Use Of Research Evidence Research Articles

Why do we need for timeliness of research in decision-making?

Abstract Background Compared to the policy process, the research process is slow. As a result, research evidence is not always available when needed in the policy process. These differences in timelines between research and policy hinder the use of research evidence in the policy process. In order to support evidence-based policy making, timeliness of research is important. Methods Examples are provided, e.g. where research was on time to be included in the policy process and where research was too late to be included in it. These examples are described and analysed to provide for recommendations on how to better align both processes. Results It is shown that in order to create timeliness of research, policy makers and researchers should talk on a regular basis. This increases the chance that results from the research are included in policy making. Conclusions Timeliness of research is important for evidence-based policy making. In order to create timeliness of research, interaction between researchers and policy makers is important.

Danish policymakers and research evidence in public health policy process

Abstract Background Evidence-informed policymaking in public health, understood as interaction of the best available research evidence and “other types of evidence”, is known to have sound influence on population well-being. However, lack of using and producing research evidence by public health policymakers has been well documented. The aim of this study was to assess policymakers’ research involvement in the research process as well as motivators and barriers for the use and production of research evidence. Methods A cross-sectional online survey was carried out in the period of Dec 2018 - Jan 2019 using a pre-tested, self-administrated questionnaire. Participants were Danish policymakers’ members of the Danish Society of Public Health (DSPH) and with practical experience being involved in a health policy-making process. The questionnaire was distributed through the DSPH members email list. Reported outcome variables; for this abstract are parts of the larger study: health policymakers’ research involvement in the last 12Mo; policymakers’ motivators and barriers to use and produce research in policy-making. Results Response rate: 100/480 (15%). 78% were involved in critical evaluation of research for policy-making; 77% were able to identify relevant research literature; 41% did not use research evidence; 40% did not conduct any surveys; 57% did not write research reports; 65% never used reference systems; 46% did not analyze any research data. The three motivators reported to use and produce research in the last 12Mo were: identification of the problem that needs to be addressed; development of research skills; and job satisfaction. The three main barriers were: other job-related priorities; lack of time for research; lack of research funding. Conclusions This study reinforced that public health policymakers need more practical knowledge and skills as well as organizational support and management to use and produce research evidence for evidence-informed policy-making. Key messages Successful evidence-informed policymaking requires capacity-building interventions targeting policymakers, supported, implemented and evaluated by their organizations. Policymakers do not dismiss evidence-informed policy practice, but their “positions” and conditions at a work place sometimes do not allow them to fully follow it.

Practitioner Perceptions of Evidence-Based Practice in Elite Sport in the United States of America.

Fullagar, HHK, Harper, LD, Govus, A, McCunn, R, Eisenmann, J, and McCall, A. Practitioner perceptions of evidence-based practice in elite sport in the United States of America. J Strength Cond Res 33(11): 2897-2904, 2019-Practitioners' perceptions regarding the use and effectiveness of research evidence in sport is not well understood. The purpose of the present study was to examine practitioners' perceptions around the use, implementation, and barriers to evidence-based practice (EBP) in sport science in the United States of America (USA). A survey (28 items) was completed by 67 full-time staff who were a physical performance team member employed by universities or professional sporting organizations in the USA. Questions included the use of research, contribution of research areas, barriers to accessing and implementing EBP, and methods of feedback to the coach and players. All respondents (100%) stated they used research evidence in their performance/training program, ranking research as contributing most (largest contribution = 1 to smallest contribution = 4) to individualized preparation or recovery recommendations (1.98 ± 1.02). The top 3 preferred sources of information were "peer-reviewed research" (100% of respondents), "conferences/seminars" (76%), and "practitioners within your sport" (63%). Commonly reported perceived barriers between accessing and implementing research were "lack of staff" (accessing = 33%, implementing = 46%) "time" (accessing = 38%, implementing = 48%) and nonapplicable research (accessing = 33%, implementing = 37%), whereas "poor player compliance" was a clear barrier to implementing EBP (56%). Practitioners most preferred, and actual, method of feedback for coaching staff (87% for both) and players (94 and 95%, respectively) was "informal conversations/speaking." Improved access to educational and financial resources, increased integration of staff in coach settings and understanding of player/coach contexts may help to alleviate barriers to EBP.

