Use Of Evidence In Decision-making Research Articles

A modified action framework to develop and evaluate academic-policy engagement interventions

BackgroundThere has been a proliferation of frameworks with a common goal of bridging the gap between evidence, policy, and practice, but few aim to specifically guide evaluations of academic-policy engagement. We present the modification of an action framework for the purpose of selecting, developing and evaluating interventions for academic-policy engagement.MethodsWe build on the conceptual work of an existing framework known as SPIRIT (Supporting Policy In Health with Research: an Intervention Trial), developed for the evaluation of strategies intended to increase the use of research in health policy. Our aim was to modify SPIRIT, (i) to be applicable beyond health policy contexts, for example encompassing social, environmental, and economic policy impacts and (ii) to address broader dynamics of academic-policy engagement. We used an iterative approach through literature reviews and consultation with multiple stakeholders from Higher Education Institutions (HEIs) and policy professionals working at different levels of government and across geographical contexts in England, alongside our evaluation activities in the Capabilities in Academic Policy Engagement (CAPE) programme.ResultsOur modifications expand upon Redman et al.’s original framework, for example adding a domain of ‘Impacts and Sustainability’ to capture continued activities required in the achievement of desirable outcomes. The modified framework fulfils the criteria for a useful action framework, having a clear purpose, being informed by existing understandings, being capable of guiding targeted interventions, and providing a structure to build further knowledge.ConclusionThe modified SPIRIT framework is designed to be meaningful and accessible for people working across varied contexts in the evidence-policy ecosystem. It has potential applications in how academic-policy engagement interventions might be developed, evaluated, facilitated and improved, to ultimately support the use of evidence in decision-making.

Understanding evidence ecosystems: What influences the production, translation, and use of modeled evidence in Burkina Faso, Nigeria, India, and Kenya?

Background This study sought to document and understand facilitators and barriers to producing, translating, and using modeled evidence in decision-making in Burkina Faso, Nigeria, India, and Kenya. We explored researcher-decision-maker engagement mechanisms as key facilitators of evidence use, with a focus on knowledge brokers and boundary organizations. Methods The study used mixed methods drawing on analysis from key informant interviews and surveys, complemented by a rapid desk review to map modeling activities and actors. The survey was conducted online while the qualitative research entailed in-depth interviews with modelers, knowledge brokers, and decision-makers working in a representative variety of health fields, organizations, and levels of government. This study was approved by Health Media Lab IRB (Institutional Review Board) in the United States and a local IRB in each study country and conducted between September 2021 and June 2022. Results Informants interviewed for this study described a range of factors that facilitate and inhibit the use of modeled evidence in public health decision-making at the individual, organizational, and environmental levels. Key themes included the capacity to produce, translate, and use modeled evidence; the timing and relevance of modeling outputs; the existence of communications channels between modelers and decision-makers; the strength of underlying data systems; the role of sustained funding; and the impact of global crises. Conclusion This study highlights the importance of taking an ecosystem approach to supporting modeling activities, considering individual, organizational, and environmental factors and how different actors and interact to inform the production, translation, and use of modeled evidence. Structured interaction that promotes dialogue, debate, and joint sense making between the producers and users of evidence is critical to informing and influencing the use of evidence in decision-making.

Health research prioritization in Somalia: setting the agenda for context specific knowledge to advance universal health coverage.

Despite recognition that health research is an imperative to progress toward universal health coverage, resources for health research are limited. Yet, especially in sub-Saharan Africa, more than 85% of the resources available for health research are spent on answering less relevant research questions. This misalignment is partially due to absence of locally determined health research priorities. In this study, we identified health research priorities which, if implemented, can inform local interventions required to accelerate progress toward universal health coverage in Somalia. We adapted the child health and nutrition research initiative method for research priority setting and applied it in 4 major phases: (1) establishment of an exercise management team, (2) a web-based survey among 84 respondents to identify health research questions; (3) categorization of identified health research questions; and (4) a workshop with 42 participants to score and rank the identified health research questions. Ethical approval was received from ethics review committee of the London School of Hygiene and Tropical Medicine (Ref:26524) and the Somali Research and Development Institute (Ref: EA0143). Two hundred and thirty-one unique health research questions were identified and categorized under health systems, services and social determinants (77), communicable diseases (54), non-communicable diseases (41) and reproductive, maternal, new-born, child, adolescent health and nutrition (59). A priority score ranging from 1 to 9 was assigned to each of the questions. For each category, a list of 10 questions with the highest priority scores was developed. Across the four categories, an overall list of 10 questions with the highest priority scores was also developed. These related to bottlenecks to accessing essential health services, use of evidence in decision making, antimicrobial resistance, distribution and risk factors for non-communicable diseases, post-traumatic stress disorder and factors associated with low antenatal care attendance among others. The developed priority research questions can be used to focus health research and to inform appropriation of health research resources to questions that contribute to generation of local health system knowledge which is required to accelerate progress toward universal health coverage in Somalia. The Somalia national institute of health should set up a consortium for provision of technical and financial support for research addressing the identified priority research questions, establish a mechanism to continuously monitor the extent to which new health interventions in Somalia are informed by knowledge generated through conducting prioritized health research and prioritize interventions aimed at strengthening the broader national health research system for Somalia.

