Use Of Research-based Evidence Research Articles

Forensic mental health nursing and evidence-based practice: a quantitative study

Background: Little is known about the personal, professional and workplace factors that influence evidence-based practice for forensic mental health nurses. Aim: This study describes the sources of practice knowledge for forensic mental health nurses, and the factors that influence the implementation of evidence-based practice. Design: This research study utilised a cross sectional survey design. Methods: All nurses (n = 244) working in one forensic mental health in-patient facility were sent an electronic invitation to complete the Developing Evidence Based Practice Questionnaire. Data was analysed to calculate descriptive statistics. Findings: Fifty-three respondents completed the survey. Respondents reported using experiential knowledge and locally derived sources of information more frequently than research-based evidence to inform their practice. Respondents reported being least skilled at finding, reviewing and using research evidence to change practice. The most frequently rated barriers to evidence-based practice were having insufficient time and resources to both finding and reviewing information and to implement changes in practice. Conclusions: Forensic mental health nurses tend to express a bias towards valuing social or qualitative sources of information to inform practice. Exploring the relationships between individual and organisational factors in the context of forensic mental health is recommended in order to gain further insights into the translation of evidence into practice for forensic mental health nurses. Impact statement: Unique contextual aspects of the forensic mental health environment may influence the implementation of evidence-based practice. Our study highlights that further support, resources and training is required to promote the use of research-based evidence in forensic mental health nursing.

Making the most of youth development

There is a growing international emphasis on the use of research-based evidence to inform youth program policy, practice and funding priorities, and on involving young people as subjects and actors in gathering this evidence. Youth development organisations and programs increasingly are expected to engage in research that informs their program development and illustrates their effectiveness. Research partnerships that provide community access to external research expertise are one way by which youth organisations and programs can strengthen their internal research capacity. This article explores the youth-inclusive community–university partnership underpinning the Queensland Youth Development Research Project, and examines some of the multifaceted methodological and ethical dimensions of this approach across three dimensions of research: planning, doing and finishing. Successful youth-inclusive research requires paying attention to the diversity of challenges characteristic of youth research. These challenges, influenced by the complexity of child, young adult and older adult relationships, highlight the fundamental importance of understanding how power is expressed and mediated in youth research. Overall, the article argues that youth-inclusive research can be shaped to bring broader benefits to research, scholars, young people and the wider community beyond the aim of simply improving the research process itself.

Use of Evidence in the Implementation of Social Programs: A Qualitative Study from Chile

Through this qualitative, empirical study the authors aim to explore and describe the sources of knowledge that are used to guide intervention practice by social workers in Chile. Particular attention was paid to factors that may facilitate or hinder the use of research-based evidence to guide social interventions design, implementation, and outcome evaluation. In order to explore these issues, 25 semi-structured interviews with social workers from Chilean social service non-profit organizations were conducted. The main findings suggest that social workers do not use research-based evidence to support their social interventions due to various personal organizational constraints (e.g., lack of time, lack of access to resources for disseminating evidence, lack of English command). In addition, no evaluation processes of social programs which will support evidence-based effectiveness could be found. One key barrier to support use of evidence and evidence production may be related to the fact that most non-governmental organizations maintain a hierarchical and vertical relationship with state agencies (program design, oversight, and funding) for social program development.

Research-based evidence in stroke rehabilitation: an investigation of its implementation by physiotherapists and occupational therapists

