Research Evidence In Decision Research Articles

Health research evidence: its current usage in health planning, determinants and readiness to use knowledge translation tools among health planning teams in Tanzania—an exploratory mixed-methods study protocol

IntroductionAchieving universal health coverage requires using research evidence to inform decision-making. However, little information is available on the use of research evidence in planning in lower middle-income countries, including Tanzania....

Influence of research evidence on the use of cardiovascular clinical prediction rules in primary care: an exploratory qualitative interview study

BackgroundCardiovascular clinical prediction rules (CPRs) are widely used in primary care. They accumulate research evidence through derivation, external validation, and impact studies. However, existing knowledge about the influence of research evidence on the use of CPRs is limited. Therefore, we explored how primary care clinicians’ perceptions of and experiences with research influence their use of cardiovascular CPRs.MethodsWe conducted an exploratory qualitative interview study with thematic analysis. Primary care clinicians were recruited from the WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice and Research Network (WPRN). We used purposeful sampling to ensure maximum variation within the participant group. Data were collected by conducting semi-structured online interviews. We analyzed data using inductive thematic analysis to identify commonalities and differences within themes.ResultsOf 29 primary care clinicians who completed the questionnaire, 15 participated in the interview. We identified two main themes relating to the influence of clinicians’ perceptions of and experiences with cardiovascular CPR research on their decisions about using cardiovascular CPRs: “Seek and judge” and “be acquainted and assume.” When clinicians are familiar with, trust, and feel confident in using research evidence, they might actively search and assess the evidence, which may then influence their decisions about using cardiovascular CPRs. However, clinicians, who are unfamiliar with, distrust, or find it challenging to use research evidence, might be passively acquainted with evidence but do not make their own judgment on the trustworthiness of such evidence. Therefore, these clinicians might not rely on research evidence when making decisions about using cardiovascular CPRs.ConclusionsClinicians’ perceptions and experiences could influence how they use research evidence in decisions about using cardiovascular CPRs. This implies, when promoting evidence-based decisions, it might be useful to target clinicians’ unfamiliarity, distrust, and challenges regarding the use of research evidence rather than focusing only on their knowledge and skills. Further, because clinicians often rely on evidence-unrelated factors, guideline developers and policymakers should recommend cardiovascular CPRs supported by high-quality evidence.

A comprehensive presentation of Iran's human resources for health information systems: A mixed-method case study

ObjectivesThis study is designed to evaluate the characteristics of the Human Resources for Health Information Systems (HRHISs) of Iran. It also explores the challenges of HRHISs that need to be addressed to plan a national health workforce strategy. MethodsThis mixed-method study was carried out through observational research, and semi-structured interviews with key informants in health policy, information technology and HRH management. It was conducted over two months from May to July 2019. The WHO-HRHIS assessment tool was used during the observational phase. We purposively selected representatives from different organizations and departments involved in managing the HRHIS. In the qualitative phase, purposeful and snowball sampling methods were used, and 20 interviews were conducted that each lasted minimum of 45 minutes. A content analysis was used to discuss findings. ResultsHuman Resources (HR) departments are fully equipped with information communication technology (ICT). There were 30 different HRH databases with varying HRH data elements ranging from 10 to 115 HRH data elements. Sixty-three percent of the databases were directly captured data online and daily (78%). Most organizations had no feedback mechanism for cross-checking the HRH data; only 28 % of the databases were accurate and trustworthy. Data analysis was not a regular input in the decision-making process. Data reporting and information dissemination were not provided regularly. We categorized HRHISs weaknesses into the following themes: managerial, technical, infrastructural, and systemic barriers. The categories included unintegrated governance, miscommunication between the MoHME and other organizations, organizational factors, inaccuracy in HRH data, wide disparities of HRH information in databases, infrastructural weaknesses, inadequate competent staff, and non-use of research evidence in decision making. ConclusionsThe overall HRHIS assessment demonstrated an unintegrated computerized system with various data elements generated through multiple databases in different sectors. It has not fully covered the HRH data in all parts of health sectors, particularly the private sector. This study illustrates that the current HRIS used in the country have several major challenges. We suggest planning on the identified barriers of HRHISs so that the gaps are better tackled to implement the "Global Strategy on Human Resources for Health: Workforce 2030".

