Sense and Serendipity: On being both ambitious and realistic about - PowerPoint PPT Presentation

Sense and Serendipity: On being both ambitious and realistic about increasing the impact of applied health research Rob Anderson 20 April 2016 Co-producing Impact Symposium, Healthwatch Essex with University of Essex, and ESRC

Plan of talk • Why me? A co-producing research impact story • Problems and challenges  • Opportunities and realistic ambitions  • Some concluding thoughts Opportunity for questions r.anderson@exeter.ac.uk

A story - my first experience of co-producing impact (Example 1) In at the deep end of user/practitioner engagement – my PhD (Cardiff, 1998-02): • Studying a recurring problem for practitioners (and patients) • A lone social scientist in an organisation of dentists • Sponsors: WORD – ahead of their time • Practicalities of data collection – working closely with service managers/leaders (ultimately, co-designing the new service model) • Feeding directly into policy (+ small country!) In retrospect, could say my PhD was ‘co - produced’ + I was the de facto health services ‘researcher in residence’ in these dental services for about 4 years

Why me? Or … Why did I accept Oonagh’s invitation?! • Passionate about doing applied research which makes a difference • From dull numbers to meaningful data • Subsequent diverse experiences of doing ‘implementation research’ • Brief stint on the NSW GRIPP Board (Getting Research Into Policy & Practice) • Currently a ‘Research Impact Champion’(!) within our medical school – Involved in preparing for the next REF – Performed a comparative analysis of ‘high’ and ‘low’ impact case studies in health services research, from the 2014 REF – Role: fostering more impactful research as much as capturing research impact

The University research context: What’s the REF all about? Will it help foster more impact?

REF 2014 – driving University research funding and reputation • All UK universities submitted ‘best’ papers of their core academic staff. + Research environment + • Impact - accounted for 20% of overall quality profile. • Assessed by ‘Research Impact case studies’ over 6,600! … 162 in HSR/Public Health Has stimulated much debate and activity about • How to make university research more impactful • How to document/evidence whether research has had a positive impact

Half empty

The simplistic ‘REF view’ of how research influences policy or practice Specific Particular Study policy research findings/ decision/ study(ies) evidence Service change

The impact of research on policy (and practice) is typically indirect and highly diffuse Science Communication, March 1980 vol. 1 no. 3, 381-404

More like mycelium! Would mycelium be a better metaphor?

Source: Plenary Lecture by Trish Greenhalgh, 1 st UK Knowledge Mobilisation Forum, February 2014

Some barriers to getting research into policy and practice • Clashes with political/organisational ideology • Unsupportive organisational or professional culture • Limited access to research • Lack of time to read research • Lack of skills to interpret and appraise research • Lack of autonomy to implement findings • Lack of financial and administrative support to implement research-based changes in practice Nutley, Walter & Davies, 2007. Using Evidence. Policy Press

‘Stages of waste’ in the production and reporting of research evidence Chalmers & Glasziou, 2009. Lancet 374: 86-89

Evidence & Policy Observing how and when research influences policy and practice is very hard! ( tommorrow’s workshop)

Problems and challenges - summary • Research rarely produces specific and clear answers to discrete policy and practice questions/problems • Much research waste: unimportant Qs, poor methods, unpublished or unusable results • Processes of research use are cumulative and diffuse: – Not (primarily) a problem of information flows and formats – But a social process (… networks, engagement, credibility, trust, values, experiential knowledge) • Use always alongside other competing types of knowledge and factors (politics, resources, organisational culture etc.) • AND … Holy Grail of social science – causal attribution

Half full

Opportunities and ambition: 1. The growth of Implementation Science • Studying how research influences policy and practice, and evaluating strategies for increasing the uptake of research findings by practitioners or whole organisations – now a recognised area of study – Implementation Science journal UK Knowledge Mobilisation Forum – 3 rd year –

