Research Center, Department of Medicine, and Department of Health Research and Policy, Stanford School of Medicine, Stanford, California, USA
- Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, USA
| | - Scott B Patten
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry, University of Calgary, Calgary, Canada
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology and Amsterdam Public Health research institute, VU University Amsterdam, Amsterdam, The Netherlands
| | - Ian Shrier
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Simon Gilbody
- Hull York Medical School and Department of Health Sciences, The University of York, York, UK
| | - Zahinoor Ismail
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry, University of Calgary, Calgary, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Dean McMillan
- Hull York Medical School and Department of Health Sciences, The University of York, York, UK
| | | | - Roy C Ziegelstein
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Brett D Thombs
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
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Petkovic J, Welch V, Jacob MH, Yoganathan M, Ayala AP, Cunningham H, Tugwell P. Do evidence summaries increase health policy-makers' use of evidence from systematic reviews? A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2018; 14:1-52. [PMID: 37131376 PMCID: PMC8428003 DOI: 10.4073/csr.2018.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This review summarizes the evidence from six randomized controlled trials that judged the effectiveness of systematic review summaries on policymakers' decision making, or the most effective ways to present evidence summaries to increase policymakers' use of the evidence. This review included six randomized controlled studies. A randomized controlled study is one in which the participants are divided randomly (by chance) into separate groups to compare different treatments or other interventions. This method of dividing people into groups means that the groups will be similar and that the effects of the treatments they receive will be compared more fairly. At the time the study is done, it is not known which treatment is the better one. The researchers who did these studies invited people from Europe, North America, South America, Africa, and Asia to take part in them. Two studies looked at "policy briefs," one study looked at an "evidence summary," two looked at a "summary of findings table," and one compared a "summary of findings table" to an evidence summary. None of these studies looked at how policymakers directly used evidence from systematic reviews in their decision making, but two studies found that there was little to no difference in how they used the summaries. The studies relied on reports from decision makers. These studies included questions such as, "Is this summary easy to understand?" Some of the studies looked at users' knowledge, understanding, beliefs, or how credible (trustworthy) they believed the summaries to be. There was little to no difference in the studies that looked at these outcomes. Study participants rated the graded entry format higher for usability than the full systematic review. The graded entry format allows the reader to select how much information they want to read. The study participants felt that all evidence summary formats were easier to understand than full systematic reviews. Plain language summary Policy briefs make systematic reviews easier to understand but little evidence of impact on use of study findings: It is likely that evidence summaries are easier to understand than complete systematic reviews. Whether these summaries increase the use of evidence from systematic reviews in policymaking is not clear.What is this review about?: Systematic reviews are long and technical documents that may be hard for policymakers to use when making decisions. Evidence summaries are short documents that describe research findings in systematic reviews. These summaries may simplify the use of systematic reviews.Other names for evidence reviews are policy briefs, evidence briefs, summaries of findings, or plain language summaries. The goal of this review was to learn whether evidence summaries help policymakers use evidence from systematic reviews. This review also aimed to identify the best ways to present the evidence summary to increase the use of evidence.What are the main findings of this review?: This review included six randomized controlled studies. A randomized controlled study is one in which the participants are divided randomly (by chance) into separate groups to compare different treatments or other interventions. This method of dividing people into groups means that the groups will be similar and that the effects of the treatments they receive will be compared more fairly. At the time the study is done, it is not known which treatment is the better one.The researchers who did these studies invited people from Europe, North America, South America, Africa, and Asia to take part in them. Two studies looked at "policy briefs," one study looked at an "evidence summary," two looked at a "summary of findings table," and one compared a "summary of findings table" to an evidence summary.None of these studies looked at how policymakers directly used evidence from systematic reviews in their decision making, but two studies found that there was little to no difference in how they used the summaries. The studies relied on reports from decision makers. These studies included questions such as, "Is this summary easy to understand?"Some of the studies looked at users' knowledge, understanding, beliefs, or how credible (trustworthy) they believed the summaries to be. There was little to no difference in the studies that looked at these outcomes. Study participants rated the graded entry format higher for usability than the full systematic review. The graded entry format allows the reader to select how much information they want to read.. The study participants felt that all evidence summary formats were easier to understand than full systematic reviews.What do the findings of this review mean?: Our review suggests that evidence summaries help policymakers to better understand the findings presented in systematic reviews. In short, evidence summaries should be developed to make it easier for policymakers to understand the evidence presented in systematic reviews. However, right now there is very little evidence on the best way to present systematic review evidence to policymakers.How up to date is this review?: The authors of this review searched for studies through June 2016. Executive summary/Abstract Background: Systematic reviews are important for decision makers. They offer many potential benefits but are often written in technical language, are too long, and do not contain contextual details which makes them hard to use for decision-making. Strategies to promote the use of evidence to decision makers are required, and evidence summaries have been suggested as a facilitator. Evidence summaries include policy briefs, briefing papers, briefing notes, evidence briefs, abstracts, summary of findings tables, and plain language summaries. There are many organizations developing and disseminating systematic review evidence summaries for different populations or subsets of decision makers. However, evidence on the usefulness and effectiveness of systematic review summaries is lacking. We present an overview of the available evidence on systematic review evidence summaries.Objectives: This systematic review aimed to 1) assess the effectiveness of evidence summaries on policy-makers' use of the evidence and 2) identify the most effective summary components for increasing policy-makers' use of the evidence.Search methods: We searched several online databases (Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, Global Health Library, Popline, Africa-wide, Public Affairs Information Services, Worldwide Political Science Abstracts, Web of Science, and DfiD), websites of research groups and organizations which produce evidence summaries, and reference lists of included summaries and related systematic reviews. These databases were searched in March-April, 2016.Selection criteria: Eligible studies included randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after (CBA) studies, and interrupted time series (ITS) studies. We included studies of policymakers at all levels as well as health system managers. We included studies examining any type of "evidence summary", "policy brief", or other product derived from systematic reviews that presented evidence in a summarized form. These interventions could be compared to active comparators (e.g. other summary formats) or no intervention.The primary outcomes were: 1) use of systematic review summaries decision-making (e.g. self-reported use of the evidence in policy-making, decision-making) and 2) policymaker understanding, knowledge, and/or beliefs (e.g. changes in knowledge scores about the topic included in the summary). We also assessed perceived relevance, credibility, usefulness, understandability, and desirability (e.g. format) of the summaries.Results: Our database search combined with our grey literature search yielded 10,113 references after removal of duplicates. From these, 54 were reviewed in full text and we included 6 studies (reported in 7 papers, 1661 participants) as well as protocols from 2 ongoing studies. Two studies assessed the use of evidence summaries in decision-making and found little to no difference in effect. There was also little to no difference in effect for knowledge, understanding or beliefs (4 studies) and perceived usefulness or usability (3 studies). Summary of Findings tables and graded entry summaries were perceived as slightly easier to understand compared to complete systematic reviews. Two studies assessed formatting changes and found that for Summary of Findings tables, certain elements, such as reporting study event rates and absolute differences were preferred as well as avoiding the use of footnotes. No studies assessed adverse effects. The risks of bias in these studies were mainly assessed as unclear or low however, two studies were assessed as high risk of bias for incomplete outcome data due to very high rates of attrition.Authors' conclusions: Evidence summaries may be easier to understand than complete systematic reviews. However, their ability to increase the use of systematic review evidence in policymaking is unclear.
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Busert LK, Mütsch M, Kien C, Flatz A, Griebler U, Wildner M, Stratil JM, Rehfuess EA. Facilitating evidence uptake: development and user testing of a systematic review summary format to inform public health decision-making in German-speaking countries. Health Res Policy Syst 2018; 16:59. [PMID: 29986706 PMCID: PMC6038322 DOI: 10.1186/s12961-018-0307-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 04/02/2018] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Systematic reviews are an important source of evidence for public health decision-making, but length and technical jargon tend to hinder their use. In non-English speaking countries, inaccessibility of information in the native language often represents an additional barrier. In line with our vision to strengthen evidence-based public health in the German-speaking world, we developed a German language summary format for systematic reviews of public health interventions and undertook user-testing with public health decision-makers in Germany, Austria and Switzerland. METHODS We used several guiding principles and core elements identified from the literature to produce a prototype summary format and applied it to a Cochrane review on the impacts of changing portion and package sizes on selection and consumption of food, alcohol and tobacco. Following a pre-test in each of the three countries, we carried out 18 user tests with public health decision-makers in Germany, Austria and Switzerland using the 'think-aloud' method. We analysed participants' comments according to the facets credibility, usability, understandability, usefulness, desirability, findability, identification and accessibility. We also identified elements that hindered the facile and satisfying use of the summary format, and revised it based on participants' feedback. RESULTS The summary format was well-received; participants particularly appreciated receiving information in their own language. They generally found the summary format useful and a credible source of information, but also signalled several barriers to a positive user experience such as an information-dense structure and difficulties with understanding statistical terms. Many of the identified challenges were addressed through modifications of the summary format, in particular by allowing for flexible length, placing more emphasis on key messages and relevance for public health practice, expanding the interpretation aid for statistical findings, providing a glossary of technical terms, and only including graphical GRADE ratings. Some barriers to uptake, notably the participants' wish for actionable recommendations and contextual information, could not be addressed. CONCLUSIONS Participants welcomed the initiative, but user tests also revealed their problems with understanding and interpreting the findings summarised in our prototype format. The revised summary format will be used to communicate the results of Cochrane reviews of public health interventions.
