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Scarlett J, Forsberg BC, Biermann O, Kuchenmüller T, El-Khatib Z. Indicators to evaluate organisational knowledge brokers: a scoping review. Health Res Policy Syst 2020; 18:93. [PMID: 32831095 PMCID: PMC7444249 DOI: 10.1186/s12961-020-00607-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 07/23/2020] [Indexed: 01/03/2023] Open
Abstract
Background Knowledge translation (KT) is currently endorsed by global health policy actors as a means to improve outcomes by institutionalising evidence-informed policy-making. Organisational knowledge brokers, comprised of researchers, policy-makers and other stakeholders, are increasingly being used to undertake and promote KT at all levels of health policy-making, though few resources exist to guide the evaluation of these efforts. Using a scoping review methodology, we identified, synthesised and assessed indicators that have been used to evaluate KT infrastructure and capacity-building activities in a health policy context in order to inform the evaluation of organisational knowledge brokers. Methods A scoping review methodology was used. This included the search of Medline, Global Health and the WHO Library databases for studies regarding the evaluation of KT infrastructure and capacity-building activities between health research and policy, published in English from 2005 to 2016. Data on study characteristics, outputs and outcomes measured, related indicators, mode of verification, duration and/or frequency of collection, indicator methods, KT model, and targeted capacity level were extracted and charted for analysis. Results A total of 1073 unique articles were obtained and 176 articles were qualified to be screened in full-text; 32 articles were included in the analysis. Of a total 213 indicators extracted, we identified 174 (174/213; 81.7%) indicators to evaluate the KT infrastructure and capacity-building that have been developed using methods beyond expert opinion. Four validated instruments were identified. The 174 indicators are presented in 8 domains based on an adaptation of the domains of the Lavis et al. framework of linking research to action – general climate, production of research, push efforts, pull efforts, exchange efforts, integrated efforts, evaluation and capacity-building. Conclusion This review presents a total of 174 method-based indicators to evaluate KT infrastructure and capacity-building. The presented indicators can be used or adapted globally by organisational knowledge brokers and other stakeholders in their monitoring and evaluation work.
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Affiliation(s)
- Julia Scarlett
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, SE-171 77, Stockholm, Sweden
| | - Birger C Forsberg
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, SE-171 77, Stockholm, Sweden.,Region Stockholm, Hantverkargatan 11B, 112 21, Stockholm, Sweden
| | - Olivia Biermann
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, SE-171 77, Stockholm, Sweden
| | - Tanja Kuchenmüller
- World Health Organization Regional Office for Europe, UN City, Marmorvej 51, DK-2100, Copenhagen Ø, Denmark
| | - Ziad El-Khatib
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, SE-171 77, Stockholm, Sweden. .,World Health Programme, Université du Québec en Abitibi-Témiscamingue (UQAT), 445 Boulevard de l'Université, Rouyn-Noranda, QC, J9X 5E4, Canada.
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Fulone I, Barreto JOM, Barberato-Filho S, de Carvalho MH, Lopes LC. Knowledge Translation for Improving the Care of Deinstitutionalized People With Severe Mental Illness in Health Policy. Front Pharmacol 2020; 10:1470. [PMID: 32038229 PMCID: PMC6985550 DOI: 10.3389/fphar.2019.01470] [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: 08/02/2019] [Accepted: 11/13/2019] [Indexed: 11/18/2022] Open
Abstract
Background Knowledge translation (KT) is an effective strategy that uses the best available research evidence to bring stakeholders together to develop solutions and improve public health policy-making. Despite progress, the process of deinstitutionalization in Brazil is still undergoing consolidation, and the changes and challenges that are involved in this process are complex and necessitate evidence-informed decision-making. Accordingly, this study used KT tools to support efforts that aim to improve the care that is available to deinstitutionalized people with severe mental disorders in Brazil. Methods We used the Supporting Policy Relevant Reviews and Trials tools for evidence-informed health policymaking and followed eight steps: 1) capacity building; 2) identification of a priority policy issue within a Brazilian public health system; 3) meetings with policy-makers, researchers and stakeholders; 4) development of an evidence brief (EB) that addresses the problem of deinstitutionalization; 5) facilitating policy dialogue (PD); 6) the evaluation of the EB and PD; 7) post-dialogue mini-interviews; and 8) dissemination of the findings. Results Capacity building and meetings with key informants promoted awareness about the gap between research and practice. Local findings were used to define the problem and develop the EB. Twenty-four individuals (policy-makers, stakeholders, researchers, representatives of the civil society, and public defense) participated in the PD. They received the EB to subsidise their deliberations during the PD, which in turn were used to validate and improve the EB. The PD achieved the objective of promoting an exhaustive discussion about the problem and proposed options and improved communication and interaction among those who are involved in mental health care. The features of both the EB and PD were considered to be favorable and helpful. Conclusions The KT strategy helped participants understand different perspectives and values, the interpersonal tensions that exist among those who are involved in the field of mental health, and the strategies that can bridge the gap between research and policy-making. The present findings suggest that PDs can influence practice by promoting greater engagement among stakeholders who formulate or revise mental health policies.
