
John N. Lavis- MD PhD
- Chair at McMaster University
John N. Lavis
- MD PhD
- Chair at McMaster University
About
466
Publications
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Introduction
Current institution
Education
September 1994 - September 1997
September 1992 - September 1993
London School of Economics and Political Science
Field of study
- Health Planning and Financing
September 1985 - May 1989
Publications
Publications (466)
Background
Lifestyle or behavioural changes can help to address the burden associated with chronic diseases. However, they take time and use of multiple techniques or strategies tailored to a person’s needs. The primary objective of this study was to assess the feasibility of the Healthy Lifestyles Program (HLP), a novel 12-month complex interventi...
Aim
High‐impact infectious diseases pose major global health challenges, underscoring the urgent need for robust public health preparedness. Despite efforts to improve global health security, recent pandemics have revealed significant weaknesses in health systems’ preparedness and response capabilities.
Methods
We reviewed and synthesized key stra...
Background The Rapid Evidence Support System Assessment (RESSA) was developed by the Global Evidence Commission to evaluate evidence support systems that inform policy decisions. These systems are designed to contextualize existing evidence, guide decision-making, and generate new insights to inform action. As evidence-informed policymaking gains t...
Background
The COVID-19 pandemic has had an unprecedented impact in the global research production and has also increased research waste. Living evidence syntheses (LESs) seek to regularly update a body of evidence addressing a specific question. During the COVID-19 pandemic, the production and dissemination of LESs emerged as a cornerstone of the...
Background
Globally, a growing number of calls to formalize and strengthen evidence-support systems have been released, all of which emphasize the importance of evidence-informed decision making. To achieve this, it is critical that evidence producers and decision-makers interact, and that decision-makers’ evidence needs can be efficiently translat...
Background
People living with human immunodeficiency virus (HIV) are living longer with health-related disability associated with ageing, including complex conditions. However, health systems in Canada have not adapted to meet these comprehensive care needs.
Methods
We convened three citizen panels and a national stakeholder dialogue. The panels w...
Objectives: Guidelines and essential medicine lists (EMLs) bear similarities and differences in the process that lead to decisions. Access to essential medicines is central to achieve universal health coverage. The World Health Organization (WHO) EML has guided pri-oritization of essential medicines globally for nearly 50 years, and national EMLs (...
Essential medicine lists (EMLs) are important medicine prioritization tools used by the World Health Organization (WHO) EML and over 130 countries. The criteria used by WHO’s Expert Committee on the Selection and Use of Essential Medicines has parallels to the GRADE Evidence-to-Decision (EtD) frameworks. In this study, we explored the EtD framework...
Background
While there has been widespread global acceptance of the importance of evidence-informed policy, many opportunities to inform health policy with research are missed, often because of a mismatch between when and where reliable evidence is needed, and when and where it is available. ‘Living evidence’ is an approach where systematic evidenc...
Individuals facing physical and mental multimorbidity and social marginalization are considered to have “complex health and social needs.” This study seeks to address the following question: what mental health care experiences are valued by individuals with complex health and social needs? Semi-structured interviews were conducted with fifteen indi...
Evidence-informed policy-making benefitted from much-needed attention and resources during the COVID-19 pandemic (1). As a result, 3 key movements and innovations are now making it possible to provide better evidence support (higher quality and more aligned to the speed of advisory and decision-making) for policy-making than ever.
Health systems are poorly equipped to respond to complex health and social needs, which span sectors and diagnoses. This study puts forward a framework for complex care policy. The framework was developed using critical interpretive synthesis, a method for developing theory on the basis of a transparent search and critical analysis of a heterogenou...
Background:
There is a large body of evidence evaluating quality improvement (QI) programmes to improve care for adults living with diabetes. These programmes are often comprised of multiple QI strategies, which may be implemented in various combinations. Decision-makers planning to implement or evaluate a new QI programme, or both, need reliable...
Aim: The World Health Organization (WHO) publishes a large number of health reports every year, containing recommendations to overcome societal and system barrier challenges toward targeting unmet health needs. One such report, the International Perspectives on Spi-nal Cord Injury (IPSCI), specifically describes the situation of persons with spinal...
Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. The aim of this review is to determine the effectiveness of knowledge translation interventions for facilitating evidence-informed decision-making amongst health policymakers. Copyright © 2022 The Cochrane Collaboration. Published by John Wiley & So...
Background
As systematically developed statements regarding possible courses of action, health system guidance (HSG) can assist with making decisions about addressing problems or achieving goals in health systems. However, there are conceptual and methodological challenges in HSG implementation due to the complexity of health-system policy-making,...
