Multi-directional communication between decision makers and environmental health researchers: a qualitative inquiry

It has been three decades since key leaders gathered to pave a path toward healthier and more just environments and recommendations were made to improve communication between scientists and community stakeholders who can influence decision making. Since that time, community engaged research has flourished while building the capacity of researchers to engage in the work of making change to those environments has lagged. The purpose of this study was the development of guidelines to inform interactions between researchers and decision makers and influencers who participate in the policy change process. This community engaged, pragmatic and iterative inquiry includes insight from a review of existing resources and key informant interviews. Resulting guidelines were piloted, and formative evaluation by community stakeholders informed and resulted in refinement to the guidelines. Strategies for communicating and disseminating scientific evidence are presented as well as tactics that sensitise researchers to the nuances of policy makers’ realities so they may serve as a resource for dealing with complex information and decisions. We provide tactics and archived resources in an on-line toolkit that we have cultivated over time to foster effective communication between scientists and those who have a stake in ensuring that decisions are evidence informed.</p

ASL data IDP summaries.

A) Grey matter mean CBF perfusion (ml/100g/min) measurements for the single post-label delay (PLD) sequence used across all sites. B) Grey matter mean CBF perfusion measurements for the multi-PLD sequence available only on the Siemens sites. Raw data is plotted to the left; the cross-site correlation matrices to the right (upper triangle, Pearson’s correlation; lower triangle, Spearman’s correlation).</p

Statistical results for five classes of dMRI-derived phenotypes.

In the top two panels, each column represents results for a different class of IDP, from left to right: white matter (WM) tract FA, WM tract MO, WM tract diffusivity, WM tract ICVF, WM tract OD and WM tract ISOVF. A) Distribution of log-transformed P-values from repeated measures ANOVA testing for a site effect on the mean value of individual IDPs in each class; the solid horizontal line represents the P-value equivalent to FDR = 5%. Green dots represent IDPs fitted to the ANOVA model including data from all four sites; orange dots represent P-values for each IDP fitted to the ANOVA including only data from the three Siemens sites (Cambridge, Oxford, Liverpool). There were more significant between-site differences in mean IDPs, across all 5 classes, when the GE data from KCL were included in the analysis. B) Swarm plots showing distribution of intra-class correlation coefficients (ICCs) for the same IDPs, estimated for each pair of all 4 sites (green points), for each pair of the three Siemens sites (orange points) and for comparable test-retest data drawn from the UKB cohort (blue points). Between-site reliability was generally high for all IDP classes compared to the UKB benchmark when only Siemens sites were included in the analysis. C) Each column represents finer-grained results for representative IDPs from each class of IDP: from left to right, FA right anterior thalamic radiation. MO left corona radiata, L3 left cingulate gyrus, ICVF left cingulate gyrus, OD superior cerebellar peduncle, and ISOVF superior longitudinal fasciculus. Top row, plots of each IDP for 8 subjects (coloured lines) scanned at each of 4 sites (x-axis labels); the grey violin plots indicate the distributions of the corresponding IDP in the UK Biobank reference dataset, using matched random sampling of N = 8 participants. Box and whiskers represent inter-quartile range and 95% confidence intervals respectively. Bottom row, correlations between each pair of sites for each IDP: upper triangle, Pearson’s correlations; lower triangle, Spearman’s correlations.</p

T1 images, inverse SNR and inverse CNR metrics across four sites.

A) Representative T1 images of the same subject scanned at each of 4 sites in the travelling heads study. B) left panel, plots of inverse signal-to-noise ratio (iSNR) for 8 subjects (coloured lines) scanned at each of 4 sites (x-axis labels); right panel, plots of inverse contrast-to-noise ratio (iCNR) for the same subjects and sites. The grey violin plots in both panels indicate the equivalent distributions of T1 iSNR and iCNR, respectively, in the UK Biobank reference dataset, using matched random sampling of N = 8 participants. Box and whiskers represent inter-quartile range and 95% confidence intervals respectively. The iSNR and iCNR metrics are comparable across Siemens sites (CAM = Cambridge, OXF = Oxford, LIV = Liverpool) and aligned with the UKB benchmark distribution. Both iSNR and iCNR are higher for the GE site (KCL = Kings College London) (P < 0.05), indicating lower SNR and CNR.</p

Comparison of ANOVA and Friedman tests.