Purpose: Stroke rehabilitation is a multidimensional process that is designed to facilitate restoration of and/or adaptation to loss of functioning. The use of research-based evidence in informed decision-making is insufficient. Occupational therapy and physiotherapy constitute important contributions to rehabilitation. The study aim was to investigate characteristics of the implementation of research-based evidence in stroke rehabilitation by occupational therapists and physiotherapists, using the International Classification of Functioning, Disability and Health as a conceptual framework.Method: A prospective cohort study, including all service levels within stroke rehabilitation. Consecutive patients with stroke admitted to a university hospital between May and December 2012 were enrolled by 13 therapists. Documentation of daily practice was collected from medical records. Analysis compared the therapists’ documentation with the national clinical guidelines for physiotherapy and occupational therapy in the rehabilitation of adults with brain injury.Results: The study included 131 patients. The therapists’ praxis was seen to be in agreement with the majority of the national clinical guidelines. However, joint goal-setting and evaluation using standardized measures were seldom documented.Conclusions: Although the therapists recognize evidence-based practice as a framework for achieving quality in rehabilitation, findings suggest that they do not employ research-based evidence to the fullest extent.Implications for RehabilitationIn order to individualize the rehabilitation offered, more attention and focus on involving and giving words to patients’ expectations, perceptions, experiences, and perspectives is needed.With the intention of enabling meaningful participation the health professionals need to pay more attention to the importance of environmental factors.Both guidelines and clinical practice should consider all components of the International Classification of Functioning, Disability and Health when formulating, and implementing, recommendations in rehabilitation praxis in order to aim for rehabilitation that is based both on evidence and a holistic approach.

Bridging the divide between research and policy in Nigeria: The role of a health policy advisory committee

Our research group at Ebonyi State University in Nigeria, with the help of the Alliance for Health Policy and Systems Research, has worked with government and other stakeholders to create a Health Policy Advisory Committee. We describe the key elements of the committee and how it has helped bridge gaps between researchers and policymakers to facilitate the use of research-based evidence in policy and programme development.

Nurse Executives’ Perceptions of the Executive Training for Research Application (EXTRA) Program

To improve the overall quality and effectiveness of the Canadian health care system through better decisions supported by research-based evidence (RBE), the Canadian Health Services Research Foundation (CHSRF) and partners have created the Executive Training for Research Application (EXTRA) program. To evaluate how nurse executive fellows perceive changes in their levels of knowledge of RBE and in their level of use of RBE following participation in the EXTRA program. Nurse executives in the first four cohorts of the program (2004-2007) completed a survey during their 2-year fellowship period. Statistically significant improvements were observed regarding nurse executives' perceived knowledge and use of RBE. According to the participants, the EXTRA fellowship contributes to their role and function in their organization by providing tools, learning, and access to resources and networking, which contributes to their credibility, leadership, and knowledge transfer skills. The EXTRA program has been structured to reduce barriers and to enhance the facilitators found in the literature on the implementation of evidence-based practices (EBP) in health care settings. Overall, nurse executives perceived that the benefits of participating in the EXTRA program were both individual and organizational.

Bridging the gaps between research, policy and practice in low- and middle-income countries: a survey of health care providers.

Gaps continue to exist between research-based evidence and clinical practice. We surveyed health care providers in 10 low- and middle-income countries about their use of research-based evidence and examined factors that may facilitate or impede such use. We surveyed 1499 health care providers practising in one of four areas relevant to the Millennium Development Goals (prevention of malaria, care of women seeking contraception, care of children with diarrhea and care of patients with tuberculosis) in each of China, Ghana, India, Iran, Kazakhstan, Laos, Mexico, Pakistan, Senegal and Tanzania. The proportion of respondents who reported that research was likely to change their clinical practice if performed and published in their own country (84.6% and 86.0% respectively) was higher than the proportion who reported the same about research and publications from their region (66.4% and 63.1%) or from high-income countries (55.8% and 55.5%). Respondents who were most likely to report that the use of research-based evidence led to changes in their practice included those who reported using clinical practice guidelines in paper format (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.03-2.28), using scientific journals from their own country in paper format (OR 1.70, 95% CI 1.26-2.28), viewing the quality of research performed in their country as above average or excellent (OR 1.93, 95% CI 1.16-3.22); trusting systematic reviews of randomized controlled trials (OR 1.59, 95% CI 1.08-2.35); and having easy access to the Internet (OR 1.90, 95% CI 1.19-3.02). Locally conducted or published research has played an important role in changing the professional practice of health care providers surveyed in low- and middle-income countries. Increased investments in local research, or at least in locally adapted publications of research-based evidence from other settings, are therefore needed. Although access to the Internet was viewed as a significant factor in whether research-based evidence led to concrete changes in practice, few respondents reported having easy access to the Internet. Therefore, efforts to improve Internet access in clinical settings need to be accelerated.

