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      Determinants of evidence use in public health policy making: Results from a study across six EU countries

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          Highlights

          • Media attitude towards underpinning policy with evidence influences policy decision makers.

          • Individual skills, attitudes, values of policy makers impact the extent evidence use.

          • A solid research infrastructure is facilitating but not sufficient for evidence use.

          • Factors that impact evidence use in policy making differ by country and policy context.

          • Interventions connecting policy makers and researchers in the policy context seem most promising.

          Abstract

          The knowledge-practice gap in public health is widely known. The importance of using different types of evidence for the development of effective health promotion has also been emphasized.

          Nevertheless, in practice, intervention decisions are often based on perceived short-term opportunities, lacking the most effective approaches, thus limiting the impact of health promotion strategies. This article focuses on facilitators and barriers in the use of evidence in developing health enhancing physical activity policies.

          Data was collected in 2012 by interviewing 86 key stakeholders from six EU countries (FI, DK, UK, NL, IT, RO) using a common topic guide. Content analysis and concept mapping was used to construct a map of facilitators and barriers.

          Barriers and facilitators experienced by most stakeholders and policy context in each country are analysed. A lack of locally useful and concrete evidence, evidence on costs, and a lack of joint understanding were specific hindrances. Also users’ characteristics and the role media play were identified as factors of influence.

          Attention for individual and social factors within the policy context might provide the key to enhance more sustainable evidence use. Developing and evaluating tailored approaches impacting on networking, personal relationships, collaboration and evidence coproduction is recommended.

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          Most cited references35

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          The Many Meanings of Research Utilization

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            Understanding the barriers to setting up a healthcare quality improvement process in resource-limited settings: a situational analysis at the Medical Department of Kamuzu Central Hospital in Lilongwe, Malawi

            Background Knowledge regarding the best approaches to improving the quality of healthcare and their implementation is lacking in many resource-limited settings. The Medical Department of Kamuzu Central Hospital in Malawi set out to improve the quality of care provided to its patients and establish itself as a recognized centre in teaching, operations research and supervision of district hospitals. Efforts in the past to achieve these objectives were short-lived, and largely unsuccessful. Against this background, a situational analysis was performed to aid the Medical Department to define and prioritize its quality improvement activities. Methods A mix of quantitative and qualitative methods was applied using checklists for observed practice, review of registers, key informant interviews and structured patient interviews. The mixed methods comprised triangulation by including the perspectives of the clients, healthcare providers from within and outside the department, and the field researcher’s perspectives by means of document review and participatory observation. Results Human resource shortages, staff attitudes and shortage of equipment were identified as major constraints to patient care, and the running of the Medical Department. Processes, including documentation in registers and files and communication within and across cadres of staff were also found to be insufficient and thus undermining the effort of staff and management in establishing a sustained high quality culture. Depending on their past experience and knowledge, the stakeholder interviewees revealed different perspectives and expectations of quality healthcare and the intended quality improvement process. Conclusions Establishing a quality improvement process in resource-limited settings is an enormous task, considering the host of challenges that these facilities face. The steps towards changing the status quo for improved quality care require critical self-assessment, the willingness to change as well as determined commitment and contributions from clients, staff and management.
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              How can we increase translation of research into practice? Types of evidence needed.

              This review summarizes key factors that have interfered with translation of research to practice and what public health researchers can do to hasten such transfer, focusing on characteristics of interventions, target settings, and research designs. The need to address context and to utilize research, review, and reporting practices that address external validity issues-such as designs that focus on replication, and practical clinical and behavioral trials-are emphasized. Although there has been increased emphasis on social-ecological interventions that go beyond the individual level, interventions often address each component as if it were an independent intervention. Greater attention is needed to connectedness across program levels and components. Finally, examples are provided of evaluation models and current programs that can help accelerate translation of research to practice and policy.
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                Author and article information

                Contributors
                Journal
                Health Policy
                Health Policy
                Health Policy (Amsterdam, Netherlands)
                Elsevier Scientific Publishers
                0168-8510
                1872-6054
                1 March 2017
                March 2017
                : 121
                : 3
                : 273-281
                Affiliations
                [a ]Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
                [b ]Welfare: Equality and Inclusion, National Institute for Health and Welfare, Helsinki, Finland
                [c ]Specialised Services, NHS England, London, UK
                [d ]Prevention and Health Promotion, Research Centre for Prevention and Health, Capital Region of Denmark, Glostrup, Denmark
                [e ]Center for Health Policy and Public Health, Department of Public Health, Babes-Bolyai University, Cluj-Napoca, Romania
                [f ]Unit for Health Promotion, Institute of Public Health, University of Southern Denmark, Esbjerg, Denmark
                [g ]Institute of Researches on Population and Social Policies, National Research Council, Rome, Italy
                Author notes
                [* ]Corresponding author at: Tilburg University, Tilburg School of Social and Behavioral Sciences, Department Tranzo, P.O. Box 90153, 5000 LE Tilburg, The Netherlands.TranzoTilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands L.vandegoor@ 123456uvt.nl
                [1]

                The authors would like to thank all members of the REPOPA consortium ( http://www.repopa.eu/content/consortium), especially those who have contributed to doing interviews and processing data.

                Article
                S0168-8510(17)30019-2
                10.1016/j.healthpol.2017.01.003
                5754321
                28139253
                2dfc8a23-fe45-42b6-90aa-6e6b067a7bf5
                © 2017 The Author(s)

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 19 July 2016
                : 9 January 2017
                : 10 January 2017
                Categories
                Article

                Social policy & Welfare
                policy development process,evidence-informed policy,public health policy,barriers and facilitators,semi-structured interviews,individual and social factors,policy context,structural collaboration between researchers and policy makers

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