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Affiliation(s)
- Izabela Fulone
- Pharmaceutical Sciences Graduate Course, University of Sorocaba, UNISO, Sorocaba, Brazil
| | | | - Silvio Barberato-Filho
- Pharmaceutical Sciences Graduate Course, University of Sorocaba, UNISO, Sorocaba, Brazil
| | | | - Luciane Cruz Lopes
- Pharmaceutical Sciences Graduate Course, University of Sorocaba, UNISO, Sorocaba, Brazil
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Sarkies MN, Bowles KA, Skinner EH, Haas R, Lane H, Haines TP. The effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare: a systematic review. Implement Sci 2017; 12:132. [PMID: 29137659 PMCID: PMC5686806 DOI: 10.1186/s13012-017-0662-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 11/01/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is widely acknowledged that health policy and management decisions rarely reflect research evidence. Therefore, it is important to determine how to improve evidence-informed decision-making. The primary aim of this systematic review was to evaluate the effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare. The secondary aim of the review was to describe factors perceived to be associated with effective strategies and the inter-relationship between these factors. METHODS An electronic search was developed to identify studies published between January 01, 2000, and February 02, 2016. This was supplemented by checking the reference list of included articles, systematic reviews, and hand-searching publication lists from prominent authors. Two reviewers independently screened studies for inclusion, assessed methodological quality, and extracted data. RESULTS After duplicate removal, the search strategy identified 3830 titles. Following title and abstract screening, 96 full-text articles were reviewed, of which 19 studies (21 articles) met all inclusion criteria. Three studies were included in the narrative synthesis, finding policy briefs including expert opinion might affect intended actions, and intentions persisting to actions for public health policy in developing nations. Workshops, ongoing technical assistance, and distribution of instructional digital materials may improve knowledge and skills around evidence-informed decision-making in US public health departments. Tailored, targeted messages were more effective in increasing public health policies and programs in Canadian public health departments compared to messages and a knowledge broker. Sixteen studies (18 articles) were included in the thematic synthesis, leading to a conceptualisation of inter-relating factors perceived to be associated with effective research implementation strategies. A unidirectional, hierarchal flow was described from (1) establishing an imperative for practice change, (2) building trust between implementation stakeholders and (3) developing a shared vision, to (4) actioning change mechanisms. This was underpinned by the (5) employment of effective communication strategies and (6) provision of resources to support change. CONCLUSIONS Evidence is developing to support the use of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare. The design of future implementation strategies should be based on the inter-relating factors perceived to be associated with effective strategies. TRIAL REGISTRATION This systematic review was registered with Prospero (record number: 42016032947).
