Factors influencing application of behavioural science evidence by public health decision-makers and practitioners, and implications for practice

Abstract

The National Institute of Health and Care Excellence (NICE) in the UK recommends behavioural science evidence underpins public health improvement services. In practice, level of implementation varies. This study is the first to explore factors affecting use of behaviour-specific evidence by public health decision-makers and practitioners for design and delivery of health improvement services. Twenty semi-structured interviews were conducted, along with a review of the commissioning cycle with public health decision-makers and practitioners across a range of health improvement fields (e.g. weight management). Interviews were informed and analysed using the Theoretical Domains Framework (TDF). Limited comprehension of behaviour change, challenges identifying specific behaviour change strategies and translating research into practice were prevalent. Local authority processes encouraged uptake of evidence to justify solutions as opposed to evidence-driven decision-making. Some decision-makers perceived research evidence may stifle innovation and overwhelm practitioners. Potential facilitators of research use included: ensuring uptake and implementation of evidence is compulsory within commissioning and its potential to show value for money. A strong belief in local evidence and achieving outcomes were identified as barriers to research evidence uptake. Social and environmental challenges included cultural, political, and workload pressures and journal article accessibility. Embedding behavioural science systematically into public health practice requires changes throughout the public health system; from priorities set by national public health leaders to the way in which relevant evidence is disseminated. Framing factors affecting use of behavioural science evidence using the TDF is helpful for identifying the range of interventions and support needed to affect change.

Evidence-based policy making for health promotion to reduce the burden of non-communicable diseases in Moldova

“…Health psychology research can inform the development of appropriate individual and population health promoting strategies but access by Moldovan specialists to this body of scientific evidence requires sustained support and investment. Overall, there is growing awareness of the complexities of embedding behavioural science in public health practice more widely [94]. It will be important that health promotion strategy development benefit from extensive and appropriately funded stakeholder consultations to ensure the inclusion of the latest evidence.…”

Advancing methodology for scoping reviews: recommendations arising from a scoping literature review (SLR) to inform transformation of children and adolescent mental health services.

“…Evidence-based policy requires evidence, yet the policy and research cycles operate on vastly different timescales. There is consensus that health services commissioning and clinical practice should be driven by scienti c evidence, but decision-makers often feel that gathering evidence may slow down innovation and overwhelm frontline staff (1). Workload pressures and accessibility of peer reviewed publications are often cited as barriers to uptake of research evidence by commissioners (1,2).…”

“…There is consensus that health services commissioning and clinical practice should be driven by scienti c evidence, but decision-makers often feel that gathering evidence may slow down innovation and overwhelm frontline staff (1). Workload pressures and accessibility of peer reviewed publications are often cited as barriers to uptake of research evidence by commissioners (1,2). In addition to time constraints and accessibility, practitioners may lack the skills to nd, appraise and synthesise relevant evidence (3).…”

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“…Recent key recommendations for increasing behavioural science research uptake in public health practice have highlighted the need to understand real-world practicalities and identify barriers and opportunities relevant to implementation. 2 Here we share our experience of disseminating and implementing the online version of the intervention from the BREATHE trial.…”