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Affiliation(s)
- Laura K. Busert
- Institute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
| | - Margot Mütsch
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
| | - Christina Kien
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500 Krems, Austria
| | - Aline Flatz
- Cochrane Switzerland, Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Biopôle 2, Route de la Corniche 10, 1010 Lausanne, Switzerland
| | - Ursula Griebler
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500 Krems, Austria
| | - Manfred Wildner
- Institute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
| | - Jan M. Stratil
- Institute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
| | - Eva A. Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
| | - on behalf of Cochrane Public Health Europe
- Institute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500 Krems, Austria
- Cochrane Switzerland, Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Biopôle 2, Route de la Corniche 10, 1010 Lausanne, Switzerland
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Zhu Z, Xing W, Hu Y, Zhou Y, Gu Y. Improving Evidence Dissemination and Accessibility through a Mobile-based Resource Platform. J Med Syst 2018; 42:118. [DOI: 10.1007/s10916-018-0969-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 05/18/2018] [Indexed: 10/14/2022]
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Oliver KA, de Vocht F. Defining 'evidence' in public health: a survey of policymakers' uses and preferences. Eur J Public Health 2018; 27:112-117. [PMID: 26163467 DOI: 10.1093/eurpub/ckv082] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Public health (PH) policymakers are encouraged to use evidence in the decision-making process. However, little is known about what types of evidence policymakers working in local settings prefer to use. This study aims to evaluate policymakers' needs and sources of information, at regional and local levels. An electronic survey with telephone follow-up was carried out among PH policymakers and evidence producers ( n = 152) working in a large UK city. Respondents were asked which types of evidence they used regularly, found most useful and what were their main sources of information. Semi-structured interviews ( n = 23) added were analysed quantitatively in addition to the categorical data generated by the survey. Policymakers use a much greater range of evidence and information than is often indicated in the literature on evidence-based policy. Local data were by far the most used ( n = 95%) and most valued ( n = 85%) type of information, followed by practice guidelines. The main sources of information were Government websites (84%), followed by information obtained through personal contacts (71%), including PH professionals, council officers and politicians. Academics were rarely consulted and research evidence was rarely seen as directly relevant. Conclusions: Policymakers use a wider range of evidence types than previously discussed in the literature. Although local data were most valued by policymakers, results suggest that these were accessed through personal contacts, rather than specialized organizations. Systems to provide local high-quality evidence for PH policy should be supported.
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Brownson RC, Fielding JE, Green LW. Building Capacity for Evidence-Based Public Health: Reconciling the Pulls of Practice and the Push of Research. Annu Rev Public Health 2018; 39:27-53. [PMID: 29166243 PMCID: PMC5972383 DOI: 10.1146/annurev-publhealth-040617-014746] [Citation(s) in RCA: 183] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Timely implementation of principles of evidence-based public health (EBPH) is critical for bridging the gap between discovery of new knowledge and its application. Public health organizations need sufficient capacity (the availability of resources, structures, and workforce to plan, deliver, and evaluate the preventive dose of an evidence-based intervention) to move science to practice. We review principles of EBPH, the importance of capacity building to advance evidence-based approaches, promising approaches for capacity building, and future areas for research and practice. Although there is general agreement among practitioners and scientists on the importance of EBPH, there is less clarity on the definition of evidence, how to find it, and how, when, and where to use it. Capacity for EBPH is needed among both individuals and organizations. Capacity can be strengthened via training, use of tools, technical assistance, assessment and feedback, peer networking, and incentives. Modest investments in EBPH capacity building will foster more effective public health practice.
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Affiliation(s)
- Ross C Brownson
- Prevention Research Center in St. Louis, Brown School; Department of Surgery and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri 63130, USA;
| | - Jonathan E Fielding
- Fielding School of Public Health and Geffen School of Medicine, University of California, Los Angeles, California 90095, USA;
| | - Lawrence W Green
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California 94127, USA;
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Gerrits RG, Kringos DS, van den Berg MJ, Klazinga NS. Improving interpretation of publically reported statistics on health and healthcare: the Figure Interpretation Assessment Tool (FIAT-Health). Health Res Policy Syst 2018. [PMID: 29514711 PMCID: PMC5842564 DOI: 10.1186/s12961-018-0279-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Policy-makers, managers, scientists, patients and the general public are confronted daily with figures on health and healthcare through public reporting in newspapers, webpages and press releases. However, information on the key characteristics of these figures necessary for their correct interpretation is often not adequately communicated, which can lead to misinterpretation and misinformed decision-making. The objective of this research was to map the key characteristics relevant to the interpretation of figures on health and healthcare, and to develop a Figure Interpretation Assessment Tool-Health (FIAT-Health) through which figures on health and healthcare can be systematically assessed, allowing for a better interpretation of these figures. METHODS The abovementioned key characteristics of figures on health and healthcare were identified through systematic expert consultations in the Netherlands on four topic categories of figures, namely morbidity, healthcare expenditure, healthcare outcomes and lifestyle. The identified characteristics were used as a frame for the development of the FIAT-Health. Development of the tool and its content was supported and validated through regular review by a sounding board of potential users. RESULTS Identified characteristics relevant for the interpretation of figures in the four categories relate to the figures' origin, credibility, expression, subject matter, population and geographical focus, time period, and underlying data collection methods. The characteristics were translated into a set of 13 dichotomous and 4-point Likert scale questions constituting the FIAT-Health, and two final assessment statements. Users of the FIAT-Health were provided with a summary overview of their answers to support a final assessment of the correctness of a figure and the appropriateness of its reporting. CONCLUSIONS FIAT-Health can support policy-makers, managers, scientists, patients and the general public to systematically assess the quality of publicly reported figures on health and healthcare. It also has the potential to support the producers of health and healthcare data in clearly communicating their data to different audiences. Future research should focus on the further validation of the tool in practice.
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Affiliation(s)
- Reinie G Gerrits
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Dionne S Kringos
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Michael J van den Berg
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Niek S Klazinga
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Harris C, Garrubba M, Melder A, Voutier C, Waller C, King R, Ramsey W. Sustainability in Health care by Allocating Resources Effectively (SHARE) 8: developing, implementing and evaluating an evidence dissemination service in a local healthcare setting. BMC Health Serv Res 2018; 18:151. [PMID: 29499702 PMCID: PMC5833068 DOI: 10.1186/s12913-018-2932-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 02/12/2018] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND This is the eighth in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was a systematic, integrated, evidence-based program for disinvestment within a large Australian health service. One of the aims was to explore methods to deliver existing high quality synthesised evidence directly to decision-makers to drive decision-making proactively. An Evidence Dissemination Service (EDS) was proposed. While this was conceived as a method to identify disinvestment opportunities, it became clear that it could also be a way to review all practices for consistency with current evidence. This paper reports the development, implementation and evaluation of two models of an in-house EDS. METHODS Frameworks for development of complex interventions, implementation of evidence-based change, and evaluation and explication of processes and outcomes were adapted and/or applied. Mixed methods including a literature review, surveys, interviews, workshops, audits, document analysis and action research were used to capture barriers, enablers and local needs; identify effective strategies; develop and refine proposals; ascertain feedback and measure outcomes. RESULTS Methods to identify, capture, classify, store, repackage, disseminate and facilitate use of synthesised research evidence were investigated. In Model 1, emails containing links to multiple publications were sent to all self-selected participants who were asked to determine whether they were the relevant decision-maker for any of the topics presented, whether change was required, and to take the relevant action. This voluntary framework did not achieve the aim of ensuring practice was consistent with current evidence. In Model 2, the need for change was established prior to dissemination, then a summary of the evidence was sent to the decision-maker responsible for practice in the relevant area who was required to take appropriate action and report the outcome. This mandatory governance framework was successful. The factors influencing decisions, processes and outcomes were identified. CONCLUSION An in-house EDS holds promise as a method of identifying disinvestment opportunities and/or reviewing local practice for consistency with current evidence. The resource-intensive nature of delivery of the EDS is a potential barrier. The findings from this study will inform further exploration.