An Application of the Social-ecological Systems Framework to Promoting Evidence-informed Policy and Practice

ABSTRACT Education policy continues to press for increased use of research evidence in decision-making, yet decades of research point to weak links between research and practice. We see evidence-informed improvement not as a problem with schools, but with a larger evidence-use ecosystem. As a step toward building and strengthening multidirectional paths between research, practice, and policy, we explore three overlapping research contexts: production, practice, and mediation. Despite the importance of each of these contexts in evidence-infor5med policy and practice, they are rarely considered together. In this paper, we seek to understand the social-ecological systems in which these contexts are situated and to identify problematic disconnects and promising similarities. This study draws on case studies of research production in institutions of higher education, knowledge mobilization by an intermediary organization, and school-based decision-making. We use Elinor Ostrom’s Social-ecological Systems Framework as a lens on each case, attending to resource systems, resource units, governance systems, actors, and the interactions that coordinate and align those systems to achieve positive outcomes. We then look across cases to identify barriers and opportunities to restructure and reorganize the evidence-use ecosystem in order to redesign and strengthen research-practice infrastructure and more effectively promote evidence-informed policy and practice.

Single Conversations Expand Practitioners’ Use of Research: Evidence from a Field Experiment

ABSTRACTMany people seek to increase practitioners’ use of research evidence in decision making. Two common strategies are dissemination and interaction. Dissemination can reach a wide audience at once, yet interactive strategies can be beneficial because they entail back-and-forth conversations to clarify how research evidence applies in a particular context. To date, however, we lack much direct evidence of the impact of interaction beyond dissemination. Partnering with an international sustainability-oriented NGO, I conducted a field experiment to test the impact of an interactive strategy (i.e., a single conversation) on practitioners’ use of research evidence in a pending decision. I find that the conversation had a substantial impact on research use relative to only receiving disseminated materials, which likely was due to increased self-efficacy. I also provide practical guidance on how researchers can apply this finding close to home by strengthening linkages with local decision makers.

Effectiveness of Technology-Enabled Knowledge Translation Strategies in Improving the Use of Research in Public Health: Systematic Review.

BackgroundKnowledge translation (KT) aims to facilitate the use of research evidence in decision making. Changes in technology have provided considerable opportunities for KT strategies to improve access and use of evidence in decision making by public health policy makers and practitioners. Despite this opportunity, there have been no reviews that have assessed the effects of digital technology-enabled KT (TEKT) in the field of public health.ObjectiveThis study aims to examine the effectiveness of digital TEKT strategies in (1) improving the capacity for evidence-based decision making by public health policy makers and practitioners, (2) changing public health policy or practice, and (3) changes in individual or population health outcomes.MethodsA search strategy was developed to identify randomized trials assessing the effectiveness of digital TEKT strategies in public health. Any primary research study with a randomized trial design was eligible. Searches for eligible studies were undertaken in multiple electronic bibliographic databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], Excerpta Medica dataBASE [EMBASE], PsycINFO, Cumulative Index to Nursing and Allied Health Literature [CINAHL], and Scopus) and the reference lists of included studies. A hand search of 2 journals (Implementation Science and Journal of Medical Internet Research) and a gray literature search were also conducted. Pairs of independent review authors screened studies, assessed the risk of bias, and extracted data from relevant studies.ResultsOf the 6819 citations screened, 8 eligible randomized trials were included in the review. The studies examined the impact of digital TEKT strategies on health professionals, including nurses, child care health consultants, physiotherapists, primary health care workers, and public health practitioners. Overall, 5 of the interventions were web-training programs. The remaining 3 interventions included simulation games, access to digital resource materials and the use of tailored messaging, and a web-based registry. The findings suggest that digital TEKT interventions may be effective in improving the knowledge of public health professionals, relative to control, and may be as effective as a face-to-face KT approach. The effectiveness of digital TEKT strategies relative to a control or other digital KT interventions on measures of health professional self-efficacy to use evidence to enhance practice behavior or behavioral intention outcomes was mixed. The evidence regarding the effects on changes to health policy or practice following exposure to digital TEKT was mixed. No trials assessed the effects on individual or population-level health outcomes.ConclusionsThis review is the first to synthesize the effectiveness of digital TEKT interventions in a public health setting. Despite its potential, relatively few trials have been undertaken to investigate the impacts of digital TEKT interventions. The findings suggest that although a digital TEKT intervention may improve knowledge, the effects of such interventions on other outcomes are equivocal.