Evaluation of the Executive Training for Research Application (EXTRA) Program: Design and Early Findings

The authors of this paper describe the EXTRA Program, its intended outcomes, the approach they used to evaluate the program and some initial findings regarding the program's effects on the EXTRA fellows after the initial two-year period. The program's mission is to develop capacity and leadership to optimize the use of research-based evidence in Canadian healthcare organizations. Using Kirkpatrick's four-level model for evaluating training effectiveness, the authors conclude that after two years the program appears to be having the desired effects on the fellows. There is now a need to develop a richer understanding of the effects within the host organizations and to consider ways of transferring the new knowledge to other healthcare organizations outside the EXTRA Program umbrella.

The challenges of incorporating scientific evidence into policy making. In this issue.

The challenges of incorporating scientific evidence into policy making. In this issue.

Academic Advice to Practitioners—the Role and Use of Research-Based Evidence

(2007). Academic Advice to Practitioners—the Role and Use of Research-Based Evidence. Public Money & Management: Vol. 27, No. 4, pp. 232-235.

Bridging research and policy in international development: an analytical and practical framework

Better use of research-based evidence in development policy and practice can help save lives, reduce poverty, and improve the quality of life. But for this to happen more effectively researchers need to do three things. First, they need to develop a detailed understanding of (a) the policy-making process; what are the key influencing factors, and how do they relate to each other?; (b) the nature of the evidence they have, or hope to get - is it credible, practical, and operationally useful?; and (c) all the other stakeholders involved in the policy area - who else can help to get the message across? Second, they need to develop an overall strategy for their work; identify political supporters and opponents; keep an eye out for, and be able to react to, policy windows; ensure the evidence is credible and practically useful; and build coalitions with like-minded groups. Third, they need to be entrepreneurial; get to know, and work with the policy makers, build long-term programmes of credible research, communicate effectively, use participatory approaches, identify key networkers and salespeople, and use shadow networks. Based on over five years of theoretical and case-study research, ODI's Research and Policy in Development programme has developed a simple analytical framework and practical tools that can help researchers to do this. This article is hosted by our co-publisher Taylor & Francis.

Schools That Engage Children

EVER tried stuffing a week's worth of clothes into an overnight bag? No matter how carefully you roll up the dresses, jeans, sweaters, and whatnot, they get wrinkled and out of shape, and they require a lot of fixing once unpacked. This is the only picture I could think of as I listened to some very good presentations on the importance of restoring to the nation's schools the tradition of educating students for a civic life. The American Youth Policy Forum event -- one of three in a series -- focused on the research justification for integrating community service and civic education with academic goals. The evidence is there; these initiatives do enhance academic learning. But speaking in the august hearing room of the U.S. House of Representatives, most of the researchers felt compelled to use the No Child Left Behind (NCLB) Act as the framework for their findings. They rolled up their message and stuffed it into the NCLB bag, where, in addition to getting wrinkled, it could easily be ignored. To their credit, the panelists and the entire forum attempted to provide more balance to a public school system that is now hell-bent on chasing higher scores on standardized tests. I wish them luck. Looking at the U.S. Department of Education press releases and at most of the media coverage of education, however, I get the clear message that any role the schools might play and any values they might endorse other than those embodied in NCLB are being squeezed out of shape. Indeed, they are totally out of the picture right now. This is more than shortsighted. Certainly, the core goals of NCLB are essential and not in dispute. It's how the law expects schoolpeople to achieve them that makes NCLB its own worst enemy. Take the use of research-based evidence, for example. Studies, reports, and initiatives are coming from all directions to affirm that engagement in learning, environments that value trust, and integrity in relationships between teachers and students and their families work together to make a critical difference in learning. In fact, consistent improvements in teaching and learning essentially depend on factors such as these. The Board on Children, Youth, and Families of the National Research Council recently surveyed the research about student engagement in learning, especially among urban high-schoolers, and found three factors to be equally important contributors to student engagement: high academic standards, skillful instruction, and the supports students need. (See Committee on Increasing High School Students' Engagement and Motivation to Learn, Engaging Schools: Fostering High School Students' Motivation to Learn, National Academies Press, 2004). One initiative that directly addresses this finding is the Tripod Project, directed by Ron Ferguson of the John F. Kennedy School of Government at Harvard University. Ferguson serves as a lead researcher for the Minority Student Achievement Network and helped it conduct and analyze a survey of the member districts' secondary school students that included more than 40,000 participants. The results indicated that student success depends on three qualities of teaching: content knowledge, pedagogy, and strong relationships with students. The Tripod Project is now in its second year of a professional development model that focuses teachers' attention and collaboration on these three legs. Early on, Ferguson observed, a key element of the project was trust -- of him as an outsider trying to influence the teachers' work and among the teachers themselves as a group able to discuss the project's work frankly. …