Use of research evidence in state health policymaking: Menu labeling policy in California.

Addressing the translational gap between research evidence and state health policy requires an understanding of the current use of research evidence in the state policymaking process. In this study, we explore the use of research evidence to inform the legislative debate about restaurant nutrition labeling policy in California. In 2008, California was the first state to enact a mandatory menu calorie labeling policy in the U.S. Using a qualitative approach, we examine data sources and types of evidence used in legislative documents (n = 87) related to six menu labeling bills introduced in California’s state legislature between 2003 and 2008. Federal- and state-level government agency reports were the most frequently cited sources of technical knowledge. Advocacy coalition members who were active participants involved in the policy debate were also cited as experts. Five of the six bills included evidence in related legislative documents. While documents included considerable evidence on the magnitude and severity of the obesity problem to justify policy enactment, there were a limited number of statements referring to policy effectiveness and only one statement identified attesting to implementation context and acceptability. Reference to evidence on related policy suggests policy precedence may also play an important role in policy decision making. There is a need to improve the dissemination of obesity policy effectiveness and implementation studies in a politically time sensitive manner to influence state health policy debates. Strategies are discussed to effectively integrate the use of research evidence in the state health policymaking process.

The governmental health policy-development process for Syrian refugees: an embedded qualitative case studies in Lebanon and Ontario

BackgroundThe unprecedented amount of resources dedicated to humanitarian aid has led many stakeholders to demand the use of reliable evidence in humanitarian aid decisions to ensure that desired impacts are achieved at acceptable costs. However, little is known about the factors that influence the use of research evidence in the policy development in humanitarian crises. We examined how research evidence was used to inform two humanitarian policies made in response to the Syrian refugee crisis.MethodsWe identified two policies as rich potential case studies to examine the use of evidence in humanitarian aid policy decision-making: Lebanon’s 2016 Health Response Strategy and Ontario’s 2016 Phase 2: Health System Action Plan, Syrian Refugees. To study each, we used an embedded qualitative case study methodology and recruited senior decision-makers, policy advisors, and healthcare providers who were involved with the development of each policy. We reviewed publicly available documents and media articles that spoke to the factors that influence the process. We used the analytic technique of explanation building to understand the factors that influence the use of research evidence in the policy-development process in crisis zones.ResultsWe interviewed eight informants working in government and six in international agencies in Lebanon, and two informants working in healthcare provider organizations and two in non-governmental organizations in Ontario, for a total of 18 key informants. Based on our interviews and documentary analysis, we identified that there was limited use of research evidence and that four broad categories of factors helped to explain the policy-development process for Syrian refugees – development of health policies without significant chance for derailment from other government bodies (Lebanon) or opposition parties (Ontario) (i.e., facing no veto points), government’s engagement with key societal actors to inform the policy-development process, the values underpinning the process, and external factors significantly influencing the policy-development process.ConclusionsThis study suggests that use of research evidence in the policy-development process for Syrian refugees was subordinate to key political factors, resulting in limited influence of research evidence in the development of both the Lebanese and Ontarian policy.

Clients' perceptions and experiences of targeted digital communication accessible via mobile devices for reproductive, maternal, newborn, child, and adolescent health: a qualitative evidence synthesis.

