Introducing Evidence Through Research “Push”

Abstract

A multitude of factors can influence the uptake and implementation of complex interventions in health care. A plethora of theories and frameworks recognize the need to establish relationships, understand organizational dynamics, address context and contingency, and engage key decision makers. Less attention is paid to how theories that emphasize relational contexts can actually be deployed to guide the implementation of an intervention. The purpose of the article is to demonstrate the potential role of qualitative research aligned with theory to inform complex interventions. We detail a study underpinned by theory and qualitative research that (a) ensured key actors made sense of the complex intervention at the earliest stage of adoption and (b) aided initial engagement with the intervention. We conclude that using theoretical approaches aligned with qualitative research can provide insights into the context and dynamics of health care settings that in turn can be used to aid intervention implementation.

An evaluation of a referral management and triage system for oral surgery referrals from primary care dentists: a mixed-methods study

“…67 This can help strengthen and add coherence to the findings. 79 The evaluation research, incorporating a time series analysis with a qualitative element, was progressed in harmony with the implementation of the electronic…”

Getting the most out of knowledge and innovation transfer agents in health care: a qualitative study

“…Erin's activities included providing market research, signposting people around the innovation systems, and linking people developing a service to commissioners. Two teams (Moorlands and Wetlands) were closest to more mainstream ideas of knowledge mobilisation 7,54,57,93,108,117,168 and provided formal research evidence to clinical/management teams. Some teams (Greenhills, Riverside and Homefields) were responsible for introducing or developing approaches to health-care management, such as QI methodologies and PPI approaches, through formal training and support of topic-specific networks (e.g.…”

“…Those in such a role can facilitate dialogue between research and practice, 7,93 creating awareness of both sides' interests and functions, 116 and building relationships. 54,57,117 By encouraging greater involvement of decision-makers in knowledge production and knowledge producers in decision-making, [117][118][119] and managing the 'messy engagement of multiple players', 81 these KIT agents or knowledge brokers help to dismantle the cultural and language barriers between the two worlds. They do this by translating knowledge into appropriate language, highlighting its relevance to practice and emphasising the cross-applicability of each sides' work.…”

“…They do this by translating knowledge into appropriate language, highlighting its relevance to practice and emphasising the cross-applicability of each sides' work. 11,57,116,117,120 More broadly, the role typically includes both 'hard' (obtaining and sharing diverse information) and 'soft' tasks (facilitating cross-group relationships, mentoring, coaching) to create a bridge across these knowledge gaps and foster a knowledge-responsive capacity and culture. 5,[56][57][58][59] Managing the 'messy' process 81 requires the broker to impose some form of structure on the process.…”

“…There are a wide variety of models of knowledge transfer and mobilisation outlined in various fields of health-care literature. 117,121,122 Typically, methods include workshops or other professional development activities, written communication through print and electronic media and personal face-to-face contact, building linkage and exchange. 57,93,123 Through negotiation and understanding, the knowledge being mobilised across specialisations and organisations is reframed into a mutually agreed upon version.…”