Evidence-informed Policymaking Research Articles

From Chaos to Rationality: A Contingent Meta-Model for Evidence-Informed Health Policymaking in Diverse Contexts.

Evidence-informed policymaking is a complex process that requires adapting to diverse contexts characterized by varying degrees of certainty and agreement. Existing models and frameworks often lack clear guidance for dealing with such contexts. This study aimed to develop a novel contingency model to guide the context-specific use of evidence in health policymaking. The study conducted a meta-ethnographic synthesis of 15 existing models and frameworks on evidence-informed policymaking, integrating key factors and concepts influencing the use of evidence in policy decisions. The study also adapted the Stacey Matrix, a tool for understanding the complexity of decision-making, into a quantitative scoring system to assess the levels of certainty and agreement in a given policy context. The study proposed a contingency model that delineates seven modes of decision-making based on the dimensions of certainty and agreement, ranging from rational to molasses-slow collective. For each mode, the model suggests configuring four aspects: team composition, policy idea generation, problem analysis, and consensus building. The model also highlights the multifaceted influences of evidence, interests, values, and beliefs on policy decisions. The contingency model offers researchers and policymakers a flexible framework for aligning policymaking processes with available evidence. The model also underscores the importance of context-specific approaches to evidence-informed policymaking. The model could enhance evidence-informed policymaking capacity, improving health outcomes and system performance. Further research should validate and extend the model empirically across diverse contexts.

STRATEGIES FOR INVOLVING OLDER ADULTS AND INFORMAL CAREGIVERS IN HEALTH POLICY DEVELOPMENT: A SCOPING REVIEW

Abstract Encouraging the active involvement of older adults and informal caregivers in policymaking can lead to cost-effective health and long-term care interventions and enhance the creation of responsive policies. As part of the European Union TRANS-SENIOR program, a scoping review was conducted using the Joanna Briggs Institute’s methodology. Published and grey literature was searched. Studies were included if they described the use/evaluation of methods for engaging older adults (65 years and above) and informal caregivers in local, national, or regional health policy development. Analysis was guided by the Multidimensional Framework For Patient And Family Engagement In Health And Health Care. Thirteen engagement strategies were identified from 11 publications meeting the inclusion criteria. Adopting the World Bank’s categorization of citizen engagement methods, strategies were categorized as traditional, deliberative, and others. Older adults and informal caregivers are often consulted to elicit opinions for agenda/priority setting. However, their involvement in other stages of the policy cycle: health policy formulation, implementation, and evaluation, was unclear from the literature. The described engagement methods suggested that older adults and their informal caregivers do not often have shared equal power and shared responsibility in policymaking. Findings will guide policymakers in identifying and incorporating engagement strategies to support evidence-informed policymaking processes that can improve health outcomes for older adults/informal caregivers. Future research is needed on the evaluation of involvement methods.

Challenges for research uptake for health policymaking and practice in low- and middle-income countries: a scoping review

BackgroundAn estimated 85% of research resources are wasted worldwide, while there is growing demand for context-based evidence-informed health policymaking. In low- and middle-income countries (LMICs), research uptake for health policymaking and practice is even lower, while little is known about the barriers to the translation of health evidence to policy and local implementation. We aimed to compile the current evidence on barriers to uptake of research in health policy and practice in LMICs using scoping review.MethodsThe scoping review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses-extension for Scoping Reviews (PRISMA-ScR) and the Arksey and O'Malley framework. Both published evidence and grey literature on research uptake were systematically searched from major databases (PubMed, Cochrane Library, CINAHL (EBSCO), Global Health (Ovid)) and direct Google Scholar. Literature exploring barriers to uptake of research evidence in health policy and practice in LMICs were included and their key findings were synthesized using thematic areas to address the review question.ResultsA total of 4291 publications were retrieved in the initial search, of which 142 were included meeting the eligibility criteria. Overall, research uptake for policymaking and practice in LMICs was very low. The challenges to research uptake were related to lack of understanding of the local contexts, low political priority, poor stakeholder engagement and partnership, resource and capacity constraints, low system response for accountability and lack of communication and dissemination platforms.ConclusionImportant barriers to research uptake, mainly limited contextual understanding and low participation of key stakeholders and ownership, have been identified. Understanding the local research and policy context and participatory evidence production and dissemination may promote research uptake for policy and practice. Institutions that bridge the chasm between knowledge formation, evidence synthesis and translation may play critical role in the translation process.