OK, still a daunting jargon- fest … Research diffusion Knowledge Transfer Translational Research Knowledge Mobilisation Implementation research Implementation Science Improvement Science Getting research into practice Research utilisation Evidence-Based Policy Evidence-based everything! Knowledge Exchange

Opportunities and ambition: 1. The growth of Implementation Science • Studying how research influences policy and practice, and evaluating strategies for increasing the uptake of research findings by practitioners or whole organisations – now recognised area of study – Implementation Science journal UK Knowledge Mobilisation Forum – 3 rd year – • Recognition of core theories of implementation/knowledge use: – RE-AIM (Russell Glasgow) – Normalisation Process Theory (Carl May) – CFIR (Laura Damschroder) • Recognition of key knowledge mobilisation strategies: – Knowledge brokers, Researcher-in-residence, • NIHR Knowledge Mobilisation Fellowships • NIHR HS&DR funding for implementation research (Example, ASPIRE)

More holistic, non-linear view of how research knowledge can influence policy and practice

Opportunities and ambition: 2. Progress in research prioritisation • Via NIHR and NICE – Web interface, Commissioned calls • James Lind Alliance

Opportunities and ambition: 2. Progress in research prioritisation • Via NIHR and NICE – Web interface, Commissioned calls • James Lind Alliance • Other bespoke processes for identifying practitioner uncertainties – Example – British Dental Association, web-based prioritisation of dental research topics • Membership of research funding boards (for example NIHR HS&DR panels)

Involving dental practitioners in setting the dental research agenda. Fox C, Kay E, Anderson R. British Dental Journal 217, 307 - 310 (2014) • An e-system (web pages) for capturing primary dental care practitioners' unanswered questions relating to practice • Evaluated the economic, technical and operational feasibility of the e-system to identify practice-relevant research priorities • To feed directly into dental care research commissioning (Overall, it sadly failed at all three levels - dentists just too busy or uninterested in influencing research? Or method of elicitation not sufficiently easy or interactive/face-to-face?)

Opportunities and ambition: 3. New media and tools for disseminating research • The Open Access movement (publishers & funders) • Plain English & tailored summaries • Press Releases and news coverage; crafting the findings as stories (incl. using professional writers) • Twitter/Blogs, Opinion/Editorial pieces in journals • Using graphics (and graphic artists, animators)

Engaging with graphics

Opportunities and ambition: 3. New media and tools for disseminating research • The Open Access movement (publishers & funders) • Plain English & tailored summaries • Press Releases and news coverage; crafting the findings as stories (incl. using professional writers) • Twitter/Blogs, Opinion/Editorial pieces in journals • Using graphics (and graphic artists, animators) • Face-to-face dissemination and engagement with specific potential users (e.g. roadshows, workshops)

Opportunities and ambition: 4. New opportunities for connecting researchers and practitoners/managers Persuasion and campaigning • Forming alliances (PH England, DoH, CCGs? AHSN?) • Lobbying/Govt adviser roles (NB. Recent threat) • Sense About Science • Twitter/Blogs/Facebook

Concluding thoughts: Sense • Recognising that researchers have limited (funded) time or incentives to promote the use of their own research findings • + inadequate skills? + ethical risks? • Core role, and only real control is over 3 things: – Choosing important questions – Using the best available methods – Disseminating the results as widely and in as diverse formats as possible BUT … • CAN engage with potential users of the research at ALL these stages, AND be able to map pathways to potential benefits • Incentives of REF should help (overall)

Concluding thoughts: Serendipity • The pathway between research findings and policy/practice is littered with many factors beyond rsearchers ’ control • Not every researcher can (or needs to) become a part-time journalist, a Tweeter, a slick radio presenter, or ministerial adviser etc. But we can maximise the chances of serendipity (and reduce research waste) • Embracing new tools and resources for disseminating and translating research findings to reach the right audiences • By engaging with stakeholders* throughout the research process (and our working lives – social networks, symposia … • going to Essex!