Practice perspectives

Bridging evidence and policy: the CalSPEC model for academic–legislative collaboration

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Richard L. Kravitz and Dominique Ritley

This blog post is based on the Evidence & Policy article, ‘An academic–legislative partnership for evidence-based policy: the California State Policy Evidence Consortium (CalSPEC)’.

Researchers and policymakers need each other, but each group is constrained by its own conventions, vocabularies, and norms. Researchers value evidence that is reproducible, valid, and generalizable; policymakers prioritise research that is timely, actionable, and specific. The California State Policy Evidence Consortium (CalSPEC) was created to bridge this divide by connecting university research with real-world policymaking in the California state legislature.

There is no shortage of academic units and think tanks producing research monographs and policy briefs. CalSPEC was distinctive in two respects: it aimed to muster resources across an entire university system (specifically, the University of California’s 10-campuses and 70,000 faculty and academic researchers) to address critical problems in state policy, and it was a genuinely collaborative effort, with legislative committee staff involved in topic selection and question development from the start.

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Implementation, improvement, knowledge mobilisation: what is the best way to get research evidence into healthcare practice?

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Judith Dyson, Laura Swaithes, Helen Nankervis, Una Kerin and Fiona Cowdell

This blog post is based on the Evidence & Policy article, ‘Knowledge-to-care: is there a best way of support practitioners to getting evidence into practice? An ongoing debate‘.

Getting evidence into practice is a stubborn problem. The most common approaches we see in the published literature are badged i) implementation science (ImpS), ii) improvement science (ImpR) and iii) knowledge mobilisation (KMb) with a lot of authors also citing the need for iv) public patient involvement and engagement (PPIE) and v) co-designing (Co-D) strategies to support best practices with stakeholders (usually healthcare practitioners, patients and commissioners). The questions we sought to address was: What is the best approach to improving quality of care. What strategies do we choose to improve care under what circumstances? To answer this conundrum, we conducted two reviews of the literature: top down (consulting theoretical papers from well-known authors in these fields) and bottom up (using a systematic search to sample papers from each of these fields). We held workshops with people who identified as being an expert in any of the five approaches listed above and then distributed a survey with these and similar experts.

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The challenge of sowing seeds of academic-policy engagement

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Petra Mäkelä, Annette Boaz and Kathryn Oliver

This blog post is based on the Evidence & Policy article, ‘The Capabilities in Academic Policy Engagement (CAPE) programme in England: a mixed methods evaluation’.

“[M]ore is not the moral equivalent of better.”
– Weiss 1979, p. 456

Ambitions for evidence-informed policymaking have led to a rise in knowledge-brokering initiatives between researcher and policy communities, propelling the development of a ‘rudderless mass’ of engagement activities. For researchers or policy professionals without pre-existing contacts or networks for academic-policy engagement, it can be difficult to know where to start. 

In our Evidence and Policy article, we report on a mixed methods evaluation of a programme known as Capabilities in Academic Policy Engagement (CAPE). CAPE operated as an academically-driven model, which generated an increase in engagement activities reacting to policy opportunities. Our article adds to the limited work that has empirically tested strategies for academic-policy engagement and their facilitation, to provide insights into their qualities and challenges.

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Functional dialogues: guiding vaccination policy during COVID-19 through direct knowledge transfer

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Katie Attwell, Tauel Harper and Chris Blyth

This blog post is based on the Evidence & Policy article, ‘Facilitating knowledge transfer during Australia’s COVID-19 vaccine rollout: an examination of ‘Functional Dialogues’ as an approach to bridge the evidence–policy gap’.

When the COVID-19 pandemic hit, we wanted to use our skills to help with the eventual vaccine rollout. Chris was already well-placed to do so. As Chair of Australia’s Technical Advisory Group on Immunisation (ATAGI), he had years of experience in aspects of vaccine policymaking. Katie was an emerging leader in vaccination social science and policy, and, like Chris, she had strong connections in the Western Australian Department of Health. They knew that the team focused on administering Australia’s National Immunisation Program would have their hands full with supporting the existing programme during COVID-19 times. How could they also prepare for a pandemic vaccine rollout?

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Breaking the Overton Window: on the need for adversarial co-production

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Matthew Johnson, Elliott Johnson, Irene Hardill and Daniel Nettle

This blog post is based on the Evidence & Policy article, ‘Breaking the Overton Window: on the need for adversarial co-production’

Co-production has emerged as one of the key concepts in understanding knowledge-policy interactions and is associated with involvement of users of public services in their design and delivery. At a time of permacrisis, in which ever increasing numbers of Britons are exposed to financial insecurity, the need for transformative evidence-based policymaking is urgent and great. This is particularly important in highly distressed ‘left-behind’ communities targeted by the UK Government for Levelling Up, which constitutes an attempt to improve the infrastructural, economic, social and health environments of less affluent parts of the UK.

Often, policymakers regard the transformative policies capable of addressing these crises as beyond the ‘Overton Window’, which describes a range of policies in the political centre that are acceptable to the public. This window of opportunity can shift to encompass different policies, but movement is slow and policymakers generally believe that significant change lies outside it. This creates an Overton Window-based roadblock in evidence-based policymaking.