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Affiliation(s)
- Mitchell N. Sarkies
- Kingston Centre, Monash University and Monash Health Allied Health Research Unit, 400 Warrigal Road, Heatherton, VIC 3202 Australia
| | - Kelly-Ann Bowles
- Monash University Department of Community Emergency Health and Paramedic Practice, Building H McMahons Road, Frankston, VIC 3199 Australia
| | - Elizabeth H. Skinner
- Kingston Centre, Monash University and Monash Health Allied Health Research Unit, 400 Warrigal Road, Heatherton, VIC 3202 Australia
| | - Romi Haas
- Kingston Centre, Monash University and Monash Health Allied Health Research Unit, 400 Warrigal Road, Heatherton, VIC 3202 Australia
| | - Haylee Lane
- Kingston Centre, Monash University and Monash Health Allied Health Research Unit, 400 Warrigal Road, Heatherton, VIC 3202 Australia
| | - Terry P. Haines
- Kingston Centre, Monash University and Monash Health Allied Health Research Unit, 400 Warrigal Road, Heatherton, VIC 3202 Australia
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Waqa G, Moodie M, Snowdon W, Latu C, Coriakula J, Allender S, Bell C. Exploring the dynamics of food-related policymaking processes and evidence use in Fiji using systems thinking. Health Res Policy Syst 2017; 15:74. [PMID: 28851398 PMCID: PMC5575848 DOI: 10.1186/s12961-017-0240-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 08/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obesity and non-communicable diseases are significant public health issues globally and particularly in the Pacific. Poor diet is a major contributor to this issue and policy change is a powerful lever to improve food security and diet quality. This study aims to apply systems thinking to identify the causes and consequences of poor evidence use in food-related policymaking in selected government ministries in Fiji and to illicit strategies to strengthen the use of evidence in policymaking. METHODS The Ministry of Health and Medical Services and the Ministry of Agriculture in Fiji were invited through their respective Permanent Secretaries to participate in the study. Three 180-minute group model building (GMB) workshops were conducted separately in each ministry over three consecutive days with selected policymakers who were instrumental in developing food-related policies designed to prevent non-communicable diseases. The GMB workshops mapped the process of food-related policymaking and the contribution of scientific and local evidence to the process, and identified actions to enhance the use of evidence in policymaking. RESULTS An average of 10 policymakers participated from each ministry. The causal loop diagrams produced by each ministry illustrated the causes and consequences of insufficient evidence use in developing food policies or precursors of the specific actions. These included (1) consultation, (2) engagement with stakeholders, (3) access and use of evidence, and (4) delays in policy processes. Participants agreed to potential leverage points on the themes above, addressing pertinent policymaker challenges in precursor control, including political influence, understanding of trade policies, competing government priorities and level of awareness on the problem. Specific actions for strengthening evidence use included training in policy development and research skills, and strengthening of coordination between ministries. CONCLUSIONS The GMB workshops improved participants' understanding of how different parts of the policy system interact. The causal loop diagrams and subsequent action plans enabled the identification of systems-level interventions in both ministries to improve evidence-informed policy development. A guide for integrating multi-sectoral consultation and stakeholder engagement in developing cross-cutting policies is currently being developed.
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Affiliation(s)
- Gade Waqa
- Pacific Research Center for the Prevention of Obesity and Non-Communicable Diseases (C-POND), College of Medicine Nursing and Health Sciences, Fiji National University, Private Mail Bag, Tamavua, Suva, Republic of Fiji. .,Deakin Health Economics, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, Australia. .,Global Obesity Centre, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, Australia.
| | - Marj Moodie
- Deakin Health Economics, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, Australia.,Global Obesity Centre, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, Australia
| | - Wendy Snowdon
- Global Obesity Centre, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, Australia
| | - Catherine Latu
- Pacific Research Center for the Prevention of Obesity and Non-Communicable Diseases (C-POND), College of Medicine Nursing and Health Sciences, Fiji National University, Private Mail Bag, Tamavua, Suva, Republic of Fiji.,Global Obesity Centre, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, Australia
| | - Jeremaia Coriakula
- Pacific Research Center for the Prevention of Obesity and Non-Communicable Diseases (C-POND), College of Medicine Nursing and Health Sciences, Fiji National University, Private Mail Bag, Tamavua, Suva, Republic of Fiji.,Global Obesity Centre, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, Australia
| | - Steven Allender
- Global Obesity Centre, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, Australia
| | - Colin Bell
- Global Obesity Centre, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, Australia
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Kremer P, Mavoa H, Waqa G, Moodie M, McCabe M, Swinburn B. Knowledge-exchange in the Pacific: outcomes of the TROPIC (translational research for obesity prevention in communities) project. BMC Public Health 2017; 17:362. [PMID: 28446165 PMCID: PMC5405494 DOI: 10.1186/s12889-017-4254-3] [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: 08/27/2016] [Accepted: 04/11/2017] [Indexed: 11/20/2022] Open
Abstract
