Research for policy:A study on improving the contribution of scientific knowledge to evidence-informed health policy

Research for Policy: A study on improving the contribution of scientific knowledge to evidence-informed health The approach of evidence-informed health policy-making is generally considered as the best means of safeguarding public health: governments should take into account the best available research evidence in health policy-making. Most countries have established a National Public Health Institute (NPHI) to support their government in essential public health operations by activities such as health protection, population health assessment and research to produce evidence for policy-making. However, NPHI-researchers experience that achieving contributions to health policy-making appears to be more difficult than one would expect in view of the NPHI’s mission. In the body of scientific literature on knowledge utilization, alignment between researchers and policy-makers is recognized as an important key for enhancing contributions of scientific knowledge to policy-making. In this study, we focused on research projects, conducted by a NPHI in commission of governmental organizations. We investigated how alignment in such projects is achieved and how alignment can be improved. Our aim was to determine what a practical approach is to enhance knowledge contributions from NPHIs to evidence-informed health policy-making In three case studies, we analyzed in detail the process of a NPHI research project by using Contribution Mapping, a method developed by Kok and Schuit (2012). We identified eight key areas that require special attention during the alignment with policy-makers, the alignment areas 'goal'; 'tasks and authority'; 'quality'; 'consultative structure'; 'vertical alignment'; 'organizational environment'; 'presentation' and 'relevance and timing'. The case studies revealed that achieving alignment between researchers and policy-makers needs continuous efforts and often much more time than anticipated. Although alignment is important, scientific independence is also an important value to safeguard. Thus, researchers need insights on the role of scientific knowledge in policy-making and support of their organization in undertaking alignment efforts. Due to the ever-changing context of a research project, alignment can also be easily lost. Vertical alignment in the own organization is of major importance for achieving adequate horizontal alignment at every organizational level. Since every situation asks for specific alignment efforts, generic alignment efforts cannot be determined beforehand. Instead, researchers should regularly reflect on the alignment areas during the course of their research project. Based on our findings, we developed a reflection instrument to support researchers in reflection on alignment. The R4P tool consists of open reflection questions with examples from case studies and a possible solution to the outlined problem. This allows researchers (but also policy makers) to determine systematically which alignment efforts are required at the given moment. To conclude, NPHIs and also other knowledge institutes should acknowledge that reaching alignment needs much more effort, time and resources than often presumed. Research and knowledge production in commission of governmental organizations to serve evidence-informed health policy is in fact a delicate balancing act between alignment and independence. By organizing the institute in a way that facilitates and supports this balancing act, the NPHI may optimize its contributions to health policy. Ingrid Hegger, scientific officer at the National Institute for Public Health and the Environment RIVM, will defend her thesis on this study on Wednesday, September 6, 2017 at 4 pm in the aula of Tilburg University. Promotores: Prof.Dr.Ing.Hans van Oers (Tilburg University) and Prof.Dr.Ir. Jantine Schuit (VU University Amsterdam); Co-promotor: Dr. Susan Janssen (National Institute for Public Health and the Environment RIVM)

Analyzing the contributions of a government-commissioned research project: a case study

Background: It often remains unclear to investigators how their research contributes to the work of the commissioner. We initiated the 'Risk Model' case study to gain insight into how a Dutch National Institute for Public Health and the Environment (RIVM) project and its knowledge products contribute to the commissioner's work, the commissioner being the Health Care Inspectorate. We aimed to identify the alignment efforts that influenced the research project contributions. Based on the literature, we expected interaction between investigators and key users to be the most determining factor for the contributions of a research project.Methods: In this qualitative case study, we analyzed the alignment efforts and contributions in the Risk Model project by means of document analysis and interviews according to the evaluation method Contribution Mapping. Furthermore, a map of the research process was drafted and a feedback session was organized. After the feedback session with stakeholders discussing the findings, we completed the case study report.Results: Both organizations had divergent views on the ownership of the research product and the relationship between RIVM and the Inspectorate, which resulted in different expectations. The RIVM considered the use of the risk models to be problematic, but the inspectors had a positive opinion about its contributions. Investigators, inspectors, and managers were not aware of these remarkably different perceptions. In this research project, we identified six relevant categories of both horizontal alignment efforts (between investigators and key users) as well as vertical alignment efforts (within own organization) that influenced the contributions to the Inspectorate's work.Conclusions: Relevant alignment efforts influencing the contributions of the project became manifest at three levels: the first level directly relates to the project, the second to the organizational environment, and the third to the formal and historical relationship between the organizations. Both external and internal alignments influence the contributions of a research project. Based on the findings, we recommend that research institutes invest in a reflective attitude towards the social aspects of research projects at all levels of the organization and develop alignment strategies to enhance the contributions of research. © 2014 Hegger et al.; licensee BioMed Central Ltd

