Reports
 FOCUS on... Knowledge brokering
This issue of FOCUS on... addresses Knowledge Brokering and takes a detailed look at ways researchers and policy makers can better work together to enhance the incorporation of research into the policy making process. Sometimes it seems as if researchers and policy makers inhabit different worlds and this publication looks at what is needed to bridge the gap.
Research impact assessment in primary health care
Phase 1 (2006)
The purpose of this project was to develop a way to determine the impact of primary health care research and as part of this aim we trialled the use of the Buxton and Hanney Payback Framework and their methods of data collection to determine the impact of four nationally funded primary health care projects. The methods proved feasible to assess impact although time consuming and we have recommended some modifications to the Payback framework based on our findings. A number of questions have been raised about the assessment of research impact which would apply to any model.
Phase 2 (2007-8)
This study surveyed chief investigators using a web-based questionnaire, based on the Payback Framework, to gather information on the impact of a larger sample (n=17) of Australian primary health care research projects and how it came about.
Received Wisdoms: How health systems are using evidence to inform decision-making
This is a draft of a book profiling case studies of health management and policy organisations that have implemented evidence-informed decision-making. The aim is to capture successful and not-so-successful efforts. The final version will be released later this year, as the Canadian Health Services Research Foundation's 10th anniversary legacy document.
Building capacity for health research transfer in Western Canada: An environmental scan
This document presents the results of an environmental scan on health research transfer (RT) commissioned by the Alberta Heritage Foundation for Medical Research (AHFMR) to inform its pl ann ing processes. The scan assesses the current state of support for RT capacity-building entities in Western Canada (British Columbia, Alberta, Saskatchewan, Manitoba, Yukon, and the Northwest Territories).
It has two main areas of focus: capacity-building (programs, initiatives, and resources in the area of research transfer); and research (research conducted on this topic).
A Handbook on Knowledge Sharing: Strategies and Recommendations for Researchers, Policymakers, and Service Providers
This handbook was created by the Community-University Partnership for the Study of Children, Youth, and Families (CUP) Canada. Knowledge sharing attempts to bridge the research-practice gap by encouraging linkage and exchange among researchers, policymakers, and service providers. This handbook was created to support this linkage and exchange by reviewing what is known about knowledge-sharing strategies and their use.
Insight & Action: A digest linking those who practice knowledge transfer and exchange with relevant evidence-informed resources
The Canadian Health Services Research Foundation has launched a new weekly digest, Insight & Action: A digest linking those who practice knowledge transfer and exchange with relevant evidence-informed resources.
This new digest provides insights into important concepts of knowledge transfer and exchange, including networks, brokering, dissemination, and research use.
Evidence Informed Policy and Practice: A Review of Approaches used in Health Improvement in Scotland
This paper briefly outlines a proposal to review the approaches developed over the last three years to Evidence Informed Policy and Practice (EIPP), including the Learning Networks associated with the three national Health Demonstration Projects in Scotland.
The purpose of this review is to inform the future development of these approaches and associated professional roles within Health Scotland 's new structure and corporate strategy. The review also forms part of the evaluation work being planned for Phase 2 of the National Health Demonstration Projects.
NICS' mental health-emergency care interface project: project outcomes now online
The Mental Health-Emergency Care Interface Project, which was the first major initiative of NICS' Emergency Care Community of Practice, involved 41 hospital teams from across Australia. Teams of mental health and emergency department clinicians worked together to improve mental health care for people presenting to emergency departments.
The project's outcomes are now presented in a summary poster and a full report, and are available to download from the NICS Community of Practice webpage.
Special Conference issue - Electronic Journal of Knowledge Management
The 7th annual European Conference on Knowledge Management 2006 held in Budapest produced a particularly interesting set of papers. Fourteen papers are available online such as:
- “Successful Sharing of Project Knowledge: Initiation, Implementation and Institutionalisation”
- “Knowledge Creation through University-Industry Collaborative Research Projects”
- “Organizational Knowledge Transfer: Turning Research into Action through a Learning History”
- “Why Do Managers from Different Firms Exchange Information? A Case Study from a Knowledge-intensive Industry”.