Background The Pacific TROPIC (Translational Research for Obesity Prevention in Communities) project aimed to design, implement and evaluate a knowledge-broking approach to evidence-informed policy making to address obesity in Fiji. This paper reports on the quantitative evaluation of the knowledge-broking intervention through assessment of participants’ perceptions of evidence use and development of policy/advocacy briefs. Methods Selected staff from six organizations - four government Ministries and two nongovernment organizations (NGOs) - participated in the project. The intervention comprised workshops and supported development of policy/advocacy briefs. Workshops addressed obesity and policy cycles and developing participants’ skills in accessing, assessing, adapting and applying relevant evidence. A knowledge-broking team supported participants individually and/or in small groups to develop evidence-informed policy/advocacy briefs. A questionnaire survey that included workplace and demographic items and the self-assessment tool “Is Research Working for You?” (IRWFY) was administered pre- and post-intervention. Results Forty nine individuals (55% female, 69% 21–40 years, 69% middle-senior managers) participated in the study. The duration and level of participant engagement with the intervention activities varied – just over half participated for 10+ months, just under half attended most workshops and approximately one third produced one or more policy briefs. There were few reliable changes on the IRWFY scales following the intervention; while positive changes were found on several scales, these effects were small (d < .2) and only one individual scale (assess) was statistically significant (p < .05). Follow up (N = 1) analyses of individual-level change indicated that while 63% of participants reported increased research utilization post-intervention, this proportion was not different to chance levels. Similar analysis using scores aggregated by organization also revealed no organizational-level change post-intervention. Conclusions This study empirically evaluated a knowledge-broking program that aimed to extend evidence-informed policy making skills and development of a suite of national policy briefs designed to increase the enactment of obesity-related policies. The findings failed to indicate reliable improvements in research utilization at either the individual or organizational level. Factors associated with fidelity and intervention dose as well as challenges related to organizational support and the measurement of research utilization, are discussed and recommendations for future research presented.
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Affiliation(s)
- Peter Kremer
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3216, Australia.
| | - Helen Mavoa
- WHO Collaborating Centre for Obesity Prevention, Deakin University, Geelong, 3216, Australia
| | - Gade Waqa
- WHO Collaborating Centre for Obesity Prevention, Deakin University, Geelong, 3216, Australia.,College of Medicine Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | - Marjory Moodie
- Deakin Health Economics, Faculty of Health, Deakin University, Geelong, 3216, Australia
| | - Marita McCabe
- Institute for Health and Ageing, Australian Catholic University, Melbourne, 3000, Australia
| | - Boyd Swinburn
- WHO Collaborating Centre for Obesity Prevention, Deakin University, Geelong, 3216, Australia.,School of Population Health, University of Auckland, Auckland, 1142, New Zealand
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Waqa G, Bell C, Snowdon W, Moodie M. Factors affecting evidence-use in food policy-making processes in health and agriculture in Fiji. BMC Public Health 2017; 17:51. [PMID: 28068981 PMCID: PMC5223561 DOI: 10.1186/s12889-016-3944-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 12/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is limited research on the use of evidence to inform policy-making in the Pacific. This study aims to identify and describe factors that facilitate or limit the use of evidence in food-related policy-making in the Health and Agriculture Ministries in Fiji. METHODS Semi-structured face-to-face interviews were conducted with selected policy-makers in two government ministries that were instrumental in the development of food-related policies in Fiji designed to prevent Non-Communicable Diseases (NCDs). Snowball sampling was used to recruit, as key informants, senior policy-makers in management positions such as national advisors and directors who were based at either the national headquarters or equivalent. Interviewees were asked about their experiences in developing food-related or other policies, barriers or facilitators encountered in the policy development and implementation process and the use of evidence. Each interview lasted approximately 45-60 minutes, and was conducted in English. Audio-recorded interviews were transcribed, thematically coded and analyzed using N-Vivo 8.0 software. RESULTS Thirty-one policy-makers from the Ministry of Health and Medical Services (MoHMS n = 18) and the Ministry of Agriculture (MoA n = 13) in Fiji participated in the study. Whilst evidence is sometimes used in food-related policy-making in both the Health and Agriculture Ministries (including formal evidence such as published research and informal evidence such as personal experiences and opinions), it is not yet embedded as an essential part of the process. Participants indicated that a lack of resources, poor technical support in terms of training, the absence of clear strategies for improving competent use of evidence, procedures regarding engagement with other stakeholders across sectors, varying support from senior managers and limited consultation across sectors were barriers to evidence use. The willingness of organizations to create a culture of using evidence was reported as a facilitator. CONCLUSION The use of evidence in policy-making will only become a reality in Fiji if it is a formalized part of the government's policy-making systems. A systems approach to food-related policy-making and implementation may achieve this by helping Ministries manage the complex and dynamic nature of food-related policy-making in Fiji.
