What gets public health managers to act on research evidence?
Simple, tailored emails pointing managers to relevant research reviews increased the number of evidence-based child healthy-weight programmes their departments ran, while website access alone and an intensive knowledge broker did not.
Source
A randomized controlled trial evaluating the impact of knowledge translation and exchange strategies
Study at a glance
- Design
- RCT — Stratified randomised trial with health departments as the unit: website access only vs website plus tailored, targeted emails vs both plus a knowledge broker; surveys at baseline and post-intervention
- N
- N=108 · 108 Canadian public health departments randomised (36 per arm); follow-up data from 88
- Population
- Canadian regional and local public health departments, represented by the manager responsible for healthy body weight promotion in children
- Outcome
- Self-rated use of research evidence in a recent programme decision (global evidence-informed decision making), and the number of 11 evidence-supported childhood healthy-weight policies and programmes being implemented
Structured fields used in claim comparison tables when every cited study has a complete layer.
What they did
All Canadian public health departments were invited, and those that agreed were stratified by population size and randomly allocated to three strategies for spreading findings from seven high-quality systematic reviews on childhood healthy weight. One group only had access to a curated research website; a second also received a weekly series of seven emails with direct links to each review and a practical summary; a third received both plus a knowledge broker who worked one-on-one with managers through calls, a site visit and workshops. The manager responsible for this area was surveyed by phone before and after the 2005 intervention, and mixed-effects models compared change between groups.
What they found
None of the strategies changed managers' general rating of how much they used research evidence, though all groups rose somewhat. For the concrete outcome, the number of evidence-backed policies and programmes in place, the tailored-message group improved significantly while the website and knowledge-broker groups did not (p < 0.01 for the group effect). Organisational research culture moderated this: in departments that valued research highly, tailored messages worked best and the broker group actually declined, while in departments with low research culture the knowledge broker produced the largest gain.
The limits
What it doesn't show
Outcomes were self-reported by one manager per department, who may not have known about all programmes across divisions, and in about 30% of departments a different person answered at follow-up, adding measurement error. Around 30% of broker-group departments engaged little or not at all, website use in the control group was never measured, and the broker intervention lasted only about a year. The study counts programmes reported as in place, not whether services were delivered or whether children's weight or health changed.
Key terms
- Knowledge translation and exchange (KTE)
- Activities that move research findings into the hands of people making policy or practice decisions.
- Evidence-informed decision making
- Making policy or programme decisions by weighing the best available research together with local context, resources and expertise.
- Knowledge broker
- A person who links researchers and decision makers, helping find, interpret and apply evidence to local decisions.
- Tailored, targeted messages
- Communications matched to a recipient's specific decision-making role (tailored) and to the decision they currently face (targeted).
- Effect moderation
- When the effect of an intervention depends on a third factor, here the organisation's research culture.
- Mixed-effects model
- A regression model that handles repeated measurements on the same units by including random effects for each unit.
Flashcards
0 of 11 answers reviewed
Research intelligence for this paper
See its role on concept claims, tensions it is part of, placement history, and related discoveries.
Quiz yourself
Which strategy significantly increased evidence-based programmes overall?
Common questions
Why would the most intensive strategy, a knowledge broker, work worse than emails?
The authors suggest the broker spent time building skills and capacity, which may slow decisions in the short run, and that the broker's intensity and duration may have been too low; brokering helped mainly where research culture was weak.
Why were health departments rather than individual people randomised?
The decisions being studied are organisational programme choices, so the department is the natural unit and analysis was done at that level.
Is a self-rated 'use of evidence' score a good outcome?
The authors doubt it: it showed no effect and may be too vague, which is why they added the count of specific evidence-based programmes in place.
More on Randomized trials