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Elliott SA, Bialy L, Scott SD, Hartling L. Exploring methods for creating or adapting knowledge mobilization products for culturally and linguistically diverse audiences: a scoping review. Arch Public Health 2024; 82:111. [PMID: 39034399 PMCID: PMC11265177 DOI: 10.1186/s13690-024-01334-0] [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: 02/12/2024] [Accepted: 06/29/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Connecting end-users to research evidence has the power to improve patient knowledge and inform health decision-making. Differences in the culture and language of the end users may shape the effectiveness of knowledge mobilization (KMb). This scoping review set out to understand current approaches and methods when creating or adapting KMb products for culturally and linguistically diverse (CALD) audiences. METHODS We searched 3 databases (Ovid Medline, CINAHL via EBSCOhost, PsychINFO) from 2011 until August 2023. We included any literature about KMb product creation or adaptation processes serving CALD communities. A primary reviewer screened all identified publications and a second reviewer screened publications excluded by the primary. Data were extracted using a standardized form by one reviewer and verified by a second reviewer. Studies were categorized by type of adaptations ('surface' and/or 'deep' structure) and mapped based on type of stakeholder engagement used in the research approach (i2S model), and end-user involvement (content, design, evaluation and dissemination) in KMb product creation or adaptation. RESULTS Ten thousand two hundred ninety-nine unique titles and abstracts were reviewed, 670 full-text studies were retrieved and reviewed, and 78 studies were included in final data extraction and mapping. Twenty-four studies (31%) created or adapted exclusively text-based KMb products such as leaflets and pamphlets and 49 (63%) produced digital products such as videos (n = 16, 33%), mobile applications (n = 14, 29%), and eHealth websites (n = 7, 14%). Twenty-five studies (32%) reported following a framework or theory for their creation or adaptation efforts. Twenty-eight studies (36%) engaged stakeholders in the research approach. Nearly all (96%) involved end-users in creating or adapting the KMb products through involvement in content development (n = 64), design features (n = 52), evaluation (n = 44) and dissemination (n = 20). Thirty-two (41%) studies included reflections from the research teams on the processes for creating or adapting KMb products for CALD communities. CONCLUSION Included studies cited a variety of methods to create or adapt KMb products for CALD communities. Successful uptake of created or adapted KMb products was often the result of collaboration and involvement with end-users for more applicable, accessible and meaningful products. Further research developing guidance and best practices is needed to support the creation or adaptation of KMb products with CALD communities. REGISTRATION Protocol submitted to Open Science Framework on August 16, 2022 ( https://osf.io/9jcw4/ ).
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Affiliation(s)
- Sarah A Elliott
- Alberta Research Centre for Health Evidence (ARCHE), Faculty of Medicine and Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
| | - Liza Bialy
- Alberta Research Centre for Health Evidence (ARCHE), Faculty of Medicine and Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Shannon D Scott
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence (ARCHE), Faculty of Medicine and Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
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Mäkelä P, Boaz A, Oliver K. A modified action framework to develop and evaluate academic-policy engagement interventions. Implement Sci 2024; 19:31. [PMID: 38610039 PMCID: PMC11010317 DOI: 10.1186/s13012-024-01359-7] [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: 01/09/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND There has been a proliferation of frameworks with a common goal of bridging the gap between evidence, policy, and practice, but few aim to specifically guide evaluations of academic-policy engagement. We present the modification of an action framework for the purpose of selecting, developing and evaluating interventions for academic-policy engagement. METHODS We build on the conceptual work of an existing framework known as SPIRIT (Supporting Policy In Health with Research: an Intervention Trial), developed for the evaluation of strategies intended to increase the use of research in health policy. Our aim was to modify SPIRIT, (i) to be applicable beyond health policy contexts, for example encompassing social, environmental, and economic policy impacts and (ii) to address broader dynamics of academic-policy engagement. We used an iterative approach through literature reviews and consultation with multiple stakeholders from Higher Education Institutions (HEIs) and policy professionals working at different levels of government and across geographical contexts in England, alongside our evaluation activities in the Capabilities in Academic Policy Engagement (CAPE) programme. RESULTS Our modifications expand upon Redman et al.'s original framework, for example adding a domain of 'Impacts and Sustainability' to capture continued activities required in the achievement of desirable outcomes. The modified framework fulfils the criteria for a useful action framework, having a clear purpose, being informed by existing understandings, being capable of guiding targeted interventions, and providing a structure to build further knowledge. CONCLUSION The modified SPIRIT framework is designed to be meaningful and accessible for people working across varied contexts in the evidence-policy ecosystem. It has potential applications in how academic-policy engagement interventions might be developed, evaluated, facilitated and improved, to ultimately support the use of evidence in decision-making.
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Affiliation(s)
- Petra Mäkelä
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, Kings Cross, London, WC1H 9SH, UK.
| | - Annette Boaz
- Health and Social Care Workforce Research Unit, The Policy Institute, Virginia Woolf Building, Kings College London, 22 Kingsway, London, WC2B 6LE, UK
| | - Kathryn Oliver
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, Kings Cross, London, WC1H 9SH, UK
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Baxter H, Bearne L, Stone T, Thomas C, Denholm R, Redwood S, Purdy S, Huntley AL. The effectiveness of knowledge-sharing techniques and approaches in research funded by the National Institute for Health and Care Research (NIHR): a systematic review. Health Res Policy Syst 2024; 22:41. [PMID: 38566127 PMCID: PMC10988883 DOI: 10.1186/s12961-024-01127-5] [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: 03/29/2023] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The National Institute of Health and Care Research (NIHR), funds, enables and delivers world-leading health and social care research to improve people's health and wellbeing. To achieve this aim, effective knowledge sharing (two-way knowledge sharing between researchers and stakeholders to create new knowledge and enable change in policy and practice) is needed. To date, it is not known which knowledge sharing techniques and approaches are used or how effective these are in creating new knowledge that can lead to changes in policy and practice in NIHR funded studies. METHODS In this restricted systematic review, electronic databases [MEDLINE, The Health Management Information Consortium (including the Department of Health's Library and Information Services and King's Fund Information and Library Services)] were searched for published NIHR funded studies that described knowledge sharing between researchers and other stakeholders. One researcher performed title and abstract, full paper screening and quality assessment (Critical Appraisal Skills Programme qualitative checklist) with a 20% sample independently screened by a second reviewer. A narrative synthesis was adopted. RESULTS In total 9897 records were identified. After screening, 17 studies were included. Five explicit forms of knowledge sharing studies were identified: embedded models, knowledge brokering, stakeholder engagement and involvement of non-researchers in the research or service design process and organisational collaborative partnerships between universities and healthcare organisations. Collectively, the techniques and approaches included five types of stakeholders and worked with them at all stages of the research cycle, except the stage of formation of the research design and preparation of funding application. Seven studies (using four of the approaches) gave examples of new knowledge creation, but only one study (using an embedded model approach) gave an example of a resulting change in practice. The use of a theory, model or framework to explain the knowledge sharing process was identified in six studies. CONCLUSIONS Five knowledge sharing techniques and approaches were reported in the included NIHR funded studies, and seven studies identified the creation of new knowledge. However, there was little investigation of the effectiveness of these approaches in influencing change in practice or policy.
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Affiliation(s)
- Helen Baxter
- Evidence and Dissemination, National Institute for Health and Care Research, Twickenham, United Kingdom.
- National Institute for Health and Care Research, Applied Research Collaboration West (NIHR ARC WEST), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom.
| | - Lindsay Bearne
- Evidence and Dissemination, National Institute for Health and Care Research, Twickenham, United Kingdom
- Population Health Research Institute, St George's, University of London, London, United Kingdom
| | - Tracey Stone
- National Institute for Health and Care Research, Applied Research Collaboration West (NIHR ARC WEST), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Clare Thomas
- National Institute for Health and Care Research, Applied Research Collaboration West (NIHR ARC WEST), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- National Institute for Health and Care Research, Health Protection Research Unit in Behaviour Science and Evaluation (NIHR HPRU BSE), University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Rachel Denholm
- National Institute for Health and Care Research, Bristol Biomedical Research Centre (NIHR BRC), University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Sabi Redwood
- National Institute for Health and Care Research, Applied Research Collaboration West (NIHR ARC WEST), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Sarah Purdy
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Alyson Louise Huntley
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Ziam S, Lanoue S, McSween-Cadieux E, Gervais MJ, Lane J, Gaid D, Chouinard LJ, Dagenais C, Ridde V, Jean E, Fleury FC, Hong QN, Prigent O. A scoping review of theories, models and frameworks used or proposed to evaluate knowledge mobilization strategies. Health Res Policy Syst 2024; 22:8. [PMID: 38200612 PMCID: PMC10777658 DOI: 10.1186/s12961-023-01090-7] [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: 06/16/2023] [Accepted: 12/07/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Evaluating knowledge mobilization strategies (KMb) presents challenges for organizations seeking to understand their impact to improve KMb effectiveness. Moreover, the large number of theories, models, and frameworks (TMFs) available can be confusing for users. Therefore, the purpose of this scoping review was to identify and describe the characteristics of TMFs that have been used or proposed in the literature to evaluate KMb strategies. METHODS A scoping review methodology was used. Articles were identified through searches in electronic databases, previous reviews and reference lists of included articles. Titles, abstracts and full texts were screened in duplicate. Data were charted using a piloted data charting form. Data extracted included study characteristics, KMb characteristics, and TMFs used or proposed for KMb evaluation. An adapted version of Nilsen (Implement Sci 10:53, 2015) taxonomy and the Expert Recommendations for Implementing Change (ERIC) taxonomy (Powell et al. in Implement Sci 10:21, 2015) guided data synthesis. RESULTS Of the 4763 search results, 505 were retrieved, and 88 articles were eligible for review. These consisted of 40 theoretical articles (45.5%), 44 empirical studies (50.0%) and four protocols (4.5%). The majority were published after 2010 (n = 70, 79.5%) and were health related (n = 71, 80.7%). Half of the studied KMb strategies were implemented in only four countries: Canada, Australia, the United States and the United Kingdom (n = 42, 47.7%). One-third used existing TMFs (n = 28, 31.8%). According to the adapted Nilsen taxonomy, process models (n = 34, 38.6%) and evaluation frameworks (n = 28, 31.8%) were the two most frequent types of TMFs used or proposed to evaluate KMb. According to the ERIC taxonomy, activities to "train and educate stakeholders" (n = 46, 52.3%) were the most common, followed by activities to "develop stakeholder interrelationships" (n = 23, 26.1%). Analysis of the TMFs identified revealed relevant factors of interest for the evaluation of KMb strategies, classified into four dimensions: context, process, effects and impacts. CONCLUSIONS This scoping review provides an overview of the many KMb TMFs used or proposed. The results provide insight into potential dimensions and components to be considered when assessing KMb strategies.
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Affiliation(s)
- Saliha Ziam
- School of Business Administration, Université TÉLUQ, Montreal, Canada.
| | - Sèverine Lanoue
- Department of School and Social Adaptation Studies, Faculty of Education, Université de Sherbrooke, Sherbrooke, Canada
| | - Esther McSween-Cadieux
- Department of School and Social Adaptation Studies, Faculty of Education, Université de Sherbrooke, Sherbrooke, Canada
| | | | - Julie Lane
- Department of School and Social Adaptation Studies, Faculty of Education, Université de Sherbrooke, Sherbrooke, Canada
- Centre RBC d'expertise Universitaire en Santé Mentale, Université de Sherbrooke, Sherbrooke, Canada
| | - Dina Gaid
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | | | | | - Valéry Ridde
- Université Paris Cité, IRD (Institute for Research on Sustainable Development, CEPED, Paris, France
- Institute of Health and Development (ISED), Cheikh Anta Diop University, Dakar, Senegal
| | - Emmanuelle Jean
- Public Health Intelligence and Knowledge Translation Division, Public Health Agency of Canada, Ottawa, Canada
| | - France Charles Fleury
- Coordinator of the Interregional Consortium of Knowledge in Health and Social Services (InterS4), Rimouski, Canada
| | - Quan Nha Hong
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Ollivier Prigent
- Department of School and Social Adaptation Studies, Faculty of Education, Université de Sherbrooke, Sherbrooke, Canada
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Swaithes L, Campbell L, Anthierens S, Skrybant M, Schiphof D, French H, de Wit M, Blackburn S, Dziedzic K. Series: Public engagement with research. Part 4: Maximising the benefits of involving the public in research implementation. Eur J Gen Pract 2023; 29:2243037. [PMID: 37609798 PMCID: PMC10448833 DOI: 10.1080/13814788.2023.2243037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/03/2023] [Accepted: 07/25/2023] [Indexed: 08/24/2023] Open
Abstract
This final article in the four-part series focuses on the often neglected yet important role of the public in implementing research in General Practice and Primary Care more broadly. Experience in implementation of findings from research with public engagement in Primary Care has highlighted how partnership working with patients and the public is important in transitioning from 'what we know' from the evidence-base to 'what we do' in practice. Factors related to Primary Care research that make public engagement important are highlighted e.g. implementing complex interventions, implementing interventions that increase health equity, implementing interventions in countries with different primary healthcare system strengths. Involvement of patients and public can enhance the development of modelling and simulation included in studies on systems modelling for improving health services. We draw on the emerging evidence base to describe public engagement in implementation and offer some guiding principles for engaging with the public in the implementation in General Practice and Primary Care in general. Illustrative case studies are included to support others wishing to offer meaningful engagement in implementing research evidence.