Resources to enhance evidence-based nursing practice.

Evidence-based practice means integrating the best available research evidence with information about patient preferences, clinician skill level, and available resources to make decisions about patient care. Barriers to the use of research-based evidence occur when time, access to journal articles, search skills, critical appraisal skills, and understanding of the language used in research are lacking. Resources are available to overcome these barriers and support an evidence-based nursing practice. This article highlights available resources and describes strategies that nurses can use to develop and sustain an evidence-based nursing practice.

125 years of public health in the UK.

This paper examines four themes in public health theory and practice: all are important for the future and are illuminated by the last 125 years. First, while definitions of public health may be stable, the rationale of public health practice--'why bother?'--has altered considerably over time. A second theme revolves around personal autonomy--can we compel individuals to take health promoting measures? Third, public health practice today pays attention as never before to the use of research-based evidence, helping to answer three questions: What are the problems? What are their causes? What are the solutions? The fourth theme is the changing character, locus and focus of public health. From being predominantly locally focused within Borough Councils, albeit operating within frameworks of national legislation and one eye on global threats, it has become much more complex with emerging levels of action which encompass the neighbourhood, the strategic district, the region, nation state, Europe and finally the ever more pressing globalisation agenda as it affects the human condition. Public health has been medically dominated for the last 125 years and this is now changing. Its ties with local government are being strengthened after a break of nearly 30 years. The focus of public health has recently been strongly on health services. This reached its apogee a few years ago but is also now rapidly changing. Looking back over the last 125 years can help us identify some of the mistakes to be avoided and opportunities to be seized at this time of change.

Improving the Use of Research-Based Evidence in Policy Making: Effective Care in Pregnancy and Childbirth in the United States

The rigorous syntheses in Effective Care in Pregnancy and Childbirth (ECPC) raise the question of how these and future recommendations can effectively be used to influence the decisions of policy makers and to improve the care we receive. The fragmentation of U.S. health care is especially striking for pregnancy and childbirth care. Although the U.S. context does not contain an obvious focal point for ECPC, several organizations have leverage or influence over different facets of policy making in this area: professional associations, consumer advocates, regulatory bodies, and third-party payers. An alternative to current independent activities is the organization of a network to facilitate implementation of ECPC. The intention would be that, through interaction, members would strengthen their interest and improve their effectiveness in implementing ECPC. An initial activity might be to evaluate alternative methods for implementing a specific recommendation.

The contribution of social science research to health policy: the Royal Commission on the National Health Service.

This article adopts a case study approach to examine the contribution of social science research to health policy. It concentrates exclusively on the recent Royal Commission on the National Health Service. After describing its background and modus operandi the paper goes on to assess the Report's utilization of social science research, both in its diagnosis and recommendations. This assessment suggests that while the Commissioners made relatively little use of research-based evidence in their diagnosis, their recommendations provide the basis for a substantial increase in the contribution of social scientists, particularly in the field of health services evaluation.