Research for Policy (R4P): development of a reflection tool for researchers to improve knowledge utilization

Background: To improve knowledge utilization in policymaking, alignment between researchers and policymakers during knowledge production is essential, but difficult to maintain. In three previously reported case studies, we extensively evaluated complex research projects commissioned by policymakers to investigate how alignment is achieved in a research process and to discover ways to enhance knowledge contributions to health policy. In the present study, we investigated how the findings of these three research projects could be integrated into a practical tool for researchers to enhance their contribution to evidence-based policy. Methods: A cross-case analysis was conducted to integrate the findings of the evaluation of the three research projects and to identify important alignment areas in these projects. By means of an iterative process, we prepared a tool that includes reflection questions for researchers. The "Research for Policy" tool was tested with input from the project managers of three new research projects. Based on the findings, the final version of the Research for Policy tool was prepared. Results: By cross-case analysis of the three case studies, the following important alignment areas were identified: the goal, quality, relevance, timing, and presentation of research, the tasks and authorities of actors, the consultative structure and vertical alignment within organizations, and the organizational environment. The project managers regarded the Research for Policy tool as a useful checklist for addressing the important alignment areas in a research project. Based on their feedback, the illustrative examples from the case studies were added to the reflection questions. The project managers suggested making the tool accessible not only to researchers but also to policymakers. The format of the Research for Policy tool was further adjusted to users' needs by adding clickable links. Conclusions: Alignment between research and policymaking requires continuous efforts and a clear understanding of process issues in the research project. The Research for Policy tool offers practical alignment guidance and facilitates reflection on process issues, which supports researchers in aligning with policymakers and in acting in a context-sensitive way. © 2016 The Author(s)

Tools for the assessment of short food supply chains’ sustainability

The following represents a summary of tools applied in a working group (WP5) of the EU‐project SUPURBFOOD (“Towards sustainable modes of urban and peri‐urban food provisioning”, www.supurbfood.eu). Within WP5, three research partners, three SME’s of short food supply chains and one food consultancy from Italy, the Netherlands, Switzerland and the UK commonly explored logistical strategies that aim to make regional food delivery systems more sustainable while remaining economically viable, including addressing issues of scale. For more detailed information on the tools applied and also practical examples, this summary might be used alongside the SUPURBFOOD Report (WP5) ‘Short chain delivery of food in urban and peri‐urban areas’ that is available for download at the SUPURBFOOD project website [www.supurbfood.eu]

Public's perspective on COVID-19 adenovirus vector vaccines after thrombosis with thrombocytopenia syndrome (TTS) reports and associated regulatory actions: A cross-sectional study in six EU member states

Objective: In 2021, thrombosis with thrombocytopenia syndrome (TTS) was confirmed by the European Medicines Agency (EMA) as a rare side effect of the COVID-19 adenovirus vector vaccines Vaxzevria® and Jcovden®. This study aimed to describe the public's knowledge of TTS and how it affected the willingness to be vaccinated with COVID-19 vaccines and other vaccines in six European countries. Methods: From June to October of 2022, a multi-country cross-sectional online survey was conducted in Denmark, Greece, Latvia, Netherlands, Portugal, and Slovenia. The minimum target of participants to be recruited was based on the size of the country's population. The results were analysed descriptively. Results: In total, 3794 respondents were included in the analysis; across the six countries, 33.3 %–68.3 % reported being familiar with signs and symptoms of TTS, although 3.1–61.4 % of those were able to identify the symptoms correctly. The reported changes in willingness to be vaccinated against COVID-19 and with other vaccines varied per country. The largest reported change in the willingness to be vaccinated with Vaxzevria® and Jcovden® was observed in Denmark (61.2 %), while the willingness to be vaccinated with other COVID-19 vaccines changed most in Slovenia (30.4 %). The smallest decrease in willingness towards future vaccination against COVID-19 was reported in the Netherlands (20.9 %) contrasting with the largest decrease observed in Latvia (69.1 %). Conclusion: Knowledge about TTS seemed to have influenced the public's opinion in Europe resulting in less willingness to be vaccinated with Vaxzevria® and Jcovden®. Willingness for vaccination against COVID-19 with other vaccines and widespread use of vaccines to prevent other diseases also differed and seemed to be determined by the approaches taken by national health authorities when reacting to and communicating about COVID-19 vaccination risks. Further investigation of optimal risk communication strategies is warranted

