When does evidence-based policy turn into policy-based evidence? Configurations, contexts and mechanisms

Straßheim, Holger; Kettunen, Pekka

doi:10.1332/174426514x13990433991320

Cited by 167 publications

(103 citation statements)

References 45 publications

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“…Our participants, for example, explained that infrastructural schemes were highly politicised and that in the current climate of financial austerity in the public sector, any business cases were increasingly reduced to an economic bottom line. It has been suggested that evidence in policy should be considered as “socially embedded in authority relations” [36], and that politics is not a third pillar besides research and policy but runs through all domains [30]. …”

Section: Discussionmentioning

confidence: 99%

Negotiating multisectoral evidence: a qualitative study of knowledge exchange at the intersection of transport and public health

2017

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BackgroundFor the prevention and control of chronic diseases, two strategies are frequently highlighted: that public health should be evidence based, and that it should develop a multisectoral approach. At the end of a natural experimental study of the health impacts of new transport infrastructure, we took the opportunity of a knowledge exchange forum to explore how stakeholders assessed, negotiated and intended to apply multisectoral evidence in policy and practice at the intersection of transport and health. We aimed to better understand the challenges they faced in knowledge exchange, as well as their everyday experiences with working in multisectoral remits.MethodsIn 2015, we conducted participant observation during an interactive event with 41 stakeholders from national and local government, the third sector and academia in Cambridge, UK. Formal and informal interactions between stakeholders were recorded in observational field notes. We also conducted 18 semistructured interviews reflecting on the event and on knowledge exchange in general.ResultsWe found that stakeholders negotiated a variety of challenges. First, stakeholders had to negotiate relatively new formal and informal multisectoral remits; and how to reconcile the differing expectations of transport specialists, who tended to emphasise the importance of precedence in guiding action, and health specialists’ concern for the rigour and synthesis of research evidence. Second, research in this field involved complex study designs, and often produced evidence with uncertain transferability to other settings. Third, health outcomes of transport schemes had political traction and were used strategically but not easily translated into cost-benefit ratios. Finally, knowledge exchange meant multiple directions of influence. Stakeholders were concerned that researchers did not always have skills to translate their findings into understandable evidence, and some stakeholders would welcome opportunities to influence research agendas.ConclusionsThis case study of stakeholders’ experiences indicates that multisectoral research, practice and policymaking requires the ability and capacity to locate, understand and communicate complex evidence from a variety of disciplines, and integrate different types of evidence into clear business cases beyond sectoral boundaries.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3940-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Negotiating multisectoral evidence: a qualitative study of knowledge exchange at the intersection of transport and public health

2017

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“…In this context, this essay tries to disentangle the rhetoric with available empirical evidence to enable a more rational debate, at least in the discussion of policies, if not in the public arena. In recent years, the 'Evidence-Based Policy' (EBM) agenda has been challenged and the expression turned on its head by authors who talk about 'Policy-Based Evidence Making' (Sanderson, 2011;Strassheim & Kettunen, 2014;Torriti, 2010) ix . Critics argue that, even where facts are uncertain and values in dispute x , the EBP approach still relies on a-critical forms of empiricism and technocratic 'scientisation'…”

Section: Objectives Approach and Sourcesmentioning

confidence: 99%

The Passions and the Interests: Unpacking the 'Sharing Economy'