Enhancing evidence-informed policymaking in medicine and healthcare: stakeholder involvement in the Commons Project for rare diseases in Japan

BackgroundAlthough stakeholder involvement in policymaking is attracting attention in the fields of medicine and healthcare, a practical methodology has not yet been established. Rare-disease policy, specifically research priority setting for the allocation of limited research resources, is an area where evidence generation through stakeholder involvement is expected to be effective. We generated evidence for rare-disease policymaking through stakeholder involvement and explored effective collaboration among stakeholders.MethodsWe constructed a space called ‘Evidence-generating Commons’, where patients, family members, researchers, and former policymakers can share their knowledge and experiences and engage in continual deliberations on evidence generation. Ten rare diseases were consequently represented. In the ‘Commons’, 25 consecutive workshops were held predominantly online, from 2019 to 2021. These workshops focused on (1) clarification of difficulties faced by rare-disease patients, (2) development and selection of criteria for priority setting, and (3) priority setting through the application of the criteria. For the first step, an on-site workshop using sticky notes was held. The data were analysed based on KJ method. For the second and third steps, workshops on specific themes were held to build consensus. The workshop agendas and methods were modified based on participants’ feedback.ResultsThe ‘Commons’ was established with 43 participants, resulting in positive effects such as capacity building, opportunities for interactions, mutual understanding, and empathy among the participants. The difficulties faced by patients with rare diseases were classified into 10 categories. Seven research topics were identified as priority issues to be addressed including ‘impediments to daily life’, ‘financial burden’, ‘anxiety’, and ‘burden of hospital visits’. This was performed by synthesising the results of the application of the two criteria that were particularly important to strengthen future research on rare diseases. We also clarified high-priority research topics by using criteria valued more by patients and family members than by researchers and former policymakers, and criteria with specific perspectives.ConclusionWe generated evidence for policymaking in the field of rare diseases. This study’s insights into stakeholder involvement can enhance evidence-informed policymaking. We engaged in comprehensive discussions with policymakers regarding policy implementation and planned analysis of the participants’ experiences in this project.

‘What we lacked was the courage to take decisions that differed from the rest of the world’: expert perspectives on the role of evidence in COVID-19 policymaking in Iraq

IntroductionIraq reported its first COVID-19 case on 24 February 2020 and formed a national committee and advisory committees to support its response. While global experts have suggested that the COVID-19...

New trends in science communication fostering evidence-informed policymaking.

This article aims to assess novel trends in science communication relating to how policymakers in the field of innovation and digitalisation policy consume and use scientific findings. We investigate the mutual influence that science communication and policy have on each other and answer the question how emerging science communication trends in the science-policy nexus might influence the use of scientific findings in the policymaking process. By using Google and the largest scholarly repositories, Google Scholar, ResearchGate, and Academia.edu, from 1 st March to 31 st May 2020, we reviewed policy documents and academic literature containing relevant information on the evolution of characteristics of global, European, and national science communication activities and the interrelated policy responses to identify the most relevant current trends in the evidence-to-policy process alongside three key challenges; trust, translation, and timing. The three identified main trends are (1) a stronger engagement between science and policy, (2) more open, reliable, and accountable science communication practices with policymakers, and (3) the increasing digitalisation and visualisation of science communication. We deepened our investigation by conducting online semi-structured interviews with relevant policy stakeholders at the international and national level between 1 st May and 31 st July 2020. With the support of the European Commission and building on the existing network of partners, we identified decision-makers and advisors with relevant experience in fields related to innovation and digitalisation policy working in four countries that represent different levels of generalized social trust: Austria, Italy, Hungary, and the Netherlands, and at the international/European Union level. After an online consultation process with a global set of policymakers, these theoretical findings were translated to policy recommendations showcasing possible solutions in science communication that may be initiated, strengthened, or continued by policy stakeholders in order to reach a more effective and efficient uptake of scientific findings in evidence-informed policymaking.

