From research to policy: what have we learned?

Exploring the Triple Helix Synergy in Chinese National System of Innovation

Sustainable economic growth is closely linked to synergy in a national system of innovation. Although the dynamic synergy mechanism of the triple helix relations is essential to technology innovation, there are limited research methodologies to study or estimate the synergy effect accurately. This paper introduces a new approach in non-linear complex systems theory to offer steps towards a possible solution to this conundrum. Based on the pattern formation of the Belousov-Zhabotinsky’s reaction, the paper constructs a simulation equation to explore the evolution mechanism by comparing the ideal state with the current state in China. The research finds that (1) under the ideal balanced condition of industrial absorptive capacity and academic knowledge transfer capability, the stronger incentive policies would play much more important roles than weak policies; (2) the performance of collaborative innovation is not optimal under current situation in China, but the industrial absorptive capacity, especially in private enterprises, has exceeded the capability of knowledge transfer in academia, and it has become the main driving force to promote future innovation. If the innovation policy can be focused on the high-level balance between the knowledge network and innovation network to promote synergy in China, the innovation performance will be accelerated more efficiently.

A review of the process of knowledge transfer and use of evidence in reproductive and child health in Ghana

Background

The paper carries out a situational analysis to examine the production, dissemination and utilisation of reproductive and child health-related evidence to inform policy formulation in Ghana’s health sector.

Methods

The study used Wald’s model of knowledge production, transfer and utilisation as a conceptual model to collect relevant data via interviews and administration of questionnaire to a network of persons who either previously or currently hold policy-relevant positions in Ghana’s health sector. Additional data was also gathered through a scoping review of the knowledge transfer and research utilisation literature, existing reproductive and child health policies, protocols and guidelines and information available on the websites of relevant institutions in Ghana’s health sector.

Results

The findings of the study suggest that the health sector in Ghana has major strengths (strong knowledge production capacity, a positive environment for the promotion of evidence-informed policy) and opportunities (access to major donors who have the resources to fund good quality research and access to both local and international networks for collaborative research). What remains a challenge, however, is the absence of a robust institutional-wide mechanism for collating research needs and communicating these to researchers, communicating research findings in forms that are friendlier to policy-makers and the inability to incorporate funding for research into the budget of the health sector.

Conclusion

The study concludes, admonishing the Ministry of Health and its agencies to leverage on the existing strengths and opportunities to address the identified challenges.

Measuring Use of Research Evidence: The Structured Interview for Evidence Use

OBJECTIVES

This article describes the Standard Interview for Evidence Use (SIEU), a measure to assess the level of engagement in acquiring, evaluating, and applying research evidence in health and social service settings.

METHOD

Three scales measuring input, process, and output of research evidence and eight subscales were identified using principal axis factor analysis and parallel analysis of data collected from 202 state and county child welfare, mental health, and juvenile justice systems leaders.

RESULTS

The SIEU scales and subscales demonstrate strong internal consistency as well as convergent and discriminant validity.

CONCLUSIONS

The SIEU is easy to use and can be administered as a complete scale or as three smaller scales to separately examine evidence in acquisition, evaluation, or application. The measure demonstrates potential in understanding the role of research evidence in service settings and in monitoring the process of evidence-based practice and application of scientific principles in social work practice.

Enhancing the Capacity of Policy-Makers to Develop Evidence-Informed Policy Brief on Infectious Diseases of Poverty in Nigeria

BACKGROUND

The lack of effective use of research evidence in policy-making is a major challenge in most low- and middle-income countries (LMICs). There is need to package research data into effective policy tools that will help policy-makers to make evidence-informed policy regarding infectious diseases of poverty (IDP). The objective of this study was to assess the usefulness of training workshops and mentoring to enhance the capacity of Nigerian health policy-makers to develop evidence-informed policy brief on the control of IDP.