Use of Research Evidence in Policy and Decision-Making: Views, Attitudes and Practices of Health Policy Makers in Lusaka Province of Zambia

Background: The integration of relevant high-quality research evidence into the health decision and policy formulation process is a key strategy for improving health systems especially in developing countries such as Zambia. However, the lack of capacity to understand and value research evidence by policy and decision makers makes it difficult for them to find and use research evidence in a timely manner even when motivated to do so. This study aimed to establish the views, attitudes and practices of policy makers on the use of research evidence in policy and decision-making process in Zambia. Methodology: This descriptive cross-sectional study was conducted in Lusaka, Zambia among selected public health decision and policy making institutions. A purposive sample of 21 consenting policy makers who were working in different positions in the Ministry of Health Headquarters, Provincial and District Health Offices, Health Professions Regulatory Bodies, United Nations Agencies, International Non-Governmental Organizations and University Deans from the University of Zambia participated in the study. A self-administered questionnaire was used to collect data. The IBM? SPSS? Statistics for Windows Version 20.0 was used for data analysis. Results: The concept of Evidence Informed Health Policy was not well understood such that only less than half (47.5%) of the participants reported having heard specifically about Evidence Informed Health Policy meanwhile almost two thirds (61.9%) reported that they used research evidence in decision making and policy formulation. Similar discrepancy was expressed in the understanding of and use of rapid response mechanisms such that although (47.6%) of the participants reported having heard about it, (57%) had never used rapid response mechanisms for deci-sion-making. With regard to the sources of information, about half (52.3) of the participants reported scholarly articles as their main source of evidence. Con-clusion and Recommendations: There is need for more sensitization and ca-pacity building among the decision and policy makers on the importance of using research evidence in decision and policy making process as incorporation of relevant high-quality research evidence into the health policy making pro-cess is a key strategy for improving health systems.

About Testing, Tracking, and School Choice with Professor Adam Gamoran

Professor Adam Gamoran is the president of the William T. Grant Foundation (http://wtgrantfoundation.org/whoweare). He came to the Foundation from the University of Wisconsin-Madison, where he held the John D. MacArthur Chair in Sociology and Educational Policy Studies. In a research career spanning three decades, Adam conducted a wide range of studies focusing on inequality in education and school reform. Among his major works were a series of studies on tracking and ability grouping that identified consequences for student achievement and revealed the mechanisms through which those consequences occurred. Subsequent studies examined interventions to improve performance and reduce learning gaps, assessed through large-scale cluster-randomized trials. He was a Fulbright Scholar in the United Kingdom. He is an elected member of the National Academy of Education and the American Academy of Arts and Sciences, and was twice appointed by President Obama to serve on the National Board for Education Sciences. As president of the William T. Grant Foundation, Professor Gamoran has prioritized supporting research to deepen our understanding of the programs, policies, and practices that reduce inequality in youth outcomes, and to understand and improve the use of research evidence in decisions that affect young people. In 2013, Professor Gamoran received the Spencer Foundation Award for contributions to research on education policy from the Association for Public Policy and Management, and in 2014 he was honored with the award for Distinguished Contributions to Research in Education from the American Educational Research Association. In May 2015, he was a key-note speaker at the conference “School tracking: diverse mechanisms, effects and policy responses” that took place at the Faculty of Education, Charles University in Prague. His presence in Prague was a valuable opportunity to discuss approaches to tracking, school choice and educational policy in general and ask him many questions from the perspective of a small educational researchers’ community in Central Europe with its limited research funding and rather heated debate about equity and tracking. Nevertheless, we believe that Professor Adam Gamoran’s deep insight might be an eye-opening experience and an inspiring reading also for many other readers of our journal. (The second part of the interview about the research-policy relationships and research funding in the United States will be published in some of the next issues of our journal.) The questions were asked by David Greger (DG) and Jaroslava Simonova (JS).

