Background: ‘Embedded research’ (co-locating researchers within non-academic organisations) is advocated as a way of developing more effective services through better creation and application of knowledge.Aims and objectives: The existing literature on embedded initiatives has largely been descriptive. There has been less in the way of analysis, for example, disaggregating the components of such schemes, unpacking underpinning logics, or comparing the diverse ways in which schemes are instantiated. We aimed to explore the nature and organisation of such schemes in health settings in the UK, with the objective of providing a systematised means of understanding their makeup.Methods: This study uses a focused literature review combined with a systematic scoping exercise of extant initiatives. We assembled documentation on each scheme (n=45) and conducted in-depth interviews in twelve of them (n=17). Analytically, we focused on surfacing and articulating the key features of embedded research initiatives in relation to their intent, structure and processes. Findings were then tested and validated during a co-production workshop with embedded researchers and their managers.Findings: We identified 26 ‘clusters’ of peer-reviewed papers detailing specific embedded research initiatives, and we explored 45 extant initiatives. The initiatives were varied in intent, structure and processes, but we were able to surface ten themes representing common features: intended outcomes, power dynamics, scale, involvement, proximity, belonging, functional activities, skill and expertise, relational roles, and learning and reflection.Discussion and conclusion: The themes uncovered can be used as a framework for guiding further systematic and evaluative enquiry on embedded research initiatives.<br />Key messages<br /><ul><li>Embedded research initiatives come in a range of different shapes and sizes;</li><br /><li>Despite this variety, initiatives share a number of common features;</li><br /><li>An understanding of these features can promote dialogue about the design and management of embedded initiatives;</li><br /><li>These features can also guide systematic and evaluative enquiry of such initiatives.</li></ul>
Background The limitations of ‘knowledge transfer’ are increasingly recognised, with growing interest in ‘knowledge co-production in context’. One way of achieving the latter is by ‘embedding’ researchers in health service settings, yet how to deliver such schemes successfully is poorly understood. Objectives The objectives were to examine the nature of ‘embedded knowledge co-production’ and explore how embedded research initiatives can be designed more effectively. Design The study used four linked workstreams. Workstream 1 involved two parallel literature reviews to examine how ‘knowledge co-production’ and ‘embedded research’ are conceptualised, operationalised and discussed. In workstream 2, a scoping review of exisiting or recent ‘embedded researcher’ schemes in UK health settings was carried out. Workstream 3 involved developing four in-depth case studies on such schemes to understand their mechanisms, effectiveness and challenges. In workstream 4, insights from the other workstreams were used to provide recommendations, guidance and templates for the different ways embedded co-production may be framed and specified. The overall goal was to help those interested in developing and using such approaches to understand and address the design choices they face. Setting Embedded research initiatives in UK health settings. Data sources Data were sourced from the following: analysis of the published and grey literature (87 source articles on knowledge co-production, and 47 published reports on extant embedded research initiatives), documentation and interviews with key actors across 45 established embedded research initiatives, in-depth interviews and site observations with 31 participants over 12 months in four intensive case studies, and informal and creative engagement in workshops (n = 2) and with participants in embedded research initiatives who joined various managed discussion forums. Participants The participants were stakeholders and participants in embedded research initiatives. Results The literature reviews from workstream 1 produced practical frameworks for understanding knowledge co-production and embedded research initiatives, which, with the scoping review (workstream 2), informed the identification and articulation of 10 design concerns under three overarching categories: intent (covering outcomes and power dynamics), structures (scale, involvement, proximity and belonging) and processes (the functional activities, skills and expertise required, nature of the relational roles, and the learning mechanisms employed). Current instances of embedded research were diverse across many of these domains. The four case studies (workstream 3) added insights into scheme dynamics and life cycles, deepening understanding of the overarching categories and showing the contingencies experienced in co-producing knowledge. A key finding is that there was often a greater emphasis on embeddedness per se than on co-production, which can be hard to discern. Finally, the engaging and influencing activities running throughout (workstream 4) allowed these research-rooted insights to be translated into practical tools and resources, evidenced by peer-reviewed publications, for those interested in exploring and developing the approach. Conclusions Embedded research has a strong underpinning rationale, and more is becoming known about its design and management challenges. The tools and resources developed in this project provide a coherent evidence-informed framework for designing, operationalising and managing such schemes. It cannot yet be said with clarity that the potential benefits of embedded research are always deliverable, nor what the cost would be. Future work With the means to describe and categorise different types of embedded research initiatives, more evaluative work is now needed to examine the relative merits and costs of different designs. Funding This project was funded by the National Institute for Health Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 10, No. 3. See the NIHR Journals Library website for further project information.