Toward More Effective Use of Research in State Policymaking
J. A. Meyer, T. T. Alteras, and K. Adams, Toward More Effective Use of Research in State Policymaking, The Commonwealth Fund, December 2006
This report sets out a conceptual framework to support effective use of health services research in state health policymaking. The four stages of the research and policymaking framework are: understanding the scope and extent of the problem; developing options; implementing a program or policy; and evaluating the program or policy. For each of these stages, the authors discuss practical lessons and communication strategies gleaned from interviews with researchers and policymakers.
Websites to Watch
Canadian Health Services Research Foundation
A leader in the field of knowledge brokering, the CHSRF introduced the concept of Linkage and Exchange where policy makers work closely with researchers in developing a research topic, developing the methods and reflecting on the findings. Personal involvement of policy makers in research has been shown to increase the likelihood that the findings will be used.
NICS Emergency Care Community of Practice
A Community of Practice (CoP) is a voluntary network of people who share information, build on existing knowledge, develop expertise and solve problems for a common purpose, driven by the interest of the community involved. NICS has established an emergency care CoP for clinicians, health managers and health care professionals involved in the delivery of emergency care, so that they can share their knowledge and expertise to help close evidence-practice gaps and improve patient care.
Caresearch
The Australian Government has funded the Caresearch website that makes is as easy as possible to access information about palliative care. This website will become the Australian Palliative Care Knowledge Network in 2008. On 26 March Caresearch launched new resources for 1) patients, carers, families and friends, and 2) for GPs, with sections on quick clinical guidance, frequently asked questions, and palliative care in practice. There is also a section on current research evidence through Pubmed.
Health Evidence Network (HEN)
Public health and health care decision-makers need a trustworthy source of evidence on which to build health policy. HEN, which gives rapid access to independent and reliable health information and evidence. HEN provides answers to policy questions in the form of evidence-based reports and summaries and policy briefs focused on health systems and of relevance to the European Region's Member States.
Education Network Australia (edna)
While this is not a health site it is a very good example of an innovative knowledge network in action. edna is a joint initiative of the state and territory governments and the Australian Government, through their education departments, to provide free news, resources, networks and online tools for educators. It is a network of and for the Australian education and training community. A feature is the edna Sandpit which is a free service for Australian educators to road-test new and emerging technologies for teaching and learning. Other features include podcasting, personal learning space, and web conferencing.
Research Australia: An alliance for discoveries in health
This is an important website for health researchers to be aware of.
Research Australia is a national not-for-profit alliance of organisations and companies that are committed to making health and medical research a higher national priority. Research Australia is funded by membership subscriptions and donations and is independent of Government. Most Australian universities and research agencies are part of the alliance.
The IDEA Partnership
The IDEA Partnership is a US Government initiative dedicated to improving educational outcomes for students and young people with disabilities. It brings together a collaboration of 55 partner organisations into the work of state education agencies as allies and facilitates interaction and shared work around common interests. The IDEA Partnership has established a number of issues based Communities of Practice. By linking decision makers, practitioners and consumers in this way, the state agency has access to established networks that facilitate interpersonal information sharing and bring fresh approaches to persistent problems by uniting all groups around a common goal. Shared interests are powerful motivators that can move people to come together for extraordinary results.
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Articles of Interest
The Extent and Organizational Determinants of Research Utilization in Canadian Health Services Organizations
Omar Belkhodja Science Communication, Vol. 28, No. 3, 377-417 (2007)
This article focuses on the use of research by managers and professionals in Canadian health service organizations (ministries, regional authorities, and hospitals). The results of the analysis of the 928 responses underlined the important role that the absorption, learning, culture, and linkage mechanism variables played in determining utilization. General linear regression and regression by organizational type confirmed the importance of the linkage mechanisms, research experience, unit size, and research relevance for the users. The article also underscores the individual and organizational contextual factors' high degree of significance by expressing these contextual factors as organizational variables and by adopting a more organizational perspective of knowledge utilization analysis.
Knowledge Creation through University-Industry Collaborative Research Projects
J Hermans, A Castiaux Electronic. Journal of Knowledge Management Volume 5 Issue 1, April 2006
University-industry (U-I) relationships and their subsequent knowledge transfers are topics of high political, economical, managerial and academic interest. This paper gives a literature analysis concerning this research topic and explores inter-organizational knowledge transfer, namely the University-Industry collaborative research project. It presents findings from an exploratory study which aims at examining knowledge flows and collaborative behaviours at stake in such research projects. This analysis highlights knowledge-based limits to the reconciliation process between the university´s interests and the company´s needs, leading to limited research diffusion and organizational learning, but it also confirms the importance of the third role of university, namely participation in economic development.
