June 2012 Issue 31 1. Highlights 2. Empirical studies 3. Editorial articles 4. Systematic reviews 5. Relevant publications 6. Events 7. Relevant tools & links
News from EVIPNet Members or Activities April 2012 - Finding Evidence Capacity Building Workshop, Cameroun, Yaoundé
Next EVIPNet Events Addis Ababa, Ethiopia 27 – 30 August 2012. Evidence-Informed Health Policymaking in Low and Middle-Income Countries: An International Forum
Experiences, methods and tools for research translation to policy
1 - HIGHLIGHTS EVIPNet EMRO - New evidence brief for policy on Promoting access to high quality primary health care services in Sudan New evidence brief for policy on Promoting access to high quality primary health care services in Sudan and the dialogue summary reports. The Federal Ministry of Health has started the process of implementation of the policy options and most of the report suggestions have been translated in the national health sector plan and other relevant projects. EVIPNet Chile – New evidence brief for policy Financing options for the treatment of rare diseases in Chile The problem of financing orphan drugs for rare diseases concerns affected individuals and health systems alike. In fact, international agencies such as WHO/PAHO regard that access to essential medicines must be guaranteed by countries, including high-cost essential drugs, since they cause a significant financial impact on households and make them susceptible to falling into or remaining in poverty. Rare diseases have generated interest for a long time. Although these diseases are not specific to high income countries, because of obvious socioeconomic reasons initiatives to meet the needs of people with rare diseases have grown mostly in these countries. The problems in addressing these diseases in low and middle income countries are mainly related to their high cost of treatment. 2 - EMPIRICAL STUDIES
HIFA-EVIPNet-French brings together stakeholders to explore the information needs of policymakers and how these needs can be addressed more effectively, thereby improving the policymaking process and its
Research, evidence and policymaking: the perspectives of policy actors on improving uptake of evidence in health policy development and implementation in Uganda Orem, J.N., Mafigiri, D.K., Marchal, B., Ssengooba, F., Macq, J., Criel, B., (2012). Research, evidence and policymaking: the perspectives of policy actors on improving
impact on public health. HIFAEVIPNet-French will focus on French-speaking African countries. Join HIFA-EVIPNet-Fr To join, please email your name, job title, organisation, country of residence, and brief description of professional interests to: email@example.com
uptake of evidence in health policy development and implementation in Uganda BMC Public Health, 12(109), 16. Use of evidence in health policymaking plays an important role, especially in resource-constrained settings where informed decisions on resource allocation are paramount. Several knowledge translation (KT) models have been developed, but few have been applied to health policymaking in low income countries. If KT models are expected to explain evidence uptake and implementation, or lack of it, they must be contextualized and take into account the specificity of low income countries for example, the strong influence of donors. The main objective of this research is to elaborate a Middle Range Theory (MRT) of KT in Uganda that can also serve as a reference for other low- and middle income countries. Evaluation of a Web Portal for Improving Public Access to EvidenceBased Health Information and Health Literacy Skills: A Pragmatic Trial Austvoll-Dahlgren., A, BjĂ¸rndal., A, Odgaard-Jensen., J, Helseth., S. (2012). Evaluation of a Web Portal for Improving Public Access to Evidence-Based Health Information and Health Literacy Skills: A Pragmatic Trial. Plos ONE, 5(7), 11 Using the conceptual framework of shared decision-making and evidence-based practice, a web portal was developed to serve as a generic (non disease-specific) tailored intervention to improve the lay publicâ€™s health literacy skills. Use of the web portal was found to improve attitudes towards searching for health information. This variable was identified as the most important predictor of intention to search in both samples. Participants considered the web portal to have good usability, usefulness, and credibility. The intervention group showed slight increases in the use of evidence based information, critical appraisal skills, and participation compared to the group receiving no intervention, but these differences were not statistically significant. Despite the fact that the study was underpowered, we found that the web portal may have a positive effect on attitudes towards searching for health information. Furthermore, participants considered the web portal to be a relevant tool. It is important to continue experimenting with web-based resources in order to increase user participation in health care decision-making. Developing lay health worker policy in South Africa: a qualitative study Daniels, K., Clarke, M., Ringsberg, C. K., (2012). Developing lay health worker policy in South Africa: a qualitative study. Health Research Policy and Systems, 10(8), 11. Over the past half decade South Africa has been developing, implementing and redeveloping its Lay Health Worker (LHW) policies. Research during this period has