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Affiliation(s)
- Gade Waqa
- C-POND, Fiji School of Medicine, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji. .,Deakin Health Economics, Centre for Population Health Research, Faculty of Health, Deakin University, Melbourne, Australia.
| | - Colin Bell
- Global Obesity Centre, Centre for Population Health Research, Faculty of Health, Deakin University, Melbourne, Australia
| | - Wendy Snowdon
- Global Obesity Centre, Centre for Population Health Research, Faculty of Health, Deakin University, Melbourne, Australia
| | - Marj Moodie
- Deakin Health Economics, Centre for Population Health Research, Faculty of Health, Deakin University, Melbourne, Australia.,Global Obesity Centre, Centre for Population Health Research, Faculty of Health, Deakin University, Melbourne, Australia
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Bornbaum CC, Kornas K, Peirson L, Rosella LC. Exploring the function and effectiveness of knowledge brokers as facilitators of knowledge translation in health-related settings: a systematic review and thematic analysis. Implement Sci 2015; 10:162. [PMID: 26589972 PMCID: PMC4653833 DOI: 10.1186/s13012-015-0351-9] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 11/11/2015] [Indexed: 11/30/2022] Open
Abstract
Background Knowledge brokers (KBs) work collaboratively with key stakeholders to facilitate the transfer and exchange of information in a given context. Currently, there is a perceived lack of evidence about the effectiveness of knowledge brokering and the factors that influence its success as a knowledge translation (KT) mechanism. Thus, the goal of this review was to systematically gather evidence regarding the nature of knowledge brokering in health-related settings and determine if KBs effectively contributed to KT in these settings. Methods A systematic review was conducted using a search strategy designed by a health research librarian. Eight electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, ERIC, Scopus, SocINDEX, and Health Business Elite) and relevant grey literature sources were searched using English language restrictions. Two reviewers independently screened the abstracts, reviewed full-text articles, extracted data, and performed quality assessments. Analysis included a confirmatory thematic approach. To be included, studies must have occurred in a health-related setting, reported on an actual application of knowledge brokering, and be available in English. Results In total, 7935 records were located. Following removal of duplicates, 6936 abstracts were screened and 240 full-text articles were reviewed. Ultimately, 29 articles, representing 22 unique studies, were included in the thematic analysis. Qualitative (n = 18), quantitative (n = 1), and mixed methods (n = 6) designs were represented in addition to grey literature sources (n = 4). Findings indicated that KBs performed a diverse range of tasks across multiple health-related settings; results supported the KB role as a ‘knowledge manager’, ‘linkage agent’, and ‘capacity builder’. Our systematic review explored outcome data from a subset of studies (n = 8) for evidence of changes in knowledge, skills, and policies or practices related to knowledge brokering. Two studies met standards for acceptable methodological rigour; thus, findings were inconclusive regarding KB effectiveness. Conclusions As knowledge managers, linkage agents, and capacity builders, KBs performed many and varied tasks to transfer and exchange information across health-related stakeholders, settings, and sectors. How effectively they fulfilled their role in facilitating KT processes is unclear; further rigourous research is required to answer this question and discern the potential impact of KBs on education, practice, and policy. Electronic supplementary material The online version of this article (doi:10.1186/s13012-015-0351-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Catherine C Bornbaum
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada. .,Health & Rehabilitation Sciences, Western University, Elborn College, Room 2200, London, ON, N6A 1H1, Canada.
| | - Kathy Kornas
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada.