Assessing the capacity of ministries of health to use research in decision-making: conceptual framework and tool

BackgroundThe capacity to demand and use research is critical for governments if they are to develop policies that are informed by evidence. Existing tools designed to assess how government officials use evidence in decision-making have significant limitations for low- and middle-income countries (LMICs); they are rarely tested in LMICs and focus only on individual capacity. This paper introduces an instrument that was developed to assess Ministry of Health (MoH) capacity to demand and use research evidence for decision-making, which was tested for reliability and validity in eight LMICs (Bangladesh, Fiji, India, Lebanon, Moldova, Pakistan, South Africa, Zambia).MethodsInstrument development was based on a new conceptual framework that addresses individual, organisational and systems capacities, and items were drawn from existing instruments and a literature review. After initial item development and pre-testing to address face validity and item phrasing, the instrument was reduced to 54 items for further validation and item reduction. In-country study teams interviewed a systematic sample of 203 MoH officials. Exploratory factor analysis was used in addition to standard reliability and validity measures to further assess the items.ResultsThirty items divided between two factors representing organisational and individual capacity constructs were identified. South Africa and Zambia demonstrated the highest level of organisational capacity to use research, whereas Pakistan and Bangladesh were the lowest two. In contrast, individual capacity was highest in Pakistan, followed by South Africa, whereas Bangladesh and Lebanon were the lowest.ConclusionThe framework and related instrument represent a new opportunity for MoHs to identify ways to understand and improve capacities to incorporate research evidence in decision-making, as well as to provide a basis for tracking change.

Occupational safety and health knowledge users’ perspectives about research use

Using research evidence in decision-making requires skill, time and resources. Our objective was to examine experiences and perspectives related to research use among occupational safety and health...

115: STRATEGIES OF INTEGRATION OF EVIDENCE-BASED PRACTICE IN THE CLINICAL SETTINGS

Background and aims:The pace of change in the delivery of health care along with professional responsibilities of clinical staff to provide high quality services, wants to the necessity of incorporating...

Effects of a demand-led evidence briefing service on the uptake and use of research evidence by commissioners of health services: a controlled before-and-after study

BackgroundThe Health and Social Care Act 2012 (Great Britain.Health and Social Care Act 2012. London: The Stationery Office; 2012) has mandated research use as a core consideration of health service commissioning arrangements. We evaluated whether or not access to a demand-led evidence briefing service improved the use of research evidence by commissioners, compared with less intensive and less targeted alternatives.DesignControlled before-and-after study.SettingClinical Commissioning Groups (CCGs) in the north of England.Main outcome measuresChange at 12 months from baseline of a CCG’s ability to acquire, assess, adapt and apply research evidence to support decision-making. Secondary outcomes measured individual clinical leads’ and managers’ intentions to use research evidence in decision-making.MethodsNine CCGs received one of three interventions: (1) access to an evidence briefing service; (2) contact plus an unsolicited push of non-tailored evidence; or (3) an unsolicited push of non-tailored evidence. Data for the primary outcome measure were collected at baseline and 12 months post intervention, using a survey instrument devised to assess an organisation’s ability to acquire, assess, adapt and apply research evidence to support decision-making. In addition, documentary and observational evidence of the use of the outputs of the service was sought and interviews with CCG participants were undertaken.ResultsMost of the requests were conceptual; they were not directly linked to discrete decisions or actions but were intended to provide knowledge about possible options for future actions. Symbolic use to justify existing decisions and actions were less frequent and included a decision to close a walk-in centre and to lend weight to a major initiative to promote self-care already under way. The opportunity to impact directly on decision-making processes was limited to work to establish disinvestment policies. In terms of impact overall, the evidence briefing service was not associated with increases in CCGs’ capacity to acquire, assess, adapt and apply research evidence to support decision-making, individual intentions to use research findings or perceptions of CCGs’ relationships with researchers. Regardless of the intervention received, at baseline participating CCGs indicated that they felt that they were inconsistent in their research-seeking behaviours and their capacity to acquire research remained so at follow-up. The informal nature of decision-making processes meant that there was little or no traceability of the use of evidence.LimitationsLow baseline and follow-up response rates (of 68% and 44%, respectively) and missing data limit the reliability of these findings.ConclusionsAccess to a demand-led evidence briefing service did not improve the uptake and use of research evidence by NHS commissioners compared with less intensive and less targeted alternatives. Commissioners appear to be well intentioned but ad hoc users of research.Future workFurther research is required on the effects of interventions and strategies to build individual and organisational capacity to use research. Resource-intensive approaches to providing evidence may best be employed to support instrumental decision-making. Comparative evaluation of the impact of less intensive but targeted strategies on the uptake and use of research by commissioners is warranted.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