BackgroundGovernments and health systems are increasingly using mobile devices to communicate with patients and the public. Targeted digital client communication is when the health system transmits information to particular individuals or groups of people, based on their health or demographic status. Common types of targeted client communication are text messages that remind people to go to appointments or take their medicines. Other types include phone calls, interactive voice response, or multimedia messages that offer healthcare information, advice, monitoring, and support.ObjectivesTo explore clients' perceptions and experiences of targeted digital communication via mobile devices on topics related to reproductive, maternal, newborn, child, or adolescent health (RMNCAH).Search methodsWe searched MEDLINE (OvidSP), MEDLINE In‐Process & Other Non‐Indexed Citations (OvidSP), Embase (Ovid), World Health Organization Global Health Library, and POPLINE databases for eligible studies from inception to 3‐6 July 2017 dependant on the database (See appendix 2).Selection criteriaWe included studies that used qualitative methods for data collection and analysis; that explored clients' perceptions and experiences of targeted digital communication via mobile device in the areas of RMNCAH; and were from any setting globally.Data collection and analysisWe used maximum variation purposive sampling for data synthesis, employing a three‐step sampling frame. We conducted a framework thematic analysis using the Supporting the Use of Research Evidence (SURE) framework as our starting point. We assessed our confidence in the findings using the GRADE‐CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. We used a matrix approach to explore whether potential implementation barriers identified in our synthesis had been addressed in the trials included in the related Cochrane Reviews of effectiveness.Main resultsWe included 35 studies, from a wide range of countries on six continents. Nineteen studies were conducted in low‐ and middle‐income settings and sixteen in high‐income settings. Some of the studies explored the views of people who had experienced the interventions, whereas others were hypothetical in nature, asking what people felt they would like from a digital health intervention. The studies covered a range of digital targeted client communication, for example medication or appointment reminders, prenatal health information, support for smoking cessation while pregnant, or general sexual health information.Our synthesis showed that clients' experiences of these types of programmes were mixed. Some felt that these programmes provided them with feelings of support and connectedness, as they felt that someone was taking the time to send them messages (moderate confidence in the evidence). They also described sharing the messages with their friends and family (moderate confidence).However, clients also pointed to problems when using these programmes. Some clients had poor access to cell networks and to the internet (high confidence). Others had no phone, had lost or broken their phone, could not afford airtime, or had changed their phone number (moderate confidence). Some clients, particularly women and teenagers, had their access to phones controlled by others (moderate confidence). The cost of messages could also be a problem, and many thought that messages should be free of charge (high confidence). Language issues as well as skills in reading, writing, and using mobile phones could also be a problem (moderate confidence).Clients dealing with stigmatised or personal health conditions such as HIV, family planning, or abortion care were also concerned about privacy and confidentiality (high confidence). Some clients suggested strategies to deal with these issues, such as using neutral language and tailoring the content, timing, and frequency of messages (high confidence).Clients wanted messages at a time and frequency that was convenient for them (moderate confidence). They had preferences for different delivery channels (e.g. short message service (SMS) or interactive voice response) (moderate confidence). They also had preferences about message content, including new knowledge, reminders, solutions, and suggestions about health issues (moderate confidence). Clients' views about who sent the digital health communication could influence their views of the programme (moderate confidence).For an overview of the findings and our confidence in the evidence, please see the 'Summary of qualitative findings' tables.Our matrix shows that many of the trials assessing these types of programmes did not try to address the problems we identified, although this may have been a reporting issue.Authors' conclusionsOur synthesis identified several factors that can influence the successful implementation of targeted client communication programmes using mobile devices. These include barriers to use that have equity implications. Programme planners should take these factors into account when designing and implementing programmes. Future trial authors also need to actively address these factors and to report their efforts in their trial publications.