Approaches to monitoring and evaluation of knowledge translation platforms in low- and middle-income countries: A scoping review

Background: Knowledge Translation Platforms (KTP) attempt to bridge the "know-do gap" between researchers and policymakers. This study summarized the evidence on activities, as well as methods of monitoring and evaluation projects of KTPs in Low- and Middle-Income Countries (LMICs). Methods: The Arksey and O’Malley methodology for scoping reviews was used. The databases accessed include Medline, Global Health, CINAHL, EBSCO and Cochrane library databases. Only Studies that indicated range of activities, tools or methods used in monitoring and evaluating KTP to achieve the implementation of evidence informed policymaking in LMICs were included. The key words used includes Knowledge Translation, Monitoring and Evaluation, Platforms and Low- and Middle-Income countries. Results: Total of 3150 hits were obtained from the searched databases. 750 duplicates were identified and removed resulting to 2398 articles. Using title screening, 2123 articles were excluded resulting in 275 articles for abstract screening. Abstract screening led to exclusion 246 articles, leaving 29 articles for the full-text screening. Full-text screening resulted to exclusion of 25 articles resulting to 4 articles that meet the inclusion criteria. No relevant articles were obtained from the reference list screening and grey literature search. Conclusion: Evidence shows that Case study methodology is the predominate method of evaluating KTPs. The shortest time duration from generation to use of evidence in decision making was noticed to be 1-year. The range of activities used to monitor KTP in bridging the “know do gap” includes stakeholder’s engagement, building capacity, priority setting, meeting with stakeholders, generating policy brief, litmus testing of brief, stakeholders dialogue, evidence brief and dialogue review, disseminating of findings and implementation. The minimum and maximum number of activities performed in each KTP process is 5 and 8 activities respectively.

A research agenda for the science of actionable knowledge: Drawing from a review of the most misguided to the most enlightened claims in the science-policy interface literature

Linking science with action affords a prime opportunity to leverage greater societal impact from research and increase the use of evidence in decision-making. Success in these areas depends critically upon processes of producing and mobilizing knowledge, as well as supporting and making decisions. For decades, scholars have idealized and described these social processes in different ways, resulting in numerous assumptions that now variously guide engagements at the interface of science and society. We systematically catalog these assumptions based on prior research on the science-policy interface, and further distill them into a set of 26 claims. We then elicit expert perspectives (n = 16) about these claims to assess the extent to which they are accurate or merit further examination. Out of this process, we construct a research agenda to motivate future scientific research on actionable knowledge, prioritizing areas that experts identified as critical gaps in understanding of the science-society interface. The resulting agenda focuses on how to define success, support intermediaries, build trust, and evaluate the importance of consensus and its alternatives – all in the diverse contexts of science-society-decision-making interactions. We further raise questions about the centrality of knowledge in these interactions, discussing how a governance lens might be generative of efforts to support more equitable processes and outcomes. We offer these suggestions with hopes of furthering the science of actionable knowledge as a transdisciplinary area of inquiry.

Global Statements to Produce and Implement Evidence in the Post-COVID-19 Era Provide a Path Forward for Rehabilitation - A Joint Initiative of Cochrane Rehabilitation and the Leading Journals in the Field.

Global Statements to Produce and Implement Evidence in the Post-COVID-19 Era Provide a Path Forward for Rehabilitation - A Joint Initiative of Cochrane Rehabilitation and the Leading Journals in the Field.