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How to do knowledge mobilisation? What we know, and what we don’t

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Hannah Durrant, Rosie Havers, James Downe and Steve Martin

This blog post is based on the Evidence & Policy article, ‘Improving evidence use: a systematic scoping review of local models of knowledge mobilisation’.

Knowledge mobilisation (KM) describes a process for enabling the use of research evidence in policymaking and public service design and delivery. Approaches to KM have evolved over the last two decades – away from one-directional efforts to push research out to decision makers towards a kaleidoscope of research-policy-practice engagement across overlapping phases of knowledge production and policy action. These processes are generally poorly understood at local levels of decision-making, where the specificities of policy and public service context can undermine generic ‘what works’ claims.

Our recent Evidence & Policy article, ‘Improving evidence use: a systematic scoping review of local models of knowledge mobilisation’, identifies three key features of local KM as well as highlighting the gaps in our understanding of how KM is done and with what effect. 

Our aim was to determine how KM is done ‘on-the-ground’, which can get obscured in frameworks that emphasise complexity while simplifying process. We argue that more detail is needed on these practices of KM to inform and improve process. Equally, attention is also needed on demand for and impact of evidence on policy and practice decisions.

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We need a balanced approach to research ethics if we want our research to help everyone

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Michael Sanders and Vanessa Hirneis

This blog post is based on the Evidence & Policy article, ‘Consent, assent and randomised evaluations’.

The last decade or so have seen an explosion in the number of randomised controlled trials conducted in schools in the UK, and a similar, if less stratospheric, rise elsewhere in the world. The rise in the UK can be attributed in large part not to methodological interest by education academics, but the creation of the Education Endowment Foundation. Forming part of the UK Government’s “What Works” network aimed at improving evidence-informed decision-making in policy and overseeing a budget of more than £100 million, the EEF has funded hundreds of randomised trials of different interventions to boost children’s and young people’s attainment.

Enthusiasts of randomised trials argue that they provide the best and simplest (or least statistically burdensome) way of findings out which interventions work. However, opponents, often those responsible for designing and delivering interventions, consider them unethical because they necessitate withholding a potentially beneficial intervention from young people. In our paper, we consider another aspect of the ethics of randomised trials with young people – consent.

Informed consent is the cornerstone of postwar research, and aims to ensure that people are not experimented on against their will. As a principle, it is hard to argue with and should be at the centre of our thinking about how to run these kinds of trials.

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Naturopaths place a stronger emphasis on the patient’s experience of their health compared to information from other health professionals when making clinical decisions

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Prof Amie Steel, Dr Iva Lloyd, Prof Matthew Leach and Dr Vicky Ward

This blog post is based on the Evidence & Policy article, ‘Naturopaths’ behaviours, attitudes and perceptions towards the use of knowledge and information sources’.

The modern health landscape is dominated by the evidence-based practice paradigm which asks health professionals to prefer research evidence over other forms of knowledge and information when providing care to their patients. However, clinicians from most areas of health – including general practice and allied health – have argued that the realities of practice are not so simple. While this ‘messiness’ of clinical practice is documented for many mainstream health professions, there has been little to no research examining how clinicians from traditional medicine systems use knowledge and information in their practice, until now.

An international survey of naturopaths was recently published in Evidence and Policy which found they used a diverse range of knowledge and information sources when making clinical decisions. The survey respondents practice naturopathy, a traditional medicine system originating from Europe but now practiced in 108 countries across all world regions. Naturopathy uses a highly patient-centred and holistic clinical approach that prioritises preventive health and wellness, and patient education and empowerment.

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Evidence informed ‘evidence informed policy and practice’

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David Gough, Chris Maidment and Jonathan Sharples

This blog post is based on the Evidence & Policy article, ‘Enabling knowledge brokerage intermediaries to be evidence-informed.’

Research evidence can be useful (alongside lots of other information) in informing policy, practice and personal decision making. But does this always happen? It tends to be assumed that if research is available and relevant then it will be used in an effective self-correcting ‘evidence ecosystem’, but in many cases the ‘evidence ecosystem’ may be dysfunctional or not functioning at all. Potential users may not demand relevant evidence, not be aware of the existence of relevant research, or may misunderstand it use and relevance.

Knowledge brokerage intermediary (KBIs) agencies (such as knowledge clearinghouses and What Works Centre) aim to improve this by enabling the engagement between research use and research production. We believe that KBIs are essential innovations for improving research use. In this blog, we suggest four ways that they might be further developed by having a more overt focus on the extent that they themselves are evidence informed in their work, as we explore in our Evidence & Policy article.

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The role of intermediaries in evidence-based policymaking: insights from the education system in Israel

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Barak Ariel and Hagit Sabo-Brants

This blog post is based on the Evidence & Policy article, ‘Building bridges in place of barriers between school practitioners and researchers: on the role of embedded intermediaries in promoting evidence-based policy’.

The Israeli education system provides insights into the importance of intermediaries in evidence-based policymaking. Effective intermediaries can bridge the gap between research and practice by fostering collaboration and facilitating knowledge transfer between researchers, policymakers, and practitioners. The ideal intermediary should have the respect of both researchers and practitioners and a comprehensive understanding of both worlds. Practitioners should be involved in selecting and implementing intermediaries to meet their needs. Applying intermediaries in policymaking can result in more efficient and effective policies that benefit researchers and practitioners.

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