Knowledge brokers and new perspectives on adoption of

research results

Bob Wells, Libby Kalucy, Ellen McIntyre, Rhian Parker

2nd Rural and Remote Health

Scientific Symposium Brisbane June

2010

2

Outline of session

Introduction

Theoretical underpinnings

PHC RIS applied research findings

How do you know your research has had an impact?

APHCRI experience of fruitful interactions What is the rural perspective on this?

APHCRI and PHC RIS in future What should we be doing to support KTE in rural

research?

3

Supporting Research Use by Policymakers

Unlinked asynchronous processes

Research

process

Fortuitously linked processes

Purposefully linked processes

Research

process

KTE

processes

Policy

process

Research

process

Policy

process

Research

process

Policy

process

Source: John Lavis, 2010 http://www.phcris.org.au/activities/john_lavis_powerpoint.pdf

4

APHCRI and PHC RIS have complementary roles in knowledge

translation and exchange (KTE)The Institute

APHCRIThe Information Service

PHC RIS

Research Funds and conducts priority driven research. Research advisory board

Conducts applied research on KTE

KTE processes APHCRI priority driven research

PHC research – health services

Infrastructure Iterative research commissioning Related events

PHC research, researchersWebsite resources(eBulletin) National conference

APHCRI and Knowledge Exchange

Associate Professor Rhian Parker

6

Key points from the literature

Number of models to explain knowledge brokerage and a number of terms that describe this process. These terms include; Knowledge Translation, Knowledge Transfer, Knowledge Exchange, Research Utilisation and Research Implementation. It is generally agreed that it is a process that aims at getting research knowledge into ‘action’ through informing practice setting and/or policy or decision making settings

Explicit knowledge (research informed evidence) is one type of evidence and tacit knowledge (gained from experience) is another type of evidence. Both are utilised in decision making processes

Interactive models of knowledge exchange are now favoured, and have largely replaced more linear ‘push’ and ‘pull’ models

7

Key points from the literature

Barriers to knowledge exchange include competing interests or values and ‘cognitive’, ‘structural’ and ‘organizational’ and ‘cultural’, constraints

Facilitators to knowledge exchange include ‘generative capacity’, ‘disseminative capacity’, ‘absorptive capacity’ and ‘adaptive and responsive capacity’ as well as personal interaction

Strategies for knowledge exchange include ‘knowledge mapping’ and the use of ‘knowledge brokers’ to facilitate knowledge exchange

8

PHC RIS stories

Applied research on knowledge translation and exchange

1. Measuring impact of PHC research

2. Evaluating knowledge brokering events

3. Examining use of PHC research in health reform initiatives

9

Researcher influence and control

Tim

e

Knowledge production

Research targeting and capacity building

Informing policy and product

development

Health and health

sector benefits

Broader economic benefits

Research transfer

1. Time, researcher influence, and

impact of PHC research

PHC RIS 2009

High Low

10

Example of high impact rural project

ABCD – Audit and Best Practice in Chronic Disease

Intervention at organisational level in 12 remote Aboriginal Community Health Centres

Action research collaborative to embed continuous quality improvement approach

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Impacts of ABCD project

Research transfer Enhanced university engagement with user groups

Knowledge production 4 papers, 16 conf presentations

Research capacity building Further research opportunities, 1 PhD, staff development

Informing policy and product development

Information for policy and organisation decisions, influenced these decisions, used in education

Health and health sector benefits

Used in clinical practice, improvements in service delivery, improved health outcomes

Broader economic benefits Improved population health

1

2

Why did this project have so much impact?

Impact was intended

Facilitating organisation CRCAH made links between research/industry

Collaborative approach

Continuing partnerships in related projects

Strong ownership by NT government

Engaged appropriate people to influence educational outcomes.

13

Collaboration and action research

The collaborative approach to development of research projects in the CRCAH is designed to enhance research transfer.

The action research approach of this specific project is also designed to enhance research transfer through engagement of providers and policy makers in the research project, in interpretation of findings and in responding to research findings. (CI, ABCD Project)

14

Observing and recording impact

We knew we’d had an impact when…

our work was included in the CARPA manual

our report was used in a senate hearing

similar programs operate in other states….

???????

Why should researchers observe or document impact of their work?

15

2. PHC RIS knowledge brokering project 2009 evaluated 3 KB events

Most effective event for informing policy

Pre circulated discussion paper

Round table discussion with carefully selected experts

Chatham house rules

16

3. PHC research contributed to health reform initiatives in many ways

Working groups

Writing discussion papers

Writing submissions

Authorship of cited papers and reports

17

Submissions cited in final reports by author type and initiative

0

10

20

30

40

50

Con

sum

er o

rg

Res

earc

h or

g

Gov

ernm

ent

Prof o

rg o

r pea

k bo

dy

Com

merc

ial

Disea

se g

roup

s

Division o

f GP

Hea

lth S

ervice

Uns

pecifie

d

Issu

e gro

ups

Indi

vidu

al

Oth

er o

rg

Cha

rity

Net

wor

ks

% s

ub

mis

sio

ns c

ited

in

fin

al re

po

rt

NHHRC

NPHCS

1

8

Enhance research contribution to policy through submissions

Be aware of policy context

Use opportunities to make specific submissions in area of expertise

Contribute to submission from credible research or professional organisation

Build skills in writing a good submission

19

20

Knowledge Translation

21

APHCRI Research Translation

Synthesis of Stream Outcomes-Inform Reform

Agenda

Workshops of Key Stakeholders

Submission to NHHRC

Submission to NPHCS

22

Conversations with APHCRI

Formal presentations to DoHA Staff by APHCRI Network

Researchers;

Examples

CHRONIC DISEASE MANAGEMENT IN PRIMARY HEALTH CARE:

FROM EVIDENCE TO POLICY: Nick Zwar

THE EXPANDING ROLE OF GENERALISTS IN RURAL

& REMOTE HEALTH: Dennis Pashen

INTERNATIONAL VISITING FELLOWS (EG Dr Stephen Campbell,

University of Manchester)

23

National Health Reform Series

National Health Reform Series of policy briefings related to the health reform reports recently released to further strengthen the linkages between research and policy

A series of briefings held In Canberra between November 2009 and July 2010

Series includes Workforce (Nov 2009),GP Superclinics (February 2010) , Can local networks make a difference to primary health care (April 2010)

Presenters include researchers, consumers, professional organisations

Diverse audience and available as a podcast

24

Media Articles

25

Opinion Pieces

26

Peer Reviewed Publications

27

PHC RIS in the future

Continue infrastructure and relationships

Adapt to PHCRED Phase 3 decisions and health reform changes

Maximise KTE

28

APHCRI 2010-2014

Enhancing current Knowledge Translation activities

and developing our role in KT

Developing skilled Knowledge Brokers through the

APHCRI Network

Embedding KT in all APHCRI ANU and APHCRI

Network activities

29

What should APHCRI and

PHC RIS do to support

knowledge translation and

exchange (KTE) in rural and

remote research?

30

Acknowledgements: APHCRI and PHC RIS are funded through the PHCRED

Strategy, Australian Government Department of Health and Ageing.

www.anu.edu.au/aphcri

rhian.parker@anu.edu.au

www.phcris.org.au

phcris@flinders.edu.au

Thank you