Evidence in decision-making in the context of COVID-19 in Latin America

SummaryBackgroundThe pace of the COVID-19 pandemic poses an unprecedented challenge to the evidence-to-decision process. Latin American countries have responded to COVID-19 by introducing interventions to both mitigate the risk of infection and to treat cases. Understanding how evidence is used to inform government-level decision-making at a national scale is crucial for informing country and regional actors in ongoing response efforts.ObjectivesThis study was undertaken between February-May 2021 and aims to characterise the best available evidence (BAE) and assess the extent to which it was used to inform decision-making in 21 Latin American countries, in relation to pharmaceutical (PI) and non-pharmaceutical interventions (NPI) related to COVID-19, including the use of therapeutics (corticosteroids, hydroxychloroquine/chloroquine and ivermectin), facemask use in the community setting and the use of diagnostic tests as a requirement for international travel.MethodA three-phase methodology was used to; (i) characterise the BAE for each intervention using an umbrella review, (ii) identify government-level decisions for each intervention through a document review and (iii) assess the use of evidence to inform decisions using a novel adapted framework analysis.FindingsThe BAE is characterized by 17 living and non-living systematic reviews as evolving, and particularly uncertain for NPIs. 107 country-level documents show variation in both content and timing of decision outcomes across intervention types, with the majority of decisions taken at a time of evidence uncertainty, with only 5 documents including BAE. Seven out of eight key indicators of an evidence-to-decision process were identified more frequently among PIs than either NPI of facemask use or testing prior to travel. Overall evidence use was reported more frequently among PIs than either NPI of facemask use or travel testing (92%, 28% and 29%, respectively).InterpretationThere are limitations in the extent to which evidence use in decision-making is reported across the Latin America region. Institutionalising this process and grounding it in existing and emerging methodologies can facilitate the rapid response in an emergency setting.FundingNo funding was sourced for this work.

Developing a model for health determinants research within local government: lessons from a large, urban local authority.

Background: Socio-economic, cultural and environmental conditions strongly affect health across the life course. Local government plays a key role in influencing these wider determinants of health and levels of inequality within their communities. However, they lack the research infrastructure and culture that would enable them to develop an evidence-based approach to tackling the complex drivers of those conditions. Methods: We undertook a scoping project using some research methods and some descriptive summaries to explore the potential for, and what would be needed to develop a local authority research system for the City of Bradford, UK. This included identifying the current research landscape and any barriers and enablers to research activity within the local authority using qualitative individual and focus group interviews, a rapid review of existing local research system models, scoping and description of the use of evidence in decision making and training opportunities and existing support for local government research. Results: We identified four key themes important to developing and sustaining a research system: leadership, resource and capacity, culture, partnerships. Some use of research in decision making was evident but research training opportunities within the local authority were limited. Health research funders are slowly adapting to the local government environment, but this remains limited and more work is needed to shift the centre of gravity towards public health, local government and the community more generally. Conclusions: We propose a model for a local authority research system that can guide the development of an exemplar whole system research framework that includes research infrastructure, data sharing, research training and skills, and co-production with local partners, to choose, use, generate, and deliver research in local government.

Developing a model for health determinants research within local government: lessons from a large, urban local authority

Background: Socio-economic, cultural and environmental conditions strongly affect health across the life course. Local government plays a key role in influencing these wider determinants of health and levels of inequality within their communities. However, they lack the research infrastructure and culture that would enable them to develop an evidence-based approach to tackling the complex drivers of those conditions. Methods: We undertook a scoping project using some research methods and some descriptive summaries to explore the potential for, and what would be needed to develop a local authority research system for the City of Bradford, UK. This included identifying the current research landscape and any barriers and enablers to research activity within the local authority using qualitative individual and focus group interviews, a rapid review of existing local research system models, scoping and description of the use of evidence in decision making and training opportunities and existing support for local government research. Results: We identified four key themes important to developing and sustaining a research system: leadership, resource and capacity, culture, partnerships. Some use of research in decision making was evident but research training opportunities within the local authority were limited. Health research funders are slowly adapting to the local government environment, but this remains limited and more work is needed to shift the centre of gravity towards public health, local government and the community more generally. Conclusions: We propose a model for a local authority research system that can guide the development of an exemplar whole system research framework that includes research infrastructure, data sharing, research training and skills, and co-production with local partners, to choose, use, generate, and deliver research in local government.

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.

