Utilization of research findings for health policy making and practice: evidence from three case studies in Bangladesh

Barriers to Research Utilization in Nursing: A Systematic Review (2002–2021)

Introduction

There is an existing gap between what people learned from theory and what they clinically practiced, as revealed in research studies in nursing. This gap is primarily due to identified barriers in utilizing the research findings in actual nursing practice.

Objective

To present a scientific mapping of the Scopus-indexed literature published from 2002 to 2021, which studied barriers to research utilization in nursing using the BARRIER scale.

Methods

This systematic review utilized bibliometric analysis. One hundred seventy-nine extracted literature from Scopus was manually reviewed, and the study included 53 documents for further analysis.

Results

Remarkably, almost three-fourths of the documents identified setting-related factors as the most common barrier to research utilization in nursing (n = 39, 73.58%). This is followed by presentation-related factors (n = 16.98%) and nurse-related factors (n = 5, 9.43%), respectively. Findings revealed that insufficient time at work in implementing new ideas was perceived as the top barrier in research utilization in nursing.

Conclusion

It is crucial to determine the hindrances to the utilization of research findings. The results of this study establish the connection between research and evidence-based practice which stimulates in meeting the gap in the current nursing practice. Future studies must include research utilization studies that apply tools other than the BARRIER scale.

Investigating the process of evidence-informed health policymaking in Bangladesh: a systematic review

Over the last four decades, Bangladesh has made considerable improvements in population health, this is in part due to the use of evidence to inform policymaking. This systematic review aims to better understand critical factors that have facilitated the diffusion of scientific evidence into multiple phases of health policymaking in Bangladesh. To do this an existing policy framework designed by Shiffman and Smith in 2007, was used to extract and synthesize data from selected policy analyses. This framework was used to ensure the content, context and actors involved with evidence-informed policymaking were considered in each case where research had helped shape a health policy. The 'PRISMA Checklist' was employed to design pre-specified eligibility criteria for the selection of information sources, search strategy, inclusion and exclusion criteria, and process of data extraction and synthesis. Through our systematic search conducted from February to May 2017, we initially identified 1859 articles; after removal of duplicates, followed by the screening of titles, abstracts and full-texts, 24 articles were included in the analysis. Health policy issues included the following topics: maternal and child health, tobacco control, reproductive health, infectious disease control and the impact and sustainability of knowledge translation platforms. Findings suggested that research evidence that could be used to meet key targets associated with the Millennium Development Goals (MDGs) were more likely to be considered as a political (and therefore policy) priority. Furthermore, avenues of engagement between research organizations and the government as well as collective action from civil-society organizations were important for the diffusion of evidence into policies. Through this article, it is apparent that the interface between evidence and policy formulation occurs when evidence is, disseminated by a cohesive policy-network with strong leadership and framed to deliver solutions for problems on both the domestic and global development agenda.

Review of published evidence on knowledge translation capacity, practice and support among researchers and research institutions in low- and middle-income countries

BACKGROUND

Knowledge translation (KT) is a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically sound application of knowledge to yield beneficial outcomes for society. Effective KT requires researchers to play an active role in promoting evidence uptake. This paper presents a systematised review of evidence on low- and middle-income country (LMIC) researchers' KT capacity, practice and interventions for enhancing their KT practice (support) with the aim of identifying gaps and informing future research and interventions.

METHODS

An electronic search for peer-reviewed publications focusing on LMIC researchers' KT capacity, practice and support across all academic fields, authored in English and from the earliest records available to February 2019, was conducted using PubMed and Scopus. Selected studies were appraised using the Mixed Methods Appraisal Tool, data pertaining to publication characteristics and study design extracted, and an a priori thematic analysis of reported research findings completed.

RESULTS

The search resulted in 334 screened articles, of which 66 met the inclusion criteria. Most (n = 43) of the articles presented original research findings, 22 were commentaries and 1 was a structured review; 47 articles reported on researchers' KT practice, 12 assessed the KT capacity of researchers or academic/research institutions and 9 reported on KT support for researchers. More than half (59%) of the articles focused on sub-Saharan Africa and the majority (91%) on health research. Most of the primary studies used the case study design (41%). The findings suggest that LMIC researchers rarely conduct KT and face a range of barriers at individual and institutional levels that limit their KT practice, including inadequate KT knowledge and skills, particularly for communicating research and interacting with research end-users, insufficient funding, and inadequate institutional guidelines, structures and incentives promoting KT practice. Furthermore, the evidence-base on effective interventions for enhancing LMIC researchers' KT practice is insufficient and largely of weak quality.

