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’
• ver 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

Particular research study(ies) Study findings/ evidence Specific policy decision/ 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,

1st 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

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

Evidence & Policy

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 – 3rd year

OK, still a daunting jargon-fest …

Knowledge Mobilisation Translational Research

Implementation Science

Improvement Science

Knowledge Transfer Getting research into practice Research utilisation

Evidence-based everything!

Evidence-Based Policy Research diffusion

Implementation research

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 – 3rd 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
• f 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!

And if all else fails …

Thank you for listening! r.anderson@exeter.ac.uk