3.B. Round table: Learning from the pandemic and implementing lessons learned: moving past the rhetoric

Abstract The COVID-19 pandemic put enormous pressure on our health systems, revealing how we were unprepared for such a global threat. We have gained many insights and learned valuable lessons about what went wrong and how we should prepare for the next pandemic. These lessons are set out in a series on national and international reports. Building Back Better is a concept at the core of many of these recommendations, arguing that we should make our health systems strong, sustainable and resilient. Although calls to learn from the past are commendable and a prerequisite for transparent and evidence-informed health policymaking, we run the risk of them becoming no more than good intentions and rhetoric. It is quite astounding to see how quickly we seem to have forgotten the profound impact of the pandemic on our societies. This does not only apply to citizens, but also to policymakers. There are many other complex and urgent policy problems that require attention - including climate change, migration, the war in Ukraine, and the cost-of-living crisis. It is therefore not difficult to imagine policymakers getting distracted by the immediate political pressures, paying less attention to - seemingly - less pressing issues that require a longer-term strategy, such as implementing the lessons learned from the COVID-19 pandemic. In addition, building back better may be a catchy phrase, but as with many things, it is easier said than done, as there are huge societal challenges that need to be overcome when we want to really strengthen our health systems. Think, for example, about shortages of health workers, which will only increase due to ageing populations. Or competing budgetary pressures, with healthcare only one of many policy areas in dire need of investment. All in all, we have seen the paramount importance of building back better, but there are many challenges in practice. This roundtable will focus on how we can make sure that these lessons learned from the pandemic are actually implemented in our public health and wider health systems. The panelists will represent different perspectives and reflect on: what does the evidence tell us and what is needed at the system-level, the policy-level, and the level of the public health professional? Workshop participants will gain an understanding of what it will take to move from mere buzzwords to action, creating more resilient health systems, a fit-for-purpose and flexible health workforce, and equal access to vaccines and medicines, and what the role of different stakeholders in this could and should be. Key messages • Although we have seen the paramount importance of building our health systems back better, there are many challenges in practice. • Public health leadership, a longer-term vision and an evidence-informed approach are indispensable for realizing strong and resilient health systems. Speakers/Panelists Martin McKee LSHTM, London, UK Natasha Azzopardi Muscat WHO, Copenhagen, Denmark Dineke Zeegers Paget EUPHA Ton Coenen GGD GHOR Nederland, Utrecht, Netherlands

Estimating the burden of Long COVID symptom clusters in Ireland

Abstract Background Long COVID is a multi-system illness with the potential for a substantial impact on society, from increased healthcare costs to economic and productivity losses. Long COVID is an umbrella term with no consensus on the definition. Long COVID burden estimations in Ireland are patchy and unavailable. We set out to estimate the burden of Long COVID symptom clusters (LCSCs) in Ireland from March 2020 to February 2022. Methods Data were obtained from the Health Protection and Surveillance Centre, Ireland. We modelled estimates of the proportion of individuals with Long COVID symptoms based on the Global Burden of Disease Long COVID Study framework. Years Lived with Disability (YLD) due to Long COVID symptom clusters were estimated by age and gender. Results An estimated 1.2 million symptomatic SAR-CoV-2 infection was reported in Ireland between March 2020 and February 2022. Overall, 6.3% of individuals who had symptomatic SARS-CoV-2 experienced LCSCs. About 13,657 individuals [females: 6,724 (95% UI: 2,444, 14,439); males: 6,933 (95% UI: 2,594, 14,515)] experienced LCSCs in the first year, and 58,983 in the second year of the pandemic [females: 30,511 (95% UI: 10,377, 69,087); males: 28,472 (95% UI: 9,779, 63,988). YLD attributable to Long COVID was 1,373 (95% UI: 363, 3878) and 4,687 (95% UI: 1,111, 14,575) in the first and second year of the pandemic, respectively. Females experienced a higher Long COVID burden (3,034 YLD) than males (3,026 YLD). Females aged 25-44 years had the highest burden of Long COVID (994 YLD). Long COVID contributed 81.2% (95% UI: 61.4%, 90.2%) of the total YLD [7,464 (95% UI: 2,399, 20,467)] due to COVID-19 within the period. Conclusions Long COVID estimates are crucially important for evidence-informed policymaking and developing a model of Long COVID care in Ireland. However, the full impact of Long COVID on population health and the healthcare system will be clearer once a core set of health outcomes is developed internationally. Key messages • Post-acute consequences of COVID-19 are the major contributor to the morbidity burden. • Long COVID estimates are crucially important for evidence-informed policymaking and developing a model of Long COVID care in Ireland.