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Affiliation(s)
- Laura Swaithes
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, United Kingdom
| | - Laura Campbell
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, United Kingdom
| | - Sibyl Anthierens
- Department of Family Medicine and Population Health, University of Antwerpen, Antwerpen, Belgium
| | - Magdalena Skrybant
- National Institute of Applied Health Research Applied Research Collaboration West Midlands, Institute of Applied Health, University of Birmingham, Edgbaston, United Kingdom
| | - Dieuwke Schiphof
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Helen French
- School of Physiotherapy, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Maarten de Wit
- Patient Research Partner, Stichting Tools, The Netherlands
| | - Steven Blackburn
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Krysia Dziedzic
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, United Kingdom
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Martens M, van Olmen J, Wouters E, Boateng D, Van Damme W, Van Belle S. Using the multiple streams model to elicit an initial programme theory: from policy dialogues to a roadmap for scaling up integrated care. BMJ Glob Health 2023; 8:e012637. [PMID: 37730245 PMCID: PMC10510919 DOI: 10.1136/bmjgh-2023-012637] [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: 04/20/2023] [Accepted: 08/02/2023] [Indexed: 09/22/2023] Open
Abstract
INTRODUCTION The 'SCale-Up diaBetes and hYpertension care' Project aims to support the scale-up of integrated care for diabetes and hypertension in Cambodia, Slovenia and Belgium through the co-creation, implementation and evaluation of contextualised roadmaps. These roadmaps offer avenues for action and are built on evidence as well as stakeholder engagement in policy dialogues. Roadmaps and policy dialogues are very much intertwined and considered to be key elements for successful stakeholder-supported scale-up in integrated chronic care. Yet, little is known about how, why and under which conditions policy dialogue leads to successful roadmap implementation and scale-up of integrated care. Therefore, this study aims to use a realist approach to elicit an initial programme theory (IPT), using political science theories on the policy process. METHODS To develop the IPT, information from different sources was collected. First, an exploratory literature review on policy dialogue and scale-up definitions and success factors was performed, identifying theoretical frameworks, empirical (case) studies and realist studies (information gleaning). Second, research workshops on applying theory to the roadmap for scale-up (theory gleaning) were conducted with a multidisciplinary expert team. We used the intervention-context-actors-mechanism-outcome configuration to synthesise information from the sources into a configurational map. RESULTS The information and theory gleaning resulted into an IPT, hypothesising how policy dialogues can contribute to roadmap success in different policy stages. The IPT draws on political science theory of the multiple streams model adapted by Howlett et al to include five streams (problem, solution, politics, process and programme) that can emerge, converge and diverge across all five policy stages. CONCLUSION This paper aims to extend the knowledge base on the use of policy dialogues to build a roadmap for scale-up. The IPT describes how (dynamics) and why (theories) co-created roadmaps are expected to work in different policy stages.
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Affiliation(s)
- Monika Martens
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Josefien van Olmen
- Department of Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Edwin Wouters
- Centre for Population, Family & Health, Department of Social Sciences, University of Antwerp, Antwerp, Belgium
- Centre for Health Systems Research & Development, University of the Free State, Bloemfontein, South Africa
| | - Daniel Boateng
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Wim Van Damme
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sara Van Belle
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Lyne K, Williams C, Vardoulakis S, Matthews V, Farrant B, Butt A, Walker I, Chu C, Dennekamp M, Espinoza Oyarce DA, Ivers R, Jalaludin B, Jones PJ, Martin K, Rychetnik L. A Research Translation, Implementation and Impact Strategy for the Australian Healthy Environments and Lives (HEAL) Research Network. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6383. [PMID: 37510615 PMCID: PMC10378965 DOI: 10.3390/ijerph20146383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/29/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023]
Abstract
Healthy Environments And Lives (HEAL) is the Australian national research network established to support improvements to health, the Australian health system, and the environment in response to the unfolding climate crisis. The HEAL Network comprises researchers, community members and organisations, policymakers, practitioners, service providers, and other stakeholders from diverse backgrounds and sectors. HEAL seeks to protect and improve public health, reduce health inequities and inequalities, and strengthen health system sustainability and resilience in the face of environmental and climate change, all with a commitment to building on the strengths, knowledge, wisdom, and experience of Aboriginal and Torres Strait Islander people, culture, and communities. Supporting applied research that can inform policy and practice, and effective research translation, implementation, and impact are important goals across the HEAL Network and essential to achieve its intended outcomes. To aid translation approaches, a research translation, implementation, and impact strategy for the HEAL Network was developed. The strategy has been created to inform and guide research translation across HEAL, emphasising communication, trust, partnerships, and co-design with communities and community organisations as well as the decision-makers responsible for public policies and programs. Development of the strategy was guided by research translation theory and practice and the Health in All Policies and Environment in All Policies frameworks. As described in this paper, the strategy is underpinned by a set of principles and outlines preliminary actions which will be further expanded over the course of the HEAL Network's activities. Through these actions, the HEAL Network is well-positioned to ensure successful research translation and implementation across its program of work.
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Affiliation(s)
- Katrina Lyne
- Centre for Health in All Policies Research Translation, Health Translation SA, SAHMRI, Adelaide, SA 5000, Australia
| | - Carmel Williams
- Centre for Health in All Policies Research Translation, Health Translation SA, SAHMRI, Adelaide, SA 5000, Australia
- School of Public Health, University of Adelaide, Adelaide, SA 5000, Australia
| | - Sotiris Vardoulakis
- College of Health and Medicine, Australian National University, Canberra, ACT 2601, Australia
| | - Veronica Matthews
- University Centre for Rural Health, University of Sydney, Lismore, NSW 2480, Australia
| | - Brad Farrant
- Telethon Kids Institute, University of Western Australia, Perth, WA 6000, Australia
| | - Andrew Butt
- Centre for Urban Research, RMIT University, Melbourne, VIC 3000, Australia
| | - Iain Walker
- Melbourne Centre for Behaviour Change, University of Melbourne, Parkville, VIC 3010, Australia
| | - Cordia Chu
- Centre for Environment and Population Health, School of Medicine and Dentistry, Griffith University, Southport, QLD 4222, Australia
| | - Martine Dennekamp
- Environment Protection Authority Victoria, Carlton, VIC 3053, Australia
| | | | - Rebecca Ivers
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Bin Jalaludin
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Penelope J Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia
| | - Karina Martin
- College of Health and Medicine, Australian National University, Canberra, ACT 2601, Australia
| | - Lucie Rychetnik
- The Australian Prevention Partnership Centre, Sax Institute, Haymarket, NSW 1240, Australia
- School of Public Health, University of Sydney, Sydney, NSW 2006, Australia
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Cowdell F, Lax S, Van Onselen J, Pendleton R. Can co-created knowledge mobilisation interventions alter and enhance mindlines to improve childhood eczema care? A UK-based Social Impact Framework evaluation. BMJ Open 2023; 13:e065557. [PMID: 37076153 PMCID: PMC10124191 DOI: 10.1136/bmjopen-2022-065557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
OBJECTIVE To evaluate the impact of using knowledge mobilisation interventions to alter and enhance mindlines and improve childhood eczema care. DESIGN The eczema mindlines study involved three stages: (1) mapping and confirming eczema mindlines, (2) intervention development and delivery and (3) analysis of intervention impact. The focus of this paper is on stage 3. Data analysis was guided by the Social Impact Framework to address the questions: (1) what is the impact of this study on individuals and groups? (2) what changes in behaviour and practice have occurred due to their involvement? (3) what mechanisms have enabled these impacts or changes to occur? and (4) what are the recommendations and questions arising from this research? SETTINGS A deprived inner-city neighbourhood in central England and national/international settings. PARTICIPANTS Patients, practitioners and wider community members exposed to the interventions locally, nationally and internationally. RESULTS Data revealed tangible multi-level, relational and intellectual impacts. Mechanisms supporting impact included: simplicity and consistency of messages adapted to audience, flexibility, opportunism and perseverance, personal interconnectivity and acknowledgement of emotion. Co-created knowledge mobilisation strategies to alter and enhance mindlines mediated through knowledge brokering were effective in producing tangible changes in eczema care practice and self-management and in 'mainstreaming' childhood eczema in positive way across communities. These changes cannot be directly attributed to the knowledge mobilisation interventions, however, the evidence points to the significant contribution made. CONCLUSION Co-created knowledge mobilisation interventions offer a valuable method of altering and enhancing eczema mindlines across lay-practitioner-wider society boundaries. The Social Impact Framework provides comprehensive method of understanding and documenting the complex web of impact occurring as a result of knowledge mobilisation. This approach is transferable to managing other long-term conditions.
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Affiliation(s)
- Fiona Cowdell
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK
| | - Stephanie Lax
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
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Sharp CA, Boaden RJ, Dixon WG, Sanders C. Does the process of developing products for knowledge mobilisation from healthcare research influence their uptake? A comparative case study. Implement Sci Commun 2022; 3:132. [PMCID: PMC9749197 DOI: 10.1186/s43058-022-00360-9] [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: 02/17/2022] [Accepted: 09/30/2022] [Indexed: 12/15/2022] Open
Abstract
Background Getting knowledge from healthcare research into practice (knowledge mobilisation) remains a global challenge. One way in which researchers may attempt to do this is to develop products (such as toolkits, actionable tools, dashboards, guidance, audit tools, protocols and clinical decision aids) in addition to journal papers. Despite their increasing ubiquity, the development of such products remains under-explored in the academic literature. This study aimed to further this understanding by exploring the development of products from healthcare research and how the process of their development might influence their potential application. Methods This study compared the data generated from a prospective, longitudinal, comparative case study of four research projects which aimed to develop products from healthcare research. Qualitative methods included thematic analysis of data generated from semi-structured interviews (38), meeting observations (83 h) and project documents (300+). Cases were studied for an average of 11.5 months (range 8–19 months). Results Case comparison resulted in the identification of three main themes with the potential to affect the use of products in practice. First, aspects of the product, including the perceived need for the specific product being identified, the clarity of product aim and clarity and range of end-users. Second, aspects of development, whereby different types of stakeholder engagement appear to influence potential product application, which either needs to be ‘meaningful’, or delivered through the implicit understanding of users’ needs by the developing team. The third, overarching theme, relates to the academic context in which products are developed, highlighting how the academic context perpetuates the development of products, which may not always be useful in practice. Conclusions This study showed that aspects of products from healthcare research (need/aim/end-user) and aspects of their development (stakeholder engagement/implicit understanding of end-users) influence their potential application. It explored the motivation for product development and identifies the influence of the current academic context on product development. It shows that there is a tension between ideal ‘systems approaches’ to knowledge mobilisation and ‘linear approaches’, which appear to be more pervasive in practice currently. The development of fewer, high-quality products which fulfil the needs of specified end-users might act to counter the current cynicism felt by many stakeholders in regard to products from healthcare research. Supplementary Information The online version contains supplementary material available at 10.1186/s43058-022-00360-9.
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Affiliation(s)
- Charlotte A. Sharp
- grid.5379.80000000121662407The Centre for Epidemiology Versus Arthritis, The University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PG UK ,grid.5379.80000000121662407The Centre for Primary Care and Health Services Research + NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, The Williamson Building, Manchester, M13 9PT UK ,grid.412346.60000 0001 0237 2025Salford Royal NHS Foundation Trust, Northern Care Alliance, Salford, UK
| | - Ruth J. Boaden
- grid.5379.80000000121662407Alliance Manchester Business School, Booth Street West, Manchester, M15 6PB UK
| | - William G. Dixon
- grid.5379.80000000121662407The Centre for Epidemiology Versus Arthritis, The University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PG UK ,grid.412346.60000 0001 0237 2025Salford Royal NHS Foundation Trust, Northern Care Alliance, Salford, UK
| | - Caroline Sanders
- grid.5379.80000000121662407The Centre for Primary Care and Health Services Research + NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, The Williamson Building, Manchester, M13 9PT UK
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Ahmad R, Gordon AC, Aylin P, Redhead J, Holmes A, Evans DP. Effective knowledge mobilisation: creating environments for quick generation, dissemination, and use of evidence. BMJ 2022; 379:e070195. [PMID: 36343944 DOI: 10.1136/bmj-2022-070195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Raheelah Ahmad
- NIHR Health Protection Research Unit (HPRU) in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
- Department of Health Services Research and Management, School of Health and Psychological Sciences, City, University of London, UK
- Institute of Business and Health Management, Dow University of Health Sciences, Karachi, Pakistan
- The Surveillance and Epidemiology of Drug-resistant Infections Consortium (SEDRIC), Wellcome Trust, UK
| | - Anthony C Gordon
- Division of Anaesthetics, Pain Medicine and Intensive Care, Imperial College London, London, UK
- Imperial College Healthcare NHS Trust, Imperial College London, UK
| | - Paul Aylin
- NIHR Health Protection Research Unit (HPRU) in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
- Division of Anaesthetics, Pain Medicine and Intensive Care, Imperial College London, London, UK
| | - Julian Redhead
- Imperial College Healthcare NHS Trust, Imperial College London, UK
| | - Alison Holmes
- NIHR Health Protection Research Unit (HPRU) in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
- Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
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Pedrick-Case R, Bailey R, Beck B, Beesley B, Boruff B, Brophy S, Cross D, Dhamrait G, Duncan J, Gething P, Johnson RD, Lyons RA, Mizen A, Murray K, Pouliou T, Rafferty J, Robinson T, Rosenberg M, Schipperijn J, Thompson DA, Trost SG, Watkins A, Stratton G, Fry R, Christian H, Griffiths LJ. Built Environments And Child Health in WalEs and AuStralia (BEACHES): a study protocol. BMJ Open 2022; 12:e061978. [PMID: 36283749 PMCID: PMC9608521 DOI: 10.1136/bmjopen-2022-061978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Childhood obesity and physical inactivity are two of the most significant modifiable risk factors for the prevention of non-communicable diseases (NCDs). Yet, a third of children in Wales and Australia are overweight or obese, and only 20% of UK and Australian children are sufficiently active. The purpose of the Built Environments And Child Health in WalEs and AuStralia (BEACHES) study is to identify and understand how complex and interacting factors in the built environment influence modifiable risk factors for NCDs across childhood. METHODS AND ANALYSIS This is an observational study using data from five established cohorts from Wales and Australia: (1) Wales Electronic Cohort for Children; (2) Millennium Cohort Study; (3) PLAY Spaces and Environments for Children's Physical Activity study; (4) The ORIGINS Project; and (5) Growing Up in Australia: the Longitudinal Study of Australian Children. The study will incorporate a comprehensive suite of longitudinal quantitative data (surveys, anthropometry, accelerometry, and Geographic Information Systems data) to understand how the built environment influences children's modifiable risk factors for NCDs (body mass index, physical activity, sedentary behaviour and diet). ETHICS AND DISSEMINATION This study has received the following approvals: University of Western Australia Human Research Ethics Committee (2020/ET000353), Ramsay Human Research Ethics Committee (under review) and Swansea University Information Governance Review Panel (Project ID: 1001). Findings will be reported to the following: (1) funding bodies, research institutes and hospitals supporting the BEACHES project; (2) parents and children; (3) school management teams; (4) existing and new industry partner networks; (5) federal, state and local governments to inform policy; as well as (6) presented at local, national and international conferences; and (7) disseminated by peer-reviewed publications.