What are the best methodologies for rapid reviews of the research evidence for evidence-informed decision making in health policy and practice: a rapid review.

BackgroundRapid reviews have the potential to overcome a key barrier to the use of research evidence in decision making, namely that of the lack of timely and relevant research. This rapid review of systematic reviews and primary studies sought to answer the question: What are the best methodologies to enable a rapid review of research evidence for evidence-informed decision making in health policy and practice?MethodsThis rapid review utilised systematic review methods and was conducted according to a pre-defined protocol including clear inclusion criteria (PROSPERO registration: CRD42015015998). A comprehensive search strategy was used, including published and grey literature, written in English, French, Portuguese or Spanish, from 2004 onwards. Eleven databases and two websites were searched. Two review authors independently applied the eligibility criteria. Data extraction was done by one reviewer and checked by a second. The methodological quality of included studies was assessed independently by two reviewers. A narrative summary of the results is presented.ResultsFive systematic reviews and one randomised controlled trial (RCT) that investigated methodologies for rapid reviews met the inclusion criteria. None of the systematic reviews were of sufficient quality to allow firm conclusions to be made. Thus, the findings need to be treated with caution. There is no agreed definition of rapid reviews in the literature and no agreed methodology for conducting rapid reviews. While a wide range of ‘shortcuts’ are used to make rapid reviews faster than a full systematic review, the included studies found little empirical evidence of their impact on the conclusions of either rapid or systematic reviews. There is some evidence from the included RCT (that had a low risk of bias) that rapid reviews may improve clarity and accessibility of research evidence for decision makers.ConclusionsGreater care needs to be taken in improving the transparency of the methods used in rapid review products. There is no evidence available to suggest that rapid reviews should not be done or that they are misleading in any way. We offer an improved definition of rapid reviews to guide future research as well as clearer guidance for policy and practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s12961-016-0155-7) contains supplementary material, which is available to authorized users.

Research evidence and policy: qualitative study in selected provinces in South Africa and Cameroon.

BackgroundThe translation of research into policy and practice is enhanced by policymakers who can recognise and articulate their information needs and researchers that understand the policymakers’ environment. As researchers, we sought to understand the policymaking process and how research evidence may contribute in South Africa and Cameroon.MethodsWe conducted qualitative in-depth interviews in South Africa and focus group discussions in Cameroon with purposively sampled subnational (provincial and regional) government health programme managers. Audio recorded interviews were transcribed, thematically coded and analysed.ResultsParticipants in both countries described the complex, often lengthy nature of policymaking processes, which often include back-and-forth consultations with many diverse stakeholder groups. These processes may be influenced by political structures, relationships between national and subnational levels, funding and international stakeholder agendas. Research is not a main driver of policy, but rather current contextual realities, costs, logistics and people (clinicians, NGOs, funders) influence the policy, and research plays a part. Research evidence is frequently perceived as unavailable, inaccessible, ill-timed or not applicable. The reliability of research on the internet was questioned. Evidence-informed health decision-making (EIDM) is regarded as necessary in South Africa but is less well understood in Cameroon. Insufficient time and capacity were hindrances to EIDM in both countries. Good relationships between researchers and policymakers may facilitate EIDM. Researchers should have a good understanding of the policymaking environment if they want to influence it. Greater interaction between policymakers and researchers is perceived as beneficial when formulating research and policy questions as it raises researchers’ awareness of implementation challenges and enables the design of tailored and focused strategies to respond to policymakers’ needs.ConclusionsPolicymaking is complicated, lengthy and mostly done at national level. Provinces/regions are tasked with implementation, with more room for adaptation in South Africa than in Cameroon. Research evidence plays a role in policy but does not drive it and is seen as mostly unavailable. Researchers need a thorough understanding of the policy process and environment, how the health system operates, as well as the priorities of policymakers. This can inform effective dialogue between researchers and policymakers, and contribute to enhancing use of research evidence in decision-making.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-015-0315-0) contains supplementary material, which is available to authorized users.