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Affiliation(s)
- Claire Harris
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC Australia
- Centre for Clinical Effectiveness, Monash Health, Melbourne, VIC Australia
| | - Marie Garrubba
- Centre for Clinical Effectiveness, Monash Health, Melbourne, VIC Australia
| | - Angela Melder
- Centre for Clinical Effectiveness, Monash Health, Melbourne, VIC Australia
| | | | - Cara Waller
- Centre for Clinical Effectiveness, Monash Health, Melbourne, VIC Australia
| | - Richard King
- Medicine Program, Monash Health, Melbourne, VIC Australia
| | - Wayne Ramsey
- Medical Services and Quality, Monash Health, Melbourne, VIC Australia
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Turner S, D'Lima D, Hudson E, Morris S, Sheringham J, Swart N, Fulop NJ. Evidence use in decision-making on introducing innovations: a systematic scoping review with stakeholder feedback. Implement Sci 2017; 12:145. [PMID: 29202772 PMCID: PMC5715650 DOI: 10.1186/s13012-017-0669-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 11/08/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A range of evidence informs decision-making on innovation in health care, including formal research findings, local data and professional opinion. However, cultural and organisational factors often prevent the translation of evidence for innovations into practice. In addition to the characteristics of evidence, it is known that processes at the individual level influence its impact on decision-making. Less is known about the ways in which processes at the professional, organisational and local system level shape evidence use and its role in decisions to adopt innovations. METHODS A systematic scoping review was used to review the health literature on innovations within acute and primary care and map processes at the professional, organisational and local system levels which influence how evidence informs decision-making on innovation. Stakeholder feedback on the themes identified was collected via focus groups to test and develop the findings. RESULTS Following database and manual searches, 31 studies reporting primary qualitative data met the inclusion criteria: 24 were of sufficient methodological quality to be included in the thematic analysis. Evidence use in decision-making on innovation is influenced by multi-level processes (professional, organisational, local system) and interactions across these levels. Preferences for evidence vary by professional group and health service setting. Organisations can shape professional behaviour by requiring particular forms of evidence to inform decision-making. Pan-regional organisations shape innovation decision-making at lower levels. Political processes at all levels shape the selection and use of evidence in decision-making. CONCLUSIONS The synthesis of results from primary qualitative studies found that evidence use in decision-making on innovation is influenced by processes at multiple levels. Interactions between different levels shape evidence use in decision-making (e.g. professional groups and organisations can use local systems to validate evidence and legitimise innovations, while local systems can tailor or frame evidence to influence activity at lower levels). Organisational leaders need to consider whether the environment in which decisions are made values diverse evidence and stakeholder perspectives. Further qualitative research on decision-making practices that highlights how and why different types of evidence come to count during decisions, and tracks the political aspects of decisions about innovation, is needed.
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Affiliation(s)
- Simon Turner
- Centre for Primary Care, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
| | - Danielle D'Lima
- Department of Clinical, Educational and Health Psychology, UCL Centre for Behaviour Change, University College London, 1-19 Torrington Place, London, UK
| | - Emma Hudson
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, UK
| | - Stephen Morris
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, UK
| | - Jessica Sheringham
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, UK
| | - Nick Swart
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, UK
| | - Naomi J Fulop
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, UK
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Ponsford R, Ford J, Korjonen H, Hughes E, Keswani A, Pliakas T, Egan M. Competing for space in an already crowded market: a mixed methods study of why an online community of practice (CoP) for alcohol harm reduction failed to generate interest amongst the group of public health professionals at which it was aimed. Implement Sci 2017; 12:91. [PMID: 28732513 PMCID: PMC5521081 DOI: 10.1186/s13012-017-0622-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 07/06/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Improving mechanisms for knowledge translation (KT) and connecting decision-makers to each other and the information and evidence they consider relevant to their work remains a priority for public health. Virtual communities of practices (CoPs) potentially offer an affordable and flexible means of encouraging connection and sharing of evidence, information and learning among the public health community in ways that transgress traditional geographical, professional, institutional and time boundaries. The suitability of online CoPs in public health, however, has rarely been tested. This paper explores the reasons why particular online CoP for alcohol harm reduction hosted by the UK Health Forum failed to generate sufficient interest from the group of public health professionals at which it was aimed. METHODS The study utilises online web-metrics demonstrating a lack of online activity on the CoP. One hundred and twenty seven responses to an online questionnaire were used to explore whether the lack of activity could be explained by the target audience's existing information and evidence practices and needs. Qualitative interviews with 10 members describe in more detail the factors that shape and inhibit use of the virtual CoP by those at which it was targeted. RESULTS Quantitative and qualitative data confirm that the target audience had an interest in the kind of information and evidence the CoP was set up to share and generate discussion about, but also that participants considered themselves to already have relatively good access to the information and evidence they needed to inform their work. Qualitative data revealed that the main barriers to using the CoP were a proliferation of information sources meaning that participants preferred to utilise trusted sources that were already established within their daily routines and a lack of time to engage with new online tools that required any significant commitment. CONCLUSIONS Specialist online CoPs are competing for space in an already crowded market. A target audience that regards itself as busy and over-supplied is unlikely to commit to a new service without the assurance that the service will provide unique and valuable well-summarised information, which would reduce the need to spend time accessing competing resources.
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Affiliation(s)
- Ruth Ponsford
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
| | - Jennifer Ford
- UK Health Forum, Fleetbank House, 2-6 Salisbury Square, London, EC4Y 8JX UK
| | - Helena Korjonen
- UK Health Forum, Fleetbank House, 2-6 Salisbury Square, London, EC4Y 8JX UK
| | - Emma Hughes
- UK Health Forum, Fleetbank House, 2-6 Salisbury Square, London, EC4Y 8JX UK
| | - Asha Keswani
- UK Health Forum, Fleetbank House, 2-6 Salisbury Square, London, EC4Y 8JX UK
| | - Triantafyllos Pliakas
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
| | - Matt Egan
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
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Gemmell I, Patterson L, Verma A. The use of locally based aggregate measures in urban health policy making in European urban areas. Eur J Public Health 2017; 27:9-13. [PMID: 26163471 DOI: 10.1093/eurpub/ckv081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background National and international policy makers require data at the local level to inform evidence-based policy making and evaluate the impact of policies; however, much data are only published at national level. Data collected at local level could be used to create aggregate measures to help inform health policy. Interviews were conducted with representatives of governmental public health agencies in eight European countries to assess the availability of local data and the extent to which local data was used to help decision making in nine urban areas (UAs). Respondents commented on the barriers to the use of aggregate measures at the local level for health policy decision making. In many of the cities data were available at UA level and in some cases at sub-urban level, however, aggregate measures using local data were rarely used to help inform decision making. The main reasons for this were; poor data quality, a lack of experience in the use of aggregate measures and communication barriers between policy makers and data analysts. A 'top down' approach to decision making also limited the use of local data in the decision making process. Health data are available at urban level within European cities but aggregate measures using these data are rarely used to inform health policy decision making at the local level. Improved communication between local public health data analysts could help increase the use of these data.