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Affiliation(s)
| | - Rowena Bailey
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Ben Beck
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Bridget Beesley
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Bryan Boruff
- School of Agriculture and Environment, University of Western Australia, Perth, Western Australia, Australia
| | - Sinead Brophy
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Donna Cross
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Gursimran Dhamrait
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - John Duncan
- School of Agriculture and Environment, University of Western Australia, Perth, Western Australia, Australia
| | - Peter Gething
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Rhodri D Johnson
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Ronan A Lyons
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Amy Mizen
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Theodora Pouliou
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - James Rafferty
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Trina Robinson
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Michael Rosenberg
- School of Human Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Daniel A Thompson
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Alan Watkins
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Gareth Stratton
- Research Centre in Applied Sports, Technology, Exercise and Medicine, Swansea University, Swansea, UK
| | - Richard Fry
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Hayley Christian
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Lucy J Griffiths
- Population Data Science, Swansea University Medical School, Swansea, UK
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MacLeod MLP, Leese J, Garraway L, Oelke ND, Munro S, Bailey S, Hoens AM, Loo S, Valdovinos A, Wick U, Zimmer P, Li LC. Engaging with patients in research on knowledge translation/implementation science methods: a self study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:41. [PMID: 35941661 PMCID: PMC9358643 DOI: 10.1186/s40900-022-00375-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND In 2017, the British Columbia (Canada) SUPPORT (SUpport for People and Patient-Oriented Research) Unit created six methods clusters to advance methodologies in patient and public oriented research (POR). The knowledge translation (KT)/implementation science methods cluster identified that although there was guidance about how to involve patients and public members in POR research generally, little was known about how best to involve patients and public members on teams specifically exploring POR KT/implementation science methodologies. The purpose of this self-study was to explore what it means to engage patients and the public in studies of POR methods through the reflections of members of five KT/implementation science teams. METHODS Informed by a collaborative action research approach, this quality improvement self-study focused on reflection within four KT/implementation science research teams in 2020-2021. The self-study included two rounds of individual interviews with 18 members across four teams. Qualitative data were analyzed using a thematic analysis approach followed by a structured discussion of preliminary findings with the research teams. Subsequently, through two small group discussion sessions, the patients/public members from the teams refined the findings. RESULTS Undertaking research on POR KT/implementation science methodologies typically requires teams to work with the uncertainty of exploratory and processual research approaches, make good matches between patients/public members and the team, work intentionally yet flexibly, and be attuned to the external context and its influences on the team. POR methodological research teams need to consider that patients/public members bring their life experiences and world views to the research project. They become researchers in their own right. Individual and team reflection allows teams to become aware of team needs, acknowledge team members' vulnerabilities, gain greater sensitivity, and enhance communication. CONCLUSIONS The iterative self-study process provided research team members with opportunities for reflection and new understanding. Working with patients/public team members as co-researchers opens up new ways of understanding important aspects of research methodologies, which may influence future KT/implementation science research approaches.
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Affiliation(s)
- Martha L. P. MacLeod
- School of Nursing, University of Northern British Columbia, 3333 University Way, Prince George, BC V2N 4Z9 Canada
| | - Jenny Leese
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Centre for Implementation Research, The Ottawa Hospital Research Institute, Ottawa, Canada
- Arthritis Research Canada, Vancouver, BC Canada
| | - Leana Garraway
- Health Research Institute, University of Northern British Columbia, Prince George, BC Canada
| | - Nelly D. Oelke
- School of Nursing, University of British Columbia, Okanagan, Kelowna, BC Canada
- Rural Coordination Centre of BC, Vancouver, BC Canada
| | - Sarah Munro
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC Canada
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC Canada
| | - Sacha Bailey
- BC Centre for Ability, Vancouver, BC Canada
- Centre for Research on Children and Families, Montreal, QC Canada
| | - Alison M. Hoens
- Arthritis Research Canada, Vancouver, BC Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, BC Canada
| | - Sunny Loo
- Patient Partner, Michael Smith Health Research BC, PaCER Certified, University of Calgary, Calgary, AB Canada
| | - Ana Valdovinos
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC Canada
| | - Ursula Wick
- University of British Columbia, Okanagan, Kelowna, BC Canada
| | - Peter Zimmer
- University of Northern British Columbia, Prince George, BC Canada
| | - Linda C. Li
- Arthritis Research Canada, Vancouver, BC Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, BC Canada
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Exploring research impact; why it matters? Curr Opin Otolaryngol Head Neck Surg 2022; 30:188-193. [PMID: 35635114 DOI: 10.1097/moo.0000000000000801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Making research impactful is becoming a vital part of research proposal development. Funding bodies now require evidence of clear dissemination strategies that demonstrate achievable broad impact from proposed studies. This review addresses what impact means in practice and how to achieve it. RECENT FINDINGS Research impact is defined as making real change in the real world. The review explores different kinds of impact, why it is important, the challenges faced, and planning for impact. Creative ways in which impact may be achieved, specifically through storytelling, utilizing infographics and animations are explored. The impact of social media platforms to maximize reach of potential research, alongside measuring impact is discussed. SUMMARY Researchers may need to develop new skills, to create impactful research outputs for global dissemination across several social media platforms. By utilizing methods that maximize engagement with target audiences, translating and implementing quality evidence into clinical practice may be achieved more rapidly.
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Freebairn L, Song YJC, Occhipinti JA, Huntley S, Dudgeon P, Robotham J, Lee GY, Hockey S, Gallop G, Hickie IB. Applying systems approaches to stakeholder and community engagement and knowledge mobilisation in youth mental health system modelling. Int J Ment Health Syst 2022; 16:20. [PMID: 35462553 PMCID: PMC9036722 DOI: 10.1186/s13033-022-00530-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background There is a significant push to change the trajectory of youth mental ill-health and suicide globally. Ensuring that young people have access to services that meet their individual needs and are easily accessible is a priority. Genuine stakeholder engagement in mental health system design is critical to ensure that system strengthening is likely to be successful within these complex environments. There is limited literature describing engagement processes undertaken by research teams in mental health program implementation and planning. This protocol describes the methods that will be used to engage local communities using systems science methods to mobilize knowledge and action to strengthen youth mental health services. Methods Using participatory action research principles, the research team will actively engage with local communities to ensure genuine user-led participatory systems modelling processes and enhance knowledge mobilisation within research sites. Ensuring that culturally diverse and Aboriginal and Torres Strait Islander community voices are included will support this process. A rigorous site selection process will be undertaken to ensure that the community is committed and has capacity to actively engage in the research activities. Stakeholder engagement commences from the site selection process with the aim to build trust between researchers and key stakeholders. The research team will establish a variety of engagement resources and make opportunities available to each site depending on their local context, needs and audiences they wish to target during the process. Discussion This protocol describes the inclusive community engagement and knowledge mobilization process for the Right care, first time, where you live research Program. This Program will use an iterative and adaptive approach that considers the social, economic, and political context of each community and attempts to maximise research engagement. A theoretical framework for applying systems approaches to knowledge mobilization that is flexible will enable the implementation of a participatory action research approach. This protocol commits to a rigorous and genuine stakeholder engagement process that can be applied in mental health research implementation. Supplementary Information The online version contains supplementary material available at 10.1186/s13033-022-00530-1.
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Affiliation(s)
- Louise Freebairn
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, 94 Mallett Street, Camperdown, Sydney, NSW, 2050, Australia. .,Research School of Public Health, Australian National University, Canberra, Australia. .,Computer Simulation & Advanced Research Technologies (CSART), Sydney, Australia.
| | - Yun Ju Christine Song
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, 94 Mallett Street, Camperdown, Sydney, NSW, 2050, Australia
| | - Jo-An Occhipinti
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, 94 Mallett Street, Camperdown, Sydney, NSW, 2050, Australia.,Computer Simulation & Advanced Research Technologies (CSART), Sydney, Australia
| | - Samantha Huntley
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, 94 Mallett Street, Camperdown, Sydney, NSW, 2050, Australia
| | - Pat Dudgeon
- School of Indigenous Studies, University of Western Australia, Perth, Australia
| | - Julie Robotham
- School of Indigenous Studies, University of Western Australia, Perth, Australia
| | - Grace Yeeun Lee
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, 94 Mallett Street, Camperdown, Sydney, NSW, 2050, Australia
| | - Samuel Hockey
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, 94 Mallett Street, Camperdown, Sydney, NSW, 2050, Australia
| | - Geoff Gallop
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, 94 Mallett Street, Camperdown, Sydney, NSW, 2050, Australia
| | - Ian B Hickie
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, 94 Mallett Street, Camperdown, Sydney, NSW, 2050, Australia
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Finucane A, Carduff E, Meade R, Doyle S, Fenning S, Cumming S, Hekerem D, Rahman F, Lugton J, Johnston B, Murray SA. Palliative care research promotion in policy and practice: a knowledge exchange process. BMJ Support Palliat Care 2021; 12:bmjspcare-2021-003096. [PMID: 34400402 PMCID: PMC9380483 DOI: 10.1136/bmjspcare-2021-003096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/24/2021] [Indexed: 11/04/2022]
Abstract
In palliative care, as in many areas of medicine, there is a considerable amount of research conducted that makes sound recommendations but does not result consistently in improved care. For instance, though palliative care has been shown to benefit all people with a life-threatening illness, its main reach continues to be for those with cancer. Drawing on relational models of research use, we set out to engage policy-makers, educators, clinicians, commissioners and service providers in a knowledge exchange process to identify implications of research for Scottish palliative care priorities. First, we mapped the existing palliative care research evidence in Scotland. We then organised evidence review meetings and a wider stakeholder event where research producers and users came together to coproduce implications of the evidence for policy, education and practice. We used questionnaires and key stakeholder feedback meetings to explore impacts of this process on research uptake and use immediately after the events and over time. In this paper, we reflect on this knowledge exchange process and the broader context in which it was set. We found that participation fostered relationships and led to a rich and enthusiastic exploration of research evidence from multiple perspectives. Potential impacts relating to earlier identification for palliative care, education and need-based commissioning ensued. We make suggestions to guide replication.
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Affiliation(s)
- Anne Finucane
- Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
- Policy and Research, Marie Curie Hospice, Edinburgh, UK
- Primary Palliative Care Research Group, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Emma Carduff
- Primary Palliative Care Research Group, Usher Institute, University of Edinburgh, Edinburgh, UK
- Policy and Research, Marie Curie Hospice, Glasgow, UK
| | - Richard Meade
- Policy and Research, Marie Curie Scotland, Edinburgh, UK
| | - Sarah Doyle
- Queen's Nursing Institute Scotland, Edinburgh, UK
| | - Stephen Fenning
- NHS Fife Specialist Palliative Care Service, NHS Fife, Kircaldy, UK
| | | | - Diana Hekerem
- Improvement Hub (iHub), Healthcare Improvement Scotland, Edinburgh, UK
| | - Fariel Rahman
- Children's Hospice Association Scotland, Edinburgh, UK
| | - Jean Lugton
- Policy and Research, Marie Curie Hospice, Edinburgh, UK
| | - Bridget Johnston
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
- NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK
| | - Scott A Murray
- Primary Palliative Care Research Group, Usher Institute, University of Edinburgh, Edinburgh, UK
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McGrath D, Plummer R, Bowen A. Cultivating our urban forest future: a value-chain perspective. Facets (Ott) 2021. [DOI: 10.1139/facets-2021-0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
For cities to grow their urban forest canopy the formula appears rather straightforward: the right trees, plus the right conditions, plus the right care equals success. These simplified “tree chain of custody” steps, however, represent activities within a complex value-chain in Canada. Given that there is heightened demand for urban tree planting as natural climate solutions become the norm, how can we prepare the value-chain to meet these demands? To answer this question, we outline the pathways by which trees presently go from nurseries into urban and peri-urban areas. Delineating the actors, roles, and present barriers to success exposes the complexity of the process and relationships in the value-chain, as there are distinct phases with multiple actor groups involved who influence, and are influenced, by one another. We explore the issues that pose prominent challenges to, as well as opportunities for, the value-chain. Emergent themes include communication, forecasting demand and timing, underpricing and undervaluing tree establishment, lack of awareness on the importance of soils, juvenile tree health, species selection, and gaps in evidence-based decision support tools. The touchstones of science and innovation, collaboration, and knowledge mobilization are pertinent for the value-chain in Canada to draw upon to navigate the future.
