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      The Right Kind of Evidence—Integrating, Measuring, and Making It Count in Health Equity Research

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          Abstract

          As health equity researchers, we need to produce research that is useful, policy-relevant, able to be understood and applied, and uses integrated knowledge translation (KT) approaches. The Manitoba Centre for Health Policy and its history of working with provincial government as well as regional health authorities is used as a case study of integrated KT. Whether or not health equity research “takes the day” around the decision-making table may be out of our realm, but as scientists, we need to ensure that it is around the table, and that it is understood and told in a narrative way. However, our conventional research metrics can sometimes get in the way of practicality and clear understanding. The use of relative rates, relative risks, or odds ratios can actually be detrimental to furthering political action. In the policy realm, showing the rates by socioeconomic group and trends in those rates, as well as incorporating information on absolute differences, may be better understood intuitively when discussing inequity. Health equity research matters, and it particularly matters to policy-makers and planners at the top levels of decision-making. We need to ensure that our messages are based on strong evidence, presented in ways that do not undermine the message itself, and incorporating integrated KT models to ensure rapid uptake and application in the real world.

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          Most cited references7

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          Demystifying knowledge translation: learning from the community.

          While there is increasing interest in research related to so-called Knowledge Translation, much of this research is undertaken from the perspective of researchers. The objective of this paper is to explore, through the participatory evaluation of Manitoba's The Need to Know Project, the characteristics of effective knowledge translation initiatives from the perspective of community partners. The multi-method evaluation adopted a utilization-focused approach, where stakeholders participated in identifying evaluation questions, and methods were made transparent to participants. Over 100 open-ended, semi-structured interviews were conducted with project stakeholders over the first three years of the project. These interviews explored the perspectives of participants on all aspects of project development. Formal feedback processes allowed further refinement of emerging theory. This research suggests that there has been insufficient emphasis on personal factors in knowledge translation. The themes of 'quality of relationships' and 'trust' connected many different components of knowledge translation, and were essential for collaborative research. Organizational barriers and lack of confidence in researchers present greater challenges to knowledge translation than individual interest or community capacity. The costs of participation in collaborative research for community partners and the benefits for researchers, also require greater attention. Participation of community partners in The Need to Know Project has provided unique perspectives on knowledge translation theory. It has identified limitations to the common interpretations of knowledge translation principles and highlighted the characteristics of collaborative research initiatives that are of greatest importance to community partners.
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            How to translate health research knowledge into effective healthcare action.

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              Enhancing policymakers' understanding of disparities: relevant data from an information-rich environment.

              Information-rich environments, with access and funding provided by government, make it possible to organize longitudinal administrative data to support analyses of policy-relevant questions. This paper describes insights into children's well-being and social equity obtained from data available in Manitoba, Canada, and highlights findings that have engaged policymakers. Analyses draw on Manitoba-linked data providing information over time (going back to 1970 in some files) and across space (with residential location documented every six months) for each provincial resident. Routinely collected data from the Ministries of Health, Education, and Family Services and Consumer Affairs have been integrated with a population registry. Identifying risk factors and presenting outcomes by social groups and by local communities capture the attention of policymakers. Linking an individual's area of residence to census and health data has led to developing measures of population health status and socioeconomic status. These measures focus on whether delivery patterns track health and educational needs, and a population registry makes it possible to describe who is (and is not) served by each program. The nature of health and social research has been changed by the development of information-rich environments. Many findings in Manitoba could not be replicated without a population registry. Engaging decision makers through effective presentations can ensure continuing support for diverse efforts based on these environments, and this article suggests ways of better communicating with policymakers. © 2010 Milbank Memorial Fund. Published by Wiley Periodicals Inc.
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                Author and article information

                Contributors
                pat_martens@cpe.umanitoba.ca
                Journal
                J Urban Health
                J Urban Health
                Journal of Urban Health : Bulletin of the New York Academy of Medicine
                Springer US (Boston )
                1099-3460
                1468-2869
                7 July 2012
                7 July 2012
                December 2012
                : 89
                : 6
                : 925-936
                Affiliations
                Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada
                Article
                9738
                10.1007/s11524-012-9738-y
                3531355
                22772770
                04bbd140-2000-45fc-a888-01470fbe1fea
                © The Author(s) 2012
                History
                Categories
                Article
                Custom metadata
                © The New York Academy of Medicine 2012

                Public health
                integrated knowledge translation,health inequity measures,longitudinal analysis of socioeconomic gaps,lorenz curve,relative versus absolute risk,manitoba centre for health policy,the need to know team

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