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Carter N, Dobbins M, Peachey G, Hoxby H, Ireland S, Akhtar-Danesh N, Dicenso A. Knowledge Transfer and Dissemination of Advanced Practice Nursing Information and Research to Acute-Care Administrators. Can J Nurs Res 2017; 46:10-27. [DOI: 10.1177/084456211404600203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Jacob RR, Allen PM, Ahrendt LJ, Brownson RC. Learning About and Using Research Evidence Among Public Health Practitioners. Am J Prev Med 2017; 52:S304-S308. [PMID: 28215386 PMCID: PMC5581939 DOI: 10.1016/j.amepre.2016.10.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 09/27/2016] [Accepted: 10/10/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Funders and accreditation standards increasingly call on state and local public health agencies to use the best available science. Using research evidence is a key process in practicing evidence-based decision making (EBDM). This study explored preferences for and uses of research evidence, and examined correlates regarding frequency of use. METHODS In 2014, eligible staff from 12 state health departments and their partnering agencies were invited to complete an online self-report questionnaire and achieved an 82% response rate (1,237/1,509). The cross-sectional data analyzed in 2015 were baseline to a study on enhancing EBDM capacity and supports. RESULTS Webinars/workshops was the most frequently selected method to learn public health findings among those in state and local health departments, whereas academic journals was the top selection by those in universities and healthcare facilities (p<0.001). Several modifiable EBDM practices were associated with more frequent use of research evidence, including direct supervisor expectations for EBDM use and performance evaluation based partially on EBDM use (AOR=2.5, 95% CI=1.9, 3.2 and AOR=2.5, 95% CI=2.1, 2.9, respectively). Increased numbers of EBDM practices were associated with higher odds of frequent research evidence use. Participant characteristics associated with higher research evidence use and adjusted for were job role, education attainment, and gender. CONCLUSIONS To translate research into public health practice, researchers can tailor evidence on intervention implementation and effectiveness and disease burden to accessible and preferred formats for public health workers and partners. Management practices to support evidence-based disease prevention can be instituted and fostered in public health and partnering agencies.
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Affiliation(s)
| | - Peg M Allen
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri
| | | | - Ross C Brownson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri; School of Medicine, Washington University in St. Louis, St. Louis, Missouri
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Piñeros M, Abriata MG, Mery L, Bray F. Cancer registration for cancer control in Latin America: a status and progress report. Rev Panam Salud Publica 2017; 41:e2. [PMID: 31391813 PMCID: PMC6660887 DOI: 10.26633/rpsp.2017.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 12/21/2015] [Indexed: 12/30/2022] Open
Abstract
Cancer incidence by type has been included as a core indicator in the World Health Organization (WHO) Global Monitoring Framework for the Prevention and Control of Noncommunicable Diseases. The Global Initiative for Cancer Registry Development (GICR), coordinated by the International Agency for Research on Cancer (IARC), supports low- and middle-income countries to reduce disparities in cancer information for cancer control by increasing the coverage and quality of cancer registration. A baseline assessment has been performed at the IARC Regional Hub for Latin America using secondary and public information sources. Countries have been categorized according to the following criteria for population-based cancer registries (PBCRs): 1) "has no established PBCR (but some registration activity)," 2) "has established PBCR(s) but none of high-quality," and 3) "has established, high-quality PBCR(s) (regional or national)." Currently, in LatinAmerica, most countries have cancer control plans in place; PBCRs cover approximately20% of the region's population, though only 7% are deemed as having high-quality information. No information is available on the extent of use of the information generated by PBCRs for cancer control purposes. Though there are important advances in cancer registration in the region, there is still much to be done. This report also outlines key elementsfor improving cancer surveillance in the region, including 1) involvement of local stakeholders and experts, 2) integration of cancer registries into existing surveillance systems(accounting for the complexities and particularities of cancer surveillance), 3) improvementin data availability and quality, 4) enhanced communication and dissemination, and 5) better linkages between cancer registries and cancer planning and cancer research.
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Affiliation(s)
- Marion Piñeros
- Cancer Surveillance SectionInternational Agency for Research on CancerLyonFrance
| | | | - Les Mery
- Cancer Surveillance SectionInternational Agency for Research on CancerLyonFrance
| | - Freddie Bray
- Cancer Surveillance SectionInternational Agency for Research on CancerLyonFrance
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Petkovic J, Welch V, Jacob MH, Yoganathan M, Ayala AP, Cunningham H, Tugwell P. The effectiveness of evidence summaries on health policymakers and health system managers use of evidence from systematic reviews: a systematic review. Implement Sci 2016; 11:162. [PMID: 27938409 PMCID: PMC5148903 DOI: 10.1186/s13012-016-0530-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 12/02/2016] [Indexed: 11/20/2022] Open
Abstract
Background Systematic reviews are important for decision makers. They offer many potential benefits but are often written in technical language, are too long, and do not contain contextual details which make them hard to use for decision-making. There are many organizations that develop and disseminate derivative products, such as evidence summaries, from systematic reviews for different populations or subsets of decision makers. This systematic review aimed to (1) assess the effectiveness of evidence summaries on policymakers’ use of the evidence and (2) identify the most effective summary components for increasing policymakers’ use of the evidence. We present an overview of the available evidence on systematic review derivative products. Methods We included studies of policymakers at all levels as well as health system managers. We included studies examining any type of “evidence summary,” “policy brief,” or other products derived from systematic reviews that presented evidence in a summarized form. The primary outcomes were the (1) use of systematic review summaries in decision-making (e.g., self-reported use of the evidence in policymaking and decision-making) and (2) policymakers’ understanding, knowledge, and/or beliefs (e.g., changes in knowledge scores about the topic included in the summary). We also assessed perceived relevance, credibility, usefulness, understandability, and desirability (e.g., format) of the summaries. Results Our database search combined with our gray literature search yielded 10,113 references after removal of duplicates. From these, 54 were reviewed in full text, and we included six studies (reported in seven papers) as well as protocols from two ongoing studies. Two studies assessed the use of evidence summaries in decision-making and found little to no difference in effect. There was also little to no difference in effect for knowledge, understanding or beliefs (four studies), and perceived usefulness or usability (three studies). Summary of findings tables and graded entry summaries were perceived as slightly easier to understand compared to complete systematic reviews. Two studies assessed formatting changes and found that for summary of findings tables, certain elements, such as reporting study event rates and absolute differences, were preferred as well as avoiding the use of footnotes. Conclusions Evidence summaries are likely easier to understand than complete systematic reviews. However, their ability to increase the use of systematic review evidence in policymaking is unclear. Trial registration The protocol was published in the journal Systematic Reviews (2015;4:122) Electronic supplementary material The online version of this article (doi:10.1186/s13012-016-0530-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jennifer Petkovic
- University of Split School of Medicine, Split, Croatia. .,Bruyère Research Institute, University of Ottawa, 43 Bruyère Street, Annex E room 302, Ottawa, ON, K1N 5C8, Canada.
| | - Vivian Welch
- Bruyère Research Institute, University of Ottawa, 43 Bruyère Street, Annex E room 302, Ottawa, ON, K1N 5C8, Canada.,School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada
| | - Maria Helena Jacob
- Bruyère Research Institute, University of Ottawa, 43 Bruyère Street, Annex E room 302, Ottawa, ON, K1N 5C8, Canada
| | - Manosila Yoganathan
- Bruyère Research Institute, University of Ottawa, 43 Bruyère Street, Annex E room 302, Ottawa, ON, K1N 5C8, Canada
| | - Ana Patricia Ayala
- Gerstein Science Information Centre, University of Toronto, Toronto, Canada
| | - Heather Cunningham
- Gerstein Science Information Centre, University of Toronto, Toronto, Canada
| | - Peter Tugwell
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada.,Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada.,Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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Newman K, Dobbins M, Yost J, Ciliska D. Information Seeking When Problem Solving: Perspectives of Public Health Professionals. Worldviews Evid Based Nurs 2016; 14:145-153. [PMID: 27926793 DOI: 10.1111/wvn.12187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Given the many different types of professionals working in public health and their diverse roles, it is likely that their information needs, information-seeking behaviors, and problem-solving abilities differ. Although public health professionals often work in interdisciplinary teams, few studies have explored their information needs and behaviors within the context of teamwork. This study explored the relationship between Canadian public health professionals' perceptions of their problem-solving abilities and their information-seeking behaviors with a specific focus on the use of evidence in practice settings. It also explored their perceptions of collaborative information seeking and the work contexts in which they sought information. METHODS Key Canadian contacts at public health organizations helped recruit study participants through their list-servs. An electronic survey was used to gather data about (a) individual information-seeking behaviors, (b) collaborative information-seeking behaviors, (c) use of evidence in practice environments, (d) perceived problem-solving abilities, and (e) demographic characteristics. RESULTS Fifty-eight public health professionals were recruited, with different roles and representing most Canadian provinces and one territory. A significant relationship was found between perceived problem-solving abilities and collaborative information-seeking behavior (r = -.44, p < .00, N = 58), but not individual information seeking. The results suggested that when public health professionals take a shared, active approach to problem solving, maintain personal control, and have confidence, they are more likely collaborate with others in seeking information to complete a work task. LINKING EVIDENCE TO ACTION Administrators of public health organizations should promote collaboration by implementing effective communication and information-seeking strategies, and by providing information resources and retrieval tools. Public health professionals' perceived problem-solving abilities can influence how they collaborate in seeking information. Educators in public health organizations should tailor training in information searching to promote collaboration through collaborative technology systems.