Background: Embedded research involves co-locating researchers within non-academic organisations to better link research and practice. Embedded research initiatives are often complex and emergent with a range of underlying intents, structures and processes. This can create tensions within initiatives and contributes to ongoing uncertainty about the most suitable designs and the effectiveness of different approaches.Aims and objectives: We aimed to devise a practical framework to support those designing and cultivating embedded research by operationalising findings from an extensive study of existing initiatives.Key conclusions: The underpinning research on embedded initiatives – a literature review and scoping exercise of initiatives in health settings across the UK – showed that such initiatives share ten common sets of concerns in relation to their intent, structure and processes. We used these insights during a co-production workshop with embedded researchers and their managers that made use of a range of creative activities.The workshop resulted in a practical framework (and associated web-based tools) that draw on the metaphor of a garden to represent the growing, emergent nature of embedded research initiatives and the active work which individuals and organisations need to put into planning and maintaining such initiatives. Each of the aspects is represented as a separate area within the garden using relevant visual metaphors. Building on this, we also present a series of reflective questions designed to facilitate discussion and debate about design features, and we link these to the wider literature, thereby helping those involved to articulate and discuss their preferences and expectations.<br />Key messages<br /><ul><li>Embedded research initiatives are becoming increasingly popular across public sector organisations;</li><br /><li>There are many choices to be made when designing an embedded research initiative, and fresh challenges and tensions emerge as initiatives unfold;</li><br /><li>We present a structured, multilayered framework to support those designing, analysing and managing embedded research initiatives;</li><br /><li>The framework can support transparency, dialogue, agreement of expectations and ongoing learning within and between initiatives.</li></ul>
Trans-national medicine, historically associated with colonial politics, is now central to discourses of global health and development, thrust into mainstream media by catastrophic events (earthquakes, disease epidemics), and enshrined in the 2015 Sustainable Development Goals. Volunteer human-resource is an important contributor to international health-development work. International Voluntary Health Networks (IVHNs, that connect richer and poorer countries through healthcare) are situated at a meeting-point between geographies and sociologies of health. More fully developed social-geographic understandings will illuminate this area, currently dominated by instrumental health-professional perspectives. The challenge we address is to produce a geographically and sociologically-robust conceptual framework that appropriately recognises IVHNs' potentials for valuable impacts, while also unlocking spaces of constructive critique. We examine the importance of the social in health geography, and geographical potentials in health sociology (focusing on professional knowledge construction, inequality and capital, and power), to highlight the mutual interests of these two fields in relation to IVHNs. We propose some socio-geographical theories of IVHNs that do not naturalise inequality, that understand health as a form of capital, prioritise explorations of power and ethical practice, and acknowledge the more-than-human properties of place. This sets an agenda for theoretically-supported empirical work on IVHNs.
Avoiding philosophy as a trump-card in sociological writing. A study from the discourse of evidence-based healthcare. Abstract.In this article I explore a situation where health sociologists encounter pure-philosophical reasoning in the fabric of social life. Accounts of the relationship between philosophy and sociology tend to be framed in abstract theory, so there is a need for practical ways to anchor philosophical reasoning in sociological writing. I consider the use of philosophies as strategic tools for socially-grounded understanding, rather than rhetorical trump-cards which bypass socio-political questions. I present my understanding in two stages: first, I discuss my example topic of Evidence-Based Healthcare (EBHC), reviewing some philosophical contributions by writers in that discourse. These niche-writings I contextualise briefly in relation to other academic meetings between philosophy and sociology. Second, I offer three philosophical perspectives on the topic of EBHC, and outline their significance for understanding it sociologically. I conclude that to navigate the difficult ground where philosophy and sociology meet, sociologists can entrain pure-philosophical argumentation to the purpose of critical, socially-situated understandings.
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