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Affiliation(s)
- Darby McGrath
- Environmental Horticulture, Vineland Research & Innovation Centre, 4890 Victoria Avenue North, Box 400, Vineland Station, ON L0R 2E0, Canada
| | - Ryan Plummer
- Environmental Sustainability Research Centre, Brock University, St. Catharines, ON L2S 3A1, Canada
| | - Amy Bowen
- Consumer Insights, Vineland Research & Innovation Centre, 4890 Victoria Avenue North, Box 400, Vineland Station, ON L0R 2E0, Canada
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Eljiz K, Greenfield D, Hogden A, Taylor R, Siddiqui N, Agaliotis M, Milosavljevic M. Improving knowledge translation for increased engagement and impact in healthcare. BMJ Open Qual 2020; 9:bmjoq-2020-000983. [PMID: 32943430 PMCID: PMC7500202 DOI: 10.1136/bmjoq-2020-000983] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 08/13/2020] [Accepted: 08/18/2020] [Indexed: 12/22/2022] Open
Abstract
Ineffective knowledge dissemination contributes to clinical practice and service improvements not being realised. Meaningful knowledge translation can occur through the understanding and matching of appropriate communication mediums that are relevant for different stakeholders or audiences. To this end, we present a dissemination instrument, the 'REAch and Diffusion of health iMprovement Evidence' (README) checklist, for the communication of research findings, integrating both traditional and newer communication mediums. Additionally, we propose a 'Strategic Translation and Engagement Planning' (STEP) tool, for use when deciding which mediums to select. The STEP tool challenges the need for communicating complex and simple information against the desire for passive or active stakeholder interaction. Used collaboratively by academics and health professionals, README and STEP can promote co-production of research, subsequent diffusion of knowledge, and develop the capacity and skills of all stakeholders.
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Affiliation(s)
- Kathy Eljiz
- Australian Institute of Health Service Management, University of Tasmania, Sydney, New South Wales, Australia
| | - David Greenfield
- Australian Institute of Health Service Management, University of Tasmania, Sydney, New South Wales, Australia
| | - Anne Hogden
- Australian Institute of Health Service Management, University of Tasmania, Sydney, New South Wales, Australia
| | - Robyn Taylor
- Australian Institute of Health Service Management, University of Tasmania, Sydney, New South Wales, Australia
| | - Nazlee Siddiqui
- Australian Institute of Health Service Management, University of Tasmania, Sydney, New South Wales, Australia
| | - Maria Agaliotis
- Australian Institute of Health Service Management, University of Tasmania, Sydney, New South Wales, Australia
| | - Marianna Milosavljevic
- Research Operations, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
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Haynes A, Rychetnik L, Finegood D, Irving M, Freebairn L, Hawe P. Applying systems thinking to knowledge mobilisation in public health. Health Res Policy Syst 2020; 18:134. [PMID: 33203438 PMCID: PMC7670767 DOI: 10.1186/s12961-020-00600-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 07/03/2020] [Indexed: 12/13/2022] Open
Abstract
CONTEXT Knowledge mobilisation (KM) is a vital strategy in efforts to improve public health policy and practice. Linear models describing knowledge transfer and translation have moved towards multi-directional and complexity-attuned approaches where knowledge is produced and becomes meaningful through social processes. There are calls for systems approaches to KM but little guidance on how this can be operationalised. This paper describes the contribution that systems thinking can make to KM and provides guidance about how to put it into action. METHODS We apply a model of systems thinking (which focuses on leveraging change in complex systems) to eight KM practices empirically identified by others. We describe how these models interact and draw out some key learnings for applying systems thinking practically to KM in public health policy and practice. Examples of empirical studies, tools and targeted strategies are provided. FINDINGS Systems thinking can enhance and fundamentally transform KM. It upholds a pluralistic view of knowledge as informed by multiple parts of the system and reconstituted through use. Mobilisation is conceived as a situated, non-prescriptive and potentially destabilising practice, no longer conceptualised as a discrete piece of work within wider efforts to strengthen public health but as integral to and in continual dialogue with those efforts. A systems approach to KM relies on contextual understanding, collaborative practices, addressing power imbalances and adaptive learning that responds to changing interactions between mobilisation activities and context. CONCLUSION Systems thinking offers valuable perspectives, tools and strategies to better understand complex problems in their settings and for strengthening KM practice. We make four suggestions for further developing empirical evidence and debate about how systems thinking can enhance our capacity to mobilise knowledge for solving complex problems - (1) be specific about what is meant by 'systems thinking', (2) describe counterfactual KM scenarios so the added value of systems thinking is clearer, (3) widen conceptualisations of impact when evaluating KM, and (4) use methods that can track how and where knowledge is mobilised in complex systems.
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Affiliation(s)
- Abby Haynes
- The Australian Prevention Partnership Centre, Sydney, Australia.
- University of Sydney, Menzies Centre for Health Policy, Sydney, Australia.
- University of Sydney, School of Public Health, Institute for Musculoskeletal Health, PO Box M179, Missenden Road, Camperdown, NSW, 2050, Australia.
| | - Lucie Rychetnik
- The Australian Prevention Partnership Centre, Sydney, Australia
- University of Sydney, School of Public Health, Sydney, Australia
- University of Notre Dame Australia, School of Medicine, Sydney, Australia
| | - Diane Finegood
- Morris J. Wosk Centre for Dialogue and Department of Biomedical Physiology & Kinesiology, Simon Fraser University, Vancouver, Canada
| | - Michelle Irving
- The Australian Prevention Partnership Centre, Sydney, Australia
- University of Sydney, Menzies Centre for Health Policy, Sydney, Australia
| | - Louise Freebairn
- The Australian Prevention Partnership Centre, Sydney, Australia
- ACT Health Directorate, ACT Government, Canberra, Australia
| | - Penelope Hawe
- The Australian Prevention Partnership Centre, Sydney, Australia
- University of Sydney, Menzies Centre for Health Policy, Sydney, Australia
- O'Brien Institute of Public Health, University of Calgary, Calgary, Canada
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Delnord M, Tille F, Abboud LA, Ivankovic D, Van Oyen H. How can we monitor the impact of national health information systems? Results from a scoping review. Eur J Public Health 2020; 30:648-659. [PMID: 31647526 PMCID: PMC7445047 DOI: 10.1093/eurpub/ckz164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background National health information (HI) systems provide data on population health, the determinants of health and health system performance within countries. The evaluation of these systems has traditionally focused on statistical practices and procedures, and not on data use or reuse for policy and practice. This limits the capacity to assess the impact of HI systems on healthcare provision, management and policy-making. On the other hand, the field of Knowledge Translation (KT) has developed frameworks to guide evidence into practice. Methods A scoping review of the KT literature to identify the essential mechanisms and determinants of KT that could help monitor the impact of HI systems. Results We examined 79 publications and we identified over 100 different KT frameworks but none of these were focused on HI systems per se. There were specific recommendations on disseminating evidence to stakeholders at the institutional and organizational level, and on sustaining the use of evidence in practice and the broader community setting. Conclusions We developed a new model, the HI-Impact framework, in which four domains are essential for mapping the impact of national HI systems: (i) HI Evidence Quality, (ii) HI System Responsiveness, (iii) Stakeholder Engagement and (iv) Knowledge Integration. A comprehensive impact assessment of HI systems requires addressing the use of HI in public health decision-making, health service delivery and in other sectors which might have not been considered previously. Monitoring Stakeholder Engagement and Knowledge Integration certifies that the use of HI in all policies is an explicit point of assessment.
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Affiliation(s)
- Marie Delnord
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | - F Tille
- Department of Medical Sociology and Rehabilitation Science, Charité Berlin University of Medicine, Berlin, Germany
| | - L A Abboud
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium
| | - D Ivankovic
- Department of Public Health, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Division of Health Informatics and Biostatistics, Croatian Institute of Public Health, Zagreb, Croatia
| | - H Van Oyen
- Department of Epidemiology and public health, Sciensano, Brussels, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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Swaithes L, Dziedzic K, Finney A, Cottrell E, Jinks C, Mallen C, Currie G, Paskins Z. Understanding the uptake of a clinical innovation for osteoarthritis in primary care: a qualitative study of knowledge mobilisation using the i-PARIHS framework. Implement Sci 2020; 15:95. [PMID: 33115490 PMCID: PMC7594414 DOI: 10.1186/s13012-020-01055-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 10/15/2020] [Indexed: 01/31/2023] Open
Abstract
Background Osteoarthritis is a leading cause of pain and disability worldwide. Despite research supporting best practice, evidence-based guidelines are often not followed. Little is known about the implementation of non-surgical models of care in routine primary care practice. From a knowledge mobilisation perspective, the aim of this study was to understand the uptake of a clinical innovation for osteoarthritis and explore the journey from a clinical trial to implementation. Methods This study used two methods: secondary analysis of focus groups undertaken with general practice staff from the Managing OSteoArthritis in ConsultationS research trial, which investigated the effectiveness of an enhanced osteoarthritis consultation, and interviews with stakeholders from an implementation project which started post-trial following demand from general practices. Data from three focus groups with 21 multi-disciplinary clinical professionals (5–8 participants per group), and 13 interviews with clinical and non-clinical stakeholders, were thematically analysed utilising the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, in a theoretically informative approach. Public contributors were involved in topic guide design and interpretation of results. Results In operationalising implementation of an innovation for osteoarthritis following a trial, the importance of a whole practice approach, including the opportunity for reflection and planning, were identified. The end of a clinical trial provided opportune timing for facilitating implementation planning. In the context of osteoarthritis in primary care, facilitation by an inter-disciplinary knowledge brokering service, nested within an academic institution, was instrumental in supporting ongoing implementation by providing facilitation, infrastructure and resource to support the workload burden. ‘Instinctive facilitation’ may involve individuals who do not adopt formal brokering roles or fully recognise their role in mobilising knowledge for implementation. Public contributors and lay communities were not only recipients of healthcare innovations but also potential powerful facilitators of implementation. Conclusion This theoretically informed knowledge mobilisation study into the uptake of a clinical innovation for osteoarthritis in primary care has enabled further characterisation of the facilitation and recipient constructs of i-PARIHS by describing optimum timing for facilitation and roles and characteristics of facilitators. Supplementary Information The online version contains supplementary material available at 10.1186/s13012-020-01055-2.
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Affiliation(s)
- Laura Swaithes
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK.
| | - Krysia Dziedzic
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - Andrew Finney
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - Elizabeth Cottrell
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - Clare Jinks
- Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - Christian Mallen
- Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - Graeme Currie
- Entrepreneurship & Innovation, Organising Healthcare Research Network, Warwick Business School, The University of Warwick, Coventry, CV4 7AL, UK
| | - Zoe Paskins
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
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Robinson T, Skouteris H, Burns P, Melder A, Bailey C, Croft C, Spyridonidis D, Teede H. Flipping the paradigm: a qualitative exploration of research translation centres in the United Kingdom and Australia. Health Res Policy Syst 2020; 18:111. [PMID: 32993658 PMCID: PMC7523298 DOI: 10.1186/s12961-020-00622-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 08/27/2020] [Indexed: 11/17/2022] Open
Abstract
Background Over the past decade, Research Translation Centres (RTCs) have been established in many countries. These centres (sometimes referred to as Academic Health Science Centres) are designed to bring universities and healthcare providers together in order to accelerate the generation and translation of new evidence that is responsive to health service and community priorities. This has the potential to effectively ‘flip’ the traditional research and education paradigms because it requires active participation and continuous engagement with stakeholders (especially service users, the community and frontline clinicians). Although investment and expectations of RTCs are high, the literature confirms a need to better understand the processes that RTCs use to mobilise knowledge, build workforce capacity, and co-produce research with patients and the public to ensure population impact and drive healthcare improvement. Methods Semi-structured interviews were conducted with selected leaders and members from select RTCs in England and Australia. Convenience sampling was utilised to identify RTCs, based on their geography, accessibility and availability. Purposive sampling and a snowballing approach were employed to recruit individual participants for interviews, which were conducted face to face or via videoconferencing. Interviews were recorded, transcribed verbatim and analysed using a reflexive and inductive approach. This involved two researchers comparing codes and interrogating themes that were analysed inductively against the study aims and through meetings with the research team. Results A total of 41 participants, 22 from England and 19 from Australia were interviewed. Five major themes emerged, including (1) dissonant metrics, (2) different models of leadership, (3) public and patient involvement and research co-production, (4) workforce development and (5) barriers to collaboration. Conclusions Participants identified the need for performance measures that capture community impact. Better aligned success metrics, enhanced leadership, strategies to partner with patients and the public, enhanced workforce development and strategies to enhance collaboration were all identified as crucial for RTCs to succeed.
