Policy is political; our ideas about knowledge translation must be too

Morgan‐Trimmer, Sarah

doi:10.1136/jech-2014-203820

Cited by 17 publications

(12 citation statements)

References 18 publications

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“…In keeping with this, Liverani et al's (2013) systematic review found a dearth of empirical studies investigating the political and institutional factors shaping evidence utilisation in the health sector. A recent editorial in the Journal of Epidemiology and Community Health highlights the limited penetration of this message amongst scholars and practitioners in the health community (Morgan-Trimmer, 2014).…”

Section: Evidence-based Health Policymentioning

confidence: 99%

“…In some contexts, efforts to address a lack of capacity in both evidence synthesis and use are important steps in improved policy outcomes. However, it has been noted that the predominant discourse of EBPM fails to take sufficient account of the inherently political nature of the policy-making process (Sanderson, 2009;Russell et al, 2008;Pawson, 2006;Barnes and Parkhurst, 2014;Morgan-Trimmer, 2014;Greenhalgh and Wieringa, 2011;Smith, 2013a). Advocates of EBPM appear to assume that the right policy prescription can be derived from relevant research evidence.…”

Section: Introductionmentioning

confidence: 99%

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The ‘good governance’ of evidence in health policy

Hawkins

Parkhurst

2016

Evidence &Amp; Policy

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Calls for evidence-based policy often fail to recognise the fundamentally political nature of policy making. Policy makers must identify, evaluate and utilise evidence to solve policy problems in the face of competing priorities and political agendas. Evidence should inform but cannot determine policy choices. This paper draws on theories of 'good governance' to develop a framework for analysing and evaluating processes of evidence-informed policy making. 'Good governance' requires the use of appropriate bodies of high-quality evidence to inform policy and promotes decision-making processes that are transparent, accountable and open to contestation by the populations they govern.

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Section: Evidence-based Health Policymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The ‘good governance’ of evidence in health policy

Hawkins

Parkhurst

2016

Evidence &Amp; Policy

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“…It is the task of public representatives to scrutinise knowledge production, and when and how knowledge should be used. 26,27 Second, legitimate government requires working through vexing moral choices; this can only be done through debate. 12 Third, there are risks with equating the right to power with the possession of knowledge -akin to 'epistocracy', a term coined by Estland to describe the type of society in which experts rule over democratic policy.…”

Section: Critical Theory and Political Philosophymentioning

confidence: 99%

Challenges of integrating evidence into health policy and planning: linking multiple disciplinary approaches

Schneider

Blyth

2017

Public Health Res Pr

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Objectives: To explore the challenges that arise through the multidisciplinary nature of evidence informed policy making (EIPM).Type of program or service: Education and practice for EIPM. Methods:This article summarises and compares four disciplinary approaches to EIPM with highly contrasting starting points: behavioural science, policy science, critical theory and intervention research. Key insights and theories are highlighted to provide a gateway into each, and to complement what is already known about the evidence needs of policy makers in terms of high-quality, timely and well-communicated research evidence. Lessons learnt:The extension of the evidence based medicine approach to EIPM has created interest in the processes of use of evidence in health policy and planning. Research in this field has spanned multiple disciplines; however, the disciplines use very different research methods and begin with different basic assumptions. Thus, despite the multidisciplinary nature of EIPM, true interdisciplinary research and action remain a challenge. We conclude with a set of key questions that can be used as a gateway to interdisciplinary EIPM in the future.

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“…Health policy is political [ 4 ]. Policymakers have goals which reflect the social values and interests they are promoting, influenced by public concerns and mass media attention to a problem, and, to a lesser extent, by data [ 5 ].…”

Section: Accumulating Large Lessons From Small Changesmentioning

confidence: 99%

Evaluation as evolution: a Darwinian proposal for health policy and systems research

Martiniuk

Abimbola

Zwarenstein

2015

Health Res Policy Sys

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BackgroundHealth systems are complex and health policies are political. While grand policies are set by politicians, the detailed implementation strategies which influence the shape and impact of these policies are delegated to technical personnel. This is an underappreciated opportunity for optimising health systems. We propose that selective ‘breeding’ through successive evaluations of and selection among implementation strategies is a metaphor that health system thinkers can use to improve health care.DiscussionSimilar to Darwinian evolution, the acceptance and accumulation of successful choices and the detection and discarding of unsuccessful ones would improve health systems in small and uncontroversial ways, over time. The effects of better implementation choices would be synergistic and cumulative, accumulating large impact (and lessons) from small changes. Just as with evolution of species, this means that even slight improvements over usual outcomes makes these numerous small choices as important a focus for system improvement as the overarching policy itself. Several alternative implementation approaches can be compared under real-world conditions in prospective head-to-head experimental and non-experimental explorations to understand whether and to what extent a strategy works and what works for whom, how, and under what circumstances in different locations. As in breeding or evolution, the best variants would spread to become the new, proven superior, implementation strategies for that policy in those settings.ConclusionsEvolution does not produce a new species whole, in a single transaction. Instead it gathers new parts and powers over time as different combinations are tested through competition with one another, to survive and spread or become extinct. Without necessarily changing or challenging grand policies, extending this idea to health systems innovation can facilitate thinking around how local, small – but cumulative – improvements in implementation potentially contribute to a pattern of successive adaptation spreading within its viable niche and ultimately providing locally-derived, long-term improvements in health systems.

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Policy is political; our ideas about knowledge translation must be too

Cited by 17 publications

References 18 publications

The ‘good governance’ of evidence in health policy

The ‘good governance’ of evidence in health policy

Challenges of integrating evidence into health policy and planning: linking multiple disciplinary approaches

Evaluation as evolution: a Darwinian proposal for health policy and systems research

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