Developing a model for health determinants research within local government: lessons from a large, urban local authority

Background: Socio-economic, cultural and environmental conditions strongly affect health across the life course. Local government plays a key role in influencing these wider determinants of health and levels of inequality within their communities. However, they lack the research infrastructure and culture that would enable them to develop an evidence-based approach to tackling the complex drivers of those conditions. Methods: We undertook a scoping project to explore the potential for, and what would be needed to develop a local authority research system for the City of Bradford, UK. This included identifying the current research landscape and any barriers and enablers to research activity within the local authority using qualitative individual and focus group interviews, a rapid review of existing local research system models, scoping of the use of evidence in decision making and training opportunities and existing support for local government research. Results: We identified four key themes important to developing and sustaining a research system: leadership, resource and capacity, culture, partnerships. Some use of research in decision making was evident but research training opportunities within the local authority were limited. Health research funders are slowly adapting to the local government environment, but this remains limited and more work is needed to shift the centre of gravity towards public health, local government and the community more generally. Conclusions: We propose a model for a local authority research system that can guide the development of an exemplar whole system research framework that includes research infrastructure, data sharing, research training and skills, and co-production with local partners, to choose, use, generate, and deliver research in local government.

Policy dialogue to support maternal newborn child health evidence use in policymaking: The lessons learnt from the Nigeria research days first edition.

The use of evidence in decision-making and practice can be improved through diverse interventions, including policy dialogue. The Department of Family Health, Federal Ministry of Health of Nigeria initiated and organized the Nigeria Research Days (NRD), to serve as a platform for exchange between researchers and policymakers for improving maternal, new-born and child health. The study reports on the conceptualization, organization and lessons learned from the first edition. A cross-sectional study was designed to assess the effectiveness of a policy dialogue during the NRDs. Data were collected from the feasibility and workshop evaluation surveys. A descriptive analysis of data was performed. As a result, the Nigeria Research Days meets all the criteria for a successful policy dialogue. The participants positively rated the content and format of the meeting and made suggestions for improvement. They were willing to implement the recommendations of the final communiqué. The lessons learned from this first edition will be used to improve future editions.

Towards a better integration of social sciences in arbovirus research and decision-making: an experience from scientific collaboration between Cuban and Quebec institutions.

In 2017, the Institute of Tropical Medicine Pedro Kourí, University of Montreal Public Health Research Institute, and McGill University joined efforts to provide scenarios for scientific exchange and knowledge dissemination about the social science contribution on arboviral research. This commentary describes the scientific collaboration between Cuban and Canadian (Quebec) institutions, illustrating the need and opportunities to facilitate research and effective decision-making processes for arboviral prevention and control, going beyond traditional biomedical aspects. We organized a set of scientific activities within three international events conducted in Cuba between 2017 and 2018. Given the collaborating institutions’ expertise and the knowledge gaps in arboviral research, we selected three main thematic areas: social determinants and equity, community-based interventions and use of evidence for decision-making. The partnership shows that interdisciplinary collaboration and the use and integration of quantitative and qualitative methods from the social sciences is essential to face the current challenges in arbovirus research.

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.

How do decision-makers use evidence in community health policy and financing decisions? A qualitative study and conceptual framework in four African countries.

Various investments could help countries deliver on the universal health coverage (UHC) goals set by the global community; community health is a pillar of many national strategies towards UHC. Yet despite resource mobilization towards this end, little is known about the potential costs and value of these investments, as well as how evidence on the same would be used in related decisions. This qualitative study was conducted to understand the use of evidence in policy and financing decisions for large-scale community health programmes in low- and middle-income countries. Through key informant interviews with 43 respondents in countries with community health embedded in national UHC strategies (Ethiopia, Kenya, Malawi, Mozambique) and at global institutions, we investigated evidence use in community health financing and policy decision-making, as well as evidentiary needs related to community health data for decision-making. We found that evidence use is limited at all levels, in part due to a perceived lack of high-quality, relevant evidence. This perception stems from two main areas: first, desire for local evidence that reflects the context, and second, much existing economic evidence does not deal with what decision-makers value when it comes to community health systems—i.e. coverage and (to a lesser extent) quality. Beyond the evidence gap, there is limited capacity to assess and use the evidence. Elected officials also face political challenges to disinvestment as well as structural obstacles to evidence use, including the outsized influence of donor priorities. Evaluation data must to speak to decision-maker interests and constraints more directly, alongside financiers of community health providing explicit guidance and support on the role of evidence use in decision-making, empowering national decision-makers. Improved data quality, increased relevance of evidence and capacity for evidence use can drive improved efficiency of financing and evidence-based policymaking.

