Research in Practice is a column in the Evidence Based Library and Information Practice journal, published quarterly.

In the ever-evolving landscape of health systems, citizen advocacy stands as a tool for influencing policy aiming to strengthen health systems. This dissertation delves into the multifaceted nature of health policy advocacy and how citizen advocates can leverage research evidence in addition to the commonly used emotional messaging to influence policy. The first study is a critical interpretive synthesis (CIS), creating a theoretical framework that helps us understand the roles of citizen health policy advocates and their relation to research evidence. The second study is a multiple-case study that examines the approaches taken by citizen-serving NGOs in their advocacy training and whether and how research evidence is incorporated into the training. The third study is a qualitative descriptive study that explores citizens' experiences participating in these training modules and their perceptions of factors affecting the incorporation of research evidence in the training. In Chapter 2, we included 32 publications in the CIS, and four thematic groups were identified, including the roles of citizen health policy advocates, how research evidence could support them and the facilitators and barriers to their use of research evidence. In Chapter 3, we conducted a documentary review of 27 documents and interviewed 16 staff and board members of three organizations that provide advocacy training to citizen advocates. In Chapter 3, we interviewed 14 citizens who participated in the training of the three organizations. v The first study outlined how citizens could use research evidence and its importance to their advocacy roles, while the last two studies provide an understanding of how citizen-serving organizations offer training to citizen advocates and whether, how, and under what conditions they include research evidence in training. / Thesis / Doctor of Philosophy (PhD) / Advocacy is an effective way to influence policies in democratic societies. One of those areas that are influenced by policy advocacy is health systems. Citizens who advocate for improving their health systems often rely on personal emotional messages rather than peer-reviewed research evidence. This dissertation tries to understand why this is the case and how research evidence can support those citizens. We also explore the factors that encourage or hinder citizens from using research evidence in health policy advocacy. We then examine three citizen-serving organizations that support citizens with advocacy training and explore how they support the trainees to use research evidence in advocacy. We also examine the experiences of citizens who participated in those training sessions and how they perceive the utility of research evidence in their advocacy to strengthen their health systems.

Background Selective reporting of outcomes within a published study based on their nature or direction can result in systematic differences between reported and unreported data. Direct evidence of outcome reporting bias is limited to case reports. Objective To study empirically the nature of outcome reporting bias in randomised controlled trials (RCTs). Methods Three cohorts of RCTs were identified: PubMed-indexed RCTs published in December 2000; trial protocols approved by a Danish ethics committee from 1994-95; and trial protocols funded by a government agency in Canada from 1990-98. Data on reported and unreported outcomes were recorded from all trial publications and a survey of authors. An outcome was considered incompletely reported if insufficient data were presented for meta-analysis. Odds ratios relating the completeness of outcome reporting to statistical significance were calculated for each trial, and then pooled using a random effects meta-analysis. Protocols and publications were also reviewed for discrepancies in primary outcome reporting. Results 519 trials with 10,557 outcomes, 102 trials with 3613 outcomes, and 48 trials with 1390 outcomes were identified for the PubMed, ethics committee, and funding agency cohorts respectively. 22%-35% of outcomes per parallel group study were, on average, incompletely reported for meta-analysis. Fully reported outcomes had a two- to three-fold higher odds of being statistically significant compared to incompletely reported outcomes. The most common reasons given for omitting outcomes included a lack of clinical importance, lack of statistical significance, and space constraints. Major discrepancies between primary outcomes in protocols and publications were found in one half of trials. Discussion and conclusions The reporting of trial outcomes is frequently inadequate for meta-analysis; is biased to favour statistical significance; and is inconsistent with pre-specified protocol outcomes. Unacknowledged modifications to outcomes specified in trial protocols constitute scientific misconduct. Meta-analyses may therefore produce inflated and unreliable estimates of treatment effect.

Is public health policy based on scholarly evidence? With the manifold variables that policy makers must consider, is evidence-based policy even realistic? While strategies exist to translate research into policy, a need to understand better how that can play out in real-life remains. Using interviews from informants occupying a range of positions, and considering the atmosphere created by media reports, this study examines the case of smoking privileges at East Coast Forensic Hospital. After a patient committed murder while on leave, apparently to smoke, public pressure over public safety, a relative lack of relevant scholarship, ethical considerations, and the divergent voices of stakeholders created challenging circumstances for policy makers. Through the use of case study methodology, this project identifies the kinds of information that are employed in the creation or modification of policy and offers insights concerning how the influences exerted on policy makers determine how information is employed.

