The impact of context on evidence utilization: A framework for expert groups developing health policy recommendations

Dobrow, Mark; Goel, Vivek; Lemieux‐Charles, Louise; Black, Nick

doi:10.1016/j.socscimed.2006.04.020

Cited by 147 publications

(108 citation statements)

References 24 publications

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“…Dobrow et al 2006), but remains a particularly problematic concept. For instance, although we have some understanding of the different types of contextual features which may constrain or enable knowledge exchange, these tend to be relatively narrowly defined, frequently focusing on the behaviour and beliefs of individual knowledge users or on the characteristics of the organisations in which those individuals operate (see e.g.…”

Section: Discussionmentioning

confidence: 99%

Exploring knowledge exchange: A useful framework for practice and policy

Ward¹,

Smith²,

House³

et al. 2012

Social Science & Medicine

196

245

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Section: Discussionmentioning

confidence: 99%

Exploring knowledge exchange: A useful framework for practice and policy

Ward¹,

Smith²,

House³

et al. 2012

Social Science & Medicine

196

245

View full text Add to dashboard Cite

“…Studies have shown, for example, that the same evidence may lead to different outcomes in different decision-making contexts, 80 or that some translational activities, such as knowledge-broker roles, may be adaptable to different contexts. 49 At the same time, there remains a gap within the existing literature on how contextual features influence the KT process.…”

Section: The Impact Of the Institutional And Policy Contextmentioning

confidence: 99%

Networked innovation in the health sector: comparative qualitative study of the role of Collaborations for Leadership in Applied Health Research and Care in translating research into practice

Scarbrough

D'Andreta

Evans

et al. 2014

Health Services and Delivery Research

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BackgroundCollaborations for Leadership in Applied Health Research and Care (CLAHRCs) were an initiative of the National Institute for Health Research in response to a new research and development strategy in the NHS: ‘Best Research for Best Health’. They were designed to address the ‘second gap in translation’ identified by the Cooksey review; namely, the need to improve health care in the UK by translating clinical research into practice more effectively. Nine CLAHRCs, each encompassing a university in partnership with local NHS bodies, were funded over the period 2008–13.AimsThe aim of this report is to provide an independent and theory-based evaluation of CLAHRCs as a new form of networked innovation in the health sector. This evaluation is based on an intensive research study involving three CLAHRCs in the UK and three international organisations (one in the USA and two in Canada). This study was carried out over two overlapping time phases so as to capture changes in the CLAHRCs over time. Networked innovation in the health sector is conceptualised as involving the translation of knowledge via informal social networks.MethodsA mix of research methods was used to help ensure the validity and generalisability of the study. These methods addressed the development of each CLAHRC over time, over multiple levels of analysis, and with particular reference to the translation of knowledge across the groups involved, and the quality of the informal underpinning network ties that supported such translation. Research methods, therefore, included a qualitative enquiry based on case studies and case analysis, cognitive mapping methods, and social network analysis.FindingsThrough our study, we found that each one of our samples of CLAHRCs appropriated the CLAHRC idea in a particular way, depending on their different interpretations or ‘visions’ of the CLAHRC’s role in knowledge translation (KT), and different operating models of how such visions could be achieved. These helped to shape the development of social networks (centralised vs. decentralised) and each CLAHRC’s approach to KT activity (‘bridging’ vs. ‘blurring’ the boundaries between professional groups). Through a comparative analysis, we develop an analytical model of the resultant capabilities which each case, including our international sites, developed for undertaking innovation, encompassing a combination of both ‘integrative capability’ (the ability to move back and forth between scientific evidence and practical application) and ‘relational capability’ (the ability of groups and organisations to work together). This extends previous models of KT by highlighting the effects of leadership and management, and the emergence of social network structures. We further highlight the implications of this analysis for policy and practice by discussing how network structures and boundary-spanning roles and activities can be tailored to different KT objectives.ConclusionsDifferent interpretations and enactments of the CLAHRC mission ultimately led to differing capabilities for KT among our studied initiatives. Further research could usefully explore how these different capabilities are produced, and how they may be more or less appropriate for particular national health-care settings, with a view to improving the design blueprint for future KT initiatives.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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“…They conclude from their empirical findings of evidence use in healthcare organisations that 'local contexts are multifaceted, multidimensional configurations of forces which often interact in complex ways ... [and] that context is socially perceived and enacted, and is, therefore, actively brought into the processes of innovation ' (2005: 102-3). While Dobrow et al (2006) considered the impact of context on evidence use by expert groups, their analysis did not go beyond the policy formulation stage to policy implementation. Pawson (2006: 24-5) We argue here for a broader and more inclusive definition of context, which considers the resource, ethical, institutional and political environments that shape not just the development of policy options, but also their implementation.…”

Section: The Need For a Broader Viewmentioning

confidence: 99%

“…If the active role and broad nature of context is accepted, it suggests a potential difficulty with the argument that global methods can be used to apply evidence in different decision-making contexts, as Dobrow et al (2006) advocate. Similarly, the primacy of context in policy making calls into question the notion of` global evidence' and `global public goods' (Lavis et al, 2008).…”

Section: Lessons From the Case Study: (2) Implications For Research Umentioning

confidence: 99%

When good evidence is not enough: the role of context in bowel cancer screening policy in New Zealand

Flitcroft

Gillespie

Carter³

et al. 2011

Evidence &Amp; Policy

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Bowel cancer is a serious health problem in developed countries. Australia, the United Kingdom (UK) and New Zealand (NZ) reviewed the same randomised controlled trial evidence on the benefits and harms of population-based bowel cancer screening. Yet only NZ, with the highest age standardised rate of bowel cancer mortality, decided against introducing a bowel cancer screening programme. This case study of policy making explores the unique resource, ethical, institutional and political environments in which the evidence was considered. It highlights the centrality of context in assessing the relative worth of evidence in policy making and raises questions about the suitability of knowledge utilisation strategies.

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The impact of context on evidence utilization: A framework for expert groups developing health policy recommendations

Cited by 147 publications

References 24 publications

Exploring knowledge exchange: A useful framework for practice and policy

Exploring knowledge exchange: A useful framework for practice and policy

Networked innovation in the health sector: comparative qualitative study of the role of Collaborations for Leadership in Applied Health Research and Care in translating research into practice

When good evidence is not enough: the role of context in bowel cancer screening policy in New Zealand

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