Looking for interaction: quantitative measurement of research utilization by Dutch local health officials

Abstract

BackgroundIn the Netherlands, local authorities are required by law to develop local health memoranda, based on epidemiological analyses. The purpose of this study was to assess the actual use of these epidemiological reports by municipal health officials and associated factors that affect this use.MethodBased on a conceptual framework, we designed a questionnaire in which we operationalized instrumental, conceptual, and symbolic use, the interaction between researchers and local health officials, and four clusters of barriers in this interaction process. We conducted an internet survey among 155 Dutch local health officials representing 35% of all Dutch municipalities. By means of multiple regression analyses, we gained insight into the related factors for each of the three types of research utilization.ResultsThe results show that local health officials use epidemiological research more often in a conceptual than an instrumental or symbolic way. This can be explained by the complexity of the local policy process which is often linked to policies in other areas, and the various policy actors involved. Conceptual use was statistically associated with a presentation given by the epidemiologist during the policy process, the presence of obstructions regarding the report's accessibility, and the local official's personal belief systems and interests originating from different professional values and responsibilities. Instrumental and symbolic use increased with the involvement of local officials in the research process.ConclusionsThe results of this study provide a partial solution to understanding and influencing research utilization. The quantitative approach underpins earlier qualitative findings on this topic. The outcomes suggest that RPHS epidemiologists can use different strategies to improve research utilization. 'Blurring the boundaries', and the enhancement of interfaces between epidemiologists and local health officials, like direct interactions into each other's work processes, is expected to create better possibilities for optimizing research use.

Utilization of a population health survey in policy and practice: a case study

“…We identified only one such study by de Goede and colleagues, exploring the use of epidemiological research in the development of local public health policy in the Netherlands [9,10]. This study found that survey data was more often used in a conceptual way to improve understanding of the health problem or issue, rather than in a specific and direct way (instrumental use) or to justify a position or particular course of action (symbolic use) [10]. Research use was influenced by interaction between researchers and local health officials, the personal belief systems of the actors involved, and a range of contextual factors [9].…”

Evaluating and Using Observational Evidence: The Contrasting Views of Policy Makers and Epidemiologists

“…There is also a range of political, economic, and social drivers which affect decisions during policy development. In order to support a particular policy agenda, while also managing the competing interests of diverse stakeholders, policy makers may use specific information without giving consideration to all the available evidence (4, 7) or may not be able to directly translate the findings, or recommendations, from epidemiological research into action within their particular context (8). …”

Connecting Research to Action: Perspectives on Research Utilisation

“…Repeated claims are well recognised, on the one hand that practitioners make too little use of research (De Goede et al, 2012;Hanney et al, 2003;Landry et al, 2007) and on the other that researchers pay insufficient attention to making their findings known, useful, and usable (Cooper and Levin, 2010;Nutley et al, 2007). When addressing this challenge, the research utilisation literature frequently envisages two communities or cultures: those who generate research and those who might use it.…”

“…In fact, KPU literature offers a diverse range of knowledge exchange models and emphases. Some highlight broadly the quality of interaction between participants from both communities and the fit between their values and beliefs (De Goede et al, 2012;Weiss, 1979). Others, such as linkage models, concern researchers and users sharing expertise, knowledge and learning for specific purposes (Bowen and Martens, 2005).…”

“…So, for example, KPU looks directly at the nature and stages of research use. Several studies suggest the need to clarify and broaden understanding and measurement of research use, beyond instrumental use (direct application in, and impact upon, practice), to include conceptual use (altered understanding and thinking in practice situations) and symbolic use (superficially endorsing, but in practice ignoring research when it contradicts received wisdoms, dominant norms and political or resource priorities) (De Goede et al, 2012;Ginsburg et al, 2007;Wallin et al, 2012;Weiss, 1979). In line with this broadened understanding, KPU has also attempted to characterise and measure stages of research use, notably with Knott and Wildavsky's (1980) scale conceiving a seven-stage progressive process involving 'reception, cognition, reference, effort, adoption, implementation, and impact' (p.…”