Knowledge translation strategies to improve the use of evidence in public health decision making in local government: intervention design and implementation plan

Implementation Science

Boyd Swinburn⁵  Rebecca Conning²  Marjorie Moodie¹  Catherine Burns⁵  Tahna L Pettman²  Rachel Clark⁶  Mark Petticrew³  Laurence Moore⁴  Laurie Anderson⁸  Maureen Dobbins⁷  Elizabeth Waters²  Rebecca Armstrong² 

[1] Deakin Health Economics, School of Health and Social Development, Deakin University, Burwood Highway, Burwood, Victoria, Australia;Jack Brockhoff Child Health and Wellbeing Program, McCaughey VicHealth CentreMelbourne School of Population and Global Health, University of Melbourne, Level 5/207 Bouverie Street, Carlton, Victoria, Australia;London School of Hygiene and Tropical Medicine, University of London, Keppel St, London, UK;Cardiff Institute of Society and Health, School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, Wales, UK;Population Health Strategic Research, Deakin University, 221 Burwood Highway, Burwood, Victoria, Australia;The Center of Excellence in Intervention and Prevention Science, Melbourne, Australia;School of Nursing, McMaster University, Main Street West, Hamilton, Ontario, Canada;Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA

关键词: Decision-making;    Public health;    Evidence;    Knowledge translation;   

Others  :  811024
DOI  :  10.1186/1748-5908-8-121

 received in 2012-12-13, accepted in 2013-09-18,  发布年份 2013

【 摘 要 】

Background

Knowledge translation strategies are an approach to increase the use of evidence within policy and practice decision-making contexts. In clinical and health service contexts, knowledge translation strategies have focused on individual behavior change, however the multi-system context of public health requires a multi-level, multi-strategy approach. This paper describes the design of and implementation plan for a knowledge translation intervention for public health decision making in local government.

Methods

Four preliminary research studies contributed findings to the design of the intervention: a systematic review of knowledge translation intervention effectiveness research, a scoping study of knowledge translation perspectives and relevant theory literature, a survey of the local government public health workforce, and a study of the use of evidence-informed decision-making for public health in local government. A logic model was then developed to represent the putative pathways between intervention inputs, processes, and outcomes operating between individual-, organizational-, and system-level strategies. This formed the basis of the intervention plan.

Results

The systematic and scoping reviews identified that effective and promising strategies to increase access to research evidence require an integrated intervention of skill development, access to a knowledge broker, resources and tools for evidence-informed decision making, and networking for information sharing. Interviews and survey analysis suggested that the intervention needs to operate at individual and organizational levels, comprising workforce development, access to evidence, and regular contact with a knowledge broker to increase access to intervention evidence; develop skills in appraisal and integration of evidence; strengthen networks; and explore organizational factors to build organizational cultures receptive to embedding evidence in practice. The logic model incorporated these inputs and strategies with a set of outcomes to measure the intervention’s effectiveness based on the theoretical frameworks, evaluation studies, and decision-maker experiences.

Conclusion

Documenting the design of and implementation plan for this knowledge translation intervention provides a transparent, theoretical, and practical approach to a complex intervention. It provides significant insights into how practitioners might engage with evidence in public health decision making. While this intervention model was designed for the local government context, it is likely to be applicable and generalizable across sectors and settings.

Trial registration

Australia New Zealand Clinical Trials Register ACTRN12609000953235.