The Use of Evidence-Based Management in Nursing Management

Evidence-based management (EBM) has been developed as a management framework for improving the quality of decisions. To use that, we need to identify the sources of evidence and to assess the utilisation of evidence in EBM. Therefore, the purpose of this study was to assess the utilisation of evidences and to identify predominantly used sources in EBM among nursing managers in Tabriz, north-west Iran. A facility-based descriptive cross-sectional study design was used in Tabriz hospitals. Out of 276 nursing managers eligible for the study from the Tabriz hospitals (n = 20), 205 nursing managers completed and returned the self-administered questionnaire, which indicated a response rate of 74.27 per cent. The questionnaire components included scientific and research evidence (four sources), facts and information from the hospitals (four sources), political-social development plans (three sources), the managers’ professional expertise (three sources), ethical-moral evidence (three sources), and values and expectations of all stakeholders (three sources). The results showed that the average use of scientific and research evidence (58.41 ± 13.23) was less than other sources of evidence. The average use of values and expectations of all stakeholders’ political-social development plans was (67.15 ± 14.78), managers’ professional expertise (70.47 ± 12.49), and ethical-moral evidence (68.91 ± 11.62). In addition, hospital ownership and the participants’ gender influence the use of facts and information of hospital and managers’ professional expertise. The findings showed that nursing managers were more customer- and expertise-oriented in the decision-making process. From the study findings we recommend utilisation of all the sources of evidence for decision-making in a full evidence-based nursing management process.

The role of psychology in evidence-based policymaking: Mapping opportunities for strategic investment in poverty reduction.

Increasing efforts are being undertaken to understand how to improve the use of research evidence in policy settings. In particular, growing efforts to understand the use of research in legislative contexts. Although high-profile examples of psychology's contributions to public policy exist-particularly around antipoverty legislation-little systematic review has quantified how the field has informed federal policy across time. Recognizing the importance of exploring psychology's use in policymaking, we provide an overview of psychology's presence in federal antipoverty legislation over the last 2 decades by reviewing the over 6,000 antipoverty bills introduced to the U.S. Congress since 1993 for mentions of psychology. Further, to explore how psychology's contributions are related to policymakers' attributions about the causes of poverty, their public statements and voting behavior is considered. Key gaps in our scientific knowledge for informing poverty-related policy are identified. Opportunities to enhance the relevance of psychology in poverty reduction efforts, including the evidence-based policy movement, are described. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Evaluation of an HIV-specific rapid response service for community-based organisations in Ontario, Canada

BackgroundTo support AIDS service organisations and other community-based organisations’ use of research evidence to inform HIV-related programmes, services and policies, the Ontario HIV Treatment Network (OHTN) developed a Rapid Response Service. The final product of the rapid response process at the OHTN, which is more streamlined than that of traditional systematic reviews, consists of a detailed report answering questions regarding an HIV-specific issue and how the findings apply within the local context. In 2016, the OHTN conducted an evaluation to assess the effectiveness of its Rapid Response Service. This article reports on the development of this service as well as the results of the evaluation.MethodsAll rapid responses published between January 1, 2009, and September 30, 2016, by the OHTN (n = 102) were analysed using univariate analyses. Frequency distributions were determined for the following variables for each rapid response: populations observed, topics covered, requestor affiliations and number of downloads from the OHTN’s website. Requestors of rapid responses were also interviewed regarding perceived helpfulness and utility of the service and final products, and suggestions for changes to the service. Six-month follow-up interviews were conducted to determine how affiliated organisations used the evidence from the rapid response they requested.ResultsThe 102 rapid responses published covered 14 different populations of interest. Topics covered included the HIV prevention, engagement and care cascade, determinants of health, syndemics, and comorbidities. Requestor affiliations consisted of AIDS service organisations, government agencies and policy-makers, non-HIV-focused community-based organisations, and hospitals, universities or health centres. Requestors perceived most aspects of the Rapid Response Service as very helpful and most frequently suggested that the rapid responses should provide recommendations. Follow-up interviews regarding the impact of rapid responses show that rapid responses have been used to assist organisations in numerous activities.ConclusionsOrganisations that have used the OHTN’s Rapid Response Service describe it as a valuable service useful for the development of programmes and policies. Improvements in capacity-building efforts may increase its utility. Describing the findings of this evaluation may serve as a reference for similar programmes to increase the use of research evidence among public health decision-makers.

