Using Evidence to Inform Health Policy: Case Study

MRC Social and Public Health Sciences Unit, Glasgow G12 8RZ.
BMJ Clinical Research (Impact Factor: 14.09). 02/2001; 322(7280):222-5.
Source: PubMed
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Available from: Sally Macintyre,
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    • "The bulk of the intervention evidence in EBP uses only research utilisation or uptake as an outcome (or, in some cases, merely attitudes and intentions regarding research use). Nonetheless, it is still widely claimed that decisions made in partnership between “politicians and researchers & lay people are more likely to result in positive health outcomes” [86] and many researchers continue to advocate for increased use of research evidence [99]. "
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    ABSTRACT: Despite 40 years of research into evidence-based policy (EBP) and a continued drive from both policymakers and researchers to increase research uptake in policy, barriers to the use of evidence are persistently identified in the literature. However, it is not clear what explains this persistence - whether they represent real factors, or if they are artefacts of approaches used to study EBP. Based on an updated review, this paper analyses this literature to explain persistent barriers and facilitators. We critically describe the literature in terms of its theoretical underpinnings, definitions of 'evidence', methods, and underlying assumptions of research in the field, and aim to illuminate the EBP discourse by comparison with approaches from other fields. Much of the research in this area is theoretically naive, focusing primarily on the uptake of research evidence as opposed to evidence defined more broadly, and privileging academics' research priorities over those of policymakers. Little empirical data analysing the processes or impact of evidence use in policy is available to inform researchers or decision-makers. EBP research often assumes that policymakers do not use evidence and that more evidence - meaning research evidence - use would benefit policymakers and populations. We argue that these assumptions are unsupported, biasing much of EBP research. The agenda of 'getting evidence into policy' has side-lined the empirical description and analysis of how research and policy actually interact in vivo. Rather than asking how research evidence can be made more influential, academics should aim to understand what influences and constitutes policy, and produce more critically and theoretically informed studies of decision-making. We question the main assumptions made by EBP researchers, explore the implications of doing so, and propose new directions for EBP research, and health policy.
    Health Research Policy and Systems 07/2014; 12(1):34. DOI:10.1186/1478-4505-12-34 · 1.86 Impact Factor
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    • "Despite an increasing body of research on the uptake and impact of research on policy, and encouragement for policymaking to be evidence-informed [1], research often struggles to identify a policy audience. The research-policy gap’ is the subject of much commentary and research activity [2-4]. "
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    ABSTRACT: The gap between research and practice or policy is often described as a problem. To identify new barriers of and facilitators to the use of evidence by policymakers, and assess the state of research in this area, we updated a systematic review. Systematic review. We searched online databases including Medline, Embase, SocSci Abstracts, CDS, DARE, Psychlit, Cochrane Library, NHSEED, HTA, PAIS, IBSS (Search dates: July 2000 - September 2012). Studies were included if they were primary research or systematic reviews about factors affecting the use of evidence in policy. Studies were coded to extract data on methods, topic, focus, results and population. 145 new studies were identified, of which over half were published after 2010. Thirteen systematic reviews were included. Compared with the original review, a much wider range of policy topics was found. Although still primarily in the health field, studies were also drawn from criminal justice, traffic policy, drug policy, and partnership working. The most frequently reported barriers to evidence uptake were poor access to good quality relevant research, and lack of timely research output. The most frequently reported facilitators were collaboration between researchers and policymakers, and improved relationships and skills. There is an increasing amount of research into new models of knowledge transfer, and evaluations of interventions such as knowledge brokerage. Timely access to good quality and relevant research evidence, collaborations with policymakers and relationship- and skills-building with policymakers are reported to be the most important factors in influencing the use of evidence. Although investigations into the use of evidence have spread beyond the health field and into more countries, the main barriers and facilitators remained the same as in the earlier review. Few studies provide clear definitions of policy, evidence or policymaker. Nor are empirical data about policy processes or implementation of policy widely available. It is therefore difficult to describe the role of evidence and other factors influencing policy. Future research and policy priorities should aim to illuminate these concepts and processes, target the factors identified in this review, and consider new methods of overcoming the barriers described.
    BMC Health Services Research 01/2014; 14(1):2. DOI:10.1186/1472-6963-14-2 · 1.71 Impact Factor
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    • "Against this backdrop, it is perhaps unsurprising that a wealth of studies and commentaries consider the use of public health evidence in policy and practice (Lavis et al. 2004; Macintyre et al. 2001; Katikireddi et al. 2011; Nutbeam and Boxall 2008; Hunter 2009; Petticrew et al. 2004; Smith 2007). Yet, despite official commitments to, and widespread disciplinary support for, 'evidence-based' public health policy, most studies continue to conclude that public health policies are not evidence-based (Macintyre et al. 2001; Katikireddi et al. 2011; Hunter 2009; Smith 2007; Bartley 1994). As Wehrens and colleagues note, this disjuncture is often conceptualised as a 'knowledge to action gap' and this, in turn, has stimulated efforts to build 'bridges' to overcome such 'gaps' (Wehren et al. 2011). "
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    ABSTRACT: Public health research is overtly orientated towards influencing policy and yet, despite official commitments to ‘evidence-based policy’, most analyses conclude that the impact of public health research has been limited. Based on an analysis of post-1997 UK policy statements and interviews with 112 key actors, this paper argues that the failure of ‘evidence-based’ policy to emerge relates to the fact it is ideas, not evidence, which travel between research and policy, and that these malleable entities are translated as they move between actors. By unpacking six factors that appear to have shaped the ‘interplay of ideas’ about health inequalities, this paper draws attention to the ways in which policy influences research (as well as vice versa). The paper argues that two distinct ‘idea-types’ are evident within the data, each of which helps explain the difficulties in achieving ‘evidence-based’ policy responses to health inequalities: ‘institutionalised ideas’ and ‘chameleonic ideas’.
    Science and Public Policy 09/2013; 41(5):561-574. DOI:10.1093/scipol/sct085 · 0.98 Impact Factor
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