| | - Leslea Peirson
- McMaster Evidence Review and Synthesis Centre, School of Nursing, McMaster University Faculty of Health Sciences, 1280 Main St. W., Hamilton, ON, L8S 4L8, Canada.
| | - Laura C Rosella
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada. .,Public Health Ontario, Santé publique Ontario, 480 University Avenue, Suite 300, Toronto, ON, M5G 1V2, Canada. .,Institute for Clinical Evaluative Sciences (ICES), G1 06, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
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Perspectives of Fijian Policymakers on the Obesity Prevention Policy Landscape. BIOMED RESEARCH INTERNATIONAL 2015; 2015:926159. [PMID: 26380307 PMCID: PMC4561938 DOI: 10.1155/2015/926159] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 03/10/2015] [Indexed: 01/07/2023]
Abstract
In Fiji and other Pacific Island countries, obesity has rapidly increased in the past decade. Therefore, several obesity prevention policies have been developed. Studies show that their development has been hampered by factors within Fiji's policy landscape such as pressure from industry. Since policymakers in the Fijian national government are primarily responsible for the development of obesity policies, it is important to understand their perspectives; we therefore interviewed 15 policymakers from nine Fijian ministries. By applying the "attractor landscape" metaphor from dynamic systems theory, we captured perceived barriers and facilitators in the policy landscape. A poor economic situation, low food self-sufficiency, power inequalities, inappropriate framing of obesity, limited policy evidence, and limited resource sharing hamper obesity policy developments in Fiji. Facilitators include policy entrepreneurs and policy brokers who were active when a window of opportunity opened and who strengthened intersectoral collaboration. Fiji's policy landscape can become more conducive to obesity policies if power inequalities are reduced. In Fiji and other Pacific Island countries, this may be achievable through increased food self-sufficiency, strengthened intersectoral collaboration, and the establishment of an explicit functional focal unit within government to monitor and forecast the health impact of policy changes in non-health sectors.
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El-Jardali F, Lavis J, Moat K, Pantoja T, Ataya N. Capturing lessons learned from evidence-to-policy initiatives through structured reflection. Health Res Policy Syst 2014; 12:2. [PMID: 24438365 PMCID: PMC3904410 DOI: 10.1186/1478-4505-12-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 01/09/2014] [Indexed: 11/10/2022] Open
Abstract
Background Knowledge translation platforms (KTPs), which are partnerships between policymakers, stakeholders, and researchers, are being established in low- and middle-income countries (LMICs) to enhance evidence-informed health policymaking (EIHP). This study aims to gain a better understanding of the i) activities conducted by KTPs, ii) the way in which KTP leaders, policymakers, and stakeholders perceive these activities and their outputs, iii) facilitators that support KTP work and challenges, and the lessons learned for overcoming such challenges, and iv) factors that can help to ensure the sustainability of KTPs. Methods This paper triangulated qualitative data from: i) 17 semi-structured interviews with 47 key informants including KTP leaders, policymakers, and stakeholders from 10 KTPs; ii) document reviews, and iii) observation of deliberations at the International Forum on EIHP in LMICs held in Addis Ababa in August 2012. Purposive sampling was used and data were analyzed using thematic analysis. Results Deliberative dialogues informed by evidence briefs were identified as the most commendable tools by interviewees for enhancing EIHP. KTPs reported that they have contributed to increased awareness of the importance of EIHP and strengthened relationships among policymakers, stakeholders, and researchers. Support from policymakers and international funders facilitated KTP activities, while the lack of skilled human resources to conduct EIHP activities impeded KTPs. Ensuring the sustainability of EIHP initiatives after the end of funding was a major challenge for KTPs. KTPs reported that institutionalization within the government has helped to retain human resources and secure funding, whereas KTPs hosted by universities highlighted the advantage of autonomy from political interests. Conclusions The establishment of KTPs is a promising development in supporting EIHP. Real-time lesson drawing from the experiences of KTPs can support improvements in the functioning of KTPs in the short term, while making the case for sustaining their work in the long term. Lessons learned can help to promote similar EIHP initiatives in other countries.
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Affiliation(s)
- Fadi El-Jardali
- Department of Health Management and Policy, American University of Beirut, Riad El Solh, PO Box 11-0236, Beirut 1107 2020, Lebanon.
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