Beyond "Two Cultures": Guidance for Establishing Effective Researcher/Health System Partnerships

Bowen, Sarah; Botting, Ingrid; Graham, Ian D.; Huebner, Lori-Anne

doi:10.15171/ijhpm.2016.71

Cited by 43 publications

(58 citation statements)

References 49 publications

(53 reference statements)

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“…According to the theory delineated in Fig. 3 , researcher–decision-maker collaboration (the intervention that is IKT) fosters both capacity-building and relationship-building (M1) [ 2 , 18 , 21 – 23 ]. Researchers gain skills in working and communicating effectively with decision-makers, and learn from them about organisational needs and context (M1a); decision-makers improve their research literacy and ability to work with researchers (M1b).…”

Section: Main Textmentioning

confidence: 99%

Advancing the evaluation of integrated knowledge translation

Kreindler

2018

Health Res Policy Sys

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BackgroundIntegrated knowledge translation (IKT) flows from the premise that knowledge co-produced with decision-makers is more likely to inform subsequent decisions. However, evaluations of manager/policy-maker-focused IKT often concentrate on intermediate outcomes, stopping short of assessing whether research findings have contributed to identifiable organisational action. Such hesitancy may reflect the difficulty of tracing the causes of this distal, multifactorial outcome. This paper elucidates how an approach based on realistic evaluation could advance the field.Main TextRealistic evaluation views outcomes as a joint product of intervention mechanisms and context. Through identification of context–mechanism–outcome configurations, it enables the systematic testing and refinement of ‘mid-range theory’ applicable to diverse interventions that share a similar underlying logic of action. The ‘context-sensitive causal chain’ diagram, a tool adapted from the broader theory-based evaluation literature, offers a useful means of visualising the posited chain from activities to outcomes via mechanisms, and the context factors that facilitate or disrupt each linkage (e.g. activity–mechanism, mechanism–outcome).Drawing on relevant literature, this paper proposes a context-sensitive causal chain by which IKT may generate instrumental use of research findings (i.e. direct use to make a concrete decision) and identifies an existing tool to assess this outcome, then adapts the chain to describe a more subtle, indirect pathway of influence. Key mechanisms include capacity- and relationship-building among researchers and decision-makers, changes in the (perceived) credibility and usability of findings, changes in decision-makers’ beliefs and attitudes, and incorporation of new knowledge in an actual decision. Project-specific context factors may impinge upon each linkage; equally important is the organisation’s absorptive capacity, namely its overall ability to acquire, assimilate and apply knowledge. Given a sufficiently poor decision-making environment, even well-implemented IKT that triggers important mechanisms may fall short of its desired outcomes. Further research may identify additional mechanisms and context factors.ConclusionBy investigating ‘what it is about an intervention that works, for whom, under what conditions’, realistic evaluation addresses questions of causality head-on without sacrificing complexity. A realist approach could contribute greatly to our ability to assess – and, ultimately, to increase – the value of IKT.

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Section: Main Textmentioning

confidence: 99%

Advancing the evaluation of integrated knowledge translation

Kreindler

2018

Health Res Policy Sys

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“…Emerging scholarship focusing on participatory action research [ 8 , 36 ], the UK CLAHRCs [ 37 – 42 ] and CIHR’s evaluation of its IKT programmes [ 43 , 44 ], is beginning to support the claims that IKT may lead to increased knowledge user capacity to use research; produce research that is more useful to knowledge users; increase the use of research in practice, health systems and policy decisions; and improve patient and health system outcomes. Studies are appearing describing how research partnerships work [ 45 – 47 ]. There is some evidence to suggest that in these collaborative research partnerships, researchers are the ones who benefit more by learning about the knowledge users’ context [ 11 , 48 ].…”

Section: Introductionmentioning

confidence: 99%

Moving knowledge into action for more effective practice, programmes and policy: protocol for a research programme on integrated knowledge translation

2018

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BackgroundHealth research is conducted with the expectation that it advances knowledge and eventually translates into improved health systems and population health. However, research findings are often caught in the know-do gap: they are not acted upon in a timely way or not applied at all. Integrated knowledge translation (IKT) is advanced as a way to increase the relevance, applicability and impact of research. With IKT, knowledge users work with researchers throughout the research process, starting with identification of the research question. Knowledge users represent those who would be able to use research results to inform their decisions (e.g. clinicians, managers, policy makers, patients/families and others). Stakeholders are increasingly interested in the idea that IKT generates greater and faster societal impact. Stakeholders are all those who are interested in the use of research results but may not necessarily use them for their own decision-making (e.g. governments, funders, researchers, health system managers and policy makers, patients and clinicians). Although IKT is broadly accepted, the actual research supporting it is limited and there is uncertainty about how best to conduct and support IKT. This paper presents a protocol for a programme of research testing the assumption that engaging the users of research in phases of its production leads to (a) greater appreciation of and capacity to use research; (b) the production of more relevant, useful and applicable research that results in greater impact; and (c) conditions under which it is more likely that research results will influence policy, managerial and clinical decision-making.MethodsThe research programme will adopt an interdisciplinary, international, cross-sector approach, using multiple and mixed methods to reflect the complex and social nature of research partnerships. We will use ongoing and future natural IKT experiments as multiple cases to study IKT in depth, and we will take advantage of the team’s existing relationships with provincial, national and international organizations. Case studies will be retrospective and prospective, and the 7-year grant period will enable longitudinal studies. The initiation of partnerships, funding processes, the research lifecycle and then outcomes/impacts post project will be studied in real time. These living laboratories will also allow testing of strategies to improve the efficiency and effectiveness of the IKT approach.DiscussionThis is the first interdisciplinary, systematic and programmatic research study on IKT. The research will provide scientific evidence on how to reliably and validly measure collaborative research partnerships and their impacts. The proposed research will build the science base for IKT, assess its relationship with research use and identify best practices and appropriate conditions for conducting IKT to achieve the greatest impact. It will also train and mentor the next generation of IKT researchers.

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“…2-5 Rycroft-Malone et al 6 note that, while promising, the IKT approach is not without its challenges. The authors highlight issues of power, politics, and perceptions that require careful attention if an IKT approach is to be successful.…”

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confidence: 99%