Taking Power, Politics, and Policy Problems Seriously

Abstract

Knowledge Translation (KT) is a growing movement in clinical and health services research, aimed to help make research more relevant and to move research into practice and policy. This paper examines the conventional model of policy change presented in KT and assesses its applicability for increasing the impact of urban health research on urban health policy. In general, KT conceptualizes research utilization in terms of the technical implementation of scientific findings, on the part of individual decision-makers who can be "targeted" for a KT intervention, in a context that is absent of political interests. However, complex urban health problems and interventions infrequently resemble this single decision, single decision-maker model posited by KT. In order to clarify the conditions under which urban health research is more likely or not to have an influence on public policy development, we propose to supplement the conventional model with three concepts drawn from the social science: policy stages, policy networks, and a discourse analysis approach for theorizing power in policy-making.

Introduction—Knowledge Translation and Urban Health Equity: Advancing the Agenda

“…Wallace, 11 on the other hand, is sceptical of research-policy collaborations for urban health, pointing to governments' continued support for the war on drugs, in spite of mounting evidence about the health and social effectiveness of harm reduction approaches. The limits to genuine collaboration between researchers and decision makers are also important for Muntaner et al 17 and are discussed in the paper by Murphy and Fafard 16 , who use a discourse analysis approach to show why researcher/decision maker relationships may in fact be highly undesirable to both parties, particularly if their definitions of the policy problem are conflicting.…”

“…13,16,23 The authors of the papers collected here show how the urban health research community can draw on the ongoing efforts in these other disciplines to work through such complex KT challenges. In sum, these papers suggest an exciting and complex agenda for urban health researchers, that will foster greater intentionality and deliberateness in relation to both our policy change goals, and our diverse research roles.…”

Three lessons from evidence-based medicine and policy: increase transparency, balance inputs and understand power

“…While these moves were significant in medicine, methodological pluralism has always been more acceptable in policy (Ingold and Monaghan, n.d.;Murphy and Fafard, 2012). Policy meanings affect the presentation, acceptance and framing of evidence and are vital to identifying levers for action (Grundmann and Stehr, 2012;Pearce et al, 2017).…”

“…Some have begun to use policy studies to explore the importance and dynamics of power, inclusivity and advocacy (e.g., Cairney, 2017;Liverani et al, 2013;Pearce, 2014;Wesselink et al, 2014;Head, 2008). Acknowledging the importance of power, however, has not yet been taken on board by practitioners when developing strategies to support evidence informed decision-making (Fafard, 2015;Head, 2010;Murphy and Fafard, 2012;Parkhurst, 2017b;Smith, 2013a).…”

Priorities of Municipal Policy Makers in Relation to Physical Activity and the Built Environment

“…Scientific articles call for public health professionals to appeal to policymakers on the basis of evidence to support physical activity initiatives 6 or recommend that policymakers “implement” findings from research. 7 However, multiple issues influence policymaker decisions, including budget, policy compatibility, and stakeholder interests. 8, 9 Understanding policymaker priorities and how to better target messages for this audience is critical for translating scientific findings into policy actions 10, 11 and identifying leverage points in the policy process.…”