Especially in times of crisis, the relationship between evidence and policymaking may change dramatically. The current Covid-19 crisis generated manifestations of ‘evidence informed policymaking’ in an unprecedented way, both nationally and locally. It also showed that the need to use internationally organised, reliable data for effective policy interventions has never been more urgent in times of peace. This information needs to be both profound and directly available.
In the processes of shaping evidence informed policymaking, scientists from all kinds of disciplines play a crucial role to substantiate the development of policies. An international, virtual conference taking place 15–18 December 2020 will treat the outcomes of the current crisis as input for the challenge of professionalising the structured interaction between evidence and policymaking. The current learning processes will be analysed in the context of the existing knowledge infrastructure for policymakers. Instruments for creating evidence for policymakers have recently grown with the introduction of Big Data and the development of algorithms. Another widespread trend is the use of innovative evaluation processes in order to enhance the effectiveness of policy instruments and the growth of new standards for experimental policies.
Complexity in healthcare systems presents knowledge translation (KT) challenges but also opportunities. Our Evidence & Policy article, ‘Connecting knowledge and action in complex health systems: examples from British Columbia, Canada’, illustrates ways we have harnessed complexity to narrow the gap between knowledge and action. We work across different health authorities and funding agencies building strong relationships with those who use research, fostering innovation, supporting evidence-based decision-making and helping people to de-implement obsolete practices. We share a commitment to building strong connections between knowledge and action, and our work is enhanced by embracing the inherent intricacies of the systems in which we work.
We share examples from our practice areas of how we navigate the demands of knowledge translation using responsive solutions and relationship building to support KT that promotes health. While many health systems leaders continue to perceive researchers and research as irrelevant and disconnected from their realities, we have found that when research is undertaken with people who use it, reciprocal and responsive relationships can overcome this barrier and lead to collaborations that support healthcare improvements. Embracing research as a public good requires reimagining the relationships and structures of both research and KT, and we are encouraged by the many ways we’ve seen this happen.
This special issue uses the lens of Creativity and Co-production to explore the meaning of ‘evidence’ and whose meaning counts. It considers what the terms ‘creating’, ‘making’ and ‘production’ mean with regards knowledge creation, sharing and putting into action. It examines the potential role that created artefacts play. For example, what are the values embodied and represented in ‘knowledge artefacts’ and what affordance and agency might they give to human actors?
Areas for discussion include:
What evidence is valid, who produces it, and how was it produced?
What is the process by which ‘evidence’ can be interrogated by others, made sense of, and acted upon?
Not acting on evidence is commonly described as the ‘evidence gap’. Could this be broken down into a series of ‘micro’ gaps between Evidence and Knowledge, Knowledge and Knowing, Knowing and Action?
What role do creative practices, tangible objects, and visual language play in bridging each of these micro gaps?
How do we implement shared decision-making into routine practice? Health systems are struggling with this question worldwide. Instead of simplifying this challenge into barriers and facilitators, what if we embraced its complexity?
In recent years there have been increasing calls for the implementation of shared decision-making in routine clinical care. Shared decision-making is particularly helpful for decisions where there are multiple appropriate options, and the ‘best’ decision rests with the patient’s preferences.
In my work with federal agencies over the last 15 years on violence prevention, social emotional learning, mental health and homelessness, the idea of translating research to practice has become increasingly important. We know there is a gap between what we discover through research and what is applied by practitioners, funders and policymakers.
Over the past decade, federal agencies — and the US Department of Health and Human Services (HHS), in particular — have sought to learn more about the ‘science’ of implementing programmes, practices and policies. They want to invest smartly and do a better job of ensuring the most evidence-based decisions. These are noble goals — especially during this pandemic, when health and human service organizations are being asked to do things they have never done before, with lightning speed. Unfortunately, it gets complicated fast: Each field has its own terminology, frameworks and measures, making it difficult to synthesise information and create a shared body of knowledge across disciplines. So where do we start?
On the understanding that human beings are relational and storytelling animals, who make sense of the world through narrative and dialogue, we developed a story-telling approach to using evidence, which started by developing what has been described as an ‘enriched environment of care and learning’. Within such an environment, everyone involved should gain a sense of security, continuity, belonging, purpose, achievement and significance. To enable this, we started with their priorities and valued their evidence (i.e. practice knowledge, lived experience of older people and carers and organisational knowledge), alongside the research evidence, which we were careful not to impose on them. A challenge for the research team was how to do this.
What does it mean to use evidence in policymaking? This seemingly simple question has been remarkably under-defined in all the calls for increased use of evidence. Indeed, many of those who champion ‘evidence-based policymaking’ do little to explain what it means for a policy to be evidence-based, and have trouble explaining what evidence use actually means when decision makers have multiple competing goals and social concerns. Evidence is simply seen as a good thing – and more use is better – without really considering what that means or what happens when there is disagreement around which evidence to use for what goals.
Policy scholars who study evidence, on the other hand, have approached the issue from the perspective that ‘evidence use’ can mean any number of things within a policy setting. The literature can, therefore, appear divided into two extremes: either evidence use is taken for granted to be a known (assumed to be good) thing, with little consideration of political realities, or alternatively it is seen as multidimensional, the form of which is constructed by the nature of policy ideas, processes, and interactions.
Our university-policy maker partnership produces ‘fake’ abstracts of articles we’ve not written yet (on results we frankly don’t even know we’ve got) to loosen up thinking. It helps the team visualise pathways for policy action.
Ours is a tricky situation, politically-speaking. A health department is undertaking Australia’s largest ever scale-up of evidence-based childhood obesity programs into every school and childcare centre across the state. It costs $45m. They have an electronic data monitoring system in place. It’s already telling them that targets are being met. But rather than just rest on their success, they invite a team of researchers to do a behind-the-scenes, no-holds-barred ethnography. It could reveal the ‘real’ story of what’s goes on at the ground level.
Jennifer Lawlor, Kathryn McAlindon, Kristen Mills, Jennifer Neal and Zachary Neal
Policy makers are working hard to promote the use of research in education. But, does ‘research’ mean the same thing to policy makers and educators? While this question might seem basic, it’s important to know if policy makers and educators are speaking the same language.
It examines similarities and differences between educators’ definitions of research and the definitions used in US Federal education policy. Our findings show that educators tend to focus on the process and products of research, while policy definitions focus on data and outcomes.
‘Wouldn’t it be great if the evidence-to-policy work we’re seeing on the rise in Africa could be visible to a wider audience?’ That was the question my colleagues at the William and Flora Hewlett Foundation and I had on our minds in 2017, seeing the creativity and resourcefulness of a host of organisations and champions from the region as they advanced a complex agenda. Now, just a few years later, the opportunity to learn from African experiences is realised in the volume Using Evidence in Policy and Practice: Lessons from Africa, edited by Ian Goldman and Mine Pabari (Routledge, 2020). The book, which both articulates a conceptual framework for thinking about the elements of a contextually-determined evidence ecosystem and presents eight case studies about diverse experiences, adds immeasurably to the literature on evidence-informed decision making.