CONCLUSIONS

More high-quality research on researchers' KT capacity, practice and effective KT capacity strengthening interventions is needed. Study designs that extend beyond case studies and descriptive studies are recommended, including better designed evaluation studies, e.g. use of realist approaches, pragmatic trials, impact evaluations, implementation research and participatory action research.

Knowledge translation for public health in low- and middle- income countries: a critical interpretive synthesis

Background

Effective knowledge translation allows the optimisation of access to and utilisation of research knowledge in order to inform and enhance public health policy and practice. In low- and middle- income countries, there are substantial complexities that affect the way in which research can be utilised for public health action. This review attempts to draw out concepts in the literature that contribute to defining some of the complexities and contextual factors that influence knowledge translation for public health in low- and middle- income countries.

Methods

A Critical Interpretive Synthesis was undertaken, a method of analysis which allows a critical review of a wide range of heterogeneous evidence, through incorporating systematic review methods with qualitative enquiry techniques. A search for peer-reviewed articles published between 2000 and 2016 on the topic of knowledge translation for public health in low- and middle – income countries was carried out, and 85 articles were reviewed and analysed using this method.

Results

Four main concepts were identified: 1) tension between ‘global’ and ‘local’ health research, 2) complexities in creating and accessing evidence, 3) contextualising knowledge translation strategies for low- and middle- income countries, and 4) the unique role of non-government organisations in the knowledge translation process.

Conclusion

This method of review has enabled the identification of key concepts that may inform practice or further research in the field of knowledge translation in low- and middle- income countries.

Electronic supplementary material

The online version of this article (10.1186/s41256-018-0084-9) contains supplementary material, which is available to authorized users.

Research dissemination workshops: observations and implications based on an experience in Burkina Faso

Background

In Burkina Faso, malaria remains the primary cause of healthcare use, morbidity and child mortality. Therefore, efforts are needed to support the knowledge transfer and application of the results of numerous studies to better formulate and implement programs in the fight against the malaria pandemic. To this end, a 2-day dissemination workshop was held to share the most recent results produced by a multidisciplinary research team. The objective of the present study was to evaluate the workshop and the policy briefs distributed there, the effects these produced on research results use and the processes that facilitated, or not, the application of the knowledge transmitted.

Methods

A mixed-methods design was used. The data were drawn from a quantitative evaluation questionnaire completed after the workshop (n = 25/31) and qualitative interviews conducted with the researchers and various actors who attended the workshop (n = 11) and with participants in working groups (n = 40) that later analysed the policy briefs distributed at the workshop.

Results

The participants recognised the quality of the research results presented, but felt that more needed to be done to adapt the researchers’ language and improve the functioning of the workshop. The potential effects of the workshop were rather limited. Effects were mainly at two levels: individual (e.g. acquisition of new knowledge, personal awareness raising) and local (e.g. change of practice in a local non-governmental organisation). Most participants perceived the utility of the research results, but several reported that their narrow decisional power limited their ability to apply this knowledge.

Conclusions

This study showed the importance of workshops to inform key actors of research results and the need to undertake several different activities to increase the chances that the knowledge will be applied. Several recommendations are proposed to improve knowledge translation approaches in the West African context, including organising working and discussion groups, developing an action plan at the end of the workshop and offering support to participants after the workshop, among others.

The impact on healthcare, policy and practice from 36 multi-project research programmes: findings from two reviews

BACKGROUND

We sought to analyse the impacts found, and the methods used, in a series of assessments of programmes and portfolios of health research consisting of multiple projects.

METHODS

We analysed a sample of 36 impact studies of multi-project research programmes, selected from a wider sample of impact studies included in two narrative systematic reviews published in 2007 and 2016. We included impact studies in which the individual projects in a programme had been assessed for wider impact, especially on policy or practice, and where findings had been described in such a way that allowed them to be collated and compared.

