Negative stereotypes about the policymaking process hinder productive action toward evidence-based policy.

A dearth of clear, relevant and reliable research evidence continue to block the use of research, according to a study of 145 research papers on evidence use. According to the authors of the review, Kathryn Oliver, Simon Innvær, Theo Lorenc, Jenny Woodman, and James Thomas difficulty finding and accessing this research is also a major problem

Translating research into policy and practice in developing countries: a case study of magnesium sulphate for pre-eclampsia.

BACKGROUND: The evidence base for improving reproductive health continues to grow. However, concerns remain that the translation of this evidence into appropriate policies is partial and slow. Little is known about the factors affecting the use of evidence by policy makers and clinicians, particularly in developing countries. The objective of this study was to examine the factors that might affect the translation of randomised controlled trial (RCT) findings into policies and practice in developing countries. METHODS: The recent publication of an important RCT on the use of magnesium sulphate to treat pre-eclampsia provided an opportunity to explore how research findings might be translated into policy. A range of research methods, including a survey, group interview and observations with RCT collaborators and a survey of WHO drug information officers, regulatory officials and obstetricians in 12 countries, were undertaken to identify barriers and facilitators to knowledge translation. RESULTS: It proved difficult to obtain reliable data regarding the availability and use of commonly used drugs in many countries. The perceived barriers to implementing RCT findings regarding the use of magnesium sulphate for pre-eclampsia include drug licensing and availability; inadequate and poorly implemented clinical guidelines; and lack of political support for policy change. However, there were significant regional and national differences in the importance of specific barriers. CONCLUSION: The policy changes needed to ensure widespread availability and use of magnesium sulphate are variable and complex. Difficulties in obtaining information on availability and use are combined with the wide range of barriers across settings, including a lack of support from policy makers. This makes it difficult to envisage any single intervention strategy that might be used to promote the uptake of research findings on magnesium sulphate into policy across the study settings. The publication of important trials may therefore not have the impacts on health care that researchers hope for

Localising and tailoring published research evidence helps public health decision making

Background Published research evidence is typically not readily applicable to practice but needs to be actively mobilised. Objectives This paper explores the mechanisms used by information professionals with a specific knowledge mobilisation role to make evidence useful for local decision making and planning of public health interventions. Methods Data are drawn from a NIHR project that studied how, when, where and by whom published research evidence is used in commissioning and planning across two sites (one in England and one in Scotland). Data included 11 in‐depth interviews with information professionals, observations at meetings and documentary analysis. Results Published research evidence is made fit for local commissioning and planning purposes by information professionals through two mechanisms. They localise evidence (relate evidence to local context and needs) and tailor it (present actionable messages). Discussion Knowledge mobilisation roles of information professionals are not recognised and researched. Information professionals contribute to the ‘inform’ and ‘relational’ functions of knowledge mobilisation; however, they are less involved in improving the institutional environment for sustainable knowledge sharing. Conclusion Information professionals are instrumental in shaping what evidence enters local decision making processes. Identifying and supporting knowledge mobilisation roles within health libraries should be the focus of future research and training

What guidance are researchers given on how to present network meta-analyses to end-users such as policymakers and clinicians? A systematic review

© 2014 Sullivan et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Introduction: Network meta-analyses (NMAs) are complex methodological approaches that may be challenging for non-technical end-users, such as policymakers and clinicians, to understand. Consideration should be given to identifying optimal approaches to presenting NMAs that help clarify analyses. It is unclear what guidance researchers currently have on how to present and tailor NMAs to different end-users. Methods: A systematic review of NMA guidelines was conducted to identify guidance on how to present NMAs. Electronic databases and supplementary sources were searched for NMA guidelines. Presentation format details related to sample formats, target audiences, data sources, analysis methods and results were extracted and frequencies tabulated. Guideline quality was assessed following criteria developed for clinical practice guidelines. Results: Seven guidelines were included. Current guidelines focus on how to conduct NMAs but provide limited guidance to researchers on how to best present analyses to different end-users. None of the guidelines provided reporting templates. Few guidelines provided advice on tailoring presentations to different end-users, such as policymakers. Available guidance on presentation formats focused on evidence networks, characteristics of individual trials, comparisons between direct and indirect estimates and assumptions of heterogeneity and/or inconsistency. Some guidelines also provided examples of figures and tables that could be used to present information. Conclusions: Limited guidance exists for researchers on how best to present NMAs in an accessible format, especially for non-technical end-users such as policymakers and clinicians. NMA guidelines may require further integration with end-users' needs, when NMAs are used to support healthcare policy and practice decisions. Developing presentation formats that enhance understanding and accessibility of NMAs could also enhance the transparency and legitimacy of decisions informed by NMAs.The Canadian Institute of Health Research (CIHR) Drug Safety and Effectiveness Network (Funding reference number – 116573)