Background
In 2018, Ontario implemented a pharmacare program (Ontario Health Insurance Plan Plus [OHIP+]) to provide children and youth younger than 25 years with full coverage for prescription medications in the provincial formulary. We aimed to assess the use of public drug plans and costs of publicly covered prescriptions before and after the pr...
There are over 250,000 international treaties that aim to foster global cooperation. But are treaties actually helpful for addressing global challenges? This systematic field-wide evidence synthesis of 224 primary studies and meta-analysis of the higher-quality 82 studies finds treaties have mostly failed to produce their intended effects. The only...
Background
Evidence briefs for policy (EBP) draw on best-available data and research evidence (e.g., systematic reviews) to help clarify policy problems, frame options for addressing them, and identify implementation considerations for policymakers in a given context. An increasing number of governments, non-governmental organizations and research...
Enhancing the use of technology in long-term care has been identified as a key part of broader efforts to strengthen the sector in the wake of the COVID-19 pandemic. To inform such efforts, we convened a series of citizen panels, followed by a national stakeholder dialogue with system leaders focused on reimagining the long-term care sector using t...
To assess different institutional responses in terms of the evidence-policy-society nexus and to learn lessons on how to build equity-centred, agile and responsive evidence informed decision-making mechanisms, WHO convened its first Global Evidence-to-Policy Summit in late 2021. The Summit, organized by the newly created Evidence to Policy Unit at...
Background
While calls for institutionalization of evidence-informed policy-making (EIP) have become stronger in recent years, there is a paucity of methods that governments and organizational knowledge brokers can use to sustain and integrate EIP as part of mainstream health policy-making. The objective of this paper was to conduct a knowledge syn...
Background:
Inappropriate health care leads to negative patient experiences, poor health outcomes and inefficient use of resources. We aimed to conduct a systematic review of inappropriately used clinical practices in Canada.
Methods:
We searched multiple bibliometric databases and grey literature to identify inappropriately used clinical practi...
Background
The institutionalization of evidence-informed health policy-making (EIHP) is complex and complicated. It is complex because it has many players and is complicated because its institutionalization will require many changes that will be challenging to make. Like many other issues, strengthening EIHP needs a road map, which should consider...
Approaches for rapid reviews that focus on streamlining systematic review methods are not always suitable for exploring complex policy questions, as developing and testing theories to explain these complexities requires configuring diverse qualitative, quantitative, and mixed methods studies. Our objective was therefore to provide a guide to select...
Background
A large proportion of postgraduate students the world over complete a research thesis in partial fulfilment of their degree requirements. This study identified and evaluated support mechanisms for research generation and utilization for masters’ students in health institutions of higher learning in Uganda.
Methods
This was a self-admini...
Background:
There has been an increase in the number of policy support organizations (PSOs) that have been created to foster the systematic use of evidence in health system policymaking. Our aim was to identify approaches for establishing a PSO or similar entities by soliciting insights from those with practical experience with developing and oper...
Background
Current incentive programmes are not sufficient to motivate researchers and policy-makers to use research evidence in policy-making. We conducted a mixed-methods design to identify context-based policy options for strengthening motivations among health researchers and policy-makers to support evidence-informed health policy-making (EIHP)...
Background:
Context is recognized as important to successful knowledge translation (KT) in health settings. What is meant by context, however, is poorly understood. The purpose of the current study was to elicit tacit knowledge about what is perceived to constitute context by conducting interviews with a variety of health system stakeholders inter...
Background
The fields of implementation science and knowledge translation have evolved somewhat independently from the field of policy implementation research, despite calls for better integration. As a result, implementation theory and empirical work do not often reflect the implementation experience from a policy lens nor benefit from the scholar...
Background
Post–graduate students world over complete a research thesis in partial fulfillment of their degree requirements. This study identified and evaluated support mechanisms for research generation and utilization for masters’ students in health institutions of higher learning in Uganda.
Methods
A self administered cross–sectional survey usin...
Background: Oman has prioritised enhanced efforts for supporting evidence-informed policymaking (EIPM), including establishing a knowledge translation department in the Omani Ministry of Health (MOH).
Aim and objective: Our aim was to gather insights to guide the process of activating this department.
Methods: We conducted a document review and in-...
Background: As systematically developed statements about possible courses of action, health-system guidance (HSG) can assist with making decisions and developing policies to address problems or achieve goals in health systems. However, there are conceptual and methodological challenges related to HSG implementation due to the complexity of health s...
The COVID-19 pandemic is one of the greatest health and societal challenges that the world has collectively faced in many decades. Policy, public health, clinical and individual decision makers are actively seeking evidence and evidence-based guidance (e.g. health technology assessments, clinical practice guidelines) on prevention, management and m...