Stakeholder Engagement Strategies for Policy and Programmatic Uptake: Lessons from the Drivers of Food Choice Competitive Grants Program

Abstract Objectives This study drew upon experiences of stakeholder engagement in food choice research to advance knowledge about best practices. Methods The Drivers of Food Choice Competitive Grants Program aimed to understand food choice in low- and middle-income-countries. All funded proposals included stakeholder engagement strategies. Data were from document review of proposals and reports and semi-structured interviews with the principal investigators of the 15 projects. Interviews were transcribed and uploaded into NVIVO 12. The lead author analyzed interviews thematically using an a priori code list and led discussion of themes and patterns through peer review with co-authors. Results Grantees developed and implemented a range of strategies. “Uni-directional” strategies were researcher-driven and informational, did not seek input from the target stakeholder, and included one-way communication such as emails, newsletters, meetings, press releases, technical briefs, newspaper articles, and public engagement efforts. “Bi-directional” strategies sought collaboration with stakeholders. Examples were workshops which sought feedback on stakeholder identification, research questions, methods, results, and recommendations. Grantees used unidirectional strategies to increase buy-in and generate demand for results, which helped promote the use of evidence for decision-making. Bi-directional strategies were integral to knowledge production. Grantees thought that bi-directional engagement enhanced the immediate applicability of the research. Grantees developed more- and less-intensive strategies that involved both bi-and uni-directional engagement, depending on goals for uptake. Conclusions This research sheds light on the role of stakeholder engagement strategies in advancing multisectoral nutrition. The current landscape of research and practice is fast-paced and complex; ensuring relevance of research via diverse stakeholder engagement strategies should remain a priority for researchers and funders. Our findings may aid researchers in constructing strategies that are responsive to diverse research programs and goals within complex multisectoral nutrition landscapes. Funding Sources UK Government's Department for International Development and Bill & Melinda Gates Foundation.

An evaluation of a training intervention to support the use of evidence in healthcare commissioning in England.

Clinical commissioning groups (CCGs) in England are responsible for the health of their populations through the services they provide, yet we know that the use of evidence to inform commissioning decisions is low. A programme of training in seven CCGs in England was instigated in a joint piece of work by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care and Academic Health Science Network in the West of England, to help build an evidence informed culture in commissioning. Evidence workshops were delivered in each of the seven CCGs in the West of England by an experienced senior lecturer (the author) and local healthcare librarians. The workshop was developed by the author and an information scientist and included guidance and demonstration of a systematic evidence search covering both traditional and grey literature, and a brief look at quality of evidence including a critical appraisal activity. Participants were asked to evaluate the workshop on the day and to indicate an intended action they would take as a result of the workshop; a short follow-up interview was carried out with a sample of participants between 3 and 6 months later, to identify any longer term impact of the training. A total of 63 staff in a variety of commissioning-related roles attended the workshops between March and September 2016. 95% rated the workshop overall as either 'excellent' or 'good'. Of particular value was the involvement of the local healthcare librarian, helping to promote their expertise and services; and the discussion of grey literature as a valuable source of evidence. A variety of intended actions as a result of the training included initiating a thorough search for evidence for new projects, use of bibliographic databases, and making use of local library services for evidence searching. Follow-up interviews with nine staff revealed a positive impact in the longer-term. This ranged from simply triggering an interest in using evidence, boosting motivation and sharing information with colleagues; to changes in processes such as broadening the responsibility for finding and filtering evidence for business cases; to one clear case of financial savings resulting from a search for evidence by a senior commissioning manager. Offering short, interactive training workshops is valued by healthcare commissioners and can make a difference to their approach to and use of evidence in decision-making. There is a need for a flexible approach to the concept of evidence in healthcare commissioning, which includes the use of grey literature, and training can encourage and support the systematic search for an appraisal of this type of evidence. Tools for improving and sustaining this aspect of evidence use by commissioners are included here.

Strengthening capacity to use research evidence in health sector policy-making: experience from Kenya and Malawi