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Affiliation(s)
- Tracy Robinson
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria, 3168, Australia. .,School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Bathurst, NSW, 2795, Australia. .,Monash Partners Academic Health Science Centre, Clayton, Victoria, Australia.
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria, 3168, Australia.,Monash Partners Academic Health Science Centre, Clayton, Victoria, Australia
| | - Prue Burns
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria, 3168, Australia.,School of Management, College of Business, RMIT University, Melbourne, Australia
| | - Angela Melder
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria, 3168, Australia.,Monash Partners Academic Health Science Centre, Clayton, Victoria, Australia.,Monash Health, Clayton, Victoria, Australia
| | - Cate Bailey
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria, 3168, Australia
| | - Charlotte Croft
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria, 3168, Australia.,Warwick Business School, Gibbet Hill Road, Coventry, CV4 7AL, United Kingdom
| | - Dmitrios Spyridonidis
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria, 3168, Australia.,Warwick Business School, Gibbet Hill Road, Coventry, CV4 7AL, United Kingdom
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria, 3168, Australia. .,Monash Partners Academic Health Science Centre, Clayton, Victoria, Australia. .,Monash Health, Clayton, Victoria, Australia.
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22
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Sharp CA, Swaithes L, Ellis B, Dziedzic K, Walsh N. Implementation research: making better use of evidence to improve healthcare. Rheumatology (Oxford) 2020; 59:1799-1801. [PMID: 32252071 DOI: 10.1093/rheumatology/keaa088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/16/2020] [Accepted: 01/31/2020] [Indexed: 01/03/2023] Open
Affiliation(s)
- Charlotte A Sharp
- The Kellgren Centre for Rheumatology, Manchester University Hospitals NHS Foundation Trust.,Alliance Manchester Business School, The University of Manchester, Manchester
| | - Laura Swaithes
- Primary Care Centre Versus Arthritis, School of Primary Community and Social Care, Keele University, Keele
| | - Benjamin Ellis
- Rheumatology, Hammersmith Hospital, Imperial College Healthcare NHS Trust.,Policy, Health and Social Care Improvement, Versus Arthritis, London
| | - Krysia Dziedzic
- Primary Care Centre Versus Arthritis, School of Primary Community and Social Care, Keele University, Keele
| | - Nicola Walsh
- Department of Allied Health Professionals, Centre for Health and Clinical Research, University of the West of England, Bristol, UK
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23
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Kunpeuk W, Teekasap P, Kosiyaporn H, Julchoo S, Phaiyarom M, Sinam P, Pudpong N, Suphanchaimat R. Understanding the Problem of Access to Public Health Insurance Schemes among Cross-Border Migrants in Thailand through Systems Thinking. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145113. [PMID: 32679855 PMCID: PMC7400460 DOI: 10.3390/ijerph17145113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 01/05/2023]
Abstract
Thailand has become a popular destination for international migrant workers, particularly from Cambodia, Lao PDR, and Myanmar. However, only a fraction of these migrant workers were insured by public health insurance. The objective of this study was to apply systems thinking to explore contextual factors affecting access to public health insurance among cross-border migrants in Thailand. A group model building approach was applied. Participants (n = 20) were encouraged to share ideas about underlying drivers and barriers of migrants' access to health insurance. The causal loop diagram and stock and flow diagram were synthesised to identify the dynamics of access to migrant health insurance. Results showed that nationality verification is an important mechanism to deal with the precarious citizenship status of undocumented migrants. However, some migrants are still left uninsured. The likely explanations are the semi-voluntary nature of the Health Insurance Card Scheme, administrative delay of the enrollment process, and resistance of some employers to hiring migrants. As a result, findings suggest that effective communication is required to raise acceptance towards insurance among migrants and their employers. A participatory public policy process is needed to create a good balance of migrant policies among diverse authorities.
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Affiliation(s)
- Watinee Kunpeuk
- International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand; (H.K.); (S.J.); (M.P.); (P.S.); (N.P.); (R.S.)
- Correspondence: ; Tel.: +66-2-590-2366; Fax: +66-2-590-2385
| | - Pard Teekasap
- Faculty of Business Administration and Technology, Stamford International University, Motorway Road—Km2, Prawet, Bangkok 10250, Thailand;
| | - Hathairat Kosiyaporn
- International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand; (H.K.); (S.J.); (M.P.); (P.S.); (N.P.); (R.S.)
| | - Sataporn Julchoo
- International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand; (H.K.); (S.J.); (M.P.); (P.S.); (N.P.); (R.S.)
| | - Mathudara Phaiyarom
- International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand; (H.K.); (S.J.); (M.P.); (P.S.); (N.P.); (R.S.)
| | - Pigunkaew Sinam
- International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand; (H.K.); (S.J.); (M.P.); (P.S.); (N.P.); (R.S.)
| | - Nareerut Pudpong
- International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand; (H.K.); (S.J.); (M.P.); (P.S.); (N.P.); (R.S.)
| | - Rapeepong Suphanchaimat
- International Health Policy Program, Ministry of Public Health, Tiwanon Road, Nonthaburi 11000, Thailand; (H.K.); (S.J.); (M.P.); (P.S.); (N.P.); (R.S.)
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand
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Hyseni L, Guzman-Castillo M, Kypridemos C, Collins B, Schwaller E, Capewell S, Boland A, Dickson R, O'Flaherty M, Gallacher K, Hale P, Lloyd-Williams F. Engaging with stakeholders to inform the development of a decision-support tool for the NHS health check programme: qualitative study. BMC Health Serv Res 2020; 20:394. [PMID: 32393313 PMCID: PMC7212552 DOI: 10.1186/s12913-020-05268-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 04/29/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The NHS Health Check Programme is a risk-reduction programme offered to all adults in England aged 40-74 years. Previous studies mainly focused on patient perspectives and programme delivery; however, delivery varies, and costs are substantial. We were therefore working with key stakeholders to develop and co-produce an NHS Health Check Programme modelling tool (workHORSE) for commissioners to quantify local effectiveness, cost-effectiveness, and equity. Here we report on Workshop 1, which specifically aimed to facilitate engagement with stakeholders; develop a shared understanding of current Health Check implementation; identify what is working well, less well, and future hopes; and explore features to include in the tool. METHODS This qualitative study identified key stakeholders across the UK via networking and snowball techniques. The stakeholders spanned local organisations (NHS commissioners, GPs, and academics), third sector and national organisations (Public Health England and The National Institute for Health and Care Excellence). We used the validated Hovmand "group model building" approach to engage stakeholders in a series of pre-piloted, structured, small group exercises. We then used Framework Analysis to analyse responses. RESULTS Fifteen stakeholders participated in workshop 1. Stakeholders identified continued financial and political support for the NHS Health Check Programme. However, many stakeholders highlighted issues concerning lack of data on processes and outcomes, variability in quality of delivery, and suboptimal public engagement. Stakeholders' hopes included maximising coverage, uptake, and referrals, and producing additional evidence on population health, equity, and economic impacts. Key model suggestions focused on developing good-practice template scenarios, analysis of broader prevention activities at local level, accessible local data, broader economic perspectives, and fit-for-purpose outputs. CONCLUSIONS A shared understanding of current implementations of the NHS Health Check Programme was developed. Stakeholders demonstrated their commitment to the NHS Health Check Programme whilst highlighting the perceived requirements for enhancing the service and discussed how the modelling tool could be instrumental in this process. These suggestions for improvement informed subsequent workshops and model development.
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Affiliation(s)
- Lirije Hyseni
- Department of Public Health & Policy, University of Liverpool, 3rd floor Whelan Building, Room 3.09, Liverpool, L69 3GB, UK.
| | - Maria Guzman-Castillo
- Department of Public Health & Policy, University of Liverpool, 3rd floor Whelan Building, Room 3.09, Liverpool, L69 3GB, UK
| | - Chris Kypridemos
- Department of Public Health & Policy, University of Liverpool, 3rd floor Whelan Building, Room 3.09, Liverpool, L69 3GB, UK
| | - Brendan Collins
- Department of Public Health & Policy, University of Liverpool, 3rd floor Whelan Building, Room 3.09, Liverpool, L69 3GB, UK
| | - Ellen Schwaller
- Department of Public Health & Policy, University of Liverpool, 3rd floor Whelan Building, Room 3.09, Liverpool, L69 3GB, UK
| | - Simon Capewell
- Department of Public Health & Policy, University of Liverpool, 3rd floor Whelan Building, Room 3.09, Liverpool, L69 3GB, UK
| | - Angela Boland
- Department of Health Services Research, Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Rumona Dickson
- Department of Health Services Research, Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Martin O'Flaherty
- Department of Public Health & Policy, University of Liverpool, 3rd floor Whelan Building, Room 3.09, Liverpool, L69 3GB, UK
| | - Kay Gallacher
- Department of Public Health & Policy, University of Liverpool, 3rd floor Whelan Building, Room 3.09, Liverpool, L69 3GB, UK
| | - Peter Hale
- Department of Public Health & Policy, University of Liverpool, 3rd floor Whelan Building, Room 3.09, Liverpool, L69 3GB, UK
| | - Ffion Lloyd-Williams
- Department of Public Health & Policy, University of Liverpool, 3rd floor Whelan Building, Room 3.09, Liverpool, L69 3GB, UK
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25
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Grooten L, Vrijhoef HJM, Alhambra-Borrás T, Whitehouse D, Devroey D. The transfer of knowledge on integrated care among five European regions: a qualitative multi-method study. BMC Health Serv Res 2020; 20:11. [PMID: 31900146 PMCID: PMC6942405 DOI: 10.1186/s12913-019-4865-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 12/23/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND To examine how the knowledge transfer processes unfolded within SCIROCCO, a EU funded project (3rd Health Programme (2014-2020)) that aimed to facilitate the process of knowledge sharing across five European regions, to speed up adoption and scaling-up of integrated care initiatives. METHODS A qualitative multi-method design was used. Data collection methods included focus groups, project documents and action plans of the regions. The data was analysed using a qualitative content-analysis procedure, which was guided by the frameworks of knowledge exchange and the why, whose, what, how framework for knowledge mobilisers. RESULTS All five components (including the themes) of knowledge exchange could be identified in the approach developed on the knowledge transfer processes. The four questions and accompanying categories of the framework of knowledge mobilisation were also identified to a large degree. CONCLUSIONS The observed incorporation of distinct forms of knowledge from multiple sources and the observed dynamic and fluid knowledge transfer processes both suggest that SCIROCCO developed a comprehensive knowledge transfer approach aiming to enable the adoption and scaling-up of integrated care. Overall, the multi-method qualitative nature of this research has allowed some new and practical insights in the knowledge transfer activities on integrated care between several European regions. To obtain a clear understanding of the content of the knowledge transfer approaches, which could assist the operationalising of models to support the evaluation of knowledge transfer activities, it is strongly recommended that further research of this type should be conducted in other research settings.
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Affiliation(s)
- Liset Grooten
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, P.O. 103, B-1090, Brussels, Belgium
| | - Hubertus Johannes Maria Vrijhoef
- Department Patient & Care, Maastricht University Medical Center, Maastricht, the Netherlands
- Panaxea B.V, Amsterdam, the Netherlands
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussel, Belgium
| | | | - Diane Whitehouse
- European Health Telematics Association (EHTEL), Brussels, Belgium
| | - Dirk Devroey
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, P.O. 103, B-1090, Brussels, Belgium
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Freebairn L, Atkinson JA, Osgood ND, Kelly PM, McDonnell G, Rychetnik L. Turning conceptual systems maps into dynamic simulation models: An Australian case study for diabetes in pregnancy. PLoS One 2019; 14:e0218875. [PMID: 31247006 PMCID: PMC6597234 DOI: 10.1371/journal.pone.0218875] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 06/11/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND System science approaches are increasingly used to explore complex public health problems. Quantitative methods, such as participatory dynamic simulation modelling, can mobilise knowledge to inform health policy decisions. However, the analytic and practical steps required to turn collaboratively developed, qualitative system maps into rigorous and policy-relevant quantified dynamic simulation models are not well described. This paper reports on the processes, interactions and decisions that occurred at the interface between modellers and end-user participants in an applied health sector case study focusing on diabetes in pregnancy. METHODS An analysis was conducted using qualitative data from a participatory dynamic simulation modelling case study in an Australian health policy setting. Recordings of participatory model development workshops and subsequent meetings were analysed and triangulated with field notes and other written records of discussions and decisions. Case study vignettes were collated to illustrate the deliberations and decisions made throughout the model development process. RESULTS The key analytic objectives and decision-making processes included: defining the model scope; analysing and refining the model structure to maximise local relevance and utility; reviewing and incorporating evidence to inform model parameters and assumptions; focusing the model on priority policy questions; communicating results and applying the models to policy processes. These stages did not occur sequentially; the model development was cyclical and iterative with decisions being re-visited and refined throughout the process. Storytelling was an effective strategy to both communicate and resolve concerns about the model logic and structure, and to communicate the outputs of the model to a broader audience. CONCLUSION The in-depth analysis reported here examined the application of participatory modelling methods to move beyond qualitative conceptual mapping to the development of a rigorously quantified and policy relevant, complex dynamic simulation model. The analytic objectives and decision-making themes identified provide guidance for interpreting, understanding and reporting future participatory modelling projects and methods.