Evidence-informed health policy: are we beginning to get there at last

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

An exploratory cluster randomised controlled trial of knowledge translation strategies to support evidence-informed decision-making in local governments (The KT4LG study)

Background: Childhood overweight and obesity is the most prevalent and, arguably, politically complex child health problem internationally. Governments, communities and industry have important roles to play, and are increasingly expected to deliver an evidence-informed system-wide prevention program. However, efforts are impeded by a lack of organisational access to and use of research evidence. This study aims to identify feasible, acceptable and ideally, effective knowledge translation (KT) strategies to increase evidence-informed decision making in local governments, within the context of childhood obesity prevention as a national policy priority.Methods/Design: This paper describes the methods for KT4LG, a cluster randomised controlled trial which is exploratory in nature, given the limited evidence base and methodological advances. KT4LG aims to examine a program of KT strategies to increase the use of research evidence in informing public health decisions in local governments. KT4LG will also assess the feasibility and acceptability of the intervention. The intervention program comprises a facilitated program of evidence awareness, access to tailored research evidence, critical appraisal skills development, networking and evidence summaries and will be compared to provision of evidence summaries alone in the control program. 28 local governments were randomised to intervention or control, using computer generated numbers, stratified by budget tertile (high, medium or low). Questionnaires will be used to measure impact, costs, and outcomes, and key informant interviews will be used to examine processes, feasibility, and experiences. Policy tracer studies will be included to examine impact of intervention on policies within relevant government policy documents.Discussion: Knowledge translation intervention studies with a focus on public health and prevention are very few in number. Thus, this study will provide essential data on the experience of program implementation and evaluation of a system-integrated intervention program employed within the local government public health context. Standardised programs of system, organisational and individual KT strategies have not been described or rigorously evaluated. As such, the findings will make a significant contribution to understanding whether a facilitated program of KT strategies hold promise for facilitating evidence-informed public health decision making within complex multisectoral government organisations.<br /

Aligning research to meet policy objectives for migrant families: an example from Canada

<p>Abstract</p> <p>Background</p> <p>'Evidence-based policy making' for immigrants is a complicated undertaking. In striving toward this goal, federal Canadian partners created the <it>Metropolis Project </it>in 1995 to optimize a two-way transfer of knowledge (researchers – policy makers) within five Canadian Centres of Excellence focused on migrants newly arrived in Canada. Most recently, <it>Metropolis </it>federal partners, including the Public Health Agency of Canada, defined one of six research priority areas as, immigrant 'families, children, and youth'. In order to build on previous work in the partnership, we sought to determine what has been studied within this research-policy partnership about immigrant 'families, children, and youth' since its inception.</p> <p>Methods</p> <p>Annual reports and working papers produced in the five Centres of Excellence between 1996–2006 were culled. Data on academic works were extracted, results coded according to eleven stated federal policy priority themes, and analyzed descriptively.</p> <p>Results</p> <p>139 academic works were reviewed. All federal priority themes, but few specific policy questions were addressed. The greatest volume of policy relevant works were identified for <it>Services </it>(n = 42) and <it>Education and Cultural Identity </it>(n = 39) priority themes.</p> <p>Conclusion</p> <p>Research conducted within the last 10 years is available to inform certain, not all, federal policy questions. Greater specificity in federal priorities can be expected to more clearly direct future research within this policy-research partnership.</p

Improving the use of research evidence in guideline development: 15. Disseminating and implementing guidelines

BACKGROUND: The World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the 15(th )of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this. OBJECTIVES: In this review we address strategies for the implementation of recommendations in health care. METHODS: We examined overviews of systematic reviews of interventions to improve health care delivery and health care systems prepared by the Cochrane Effective Practice and Organisation of Care (EPOC) group. We also conducted searches using PubMed and three databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct systematic reviews ourselves. Our conclusions are based on the available evidence, consideration of what WHO and other organisations are doing and logical arguments. KEY QUESTIONS AND ANSWERS: What should WHO do to disseminate and facilitate the uptake of recommendations? • WHO should choose strategies to implement their guidelines from among those which have been evaluated positively in the published literature on implementation research • Because the evidence base is weak and modest to moderate effects, at best, can be anticipated, WHO should promote rigorous evaluations of implementation strategies. What should be done at headquarters, by regional offices and in countries? • Adaptation and implementation of WHO guidelines should be done locally, at the national or sub-national level. • WHO headquarters and regional offices should support the development and evaluation of implementation strategies by local authorities