Diss. (sammanfattning) Linköping : Univ., 2004. / Härtill 5 uppsatser.

<p><strong>Research objectives</strong>: 1) Develop an online repository of policy-relevant documents addressing healthcare renewal in Canada; and 2) describe the general contents of policy-relevant documents addressing healthcare renewal in Canada. <strong>Methods</strong>: The methods for this study were iteratively developed using an approach similar to a scoping review. Documents were identified through website hand-searches and sixteen Canadian health organizations that contributed to the development of the online repository. The majority of organizations are government health ministries/departments or government-supported health organizations. The focus of the analysis was to calculate general descriptive frequencies of the distribution of documents included in the online repository, specifically: 1) the general characteristics of the documents, such as document type, publication year and jurisdictional focus; 2) document themes by national priority areas; 3) document themes by health system topics; and 4) contributing organizations. <strong>Results</strong>: A total of 304 documents were coded for inclusion in the online repository<br />(<a href="http://eihrportal.org/">http://eihrportal.org</a>). The Health Council of Canada contributed the largest amount of documents (n=60, 19%). The top three types of documents are health and health system data (n=75, 25%), situation analysis (n=72, 24%) and jurisdictional review (n=49, 16%). The top three national priority areas addressed in the documents are health human resources (n=270, 89%), quality as a performance indicator (n=210, 69%) and information technology (n=183, 60%). The least commonly addressed national priority areas are technology assessment (n=19, 6%), prescription drug coverage (n=68, 22%) and Aboriginal health (n=87, 29%). <strong>Conclusion</strong>: The process of developing a systematic method for identifying policy-relevant documents and retrieving useful information from these documents can be reproduced by anyone interested in using this type of evidence to inform their health policymaking. A number of implications exist for policy and research, both in Canada and in low- and middle-income countries, which have to be considered in relation to the unique nature of this type of evidence.</p> / Master of Science (MSc)

This applied research project responds to a critical problem in health and development: how to effectively translate our research evidence to the communities with and for whom we work in order to stimulate successful, sustainable health promotion activities and social change. The tangible product of this research is a handbook for health and outreach workers from immigrant communities from the Horn of Africa living in Toronto. The handbook is a resource which will be used as a starting point for the generation of community-based health initiatives, in this case, HIV/AIDS prevention programs. The research applies a conceptual approach which emphasizes participatory action research theory and methodology, and equitable, transcontextual research partnerships. It uses a model which merges both scientific evidence and experiential (ethnographic) evidence of risk and vulnerability to create new understandings on which to base the development of health programs. Stories, grounded in ethnographic evidence, are at the heart of the research strategy. The handbook is an example of experimental ethnographic writing: dialogue is used to communicate research evidence, health, and skills information; and a number of personal narrative:s have been constructed as resources to help health workers generate dialogue on issues of risk and vulnerability, and begin a process of reflection and action. In a larger context, the lessons learned as this work is implemented and evaluated in the community will contribute to the knowledge of intervention science. The research also serves as an example of ethical anthropology and raises for discussion ethnography's future project at the tum of the century. With attention to how anthropologists represent their work, 'moral ethnography' can serve a larger human project, helping us better understand what it is to be human and stimulating moral conversations about how we want to live. / Thesis / Master of Arts (MA)

