Evidence & Policy最新文献

{"title":"The carer-related knowledge exchange network (CAREN): enhancing the relationship between research and evidence and policy and practice","authors":"M. Larkin, A. Milne","doi":"10.1332/174426418X15299594689303","DOIUrl":"https://doi.org/10.1332/174426418X15299594689303","url":null,"abstract":"Background:Although there is now an extensive international body of research and evidence about care and carers it is fragmented and disparate. Without synthesis, organisation and accessibility it cannot effectively inform and improve policy and practice with carers.\u0000 Key points for discussion:This paper makes the case for an accessible carer-related research and evidence resource for stakeholders in carer-related domains across policy, practice, research to address this systemic deficit in the carers field. The Carer-related Knowledge Exchange\u0000 Network (CAREN) has recently been established in recognition of this case. This timely resource is a freely accessible knowledge exchange network that provides relevant stakeholders (for example, carers, commissioners, policymakers, practitioners, employers, third sector organisations, researchers\u0000 and research funders) with access to a regularly updated and coherent database of carer-related research and evidence; offers interactive opportunities to exchange and generate knowledge; facilitates links and information sharing; and disseminates innovative practice, interventions and services.\u0000 CAREN’s development, dimensions and functionality are outlined. In addition, the paper identifies and explores the challenges of sustaining CAREN and its further development ‐ namely long-term funding and ensuring that it meets the needs of its many and diverse users. Conclusions\u0000 and implications:It is anticipated that CAREN will make a significant contribution to research, policy development and service and practice improvement with carers, and will enhance the effectiveness of its stakeholders’ activities. The realisation of CAREN’s potential\u0000 will ensure that it can, and continues to, make a significant, sustained and cost-effective contribution to addressing a critical global issue of the 21st century.","PeriodicalId":51652,"journal":{"name":"Evidence & Policy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42433357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collective knowledge brokering: the model and impact of an embedded team","authors":"L. Wye, H. Cramer, K. Beckett, M. Farr, A. May, J. Carey, Rebecca S. Robinson, Rachel Anthwal, James Rooney, H. Baxter","doi":"10.1332/174426419X15468577044957","DOIUrl":"https://doi.org/10.1332/174426419X15468577044957","url":null,"abstract":"Background:The Bristol Knowledge Mobilisation (KM) Team was an unusual collective brokering model, consisting of a multi-professional team of four managers and three academics embedded in both local healthcare policymaking (aka commissioning) and academic primary care.\u0000 Aims and objectives:They aimed to encourage ‘research-informed commissioning’ and ‘commissioning-informed research’. This paper covers context, structure, processes, advantages, challenges and impact. Methods:Data sources from brokers\u0000 included personal logs, reflective essays, exit interviews and a team workshop. These were analysed inductively using constant comparison. To obtain critical distance, three external evaluations were conducted, using interviews, observations and documentation. Findings:Stable,\u0000 solvent organisations; senior involvement with good inter-professional relationships; secure funding; and networks of engaged allies in host organisations supported the brokers. Essential elements were two-way embedding, ‘buddying up’, team leadership, brokers’ interpersonal\u0000 skills, and two-year, part-time contracts. By working collectively, the brokers fostered cross-community interactions and modelled collaborative behaviour, drawing on each other’s ‘insider’ knowledge, networks and experience. Challenges included too many taskmasters, unrealistic\u0000 expectations and work overload. However, team-brokering provided a safe space to be vulnerable, share learning, and build confidence. As host organisations benefitted most from embedded brokers, both communities noted changes in attitude, knowledge, skills and confidence. The team were more\u0000 successful in fostering ‘commissioning-informed research’ with co-produced research grants than ‘research-informed commissioning’. Discussion and conclusions:Although still difficult, the collective support and comradery of an embedded, two-way, multi-professional\u0000 team made encouraging interactions, and therefore brokering, easier. A team approach modelled collaborative behaviour and created a critical mass to affect cultural change.","PeriodicalId":51652,"journal":{"name":"Evidence & Policy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46273621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based cervical screening: experts’ normative views of evidence and the role of the ‘evidence-based brand’","authors":"Jane H