Telling stories: News media, health literacy and public policy in Canada
M Hayes, IE Ross, M Gasher, D Gutstein, JR Dunn, RA Hackett. Soc Sci Med. 2007 Mar 1 [Epub ahead of print]
This study examined the extent to which newspaper coverage of health stories reflect issues embedded in health policy documents. This project analysed the relative distribution of health stories using content analysis using a sample of 4732 stories from 13 Canadian daily newspapers. Stories were sorted into categories identified as major influences shaping the health status of populations in the document Toward a Healthy Future (Second Report on the Health of Canadians (1999)) (TAHF). Topics related to service provision, delivery or management accounted for 65% of all stories. The overall prominence of topics in newspapers is not consistent with the relative importance assigned to health influences in TAHF. Socio-economic influences were rarely reported on.
Describing the impact of health services and policy research
S Kuruvilla, N Mays, G Walt. J Health Serv Res Policy. 2007 Apr;12 Suppl 1:23-31
In an essentially applied area of research, there are particular pressures on health services and policy researchers to describe the impact of their work. However, specialized research impact assessments often require skills and resources beyond those available to individual researchers, and ad hoc accounts impose a considerable burden to generate. This paper describes an initial attempt to develop a methodical approach to identify and describe research impact.
UK Health Services Research Network: at last, a health services research organization
N Black. J Health Serv Res Policy. 2007 Apr;12 Suppl 1:1-2
This editorial summarises the establishment and activities of the Health Services Research Network in the UK . This network aims to enhance both the quality and quantity of health services research and, more importantly, the impact such research has on health-care policy and services through a close alignment with NHS managers and policy-makers. The Network also provides a collective voice for researchers, lobbies to protect and enhance funding opportunities, and promotes issues of common interest to researchers, funders, universities and government. The Network prepares and circulates briefing documents on topics that otherwise might have remained marginal on the management agenda, prepares responses to national consultations, produces reports to raise researcher's awareness of policy issues and hosts research meetings to bring together researchers and NHS managers to explore and discover common interests. Network members are also invited to attend meetings with key policy makers. [Abstract by PHC RIS]
Survival of the Ideas that Fit: An Evolutionary Analogy for the Use of Evidence in Policy
A Stevens. Social Policy and Society (2007), 6: 25-35 Cambridge University Press
This paper explores bias in the use of evidence in policy. It argues that existing models of the evidence-policy relationship neglect the tendency for attention to be paid only to that evidence helpful to the interests of powerful social groups. An evolutionary analogy is used to explain how this bias arises, without the need for irrationality or conspiracy on the part of policy makers. Examples are given in the fields of drug, asylum and other policies, and the possible responses by researchers to the biased use of research evidence are discussed.
New Terms of Research and Knowledge Production in Scotland: The discourse of knowledge transfer
R Jones. Discourse Volume 28, Number 1/March 2007
In the past 10 years the Scottish higher education sector has experienced the emergence and continual development of policies for knowledge transfer. This policy partly parallels the wider UK higher education policy agenda and its focus on the “third mission” (i.e. the rate and extent to which universities disseminate knowledge and how commercial organizations can capitalize on it). However, the policy texts on knowledge transfer are, to varying degrees, inflected with content reflecting the specificities of the Scottish context. This paper emerges from research focused on this context and explores critically the ways in which the discourse of knowledge transfer has emerged and how knowledge, knowledge production, and the dissemination of knowledge have been constructed here.
Understanding the information needs of public health practitioners: A literature review to inform design of an interactive digital knowledge management system
D Revere, AM Turner, A Madhavan, N Rambo, PF Bugni, A Kimball, SS Fuller. J Biomed Inform. 2007 Jan 11
This paper reports the results of a literature review focused on the information needs of public health professionals. The authors reviewed the public health literature to answer the following questions: What are the information needs of public health professionals? In what ways are those needs being met? What are the barriers to meeting those needs? What is the role of the Internet in meeting information needs? The literature consistently indicated a critical need for comprehensive, coordinated, and accessible information to meet the needs of the public health workforce.