highlighted challenges with LHW programme implementation. These challenges have included an increased burden of care for female LHWs. The aim of this study was to explore contemporary LHW policy development processes and the extent to which issues of gender are taken up within this process. LHW policy redevelopment focused on resolving issues of LHW working conditions through an active process involving many actors and strong debates. Within this process the issue of gender had no champion and never reached the LHW policy agenda. Future research may consider how to incorporate the voices of ordinary women into the policy making process. 3 – EDITORIAL ARTICLES An introduction to systematic reviews Gough, D., Oliver, S., Thomas, J., (2012). Chapter 1 of book An introduction to systematic reviews. London, Sage Publications -
Introduces the logic and purpose of systematic reviews Explains their value for making decisions Considers what ‘systematic’ means when applied to reviewing literature Explains how review methods may vary while being systematic Introduces some of the current debates Explains to readers what to expect from the rest of the book
This book provides an introduction to the logic of systematic reviews, to the range of current and developing methods for reviewing, and to the consequences of reviewing systematically for the production and use of research. There are many excellent books available on different types of systematic review. This book differs from most others currently available in examining the nature of the basic components of all reviews driven by any research questions and including any research methods and types of data. An optimal search filter for retrieving systematic reviews and meta analyses Lee, E., Dobbins, M., DeCorby, K., McRae, L., Tirilis, D., Husson, H., (2012). An optimal search filter for retrieving systematic reviews and meta analyses. BMC Medical Research Methodology, 12(51), 22. The health-evidence.ca Systematic Review search filter is a useful tool for identifying published systematic reviews, with further screening to identify those evaluating the effectiveness of public health interventions. The filter that narrows the focus saves
considerable time and resources during updates of this online resource, without sacrificing sensitivity. Evidence summaries: the evolution of a rapid review approach Khangura, S., Konnyu, K., Cushman, R., Grimshaw,.J, Moher, D., (2012). Evidence summaries: the evolution of a rapid review approach. Systematic Reviews Journal, 1(10), 9 Rapid reviews have emerged as a streamlined approach to synthesizing evidence typically for informing emergent decisions faced by decision makers in health care settings. Although there is growing use of rapid review â€˜methodsâ€™, and proliferation of rapid review products, there is a dearth of published literature on rapid review methodology. This paper outlines our experience with rapidly producing, publishing and disseminating evidence summaries in the context of our Knowledge to Action (KTA) research program. The evolution of the KTA rapid review evidence summaries has been a positive one. We have developed an approach that appears to be addressing a need by knowledge users for timely, user-friendly, and trustworthy evidence and have transparently reported these methods here for the wider rapid review and scientific community. Knowledge translation of research findings M Grimshaw, J., P Eccles,. M, N Lavis, J., J Hill, S., E Squires, J., (2012). Knowledge translation of research findings. Implementation Science, 7(50), 29 Authors suggest that the basic unit of knowledge translation should usually be up-todate systematic reviews or other syntheses of research findings. Knowledge translators need to identify the key messages for different target audiences and to fashion these in language and knowledge translation products that are easily assimilated by different audiences. The relative importance of knowledge translation to different target audiences will vary by the type of research and appropriate endpoints of knowledge translation may vary across different stakeholder groups. There are a large number of planned knowledge translation models, derived from different disciplinary, contextual (i.e., setting), and target audience viewpoints. Most of these suggest that planned knowledge translation for healthcare professionals and consumers is more likely to be successful if the choice of knowledge translation strategy is informed by an assessment of the likely barriers and facilitators. Although our evidence on the likely effectiveness of different strategies to overcome specific barriers remains incomplete, there is a range of informative systematic reviews of interventions aimed at healthcare professionals and consumers (i.e., patients, family members, and informal carers) and of factors important to research use by policy
makers. 4 - SYSTEMATIC REVIEWS The McMaster Health Forum Health Systems Evidence provides links to graded systematic reviews that may be helpful for evidence-informed policy-making.