Williams, L. Rychetnik, S. Carter","doi":"10.1332/174426418X15378680442744","DOIUrl":"https://doi.org/10.1332/174426418X15378680442744","url":null,"abstract":"Organised cervical screening programmes are a combination of arrangements designed to maximise benefit and minimise harm associated with cervical cancer at the population level. Many organised programmes are described as 'evidence-based', reflecting an expectation that healthcare should be based on the tenets of Evidence-Based Medicine (EBM). EBM is both normalised and contested. As part of a larger study of how cervical screening came to be the way it is, we conducted a grounded theory study of cervical screening experts' perspectives on evidence and its use in guideline development processes. We sampled from several countries and across a range of professional backgrounds. Analysis was developed through transcript coding and memo writing, using constant comparison to develop insight and connections between concepts. We found that the 'evidence-based' descriptor was used rhetorically to indicate scientific trustworthiness; in short 'evidence-based' indicated 'good'. Experts held ideal conceptions of evidence and its use as objective and value-free, yet reported experiences that suggested those ideals were unattainable in practice. The 'evidence-based' ideal included restricting what counts as evidence to matters of science and epidemiology. This produced pronounced attention to matters of efficacy and effectiveness of cervical screening tests, and neglected decisions relating to the other arrangements that combine to produce an organised screening programme. Rhetorical use of the 'evidence-based brand' appeals to a particular kind of authority: one which is difficult to achieve in practice, and belies the variety of information that is required and the socially negotiated nature of policy and programme decisions.","PeriodicalId":51652,"journal":{"name":"Evidence & Policy","volume":"16 1","pages":"359-374"},"PeriodicalIF":2.1,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42092059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collaborating to improve evidence use","authors":"Katherine E. Smith, P. Cairney","doi":"10.1332/174426420x15925529059125","DOIUrl":"https://doi.org/10.1332/174426420x15925529059125","url":null,"abstract":"","PeriodicalId":51652,"journal":{"name":"Evidence & Policy","volume":"16 1","pages":"333-336"},"PeriodicalIF":2.1,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1332/174426420x15925529059125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47910851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving the enabling environment for evidence-informed policymaking: an example from Indonesia","authors":"Elisabeth Jackson, Arnaldo Pellini, B. Prasetiamartati","doi":"10.1332/174426418X15394255863408","DOIUrl":"https://doi.org/10.1332/174426418X15394255863408","url":null,"abstract":"Background:Indonesia’s growth and prosperity as a lower-middle-income country hinges on the ability of policymakers to develop effective public policies based on evidence. Yet Indonesia’s policy and regulatory environment does not support the production of high-quality\u0000 evidence and its use in policymaking. Key points for discussion:This article examines an international donor programme which aims to build sustainable capacity for evidence-informed policymaking by improving this enabling environment. The article reflects on the programme’s\u0000 experience in working with local stakeholders to reform public procurement regulations to make commissioning of research easier. This experience suggests that facilitating stakeholders to work together to define a problem and break it down into its component parts helps generate realistic\u0000 entry points and feasible solutions. It also suggests that a focus on purposively expanding the space for reform is necessary throughout the reform process. Leadership by individuals with decision-making authority is critical, as is building consensus around problems and maintaining momentum\u0000 for solving them. Most importantly, to work effectively, programme staff and facilitators need to engage with the political economy of the policy problem. Conclusion and implications:This experience provides lessons for those seeking to support the systems that underpin\u0000 evidence-informed policymaking in other middle-income country contexts.","PeriodicalId":51652,"journal":{"name":"Evidence & Policy","volume":"16 1","pages":"503-514"},"PeriodicalIF":2.1,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1332/174426418X15394255863408","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43011319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Making evidence and policy in public health emergencies: lessons from COVID-19 for adaptive evidence-making and intervention","authors":"K. Lancaster, T. Rhodes, M. Rosengarten","doi":"10.1332/174426420x15913559981103","DOIUrl":"https://doi.org/10.1332/174426420x15913559981103","url":null,"abstract":"Background:In public health emergencies, evidence, intervention, decisions and translation proceed simultaneously, in greatly compressed timeframes, with knowledge and advice constantly in flux. Idealised