The emerging Web 2.0 social software: an enabling suite of sociable technologies in health and health care education
N Maged, K Boulos, S Wheeler. Health Information and Libraries Journal Volume 24 Issue 1 Page 2 - March 2007
Web 2.0 sociable technologies and social software are presented as enablers in health and health care, for organizations, clinicians, patients and laypersons. They include social networking services, collaborative filtering, social bookmarking, folksonomies, social search engines, file sharing and tagging, mashups, instant messaging, and online multi-player games. The more popular Web 2.0 applications in education, namely wikis, blogs and podcasts, are but the tip of the social software iceberg.
Lessons from the evaluation of the UK's NHS R&D Implementation Methods Programme
B Soper, SR Hanney Implementation Science 2007, 2: 7 19 February 2007
The Health Economics Research Group (HERG), Brunel University, conducted an evaluation of the NHS R&D Programme in 2002. This evaluation was intended to cover: the quality of outputs, lessons to be learnt about the communication strategy and the commissioning process, and the benefits from the projects. Their findings about the impact of the work funded, and the difficulties faced by those developing the IMP, have implications for the development of strategic programmes of research in general, as well as for the development of more effective research in this field.
From shared databases to communities of practice: A taxonomy of collaboratories
N Bos, A Zimmerman, J Olson, J Yew, J Yerkie, E Dahl, et. al. (2007). Journal of Computer-Mediated Communication, 12 (2), article 16
Promoting affiliation between scientists is relatively easy, but creating larger organizational structures is much more difficult, due to traditions of scientific independence, difficulties of sharing implicit knowledge, and formal organizational barriers. The Science of Collaboratories (SOC) project conducted a broad five-year review to take stock of the diverse ecosystem of projects that fit our definition of a collaboratory and to distill lessons learned in the process. This article describes one of the main products of that review, a seven-category taxonomy of collaboratory types. The types are: Distributed Research Centers, Shared Instruments, Community Data Systems, Open Community Contribution Systems, Virtual Communities of Practice, Virtual Learning Communities, and Community Infrastructure Projects. Each of the types is defined and illustrated with one example, and key technical and organizational issues are identified.
Health researchers in Alberta: an exploratory comparison of defining characteristics and knowledge translation activities
MS Newton, CA Estabrooks, P Norton, JM Birdsell, AJ Adewale, R Thornley. Implementation Science 2007, 2:1
Canadian funding agencies are no longer content to support research that solely advances scientific knowledge, and key directives are now in place to promote research transfer to policy- and decision-makers. Therefore, it is necessary to improve our understanding of how researchers are trained and supported to facilitate knowledge translation activities. In this study, the authors investigated differences in health researcher characteristics and knowledge translation activities.
Academic Health Center Management of Chronic Diseases through Knowledge Networks: Project ECHO
S Arora, CM Geppert, S Kalishman, D Dion, F Pullara, B Bjeletich, G Simpson, DC Alverson, LB Moore, D Kuhl, JV Scaletti. Acad Med. 2007 Feb;82(2):154-160
The authors describe an innovative academic health center (AHC)-led program of health care delivery and clinical education for the management of complex, common, and chronic diseases in underserved areas. Telemedicine and Internet connections enable specialists in the program to comanage patients with complex diseases, using case-based knowledge networks and learning loops. The program represents a paradigm shift in thinking and funding, moving from traditional fee-for-service models to public health funding of knowledge networks.
Personal Interaction with Researchers or Detached Synthesis of the Evidence: Modelling the Health Policy Paradox
S Hanney. UK Evaluation and Research In Education Vol. 18, No. 1&2, 2004
Personal interaction between health policy makers and researchers is widely seen as the key to enhancing research use, but there are also increasing demands that policies be based on syntheses of the available evidence. A potential paradox arises in that whilst interaction may result in greater use of the evidence it might also lead to a partial selection of evidence, not consistent with a systematic overview.
