Why do many local governments fail to support evidence-based practice?

This blog post is based on the Evidence & Policy article, ‘Local politicians in action? The relationship between perceived prerequisites and actions of political committees responsible for social services in supporting the implementation of evidence-based practice


Annika Bäck

Basing health care and social services on the best available knowledge is a crucial policy issue in many countries to increase quality and reduce unnecessary, or even harmful, care. But as policy implementation research makes clear, what is formulated as goals at the national level is not necessarily what is implemented at local level.

Evidence-based practice is the integration of research evidence, client preferences and professional expertise in decision-making. The implementation of evidence-based practice has encountered many hurdles. Some of these challenges are related to a non-supportive organisational context with insufficient leadership support due to, for example, poor skills in providing guidance about evidence-based practice and lack of organisational resources.

Local political committees have a role to play in implementing evidence-based practice, as they affect the context for health and social service organisations, and therefore maybe enablers or barriers for implementation. Hence, they are one piece of the puzzle for successful implementation of evidence-based practice. However, little is known about the role of local political committees when it comes to implementing evidence-based practice. What actions do local political committees take to support the implementation of evidence-based practice? And how are these actions related to the committees’ capability, motivation and opportunity to support implementation? These questions are examined in our Evidence & Policy article, Local politicians in action? The relationship between perceived prerequisites and actions of political committees responsible for social services in supporting the implementation of evidence-based practice.

In this study we surveyed 181 chairs and vice-chairs of local political committees responsible for social services in Sweden. We asked them about their committee’s actions to support the implementation of evidence-based practice. In addition they assessed the committee’s capability, motivation and opportunities to support the implementation of evidence-based practice.

Local political committees’ actions to support the implementation of EBP can be clustered in three groups: the passive (n=63), the neutral (n=79) and the active (n=39). Passive committees were less inclined to report doing any of the proposed actions to support implementation, such as allocating resources for evidence-based practice, communicating that evidence-based practice is a priority, and requesting that social service professionals use research knowledge. In contrast, the active group were most inclined to report taking action to support implementation. The active group also reported having more capability, motivation and opportunity to take action, than did the neutral and passive groups. The active group had likewise more highly educated chairs/vice-chairs than the other groups. Based on theory, behaviour is made possible through capability, motivation and opportunity. So a theoretical assumption is that committees with better conditions for taking action will be more active in supporting the implementation of evidence-based practice. This assumption could not, however, be statistically tested in our cross-sectional study.

Local political committees’ actions to support the implementation of evidence-based practice in this study varied greatly. Since local political committees shape the context for social service organisations, our results indicate that local political committees may need increased knowledge about evidence-based practice, but knowledge is not enough. There also needs to be efforts to strengthen motivation and opportunities for local political committees to take action in supporting implementation of evidence-based practice. One way to strengthen the capability, motivation and opportunities could be education and training during the term of office for the committees. Such training would be especially important for the passive committees.


Annika Bäck is a doctoral student at Karolinska Institutet, Department of Learning, Informatics, Management and Ethics. Her doctoral research involves examining how the local politico-administrative leadership view and affect the implementation of evidence-based practice in social services.


You can read the original research in Evidence & Policy:

Bäck, Annika; Schwarz, Ulrica von Thiele; Bergström, Anna; Hasson, Henna and Richter, Anne (2021). Local politicians in action? The relationship between perceived prerequisites and actions of political committees responsible for social services in supporting the implementation of evidence-based practice Evidence & Policy, DOI: 10.1332/174426421X16178101375342.


Image credit: Photo by Mel Poole on Unsplash


If you enjoyed this blog post, you may also be interested to read:

The legitimacy of experts in policy: navigating technocratic and political accountability in the case of global poverty governance

Analysts, advocates and applicators: three discourse coalitions of UK evidence and policy [Open Access]

Does evaluation quality enhance evaluation use?


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