【 授权许可】

   
2013 Armstrong et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]National Collaborating Centre for Methods and Tools: A Model for Evidence-Informed Decision-Making in Public Health. [fact sheet]. 2012. Retrieved from http://www.nccmt.ca/pubs/FactSheet_EIDM_EN_WEB.pdf webcite
• [2]Brownson RC, Fielding JE, Maylahn CM: Evidence-based public health: a fundamental concept for public health practice. Annu Rev Public Health 2009, 30:175-201.
• [3]Nutley S, Walter I, Davies H: From knowing to doing: a framework for understanding the evidence into practice agenda. Eval Program Plann 2003, 9:125-148.
• [4]Bowen S, Zwi AB: Pathways to “evidence-informed” policy and practice: a framework for action. PLoS Med 2005, 2:e166.
• [5]Oxman AD, Lavis JN, Fretheim A, Lewin S: SUPPORT tools for evidence-informed health policymaking (STP) 17: dealing with insufficient research evidence. Health Res Policy Syst 2009, 7(Suppl 1):S17. BioMed Central Full Text
• [6]Lavis JN, Wilson MG, Oxman AD, Lewin S, Fretheim A: SUPPORT tools for evidence-informed health policymaking (STP) 4: using research evidence to clarify a problem. Health Res Policy Syst 2009, 7(Suppl 1):S4. BioMed Central Full Text
• [7]Macintyre S, Petticrew M: Good intentions and received wisdom are not enough. J Epidemiol Community Health 2000, 54:802-803.
• [8]Chalmers I: Trying to do more good than harm in policy and practice: the role of rigorous, transparent, up-to-date evaluations. Ann Am Acad Pol Soc Sci 2003, 589:22-40.
• [9]Chalmers I: If evidence-informed policy works in practice, does it matter if it doesn’t work in theory? Evid Policy: A J Res, Debate Pract 2005, 1:227-242.
• [10]Canadian Institutes of Health Research: Knowledge translation strategy 2004 —2009: Innovation in action. Ottawa, ON: Canadian Institutes of Health Research; 2004.
• [11]Task Force on Health Systems Research: Informed choices for attaining the millennium development goals: towards an international cooperative agenda for health systems research. Lancet 2004, 364:997-1003.
• [12]Banks G: Evidence-based policy-making: What is it? How do we get it?. Canberra: COMMONWEALTH OF AUSTRALIA; 2008. [ANU Public Lecture Series, presented by ANZSOG]
• [13]Petticrew M, Whitehead M, Macintyre SJ, Graham H, Egan M: Evidence for public health policy on inequalities: 1: the reality according to policymakers. J Epidemiol Community Health 2004, 58:811-816.
• [14]Davies HTO, Nutley SM: Evidence-based policy and practice: moving from rhetoric to reality. Third International, Inter-disciplinary Evidence-Based Policies and Indicator Systems Conference, Centre for Public Policy and Management, University of St Andrews; 2001.
• [15]Bowen S, Erickson T, Martens PJ, Crockett S: More than “Using Research”: the real challenges in promoting evidence-informed decision-making. Healthc Policy 2009, 4:87-102.
• [16]Hanney S, Gonzalez-Block M, Buxton M, Kogan M: The utilisation of health research in policy-making: concepts, examples and methods of assessment. Health Res Policy Syst 2003, 1:2. BioMed Central Full Text
• [17]Davies HTO, Nutley SM, Walter I: Assessing the impact of social science research: conceptual, methodological and practical issues: a background discussion paper. UK: Research Unit for Research Utilization, School of Management, University of St Andrews; 2005.
• [18]Innvaer S, Vist G, Trommald M, Oxman A: Health policy-makers’ perceptions of their use of evidence: a systematic review. J Health Serv Res Policy 2002, 7:239-244.
• [19]Elliott H, Popay J: How are policy makers using evidence? Models of research utilisation and local NHS policy making. J Epidemiol Community Health 2000, 54:461-468.
• [20]Armstrong R, Waters E, Moore L, Riggs E, Cuervo LG, Lumbiganon P, Hawe P: Improving the reporting of public health intervention research: advancing TREND and CONSORT. J Public Health (Oxf) 2008, 30:103-109.
• [21]Rogers EM: Diffusion of Innovations. New York: The Free Press; 1962.
• [22]Tetroe JM, Graham ID, Foy R, Robinson N, Eccles MP, Wensing M, Durieux P, Legare F, Nielson CP, Adily A, et al.: Health research funding agencies’ support and promotion of knowledge translation: an international study. Milbank Q 2008, 86:125-155.