Background: Knowledge translation (KT) platforms are organisations, initiatives and networks that focus on supporting evidence-informed policy-making at least in part about the health-system arrangements that determine whether the right programmes, services and products get to those who need them. Many descriptions and evaluations of KT platforms i...
Background
Terms used to describe government-led resource withdrawal from ineffective and unsafe medical services, including ‘rationing’ and ‘disinvestment’, have tended to be used interchangeably, despite having distinct characteristics. This lack of descriptive precision for arguably distinct terms contributes to the obscurity that hinders effect...
Introduction
Gut microbiome and diet may be important in irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) and comorbid psychiatric conditions, but the mechanisms are unclear. We will create a large cohort of patients with IBS, IBD and healthy controls, and follow them over time, collecting dietary and mental health information and b...
Background:
In response to worldwide calls for the need to support evidence-informed policy-making (EIPM), more countries are increasingly interested in enhancing their efforts to use research to inform policy-making. In order to inform the efforts of those asked to lead the support of EIPM, our aim is to develop a conceptual framework to guide th...
Background:
Although values underpin the goals pursued in health systems, including how health systems benefit the population, it is often not clear how values are incorporated into policy decision-making about health systems. The challenge is to encompass social/citizen values, health system goals, and financial realities and to incorporate them...
Background: The fields of implementation science and knowledge translation have evolved somewhat independently from the field of policy implementation research, despite calls for better integration. As a result, implementation theory and empirical work do not often reflect the implementation experience from a policy lens nor benefit from the schola...
Background: The fields of implementation science and knowledge translation have evolved somewhat independently from the field of policy implementation research, despite calls for better integration. As a result, implementation theory and empirical work do not often reflect the implementation experience from a policy lens nor benefit from the schola...
Background: The fields of implementation science and knowledge translation have evolved somewhat independently from the field of policy implementation research, despite calls for better integration. As a result, implementation theory and empirical work do not often reflect the implementation experience from a policy lens nor benefit from the schola...
Background:
Midwives' roles in sexual and reproductive health and rights continues to evolve. Understanding the profession's role and how midwives can be integrated into health systems is essential in creating evidence-informed policies. Our objective was to develop a theoretical framework of how political system factors and health systems arrange...
Objectives
Accountable care organizations were implemented as a system-level approach to address quality differences and curb increasing healthcare costs in the United States of America, and have garnered the interest of policy makers in other countries to support better management of patients. The objectives of this paper are to: (1) identify the...
Background:
Research funders in Canada and abroad have made substantial investments in supporting collaborative research approaches to generating and translating knowledge as it is believed to increase knowledge use. Canadian health research funders have advocated for the use of integrated knowledge translation (IKT) in health research, however, t...
Background:
Despite the significant variability in the role and integration of midwifery across provincial and territorial health systems, there has been limited scholarly inquiry into whether, how and under what conditions midwifery has been assigned roles and integrated into Canada's health systems.
Methods:
We use Yin's (2014) embedded single...
Background:
Decision-makers in crisis zones are faced with the challenge of having to make health-related decisions under limited time and resource constraints and in light of the many factors that can influence their decisions, of which research evidence is just one. To address a key gap in the research literature about how best to support the us...
Background:
Chile and Colombia are examples of Latin American countries with health systems shaped by similar values. Recently, both countries have crafted policies to regulate the participation of private for-profit insurance companies in their health systems, but through very different mechanisms. This study asks: what values are important in th...
Background:
Humanitarian action in crisis zones is fraught with many challenges, including lack of timely and accessible research evidence to inform decision-making about humanitarian interventions. Evidence websites have the potential to address this challenge. Evidence Aid is the only evidence website designed for crisis zones that focuses on pr...
Background:
Translating research evidence from global guidance into policy can help strengthen health systems. A workbook was developed to support the contextualization of the WHO's 'Optimizing health worker roles to improve maternal and newborn health' (OptimizeMNH) guidance. This study evaluated the use of the workbook for the development of evi...
Background:
The unprecedented amount of resources dedicated to humanitarian aid has led many stakeholders to demand the use of reliable evidence in humanitarian aid decisions to ensure that desired impacts are achieved at acceptable costs. However, little is known about the factors that influence the use of research evidence in the policy developm...
Introduction
Rates of chronic conditions, such as diabetes, cardiovascular disease and obesity are increasing in Canada and internationally. There are effective lifestyle interventions that are known to improve chronic conditions. However, there is often a gap in ‘how to’ make lifestyle changes. Mental health and other determinants of health play a...
Objective
Public deliberations are an increasingly popular tool to engage citizens in the development of health policies and programmes. However, limited research has been conducted on how to best synthesize and summarize information on health policy issues for citizens. To begin to address this gap, our aim was to map the literature on the prepara...