Effects of a demand-led evidence briefing service on the uptake and use of research evidence by commissioners of health services: protocol for a controlled before and after study.

BackgroundClinical Commissioning Groups (CCGs) are mandated to use research evidence effectively to ensure optimum use of resources by the National Health Service (NHS), both in accelerating innovation and in stopping the use of less effective practices and models of service delivery. We intend to evaluate whether access to a demand-led evidence service improves uptake and use of research evidence by NHS commissioners compared with less intensive and less targeted alternatives.Methods/designThis is a controlled before and after study involving CCGs in the North of England. Participating CCGs will receive one of three interventions to support the use of research evidence in their decision-making: 1) consulting plus responsive push of tailored evidence; 2) consulting plus an unsolicited push of non-tailored evidence; or 3) standard service unsolicited push of non-tailored evidence. Our primary outcome will be changed at 12 months from baseline of a CCGs ability to acquire, assess, adapt and apply research evidence to support decision-making. Secondary outcomes will measure individual clinical leads and managers’ intentions to use research evidence in decision making. Documentary evidence of the use of the outputs of the service will be sought. A process evaluation will evaluate the nature and success of the interactions both within the sites and between commissioners and researchers delivering the service.DiscussionThe proposed research will generate new knowledge of direct relevance and value to the NHS. The findings will help to clarify which elements of the service are of value in promoting the use of research evidence. Those involved in NHS commissioning will be able to use the results to inform how best to build the infrastructure they need to acquire, assess, adapt and apply research evidence to support decision-making and to fulfil their statutory duties under the Health and Social Care Act.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-014-0199-4) contains supplementary material, which is available to authorized users.

A cross-sectional survey of supports for evidence-informed decision-making in healthcare organisations: a research protocol.

BackgroundThis protocol builds on the development of a) a framework that identified the various supports (i.e. positions, activities, interventions) that a healthcare organisation or health system can implement for evidence-informed decision-making (EIDM) and b) a qualitative study that showed the current mix of supports that some Canadian healthcare organisations have in place and the ones that are perceived to facilitate the use of research evidence in decision-making. Based on these findings, we developed a web survey to collect cross-sectional data about the specific supports that regional health authorities and hospitals in two Canadian provinces (Ontario and Quebec) have in place to facilitate EIDM.Methods/designThis paper describes the methods for a cross-sectional web survey among 32 regional health authorities and 253 hospitals in the provinces of Quebec and Ontario (Canada) to collect data on the current mix of organisational supports that these organisations have in place to facilitate evidence-informed decision-making. The data will be obtained through a two-step survey design: a 10-min survey among CEOs to identify key units and individuals in regard to our objectives (step 1) and a 20-min survey among managers of the key units identified in step 1 to collect information about the activities performed by their unit regarding the acquisition, assessment, adaptation and/or dissemination of research evidence in decision-making (step 2). The study will target three types of informants: CEOs, library/documentation centre managers and all other key managers whose unit is involved in the acquisition, assessment, adaptation/packaging and/or dissemination of research evidence in decision-making. We developed an innovative data collection system to increase the likelihood that only the best-informed respondent available answers each survey question. The reporting of the results will be done using descriptive statistics of supports by organisation type and by province.DiscussionThis study will be the first to collect and report large-scale cross-sectional data on the current mix of supports health system organisations in the two most populous Canadian provinces have in place for evidence-informed decision-making. The study will also provide useful information to researchers on how to collect organisation-level data with reduced risk of self-reporting bias.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-014-0146-4) contains supplementary material, which is available to authorized users.

Health research in Africa: are we communicating our findings to relevant stakeholders?

Health research in Africa: are we communicating our findings to relevant stakeholders?