2016

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Digital platforms generally placed under the 'sharing economy' and various other labels match different groups of users and providers and enable the increase in scale and speed for traditional transactions such as selling, renting, lending, labour trade, and provision of services. In many cases, these platform-mediated activities involve peer-topeer or peer-to-business transactions that occur in a regulatory vacuum. Since 2014, the phenomenal growth of a few large commercial 'sharing' platforms, the increasing number of economic sectors affected, and the conflicting interests among the stakeholders involved have made the 'sharing economy' a domain of conflictual rhetoric and public controversies, legal disputes, and even violent protests. The various expressions used to refer to 'sharing' platforms, by now appropriated by practitioners and stakeholders, are 'floating signifiers' for all sorts of different activities, in what can be called the rhetorical politics of platformisation. Terms and concepts are used in such confused and confusing ways that it is at times difficult to ascertain whether advocates, opponents, regulators, and policy makers are discussing the same phenomenon. There is a closed self-reproducing loop between conceptual ambiguity, rhetorical controversies, and lack of sound measurement and empirical evidence. This loop, in turn, limits the space for a rational debate of alternative policy options and contributes to the fragmented regulatory approaches which currently address the 'sharing economy'. This theoretically-inspired and empirically-informed critical essay (i) unpacks the 'sharing economy' rhetoric, (ii) clears the field of semantic and conceptual ambiguity by providing a heuristicallyuseful and empirically-grounded typology, (iii) maps the controversies against available empirical evidence on the functioning and on the impacts of 'sharing' platforms, (iv) reviews the debate and the literature which focuses on regulatory and policy issues, and (v) discusses all these aspects in terms of their policy implications, and of future European research on this topic. It does so in a unique way, because of the extensive evidence base used and the inter-disciplinary approach it takes in which theoretical and empirical economics, sociology, anthropology, regulatory and legal studies, and rhetorical analysis converge. The evidence comprises: a) 120 media items (newspapers and magazine articles; blogs especially by 'sharing economy' advocacy groups and organisations; industry briefs etc.); b) in-depth analysis of a purposive sample of 70 platforms (website, blog, public relations and self-reports, etc.); c) 140 sources, consisting of scientific items (115) and broadly defined reports (25), selected using a formalised protocol and systematically reviewed; c) about 60 reports released by interested parties (industrial associations, platforms own reports and public relation materials); d) 70 indirectly relevant scientific contributions and policy reports.

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“…Research evidence was later developed to support a policy already selected. The field of public health may be especially prone to the generation of “policy‐based evidence,” because of the pressure to make “science‐based” decisions under profound and often inescapable time constraints and because policy formation often occurs at the limits of existing knowledge . The impulse to take action may influence decision makers’ interpretations of the evidence, and perceptions of a need to protect credibility and deflect criticism may promote a tendency to find evidence that supports existing policies and to conceal conceptual doubts in the backstage…”

Section: Resultsmentioning

confidence: 99%

Evidence and the Politics of Deimplementation: The Rise and Decline of the “Counseling and Testing” Paradigm for HIV Prevention at the US Centers for Disease Control and Prevention

Johns

Bayer

Fairchild

2016

The Milbank Quarterly

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Policy Points: In situations of scientific uncertainty, public health interventions, such as counseling for HIV infection, sometimes must be implemented before obtaining evidence of efficacy. The history of HIV counseling and testing, which served as the cornerstone of HIV prevention efforts at the US Centers for Disease Control and Prevention (CDC) for a quarter of a century, illustrates the influence of institutional resistance on public health decision making and the challenge of de‐implementing well‐established programs. Context In 1985, amid uncertainty about the accuracy of the new test for HIV, public health officials at the Centers for Disease Control and Prevention (CDC) and AIDS activists agreed that counseling should always be provided both before and after testing to ensure that patients were tested voluntarily and understood the meaning of their results. As the “exceptionalist” perspective that framed HIV in the early years began to recede, the purpose of HIV test counseling shifted over the next 30 years from emphasizing consent, to providing information, to encouraging behavioral change. With this increasing emphasis on prevention, HIV test counseling faced mounting doubts about whether it “worked.” The CDC finally discontinued its preferred test counseling approach in October 2014. Methods Drawing on key informant interviews with current and former CDC officials, behavioral scientists, AIDS activists, and others, along with archival material, news reports, and scientific and governmental publications, we examined the origins, development, and decline of the CDC's “counseling and testing” paradigm for HIV prevention. Findings Disagreements within the CDC emerged by the 1990s over whether test counseling could be justified on the basis of efficacy and cost. Resistance to the prospect of policy change by supporters of test counseling in the CDC, gay activists for whom counseling carried important ethical and symbolic meanings, and community organizations dependent on federal funding made it difficult for the CDC to de‐implement the practice. Conclusions Analyses of changes in public health policy that emphasize the impact of research evidence produced in experimental or epidemiological inquiries may overlook key social and political factors involving resistance to deimplementation that powerfully shape the relationship between science and policy.

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When does evidence-based policy turn into policy-based evidence? Configurations, contexts and mechanisms

Cited by 167 publications

References 45 publications

Negotiating multisectoral evidence: a qualitative study of knowledge exchange at the intersection of transport and public health

Negotiating multisectoral evidence: a qualitative study of knowledge exchange at the intersection of transport and public health

The Passions and the Interests: Unpacking the 'Sharing Economy'

Evidence and the Politics of Deimplementation: The Rise and Decline of the “Counseling and Testing” Paradigm for HIV Prevention at the US Centers for Disease Control and Prevention

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