RESULTS

Included programmes were highly diverse in terms of location (11 different countries plus two multi-country ones), number of component projects (8 to 178), nature of the programme, research field, mode of funding, time between completion and impact assessment, methods used to assess impact, and level of impact identified. Thirty-one studies reported on policy impact, 17 on clinician behaviour or informing clinical practice, three on a combined category such as policy and clinician impact, and 12 on wider elements of impact (health gain, patient benefit, improved care or other benefits to the healthcare system). In those multi-programme projects that assessed the respective categories, the percentage of projects that reported some impact was policy 35% (range 5-100%), practice 32% (10-69%), combined category 64% (60-67%), and health gain/health services 27% (6-48%). Variations in levels of impact achieved partly reflected differences in the types of programme, levels of collaboration with users, and methods and timing of impact assessment. Most commonly, principal investigators were surveyed; some studies involved desk research and some interviews with investigators and/or stakeholders. Most studies used a conceptual framework such as the Payback Framework. One study attempted to assess the monetary value of a research programme's health gain.

CONCLUSION

The widespread impact reported for some multi-project programmes, including needs-led and collaborative ones, could potentially be used to promote further research funding. Moves towards greater standardisation of assessment methods could address existing inconsistencies and better inform strategic decisions about research investment; however, unresolved issues about such moves remain.

A Knowledge Brokering Program in Burkina Faso (West Africa): Reflections from Our Experience

Abstract-In Burkina Faso, inadequate interaction among researchers, decision makers, and practitioners, together with low use of research results, impedes the development of health policies and interventions to improve equity. A knowledge translation strategy was implemented as part of a research program. The broker and his team promoted links between actors (health agents, nongovernmental organizations, public administration, policy makers, researchers), provided them with research results related to their needs, and supported them in applying this knowledge in their practices. The strategy was first implemented in Kaya District, Burkina Faso. To increase impact on population health, the strategy included widening the sphere of action through collaboration with the Ministry of Health. The broker was affiliated with a public health consulting firm in the capital, Ouagadougou, and supported by Canadian experts and a senior Burkinabè broker. Evaluation shows that research use increased at the local level among health mutuals, regional nongovernmental organizations, and health professionals in Kaya, but the objective of reaching Ministry of Health decision makers was not achieved. Results highlight the need for better training in knowledge transfer for both local and international researchers and proper identification of the gateways to reach high level decision makers. This ambitious strategy encountered several obstacles: difficult access to decision makers, poor team communication, and broker's nonconducive working environment. Future brokering strategies should analyze the political situation in depth to determine when and how to approach national and regional decision makers; invest time and effort in developing different actors' (including researchers') knowledge transfer skills; and ensure sufficient and good quality communications and resources within the team.

Which health research gets used and why? An empirical analysis of 30 cases

BACKGROUND

While health research is considered essential for improving health worldwide, it remains unclear how it is best organized to contribute to health. This study examined research that was part of a Ghanaian-Dutch research program that aimed to increase the likelihood that results would be used by funding research that focused on national research priorities and was led by local researchers. The aim of this study was to map the contribution of this research to action and examine which features of research and translation processes were associated with the use of the results.

METHODS

Using Contribution Mapping, we systematically examined how 30 studies evolved and how results were used to contribute to action. We combined interviews with 113 purposively selected key informants, document analysis and triangulation to map how research and translation processes evolved and contributions to action were realized. After each case was analysed separately, a cross-case analysis was conducted to identify patterns in the association between features of research processes and the use of research.

RESULTS

The results of 20 of the 30 studies were used to contribute to action within 12 months. The priority setting and proposal selection process led to the funding of studies which were from the outset closely aligned with health sector priorities. Research was most likely to be used when it was initiated and conducted by people who were in a position to use their results in their own work. The results of 17 out of 18 of these user-initiated studies were translated into action. Other features of research that appeared to contribute to its use were involving potential key users in formulating proposals and developing recommendations.

CONCLUSIONS

Our study underlines the importance of supporting research that meets locally-expressed needs and that is led by people embedded in the contexts in which results can be used. Supporting the involvement of health sector professionals in the design, conduct and interpretation of research appears to be an especially worthwhile investment.