An Organizational Intervention to Influence Evidence-Informed Decision Making in Home Health Nursing

The aims of this study were to field test and evaluate a series of organizational strategies to promote evidence-informed decision making (EIDM) by nurse managers and clinical leaders in home healthcare. EIDM is central to delivering high-quality and effective healthcare. Barriers exist and organizational strategies are needed to support EIDM. Management and clinical leaders from 4 units participated in a 20-week organization-focused intervention. Preintervention (n = 32) and postintervention (n = 17) surveys and semistructured interviews (n = 15) were completed. Statistically significant increases were found on 4 of 31 survey items reflecting an increased organizational capacity for participants to acquire and apply research evidence in decision making. Support from designated facilitators with advanced skills in finding, appraising, and applying research was the highest rated intervention strategy. Results are useful to inform the development of organizational infrastructures to increase EIDM capacity in community-based healthcare organizations.

Knowledge brokering in public health: a tale of two studies

ObjectivesA Knowledge Broker is one approach for facilitating the integration of evidence-informed decision making in public health practice. In this paper, the findings from two studies investigating a Knowledge Broker intervention as a means of enhancing capacity for evidence-informed decision making are presented. Contextual factors that facilitate this strategy are also identified. Study designThis paper describes work done through a single mixed-methods study (randomized controlled trial with a qualitative component) and a case study. MethodsThe Health Evidence team conducted two studies examining Knowledge Broker impact in Canadian public health departments. The effectiveness of knowledge translation strategies of varying intensities for promoting the use of research evidence in decisions related to child obesity prevention were explored via a randomized controlled trial with a fundamental descriptive component (2003–2007). In a case study (2010–2013), the authors partnered with three health departments to develop and implement tailored strategies targeted at the organization. Knowledge Brokers worked with designated staff in these studies via one-on-one consultations, small group meetings, and/or workshops and presentations. The Knowledge Broker role was assessed by analysing data from close-ended surveys, interviews, organizational documents, and reflective journals. ResultsIn this paper, the authors focus on findings from the qualitative analysis of implementing the Knowledge Broker role in both studies and explore several contextual factors that impacted study outcomes. Knowledge Brokers were shown to enhance individual capacity by improving knowledge and skill in searching for, critically appraising, and applying research evidence to practice-based issues. Organizational capacity was also enhanced with strong management support and policies. Effective Knowledge Broker attributes included both expertise in research methodology and public health, as well as intangible traits such as approachability and patience. Finally, optimal positioning and ways of working were identified, including the importance of in-person meetings and neutrality of the Knowledge Broker. ConclusionsKnowledge brokering is a potentially promising knowledge translation strategy for public health, though additional feasibility and cost-effectiveness data are still needed. The research presented here further highlights the importance of context and adopting a tailored approach to implement a Knowledge Broker strategy.

Linking Research to Action for Youth Violence Prevention: Community Capacity to Acquire, Assess, Adapt and Apply Research Evidence

Community-based organizations (CBOs) are important stakeholders in the health system, providing many valuable community-based programs and services. However, limited efforts have been made to encourage CBOs to incorporate research evidence into service provision, and their capacity to do so is not well understood. Therefore, the primary goal of this research was to examine CBOs' perceptions of: 1) the frequency of using research and other forms of evidence related to youth violence prevention, and 2) their capacity to acquire, assess, adapt and apply research evidence. CBOs involved in youth violence prevention completed a survey (n=35) and/or attended a focus group (n=16). Survey questions were adapted from the Canadian Health Services Research Foundation's "Is Research Working for You?" tool. CBOs' reported use of and capacity to acquire research evidence was high. CBOs reported possessing the structures, processes, and organizational culture needed to apply research evidence in decision-making. Assessing research evidence was a challenge for CBO staff, although many have external experts who can effectively do so. Generally, CBOs reported adequate capacity to adapt (i.e., synthesize, contextualize, and present) research evidence. Adapting research evidence for use in particular populations or geographical areas presented a considerable challenge. Although many barriers and socio-political complexities make linking research to action challenging, we found that CBOs generally feel competent and well equipped. Our findings support the viability of extending the push for evidence-based health care to community contexts so that the most effective programs and services for Canadians can be offered.