Background
Context of Dutch local health policy development
Aim of this study
Methods
Literature review
Narratives
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Research context: aim, persons who give the assignment, financiers, collaborative partners, research method;
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Main outcomes of the research, considered important by epidemiologists;
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Follow up given to the results;
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Explanation of this follows up.
The construction of the framework
Findings
Theoretical explanations for research utilization
Model | Characteristics | Shortcomings |
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Model 1 | • Assumes linear sequence from supply of research to utilization by decision makers • Assumes that high quality research will automatically lead to higher uptake and use by decision makers • Content attributes of the research influence its use by decision makers. For example: notability, complexity, validity and reliability • Type of research influences its use by decision makers. For example: theoretical/applied, quantitative/qualitative, research domains and disciplines | • No acknowledgment of the incremental nature of policymaking, • Quality is a necessary, but not sufficient, condition for user's attention. • It is not always clear who takes responsibility for transfer, • There is a process of transforming academic knowledge into useable knowledge |
Model 2 | • Assumes linear sequence from supply of research to utilization by decision makers • Recognizes the fact that knowledge transfer is not automatic. • Suggests that an extra step should be added to research activities by developing dissemination models. It suggests developing a strategy to disseminate research results. • Type of research output (results) explains research utilization • Dissemination efforts explain research utilization | • Assumes "unidirectional" dissemination from producers to users. • Includes neither the involvement of potential users in the selection of transferable information nor involvement in the production of research data. |
Model 3 | • Assumes a linear sequence from supply of research to utilization by decision makers • The initiative is shift to the policy makers. As such, this explanation asserts that as policy makers identify problems and define the needs, they ask researchers to conduct studies that will generate alternatives or solutions. • Knowledge utilization is explained by the needs of users. | • No acknowledgement of the incremental nature of policymaking. • Does not consider the fact that the results of necessary research can be pushed aside because they do not stroke with personal or organizational interests • Omits the interaction between producers and users of research findings. |
Model 4 | • Assumes a linear sequence from supply of research to utilization by decision makers • Variant of Demand Pull Explanation • Stresses that personal and organizational interests are important impeding factor for research utilization. • Important factors are organizational structures, types of policy domains, needs of organizations and positions of actors. • Within this explanation, the use of knowledge increases "as users consider research pertinent, as research coincides with their needs, as users' attitudes give credibility to research and when results reach users at the right time". | • No acknowledgement of incremental nature of policymaking • Places too much emphasis on the interest of users and neglects the fact that users do not merely act as rational consumers, looking for their own profit. Users have also irrational preferences, belief systems and values |
Model 5 | • Assumes a cultural gap between researchers and users, which is visible in different communities, different language and different methods of communication • Adaptation of research products by users reduces the cultural gap utilization; therefore researchers should invest in more readable and appealing reports, make more specific recommendations and focus on factors amenable to interventions by users • Acquisition efforts by research users reduce the cultural gap. This means that users are making an effort to influence the research agenda by discussing the subject and scope of research projects with researchers and discuss results. | • No assumption about the process, either linear or incremental. • Emphasizes the cultural gap and pays no attention to factors mentioned above • No attention for the influence of the construction of the policy network, advocacy coalitions an institutional constellations |
Model 6 | • Offshoot of the Two Communities Explanation and is analogous to the elected affinities model. • The process is a set of interactions between researchers and users, rather than a linear move from research to decisions • This explanation suggests that research utilization is brought about by various interactions between the researchers and the policy makers. Interaction does not start with the needs of researchers or needs of policymakers. • It is assumed that the more sustained and intense interaction between researchers and users, the more likely utilization will occur. • Important factors are the so-called linkage mechanisms and dissemination efforts |
Identifying specific barriers between policymakers and researchers
Specific barriers | Lit ref | Identified critical key factors of influence | Problem level | Problem domain |
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1. No awareness of researchers about the policy process | and mentioned in inventory | Creating insight in working processes | Process | Expectations (Preparation phase of research) |
2. Finding researchable questions | and mentioned in inventory | Negotiate research questions, make an inventory on the need of information | Process | Expectations (Preparation phase of research) |
3. Answers about a specific item | and mentioned in inventory | Discuss limitations of study design and timelines | Process | Expectations (Preparation phase of research) |
4. Limited results by choice of study design, mostly cross-sectional studies, no causes and solutions | and mentioned in inventory | Discuss limitations of study design and timelines | Process | Expectations (Preparation phase of research) |
5. Degree of uncertainty | Discuss limitations of study design and timelines | Process | Expectations (Preparation phase of research) | |
6. Actuality | and mentioned in inventory | Discuss limitations of study design and timelines | Process | Expectations (Preparation phase of research) |
7. Timing | and mentioned in inventory | Which research information is given at what time | Process | Expectations (Preparation phase of research) |
8. Language | and mentioned in inventory | For which target group is the information intended; what jargon is used How convincing is the research message How is the package What is the relation with other policy domains | Process | Transfer (Publication phase of research) |
9. Conflicting knowledge by other Researchers | Collecting other research information | Process | Transfer (Publication phase of research) | |
10. Media | Communicating with media | Process | Transfer (Publication phase of research) | |
11. Perceived robustness of evidence | How do stakeholders perceive the quality of the research | Individual | Acceptance | |
12. Perceived credibility of source: researchers or other stakeholders | and mentioned in inventory | Who is bringing the message | Individual | Acceptance |
13. "Fit" with personal knowledge, values or belief systems, preferences and traditions | and mentioned in inventory | Individual | Acceptance | |
14. Consider whether or not a problem is important enough to deal with, relevance | Individual level | Interpretation | ||
15. Consider connection with own personal or institutional interests | Individual level | Interpretation | ||
16. Consider whose responsibility it is to take action | Individual level | Interpretation | ||
17. Consider which solutions are at hand | Individual level | Interpretation |
Concepts of research utilization or research impact
Concept of research utilization | Description | |
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Instrumental | When research is acted upon in specific and direct ways, i.e. to solve a problem at hand | |
Conceptual | Contributing to improved understanding of the subject matter, related problems, more general and indirect form of enlightenment | |
Symbolic | Justify a position or course of action for reasons that have nothing to do with the research findings (political use) or use the fact that research is being done to justify inaction on other fronts (tactical use) | |
1. Reception | Research results are received by actors | |
2. Cognition | Research results are read and understood | |
3. Reference | Research results change a way of thinking by actors | |
4. Effort | Efforts are made to get the research results into policy even when this was not successful | |
5. Adoption | Research results has direct influence not only on the policy process but on the context of the policy | |
6. Implementation | Research results not only has been used for policy formulation but also translated into practice | |
7. Impact | This refers to successful implemented policy initiated by research results. |
Towards a conceptual analytical framework
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Variety of actors in terms of size, interests, power and perception of problems;
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Reservations on the part of individual actors, the willingness to cooperate and their strive for autonomy;
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Mutual dependencies between the actors on each other's resources and decisions;
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Fragmented problem solving ability where actors also depend on each other's resources and;
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Coordination by bargaining where decisions are a result of consultation and bargaining processes.