Sally Redman on behalf of the CIPHER team

Perspectives: Early findings from SPIRIT

SPIRITStepped wedge trial in 6 agencies

• Agency for Clinical Innovation• Clinical Excellence Commission• Ministry of Health (Centre for Population Health)• Justice Health• Cancer Institute NSW• A national agency

Testing a multifaceted program designed to increase the use of research in policy and programs

Organisations are incredibly different:

Policy agencies value research• 79% said in their organisation leaders believe it is important to use

research in policy or program development

• 95% believed it is valuable to use research in policy or program work to decide about content or direction of a policy or program

Organisational approaches differ

Do your policies on how to develop policies or programs encourage or require research use?

Yes, very much so

Yes, to some extent

No

Does your organisation provide access to training for staff in how to access research, appraise and apply research?

No Yes, very much so

No

In the last 6 months, has your organisation undertaken internal research to support policy development, implementation, evaluation?

No Yes, very much so

Yes, very much so

Staff views differ

% % %

It is usually or always expected that policies or programs will be evaluated

89 93 34

Interaction with researchers or research organisations is usually or always encouraged

96 25 44

Complex agencies, complex problem solving

Tailored solutions based on how each agency engages with and uses research

Tools to measure and feedback current practice­ what do staff do ­ what does the organisation do ­ how is research used in policy products

Range of strategies that are highly flexible

Making research work will require….

• All agencies flagged evaluation as a priority area for capacity development

• Five of six agencies requested a session to build staff skills in evaluation

• 12% of staff very confident in their skills in evaluation

Evaluation is a major priority

Bring together research and program expertise to answer real questions within a real world context

Some excellent examples eg: • RCT of screening women 40-49 Moss SM et al Lancet. 2006;368:2053–

60.

• 7 separate evaluations of the Scottish smoke free laws Haw et al, J Public Health 2006: 28; 24-30

• Feedback to publicans about alcohol related incidents among their patrons Wiggers et al Drug Alcohol Rev 2004 Sep;23(3):355-64

Embed research into policy &program rollout

• Identify opportunity early in program design

• Engage with research expertise early

• Seriously consider flexible roll out

• Stimulate community discussion about ‘trials’

• Strengthen rigour and knowledge of designs beyond RCTs

• Faster funding models

Embed research into policy &program rollout

Priorities for action

• Enable agencies to understand how they use research and opportunities for improvement

• Develop better approaches to embedding research into the rollout of policies and programs

• Provide better incentives for researchers to work with policy agencies through tighter recognition in track record evaluation and funding