Making more sense out of evidence-based practice

Evidence-based policy and practice and knowledge mobilisation are frequently used terms, but what are the key challenges in using research to develop and improve services for children and families? In this blog, CRFR Co-Director (Knowledge Exchange) Sarah Morton reflects on a recent talk at The Factor-Inwentash Faculty of Social Work at the University of Toronto.

I was delighted to be asked to open up a discussion about what we mean by knowledge based approaches, what helps and hinders knowledge utilization, and what approaches we can take to enhance knowledge mobilisation in different policy and practice settings. 

I drew on my 12 years experiences of leading knowledge exchange at the Centre for Research on Families and Relationships (www.crfr.ac.uk) based at the University of Edinburgh, with partners across Scottish Universities. This built on my experience of working in voluntary and statutory sectors on family and relationship issues, and more recently my PhD looked at how research impact occurs, and how it can be assessed.[1] 

In the space of a blog there is perhaps room for three key messages from my talk:

• What do we mean by research-utilisation?
• What is evidence for service and practice?
• Key ways of improving research use

What do we mean by research utilisation?
We often think that using research means creating a policy or practice change based on research findings, but research can be used in many ways. Drawing on work by Nutley et al (2007) research might raise awareness of an issue, change people’s knowledge or understanding of an issue, challenge attitudes, perceptions or ideas – all of these are pre-requisites of policy or practice change.

What is evidence for service and practice?
I have become concerned recently that we are narrowing our definition of evidence-based practice to mean solely that we are using programmes based on randomised controlled trials (RCT’s), for example, parenting programmes. Whilst this kind of evidence-based practice has its place, it is also problematic. Usually the trials have taken place in different contexts and countries, and adopting them wholesale undermines the expertise of local practitioners and underplays the cultural differences between communities. Recent work with Evaluation Support Scotland (http://www.evaluationsupportscotland.org.uk/) set out a range of ways we can think about evidence-based practice and services.

A programme can be evidenced-based in various ways:

• Our evidence: We have run this programme before and collected evidence to show that it worked for this group.
• Similar organisation evidence: Another organisation like us has run this programme before and collected evidence to show it would work (although not experimentally tested it).
• Broad research evidence: We’ve reviewed the research base and found strong evidence from research that the approach we are taking can work for the client group we are working with
• ‘What works’ evidence: This approach has been subject to randomised control trials (RCT) and we believe that our client group and context are similar enough for the same approach to work here.
• Innovation in the evidence-gap: Where there is no clear and appropriate evidence of what works for a particular client group, a programme can contribute to the evidence by experimenting and evaluating an approach that looks like it might work (from the available evidence). 

A full version of this discussion is available here: http://www.crfr.ac.uk/assets/CRFR_ESS_IS_Evidence_base_briefing.pdf

Key ways of improving research use.
There is well documented discussion of the key challenges for research use (e.g. Walter et al 2003). In order to improve the way that research links with policy and practice we need:

1. Translation – research in easily accessible forms for all those who might use it (this might be different for different groups).
2. Networks of relationships between researchers, policy-makers and practitioners to ensure that research is discussed, new research agendas have joint ownership and the possibility for close partnerships throughout the research cycle[2].
3. Learning organisations with strong leadership that recognise and understand new knowledge, assimilate and combine it with existing knowledge and translate knowledge into actions that will benefit the organisation[3].

We have a long way to go to develop these new ways of working that will enable researcher, policy-makers and practitioners to close the gap between knowledge and action. Organisations like The Factor—Inwentash Faculty of Social Work and CRFR are important in leading the way.

Dr Sarah Morton, BA, MSc, MSc.
Co-Director of the Centre for Research on Families and Relationships at the University of Edinburgh. Knowledge Exchange Specialist to the Scottish School of Public Health Research. Associate of the Research Unit for Research Utilisation (St Andrew’s University), and the National (UK) Coordinating Centre for Public Engagement. 

[1] Morton (fasttrack 2014) Creating research impact: the roles of research-users in interactive research mobilization. Evidence and Policy
[2] Best and Holmes(2010): Systems thinking for Knowledge to Action. Evidence and Policy May
[3] Harvey, G., et al. (2010). Absorptive Capacity: how organisations assimilate and apply knowledge to improve performance. Connecting knowledge and performance in public services : from knowing to doing. K. Walshe, G. Harvey and P. Jas. (eds) Cambridge University Press.