Wednesday, 19 March 2014

Journal Club: Is that clear?

Relevance, access, collaboration, timeliness – magic words in the world of knowledge exchange. They were also key factors, helpfully identified by Oliver et al in their systematic review of studies of barriers and facilitators in using evidence. Taking the lead from Research Impact’s Journal Club, the CRFR Knowledge Exchange reading group ‘Practice what you preach’ met to discuss the review and reflect on our own experience of working in the field of evidence-use. We have captured our thoughts here, with links to some examples.
Oliver, K., Innvar, S., Lorenc, T., Woodman, J and Thomas, T. (2014). A systematic review of barriers to and facilitators of the use of evidence by policymakers, BMC Health Services Research, 14:2

Stop talking about dissemination
  • Is it time to move beyond the concept of dissemination[i]? Dissemination was a key term in many of the papers in this systematic review. Research needs to get out there, but this one-way concept isn’t going to achieve results in getting policy makers engaged with research. We, along with the rest of the academic community, talk more about engagement, impact, and collaboration. It is important to plan, from the outset, how different audiences will be able to access and use research.
  • It is a shame that the report authors grouped ‘access to research’ with ‘dissemination’ in their factor analysis. They are two very distinct issues – does it mean access to primary research, and/or research being made accessible through translation? A breakdown of these terms would have provided a clearer understanding of the barriers and facilitators for policy-makers.

How clear is clear?
  • It would have been helpful if the authors had unpacked what was meant by 'clarity of research findings' within the studies they analysed. Were they referring to research which was written clearly and easy to understand, or were they referring to research which had clear recommendations and proposals? Research rarely provides clear recommendations of potential actions even though that is often what policy-makers and practitioners want.
  • Knowledge exchange and mobilisation work means working with the available evidence to help shape what might happen next. We explored this in our CRFR briefing ‘Claiming an evidence base for services and interventions’. We are constantly working in this terrain as knowledge brokers for example:
    • Growing Up in Scotland (GUS) – practitioners often ask for more information about how to use study research findings in practice. 
    • About Families project and Evidence Request Bank development project– we often explain that research doesn’t provide direct answers, it poses questions and helps service professionals reflect on practice and share understandings with colleagues
  • So we need to separate out ideas of knowledge exchange and implementation, as Melanie Barwick, who is running a KE training course here in Edinburgh in May says:
    “Knowledge translation and implementation are complimentary but different constructs. Knowledge translation involves helping others to understand the evidence; implementation involves supporting them to make the changes needed to apply the evidence. Impact means capturing that people knew what to do with the knowledge you shared.”

What are people doing?
  • We noted that most studies included in the review were based on researcher’s or policy-makers perceptions of evidence use. There is a big difference between what people think they or others do, and what those people actually do. Sarah Morton’s forthcoming publication in Evidence and Policy will explore exactly what research-users do to apply research to policy or practice.
  • The research-policy gap still appears as a barrier to evidence use within this review. Lack of policymaker research skills was also highlighted as a barrier, and we wondered, given the sheer amount of policy-relevant research that is produced, whether these two factors were linked. The issue of a research skills gap in local policy-making has been highlighted elsewhere[ii].
  • So does more need to be done to present research in formats that can be easily digested into the policy environment? We have been working on this…

Improving collaboration
  • In our experience collaboration and access are closely linked. Close collaborations between policy-makers and researchers increases access to research surely?
  • There is general recognition of the importance of relationships between policy and research sectors, and issues are now more about nurturing a collaborative approach where both parties are active participants.
  • We were also pleased to see that comparing the previous review with this one, mistrust is less of an issue. It seems a success of those working within the broad knowledge exchange field that the various audiences are at least recognising the role each other plays.

Tactical evidence
  • We noted that the article didn’t refer to tactical or political use of evidence; that is when evidence is used or presented in a certain way to provide a desired answer. We felt that it must have been mentioned in some of the research included in the review.


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