Building Bridges Between Research and Health Policy Decision-Making

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Building Bridges Between Research and Health
Policy Decision-Making
Jasmine Lefebvre Senior Knowledge Translation
Specialist
Canadian Research Data Centre Network National
Conference, October 22-24, 2012
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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

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Overview of CIHR

• CIHR is the Government of Canadas 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

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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
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Knowledge Translation is part of our mandate
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Health Research Roadmap

• 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)

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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

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Challenges in supporting research use in
policymaking

1. Research isnt valued as an information input
   (general climate for research use)
2. Research isnt relevant (production)
3. Research isnt easy to use (translation)

1. Research isnt communicated effectively (push)
2. Research isnt available when policymakers need
   it and in a form that they can use (facilitating
   pull)
3. Policymakers lack mechanisms to prompt them to
   use research in policymaking (pull)
4. Policymakers lack fora where systems challenges
   can be worked through with key stakeholders
   (exchange)

Taken from Dr. Johns Lavis presentation to the
HealthCare 2010 Symposium
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Barriers and facilitators to researcher/policymake
r collaboration
Facilitators Barriers
  absence of personal contact
personal contact lack of timeliness or relevance of research
timeliness and relevance of research cultural differences, mutual mistrust
summaries policy recommendations concerns about quality of research
time commitments and constraints
  staff turnover
 
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.
Innvaer et al. (2002) J Health Serv Res Policy,
7(4)239-44.
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Knowledge translation activities to link the
research and policymaking processes
Knowledge Translation Processes
Policy-Making Process
Research Process
Purposefully linked processes
Taken from Dr. Johns Lavis presentation to the
HealthCare 2010 Symposium
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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
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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
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CIHR initiatives contributing to bridging
research and policy
EIHR
EoT
Best Brains Exchanges Expedited Knowledge
Synthesis
Healthcare Renewal Policy Analysis Science
Policy Fellowships
PHSI
Other funding tools are also used within the
EIHR initiative
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EoT Best Brains Exchanges
What is a Best Brains Exchange?

• 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

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EoT Expedited Knowledge Synthesis
What is an Expedited Knowledge Synthesis?

• 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.

Recent topics EIHR, Suicide Prevention, MS
(CCSVI)
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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

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Research responding to the needs of policy and
decision makers

• Expedited Knowledge Synthesis
• Healthcare Renewal Policy Analysis

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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)
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Partnerships for Health System Improvement (PHSI)

• PHSI offers Canadas 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.

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Outcomes and Lessons Learned
Feedback from Policy Makers (Ministry leads)

• Cultivated an appreciation for and tendency to
  consider health services research (Theres a
  tone and culture shift Im feeling about valuing
  and appreciating health services research in our
  policy)
• Fostered relationships with researchers (were
  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 were
  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

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Outcomes and Lessons Learned
Feedback from Researchers

• 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! its an
  absolutely fabulous initiative.
• Absolutely CIHR should continue the program.
  Id advocate for this because its a very
  effective use of KT dollars.

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Outcomes and Lessons Learned
Feedback from Science Policy Fellows
"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
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For More Information

• Website About Knowledge Translation
• http//www.cihr-irsc.gc.ca/e/29418.html

E-mail kt-ac_at_cihr-irsc.gc.ca jasmine.lefebvre_at_ci
hr-irsc.gc.ca
Thank you