BackgroundAmong the many barriers to evidence use in decision-making, weak capacity for evidence use has attracted a lot of focus in the last decade. The study aims to inform and enrich ongoing and future efforts to strengthen capacity for evidence use by presenting and discussing the experiences and lessons of a project implemented in Kenya and Malawi to strengthen individual and institutional capacity for evidence use within the ministries of health (MoHs).MethodsThis paper draws on the internal and external evaluations of a 3-year project funded by the United Kingdom’s Department for International Development, the Strengthening Capacity to Use Research Evidence in Health Policy (SECURE Health). To strengthen individual capacity, the project implemented a training and mentorship programme for 60 mid-level policy-makers in the two MoHs. To strengthen institutional capacity, the project conducted sustained advocacy with top leaders to strengthen structures that enable evidence-informed decision-making (EIDM), supported Kenya to develop research-for-health policies and priorities, supported Malawi to review the implementation of its health research agenda, developed EIDM guidelines for both MoHs, and supported bi-annual evidence dialogues to improve interactions and raise the profile of evidence. Internal evaluation included baseline and endline surveys (93 baseline and 92 endline interviews), 60 in-depth interviews, and intervention-specific evaluations (pre–post tests for training workshops, feedback forms for policy dialogues and tracking effects of advocacy efforts). The external evaluation was implemented alongside project implementation, conducting three annual evaluations.ResultsThe results show that training and mentorship programmes in EIDM were effective in improving competencies of civil servants. However, such programmes need to train a critical mass to be effective in enhancing EIDM practice at the MoHs. On strengthening institutional capacity for EIDM, while the project achieved some success, it did not realise long-lasting effects because of its limited time of implementation and limited focus on sustained political economy analysis, which meant that the intervention was negatively affected by frequently changing interests within the MoHs.ConclusionsAlthough training and mentorship are effective in improving EIDM competencies, they need to be incorporated in existing pre-service and in-service training programmes for sustainability. Strengthening institutional capacity for evidence use is complex and needs sustained political commitment and long-term investments.

The use of evidence in decision making by hospital managers in Lebanon: A cross-sectional study.

Knowledge synthesis products have emerged as support agents for decision making in clinical practice and policy. However, their use for evidence-informed decision making remains limited in health care management especially in low- and middle-income countries. This study assesses the use of evidence by middle and senior managers in Lebanese hospitals. This multihospital cross-sectional study used a self-administered web survey of middle and senior managers. Hospitals were purposively selected, and data were analyzed using descriptive statistics and thematic analysis. Hospital participation rate was 25%, while adjusted managers' response rate was 44.8%. Prevalence of using evidence was 70%, while prevalence of evidence-seeking behavior was 90%. Evidence was mainly used in design of policies, protocols, and procedures; nursing issues; or procurement decisions. Facilitators for evidence-informed decision making included upper management support and organizational culture, whereas limited resources such as funding, time, and training hindered use of evidence. Findings indicate that utilization of evidence was comparable with that of high-income countries. Training and continuous education were crucial for advancing evidence-informed decision making among hospital managers. However, neither the quality nor the sources of evidence used for decision making were assessed in this study. Future studies should assess the quality and sources of evidence utilized in decision making.

Collaboration and engagement produce more actionable science: quantitatively analyzing uptake of fish tracking studies.

Aquatic telemetry technology generates new knowledge about the underwater world that can inform decision-making processes and thus can improve conservation and natural resource management. Still, there is lack of evidence on how telemetry-derived knowledge can or has informed management, and what factors facilitate or deter its use. We present one of the first quantitative studies related to the science-action gap and evaluate factors that influence the uptake of fish telemetry findings into policies and practices, as well as social acceptance of these findings. We globally surveyed 212 fish telemetry researchers regarding the knowledge uptake of an applied fish telemetry research project of their choice. Respondents' personal and professional attributes, as well as the attributes of their chosen projects, were analyzed using machine learning algorithms to identify important factors that influenced the uptake (i.e., use, trust, and/or acceptance) of their findings. Researchers with extensive collaborations and who spent more time engaging in public outreach experienced greater uptake of their findings. Respondents with greater telemetry experience and commitment (e.g., more telemetry publications, higher proportion of research on fish telemetry) tended to achieve more social acceptance of their findings. Projects led by researchers who were highly involved and familiar with the fisheries management processes, and those where greater effort was devoted to research dissemination, also tended to experience greater uptake. Last, the levels of complexity and controversy of the issue addressed by the research project had a positive influence on the uptake of findings. The empirical results of this study support recent messages in the science practitioner literature for greater collaboration, knowledge co-production with partners, and public engagement to enable the transfer of knowledge and the use of evidence in decision-making and policies. Scientific organizations should consider shifting reward incentives to promote engagement and collaboration with non-scientific actors, and perhaps even rethinking hiring practices to consider personal and professional characteristics or attitudes such as altruism and networking skills given the influence of these factors in our model. Last, networks composed of both research and practice potentially have a key role in brokering and facilitating knowledge exchange and actions.