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Affiliation(s)
- Kristine Newman
- Assistant Professor, Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Maureen Dobbins
- Professor, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer Yost
- Assistant Professor, School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Donna Ciliska
- Professor, School of Nursing, McMaster University, Hamilton, Ontario, Canada
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Abstract
OBJECTIVES Rapid reviews can be conducted in a narrower time frame, as compared to systematic reviews, by featuring restrictions. To estimate the validity of the results, assessment of methodological quality is required. Our aim was to analyze the methodological restrictions of rapid reviews compared with systematic reviews using the AMSTAR checklist and assess its feasibility for rapid reviews. METHODS A systematic search for literature on rapid reviews of surgical interventions was conducted in three databases: Medline, Embase, and the Cochrane library. Additionally, health technology assessment (HTA) databases were searched. We analyzed reviews using AMSTAR and additionally compared the results with those of an overview of reviews on the same topic. RESULTS Items found more frequently in rapid reviews were search for gray literature (65 percent versus 33 percent), listing of excluded studies (59 percent versus 37 percent), and provision of study characteristics (77 percent versus 44 percent), whereas consideration of study quality in formulating conclusions, conduct of meta-analysis, and statement of conflicts of interest were less frequent. Median time between search and publication was 8 months, with a range between 1 and 27. CONCLUSIONS With some adjustments, AMSTAR can be used as a checklist for rapid reviews to describe methodological restrictions in comparison to systematic reviews and to roughly estimate the validity of the results. Strikingly, only 14.3 percent of rapid reviews were published within 3 months.
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Abstract
BACKGROUND Knowledge management (KM) encompasses strategies, processes, and practices that allow an organization to capture, share, store, access, and use knowledge. Ideal KM combines different sources of knowledge to support innovation and improve performance. PURPOSES Despite the importance of KM in health care organizations (HCOs), there has been very little empirical research to describe KM in this context. This study explores KM in HCOs, focusing on the status of current intraorganizational KM. The intention is to provide insight for future studies and model development for effective KM implementation in HCOs. METHODOLOGY/APPROACH A qualitative methods approach was used to create an empirically based model of KM in HCOs. Methods included (a) qualitative interviews (n = 24) with senior leadership to identify types of knowledge important in these roles plus current information-seeking behaviors/needs and (b) in-depth case study with leaders in new executive positions (n = 2). The data were collected from 10 HCOs. Our empirically based model for KM was assessed for face and content validity. FINDINGS The findings highlight the paucity of formal KM in our sample HCOs. Organizational culture, leadership, and resources are instrumental in supporting KM processes. An executive's knowledge needs are extensive, but knowledge assets are often limited or difficult to acquire as much of the available information is not in a usable format. We propose an empirically based model for KM to highlight the importance of context (internal and external), and knowledge seeking, synthesis, sharing, and organization. Participants who reviewed the model supported its basic components and processes, and potential for incorporating KM into organizational processes. DISCUSSION Our results articulate ways to improve KM, increase organizational learning, and support evidence-informed decision-making. PRACTICE IMPLICATIONS This research has implications for how to better integrate evidence and knowledge into organizations while considering context and the role of organizational processes.
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Hämäläinen RM, Aro AR, Lau CJ, Rus D, Cori L, Syed AM. Cross-sector cooperation in health-enhancing physical activity policymaking: more potential than achievements? Health Res Policy Syst 2016; 14:33. [PMID: 27129850 PMCID: PMC4850638 DOI: 10.1186/s12961-016-0103-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 04/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The cooperation of actors across policy fields and the need for cross-sector cooperation as well as recommendations on how to implement cross-sector cooperation have been addressed in many national and international policies that seek to solve complex issues within societies. For such a purpose, the relevant governance structure between policy sectors is cross-sector cooperation. Therefore, cross-sector cooperation and its structures need to be better understood for improved implementation. This article reports on the governance structures and processes of cross-sector cooperation in health-enhancing physical activity (HEPA) policies in six European Union (EU) member states. METHODS Qualitative content analysis of HEPA policies and semi-structured interviews with key policymakers in six European countries. RESULTS Cross-sector cooperation varied between EU member states within HEPA policies. The main issues of the cross-sector policy process can be divided into stakeholder involvement, governance structures and coordination structures and processes. Stakeholder involvement included citizen hearings and gatherings of stakeholders from various non-governmental organisations and citizen groups. Governance structures with policy and political discussions included committees, working groups and consultations for HEPA policymaking. Coordination structures and processes included administrative processes with various stakeholders, such as ministerial departments, research institutes and private actors for HEPA policymaking. Successful cross-sector cooperation required joint planning and evaluation, financial frameworks, mandates based on laws or agreed methods of work, communication lines, and valued processes of cross-sector cooperation. CONCLUSIONS Cross-sector cooperation required participation with the co-production of goals and sharing of resources between stakeholders, which could, for example, provide mechanisms for collaborative decision-making through citizen hearing. Clearly stated responsibilities, goals, communication, learning and adaptation for cross-sector cooperation improve success. Specific resources allocated for cross-sector cooperation could enhance the empowerment of stakeholders, management of processes and outcomes of cross-sector cooperation.
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Affiliation(s)
| | - Arja R Aro
- Department of Public Health, Unit for Health Promotion Research, University of Southern Denmark, Niels Bohrs Vej 9, 6700, Esbjerg, Denmark
| | - Cathrine Juel Lau
- Research Centre for Prevention and Health, The Capital Region of Denmark, Ndr. Ringvej 57, Afsnit 84/85, 2600, Glostrup, Denmark
| | - Diana Rus
- Administrative and Communication Sciences, Cluj School of Public Health, College of Political, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Liliana Cori
- Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, 56124, Italy
| | - Ahmed M Syed
- NHS England, 80 London Road, London, SE1 6LH, United Kingdom
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Thombs BD, Benedetti A, Kloda LA, Levis B, Azar M, Riehm KE, Saadat N, Cuijpers P, Gilbody S, Ioannidis JPA, McMillan D, Patten SB, Shrier I, Steele RJ, Ziegelstein RC, Loiselle CG, Henry M, Ismail Z, Mitchell N, Tonelli M. Diagnostic accuracy of the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) for detecting major depression: protocol for a systematic review and individual patient data meta-analyses. BMJ Open 2016; 6:e011913. [PMID: 27075844 PMCID: PMC4838677 DOI: 10.1136/bmjopen-2016-011913] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION The Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) has been recommended for depression screening in medically ill patients. Many existing HADS-D studies have used exploratory methods to select optimal cut-offs. Often, these studies report results from a small range of cut-off thresholds; cut-offs with more favourable accuracy results are more likely to be reported than others with worse accuracy estimates. When published data are combined in meta-analyses, selective reporting may generate biased summary estimates. Individual patient data (IPD) meta-analyses can address this problem by estimating accuracy with data from all studies for all relevant cut-off scores. In addition, a predictive algorithm can be generated to estimate the probability that a patient has depression based on a HADS-D score and clinical characteristics rather than dichotomous screening classification alone. The primary objectives of our IPD meta-analyses are to determine the diagnostic accuracy of the HADS-D to detect major depression among adults across all potentially relevant cut-off scores and to generate a predictive algorithm for individual patients. We are already aware of over 100 eligible studies, and more may be identified with our comprehensive search. METHODS AND ANALYSIS Data sources will include MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, PsycINFO and Web of Science. Eligible studies will have datasets where patients are assessed for major depression based on a validated structured or semistructured clinical interview and complete the HADS-D within 2 weeks (before or after). Risk of bias will be assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Bivariate random-effects meta-analysis will be conducted for the full range of plausible cut-off values, and a predictive algorithm for individual patients will be generated. ETHICS AND DISSEMINATION The findings of this study will be of interest to stakeholders involved in research, clinical practice and policy.