A research protocol for studying participatory processes in the use of evidence in child welfare systems

This paper presents a protocol for a funded study of technical assistance strategies used to support the use of evidence, and, in particular, how participatory processes contribute to the use of evidence to improve outcomes for populations. Findings from the study will increase understanding of the relationships between technical assistance, stakeholder participation and evidence use in child and family services. The authors argue that publishing such a protocol can increase transparency between researchers and practitioners and raise awareness of the need for research on how stakeholder participation can strengthen evidence use in child welfare service settings. The authors also reflect on the potential value and limitations of published protocols. This study will systematically gather input from stakeholders with expertise in technical assistance to develop a compilation of strategies that can be used to support the use of evidence. The study will identify strategies that include stakeholder involvement and assess which strategies under what conditions facilitated the use of research evidence. The study will address four research questions: What technical assistance strategies are used to support the use of research evidence? What are the consensus-driven terms and definitions of identified strategies? To what extent do technical assistance strategies involve stakeholders and for what purpose?

Promoting co-production in the generation and use of research evidence to improve service provision in special care dentistry.

Special care dentistry (SCD) provides holistic oral service provision for people with complex health and care needs. These can include physical, sensory, intellectual, mental, medical, emotional or social impairment or disability or, more often, a combination of these factors. The level of disability within these population groups can vary, and a proportion of people will have multiple and overlapping impairments and/or medical conditions. This paper explores a number of possible research methods that may better reflect the diversity and challenges of this population group, where the emphasis is placed on co-production and co-design.

Predictors of Nurses' Research Use in Canadian Long-term Care Homes

ObjectivesWe examined the influence of individual characteristics and organizational context features on nurses' self-reported use of research evidence in long-term care (LTC) homes. DesignA cross-sectional analysis of survey data collected in the Translating Research in Elder Care program. Setting and participants756 nurses (registered nurses and licensed practical nurses) from 89 LTC homes in Western Canada. MethodsGeneralized estimating equation modeling was used to identify which individual characteristics and organizational context features significantly predicted (P < .05) 3 kinds of self-reported research use by nurses: instrumental (the direct application of research findings), conceptual (using research findings to change thinking), and persuasive (using research findings to convince others). ResultsNurses reported a moderate to high level of research use. There were no significant differences in mean research use scores by nursing role. Only 2 variables were associated with all 3 kinds of research use: having a positive attitude toward research, and availability of structural and electronic resources. Additional variables associated with instrumental research use were problem-solving ability, engaging in formal interactions (eg, education sessions), and better perceptions of organizational slack–staff (the availability of sufficient staff). Additional variables associated with conceptual research use were self-determination and job efficacy. Finally, additional variables associated with persuasive research use were belief suspension (the ability to suspend previously held beliefs), organizational citizenship behavior (one's voluntary commitment to the organization), self-determination, job efficacy, evaluation, and better perceptions of organizational slack–time (perceived availability of extra time). Conclusions and implicationsConceptual and persuasive research use were most strongly influenced by individual characteristics, whereas instrumental research use was predicted equally by individual and organizational variables. Nurses working in LTC are positioned in leadership roles; by targeting both the individual- and organizational-level predictors of nurses' research use, they can improve conditions for individuals living in LTC.

Health researchers and policy makers involvement in knowledge translation activities in Malawi