An evidence-informed policymaking (EIPM) competency profile for the Brazilian Health System developed through consensus: process and outcomes

BackgroundEvidence-informed policymaking (EIPM) requires a set of individual and organizational knowledge, skills and attitudes that should be articulated with background factors and needs. In this regard, the development of an EIPM competency profile is important to support the diagnosis, planning and implementation of EIPM.PurposeTo present the process and outcomes of the development of an EIPM competency profile by an expert committee, to be applied in different contexts of the Brazilian Health System.MethodsA committee of experts in EIPM shared different views, experiences and opinions to develop an EIPM competency profile for Brazil. In six consensus workshops mediated by facilitators, the committee defined from macro problems to key actions and performances essential for the competency profile. The development steps consisted of: (1) Constitution of the committee, including researchers, professionals with practical experience, managers, and educators; (2) Development of a rapid review on EIPM competency profiles; (3) Agreement on commitments and responsibilities in the processes; (4) Identification and definition of macro problems relating to the scope of the competency profile; and (5) Outlining of general and specific capacities, to be incorporated into the competency profile, categorized by key actions.ResultsThe development of the EIPM competency profile was guided by the following macro problems: (1) lack of systematic and transparent decision-making processes in health policy management; (2) underdeveloped institutional capacity for knowledge management and translation; and (3) incipient use of scientific evidence in the formulation and implementation of health policies. A general framework of key actions and performances of the EIPM Competency Profile for Brazil was developed, including 42 specific and general key actions distributed by area of activity (Health Management, Scientific Research, Civil Society, Knowledge Translation, and Cross-sectional areas).ConclusionsThe competency profile presented in this article can be used in different contexts as a key tool for the institutionalization of EIPM.

Factors that influence evidence-informed meso-level regional primary health care planning: a qualitative examination and conceptual framework

BackgroundEvidence-informed primary health care (PHC) planning in decentralised, meso-level regional organisations has received little research attention. In this paper we examine the factors that influence planning within this environment, and present a conceptual framework.MethodsWe employed mixed methods: case studies of five Australian Primary Health Networks (PHNs), involving 29 primary interviews and secondary analysis of 38 prior interviews; and analysis of planning documents from all 31 PHNs. The analysis was informed by a WHO framework of evidence-informed policy-making, and institutional theory.ResultsInfluential actors included federal and state/territory governments, Local Health Networks, Aboriginal Community Controlled Health Organisations, local councils, public hospitals, community health services, and providers of allied health, mental health and aged care services. The federal government was most influential, constraining PHNs’ planning scope, time and funding. Other external factors included: the health service landscape; local socio-demographic and geographic characteristics; (neoliberal) ideology; interests and politics; national policy settings and reforms; and system reorganisation. Internal factors included: organisational structure; culture, values and ideology; various capacity factors; planning processes; transition history; and experience. The additional regional layer of context adds to the complexity of planning.ConclusionsLike national health policy-making, meso-level PHC planning occurs in a complex environment, but with additional regional factors and influences. We have developed a conceptual framework of the meso-level PHC planning environment, which can be employed by similar regional organisations to elucidate influential factors, and develop strategies and tools to promote transparent, evidence-informed PHC planning for better health outcomes.

New governance of the digital health agency: a way out of the joint decision trap to implement electronic health records in Germany?

Fragmentation in health systems leads to discontinuities in the provision of health services, reduces the effectiveness of interventions, and increases costs. In international comparisons, Germany is notably lagging in the context of healthcare (data) integration. Despite various political efforts spanning decades, intersectoral care and integrated health data remain controversial and are still in an embryonic phase in the country. Even more than 2 years after its launch, electronic health record (elektronische Patientenakte; ePA) users in Germany constitute only 1 per cent of the statutorily insured population, and ongoing political debates suggest that the path to broader coverage is fraught with complexities. By exploring the main stakeholders in the existing (fragmented) health system governance in Germany and their sectoral interests, this paper examines the implementation of ePA through the lens of corporatism, offering insights based on an institutional decision theory. The central point is that endeavours to better integrate health data for clinical care, scientific research and evidence-informed policymaking in Germany will need to address the roles of corporatism and self-governance.