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Affiliation(s)
- Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
- Department of Psychiatry, McGill University, Montreal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada
- Department of Medicine, McGill University, Montreal, Québec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Québec, Canada
- Department of Psychology, McGill University, Montreal, Québec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada
- Department of Medicine, McGill University, Montreal, Québec, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Québec, Canada
| | - Lorie A Kloda
- Department of Libraries, Concordia University, Montreal, Québec, Canada
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada
| | - Marleine Azar
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada
| | - Kira E Riehm
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
| | - Nazanin Saadat
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology and EMGO Institute, VU University Amsterdam, Amsterdam,The Netherlands
| | - Simon Gilbody
- Department of Health Sciences, Hull York Medical School, University of York, York, UK
| | - John P A Ioannidis
- Department of Medicine, Health Research and Policy,Stanford Prevention Research Center, Stanford School of Medicine,Stanford, California, USA
- Department of Statistics,Stanford University School of Humanities and Sciences, Stanford, California, USA
| | - Dean McMillan
- Department of Health Sciences, Hull York Medical School, University of York, York, UK
| | - Scott B Patten
- Department of Community Health Sciences, University of Calgary, Calgary, Edmonton, Canada
- Department of Psychiatry, University of Calgary, Calgary, Edmonton, Canada
| | - Ian Shrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada
| | - Russell J Steele
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
- Department of Mathematics and Statistics, McGill University, Montreal, Québec, Canada
| | - Roy C Ziegelstein
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Carmen G Loiselle
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
- Department of Oncology, McGill University, Montreal, Québec, Canada
| | - Melissa Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Edmonton, Canada
| | - Zahinoor Ismail
- Department of Community Health Sciences, University of Calgary, Calgary, Edmonton, Canada
- Department of Oncology, McGill University, Montreal, Québec, Canada
| | - Nicholas Mitchell
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Edmonton, Canada
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Turner S, Morris S, Sheringham J, Hudson E, Fulop NJ. Study protocol: DEcisions in health Care to Introduce or Diffuse innovations using Evidence (DECIDE). Implement Sci 2016; 11:48. [PMID: 27044391 PMCID: PMC4820966 DOI: 10.1186/s13012-016-0412-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 03/25/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A range of evidence informs healthcare decision-making, from formal research findings to 'soft intelligence' or local data, as well as practical experience or tacit knowledge. However, cultural and organisational factors often prevent the translation of such evidence into practice. Using a multi-level framework, this project will analyse how interactions between the evidence available and processes at the micro (individual/group) and meso (organisational/system) levels influence decisions to introduce or diffuse innovations in acute and primary care within the National Health Service in the UK. METHODS/DESIGN This study will use a mixed methods design, combining qualitative and quantitative methods, and involves four interdependent work streams: (1) rapid evidence synthesis of relevant literature with stakeholder feedback; (2) in-depth case studies of 'real-world' decision-making in acute and primary care; (3) a national survey and discrete choice experiment; and (4) development of guidance for decision-makers and evaluators to support the use of evidence in decision-making. DISCUSSION This study will enhance the understanding of decision-makers' use of diverse forms of evidence. The findings will provide insights into how and why some evidence does inform decisions to introduce healthcare innovations, and why barriers persist in other cases. It will also quantify decision-makers' preferences, including the 'tipping point' of evidence needed to shift stakeholders' views. Practical guidance will be shared with healthcare decision-makers and evaluators on uses of evidence to enable the introduction and diffusion of innovation.
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Affiliation(s)
- Simon Turner
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Stephen Morris
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Jessica Sheringham
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Emma Hudson
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Naomi J Fulop
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
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Kothari A, McPherson C, Gore D, Cohen B, MacDonald M, Sibbald SL. A multiple case study of intersectoral public health networks: experiences and benefits of using research. Health Res Policy Syst 2016; 14:11. [PMID: 26865251 PMCID: PMC4750196 DOI: 10.1186/s12961-016-0082-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 01/27/2016] [Indexed: 11/23/2022] Open
Abstract
Background Network partnerships between public health and third sector organisations are being used to address the complexities of population level social determinants of health and health equity. An understanding of how these networks use research and knowledge is crucial to effective network design and outcome evaluation. There is, however, a gap in the literature regarding how public health networks use research and knowledge. The purpose of this paper is to report on the qualitative findings from a larger study that explored (1) the experiences of public health networks with using research and knowledge, and (2) the perceived benefits of using research and knowledge. Methods A multiple case study approach framed this study. Focus group data were collected from participants through a purposive sample of four public health networks. Data were analyzed using Framework Analysis and Nvivo™ software supported data management. Each network had the opportunity to participate in data interpretation. Results All networks used published research studies and other types of knowledge to accomplish their work, although in each network research and knowledge played different but complementary roles. Neither research nor other types of knowledge were privileged, and an approach that blended varied knowledge types was typically used. Network experiences with research and knowledge produced individual and collective benefits. A novel finding was that research and knowledge were both important in shaping network function. Conclusions This study shifts the focus in the current literature from public health departments to the community setting where public health collaborates with a broader spectrum of actors to ameliorate health inequities. Both formal research and informal knowledge were found to be important for collaborative public health networks. Examining the benefits of research and knowledge use within public health networks may help us to better understand the relationships among process (the collaborative use of research and knowledge), structure (networks) and outcomes (benefits).
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Affiliation(s)
- Anita Kothari
- School of Health Studies, The University of Western Ontario, Labatt Health Sciences Building, Room 222, London, ON, N6A 5B9, Canada.
| | - Charmaine McPherson
- School of Nursing, St. Francis Xavier University, Antigonish, Box 5000, NS, B2G 2W5, Canada.
| | - Dana Gore
- School of Health Studies, The University of Western Ontario, Labatt Health Sciences Building, Room 222, London, ON, N6A 5B9, Canada.
| | - Benita Cohen
- College of Nursing, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada.
| | - Marjorie MacDonald
- School of Nursing, University of Victoria, Victoria, BC, V8P 5C2, Canada.
| | - Shannon L Sibbald
- School of Health Studies, The University of Western Ontario, Labatt Health Sciences Building, Room 222, London, ON, N6A 5B9, Canada. .,Department of Family Medicine, The University of Western Ontario, London, ON, N6A 5B9, Canada.
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Choi BCK, Li L, Lu Y, Zhang LR, Zhu Y, Pak AWP, Chen Y, Little J. Bridging the gap between science and policy: an international survey of scientists and policy makers in China and Canada. Implement Sci 2016; 11:16. [PMID: 26852131 PMCID: PMC4744416 DOI: 10.1186/s13012-016-0377-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 01/29/2016] [Indexed: 12/03/2022] Open
Abstract
Background Bridging the gap between science and policy is an important task in evidence-informed policy making. The objective of this study is to prioritize ways to bridge the gap. Methods The study was based on an online survey of high-ranking scientists and policy makers who have a senior position in universities and governments in the health sector in China and Canada. The sampling frame comprised of universities with schools of public health and medicine and various levels of government in health and public health. Participants included university presidents and professors, and government deputy ministers, directors general and directors working in the health field. Fourteen strategies were presented to the participants for ranking as current ways and ideal ways in the future to bridge the gap between science and policy. Results Over a 3-month survey period, there were 121 participants in China and 86 in Canada with response rates of 30.0 and 15.9 %, respectively. The top strategies selected by respondents included focus on policy (conducting research that focuses on policy questions), science-policy forums, and policy briefs, both as current ways and ideal ways to bridge the gap between science and policy. Conferences were considered a priority strategy as a current way, but not an ideal way in the future. Canadian participants were more in favor of using information technology (web-based portals and email updates) than their Chinese counterparts. Among Canadian participants, two strategies that were ranked low as current ways (collaboration in study design and collaboration in analysis) became a priority as ideal ways. This could signal a change in thinking in shifting the focus from the “back end” or “downstream” (knowledge dissemination) of the knowledge transfer process to the “front end” or “upstream” (knowledge generation). Conclusions Our international study has confirmed a number of previously reported priority strategies to bridge the gap between science and policy. More importantly, our study has contributed to the future work on evidence-based policy making by comparing the responses from China and Canada and the current and ideal way for the future. Our study shows that the concept and strategies of bridging the gap between science and policy are not static but varying in space and evolving over time.
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Affiliation(s)
- Bernard C K Choi
- Injury Prevention Research Centre, Medical College of Shantou University, Shantou, China. .,School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Liping Li
- Injury Prevention Research Centre, Medical College of Shantou University, Shantou, China.
| | - Yaogui Lu
- Injury Prevention Research Centre, Medical College of Shantou University, Shantou, China.
| | - Li R Zhang
- Population and Public Health Program, British Columbia Provincial Health Services Authority, Vancouver, BC, Canada.
| | - Yao Zhu
- Injury Prevention Research Centre, Medical College of Shantou University, Shantou, China.
| | | | - Yue Chen
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Julian Little
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada.
