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      Pathways to “Evidence-Informed” Policy and Practice: A Framework for Action

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      PLoS Medicine
      Public Library of Science

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          Abstract

          Bowen and Zwi propose a new framework that can help researchers and policy makers to navigate the use of evidence.

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          Most cited references60

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          The Many Meanings of Research Utilization

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            The utilisation of health research in policy-making: concepts, examples and methods of assessment

            The importance of health research utilisation in policy-making, and of understanding the mechanisms involved, is increasingly recognised. Recent reports calling for more resources to improve health in developing countries, and global pressures for accountability, draw greater attention to research-informed policy-making. Key utilisation issues have been described for at least twenty years, but the growing focus on health research systems creates additional dimensions. The utilisation of health research in policy-making should contribute to policies that may eventually lead to desired outcomes, including health gains. In this article, exploration of these issues is combined with a review of various forms of policy-making. When this is linked to analysis of different types of health research, it assists in building a comprehensive account of the diverse meanings of research utilisation. Previous studies report methods and conceptual frameworks that have been applied, if with varying degrees of success, to record utilisation in policy-making. These studies reveal various examples of research impact within a general picture of underutilisation. Factors potentially enhancing utilisation can be identified by exploration of: priority setting; activities of the health research system at the interface between research and policy-making; and the role of the recipients, or 'receptors', of health research. An interfaces and receptors model provides a framework for analysis. Recommendations about possible methods for assessing health research utilisation follow identification of the purposes of such assessments. Our conclusion is that research utilisation can be better understood, and enhanced, by developing assessment methods informed by conceptual analysis and review of previous studies.
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              Evidence-based health policy: context and utilisation.

              Evidence-based decision-making is centred on the justification of decisions. In the shift from an individual-clinical to a population-policy level, the decision-making context becomes more uncertain, variable and complex. To address this we have developed a conceptual framework for evidence-based decision-making, focusing on how context impacts on what constitutes evidence and how that evidence is utilised. We present two distinct orientations towards what constitutes evidence, representing different relationships between evidence and context. We also categorise the decision-making context based on the ways in which context impacts on evidence-based decision-making. Furthermore, we invoke the concept of axes of evidence-based decision-making to describe the relationship between evidence and context as we move from evidence-based medicine to evidence-based health policy. From this, we suggest that it may be more important how evidence is utilised than how it is defined. Based on the research and knowledge utilisation literature, we present a process model of evidence utilisation, which forms the basis for the conceptual framework for context-based evidence-based decision-making. The conceptual framework attempts to capture the role that context plays in the introduction, interpretation and application of evidence. We illustrate this framework with examples from policy development for colorectal cancer screening.
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                Author and article information

                Journal
                PLoS Med
                pmed
                PLoS Medicine
                Public Library of Science (San Francisco, USA )
                1549-1277
                1549-1676
                July 2005
                31 May 2005
                : 2
                : 7
                : e166
                Author notes

                Shelley Bowen is a doctoral candidate and Anthony B. Zwi is Professor and Head at the School of Public Health and Community Medicine at the University of New South Wales, Randwick, Australia.

                Competing Interests: The authors declare that they have no competing interests.

                *To whom correspondence should be addressed. E-mail: shelley_bowen@ 123456smartchat.net.au
                Article
                10.1371/journal.pmed.0020166
                1140676
                15913387
                213290d3-5be7-45a7-bcb4-1f877e67d4ce
                Copyright: © 2005 Bowen and Zwi. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
                History
                Categories
                Policy Forum
                Epidemiology/Public Health
                Health Policy
                Health Policy
                Public Health

                Medicine
                Medicine

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