Challenges and Prospects for Evidence-Informed Policy in Criminology

The relevance of criminology to matters of public policy has been hotly debated throughout the history of the discipline. Yet time and again, we have borne witness to the consequences of harmful criminal justice practices that do little to reduce crime or improve the lives of our most vulnerable populations. Given the urgent need for evidence-informed responses to the problems that face our society, we argue here that criminologists can and should have a voice in the process. Accordingly, this review describes challenges and prospects for evidence-informed policymaking on matters of crime and justice. In terms of challenges, we review discourse on what constitutes evidence, issues with providing guidance under conditions of causal uncertainty, and practical constraints on evidence-informed policymaking. For prospects, we consider the important roles of institutional support, graduate training, and multiple translational strategies for the evidence-informed movement. Finally, we end with several considerations for advancing translational criminology through expanded promotion and tenure criteria, curricula revision, and prioritizing the organization of knowledge. More broadly, our goals are to stimulate disciplinary thinking regarding the ways in which criminology may play a more meaningful role in effectively confronting the ongoing challenges of crime in society.

Research-policy engagement activities and research impact: nursing and health science researcher perspectives

Background: Strategies to help researchers use the research evidence they (co)produce to inform policy should be tailored to the context. Yet there is little guidance on research-policy engagement activities in nursing and health sciences disciplines. Aims and objectives: We explored the experiences and perspectives of nursing and health sciences researchers at different career stages, regarding research-policy engagement activities and their impacts on policy. We also explored researchers’ understanding of terminology and theory regarding research-policy engagement. Methods: We conducted semi-structured qualitative interviews with 17 researchers, at various career stages, and conducted content and thematic analysis of the data. Findings: ‘Disseminating and communicating research’, and ‘building professional partnerships’ were the most common types of activity, with senior researchers favouring the latter. Early and mid-career researchers favoured the former, citing the need to build credibility and track record before engaging with policy actors. We identified individual and contextual factors that influence policy impact and researchers’ capacity to engage in such activities. Researchers’ conceptions and understanding regarding evidence-informed policymaking theory and process varied. Terminology also varied, with ‘knowledge translation’ the most common term. Discussion and conclusions: Despite evidence indicating the limited effectiveness of dissemination activities on policy, researchers pursue such efforts, to enable the formation of relationships with influential policy actors and policy impact in the longer term, and because of academia’s drive for research outputs. Researchers would benefit from supportive organisational contexts and greater knowledge of research-policy engagement theory, evidence and practice, through tailored workshops addressing relational and political considerations, as well as structured mentoring.

Institutionalizing evidence-informed policy-making in the postpandemic era.

Institutionalizing evidence-informed policy-making in the postpandemic era.

Information literacy and its link to evidence-informed policymaking in Zimbabwe

This paper explored the link between information literacy (IL) and other factors that enable or inhibit the utilisation of research evidence in policymaking in Zimbabwe. The study assumes that if policymakers possess appropriate IL skills to access, assess, synthesise, and apply research evidence, they will naturally use the evidence to inform their policy decisions. Face-to-face interviews with 26 policymakers — technocrats selected from the Parliament of Zimbabwe and two ministries, Industry and Commerce, and Youth, Sport, and Recreation — produced evidence to inform the findings and conclusions. Data synthesis using thematic content analysis confirmed the findings. The results show that while IL skills are critical in enabling policymakers' use of research evidence, multiple other factors also influence the use of research evidence in policymaking due to the complexity of the process. The political and socioeconomic context plays a profound role because of the intricate and nonlinear nature of the policymaking process. Therefore, enhancing evidence use in policymaking revolves around strengthening IL skills at the individual level, including institutional and the broader policy ecosystem, by acknowledging and leveraging personal and institutional relationships. This insight illuminates the need to reorient IL programmes to link them to these other factors.