5 - RELEVANT PUBLICATIONS Multiple crises and global health: New and necessary frontiers of health politics Schrecker,.T, (2012): Multiple crises and global health: New and necessary frontiers of health politics, Global Public Health: An International Journal for Research, Policy and Practice, 7(6), 11. The world economy is entering an era of multiple crises, involving finance, food security and global environmental change. This article assesses the implications for global public health, describes the contours of post-2007 crises in food security and finance, and then briefly indicates the probable health impacts. There follows a discussion of the crisis of climate change, one that will unfold over a longer time frame but with manifestations that may already be upon us. The article then discusses the political economy of responses to these crises, noting the formidable obstacles that exist to equitable resolution. The article concludes by noting the threat that such crises present to recent progress in global health, arguing that global health researchers and practitioners must become more familiar with the relevant social processes, and that proposed solutions that neglect the continuing importance of the nation-state are misdirected. A Web-based archive of systematic review data Ip, S., Hadar, N., Keefe, S., Parkin, C., Lovin, R., M Balk, E., Joseph Lau, J., (2012). A Web-based archive of systematic review data. Systematic Reviews Journal, 1(15), 7. Systematic reviews have become increasingly critical to informing healthcare policy; however, they remain a timeconsuming and labor-intensive activity. The extraction of data from constituent studies comprises a significant portion of this effort, an activity which is often needlessly duplicated, such as when attempting to update a previously conducted review or in reviews of overlapping topics. In order to address these inefficiencies, and to improve the speed and quality of healthcare policy- and
decision making, we have initiated the development of the Systematic Review Data Repository, an open collaborative Web-based repository of systematic review data. As envisioned, this resource would serve as both a central archive and data extraction tool, shared among and freely accessible to organizations producing systematic reviews worldwide. A suite of easy-to-use software tools with a Web frontend would enable researchers to seamlessly search for and incorporate previously deposited data into their own reviews, as well as contribute their own. In developing this resource, we identified a number of technical and non-technical challenges, as well as devised a number of potential solutions, including proposals for systems and software tools to assure data quality, stratify and control user access effectively and flexibly accommodate all manner of study data, as well as means by which to govern and foster adoption of this new resource. Herein we provide an account of the rationale and development of the Systematic Review Data Repository thus far, as well as outline its future trajectory. Activating the knowledge-to-action cycle for geriatric care in India M Evans,J., R Kiran, P., K Bhattacharyya, O., (2011). Activating the knowledge-toaction cycle for geriatric care in India. Health Research Policy and Systems, 9(42), 10. Despite a rapidly aging population, geriatrics - the branch of medicine that focuses on healthcare of the elderly – is relatively new in India, with many practicing physicians having little knowledge of the clinical and functional implications of aging. Negative attitudes and limited awareness, knowledge or acceptance of geriatrics as a legitimate discipline contribute to inaccessible and poor quality care for India’s old. The aim of this paper is to argue that knowledge translation is a potentially effective tool for engaging Indian healthcare providers in the delivery of high quality geriatric care. The paper describes India’s context, including demographics, challenges and current policies, summarizes evidence on provider behaviour change, and integrates the two in order to propose an action plan for promoting improvements in geriatric care. A rapid situational analysis of health policy and systems research in the western pacific region A technical report submitted to the World Health Organization, Western Pacific Regional Office Manila, Philippines This rapid situational analysis shows that there is an existing and growing core of HPSR institutions and organizations in the Western Pacific. As put forth by some key informants, “There is no one center of excellence here; there are many centers of excellence in the Western Pacific Region.” There is, however, unevenness in research