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Affiliation(s)
- Louise Freebairn
- ACT Health, Canberra, Australia
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, Australia
- University of Notre Dame, Sydney, Australia
- * E-mail:
| | - Jo-An Atkinson
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, Australia
- Decision Analytics, Sax Institute, Sydney, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Nathaniel D. Osgood
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, Australia
- Computer Science, University of Saskatchewan, Saskatoon, Canada
- Department of Community Health … Epidemiology, University of Saskatchewan, Saskatoon, Canada
| | - Paul M. Kelly
- ACT Health, Canberra, Australia
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, Australia
- Medical School, The Australian National University, Canberra, Australia
| | | | - Lucie Rychetnik
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, Australia
- University of Notre Dame, Sydney, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
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Williamson A, Makkar SR, Redman S. How was research engaged with and used in the development of 131 policy documents? Findings and measurement implications from a mixed methods study. Implement Sci 2019; 14:44. [PMID: 31039811 PMCID: PMC6492336 DOI: 10.1186/s13012-019-0886-2] [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: 11/18/2018] [Accepted: 03/29/2019] [Indexed: 11/19/2022] Open
Abstract
Background Much has been written about the use of evidence in policy; however, there is still little known about whether and how research is engaged with and used in policy development or the impact of reported barriers and facilitators. This paper aims to (1) describe the characteristics of 131 policy documents, (2) describe the ways in which research was engaged with (e.g. was searched for, appraised or generated) and used (e.g. to clarify understanding, persuade others or inform a policy) in the development of these policy documents, and (3) identify the most commonly reported barriers and facilitators and describe their association with research engagement and use. Methods Six health policy and program development agencies based in Sydney, Australia, contributed four recently finalised policy documents for consideration over six measurement periods. Structured, qualitative interviews were conducted with the policymakers most heavily involved in developing each of the 131 policy documents. Interviews covered whether and how research was engaged with and used in the development of the policy product and any barriers or facilitators related to this. Interviews were scored using the empirically validated SAGE tool and thematically analysed. Descriptive statistics were calculated for all key variables and comparisons made between agencies. Multiple regression analyses were used to estimate the impact of specific barriers and facilitators on research engagement and use. Results Our data shows large variations between policy agencies in the types of policy documents produced and the characteristics of these documents. Nevertheless, research engagement and use was generally moderate across agencies. A number of barriers and facilitators to research use were identified. No barriers were significantly associated with any aspects of research engagement or use. Access to consultants and relationships with researchers were both associated with increased research engagement but not use. Thus, access to consultants and relationships with researchers may increase the extent and quality of the evidence considered in policy development. Conclusions Our findings suggest that those wishing to develop interventions and programs designed to improve the use of evidence in policy agencies might usefully target increasing access to consultants and relationships with researchers in order to increase the extent and quality of the research considered, but that a greater consideration of context might be required to develop strategies to increase evidence use. Electronic supplementary material The online version of this article (10.1186/s13012-019-0886-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna Williamson
- The Sax Institute, Level 13, Building 10, 235 Jones Street, Ultimo, NSW, 2007, Australia. .,School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia. .,School of Public Health, University of Sydney, Sydney, Australia.
| | - Steve R Makkar
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Sally Redman
- The Sax Institute, Level 13, Building 10, 235 Jones Street, Ultimo, NSW, 2007, Australia
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Abstract
BACKGROUND In 2005, Pearson et al. presented a developmental framework of evidence-based practice that sought to situate healthcare evidence and its role and use within the complexity of practice settings globally. A decade later, it was deemed timely to re-examine the Model and its component parts to determine whether they remain relevant and a true and accurate reflection of where the evidence-based movement is today. METHODS A two-phase process was employed for this project. Phase 1 involved a citation analysis, conducted using the index citation of the original source article on the Joanna Briggs Institute (JBI) Model by Pearson et al. The databases searched were Web of Science and Google Scholar from year of publication (2005) to July 2015. Duplicates and articles in languages other than English were removed, and all results were imported and combined in an Excel spreadsheet for review, coding and interpretation. Phase 2 (model revision) occurred in two parts. Part 1 involved revision of the Model by an internal working group. This revised version of the Model was then subjected to a process of focus group discussion (Part 2) that engaged staff of the Joanna Briggs Collaboration during the 2015 annual general meeting. These data were recorded then transcribed for review and consideration. RESULTS The citation analysis revealed that the Model was primarily utilized to conceptualize evidence and evidence-based healthcare, but that language used in relation to concepts within the Model was variable. Equally, the working group and focus group feedback confirmed that there was a need to ensure the language utilized in the Model was internationally appropriate and in line with current international trends. This feedback and analysis informed the revised version of the JBI Model. CONCLUSION Based on the citation analysis, working group and focus group feedback the new JBI Model for Evidence Based Healthcare attempts to utilize more internationally appropriate language to detail the intricacies of the relationships between systems and individuals across different settings and the need for contextual localization to enable policy makers and practitioners to make evidence-based decisions at the point of care.
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Degeling C, Thomas R, Rychetnik L. Citizens' juries can bring public voices on overdiagnosis into policy making. BMJ 2019; 364:l351. [PMID: 30700440 DOI: 10.1136/bmj.l351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Chris Degeling
- Australian Centre for Health Engagement, Evidence and Values, University of Wollongong, Australia
| | - Rae Thomas
- Centre for Research in Evidence Based Practice, Bond University, Australia
| | - Lucie Rychetnik
- School of Medicine Sydney, University of Notre Dame, Australia
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Brocklehurst PR, Baker SR, Listl S, Peres MA, Tsakos G, Rycroft-Malone J. How Should We Evaluate and Use Evidence to Improve Population Oral Health? Dent Clin North Am 2019; 63:145-156. [PMID: 30447789 DOI: 10.1016/j.cden.2018.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Generating and implementing evidence-based policy is an important aim for many publicly funded health systems. In dentistry, this is based on the assumption that evidence-based health care increases the efficiency and effectiveness of interventions to improve oral health at a population level. This article argues that a linear logic model that links the generation of research evidence with its use is overly simplistic. It also challenges an uncritical interpretation of the evidence-based paradigm and explores approaches to the evaluation of complex interventions and how they can be embedded into policy and practice to improve oral health at a population level.
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Affiliation(s)
| | - Sarah R Baker
- The School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Stefan Listl
- Faculty of Medical Sciences, Radboud University, The Netherlands
| | - Marco A Peres
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College, 1-19 Torrington Place, London, UK
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Thompson MR, Barcott DS. The Role of the Nurse Scientist as a Knowledge Broker. J Nurs Scholarsh 2019; 51:26-39. [PMID: 30354032 PMCID: PMC6329672 DOI: 10.1111/jnu.12439] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE This article introduces the importance and nature of the role of the nurse scientist as a knowledge broker. DESIGN A systematic literature review was completed using a modified version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) appraisal tool to trace the emergence and characteristics of the knowledge broker role across disciplines internationally and in the United States. METHODS Salient publications were identified using PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Sociological Abstracts, and ProQuest Dissertations & Theses, as well as hand searches and searches of the grey literature. Authors used these resources to define the knowledge broker role and with their role-related experiences developed the Thompson Knowledge Brokering Model. FINDINGS A knowledge broker is one who connects science and society by building networks and facilitating opportunities among knowledge producers and knowledge users. The knowledge broker role includes three components: forming and sustaining partnerships; facilitating knowledge application; and creating new knowledge. There are five major strategies central to each role component: establish, engage, educate, empower, and evaluate. CONCLUSIONS The knowledge broker role has been increasingly recognized worldwide as key to translating science into practice and policy. The nurse scientist is ideally suited for this role and should be promoted worldwide. The Thompson Knowledge Brokering Model can be used as a guide for nurse scientists. CLINICAL RELEVANCE The role of the knowledge broker is to facilitate translation of useful research to practice and policy by connecting stakeholders through meaningful engagement.
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Affiliation(s)
- Marcella Remer Thompson
- Delta Upsilon-at-Large; College of Nursing, University of Rhode Island, Providence, Rhode Island, Adjunct Assistant Professor, Pathology & Laboratory Medicine, Brown University, and Co-Leader of Community Engagement, Superfund Research Program, Brown University, all in Providence, RI, USA
| | - Donna Schwartz Barcott
- Delta Upsilon At-Large; College of Nursing, University of Rhode Island, Providence, RI, USA
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Freebairn L, Atkinson JA, Kelly PM, McDonnell G, Rychetnik L. Decision makers' experience of participatory dynamic simulation modelling: methods for public health policy. BMC Med Inform Decis Mak 2018; 18:131. [PMID: 30541523 PMCID: PMC6291959 DOI: 10.1186/s12911-018-0707-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 11/12/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Systems science methods such as dynamic simulation modelling are well suited to address questions about public health policy as they consider the complexity, context and dynamic nature of system-wide behaviours. Advances in technology have led to increased accessibility and interest in systems methods to address complex health policy issues. However, the involvement of policy decision makers in health-related simulation model development has been lacking. Where end-users have been included, there has been limited examination of their experience of the participatory modelling process and their views about the utility of the findings. This paper reports the experience of end-user decision makers, including senior public health policy makers and health service providers, who participated in three participatory simulation modelling for health policy case studies (alcohol related harm, childhood obesity prevention, diabetes in pregnancy), and their perceptions of the value and efficacy of this method in an applied health sector context. METHODS Semi-structured interviews were conducted with end-user participants from three participatory simulation modelling case studies in Australian real-world policy settings. Interviewees were employees of government agencies with jurisdiction over policy and program decisions and were purposively selected to include perspectives at different stages of model development. RESULTS The 'co-production' aspect of the participatory approach was highly valued. It was reported as an essential component of building understanding of the modelling process, and thus trust in the model and its outputs as a decision-support tool. The unique benefits of simulation modelling included its capacity to explore interactions of risk factors and combined interventions, and the impact of scaling up interventions. Participants also valued simulating new interventions prior to implementation in the real world, and the comprehensive mapping of evidence and its gaps to prioritise future research. The participatory aspect of simulation modelling was time and resource intensive and therefore most suited to high priority complex topics with contested options for intervening. CONCLUSION These findings highlight the value of a participatory approach to dynamic simulation modelling to support its utility in applied health policy settings.
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Affiliation(s)
- Louise Freebairn
- ACT Health, GPO Box 825, Canberra, ACT 2601 Australia
- The Australian Prevention Partnership Centre, Sax Institute, PO Box K617, Haymarket, Sydney, NSW 1240 Australia
- School of Medicine, University of Notre Dame, PO Box 944, Broadway, Sydney, NSW 2007 Australia
| | - Jo-An Atkinson
- The Australian Prevention Partnership Centre, Sax Institute, PO Box K617, Haymarket, Sydney, NSW 1240 Australia
- Decision Analytics, Sax Institute, Sydney, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW 2006 Australia
| | - Paul M. Kelly
- ACT Health, GPO Box 825, Canberra, ACT 2601 Australia
- The Australian Prevention Partnership Centre, Sax Institute, PO Box K617, Haymarket, Sydney, NSW 1240 Australia
- School of Medicine, The Australian National University, ACT, Canberra, 2601 Australia
| | | | - Lucie Rychetnik
- The Australian Prevention Partnership Centre, Sax Institute, PO Box K617, Haymarket, Sydney, NSW 1240 Australia
- School of Medicine, University of Notre Dame, PO Box 944, Broadway, Sydney, NSW 2007 Australia
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Kislov R, Wilson PM, Knowles S, Boaden R. Learning from the emergence of NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRCs): a systematic review of evaluations. Implement Sci 2018; 13:111. [PMID: 30111339 PMCID: PMC6094566 DOI: 10.1186/s13012-018-0805-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 08/03/2018] [Indexed: 11/10/2022] Open
Abstract
Background Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) were funded by NIHR in England in 2008 and 2014 as partnerships between universities and surrounding health service organisations, focused on improving the quality of healthcare through the conduct and application of applied health research. The aim of this review is to synthesise learning from evaluations of the CLAHRCs. Methods Fifteen databases including CINAHL, MEDLINE, EMBASE and PsycINFO were searched to identify any evaluations of CLAHRCs. Current and archived CLAHRC websites and the reference lists of retrieved articles were scanned to identify any additional evaluations. Searches were restricted to English language only. Any publications from evaluations of the CLAHRCs were eligible for inclusion if they fulfilled at least one of three pre-specified inclusion criteria. A narrative synthesis was undertaken. Results Twenty-six evaluations (reported in 37 papers) were deemed eligible for inclusion. Evaluations focused on describing and exploring the formative partnerships, vision, values, structures and processes of CLAHRCs; the nature and role of boundaries; the deployment of knowledge brokers and hybrid roles to support knowledge mobilisation; patient and public involvement; and capacity building. The relative lack of data about the early impact of CLAHRCs on health care provision or outcomes is notable. Conclusions Much of the evaluative focus on CLAHRCs has been on how they have been organised and on the development of theory around their emergent properties. Evidence is lacking on the impact of CLAHRCs particularly in relation to the knowledge mobilisation processes and practices adopted. Further evaluation of CLAHRCs and other similar research and practice partnerships is warranted and should focus on which knowledge mobilisation approaches work where, how and why. Trial registration PROSPERO (Registration number: CRD42016042945). Electronic supplementary material The online version of this article (10.1186/s13012-018-0805-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Roman Kislov
- Alliance Manchester Business School, University of Manchester, Manchester, UK.,NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, Manchester, UK
| | - Paul M Wilson
- Alliance Manchester Business School, University of Manchester, Manchester, UK. .,NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, Manchester, UK.