Palliative care delivery models: a systematic scoping review protocol.

This scoping review will map out the evidence for palliative care delivery models in hospitals and the challenges of their application in practice from 2012 to 2022. A list of the predetermined MeSH terms will be used to search electronic databases for the relevant literature in English or Persian. The Joanna Briggs Institute Reviewer's guideline will be used to qualitatively appraise the identified reports and to assess their scientific rigour. Information about the introduced models will be summarised in extraction sheets and a narrative synthesis of the retrieved data will be performed and tabulated for benchmarking analysis. The findings will be applicable for evidence-informed policy-making in health systems and in response to palliative care unmet needs. The study results could also be accommodated in decision-making processes for the adoption of an integrated PalC model to achieve enhanced organisational performance in clinical settings.

Evidence synthesis to policy: development and implementation of an impact-oriented approach from the Eastern Mediterranean Region

BackgroundDespite the importance of evidence syntheses in informing policymaking, their production and use remain limited in the Eastern Mediterranean region (EMR). There is a lack of empirical research on approaches to promote and use policy-relevant evidence syntheses to inform policymaking processes in the EMR.ObjectiveThis study sought to describe the development of an impact-oriented approach to link evidence synthesis to policy, and its implementation through selected case studies in Lebanon, a middle-income country in the EMR.MethodsThis study followed a multifaceted and iterative process that included (i) a review of the literature, (ii) input from international experts in evidence synthesis and evidence-informed health policymaking, and (iii) application in a real-world setting (implementation). We describe four selected case studies of implementation. Surveys were used to assess policy briefs, deliberative dialogues, and post-dialogue activities. Additionally, Kingdon’s stream theory was adopted to further explain how and why the selected policy issues rose to the decision agenda.ResultsThe approach incorporates three interrelated phases: (1) priority setting, (2) evidence synthesis, and (3) uptake. Policy-relevant priorities are generated through formal priority setting exercises, direct requests by policymakers and stakeholders, or a focusing event. Identified priorities are translated into focused questions that can be addressed via evidence synthesis (phase 1). Next, a scoping of the literature is conducted to identify existing evidence syntheses addressing the question of interest. Unless the team identifies relevant, up-to-date and high-quality evidence syntheses, it proceeds to conducting SRs addressing the priority questions of interest (phase 2). Next, the team prepares knowledge translation products (e.g., policy briefs) for undertaking knowledge uptake activities, followed by monitoring and evaluation (phase 3). There are two prerequisites to the application of the approach: enhancing contextual awareness and capacity strengthening. The four case studies illustrate how evidence produced from the suites of activities was used to inform health policies and practices.ConclusionsTo our knowledge, this is the first study to describe both the development and implementation of an approach to link evidence synthesis to policy in the EMR. We believe the approach will be useful for researchers, knowledge translation platforms, governments, and funders seeking to promote evidence-informed policymaking and practice.

Evidence Informed Policy Making: A Conceptual Analysis

Traditional way of policymaking process –top-down approach- is thought to be less effective as this hardly consults with the pertinent stakeholders who are the mainly implementers and beneficiaries. In order to address the shortcomings of that approach, policy scientists advocate undertaking such policies, which are based on data, value-driven and people-centric. This process is called evidence-informed policy making (EIPM). This study analyzes EIPM process how effectively it works and why it brings benefits to the citizen. It is found that because of scientific procedure, bottom-up approach, consultation and involvement of diverse stakeholders, research-driven data, the EIPM yields positive results. Any public policy taken following the EIPM process is found environmentally fit, administratively workable, politically and socially acceptable, and economically and financially viable.

