Building Bridges Between Research and Health Policy Decision-Making

Canadian Research Data Centre Network

National Conference, October 22-24, 2012

Jasmine Lefebvre

Senior Knowledge Translation Specialist

Today I will talk about…

Overview of CIHR

Challenges in bridging research and policy

Initiatives aimed at bridging research and policy

Evidence on Tap Evidence-Informed Healthcare Renewal

Outcomes and Lessons Learned

Overview of CIHR

• CIHR is the Government of Canada’s funding agency for health research and knowledge translation

• CIHR supports more than 14,000 researchers and trainees

• CIHR funds a broad spectrum of health research, encompassing four themes:

Biomedical Clinical Health systems and services Population and public health

CIHR Approach - 13 virtual institutes

Each led by a Scientific Director who:

builds Institute and research capacity

establishes and nurtures partnerships

fosters networking, knowledge dissemination and communication

works as part of CIHR management team

conducts research

Supported by Institute Advisory Boards: linkage to stakeholder communities

Knowledge Translation is part of our mandate

• Support a high-quality, accessible and sustainable healthcare system (Strategic Direction #2)

• Support evidence-informed policy-making to improve health and the health system at provincial and federal levels (Strategic Direction #3)

Health Research Roadmap

Why bridge research and policymaking?

• Policy which is informed by systematic evidence generally leads to better outcomes

• Widely agreed that health policies do not reflect research evidence to the extent that in theory they could

• There are many genuine obstacles to evidence-informed policy-making, which require a concerted effort to build capacity

• Research indicates that exchange between the very different worlds of research and policymaking leads to more relevant research and policy decisions

Challenges in supporting research use in policymaking

1. Research isn’t valued as an information input (general climate for research use)

2. Research isn’t relevant (production)

3. Research isn’t easy to use (translation)a. Research isn’t communicated effectively (push)

b. Research isn’t available when policymakers need it and in a form that they can use (facilitating pull)

c. Policymakers lack mechanisms to prompt them to use research in policymaking (pull)

d. Policymakers lack fora where systems challenges can be worked through with key stakeholders (exchange)

Taken from Dr. John’s Lavis’ presentation to the HealthCare 2010 Symposium

“Personal two-way communication between researchers and decision-makers should be used to facilitate the use of research.

This can reduce mutual mistrust and promote a better understanding of policy-making by researchers and research by policy-makers.”

Facilitators Barriers  absence of personal contactpersonal contact lack of timeliness or relevance of researchtimeliness and relevance of research cultural differences, mutual mistrustsummaries + policy recommendations concerns about quality of research

time commitments and constraints  staff turnover 

Barriers and facilitators to researcher/policymaker collaboration

Innvaer et al. (2002) J Health Serv Res Policy, 7(4):239-44.

Research Process

Knowledge Translation Processes

Policy-Making Process

Taken from Dr. John’s Lavis’ presentation to the HealthCare 2010 Symposium

Purposefully linked processes

Knowledge translation activities to link the research and policymaking processes

Integrated Knowledge Translation

• Integrated KT: Is a way of doing research (i.e., an approach, not a method) Is collaborative, participatory, action-oriented research

Involves engaging and integrating knowledge users into the research process

• Knowledge users can be: Policymakers, decision makers, researchers, the public,

industry, clinicians, the media Investigators from different disciplines, teams, countries

Because they participate throughout the research process, the research results are more likely to be relevant to and

used by decision makers

CIHR Initiatives contributing to bridging research and policy

1. Evidence on Tap (EoT)

2. Evidence-Informed Healthcare Renewal (EIHR)

Objective: To produce high-quality, timely, and accessible evidence that is of immediate interest and use to senior government policy makers.

Objective: To provide timely and high-quality evidence - both in the short term and beyond for the perennial topics of how best to finance, sustain and govern provincial, territorial and federal healthcare systems

EIHR*EoT

Healthcare Renewal Policy Analysis

Science Policy Fellowships

CIHR initiatives contributing to bridging research and policy

Best Brains Exchanges

Expedited Knowledge Synthesis

PHSI

*Other funding tools are also used within the EIHR initiative

• A one-day meeting that brings together the “best brains” of research and decision-making on a ministry-identified, high-priority issue for a closed-door “brain dump”.

• In-camera discussions (Chatham House Rule)

• Researchers summarize the relevant evidence and suggest what it implies about possible policy directions

• Researchers and decision makers discuss the implications of the research

EoT: Best Brains Exchanges

What is a Best Brains Exchange?