| | - Sarah Knowles
- Alliance Manchester Business School, University of Manchester, Manchester, UK.,NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, Manchester, UK
| | - Ruth Boaden
- Alliance Manchester Business School, University of Manchester, Manchester, UK.,NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester, Manchester, UK
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Langley J, Wolstenholme D, Cooke J. 'Collective making' as knowledge mobilisation: the contribution of participatory design in the co-creation of knowledge in healthcare. BMC Health Serv Res 2018; 18:585. [PMID: 30045726 PMCID: PMC6060522 DOI: 10.1186/s12913-018-3397-y] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 07/15/2018] [Indexed: 11/10/2022] Open
Abstract
The discourse in healthcare Knowledge Mobilisation (KMb) literature has shifted from simple, linear models of research knowledge production and action to more iterative and complex models. These aim to blend multiple stakeholders' knowledge with research knowledge to address the research-practice gap. It has been suggested there is no 'magic bullet', but that a promising approach to take is knowledge co-creation in healthcare, particularly if a number of principles are applied. These include systems thinking, positioning research as a creative enterprise with human experience at its core, and paying attention to process within the partnership. This discussion paper builds on this proposition and extends it beyond knowledge co-creation to co-designing evidenced based interventions and implementing them. Within a co-design model, we offer a specific approach to share, mobilise and activate knowledge, that we have termed 'collective making'. We draw on KMb, design, wider literature, and our experiences to describe how this framework supports and extends the principles of co-creation offered by Geenhalgh et al. [1] in the context of the state of the art of knowledge mobilisation. We describe how collective making creates the right 'conditions' for knowledge to be mobilised particularly addressing issues relating to stakeholder relationships, helps to discover, share and blend different forms of knowledge from different stakeholders, and puts this blended knowledge to practical use allowing stakeholders to learn about the practical implications of knowledge use and to collectively create actionable products. We suggest this collective making has three domains of influence: on the participants; on the knowledge discovered and shared; and on the mobilisation or activation of this knowledge.
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Affiliation(s)
- Joe Langley
- Lab4Living, Art & Design Research Centre, Sheffield Hallam University, Sheffield, UK
- NIHR Devices for Dignity HTC, Sheffield Teaching Hospitals NHS FT, Sheffield, UK
- NIHR CLAHRC YH, Sheffield Teaching Hospitals NHS FT, Sheffield, UK
| | - Daniel Wolstenholme
- Lab4Living, Art & Design Research Centre, Sheffield Hallam University, Sheffield, UK
- NIHR CLAHRC YH, Sheffield Teaching Hospitals NHS FT, Sheffield, UK
| | - Jo Cooke
- NIHR CLAHRC YH, Sheffield Teaching Hospitals NHS FT, Sheffield, UK
- Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
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Breckenridge JP, Gianfrancesco C, de Zoysa N, Lawton J, Rankin D, Coates E. Mobilising knowledge between practitioners and researchers to iteratively refine a complex intervention (DAFNE plus) pre-trial: protocol for a structured, collaborative working group process. Pilot Feasibility Stud 2018; 4:120. [PMID: 29988686 PMCID: PMC6029123 DOI: 10.1186/s40814-018-0314-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/25/2018] [Indexed: 11/10/2022] Open
Abstract
Background Randomised controlled trials (RCTs) of complex interventions often begin with a pilot phase to test the proposed methods and refine the intervention before it is trialled. Although the Medical Research Council (MRC) recommends regular communication between the practitioners delivering the intervention and the researchers evaluating it during the pilot phase, there is a lack of practical guidance about how to undertake this aspect of pre-trial work. This paper describes a novel structured process for collaborative working, which we developed to iteratively refine a complex intervention prior to an RCT. We also describe an in-built qualitative study to learn lessons about how this approach could be used by future study teams. Methods This work forms part of a broader research programme to develop and trial a complex intervention for people with type 1 diabetes, called DAFNEplus. The intervention is being piloted in three National Health Service (NHS) diabetes centres in two waves, with refinements being incrementally implemented between each wave in response to real-time, collective learning (combining practitioner experience, process evaluation data and patient and public involvement via an advisory group). A structured ‘Collaborative Working Group’ (CWG) process, comprising monthly teleconferences and four strategically timed face-to-face meetings, is being used to identify and respond systematically to emerging implementation challenges and research findings. The group involves 25 members of the study team, including the multi-disciplinary practitioners delivering the intervention, the research teams conducting the process evaluation, the study manager and Chief Investigator. An in-built qualitative study comprising documentary analysis of meeting materials, discourse analysis of meeting transcripts, reflexive note taking, and thematic analysis of focus groups and interviews with CWG members is being undertaken to explore how the CWG works and how its processes and procedures might be improved. Discussion The CWG process offers a potential model for collaborative working in future pre-trial pilot phases and intervention development studies that operationalises MRC guidance to progressively develop a complex intervention and foster shared ownership through genuine collaboration. The findings from the qualitative study will provide insight into how to best support collaborative working to achieve optimal intervention design.
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Affiliation(s)
- Jenna P Breckenridge
- 1School of Nursing and Health Sciences, University of Dundee, 11 Airlie Place, Dundee, DD1 4HJ UK
| | - Carla Gianfrancesco
- 2Sheffield Diabetes and Endocrine Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Herries Road, Sheffield, S5 7AU UK
| | - Nicole de Zoysa
- 3Diabetes Centre, King's College Hospital, Denmark Hill, London, SE5 9RS UK
| | - Julia Lawton
- The Usher Institute of Population Health Sciences and Informatics, Edinburgh Medical School of Molecular, Genetic and Population Health Sciences, Teviot Place, Edinburgh, EH8 9AG UK
| | - David Rankin
- The Usher Institute of Population Health Sciences and Informatics, Edinburgh Medical School of Molecular, Genetic and Population Health Sciences, Teviot Place, Edinburgh, EH8 9AG UK
| | - Elizabeth Coates
- 5School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
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Turner A, Mulla A, Booth A, Aldridge S, Stevens S, Begum M, Malik A. The international knowledge base for new care models relevant to primary care-led integrated models: a realist synthesis. HEALTH SERVICES AND DELIVERY RESEARCH 2018. [PMID: 29972636 DOI: 10.3310/hsdr06250] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BackgroundThe Multispecialty Community Provider (MCP) model was introduced to the NHS as a primary care-led, community-based integrated care model to provide better quality, experience and value for local populations.ObjectivesThe three main objectives were to (1) articulate the underlying programme theories for the MCP model of care; (2) identify sources of theoretical, empirical and practice evidence to test the programme theories; and (3) explain how mechanisms used in different contexts contribute to outcomes and process variables.DesignThere were three main phases: (1) identification of programme theories from logic models of MCP vanguards, prioritising key theories for investigation; (2) appraisal, extraction and analysis of evidence against a best-fit framework; and (3) realist reviews of prioritised theory components and maps of remaining theory components.Main outcome measuresThe quadruple aim outcomes addressed population health, cost-effectiveness, patient experience and staff experience.Data sourcesSearches of electronic databases with forward- and backward-citation tracking, identifying research-based evidence and practice-derived evidence.Review methodsA realist synthesis was used to identify, test and refine the following programme theory components: (1) community-based, co-ordinated care is more accessible; (2) place-based contracting and payment systems incentivise shared accountability; and (3) fostering relational behaviours builds resilience within communities.ResultsDelivery of a MCP model requires professional and service user engagement, which is dependent on building trust and empowerment. These are generated if values and incentives for new ways of working are aligned and there are opportunities for training and development. Together, these can facilitate accountability at the individual, community and system levels. The evidence base relating to these theory components was, for the most part, limited by initiatives that are relatively new or not formally evaluated. Support for the programme theory components varies, with moderate support for enhanced primary care and community involvement in care, and relatively weak support for new contracting models.Strengths and limitationsThe project benefited from a close relationship with national and local MCP leads, reflecting the value of the proximity of the research team to decision-makers. Our use of logic models to identify theories of change could present a relatively static position for what is a dynamic programme of change.ConclusionsMultispecialty Community Providers can be described as complex adaptive systems (CASs) and, as such, connectivity, feedback loops, system learning and adaptation of CASs play a critical role in their design. Implementation can be further reinforced by paying attention to contextual factors that influence behaviour change, in order to support more integrated working.Future workA set of evidence-derived ‘key ingredients’ has been compiled to inform the design and delivery of future iterations of population health-based models of care. Suggested priorities for future research include the impact of enhanced primary care on the workforce, the effects of longer-term contracts on sustainability and capacity, the conditions needed for successful continuous improvement and learning, the role of carers in patient empowerment and how community participation might contribute to community resilience.Study registrationThis study is registered as PROSPERO CRD42016039552.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Alison Turner
- The Strategy Unit, NHS Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
| | - Abeda Mulla
- The Strategy Unit, NHS Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
| | - Andrew Booth
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Shiona Aldridge
- The Strategy Unit, NHS Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
| | - Sharon Stevens
- The Strategy Unit, NHS Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
| | - Mahmoda Begum
- The Strategy Unit, NHS Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
| | - Anam Malik
- The Strategy Unit, NHS Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
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Grove A, Clarke A, Currie G. How are evidence and knowledge used in orthopaedic decision-making? Three comparative case studies of different approaches to implementation of clinical guidance in practice. Implement Sci 2018; 13:75. [PMID: 29855341 PMCID: PMC5984395 DOI: 10.1186/s13012-018-0771-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 05/23/2018] [Indexed: 11/30/2022] Open
Abstract
Background The uptake and use of clinical guidelines is often insufficient to change clinical behaviour and reduce variation in practice. As a consequence of diverse organisational contexts, the simple provision of guidelines cannot ensure fidelity or guarantee their use when making decisions. Implementation research in surgery has focused on understanding what evidence exists for clinical practice decisions but limits understanding to the technical, educational and accessibility issues. This research aims to identify where, when and how evidence and knowledge are used in orthopaedic decision-making and how variation in these factors contributes to different approaches to implementation of clinical guidance in practice. Methods We used in-depth case studies to examine guideline implementation in real-life surgical practice. We conducted comparative case studies in three English National Health Service hospitals over a 12-month period. Each in-depth case study consisted of a mix of qualitative methods including interviews, observations and document analysis. Data included field notes from observations of day-to-day practice, 64 interviews with NHS surgeons and staff and the collection of 121 supplementary documents. Results Case studies identified 17 sources of knowledge and evidence which influenced clinical decisions in elective orthopaedic surgery. A comparative analysis across cases revealed that each hospital had distinct approaches to decision-making. Decision-making is described as occurring as a result of how 17 types of knowledge and evidence were privileged and of how they interacted and changed in context. Guideline implementation was contingent and mediated through four distinct contextual levels. Implementation could be assessed for individual surgeons, groups of surgeons or the organisation as a whole, but it could also differ between these levels. Differences in how evidence and knowledge were used contributed to variations in practice from guidelines. Conclusion A range of complex and competing sources of evidence and knowledge exists which influence the working practices of healthcare professionals. The dynamic selection, combination and use of each type of knowledge and evidence influence the implementation and use of clinical guidance in practice. Clinical guidelines are a fundamental part of practice, but represent only one type of evidence influencing clinical decisions. In the orthopaedic speciality, other distinct sources of evidence and knowledge are selected and used which impact on how guidelines are implemented. New approaches to guideline implementation need to appreciate and incorporate this diverse range of knowledge and evidence which influences clinical decisions and to take account of the changing contexts in which decisions are made. Electronic supplementary material The online version of this article (10.1186/s13012-018-0771-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Amy Grove
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
| | - Aileen Clarke
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Graeme Currie
- Entrepreneurship & Innovation, Organising Healthcare Research Network, Warwick Business School, University of Warwick, Coventry, UK
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Johnson R, Grove A, Clarke A. It's hard to play ball: A qualitative study of knowledge exchange and silo effects in public health. BMC Health Serv Res 2018; 18:1. [PMID: 29291745 PMCID: PMC5748943 DOI: 10.1186/s12913-017-2770-6] [Citation(s) in RCA: 138] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 11/28/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Partnerships in public health form an important component of commissioning and implementing services, in England and internationally. In this research, we examine the views of staff involved in a City-wide health improvement programme which ran from 2009 to 2013 in England. We examine the practicalities of partnership work in community settings, and we describe some of barriers faced when implementing a large, multi-organisation health improvement programme. METHODS Qualitative, semi-structured interviews were performed. Purposive sampling was used to identify potential participants in the programme: programme board of directors, programme and project managers and intervention managers. Interviews were conducted one-to-one. We conducted a thematic analysis using the 'one sheet of paper' technique. This involved analysing data deductively, moving from initial to axial coding, developing categories and then identifying emerging themes. RESULTS Fifteen interviews were completed. Three themes were identified. The first theme reflects how poor communication approaches hindered the ability of partnerships to deliver their aims and objectives in a range of ways and for a range of reasons. Our second theme reflects how a lack of appropriate knowledge exchange hindered decision-making, affected trust and contributed to protectionist approaches to working. This lack of shared, and communicated, understanding of what type of knowledge is most appropriate and in which circumstance made meaningful knowledge exchange challenging for decision-making and partnership-working in the City-wide health improvement programme. Theme three demonstrates how perceptions about silos in partnership-working could be problematic, but silos themselves were at times beneficial to partnerships. This revealed a mismatch between rhetoric and a realistic understanding of what components of the programme were functional and which were more hindrance than help. DISCUSSION There were high expectations placed on the concept of what partnership work was, or how it should be done. We found our themes to be interdependent, and reflective of the 'dynamic fluid process' discussed within the knowledge mobilisation literature. We contend that reframing normal and embedded processes of silos and silo-working already in use might ease resistance to some knowledge exchange processes and contribute to better long-term functioning of public health partnerships.
