Abstract
BackgroundMental health remains a neglected issue on the global health policy agenda, particularly in low- and middle-income countries (LMIC), and the translation of research evidence into policy and practice is slow. The new EVITA framework was developed to improve mental health evidence uptake and policy agenda-setting in LMICs. In addition, behavioural science methods may be able to support knowledge translation to policy.MethodsUsing a mixed-methods study design, we applied and tested the newly developed EVITA 1.1 framework against three case studies related to South Africa at the district, national and international levels. In-depth interviews with 26 experts were conducted between August and November 2019, transcribed, coded and analysed in NVivo, using iterative categorization. The data were analysed against both the EVITA framework and the MINDSPACE framework for behavioural insights.ResultsIn our case study comparison, we found that (1) research translation to the policy agenda occurs in a complex, fluid system which includes multiple “research clouds”, “policy spheres” and other networks; (2) mental health research policy agenda-setting is based on key individuals and intermediaries and their interrelationships; and (3) key challenges and strategies for successful research to policy agenda impact are known, but are frequently not strategically implemented, such as including all stakeholders to overcome the policy implementation gap. Our data also suggest that behavioural science methods can be strategically applied to support knowledge translation to policy agenda-setting.ConclusionWe found that the EVITA framework is useful for understanding and improving mental health research policy interrelationships to support evidence uptake to the policy agenda, and that behavioural science methods are effective support mechanisms. The revised EVITA 2.0 framework therefore includes behavioural insights, for improved mental health policy agenda-setting in LMICs. More research is needed to understand whether EVITA can be applied to other LMICs and to high-income contexts.
Highlights
Mental health remains a neglected issue on the global health policy agenda, in low- and middle-income countries (LMIC), and the translation of research evidence into policy and practice is slow
Through snowball sampling we identified and conducted five additional interviews with experts working on LMIC mental health research and policy interrelationships, which were not included in the case studies, but were used to triangulate and cross-validate our case study findings
Overview of our interview sample Changes following the interviews Before presenting the key findings, it is important to acknowledge the changes we made to the EVITA framework as a result of the key informant interviews
Summary
Mental health remains a neglected issue on the global health policy agenda, in low- and middle-income countries (LMIC), and the translation of research evidence into policy and practice is slow. The new EVITA framework was developed to improve mental health evidence uptake and policy agenda-setting in LMICs. In addition, behavioural science methods may be able to support knowledge translation to policy. Knowledge translation is increasingly making important contributions to accelerate the implementation of mental health evidence into research, policy and practice [8]. A recent systematic review found that few relevant and practical frameworks exist that address the specific complexities and cross-links of mental health, and support evidence translation to policy in LMICs [13, 14]. The diffuse and constantly changing, amorphous nature and hard-to-define boundaries of research, described as “research clouds”, may contribute to this challenge [15]
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