METHODS

A modified "before and after" intervention study design was used in which outcomes were measured on the target participants both before the intervention is implemented and after. A 4-point Likert scale according to the degree of adequacy; 1 = "grossly inadequate," 4 = "very adequate" was employed. The main parameter measured was participants' perceptions of their own knowledge/understanding. This study was conducted at subnational level and the participants were the career health policy-makers drawn from Ebonyi State in the South-Eastern Nigeria. A one-day evidence-to-policy workshop was organized to enhance the participants' capacity to develop evidence-informed policy brief on IDP in Ebonyi State. Topics covered included collaborative initiative; preparation and use of policy briefs; policy dialogue; ethics in health policy-making; and health policy and politics.

RESULTS

The preworkshop mean of knowledge and capacity ranged from 2.49-3.03, while the postworkshop mean ranged from 3.42-3.78 on 4-point scale. The percentage increase in mean of knowledge and capacity at the end of the workshop ranged from 20.10%-45%. Participants were divided into 3 IDP mentorship groups (malaria, schistosomiasis, lymphatic filariasis [LF]) and were mentored to identify potential policy options/recommendations for control of the diseases for the policy briefs. These policy options were subjected to research evidence synthesis by each group to identify the options that have the support of research evidence (mostly systematic reviews) from PubMed, Cochrane database and Google Scholar. After the evidence synthesis, five policy options were selected out of 13 for malaria, 3 out of 10 for schistosomiasis and 5 out of 11 for LF.

CONCLUSION

The outcome suggests that an evidence-to-policy capacity enhancement workshop combined with a mentorship programme can improve policy-makers' capacity for evidence-informed policy-making (EIP).

Evaluating a knowledge exchange intervention in cancer survivorship care: a workshop to foster implementation of Online Support Groups

PURPOSE

The purpose of the research described here is to assess the overall effectiveness of the workshop format as a Knowledge Exchange (KE) strategy in (1) disseminating scientific evidence, clinical experience, and systems information related to professionally led Online Support Groups (OSG) for cancer survivors and (2) facilitating the implementation of this intervention by a select group of end users--decision makers and clinical leads in psychosocial supportive care.

METHODS

The KE-Decision Support (KE-DS) Model, operationalizing the Health Technology Approach, guided the development of pre- and postworkshop questionnaires, and a follow-up questionnaire administered 5 months after the workshop. Questionnaire results were categorized according to participants' responses to these elements: methods of engagement, evidence (scientific, experiential, systems) and the delivery of this evidence, and external factors at the institutional level, such as administrative support, budgetary issues, etc., that influence decision-maker abilities and strategies.

RESULTS

Traditional KE strategies such as peer-reviewed journal articles are optimal for disseminating scientific evidence, while face-to-face interactions, such as in a workshop, are best used to disseminate systems-level implementation information, such as fiscal implications, budgetary requirements, and policy relevance, which is not found in journal articles or conferences. An apparent shift in workplace culture signifies the availability of institutional support for high-level staff to engage in KE.

CONCLUSIONS

As a KE strategy with identified end users, the workshop format is effective in facilitating the implementation of this intervention in participants' institutions.

Strategies for collaboration in the interdisciplinary field of emerging zoonotic diseases

The integration of the veterinary, medical and environmental sciences necessary to predict, prevent or respond to emerging zoonotic diseases requires effective collaboration and exchange of knowledge across these disciplines. There has been no research into how to connect and integrate these professions in the pursuit of a common task. We conducted a literature search looking at the experiences and wisdom resulting from collaborations built in health partnerships, health research knowledge transfer and exchange, business knowledge management and systems design engineering to identify key attributes of successful interdisciplinary (ID) collaboration. This was followed by a workshop with 16 experts experienced in ID collaboration including physicians, veterinarians and biologists from private practice, academia and government agencies. The workshop participants shared their perspectives on the facilitators and barriers to ID collaboration. Our results found that the elements that can support or impede ID collaboration can be categorized as follows: the characteristics of the people, the degree to which the task is a shared goal, the policies, practices and resources of the workplace, how information technology is used and the evaluation of the results. Above all, personal relationships built on trust and respect are needed to best assemble the disciplinary strength of the professions. The challenge of meeting collaborators outside the boundaries of one's discipline or jurisdiction may be met by an independent third party, an ID knowledge broker. The broker would know where the knowledge could be found, would facilitate introductions and would help to build effective ID teams.