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Tricco AC, Cardoso R, Thomas SM, Motiwala S, Sullivan S, Kealey MR, Hemmelgarn B, Ouimet M, Hillmer MP, Perrier L, Shepperd S, Straus SE. Barriers and facilitators to uptake of systematic reviews by policy makers and health care managers: a scoping review. Implement Sci 2016; 11:4. [PMID: 26753923 PMCID: PMC4709874 DOI: 10.1186/s13012-016-0370-1] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 01/06/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND We completed a scoping review on the barriers and facilitators to use of systematic reviews by health care managers and policy makers, including consideration of format and content, to develop recommendations for systematic review authors and to inform research efforts to develop and test formats for systematic reviews that may optimise their uptake. METHODS We used the Arksey and O'Malley approach for our scoping review. Electronic databases (e.g., MEDLINE, EMBASE, PsycInfo) were searched from inception until September 2014. Any study that identified barriers or facilitators (including format and content features) to uptake of systematic reviews by health care managers and policy makers/analysts was eligible for inclusion. Two reviewers independently screened the literature results and abstracted data from the relevant studies. The identified barriers and facilitators were charted using a barriers and facilitators taxonomy for implementing clinical practice guidelines by clinicians. RESULTS We identified useful information for authors of systematic reviews to inform their preparation of reviews including providing one-page summaries with key messages, tailored to the relevant audience. Moreover, partnerships between researchers and policy makers/managers to facilitate the conduct and use of systematic reviews should be considered to enhance relevance of reviews and thereby influence uptake. CONCLUSIONS Systematic review authors can consider our results when publishing their systematic reviews. These strategies should be rigorously evaluated to determine impact on use of reviews in decision-making.
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Affiliation(s)
- Andrea C Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, East Building, Toronto, ON, M5B 1W8, Canada.
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.
| | - Roberta Cardoso
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, East Building, Toronto, ON, M5B 1W8, Canada.
| | - Sonia M Thomas
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, East Building, Toronto, ON, M5B 1W8, Canada.
| | - Sanober Motiwala
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, East Building, Toronto, ON, M5B 1W8, Canada.
| | - Shannon Sullivan
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, East Building, Toronto, ON, M5B 1W8, Canada.
| | - Michael R Kealey
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, East Building, Toronto, ON, M5B 1W8, Canada.
- Department of Mechanical and Industrial Engineering, University of Toronto, 5 King's College Road, Toronto, ON, M5S 3G8, Canada.
| | - Brenda Hemmelgarn
- Departments of Medicine and Community Health Sciences, University of Calgary, TRW Building, 3rd Floor, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
| | - Mathieu Ouimet
- Département de science politique, Pavillon Charles-De Koninck, Université Laval, Quebec City, Canada.
| | - Michael P Hillmer
- Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, ON, M5T 3M6, Canada.
- Research, Evaluation, and Analysis Branch, Ontario Ministry of Health and Long-Term Care, 80 Grosvenor Street, Toronto, ON, M7A 1R3, Canada.
| | - Laure Perrier
- Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, ON, M5T 3M6, Canada.
| | - Sasha Shepperd
- Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Rd Campus, Headington, Oxford, Oxfordshire, OX3 7LF, UK.
| | - Sharon E Straus
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, East Building, Toronto, ON, M5B 1W8, Canada.
- Department of Geriatric Medicine, University of Toronto, 27 Kings College Circle, Toronto, ON, M5S 1A1, Canada.
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Thombs BD, Benedetti A, Kloda LA, Levis B, Riehm KE, Azar M, Cuijpers P, Gilbody S, Ioannidis JPA, McMillan D, Patten SB, Shrier I, Steele RJ, Ziegelstein RC, Tonelli M, Mitchell N, Comeau L, Schinazi J, Vigod S. Diagnostic accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for detecting major depression in pregnant and postnatal women: protocol for a systematic review and individual patient data meta-analyses. BMJ Open 2015; 5:e009742. [PMID: 26486977 PMCID: PMC4620163 DOI: 10.1136/bmjopen-2015-009742] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 09/24/2015] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Studies of the diagnostic accuracy of depression screening tools often used data-driven methods to select optimal cut-offs. Typically, these studies report results from a small range of cut-off points around whatever cut-off score is identified as most accurate. When published data are combined in meta-analyses, estimates of accuracy for different cut-off points may be based on data from different studies, rather than data from all studies for each cut-off point. Thus, traditional meta-analyses may exaggerate accuracy estimates. Individual patient data (IPD) meta-analyses synthesise data from all studies for each cut-off score to obtain accuracy estimates. The 10-item Edinburgh Postnatal Depression Scale (EPDS) is commonly recommended for depression screening in the perinatal period. The primary objective of this IPD meta-analysis is to determine the diagnostic accuracy of the EPDS to detect major depression among women during pregnancy and in the postpartum period across all potentially relevant cut-off scores, accounting for patient factors that may influence accuracy (age, pregnancy vs postpartum). METHODS AND ANALYSIS Data sources will include Medline, Medline In-Process & Other Non-Indexed Citations, PsycINFO, and Web of Science. Studies that include a diagnosis of major depression based on a validated structured or semistructured clinical interview administered within 2 weeks of (before or after) the administration of the EPDS will be included. Risk of bias will be assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Bivariate random-effects meta-analysis will be conducted for the full range of plausible cut-off values. Analyses will evaluate data from pregnancy and the postpartum period separately, as well as combining data from all women in a single model. ETHICS AND DISSEMINATION This study does not require ethics approval. Dissemination will include journal articles and presentations to policymakers, healthcare providers and researchers. SYSTEMATIC REVIEW REGISTRATION PROSPERO 2015:CRD42015024785.
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Affiliation(s)
- Brett D Thombs
- Departments of Psychiatry, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
- Department of Psychology, McGill University, Montreal, Quebec, Canada
- School of Nursing, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Lorie A Kloda
- Library, McGill University, Montreal, Quebec, Canada
| | - Brooke Levis
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Kira E Riehm
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Marleine Azar
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Pim Cuijpers
- Department of Clinical, Neuro, Developmental Psychology, VU-University, Amsterdam, The Netherlands
| | - Simon Gilbody
- Psychological Medicine and Health Services Research, Department of Health Sciences, Hull York Medical School University of York, York, UK
| | - John P A Ioannidis
- Department of Medicine, Department of Health Research and Policy, Department of Statistics, Stanford Prevention Research Center, Stanford School of Medicine, Stanford University School of Humanities and Sciences, Stanford, California, USA
| | - Dean McMillan
- Psychological Medicine and Health Services Research, Department of Health Sciences, Hull York Medical School University of York, York, UK
| | - Scott B Patten
- Departments of Psychiatry and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Ian Shrier
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Russell J Steele
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Mathematics and Statistics, McGill University, Montreal, Quebec, Canada
| | - Roy C Ziegelstein
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Nicholas Mitchell
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Liane Comeau
- Institut national de santé publique du Québec and Université de Montréal, Montreal, Quebec, Canada
| | | | - Simone Vigod
- Department of Psychiatry, Women's College Hospital and Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada
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Hämäläinen RM, Aro AR, van de Goor I, Lau CJ, Jakobsen MW, Chereches RM, Syed AM. Exploring the use of research evidence in health-enhancing physical activity policies. Health Res Policy Syst 2015; 13:43. [PMID: 26458918 PMCID: PMC4603910 DOI: 10.1186/s12961-015-0047-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 09/22/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The gaps observed between the use of research evidence and policy have been reported to be based on the different methods of using research evidence in policymaking by researchers and actual policymakers. Some policies and policymaking processes may therefore be particularly well informed by research evidence compared to others. The aims of the present article are to explore the use of research evidence in health-enhancing physical activity (HEPA) policies, identify when research evidence was used, and find what other types of evidence were employed in HEPA policymaking. METHODS Multidisciplinary teams from six EU member states analysed the use of research evidence and other kinds of evidence in 21 HEPA policies and interviewed 86 key policymakers involved in the policies. Qualitative content analysis was conducted on both policy documents and interview data. RESULTS Research evidence was mostly used to justify the creation of HEPA policies and, generally, implicitly without citation. The policies analysed used many types of evidence other than citable research. The evidence used in HEPA policies was found to fall into the following categories: societal framework, media, everyday knowledge and intuition, research evidence, and other types of evidence. CONCLUSIONS Research evidence seems to be the only type of evidence used in policymaking. Competition between the use of other types of evidence and research evidence is constant due to the various sources of information on the Internet and elsewhere. However, researchers need to understand their role in translating research evidence into policymaking processes.