• [23]Armstrong R, Waters E, Dobbins M, Lavis John N, Petticrew M, Christensen R: Knowledge translation strategies for facilitating evidence-informed public health decision making among managers and policy-makers. Cochrane Database Syst Rev (protocol) 2011. 10.1002/14651858.CD009181
• [24]Mitton C, Adair CE, McKenzie E, Patten SB, Waye PB: Knowledge transfer and exchange: review and synthesis of the literature. Milbank Q 2007, 85:729-768.
• [25]Wandersman A, Duffy J, Flaspohler P, Noonan R, Lubell K, Stillman L, Blachman M, Dunville R, Saul J: Bridging the gap between prevention research and practice: the interactive systems framework for dissemination and implementation. Am J Community Psychol 2008, 41:171-181.
• [26]Waters E, Armstrong R, Swinburn B, Moore L, Dobbins M, Anderson L, Petticrew M, Clark R, Conning R, Moodie M, Carter R: An exploratory cluster randomised controlled trial of knowledge translation strategies to support evidence-informed decision-making in local governments (The KT4LG study). BMC Public Health 2011, 11:34. BioMed Central Full Text
• [27]Hawe P, Shiell A, Riley T: Theorising interventions as events in systems. Am J Community Psychol 2009, 43:267-276.
• [28]Department of Planning and Community Developmen: Guide to Local Government. 2013. Retrieved October 2013, from http://www.dpcd.vic.gov.au/localgovernment/guide-to-local-government webcite
• [29]Parliament of Victoria: Public Health and Wellbeing Act 2008. Parliament of Victoria; 2008.
• [30]Allender S, Gleeson E, Crammond B, Sacks G, Lawrence M, Peeters A, Loff B, Swinburn B: Moving beyond ‘rates, roads and rubbish’: how do local governments make choices about healthy public policy to prevent obesity? Aust N Z Health Policy 2009, 6:20. BioMed Central Full Text
• [31]Campbell S, Benita S, Coates E, Davies P, Penn G: Analysis for policy: evidence-based policy in practice. UK: Government Social Research Unit; 2007.
• [32]Victorian Health Promotion Foundation (VicHealth): Food for All program 2005–10: Evaluation report. Melbourne: VicHealth; 2011.
• [33]The Department of Planning and Community Development: Transport Connections Program. 2012. Retrieved 13 Dec 2012, from http://www.rdv.vic.gov.au/community-programs/transport-connections webcite
• [34]Creswell J, Plano Clark V, Gutmann M, Hanson W: Advanced mixed methods research designs. In Handbook of mixed methods in social and behavioural research. Edited by Tashakkori A, Teddlie C. California: Sage Publications; 2003.
• [35]Dobrow MJ, Goel V, Lemieux-Charles L, Black NA: The impact of context on evidence utilization: a framework for expert groups developing health policy recommendations. Soc Sci Med 2006, 63:1811-1824.
• [36]Estabrooks C: The conceptual structure of research utilization. Res Nurs Health 1999, 22:203-216.
• [37]Amara N, Ouimet M, Laundry R: New evidence on instrumental, conceptual and symbolic utilization of university research in government agencies. Sci Commun 2004, 26:75-106.
• [38]Lavis JN, Ross SE, Hurley JE, Hohenadel JM, Stoddart GL, Woodward CA, Abelson J: Examining the role of health services research in public policymaking. Milbank Q 2002, 80:125-154.
• [39]Petticrew M, Platt S, McCollam A, Wilson S, Thomas S: “We’re not short of people telling us what the problems are. We’re short of people telling us what to do”: an appraisal of public policy and mental health. BMC Public Health 2008, 8:314. BioMed Central Full Text
• [40]Grimshaw JM, Shirran L, Thomas R, Mowatt G, Fraser C, Bero L, Grilli R, Harvey E, Oxman A, O’Brien MA: Changing provider behavior: an overview of systematic reviews of interventions. Med Care 2001, 39:II2-II45.
• [41]Bero LA, Grilli R, Grimshaw JM, Harvey E, Oxman AD, Thomson MA: Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. The Cochrane effective practice and organization of care review group. Br Med J 1998, 317:465-468.
• [42]Kohatsu ND, Robinson JG, Torner JC: Evidence-based public health: an evolving concept. Am J Prev Med 2004, 27:417-421.
• [43]Orton L, Lloyd-Williams F, Taylor-Robinson D, O’Flaherty M, Capewell S: The use of research evidence in public health decision making processes: systematic review. PLoS One 2011, 6:e21704.
