UCLA Investigators Seek To Determine How Research Evidence Can Be
Made More Useful For Public Health
A Limited Study In The UK Found That Policymakers Considered Existing
Evidence Irrelevant
A small British study
more than a decade ago found that policy advisors working to improve
health equity in the UK considered the bulk of scientific evidence
irrelevant in meeting their needs. Achieving health equity in this
study was understood as the attainment of the highest level of health
possible for all people.
The data irrelevance
was attributed to dual factors, namely the naiveté of researchers
about the context of policy making and the nature of the scientific
evidence itself which was not easily translatable to the real world.
In short, there was a supply and demand disconnect between the “fact
suppliers” and the “fact consumers” leading to a lack of data
translation.
Follow Up
In order to determine
if the UK observations are valid for the US, a group of UCLA
investigators led by
Kimberly Danae
Cauley Narain
and colleagues interviewed 25 public health leaders or their designees
from different geographic areas across the country. The goal was to
further examine any existing gap between evidence needs and evidence
availability.
Themes
Researchers uncovered
seven major themes from their semi-structured qualitative interviews:
1. Funders are key
drivers of scientific evidence use. The principal need for
scientific evidence appeared to come more from the requirements of
grant funders than from the public health needs of the population.
This occurs when funders require the use of science based
interventions and these are the ones chosen by health departments
since they depend on grants from these funders. The need for evidence
in carrying out day to day operations, outbreak investigations, and
even routine policymaking did not appear important in the study.
2. CDC and national
organizations are important suppliers of scientific evidence.
Scientists are disseminating information through journals or in ways
that are different from how users retrieve information, according to
the investigators. There are “middle men” organizations involved.
Thus, if not collecting their own data, users often sought trusted
sources rather than going to the original published work.
3. Information on
intervention cost effectiveness is key to addressing health equity.
This information was seen as potentially useful in gaining support for
implementation of interventions. The cost information should be from
the local level and should show how costs and benefits can be
allocated from the government’s or the payer’s limited perspectives
and not the broader societal perspective.
4. Information on
effectiveness at the local level is essential for compelling
stakeholders to act. Users want more granular information from the
local level and want to be able to tailor interventions to suit their
needs. Also, greater collaboration between “fact providers” and “fact
consumers” before the research is designed would be very helpful.
5. Framing
scientific evidence to resonate with different audiences would help
increase the impact of evidence collected. In short, helping users to
better understand when and for whom the results might be useful would
increase translation.
6. Use simple
terminology that resonates with stakeholder users as well as
policymakers and elected officials. The presentation of evidence needs
to appeal to data utilizers on more than one level.
7. Summaries of
science and systematic reviews are highly valued. Furthermore,
grading the strength or quality of the evidence and making
recommendations for how to use the evidence were seen as particularly
valuable.
User-Friendly
In summarizing their
work, UCLA investigators concluded that users of scientific evidence
are eager to make use of information, but they would like research
designed, executed, and results packaged in more user-friendly ways.
And users want to know how the results would apply in their area, for
whom, and at what cost.
This work was
published in BMJ on September 26, 2018. To read the article in full,
visit:
https://bit.ly/2NK3kMC ■
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