approaches to evidence-based policy and practice are ill equipped to\u0000 deal with the uncertainties arising in evolving situations of need. Key points for discussion:There is much to learn from rapid assessment and outbreak science approaches. These emphasise methodological pluralism, adaptive knowledge generation, intervention pragmatism, and\u0000 an understanding of health and intervention as situated in their practices of implementation. The unprecedented challenges of novel viral outbreaks like COVID-19 do not simply require us to speed up existing evidence-based approaches, but necessitate new ways of thinking about how a more emergent\u0000 and adaptive evidence-making might be done. The COVID-19 pandemic requires us to appraise critically what constitutes ‘evidence-enough’ for iterative rapid decisions in-the-now. There are important lessons for how evidence and intervention co-emerge in social practices, and for\u0000 how evidence-making and intervening proceeds through dialogue incorporating multiple forms of evidence and expertise. Conclusions and implications:Rather than treating adaptive evidence-making and decision making as a break from the routine, we argue that this should be\u0000 a defining feature of an ‘evidence-making intervention’ approach to health.","PeriodicalId":51652,"journal":{"name":"Evidence & Policy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1332/174426420x15913559981103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48859071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of shared decision-making in healthcare policy and practice: a complex adaptive systems perspective","authors":"S. Munro, J. Kornelsen, Elizabeth S Wilcox, Sarah Kaufman, N. Bansback, Kitty K Corbett, P. Janssen","doi":"10.1332/174426419X15468571657773","DOIUrl":"https://doi.org/10.1332/174426419X15468571657773","url":null,"abstract":"Background:Despite the suggested benefits of shared decision-making (SDM), its implementation in policy and practice has been slow and inconsistent. Use of complex adaptive systems (CAS) theory may provide understanding of how healthcare system factors influence implementation\u0000 of SDM. Methods:Using the example of choice of mode of birth after a previous caesarean section, in-depth, semi-structured interviews were conducted with patients, providers, and decision makers in British Columbia, Canada, to explore the system characteristics and processes\u0000 that influence implementation of SDM. Implementation and knowledge translation principles guided study design, and constructionist grounded theory informed iterative data collection and analysis. Findings:Analysis of interviews (n=58) revealed that patients formed early\u0000 preferences for mode of delivery (after the primary caesarean) through careful deliberation of social risks and benefits. Physicians acted as information providers of clinical risks and benefits, while decision makers revealed concerns related to liability and patient safety. These concerns\u0000 stemmed from perceptions of limited access to surgical resources, which had resulted from budget constraints. Discussion and conclusions:To facilitate the effective implementation of SDM in policy and practice it may be critical to initiate SDM once patients become aware\u0000 of their healthcare options, assist patients to address the social risks that influence their preferences, manage perceptions of risk related to patient safety and litigation among physicians, and enhance access to healthcare resources.","PeriodicalId":51652,"journal":{"name":"Evidence & Policy","volume":"16 1","pages":"393-411"},"PeriodicalIF":2.1,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49510450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining brokers, intermediaries, and boundary spanners: a systematic review","authors":"J. Neal, Z. Neal, Brian Brutzman","doi":"10.31234/osf.io/psd9u","DOIUrl":"https://doi.org/10.31234/osf.io/psd9u","url":null,"abstract":"\u0000 Background: A growing literature focuses on the roles of brokers, intermediaries, and boundary spanners (BIBS) in addressing the challenges of transferring research evidence between the research and practice or policy communities.Aims and objectives: In this systematic review, we examined two research questions: (1) where, how, and when are different BIBS terms (broker, intermediary, and boundary spanner) used? and (2) which BIBS terms get defined, and when these terms are defined, who are BIBS and what do they do?Methods: We conducted literature searches designed to capture articles on BIBS and the transfer of research evidence. We extracted information about eligible articles’ characteristics, use of BIBS terms, and definitions of BIBS terms.Findings: The search revealed an initial pool of 667 results, of which 277 articles were included after screening. Although we coded 430 separate uses of BIBS terms, only 37.2% of these uses provided explicit definitions. The terms, ‘broker’ and ‘brokerage’, were commonly applied in the health sector to describe a person engaged in multiple functions. The term, ‘intermediary’, was commonly applied in the education sector to describe