Article

More Than “Using Research”: The Real Challenges in Promoting Evidence-Informed Decision-Making

School of Public Health, University of Alberta, Edmonton, AB.
Healthcare policy = Politiques de sante 03/2009; 4(3):87-102. DOI: 10.12927/hcpol.2009.20538
Source: PubMed

ABSTRACT

OBJECTIVES AND METHODS: Seventeen focus groups and 53 semi-structured individual interviews involving 205 planners and decision-makers were conducted in all 11 Regional Health Authorities (RHAs) in the province of Manitoba, Canada. Objectives were to explore perspectives on the nature and use of "evidence," and barriers to evidence-informed decision-making (EIDM). RESULTS: In spite of almost universal support in principle for using evidence in decision-making, there was little consensus among participants on what evidence is, what kind of evidence is most appropriate and how "using evidence" can best be demonstrated. Significant skepticism about EIDM was expressed. Issues related to workload, politicized decision-making and organizational factors dominated the discussion of decision-makers. Barriers to EIDM were commonly attributed to factors external to the RHAs. CONCLUSION: Effective strategies to promote EIDM must address the multiple barriers experienced by decision-makers in a complex decision-making environment. Rather than simply focusing on issues of access to evidence or development of individual capacity, strategies must focus on changing decision-making processes to support appropriate use of evidence.

    • "If senior leaders view situations, (e.g. policy development or contentious issues) as crises, as opposed to opportunities to address evidence needs, they will miss prospects for planned, structured evidence use. Organizations successful at EIDM create a culture of inquiry and curiosity, have a willingness to pursue and adopt change, anticipate and plan for evidence use and support quality improvement, trust and evaluation (Bowen et al. 2009; Peirson et al. 2012). "
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    ABSTRACT: Registered nurses with graduate preparation are in a unique position to act as knowledge brokers owing to their extensive clinical experience and ability to be seen as a credible and respected resource by their peers. Nurse knowledge brokers can bridge the gap between research producers and those that need evidence for decision-making and support capacity development for evidence-informed decision-making (EIDM). Knowledge broker competencies include graduate-level education with exposure to research methods; experience with the EIDM process; and established networking skills to bring researchers, decision-makers, stakeholders and policymakers together. For the knowledge broker to be successful, the nurse leader can cultivate an organizational culture supportive of evidence use with advocacy for mandates that require evidence for decisions, structures in place for each stage of the EIDM process, and physical resources such as library services for evidence retrieval. Copyright © 2015 Longwoods Publishing.
    No preview · Article · Mar 2015 · Nursing leadership (Toronto, Ont.)
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    • "We found that most of the barriers to develop EBPDs were control beliefs. The results of other studies support this finding, as they imply that the real challenges of research utilization in health policy are structural, environment, or system barriers (Bowen et al., 2009; Majdzadeh et al., 2012). "
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    ABSTRACT: Background: Evidence-based policy documents that are well developed by senior civil servants and are timely available can reduce the barriers to evidence utilization by health policy makers. This study examined the barriers and facilitators in developing evidence-based health policy documents from the perspective of their producers in a developing country. Methods: In a qualitative study with a framework analysis approach, we conducted semi-structured interviews using purposive and snowball sampling. A qualitative analysis software (MAXQDA-10) was used to apply the codes and manage the data. This study was theory-based and the results were compared to exploratory studies about the factors influencing evidence-based health policymaking. Results: 18 codes and three main themes of behavioral, normative, and control beliefs were identified. Factors that influence the development of evidence-based policy documents were identified by the participants: behavioral beliefs included quality of policy documents, use of resources, knowledge and innovation, being time-consuming and contextualization; normative beliefs included policy authorities, policymakers, policy administrators, and co-workers; and control beliefs included recruitment policy, performance management, empowerment, management stability, physical environment, access to evidence, policy making process, and effect of other factors. Conclusion: Most of the cited barriers to the development of evidence-based policy were related to control beliefs, i.e. barriers at the organizational and health system levels. This study identified the factors that influence the development of evidence-based policy documents based on the components of the theory of planned behavior. But in exploratory studies on evidence utilization by health policymakers, the identified factors were only related to control behaviors. This suggests that the theoretical approach may be preferable to the exploratory approach in identifying the barriers and facilitators of a behavior.
    Full-text · Article · May 2014 · Global journal of health science
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    • "We found that most of the barriers to develop EBPDs were control beliefs. The results of other studies support this finding, as they imply that the real challenges of research utilization in health policy are structural, environment, or system barriers (Bowen et al., 2009; Majdzadeh et al., 2012). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Evidence-based policy documents that are well developed by senior civil servants and are timely available can reduce the barriers to evidence utilization by health policy makers. This study examined the barriers and facilitators in developing evidence-based health policy documents from the perspective of their producers in a developing country. In a qualitative study with a framework analysis approach, we conducted semi-structured interviews using purposive and snowball sampling. A qualitative analysis software (MAXQDA-10) was used to apply the codes and manage the data. This study was theory-based and the results were compared to exploratory studies about the factors influencing evidence-based health policymaking. 18 codes and three main themes of behavioral, normative, and control beliefs were identified. Factors that influence the development of evidence-based policy documents were identified by the participants: behavioral beliefs included quality of policy documents, use of resources, knowledge and innovation, being time-consuming and contextualization; normative beliefs included policy authorities, policymakers, policy administrators, and co-workers; and control beliefs included recruitment policy, performance management, empowerment, management stability, physical environment, access to evidence, policy making process, and effect of other factors. Most of the cited barriers to the development of evidence-based policy were related to control beliefs, i.e. barriers at the organizational and health system levels. This study identified the factors that influence the development of evidence-based policy documents based on the components of the theory of planned behavior. But in exploratory studies on evidence utilization by health policymakers, the identified factors were only related to control behaviors. This suggests that the theoretical approach may be preferable to the exploratory approach in identifying the barriers and facilitators of a behavior.
    Full-text · Article · May 2014 · Global journal of health science
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