• Syntheses are often cited as the preferred source of evidence to inform decision-making but usually take too long to produce

• EKS accelerates all phases of synthesis production – application, review, research, knowledge translation.

• Decision-makers submit priority synthesis topics to CIHR

• Pre-qualified teams apply, and following merit review, selected teams synthesize the evidence in an accelerated timeframe and participate in a workshop illustrating their findings.

• Outcomes: high-quality knowledge syntheses and workshops that respond to decision-making priorities.

EoT: Expedited Knowledge Synthesis

What is an Expedited Knowledge Synthesis?

Recent topics: EIHR, Suicide Prevention, MS (CCSVI)

EIHR: Healthcare Renewal Policy Analysis

Purpose:

• to support the generation of health policy analyses that identify evidence-informed policy options for healthcare renewal (including public health) in Canada and that will be useful to health system policy and decision makers.

• to offer policy and decision makers evidence-informed policy options for healthcare renewal issues of high importance over the next two-to-three years.

Areas of Focus:

• EIHR: Financing and funding models, governance and sustainability of the healthcare system

• Expedited Knowledge Synthesis

• Healthcare Renewal Policy Analysis

Research responding to the needs of policy and decision makers

EIHR: Science Policy Fellowships

Purpose:

•To establish and nurture critical links between policy makers and external researchers in support of evidence-informed public policy by providing short-term policy assignments

• Provide trainees and investigators with exposure to how government works and how public policies are made

• Engage health research trainees and investigators in the policy-making process

• Encourage trainees and investigators to conduct policy-relevant research that addresses challenges facing society

• Assist policy-makers in gathering the external scientific expertise required to inform their decisions

Currently accepting applications (deadline Dec. 5, 2012)

Partnerships for Health System Improvement (PHSI)

• PHSI offers Canada’s health-system decision makers evidence-informed answers to their most pressing questions.

• A funding program founded on partnerships, every PHSI project involves collaboration between decision makers and researchers interested in working together to address health system challenges.

• Any applied health services and policy research topic can be addressed so long as it responds to the information needs of the participating decision makers.

Outcomes and Lessons Learned

Cultivated an appreciation for and tendency to consider health services research (“There’s a tone and culture shift I’m feeling about valuing and appreciating health services research in our policy”)

• Fostered relationships with researchers (“we’re more inclined to reach out”)

• Strengthened relationships between the Ministries and CIHR (“we have a much deeper relationship with CIHR now” and “Now you hear our Deputy talk about CIHR all the time. He talks about the Best Brains and says that what we’re trying to do is accomplish fundamental change and that CIHR, with the Best Brains, is helping us achieve this.”)

•Contributed directly to policy- and decision-making (“We went from Best Brains into action really fast,” and “it has contributed to evidence-informed decision-making – especially in terms of directions not taken.”)

•Mechanism for follow-up with individual decision makers is needed

Feedback from Policy Makers (Ministry leads)

• Most common goals are “to be useful” and “to contribute to policymaking”

• Researchers valued the exchange of ideas with decision makers, opportunity for insight into their priority questions, chance to contribute directly to policy-making, and the opportunity to network

Comments

“Put me down as a wild enthusiast!”; “it’s an absolutely fabulous initiative.”

“Absolutely [CIHR should continue the program]. I’d advocate for this because it’s a very effective use of KT dollars.”

Feedback from Researchers:

Outcomes and Lessons Learned

"I think my experience as a science policy fellow has prepared me to interact more effectively with policy makers and health professionals. I can see things from their perspective, which will be invaluable if I want to succeed as an applied researcher and impact population health through decision-making and knowledge translation." Dr. Rasha Maal-Bared, CIHR/Health Canada Science Policy Fellow

“The CIHR Science Policy Fellowship was a unique opportunity to really step out of my academic setting and get a sense of what matters most in policy development. Working alongside the policy experts at Health Canada allowed me to translate my research into a meaningful health policy discussion. Because of the links existing between Health Canada and the Canadian healthcare industry, the Fellowship also gave me a better understanding of how to bridge the gap between research and innovation.” Jason Millar , CIHR/Health Canada Science Policy Fellow

Feedback from Science Policy Fellows:

Outcomes and Lessons Learned

For More Information

Website: About Knowledge Translationhttp://www.cihr-irsc.gc.ca/e/29418.html

Thank you

E-mail: kt-ac@cihr-irsc.gc.cajasmine.lefebvre@cihr-irsc.gc.ca