Abstract
BackgroundEvidence has come to play a central role in health policymaking. However, policymakers tend to use other types of information besides research evidence. Most prior studies on evidence-informed policy have focused on the policy formulation phase without a systematic analysis of its implementation. It has been suggested that in order to fully understand the policy process, the analysis should include both policy formulation and implementation. The purpose of the study was to explore and compare two policies aiming to improve health and social care in Sweden and to empirically test a new conceptual model for evidence-informed policy formulation and implementation.MethodsTwo concurrent national policies were studied during the entire policy process using a longitudinal, comparative case study approach. Data was collected through interviews, observations, and documents. A Conceptual Model for Evidence-Informed Policy Formulation and Implementation was developed based on prior frameworks for evidence-informed policymaking and policy dissemination and implementation. The conceptual model was used to organize and analyze the data.ResultsThe policies differed regarding the use of evidence in the policy formulation and the extent to which the policy formulation and implementation phases overlapped. Similarities between the cases were an emphasis on capacity assessment, modified activities based on the assessment, and a highly active implementation approach relying on networks of stakeholders. The Conceptual Model for Evidence-Informed Policy Formulation and Implementation was empirically useful to organize the data.ConclusionsThe policy actors’ roles and functions were found to have a great influence on the choices of strategies and collaborators in all policy phases. The Conceptual Model for Evidence-Informed Policy Formulation and Implementation was found to be useful. However, it provided insufficient guidance for analyzing actors involved in the policy process, capacity-building strategies, and overlapping policy phases. A revised version of the model that includes these aspects is suggested.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-015-0359-1) contains supplementary material, which is available to authorized users.
Highlights
Evidence has come to play a central role in health policymaking
Similarities were an emphasis on capacity assessment and modification of activities based on the assessment and a highly active implementation approach relying on networks of stakeholders
We found that the Conceptual Model for Evidence-Informed Policy Formulation and Implementation (Fig. 1) was a useful tool for organizing the data
Summary
Evidence has come to play a central role in health policymaking. policymakers tend to use other types of information besides research evidence. It has been suggested that in order to fully understand the policy process, the analysis should include both policy formulation and implementation. Evidence has come to play a central role in evidence-based medicine and within health policy [1, 2]. Several authors have suggested that an unprejudiced and more explorative approach would be useful [2, 4,5,6] This would imply more focus on understanding the processes behind using evidence and taking into consideration the contextual factors. Policymakers tend to interpret evidence in a broad sense and to use other types and sources of information besides research evidence [7]. Oxman et al defined evidence-informed policymaking as an approach that aims to ensure that decision-making is informed by the best available research evidence in a systematic and transparent way [9]
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