Institutional roles, structures, funding and research partnerships towards evidence-informed policy-making: a multisector survey among policy-makers in Nigeria

BackgroundEvidence-informed policy-making aims to ensure that the best and most relevant evidence is systematically generated and used for policy-making. The aim of this study was to assess institutional structures, funding, policy-maker perspectives on researcher–policy-maker interactions and the use of research evidence in policy-making in five states in Nigeria.MethodsThis was a cross-sectional study carried out among 209 participants from two geopolitical zones in Nigeria. Study participants included programme officers/secretaries, managers/department/facility heads and state coordinators/directors/presidents/chairpersons in various ministries and the National Assembly. A pretested semi-structured self-administered questionnaire on a five-point Likert scale was used to collect information on institutional structures for policy and policy-making in participants’ organizations, the use of research evidence in policy and policy-making processes, and the status of funding for policy-relevant research in the participants’ organizations. Data were analysed using IBM SPSS version 20 software.ResultsThe majority of the respondents were older than 45 years (73.2%), were male (63.2) and had spent 5 years or less (74.6%) in their present position. The majority of the respondents’ organizations had a policy in place on research involving all key stakeholders (63.6%), integration of stakeholders’ views within the policy on research (58.9%) and a forum to coordinate the setting of research priorities (61.2%). A high mean score of 3.26 was found for the use of routine data generated from within the participants’ organizations. Funding for policy-relevant research was captured in the budget (mean = 3.47) but was inadequate (mean = 2.53) and mostly donor-driven (mean = 3.64). Funding approval and release/access processes were also reported to be cumbersome, with mean scores of 3.74 and 3.89, respectively. The results showed that capacity existed among career policy-makers and the Department of Planning, Research and Statistics to advocate for internal funds (mean = 3.55) and to attract external funds such as grants (3.76) for policy-relevant research. Interaction as part of the priority-setting process (mean = 3.01) was the most highly rated form of policy-maker–researcher interaction, while long-term partnerships with researchers (mean = 2.61) had the lower mean score. The agreement that involving policy-makers in the planning and execution of programmes could enhance the evidence-to-policy process had the highest score (mean = 4.40).ConclusionThe study revealed that although institutional structures such as institutional policies, fora and stakeholder engagement existed in the organizations studied, there was suboptimal use of evidence obtained from research initiated by both internal and external researchers. Organizations surveyed had budget lines for research, but this funding was depicted as inadequate. There was suboptimal actual participation of policy-makers in the co-creation, production and dissemination of evidence. The implementation of contextually relevant and sustained mutual institutional policy-maker–researcher engagement approaches is needed to promote evidence-informed policy-making. Thus there is a need for institutional prioritization and commitment to research evidence generation.

A landscape assessment of the activities and capacities of evidence-to-policy intermediaries (EPI) in behavioral health

BackgroundA significant gap exists between the production of research evidence and its use in behavioral health policymaking. Organizations providing consulting and support activities for improving policy represent a promising source for strengthening the infrastructure to address this gap. Understanding the characteristics and activities of these evidence-to-policy intermediary (EPI) organizations can inform the development of capacity-building activities, leading to strengthened evidence-to-policy infrastructure and more widespread evidence-based policymaking.MethodsOnline surveys were sent to 51 organizations from English-speaking countries involved in evidence-to-policy activities in behavioral health. The survey was grounded in a rapid evidence review of the academic literature regarding strategies used to influence research use in policymaking. The review identified 17 strategies, which were classified into four activity categories. We administered the surveys via Qualtrics and calculated the descriptive statistics, scales, and internal consistency statistics using R.ResultsA total of 31 individuals completed the surveys from 27 organizations (53% response rate) in four English-speaking countries. EPIs were evenly split between university (49%) and non-university (51%) settings. Nearly all EPIs conducted direct program support (mean = 4.19/5 [sd = 1.25]) and knowledge-building (4.03 [1.17]) activities. However, engagement with traditionally marginalized and non-traditional partners (2.84 [1.39]) and development of evidence reviews using formal critical appraisal methods (2.81 [1.70]) were uncommon. EPIs tend to be specialized, focusing on a group of highly related strategies rather than incorporating multiple evidence-to-policy strategies in their portfolios. Inter-item consistency was moderate to high, with scale α’s ranging from 0.67 to 0.85. Ratings of respondents’ willingness to pay for training in one of three evidence dissemination strategies revealed high interest in program and policy design.ConclusionsOur results suggest that evidence-to-policy strategies are frequently used by existing EPIs; however, organizations tend to specialize rather than engage in a breadth of strategies. Furthermore, few organizations reported consistently engaging with non-traditional or community partners. Focusing on building capacity for a network of new and existing EPIs could be a promising strategy for growing the infrastructure needed for evidence-informed behavioral health policymaking.