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New directions in evidence-based policy research: a critical analysis of the literature

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      Abstract

      Despite 40 years of research into evidence-based policy (EBP) and a continued drive from both policymakers and researchers to increase research uptake in policy, barriers to the use of evidence are persistently identified in the literature. However, it is not clear what explains this persistence – whether they represent real factors, or if they are artefacts of approaches used to study EBP. Based on an updated review, this paper analyses this literature to explain persistent barriers and facilitators. We critically describe the literature in terms of its theoretical underpinnings, definitions of ‘evidence’, methods, and underlying assumptions of research in the field, and aim to illuminate the EBP discourse by comparison with approaches from other fields. Much of the research in this area is theoretically naive, focusing primarily on the uptake of research evidence as opposed to evidence defined more broadly, and privileging academics’ research priorities over those of policymakers. Little empirical data analysing the processes or impact of evidence use in policy is available to inform researchers or decision-makers. EBP research often assumes that policymakers do not use evidence and that more evidence – meaning research evidence – use would benefit policymakers and populations. We argue that these assumptions are unsupported, biasing much of EBP research. The agenda of ‘getting evidence into policy’ has side-lined the empirical description and analysis of how research and policy actually interact in vivo. Rather than asking how research evidence can be made more influential, academics should aim to understand what influences and constitutes policy, and produce more critically and theoretically informed studies of decision-making. We question the main assumptions made by EBP researchers, explore the implications of doing so, and propose new directions for EBP research, and health policy.

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      Health policy-makers' perceptions of their use of evidence: a systematic review.

      The empirical basis for theories and common wisdom regarding how to improve appropriate use of research evidence in policy decisions is unclear. One source of empirical evidence is interview studies with policy-makers. The aim of this systematic review was to summarise the evidence from interview studies of facilitators of, and barriers to, the use of research evidence by health policy-makers. We searched multiple databases, including Medline, Embase, Sociofile, PsychLit, PAIS, IBSS, IPSA and HealthStar in June 2000, hand-searched key journals and personally contacted investigators. We included interview studies with health policy-makers that covered their perceptions of the use of research evidence in health policy decisions at a national, regional or organisational level. Two reviewers independently assessed the relevance of retrieved articles, described the methods of included studies and extracted data that were summarised in tables and analysed qualitatively. We identified 24 studies that met our inclusion criteria. These studies included a total of 2041 interviews with health policy-makers. Assessments of the use of evidence were largely descriptive and qualitative, focusing on hypothetical scenarios or retrospective perceptions of the use of evidence in relation to specific cases. Perceived facilitators of, and barriers to, the use of evidence varied. The most commonly reported facilitators were personal contact (13/24), timely relevance (13/24), and the inclusion of summaries with policy recommendations (11/24). The most commonly reported barriers were absence of personal contact (11/24), lack of timeliness or relevance of research (9/24), mutual mistrust (8/24) and power and budget struggles (7/24). Interview studies with health policy-makers provide only limited support for commonly held beliefs about facilitators of, and barriers to, their use of evidence, and raise questions about commonsense proposals for improving the use of research for policy decisions. Two-way personal communication, the most common suggestion, may improve the appropriate use of research evidence, but it might also promote selective (inappropriate) use of research evidence.
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        A systematic review of barriers to and facilitators of the use of evidence by policymakers

        Background The gap between research and practice or policy is often described as a problem. To identify new barriers of and facilitators to the use of evidence by policymakers, and assess the state of research in this area, we updated a systematic review. Methods Systematic review. We searched online databases including Medline, Embase, SocSci Abstracts, CDS, DARE, Psychlit, Cochrane Library, NHSEED, HTA, PAIS, IBSS (Search dates: July 2000 - September 2012). Studies were included if they were primary research or systematic reviews about factors affecting the use of evidence in policy. Studies were coded to extract data on methods, topic, focus, results and population. Results 145 new studies were identified, of which over half were published after 2010. Thirteen systematic reviews were included. Compared with the original review, a much wider range of policy topics was found. Although still primarily in the health field, studies were also drawn from criminal justice, traffic policy, drug policy, and partnership working. The most frequently reported barriers to evidence uptake were poor access to good quality relevant research, and lack of timely research output. The most frequently reported facilitators were collaboration between researchers and policymakers, and improved relationships and skills. There is an increasing amount of research into new models of knowledge transfer, and evaluations of interventions such as knowledge brokerage. Conclusions Timely access to good quality and relevant research evidence, collaborations with policymakers and relationship- and skills-building with policymakers are reported to be the most important factors in influencing the use of evidence. Although investigations into the use of evidence have spread beyond the health field and into more countries, the main barriers and facilitators remained the same as in the earlier review. Few studies provide clear definitions of policy, evidence or policymaker. Nor are empirical data about policy processes or implementation of policy widely available. It is therefore difficult to describe the role of evidence and other factors influencing policy. Future research and policy priorities should aim to illuminate these concepts and processes, target the factors identified in this review, and consider new methods of overcoming the barriers described.
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          Knowledge transfer and exchange: review and synthesis of the literature.

          Knowledge transfer and exchange (KTE) is as an interactive process involving the interchange of knowledge between research users and researcher producers. Despite many strategies for KTE, it is not clear which ones should be used in which contexts. This article is a review and synthesis of the KTE literature on health care policy. The review examined and summarized KTE's current evidence base for KTE. It found that about 20 percent of the studies reported on a real-world application of a KTE strategy, and fewer had been formally evaluated. At this time there is an inadequate evidence base for doing "evidence-based" KTE for health policy decision making. Either KTE must be reconceptualized, or strategies must be evaluated more rigorously to produce a richer evidence base for future activity.
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            Author and article information

            Affiliations
            [1 ]School of Social Sciences, University of Manchester, Bridgeford Street, Manchester M13 9PL, UK
            [2 ]Department of Science, Technology, Engineering and Public Policy (STEaPP), University College London, 66-72 Gower Street, London WC1E 6BT, UK
            [3 ]Faculty of Social Sciences, Oslo University College, P.O Box 1084, Blindern, 0317 OSLO, Norway
            Contributors
            Journal
            Health Res Policy Syst
            Health Res Policy Syst
            Health Research Policy and Systems
            BioMed Central
            1478-4505
            2014
            14 July 2014
            : 12
            : 34
            25023520
            4107868
            1478-4505-12-34
            10.1186/1478-4505-12-34
            Copyright © 2014 Oliver et al.; licensee BioMed Central Ltd.

            This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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