Comparison of FDR-corrected P-values for site effects derived using repeated measures ANOVA (orange) and non-parametric Friedman (green) tests. (TIF)</p

Statistical results for SWI-derived IDPs.

In the top two panels, the left column shows data for 14 IDPs derived from T2* data and the right column shows data for 14 IDPs derived from QSM data. A) Distribution of log-transformed P-values from repeated measures ANOVA testing for a site effect on the mean value of individual IDPs in each class; the solid horizontal line represents the P-value equivalent to FDR = 5%. Green dots represent IDPs fitted to the ANOVA model including data from all four sites; orange dots represent P-values for each IDP fitted to the ANOVA including only data from the three Siemens sites (Cambridge, Oxford, Liverpool). There were more significant between-site differences in mean IDPs when the GE data from KCL were included in the analysis B) Swarm plots showing distribution of intra-class correlation coefficients (ICCs) for the same IDPs, estimated for each pair of all 4 sites (green points), and for each pair of the three Siemens sites (orange points). C) Each column represents finer-grained results for representative IDPs from each class of IDP: from left to right, T2* right pallidum, QSM right pallidum. Top row, plots of each IDP for 8 subjects (coloured lines) scanned at each of 4 sites (x-axis labels). Bottom row, correlations between each pair of sites for each IDP: upper triangle, Pearson’s correlations; lower triangle, Spearman’s correlations.</p

Covid-19 Clinical Neuroscience Study (COVID-CNS) consortium membership and affiliation.

(DOCX)</p

T2 FLAIR images and statistical results for T2-derived IDPs.

A) Representative T2 FLAIR images of the same subject scanned at each of 4 sites in the travelling heads study. B) left panel, peri-ventricular white matter hyperintensity volume for 8 subjects (coloured lines) scanned at each of 4 sites (x-axis labels); right panel, correlations between each pair of sites. C) left panel, deep white matter hyperintensity volume for 8 subjects (coloured lines) scanned at each of 4 sites (x-axis labels); right panel, correlations between each pair of sites. In both B) and C), the upper triangle of the matrix shows Pearson’s correlations and the lower triangle shows Spearman’s correlations; and both IDPs were estimated using BIANCA.</p

List of IDPs.

(DOCX)</p

fMRI data quality and IDP summaries.

The two columns show data on fMRI node amplitude and fMRI connectivity IDPs. Both represent IDPs derived from 25- and 100-node ICA-based parcellations. The fMRI connectivity IDPs represent 6 modes of variation across the functional connectivity network matrices derived from both parcellations. A) Distribution of log-transformed P-values from repeated measures ANOVA testing for a site effect on the mean value of individual IDPs in each class; the solid horizontal line represents the P-value equivalent to FDR = 5%. Green dots represent IDPs fitted to the ANOVA model including data from all four sites; orange dots represent P-values for each IDP fitted to the ANOVA including only data from the three Siemens sites (Cambridge, Oxford, Liverpool). B) Swarm plots showing distribution of intra-class correlation coefficients (ICCs) for the same IDPs, estimated for each pair of all 4 sites (green points), for each pair of the three Siemens sites (orange points) and for comparable test-retest data drawn from the UKB cohort (blue points). Between-site reliability was generally high for all IDP classes compared to the UKB benchmark, whether or not GE data were included in the analysis. C) Each column represents finer-grained results for representative IDPs from each class of IDP: from left to right, fMRI node 4/25 (medial visual RSN) and summary connectivity mode #3 [15]. Top row, plots of each IDP for 8 subjects (coloured lines) scanned at each of 4 sites (x-axis labels); the grey violin plot indicates the distribution of the corresponding IDP in the UK Biobank reference dataset. Bottom row, correlations between each pair of sites for each IDP: upper triangle, Pearson’s correlations; lower triangle, Spearman’s correlations.</p