From research to public policy: an essential extension of the translation research agenda

Research translation typically includes translation from basic science into clinical research and from clinical research into everyday clinical practice. In this essay, we propose a greater emphasis on applying research findings, both basic and clinical, into effective public policies that promote health. Research can have important influences on policy by providing a scholarly basis for action research, and translation science units within academic health centers are in powerful positions to build bridges between the research and policy making communities to promote the development of evidence based policy. The results will benefit the researcher and the decision maker, as well as the research itself.

Knowledge transfer and exchange: review and synthesis of the literature

Knowledge transfer and exchange (KTE) is as an interactive process involving the interchange of knowledge between research users and researcher producers. Despite many strategies for KTE, it is not clear which ones should be used in which contexts. This article is a review and synthesis of the KTE literature on health care policy. The review examined and summarized KTE's current evidence base for KTE. It found that about 20 percent of the studies reported on a real-world application of a KTE strategy, and fewer had been formally evaluated. At this time there is an inadequate evidence base for doing "evidence-based" KTE for health policy decision making. Either KTE must be reconceptualized, or strategies must be evaluated more rigorously to produce a richer evidence base for future activity.

Implementation of evidence-based practice in community behavioral health: agency director perspectives

Despite a growing supply of evidence-based mental health treatments, we have little evidence about how to implement them in real-world care. This qualitative pilot study captured the perspectives of agency directors on the challenge of implementing evidence-based practices in community mental health agencies. Directors identified challenges as limited access to research, provider resistance, and training costs. Director leadership, support to providers, and partnerships with universities were leverage points to implement evidenced-based treatments. Directors' mental models of EBP invoked such concepts as agency reputation, financial solvency, and market niche. Findings have potential to shape implementation interventions.

A model for collaborative evaluation of university-community partnerships

INTRODUCTION

Manitoba's The Need to Know project was presented with a unique opportunity to develop a collaborative approach to evaluation, and to explore the effectiveness of a variety of evaluation methods for assessment of university-community collaborative health research partnerships.

OBJECTIVES

The evaluation was designed to incorporate participation of community partners in planning, developing, and evaluating all aspects of the project. Objectives included: (a) assessment of extent to which the project met its initial objectives; (b) assessment of extent participants needs and expectations were met; (c) refinement of evaluation questions; (d) identification of unanticipated impacts; (e) assessment of participant confidence as research team members; (f) development of knowledge translation theory; and (g) component analysis.

METHODS

A "utilisation focused" approach was used. Primary stakeholders identified evaluation questions of concern, and how findings would be used. The multimethod time series design incorporated key informant interviews, a pre/post-test survey, written workshop evaluations, and participant and unobtrusive observation. All aspects of the evaluation were made transparent to participants, and formal feedback processes were instituted.

RESULTS

There was a high level of participation in evaluation activities. Identifying evaluation questions of concern to community partners helped shape project development. While all methods provided useful information, only key informant interviews, participant observation and feedback processes provided insights into all evaluation objectives.

CONCLUSION

Collaborative evaluation can make an important contribution to development of university-community partnerships. Qualitative methods (particularly key informant interviews, participant observation, and feedback processes) provided the richest source of data, and made an important contribution to team development.

Towards enhancing national capacity for evidence informed policy and practice in falls management: a role for a "Translation Task Group"?

BACKGROUND

There has been a growing interest over recent years, both within Australia and overseas, in enhancing the translation of research into policy and practice. As one mechanism to improve the dissemination and uptake of falls research into policy and practice and to foster the development of policy-appropriate research, a "Falls Translation Task Group" was formed as part of an NHMRC Population Health Capacity Building grant. This paper reports on the group's first initiative to address issues around the research to policy and practice interface, and identifies a continuing role for such a group.