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Affiliation(s)
- Rebecca Johnson
- Collaboration for Leadership in Applied Health Research and Care West Midlands, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
| | - Amy Grove
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Aileen Clarke
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
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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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Varnell CD, Rich KL, Nichols M, Dahale D, Goebel JW, Pai ALH, Hooper DK, Modi AC. Assessing barriers to adherence in routine clinical care for pediatric kidney transplant patients. Pediatr Transplant 2017; 21:10.1111/petr.13027. [PMID: 28762577 PMCID: PMC5904833 DOI: 10.1111/petr.13027] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/21/2017] [Indexed: 01/04/2023]
Abstract
Patient-identified barriers to immunosuppressive medications are associated with poor adherence and negative clinical outcomes in transplant patients. Assessment of adherence barriers is not part of routine post-transplant care, and studies regarding implementing such a process in a reliable way are lacking. Using the Model for Improvement and PDSA cycles, we implemented a system to identify adherence barriers, including patient-centered design of a barriers assessment tool, identification of eligible patients, clear roles for clinic staff, and creating a culture of non-judgmental discussion around adherence. We performed time-series analysis of our process measure. Secondary analyses examined the endorsement and concordance of adherence barriers between patient-caregiver dyads. After three methods of testing, the most reliable delivery system was an EHR-integrated tablet that alerted staff of patient eligibility for assessment. Barriers were endorsed by 35% of caregivers (n=85) and 43% of patients (n=60). The most frequently patient-endorsed barriers were forgetting, poor taste, and side effects. Caregivers endorsed forgetting and side effects. Concordance between patient-caregiver dyads was fair (k=0.299). Standardized adherence barriers assessment is feasible in the clinical care of pediatric kidney transplant patients. Features necessary for success included automation, redundant systems with designated staff to identify and mitigate failures, aligned reporting structures, and reliable measurement approaches. Future studies will examine whether barriers predict clinical outcomes (eg, organ rejection, graft loss).
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Affiliation(s)
- Charles D. Varnell
- Division of Nephrology & Hypertension, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Kristin L. Rich
- Division of Behavioral and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA,University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Melissa Nichols
- Division of Nephrology & Hypertension, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Devesh Dahale
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Jens W. Goebel
- Division of Nephrology, Children’s Hospital Colorado, Aurora, CO, USA
| | - Ahna L. H. Pai
- Division of Behavioral and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA,University of Cincinnati College of Medicine, Cincinnati, OH, USA,Center for Treatment Adherence and Self-Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - David K. Hooper
- Division of Nephrology & Hypertension, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA,University of Cincinnati College of Medicine, Cincinnati, OH, USA,James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Avani C. Modi
- Division of Behavioral and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA,University of Cincinnati College of Medicine, Cincinnati, OH, USA,Center for Treatment Adherence and Self-Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Freebairn L, Rychetnik L, Atkinson JA, Kelly P, McDonnell G, Roberts N, Whittall C, Redman S. Knowledge mobilisation for policy development: implementing systems approaches through participatory dynamic simulation modelling. Health Res Policy Syst 2017; 15:83. [PMID: 28969642 PMCID: PMC5629638 DOI: 10.1186/s12961-017-0245-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 09/05/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Evidence-based decision-making is an important foundation for health policy and service planning decisions, yet there remain challenges in ensuring that the many forms of available evidence are considered when decisions are being made. Mobilising knowledge for policy and practice is an emergent process, and one that is highly relational, often messy and profoundly context dependent. Systems approaches, such as dynamic simulation modelling can be used to examine both complex health issues and the context in which they are embedded, and to develop decision support tools. OBJECTIVE This paper reports on the novel use of participatory simulation modelling as a knowledge mobilisation tool in Australian real-world policy settings. We describe how this approach combined systems science methodology and some of the core elements of knowledge mobilisation best practice. We describe the strategies adopted in three case studies to address both technical and socio-political issues, and compile the experiential lessons derived. Finally, we consider the implications of these knowledge mobilisation case studies and provide evidence for the feasibility of this approach in policy development settings. CONCLUSION Participatory dynamic simulation modelling builds on contemporary knowledge mobilisation approaches for health stakeholders to collaborate and explore policy and health service scenarios for priority public health topics. The participatory methods place the decision-maker at the centre of the process and embed deliberative methods and co-production of knowledge. The simulation models function as health policy and programme dynamic decision support tools that integrate diverse forms of evidence, including research evidence, expert knowledge and localised contextual information. Further research is underway to determine the impact of these methods on health service decision-making.
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Affiliation(s)
- Louise Freebairn
- ACT Government, Health Directorate, GPO Box 825, Canberra, ACT 2601 Australia
- The Australian Prevention Partnership Centre, Sax Institute, PO Box K617, Haymarket, NSW 1240 Sydney, Australia
- School of Medicine, University of Notre Dame, PO Box 944, Broadway, NSW 2007 Sydney, Australia
| | - Lucie Rychetnik
- The Australian Prevention Partnership Centre, Sax Institute, PO Box K617, Haymarket, NSW 1240 Sydney, Australia
- School of Medicine, University of Notre Dame, PO Box 944, Broadway, NSW 2007 Sydney, Australia
| | - Jo-An Atkinson
- The Australian Prevention Partnership Centre, Sax Institute, PO Box K617, Haymarket, NSW 1240 Sydney, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW 2006 Australia
| | - Paul Kelly
- ACT Government, Health Directorate, GPO Box 825, Canberra, ACT 2601 Australia
- The Australian Prevention Partnership Centre, Sax Institute, PO Box K617, Haymarket, NSW 1240 Sydney, Australia
- The Australian National University, Canberra, ACT 2601 Australia
| | - Geoff McDonnell
- The Australian Prevention Partnership Centre, Sax Institute, PO Box K617, Haymarket, NSW 1240 Sydney, Australia
- Adaptive Care Systems, Sydney, NSW 2052 Australia
| | - Nick Roberts
- The Australian Prevention Partnership Centre, Sax Institute, PO Box K617, Haymarket, NSW 1240 Sydney, Australia
| | | | - Sally Redman
- The Australian Prevention Partnership Centre, Sax Institute, PO Box K617, Haymarket, NSW 1240 Sydney, Australia
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Gaunand A, Colinet L, Joly PB, Matt M. Counting what really counts? Assessing the political impact of science. JOURNAL OF TECHNOLOGY TRANSFER 2017. [DOI: 10.1007/s10961-017-9605-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Marshall M, de Silva D, Cruickshank L, Shand J, Wei L, Anderson J. What we know about designing an effective improvement intervention (but too often fail to put into practice). BMJ Qual Saf 2016; 26:578-582. [PMID: 27986901 PMCID: PMC5502247 DOI: 10.1136/bmjqs-2016-006143] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 10/23/2016] [Accepted: 10/28/2016] [Indexed: 11/22/2022]
Affiliation(s)
- Martin Marshall
- Department of Primary Care and Population Health, University College London, London, UK
| | | | | | | | - Li Wei
- Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
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Bullock A, Barnes E, Morris ZS, Fairbank J, de Pury J, Howell R, Denman S. Getting the most out of knowledge and innovation transfer agents in health care: a qualitative study. HEALTH SERVICES AND DELIVERY RESEARCH 2016. [DOI: 10.3310/hsdr04330] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BackgroundKnowledge and innovation transfer (KIT) is recognised internationally as a complex, dynamic process that is difficult to embed in organisations. There is growing use of health service–academic–industry collaborations in the UK, with knowledge brokers linking producers with the users of knowledge and innovation.AimFocusing on KIT ‘agent’ roles within Academic Health Science Networks in England and Partnerships in Wales, we show how individual dispositions, processes and content contribute to desired outcomes.MethodsWe studied the KIT intentions of all Academic Health Science Networks in England, and the South East Wales Academic Health Science Partnership. Using a qualitative case study design, we studied the work of 13 KIT agents purposively sampled from five networks, by collecting data from observation of meetings, documentation, KIT agent audio-diaries, and semistructured interviews with KIT agents, their line managers and those they supported (‘Links’). We also used a consensus method in a meeting of experts (nominal group technique) to discuss the measurement of outcomes of KIT agent activity.FindingsThe case study KIT agents were predominantly from a clinical background with differing levels of experience and expertise, with the shared aim of improving services and patient care. Although outside of recognised career structures, the flexibility afforded to KIT agents to define their role was an enabler of success. Other helpful factors included (1) time and resources to devote to KIT activity; (2) line manager support and a team to assist in the work; and (3) access and the means to use data for improvement projects. The organisational and political context could be challenging. KIT agents not only tackled local barriers such as siloed working, but also navigated shifting regional and national policies. Board-level support for knowledge mobilisation together with a culture of reflection (listening to front-line staff), openness to challenges and receptivity to research all enabled KIT agents to achieve desired outcomes. Nominal group findings underscored the importance of relating measures to specific intended outcomes. However, the case studies highlighted that few measures were employed by KIT agents and their managers. Using social marketing theory helped to show linkages between processes, outcomes and impact, and drew attention to how KIT agents developed insight into their clients’ needs and tailored work accordingly.LimitationsLevel of KIT agent participation varied; line managers and Links were interviewed only once; and outcomes were self-reported.ConclusionsSocial marketing theory provided a framework for analysing KIT agent activity. The preparatory work KIT agents do in listening, understanding local context and building relationships enabled them to develop ‘insight’ and adapt their ‘offer’ to clients to achieve desired outcomes.Future workThe complexity of the role and the environment in which it is played out justifies more research on KIT agents. Suggestions include (1) longitudinal study of career pathways; (2) how roles are negotiated within teams and how competing priorities are managed; (3) how success is measured; (4) the place of improvement methodologies within KIT work; (5) the application of social marketing theory to comparative study of similar roles; and (6) patients as KIT agents.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Alison Bullock
- The Cardiff Unit for Research and Evaluation in Medical and Dental Education (CUREMeDE), Cardiff University, Cardiff, UK
| | - Emma Barnes
- The Cardiff Unit for Research and Evaluation in Medical and Dental Education (CUREMeDE), Cardiff University, Cardiff, UK
| | | | | | | | - Rosamund Howell
- Aneurin Bevan University Health Board, Clinical Research and Innovation Centre, St Woolos Hospital, Newport, UK
| | - Susan Denman
- School of Medicine, Cardiff University, Cardiff, UK
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Turner A, Mulla A, Booth A, Aldridge S, Stevens S, Battye F, Spilsbury P. An evidence synthesis of the international knowledge base for new care models to inform and mobilise knowledge for multispecialty community providers (MCPs). Syst Rev 2016; 5:167. [PMID: 27716415 PMCID: PMC5045634 DOI: 10.1186/s13643-016-0346-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 09/20/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND NHS England's Five Year Forward View (NHS England, Five Year Forward View, 2014) formally introduced a strategy for new models of care driven by simultaneous pressures to contain costs, improve care and deliver services closer to home through integrated models. This synthesis focuses on a multispecialty community provider (MCP) model. This new model of care seeks to overcome the limitations in current models of care, often based around single condition-focused pathways, in contrast to patient-focused delivery (Royal College of General Practitioners, The 2022 GP: compendium of evidence, 2012) which offers greater continuity of care in recognition of complex needs and multimorbidity. METHODS The synthesis, an innovative combination of best fit framework synthesis and realist synthesis, will develop a "blueprint" which articulates how and why MCP models work, to inform design of future iterations of the MCP model. A systematic search will be conducted to identify research and practice-derived evidence to achieve a balance that captures the historical legacy of MCP models but focuses on contemporary evidence. Sources will include bibliographic databases including MEDLINE, PreMEDLINE, CINAHL, Embase, HMIC and Cochrane Library; and grey literature sources. The Best Fit synthesis methodology will be combined with a synthesis following realist principles which are particularly suited to exploring what works, when, for whom and in what circumstances. DISCUSSION The aim of this synthesis is to provide decision makers in health and social care with a practical evidence base relating to the multispecialty community provider (MCP) model of care. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016039552 .
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Affiliation(s)
- Alison Turner
- Strategy Unit, Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
| | - Abeda Mulla
- Strategy Unit, Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Shiona Aldridge
- Strategy Unit, Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
| | - Sharon Stevens
- Strategy Unit, Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
| | - Fraser Battye
- Strategy Unit, Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
| | - Peter Spilsbury
- Strategy Unit, Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
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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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