The in-between world of knowledge brokering
J Lomas. BMJ 2007;334:129-132 (20 January)
The ultimate aim of people engaged in health research is to get the health service's workforce, its employers, and its suppliers to have knowledge of facts (as represented by research results) and to use these facts in their practices, policies, and products. How well organised is research to achieve this aim? And how receptive and oriented are health services to this aim? The answers seem to be "not well organised" and "not very receptive." The interpersonal connections needed to bridge this know-do gap are not yet in place. 1 An emerging role therefore exists for knowledge brokers, supported by knowledge brokering resources and agencies, to fill the gap.
A multitude of syntheses: a comparison of five approaches from diverse policy fields
A Boaz, D Ashby, D Denyer, M Egan, A Harden, DR Jones, R Pawson, D Tranfield. Evidence & Policy: A Journal of Research, Debate and Practice 2:4 November 2006, 479-502(24)
This article addresses the synthesis and use of research evidence to inform policy and practice. Presents five approaches to research synthesis, conducted in different fields, using contrasting methodologies. A number of methodological, practical and strategic implications of conducting research syntheses are explored.
Interaction' and research utilisation in health policies and programs: does it work?
A Kothari, S Birch, C Charles. 2005. Health Policy; 71(1): 117-125
Summary by the Canadian Health Services Research Foundation. Brokering Digest
Interaction between researchers and users of research remains an attractive strategy for increasing the use of research findings in policies and programs. The benefits of researcher-user interaction may also occur in unintended forms, such as education, empowerment, and enhanced critical assessment skills for research users.
Use of research results in policy decision-making, formulation, and implementation: a review of the literature
C Almeida, E Bascolo. Cad Saude Publica. 2006 00;22:S7-S19
This paper from Brazil offers a critical review of thinking on the relationship between the production of scientific knowledge and its use in policy formulation and implementation. Critiques approaches which depict the decision-making process simplistically and linearly and discusses new approaches which incorporate the complexity of policymaking and the knowledge production process.
Knowledge transfer & exchange through social networks: building foundations for a community of practice within tobacco control
D Cameron, D Norman, T Huerta. Implementation Science 2006, 1:20
Health services and population health innovations advance when knowledge transfer and exchange (KTE) occurs among researchers, practitioners, policy-makers and consumers using high-quality evidence. Communities of practice (CoP) - voluntary, self-organizing, and focused groups of individuals and organizations - may provide one option. This paper outlines an approach to lay the foundation for a CoP within the area of Web-assisted tobacco interventions (WATI).
The role and theoretical evolution of knowledge translation and exchange in public health
R Armstrong, E Waters E, H Roberts, S Oliver, J Popay. Journal of Public Health (Oxford) 2006 (Epub ahead of print)
The authors conclude that there is an urgent policy need to establish the effectiveness of KT models in a range of contexts. This must include both the consideration of development and the utilisation of knowledge.
Revisiting interaction in knowledge translation
Ginsburg L, Lewis S, Zackheim L, Casebeer A. Implementation Science 2007, 2:34. doi:10.1186/1748-5908-2-34
This work suggests that the efficacy of interaction approaches to research translation may be more limited than current theory proposes and underscores the need for more completely specified models of research utilization that can help address the slow pace of change in this area. [Abstract precis by PHC RIS]
Fostering knowledge exchange between researchers and decision-makers: Exploring the effectiveness of a mixed-methods approach
Gagliardi AR, Fraser N, Wright FC, Lemieux-Charles L, Davis D. Health Policy. 2007 Oct 10; [Epub ahead of print]
A conceptual framework for evaluating factors influencing knowledge exchange outcomes had not been previously investigated. Strategies for overcoming identified barriers include better facilitation, involving a critical volume of non-clinicians, in-person sharing of background information, and incentives for decision-makers. Further research is required to examine the effectiveness of different forms of knowledge exchange, and the degree to which they are currently being practiced. [Abstract precis by PHC RIS]
resources
SAX Institute
Examples of ways in which the evidence-policy-practice gaps are being bridged include Evidence Check and Policy in Action Roundtable from the SAX Institute
Australasian Cochrane Centre
The Policy Liaison Initiative from Australasian Cochrane Centre
the Public Health Advocacy Institute of WA (PHAIWA)
the Benevolent Society
Health in all Policies (HiaP),
an innovative policy strategy that responds to the critical role that health plays in the economies and social life of 21st century societies
Syndemics
the study of factors (eg diseases, poverty etc) interacting synergistically and contributing to excess burden of disease in a population
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