Short Food Supply Chains in Urban Areas: Who Takes the Lead? Evidence from Three Cities across Europe

Short food supply chain (SFSCs) initiatives have developed throughout Europe as an alternative to the long industrialized chains characterizing the contemporary global food industry. They are often driven by small-scale actors belonging to different phases of the chain (producers, retailers, consumers) and rooted in specific territorial contexts. Innovative organizational models of SFSCs are attracting interest in the academic field (Jarosz, 2008, Khan and Prior, 2010, Aubry and Kebir, 2013) and beyond (RUAF, 2015). This work contributes to the debate with a focus on the logistics of SFSCs in urban and peri-urban areas across Europe, specifically on the role of local intermediaries in facilitating connections between urban consumers and peri-urban and rural farmers. The structure of three small/medium enterprises (SMEs) acting as local SFSC intermediaries has been analyzed by a research network involving researchers and entrepreneurs in a mutual learning process. The aim was to identify the main business objectives of local intermediaries in SFSCs, the elements that from the SMEs point of view characterize SFSCs and their vision of sustainability. A simple theoretical model has been developed to look at leadership of SFSCs in urban and peri-urban areas. The research process provided interesting insight into the contribution that qualitative research can give to SMEs’ reflection on their organizational model (Zakic et al., 2014)

Contributions of knowledge products to health policy: a case study on the Public Health Status and Forecasts Report 2010

BACKGROUND: The Dutch Public Health Status and Forecasts report (PHSF Report) integrates research data and identifies future trends affecting public health in the Netherlands. To investigate how PHSF contributions to health policy can be enhanced, we analysed the development process whereby the PHSF Report for 2010 was produced (PHSF-2010). METHOD: To collect data, a case study approach was used along the lines of Contribution Mapping including analysis of documents from the PHSF-2010 process and interviews with actors involved. All interviews were recorded and transcribed ad verbatim and coded using an inductive code list. RESULTS: The PHSF-2010 process included activities aimed at alignment between researchers and policy-makers, such as informal meetings. However, we identified three issues that are easily overlooked in knowledge development, but provide suggestions for enhancing contributions: awareness of divergent; continuously changing actor scenarios; vertical alignment within organizations involved and careful timing of draft products to create early adopters. CONCLUSION: To enhance the contributions made by an established public health report, such as the PHSF Report, it is insufficient to raise the awareness of potential users. The knowledge product must be geared to policy-makers' needs and must be introduced into the scenarios of actors who may be less familiar. The demand for knowledge product adaptations has to be considered. This requires continuous alignment efforts in all directions: horizontal and vertical, external and internal. The findings of this study may be useful to researchers who aim to enhance the contributions of their knowledge products to health policy

Enhancing the contribution of research to health care policy-making: a case study of the Dutch Health Care Performance Report

OBJECTIVES: The Dutch Health Care Performance Report, issued by the National Institute of Public Health and the Environment, aims to monitor health care performance in The Netherlands. Both the National Institute and the Ministry of Health wish to increase the contribution of the Report to health care policy-making. Our aim was to identify ways to achieve that. METHOD: We used contribution mapping as a theoretical framework that recognizes alignment of research as crucial to managing contributions to policy-making. To investigate which areas need alignment efforts by researchers and/or policy-makers, we interviewed National Institute researchers and policy-makers from the Ministry of Health and assessed the process for developing the 2010 Report. RESULTS: We identified six areas where alignment is specifically relevant for enhancing the contributions of future versions of the Dutch Health Care Performance Report: well-balanced information for different ministerial directorates; backstage work; double role actors; reports of other knowledge institutes; data collection/generation and presentation forms. CONCLUSION: The contribution of health care performance reporting to policy-making is complex and requires continuous alignment efforts between researchers and policy-makers. These efforts should form an inseparable part of health care performance reporting and although this demands considerable resources, it is worth considering since it may pay back in better contributions to policy-making