an organisation engaged in dissemination. Finally, the terms ‘boundary spanner’ and ‘boundary spanning’ were commonly applied in the environment sector to describe people or organisations that engage in relationship building.Discussion and conclusions: Results demonstrated that when BIBS were defined, there were important (albeit implicit) distinctions between terms. Based on these results, we identify archetypal definitions for brokers, intermediaries, and boundary spanners and offer recommendations for future research.Key messagesOnly 37.2% of coded uses of BIBS in articles included explicit definitions.Brokers were commonly defined in health as people engaged in multiple functions.Intermediaries were commonly defined in education as research-disseminating organisations.Boundary spanners were commonly defined in environment as relationship-building entities.\u0000","PeriodicalId":51652,"journal":{"name":"Evidence & Policy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2020-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42194788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk, uncertainty and medical practice: changes in the medical professions following disaster","authors":"S. Abeysinghe, Claire Leoppold, Akihiko Ozaki, Mariko Morita","doi":"10.1332/174426419x15717232423159","DOIUrl":"https://doi.org/10.1332/174426419x15717232423159","url":null,"abstract":"Risk and uncertainty can destabilise and reconstruct the relationships between medicine, policy and publics. Through semi-structured interviews with medical staff following the Fukushima 3.11 Disaster, this paper demonstrates the way in which disruption (caused by disaster), coupled\u0000 with uncertainty (in this case, around radiation risk) can serve to transform medical practices. After Fukushima, a deficit in publicly-trusted approaches to disaster management meant that the role and status of key medical professionals was transformed. This reorganisation of medical work\u0000 included the development of new forms of expertise, the stretching of expertise beyond previously well-defined professional boundaries, and shifts in the way in which medical professionals understand and interact with publics. These changes signified the rise of new relationships between the\u0000 medical workers and their community, as well as adjustments in what were regarded as the boundaries of medical work. Given both the ubiquitous threat of disasters and calls for increased engagement between the medicine and the public, this case study provides insight into the forms which such\u0000 engagements can take, especially when bound by conditions of uncertainty. The paper draws upon the theoretical literature around the impact of uncertainty on policy, and combines this with medical sociological literature on the nature of medical expertise. The paper examines the shifting of\u0000 medical expertise towards mode 2 forms, and evidences the impact of a democratised science of risk on the roles and functions of medical practice.","PeriodicalId":51652,"journal":{"name":"Evidence & Policy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44835683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sharing confidential health data for research purposes in the UK: where are ‘publics’ in the public interest?","authors":"A. Sorbie","doi":"10.1332/174426419X15578209726839","DOIUrl":"https://doi.org/10.1332/174426419X15578209726839","url":null,"abstract":"In this article I respond to the tendency of the law to approach ‘the public interest’ as a legal test, thereby drawing the criticism that this narrow notion of what purports to be in the public interest is wholly disconnected from the views of actual publics, and\u0000 lacks social legitimacy. On the other hand, to simply extrapolate outputs from public engagement work into policy (or indeed law) is equally problematic, and risks being at best ineffective and at worst reinforcing existing inequalities. Given this apparent disconnect between these conceptions\u0000 of the public interest, and the shortfalls inherent in each, this article scrutinises this disjuncture. I argue that the application of a processual lens to the construction of the legal and regulatory role of the public interest sheds light on how legal notions of the public interest,\u0000 and attitudes of actual publics towards data sharing, might be reconciled. I characterise this processual approach as being iterative and flexible, specifically drawing attention to the way that multiple actors, processes and interests interact, change and evolve over time in the health research\u0000 endeavour. This approach is elaborated through two case studies that illustrate how the public interest appears in law (broadly conceived). Its application provides novel insights into the ways in which the public interest can be crafted within and beyond the law to better inform the development\u0000 of health research regulation.","PeriodicalId":51652,"journal":{"name":"Evidence & Policy","volume":"16 1","pages":"249-265"},"PeriodicalIF":2.1,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46688486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}