METHODS

A one day forum brought together falls researchers and decision-makers from across the nation to facilitate linkage and exchange. Observations of the day's proceedings were made by the authors. Participants were asked to complete a questionnaire at the commencement of the forum (to ascertain expectations) and at its completion (to evaluate the event). Observer notes and the questionnaire responses form the basis of analysis.

RESULTS

Both researchers and decision-makers have a desire to bridge the gap between research and policy and practice. Significant barriers to research uptake were highlighted and included both "health system barriers" (for example, a lack of financial and human resources) as well as "evidence barriers" (such as insufficient economic data and implementation research). Solutions to some of these barriers included the identification of clinical champions within the health sector to enhance evidence uptake, and the sourcing of alternative funding to support implementation research and encourage partnerships between researchers, decision-makers and other stakeholders.

CONCLUSION

Participants sought opportunities for ongoing networking and collaboration. Two activities have been identified as priorities: establishing a "policy-sensitive" research agenda and partnering researchers and decision-makers in the process; and establishing a National Translation Task Group with a broad membership.

The utilisation of health research in policy-making: concepts, examples and methods of assessment

The importance of health research utilisation in policy-making, and of understanding the mechanisms involved, is increasingly recognised. Recent reports calling for more resources to improve health in developing countries, and global pressures for accountability, draw greater attention to research-informed policy-making. Key utilisation issues have been described for at least twenty years, but the growing focus on health research systems creates additional dimensions.The utilisation of health research in policy-making should contribute to policies that may eventually lead to desired outcomes, including health gains. In this article, exploration of these issues is combined with a review of various forms of policy-making. When this is linked to analysis of different types of health research, it assists in building a comprehensive account of the diverse meanings of research utilisation.Previous studies report methods and conceptual frameworks that have been applied, if with varying degrees of success, to record utilisation in policy-making. These studies reveal various examples of research impact within a general picture of underutilisation.Factors potentially enhancing utilisation can be identified by exploration of: priority setting; activities of the health research system at the interface between research and policy-making; and the role of the recipients, or 'receptors', of health research. An interfaces and receptors model provides a framework for analysis.Recommendations about possible methods for assessing health research utilisation follow identification of the purposes of such assessments. Our conclusion is that research utilisation can be better understood, and enhanced, by developing assessment methods informed by conceptual analysis and review of previous studies.

How can research organizations more effectively transfer research knowledge to decision makers?

Five questions--What should be transferred to decision makers? To whom should it be transferred? By whom? How? With what effect?--provide an organizing framework for a knowledge transfer strategy. Opportunities for improving how research organizations transfer research knowledge can be found in the differences between the answers suggested by our understanding of the research literature and those provided by research-organization directors asked to describe what they do. In Canada, these opportunities include developing actionable messages for decision makers (only 30 percent of research organizations frequently or always do this), developing knowledge-uptake skills in target audiences and knowledge-transfer skills in research organizations (only 20 to 22 percent frequently or always do this), and evaluating the impact of knowledge-transfer activities (only 8 to 12 percent frequently or always conduct an evaluation). Research funders can help research organizations take advantage of these opportunities.

Examining the role of health services research in public policymaking

Conceptual, methodological, and practical issues await those who seek to understand how to make better use of health services research in developing public policy. Some policies and some policymaking processes may lend themselves particularly well to being informed by research. Different conclusions about the extent to which policymaking is informed by research may arise from different views about what constitutes health services research (is it citable research or any professional social inquiry that can aid in problem solving?) or different views about what constitutes research use (is it explicit uses of research only, or does it also include tacit knowledge or the positions of stakeholders when they are informed by research and are influential in the policymaking process?). Some conditions may favor the use of research in policymaking, like sustained interactions between researchers and policymakers. Results from an exploratory study on the use of health services research by Canadian provincial policymakers illustrate these issues.