• [44]Armstrong R: Evidence-informed public health decision-making in local government. University of Melbourne, Melbourne School of Public Health; 2011. [PhD Thesis] http://repository.unimelb.edu.au/10187/9684 webcite
• [45]Best A, Moor G, Holmes B, Clark PI, Bruce T, Leischow S, Buchholz K, Krajnak J: Health promotion dissemination and systems thinking: towards an integrative model. Am J Health Behav 2003, 27:S206-S216.
• [46]Higgins J, Green S: Cochrane handbook for systematic reviews of interventions. In The Cochrane Library. Chichester, UK: John Wiley & Sons, Ltd; 2006.
• [47]Dobbins M, Hanna S, Ciliska D, Manske S, Cameron R, Mercer S, O’Mara L, DeCorby K, Robeson P: A randomized controlled trial evaluating the impact of knowledge translation and exchange strategies. Implement Sci 2009, 4:61. BioMed Central Full Text
• [48]Dobbins M: Knowledge Translation and Exchange Questionnaire. Canadian Institute for Health Research: Canada; 2004.
• [49]Weatherly H, Drummond M, Smith D: Using evidence in the development of local health policies. Some evidence from the United Kingdom. Int J Technol Assess Health Care 2002, 18:771-781.
• [50]Bickman L: The functions of program theory. New Directions for Program Evaluation 1987, 1987(33):5-18.
• [51]Frechtling J: Logic modeling methods in program evaluation. San Francisco: John Wiley and Sons; 2007.
• [52]Millar A, Simeone RS, Carnevale JT: Logic models: a systems tool for performance management. Eval Program Plann 2001, 24:73-81.
• [53]Anderson LM, Petticrew M, Rehfuess E, Armstrong R, Ueffing E, Baker P, Francis D, Tugwell P: Using logic models to capture complexity in systematic reviews. Res Synth Methods 2011, 2:33-42.
• [54]Dearing JW: Applying diffusion of innovation theory to intervention development. Res Soc Work Pract 2009, 19:503-518.
• [55]Green LW, Ottoson JM, García C, Hiatt RA: Diffusion theory and knowledge dissemination, utilization, and integration in public health. Annu Rev Public Health 2009, 30(1):151-174.
• [56]Weiss C: The many meanings of research utilization. Public Adm Rev 1979, 426-431.
• [57]Beyer JM: Research utilization: bridging the gap between communities. J Manag Inq 1997., 6(17-22)
• [58]Hanney SR, Gonzalez-Block M, Buxton MJ, Kogan M: The utilization of health services research in policy-making: concepts, examples and methods of assessment. Health Res Policy Syst 2003., 1
• [59]Nonaka I, Takeuchi H: The knowledge creating company: How Japanese companies create the dynamics of innovation. Oxford: Oxford University Press; 1995.
• [60]Dobbins M, DeCorby K, Robeson P, Husson H, Tirilis D, Greco L: A knowledge management tool for public health: health-evidence.ca. BMC Public Health 2010, 10:496. BioMed Central Full Text
• [61]Dobbins M, Robeson P, Ciliska D, Hanna S, Cameron R, O’Mara L, Decorby K, Mercer S: A description of a knowledge broker role implemented as part of a randomized controlled trial evaluating three knowledge translation strategies. Implement Sci 2009, 4:23. BioMed Central Full Text
• [62]Baker EA, Brownson RC, Dreisinger M, McIntosh LD, Karamehic-Muratovic A: Examining the role of training in evidence-based public health: a qualitative study. Health Promot Pract 2009, 10:342-348.
• [63]Eldredge JD, Carr R, Broudy D, Voorhees RE: The effect of training on question formulation among public health practitioners: results from a randomized controlled trial. J Med Libr Assoc 2008, 96:299.
• [64]Canadian Health Services Research Foundation: Is Research Working for You? A Self-Assessment Tool and Discussion Guide for Health Services Management and Policy Organizations. Ottawa, Ontario: Canadian Health Services Research Foundation; 2005.
• [65]Kothari A, Edwards N, Hamel N, Judd M: Is research working for you? Validating a tool to examine the capacity of health organizations to use research. Implement Sci 2009, 4:46. BioMed Central Full Text
• [66]Waters E, Armstrong R, Swinburn B, Moore L, Dobbins M, Anderson L, Petticrew M, Clark R, Conning R, Moodie M, Carter R: An exploratory cluster randomised controlled trial of knowledge translation strategies to support evidence-informed decision-making in local governments (The KT4LG study). BMC Public Health 2011., 11