capacity and knowledge generation and translation in the area of health systems and policy, with low and lower middle income countries having the greatest challenges as well as the greatest potential for harnessing benefits from good HPSR programs and studies. A Guide to Evaluation in Health Research Bowen, S., (2012). A Guide to Evaluation in Health Research. Department of Public Health Sciences, School of Public Health, University of Alberta. The need for a learning module on evaluation has been identified as a priority for both researchers and peer reviewers. In response to the myriad of challenges facing the health system, both researchers and health system managers are proposing significant changes to current clinical, management and public health practice. This requires timely and rigorous assessment of current programs and innovations. Evaluation is a useful strategy for generating knowledge that can be immediately applied in a specific context, and, if certain evaluation approaches are used, can also generate transferable knowledge useful to the broader health system. In addition to the common need for some research proposals to include an evaluation component, funders are also initiating funding opportunities that focus on trialling innovations and moving knowledge into action. These proposals, by their nature, require welldesigned robust evaluation plans if useful knowledge is to be gained. However, many researchers (like health system managers) have limited evaluation knowledge and skills. 6 â€“ EVENTS WHO knowledge transfer tool on ageing April 2012 -- Knowledge derived from research and experience is of little value unless it is put into practice and its success is monitored and regularly evaluated. Hence, WHO will issue a tool to assist governments to translate ageing and health knowledge into policy and practice, with a particular emphasis on age-friendly health policies and action plans. The aim is to improve health and health systems policies and outcomes which are sensitive to the needs of older people. The objective of the Knowledge translation on ageing and health, A framework for policy development 2012 is to assist policy- and decision -makers in integrating evidence-based approaches to ageing in national health policy development processes, specific policies or programmes addressing older population needs and other health programmes concerned with such issues as HIV, reproductive health, chronic
diseases. ISQuaâ€™s 29th International Conference The International Society for Quality in Health Care is a non profit, independent organisation with members in over 70 countries, ISQua's conference offers a unique opportunity for delegates to share expertise and knowledge via a multidisciplinary forum. CEDES/IDRC Call for Proposals for research teams to conduct four country studies CEDES and IDRC are launching a competitive Call for Proposals for research teams to conduct four country studies. The selected teams will undertake policy-oriented research on the linkages between the demographic transition and financial constraints in four systemically important developing countries. The country studies are part of a global research project on Asymmetric Demography and Global Financial Governance. The country studies are to focus on: the linkages between demographic trends, the current account, and international financial flows; the ability of the domestic financial system to respond to the requirements regarding the allocation of investment, savings and risks associated with different stages of the demographic transition; and the design of initiatives for developing countries to take advantage of the demographic dividend and demographic-driven capital flows. Eligible developing countries for these case studies must be systemically important (i.e. members of the G-20) and the country teamsâ€™ research institution must be based in a developing country. Priority will be given, nonetheless, to proposals concerning four countries: Brazil, China, India, and South Africa. Each of the four selected proposals will be awarded USD 45,000 to finance wages, research expenses and the dissemination at the national level. Research teams are invited to submit Expressions of Interest by June 30th, 2012.
7 - RELEVANT TOOLS & LINKS Equity-focused knowledge translation toolkit This toolkit has specific relevance to public health, and discusses some common barriers to moving evidence into practice that the Winnipeg Regional Health Authority (WRHA) faced with their Language Access service. Inclusion of qualitative evidence is discussed, as well as the necessity of developing a business case for
interventions. This toolkit would be useful to any public health professional working to implement evidence in practice in other health equity contexts.
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