PurposeThe purpose of this paper is to explore health researchers’ involvement of policy or decision makers in knowledge translation activities in Malawi.Design/methodology/approachThe case study collected quantitative through questionnaire from health researchers from the University of Malawi. The study used inferential statistics for the analysis of the quantitative data. Pearson χ2 test was used to establish the relationship between categorical data and determine whether any observed difference between the data sets arose by chance. The Kruskal–Wallis H test was used to determine if there were statistically significant differences between independent variable and dependent variables. Data has been presented in a form of tables showing means, standard deviation and p-values.FindingsHealth researchers sometimes involve policy or decision makers in government-sponsored meetings (M=2.5, SD=1.17). They rarely involve policy or decision makers in expert committee or group meetings (M=2.4, SD=1.20). Researchers rarely involve policy or decision makers in conferences and workshops (M=2.4, SD=1.31). Rarely do researchers involve policy or decision makers in formal private or public networks (M=2.4, SD=1.17). In events organised by the colleges researchers rarely involve policy or decision makers (M=2.3, SD=1.11); and rarely share weblinks with policy or decision makers (M=2.0, SD=1,17). On average, health researchers occasionally conduct deliberate dialogues with key health policy makers and other stakeholders (M=2.5, SD=1.12). The researchers rarely established and maintained long-term partnerships policy or decision makers (M=2.2, SD=1.20). They rarely involve policy or decision makers in the overall direction of the health research conducted by themselves or the Colleges (M=2.1, SD=1.24).Research limitations/implicationsThe study recommends that there should be deliberate efforts by health researchers and policy makers to formally engage each other. Individuals need technical skills, knowledge of the processes and structures for engaging with health research evidence to inform policy and decision making. At the institutional level, the use of research evidence should be embedded within support research engagement structures and linked persons.Practical implicationsFormal interactions in a form of expert meetings and technical working groups between researchers and policy makers can facilitate the use of health research evidence in policy formulation.Social implicationsIn terms of framework there is need to put in place formal interaction frameworks between health researchers and policy makers within the knowledge translation and exchange.Originality/valueThere is dearth of literature on the levels of involvement and interaction between health researchers and health policy or decision makers in health policy, systems and services research in Malawi. This study seeks to bridge the gap with empirical evidence.

Organizational Supports for Research Evidence Use in State Public Health Agencies: A Latent Class Analysis.

Use of research evidence in public health decision making can be affected by organizational supports. Study objectives are to identify patterns of organizational supports and explore associations with research evidence use for job tasks among public health practitioners. In this longitudinal study, we used latent class analysis to identify organizational support patterns, followed by mixed logistic regression analysis to quantify associations with research evidence use. The setting included 12 state public health department chronic disease prevention units and their external partnering organizations involved in chronic disease prevention. Chronic disease prevention staff from 12 US state public health departments and partnering organizations completed self-report surveys at 2 time points, in 2014 and 2016 (N = 872). Latent class analysis was employed to identify subgroups of survey participants with distinct patterns of perceived organizational supports. Two classify-analyze approaches (maximum probability assignment and multiple pseudo-class draws) were used in 2017 to investigate the association between latent class membership and research evidence use. The optimal model identified 4 latent classes, labeled as "unsupportive workplace," "low agency leadership support," "high agency leadership support," and "supportive workplace." With maximum probability assignment, participants in "high agency leadership support" (odds ratio = 2.08; 95% CI, 1.35-3.23) and "supportive workplace" (odds ratio = 1.74; 95% CI, 1.10-2.74) were more likely to use research evidence in job tasks than "unsupportive workplace." The multiple pseudo-class draws produced comparable results with odds ratio = 2.09 (95% CI, 1.31-3.30) for "high agency leadership support" and odds ratio = 1.74 (95% CI, 1.07-2.82) for "supportive workplace." Findings suggest that leadership support may be a crucial element of organizational supports to encourage research evidence use. Organizational supports such as supervisory expectations, access to evidence, and participatory decision making may need leadership support as well to improve research evidence use in public health job tasks.

Optimizing the Impact of Public-Academic Partnerships in Fostering Policymakers' Use of Research Evidence: Proposal to Test a Conceptual Framework.