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Affiliation(s)
| | - Arja R Aro
- Unit for Health Promotion Research, Institute of Public Health, University of Southern Denmark, Niels Bohrs Vej 9, 6700, Esbjerg, Denmark.
| | - Ien van de Goor
- Tranzo, Scientific Center for Care and Welfare, Tilburg University, Postbus 90153, 5000, LE, Tilburg, The Netherlands.
| | - Cathrine Juel Lau
- Research Centre for Prevention and Health (RCPH), Capital Region of Denmark, Ndr. Ringvej 57, Afsnit 84/85, 2600, Glostrup, Denmark.
| | - Mette Winge Jakobsen
- Unit for Health Promotion Research, Institute of Public Health, University of Southern Denmark, Niels Bohrs Vej 9, 6700, Esbjerg, Denmark.
| | - Razvan M Chereches
- Center for Health Policy and Public Health, Babes-Bolyai University, Pandurilor 7, Cluj-Napoca, Romania.
| | - Ahmed M Syed
- NHS England, 80 London Road, London, SE1 6LH, UK.
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Hartling L, Guise JM, Kato E, Anderson J, Belinson S, Berliner E, Dryden DM, Featherstone R, Mitchell MD, Motu'apuaka M, Noorani H, Paynter R, Robinson KA, Schoelles K, Umscheid CA, Whitlock E. A taxonomy of rapid reviews links report types and methods to specific decision-making contexts. J Clin Epidemiol 2015; 68:1451-62.e3. [PMID: 26278023 DOI: 10.1016/j.jclinepi.2015.05.036] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 05/03/2015] [Accepted: 05/30/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Describe characteristics of rapid reviews and examine the impact of methodological variations on their reliability and validity. STUDY DESIGN AND SETTING We conducted a literature review and interviews with organizations that produce rapid reviews or related products to identify methods, guidance, empiric evidence, and current practices. RESULTS We identified 36 rapid products from 20 organizations (production time, 5 minutes to 8 months). Methods differed from systematic reviews at all stages. As time frames increased, methods became more rigorous; however, restrictions on database searching, inclusion criteria, data extracted, and independent dual review remained. We categorized rapid products based on extent of synthesis. "Inventories" list what evidence is available. "Rapid responses" present best available evidence with no formal synthesis. "Rapid reviews" synthesize the quality of and findings from the evidence. "Automated approaches" generate meta-analyses in response to user-defined queries. Rapid products rely on a close relationship with end users and support specific decisions in an identified time frame. Limited empiric evidence exists comparing rapid and systematic reviews. CONCLUSIONS Rapid products have tremendous methodological variation; categorization based on time frame or type of synthesis reveals patterns. The similarity across rapid products lies in the close relationship with the end user to meet time-sensitive decision-making needs.
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Affiliation(s)
- Lisa Hartling
- Department of Pediatrics, University of Alberta, Edmonton, Canada.
| | - Jeanne-Marie Guise
- Scientific Resource Center for the AHRQ Effective Health Care Program, Portland VA Medical Center, Portland VA Research Foundation, Portland, OR, USA
| | - Elisabeth Kato
- Center for Outcomes and Evidence, Agency for Healthcare Research and Quality, Rockville, MD, USA
| | - Johanna Anderson
- Scientific Resource Center for the AHRQ Effective Health Care Program, Portland VA Medical Center, Portland VA Research Foundation, Portland, OR, USA
| | - Suzanne Belinson
- Office of Clinical Affairs, Blue Cross Blue Shield Association, Chicago, IL, USA
| | - Elise Berliner
- Center for Outcomes and Evidence, Agency for Healthcare Research and Quality, Rockville, MD, USA
| | - Donna M Dryden
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | | | - Matthew D Mitchell
- ECRI Institute-Penn Medicine AHRQ EPC and the Center for Evidence-Based Practice and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Makalapua Motu'apuaka
- Scientific Resource Center for the AHRQ Effective Health Care Program, Portland VA Medical Center, Portland VA Research Foundation, Portland, OR, USA
| | - Hussein Noorani
- Office of Clinical Affairs, Blue Cross Blue Shield Association, Chicago, IL, USA
| | - Robin Paynter
- Scientific Resource Center for the AHRQ Effective Health Care Program, Portland VA Medical Center, Portland VA Research Foundation, Portland, OR, USA
| | - Karen A Robinson
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Karen Schoelles
- ECRI Institute-Penn Medicine AHRQ EPC and the Center for Evidence-Based Practice and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Craig A Umscheid
- ECRI Institute-Penn Medicine AHRQ EPC and the Center for Evidence-Based Practice and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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50
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Rushmer RK, Cheetham M, Cox L, Crosland A, Gray J, Hughes L, Hunter DJ, McCabe K, Seaman P, Tannahill C, Van Der Graaf P. Research utilisation and knowledge mobilisation in the commissioning and joint planning of public health interventions to reduce alcohol-related harms: a qualitative case design using a cocreation approach. HEALTH SERVICES AND DELIVERY RESEARCH 2015. [DOI: 10.3310/hsdr03330] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BackgroundConsiderable resources are spent on research to establish what works to improve the nation’s health. If the findings from this research are used, better health outcomes can follow, but we know that these findings are not always used. In public health, evidence of what works may not ‘fit’ everywhere, making it difficult to know what to do locally. Research suggests that evidence use is a social and dynamic process, not a simple application of research findings. It is unclear whether it is easier to get evidence used via a legal contracting process or within unified organisational arrangements with shared responsibilities.ObjectiveTo work in cocreation with research participants to investigate how research is utilised and knowledge mobilised in the commissioning and planning of public health services to reduce alcohol-related harms.Design, setting and participantsTwo in-depth, largely qualitative, cross-comparison case studies were undertaken to compare real-time research utilisation in commissioning across a purchaser–provider split (England) and in joint planning under unified organisational arrangements (Scotland) to reduce alcohol-related harms. Using an overarching realist approach and working in cocreation, case study partners (stakeholders in the process) picked the topic and helped to interpret the findings. In Scotland, the topic picked was licensing; in England, it was reducing maternal alcohol consumption.MethodsSixty-nine interviews, two focus groups, 14 observations of decision-making meetings, two local feedback workshops (n = 23 andn = 15) and one national workshop (n = 10) were undertaken. A questionnaire (n = 73) using a Behaviourally Anchored Rating Scale was issued to test the transferability of the 10 main findings. Given the small numbers, care must be taken in interpreting the findings.FindingsNot all practitioners have the time, skills or interest to work in cocreation, but when there was collaboration, much was learned. Evidence included professional and tacit knowledge, and anecdotes, as well as findings from rigorous research designs. It was difficult to identify evidence in use and decisions were sometimes progressed in informal ways and in places we did not get to see. There are few formal evidence entry points. Evidence (prevalence and trends in public health issues) enters the process and is embedded in strategic documents to set priorities, but local data were collected in both sites to provide actionable messages (sometimes replicating the evidence base).ConclusionsTwo mid-range theories explain the findings. If evidence hassaliency(relates to ‘here and now’ as opposed to ‘there and then’) andimmediacy(short, presented verbally or visually and with emotional appeal) it is more likely to be used in both settings. A second mid-range theory explains how differing tensions pull and compete as feasible and acceptable local solutions are pursued across stakeholders. Answering what works depends on answering for whom and where simultaneously to find workable (if temporary) ‘blends’. Gaining this agreement across stakeholders appeared more difficult across the purchaser–provider split, because opportunities to interact were curtailed; however, more research is needed.FundingThis study was funded by the Health Services and Delivery Research programme of the National Institute for Health Research.
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Affiliation(s)
- Rosemary K Rushmer
- School of Health and Social Care, Health and Social Care Institute, Teesside University, Middlesbrough, UK
| | - Mandy Cheetham
- School of Health and Social Care, Health and Social Care Institute, Teesside University, Middlesbrough, UK
| | - Lynda Cox
- Clinical Directorates, NHS England, Newcastle upon Tyne, UK
| | - Ann Crosland
- Department of Pharmacy, Health and Wellbeing, University of Sunderland, Sunderland, UK
| | - Joanne Gray
- Department of Public Health and Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | | | - David J Hunter
- Centre for Public Policy and Health, School of Medicine, Pharmacy and Health, Wolfsan Research Institute, Durham University, Durham, UK
| | - Karen McCabe
- Department of Pharmacy, Health and Wellbeing, University of Sunderland, Sunderland, UK
| | - Pete Seaman
- Glasgow Centre for Population Health, Glasgow, UK
| | | | - Peter Van Der Graaf
- School of Health and Social Care, Health and Social Care Institute, Teesside University, Middlesbrough, UK
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