Aims
To conduct a concept analysis of clinical practice contexts (work environments) in health care.
Background
Context is increasingly recognized as important to the development, delivery, and understanding of implementation strategies; however, conceptual clarity about what comprises context is lacking.
Design
Modified Walker and Avant concept...
Background:
Intermediaries are organisations or programmes that work between policy-makers and service providers to facilitate effective implementation of evidence-informed policies, programmes and practices. A number of intermediaries now exist in well-established mental health systems; however, research on them, and how they may be optimised to...
Background
To increase the likelihood of successful implementation of evidence-based practices, researchers, knowledge users, and healthcare professionals must consider aspects of context that promote and hinder implementation in their setting. The purpose of the current study was to identify contextual attributes and their features relevant to imp...
Background
Many initiatives have been taken in the Islamic Republic of Iran to promote evidence-informed health policy-making (EIHP). However, these initiatives are not systematic. Since the implementation of EIHP is not consistent and the interventions in this regard are complex, a comprehensive plan could be a useful tool for employing initiative...
Background
Timely access to evidence increases the prospects for evidence informed decision making. We evaluated user experiences of a Clearing House for Health Policy with the aim of increasing access to evidence about the Uganda health system and interventions.
Methods
We conducted in‐depth interviews with 15 potential users including policymake...
Abstract
Health systems guidance (HSG) documents contain systematically developed statements or recommendations intended to address a health system challenge. The concept of HSG is fairly new and considerable effort has been undertaken to build tools to support the contextualization of recommendations. One example is the Appraisal of Guidelines for...
Background
There is increasing recognition in Canada and globally that a substantial proportion of health care delivered is inappropriate as evidenced by (1) harmful and/or ineffective practices being overused, (2) effective clinical practices being underused, and (3) other clinical practices being misused. Inappropriate health care leads to negati...
Background
Health system expenditure on cancer drugs is rising rapidly in many OECD countries given the costly new treatments and increased rates of use due to a growing and ageing population. These factors put considerable strain on the sustainability of health systems worldwide, sparking public debate among clinicians, pharmaceutical companies, p...
Background
Health systems are increasingly focusing on the issue of ‘overuse’ of health services and how to address it. We developed a framework focused on (1) the rationale and context for health systems prioritising addressing overuse, (2) elements of a comprehensive process and approach to reduce overuse and (3) implementation considerations for...
Individual narratives about patient/family experiences of illness, and needs for information and support, can exert a powerful influence on policy formulation, particularly when a sensational story captures the attention of the media or general public. In this chapter, we situate the use and potential value of the narrative evidence within the mess...
Abstract Background While several individual studies addressing research productivity of post-graduate students are available, a synthesis of effective strategies to increase productivity and the determinants of productivity in low-income countries has not been undertaken. Further, whether or not this research from post-graduate students’ projects...
Background:
World over, stakeholders are increasingly concerned about making research useful in public policy-making. However, there are hardly any reports linking production of research by students at institutions of higher learning to its application in society. We assessed whether and how post-graduate students' research was used in evidence-in...
The application of social network analysis to policy networks continues to grow, including the application of social network analysis tools and concepts in order to explain policy outcomes. Gaps in this field of study persist in terms of both policy issues studied, as well as types of polities or networks analysed. This study extends previous resea...
Objectives
Screening has generally been met with enthusiasm, and, in some cases, has been associated with demonstrable reductions in morbidity and mortality. In other cases, the balance of benefits and harms may be less clear and may evolve over time. Recommendations to reduce (de-intensify) or stop screening altogether (de-implementation) have occ...
Background:
The use of health policy and systems research (HPSR) to inform health policy-making is an international challenge. Incorporating HPSR into decision-making primarily involves two groups, namely researchers (knowledge producers) and policy-makers (knowledge users). The purpose of this study was to compare the perceptions of Israeli healt...
Background:
Systematic reviews are infrequently used by health care managers (HCMs) and policy-makers (PMs) in decision-making. HCMs and PMs co-developed and tested novel systematic review of effects formats to increase their use.
Methods:
A three-phased approach was used to evaluate the determinants to uptake of systematic reviews of effects an...
Background:
Health systems guidance (HSG) provides recommendations to address health systems challenges. No tools exist to inform HSG developers and users about the components of high quality HSG and to differentiate between HSG of varying quality. In response, we developed a tool to assist with the development, reporting and appraisal of HSG - th...
Background
Satisfaction is a key component of the care experience and part of the health system “triple aim,” along with improving population health and reducing per capita health care costs, the other two parts of the “triple aim.” The objectives of the study were to examine birth‐experience satisfaction among women in Ontario, Canada, who receive...