BackgroundPrevious research has reported that public-academic partnerships (PAPs) can effectively promote PAP leaders’ use of research evidence in improving youth outcomes. However, the existing literature has not yet clarified whether and how PAP leaders’ use of research evidence evolves along the PAP life cycle and whether PAP partners’ concordant perceptions of usefulness of their PAP has an impact on PAP leaders’ use of research evidence. Developing a conceptual framework that recognizes the PAP life cycle and empirically identifying contexts and mechanisms of PAPs that promote PAP leaders’ use of research evidence from the PAP life cycle perspective are imperative to guide researchers and policymakers to successfully lead PAPs and foster policymakers’ use of research evidence for improving youth outcomes.ObjectiveUtilizing an integrated framework of organizational life cycle perspective, a social partnership perspective, and a realist evaluation, this study examines the extent to which PAP development and PAP leaders’ use of research evidence can be characterized into life cycle stages and identifies PAP contexts and mechanisms that explain the progress of PAPs and PAP leaders’ use of research evidence through life cycle stages. MethodsRecruiting PAPs across the United States that aim to improve mental health and promote well-being of youth aged 12-25 years, the study conducts a document analysis and an online survey of PAPs to inform policymakers and academic researchers on the contexts and mechanisms to increase PAP sustainability and promote policymakers’ use of research evidence in improving youth outcomes. ResultsFifty-three PAPs that meet the recruitment criteria have been identified, and document review of PAPs and participant recruitment for the online survey of PAP experience have been conducted. ConclusionsThis paper will help policymakers and researchers gain a deeper knowledge of the contexts and mechanisms for each PAP life cycle stage in order to optimize PAP leaders’ use of research evidence in achieving positive youth outcomes.International Registered Report Identifier (IRRID)DERR1-10.2196/14382

Attributes of context relevant to healthcare professionals\u2019 use of research evidence in clinical practice: a multi-study analysis

BackgroundTo increase the likelihood of successful implementation of evidence-based practices, researchers, knowledge users, and healthcare professionals must consider aspects of context that promote and hinder implementation in their setting. The purpose of the current study was to identify contextual attributes and their features relevant to implementation by healthcare professionals and compare and contrast these attributes and features across different clinical settings and healthcare professional roles.MethodsWe conducted a secondary analysis of 145 semi-structured interviews comprising 11 studies (10 from Canada and one from Australia) investigating healthcare professionals’ perceived barriers and enablers to their use of research evidence in clinical practice. The data was collected using semi-structured interview guides informed by the Theoretical Domains Framework across different healthcare professional roles, settings, and practices. We analyzed these data inductively, using constant comparative analysis, to identify attributes of context and their features reported in the interviews. We compared these data by (1) setting (primary care, hospital-medical/surgical, hospital-emergency room, hospital-critical care) and (2) professional role (physicians and residents, nurses and organ donor coordinators).ResultsWe identified 62 unique features of context, which we categorized under 14 broader attributes of context. The 14 attributes were resource access, work structure, patient characteristics, professional role, culture, facility characteristics, system features, healthcare professional characteristics, financial, collaboration, leadership, evaluation, regulatory or legislative standards, and societal influences. We found instances of the majority (n = 12, 86%) of attributes of context across multiple (n = 6 or more) clinical behaviors. We also found little variation in the 14 attributes of context by setting (primary care and hospitals) and professional role (physicians and residents, and nurses and organ donor coordinators).ConclusionsThere was considerable consistency in the 14 attributes identified irrespective of the clinical behavior, setting, or professional role, supporting broad utility of the attributes of context identified in this study. There was more variation in the finer-grained features of these attributes with the most substantial variation being by setting.

Approaches to measuring use of research evidence in K-12 settings: A systematic review

An increased focus on the use of research evidence (URE) in K-12 education has led to a proliferation of instruments measuring URE in K-12 education settings. However, to date, there has been no review of these measures to inform education researchers’ assessment of URE. Here, we systematically review published quantitative measurement instruments in K-12 education. Findings suggest that instruments broadly assess user characteristics, environmental characteristics, and implementation and practices. In reviewing instrument quality, we found that studies infrequently report reliability, validity, and demographics about the instruments they develop or use. Future work evaluating and developing instruments should explore environmental characteristics that affect URE, generate items that match up with URE theory, and follow standards for establishing instrument reliability and validity.

