Randomized trials
What gets public health managers to act on research evidence?
Open access · cc by · source: Europe PMC
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.
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
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Key findings
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.
Methodology
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.
Limitations
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.
How this study connects
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