Background: Little is known about the use of pain management evidence in Jordanian Pediatric Intensive Care Units (PICUs). Purpose: To assess the existence, content, and the factors influencing the use of pain management evidence in Jordanian PICUs. Methods: Three studies were guided by the Promoting Action on Research Implementation in Health Services (PARiHS) framework. 1. A scoping review of the literature to identify pain management interventions in the PICU; 2. A cross-sectional and multisite survey to determine the current pain management practices, and the availability and content of practice guidelines in Jordanian PICUs; 3. A correlational and multisite survey to examine the relationship between the contextual factors and nurses’ use of pain management research evidence in Jordanian PICUs. Results: 1. Twenty-seven studies were included in the scoping review. The majority of the studies focused mainly on pharmacological interventions (n= 21, 78%). Morphine and fentanyl were the most commonly used pharmacological agents for pain management in the PICUs. The use of non-pharmacological interventions was limited. 2. Four of six eligible PICUs participated in the cross-sectional study. All four units had written pain management guidelines. Fentanyl was the most commonly used pharmacological agent in two units. Intravenous infusions of opioids were not administered for patients on mechanical ventilation in two units. The use of non-pharmacological interventions was reported in one unit. 3. From the four participating units, 73 nurses completed the correlation study survey. Social capital predicted both the instrumental and conceptual research use for pain management by Jordanian PICU nurses. Structural and electronic resources predicted the instrumental research use for pain management by Jordanian PICU nurses. Conclusions: Pain management practices and supporting guidelines varied in Jordanian PICUs. Context influences Jordanian PICU nurses’ use of research for pain management. Not all of the pain management practices in Jordan are evidence informed. There is an opportunity for improvement in pain management in Jordanian PICUs.

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Introduction The main aim of the study was to explore the technical capacity of members of the 12 Sector Human Resource Development committees of the Human Resource Development Council in the management of evidence-based policymaking in the course of implementing the national and sector-specific Human Resource Development plans for all matters of national human resource development. The study set out to contribute to the urgency and growing importance of research evidence as the basis for making informed policy and practical decisions across the world. There is a significant research gap in understanding how members of the Human Resource Development committees, as policymakers in the context of this study, use research-based evidence in the course of developing Human Resource Development plans. There is limited understanding of the factors that may induce or constrain members of the committees to use research-based evidence in implementing the national and sector-specific Human Resource Development plans. Methodology The study adopted an exploratory, sequential, inductive mixed methods approach in addition to the deductive use of the Canadian Institutes of Health Research (CIHR) knowledge-to-action framework. The target participants for the study were the members of the 12 Sector Human Resource Development committees of the Human Resource Development Council who were asked to complete a questionnaire. The questionnaire elicited respondents’ perceptions about their capacity to adapt knowledge generated; identify inhibiting/ facilitating factors; assess and approve research evidence and sustainable use of research evidence. Qualitative data was collected through conducting interviews with the chairpersons of the committees. The scope of the in-depth interview questions covered respondents’ perceptions on the same key areas as in the questionnaire. This was to allow respondents to express their feelings during the in-depth discussions without any limitations. Findings The insights based on the perceptions of chairpersons and members of the committees in this current study have revealed the areas for possible improvement in managing evidence-based policies in the context of Botswana. Issues that emerged with respect to the perceptions of respondents to adaptation of research evidence included packaging and presenting research evidence; lengthy reports and use of complex language; lack of understanding of the policymaking context by researchers, and inversely, policymakers not understanding the research process; lack of collaboration and engagement between researchers and policymakers; and lack of implementation plans. Issues that related to the perceptions of respondents on factors that may inhibit or facilitate the use of research evidence entailed positive attitude towards evidence-based policies; development of policy briefs; difficulty in accessing research articles, databases and journals; building policymakers’ ability to search for relevant research evidence; insufficient time to read and evaluate research articles; lack of organisational support; and authority and decision-making power. Concerning respondents’ perceptions on assessing and approving research evidence, issues raised covered skills in interpreting the research evidence; policymakers being generalists; lack of appraisal criteria and guidelines; and training on appraising research evidence being more theoretical than practical. As for the strategic interventions suggested to sustain evidence-based policies, respondents highlighted the need for skills development for both researchers and policymakers; participation of policymakers in the research process; and provision of incentive schemes. Conclusions In conclusion, the findings of the current study show that all the sub-constructs of adaptation of research evidence, factors inhibiting or facilitating the use of research evidence, and assessing and approving the quality of research evidence are significantly and positively related to research evidence informing policy and practice. Overall, the insights emerging from this current study provide conceptual tools to use research evidence to inform policy and practice. The study sought to complement and advance the literature on the field of evidence-based policy management, essentially contributing to the research-policy interface in Botswana context. Botswana, as an emerging economy, is still grappling with understanding the dynamics of evidence-based policy management. There is still a need to initiate, develop and sustain evidence-based policy management through strategic interventions. The insights gained from the current study can be used as a basis for future research. / Educational Management and Leadership / Ph. D. (Educational Leadership and Management)