Validating the Alberta Context Tool in a multi-site Australian Emergency Department nurse population.

The organisational context of healthcare settings has an essential role in how research evidence is used in clinical practice. The Alberta Context Tool (ACT) measures 10 concepts of organisational context with higher scores indicating a more positive work environment and potentially better use of research evidence in patient care. We assessed the psychometric properties of the ACT in Emergency Departments (EDs). This validation study was conducted as part of a multi-centre trial of triage, treatment and transfer (T3 Trial) of patients with stroke admitted to EDs. Stratified sampling with proportional allocation was used to recruit ED nurses from 26 participating hospitals at baseline. Nurses completed a survey containing the ACT. Structural validity was investigated by exploratory and confirmatory factor analysis. Reliability was assessed using Cronbach’s alpha and intraclass correlation coefficients. Item-rest correlations and the average inter-item correlations were also assessed. 558 ED nurses completed the survey, comprised of 433 surveys without missing data. Our exploratory factor analysis produced a 14-factor structure, explaining 62% of variance of organisational context. For eight of ten concepts, item loadings matched the factor structure of the original ACT. Confirmatory factor analysis of the 10 ACT concepts showed moderate model fit (p = 0.001, root mean square error of approximation: 0.049, standardised root mean squared residual: 0.048). Cronbach’s alphas showed very good internal consistency for nine of ten ACT concepts (α>0.7; 0.45–0.90). Item-rest correlations indicated that most ACT items (50 of 56 items) within any concept related well to the total score of the concept. Average inter-item correlations indicated potential redundant items for three concepts (feedback processes, leadership, staffing) that were above the threshold of 0.5. While identifying a few shortcomings for some ACT concepts in an ED context, the majority of findings confirm reliability and validity of the original ACT in an Australian population of ED nurses.

AFCC Think Tanks: Promoting Dialogue on Difficult Issues in Family Law*

This article examines three think tanks sponsored by the Association of Family and Conciliation Courts, which convened representatives of different disciplines, often with differing perspectives, to address policy and practice dilemmas in family law and dispute resolution. This essay was initially commissioned by the Nuffield Foundation, London, UK, as an Insight Article for its Family Justice Observatory, which aims to improve the use of data and research evidence in the family justice system in England and Wales. The think tank process is described and analyzed, identifying factors that created challenges and those that led to success.

Health system constraints in integrating mental health services into primary healthcare in rural Uganda: perspectives of primary care providers

BackgroundThe World Health Organization issued recommendations to guide the process of integrating mental health services into primary healthcare. However, there has been general as well as context specific shortcomings in the implementation of these recommendations. In Uganda, mental health services are intended to be decentralized and integrated into general healthcare, but, the services are still underutilized especially in rural areas.PurposeThe purpose of this study was to explore the health systems constraints to the integration of mental health services into PHC in Uganda from the perspective of primary health care providers (PHCPs).MethodsThis was a cross sectional qualitative study guided by the Supporting the Use of Research Evidence (SURE) framework. We used a semi-structured interview guide to gain insight into the health systems constraints faced by PHCPs in integrating mental health services into PHC.ResultsKey health systems constraints to integrating mental health services into PHC identified included inadequate practical experience during training, patient flow processes, facilities, human resources, gender related factors and challenges with accessibility of care.ConclusionThere is need to strengthen the training of healthcare providers as well as improving the health care system that supports health workers. This would include periodic mental healthcare in-service training for PHCPs; the provision of adequate processes for outreach, and receiving, referring and transferring patients with mental health problems; empowering PHCPs at all levels to manage and treat mental health problems and adequately provide the necessary medical supplies; and increase the distribution of health workers across the health facilities to address the issue of high workload and compromised quality of care provided.