Policy Transfer and Learning in the Field of Transport a Review of Concepts and Evidence

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New directions in show-based policy enquiry: a critical analysis of the literature

Wellness Enquiry Policy and Systems book 12, Article number:34 (2014) Cite this article

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Abstruse

Despite 40 years of research into evidence-based policy (EBP) and a connected drive from both policymakers and researchers to increase enquiry uptake in policy, barriers to the use of evidence are persistently identified in the literature. All the same, it is not clear what explains this persistence – whether they represent existent factors, or if they are artefacts of approaches used to written report EBP. Based on an updated review, this paper analyses this literature to explain persistent barriers and facilitators. We critically draw the literature in terms of its theoretical underpinnings, definitions of 'evidence', methods, and underlying assumptions of inquiry in the field, and aim to illuminate the EBP soapbox past comparison with approaches from other fields. Much of the enquiry in this area is theoretically naive, focusing primarily on the uptake of enquiry evidence as opposed to evidence divers more broadly, and privileging academics' research priorities over those of policymakers. Little empirical data analysing the processes or impact of evidence utilise in policy is available to inform researchers or conclusion-makers. EBP research oftentimes assumes that policymakers do not use bear witness and that more evidence – significant inquiry evidence – use would benefit policymakers and populations. We debate that these assumptions are unsupported, biasing much of EBP inquiry. The agenda of 'getting prove into policy' has side-lined the empirical description and analysis of how research and policy actually interact in vivo. Rather than request how research evidence can be fabricated more influential, academics should aim to understand what influences and constitutes policy, and produce more than critically and theoretically informed studies of decision-making. We question the primary assumptions fabricated past EBP researchers, explore the implications of doing so, and advise new directions for EBP research, and health policy.

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Introduction: the show-based policy movement

Although sceptics tin can be found, few researchers or policymakers would publicly disagree that show-based policy (EBP) is a goal for both academe and government. Reports describing the importance – and difficulty of – achieving this goal are published with regularity [i–3]. Perhaps dissimilar other disciplines, EBP has staunch advocates who contribute to an ever-increasing body of commentary around the discipline.

EBP is sometimes said to take derived from evidence-based medicine (EBM), which dates back at least to 1972, with Archie Cochrane's seminal work on effectiveness and efficiency [4]. Since the early 1970s, both practitioners and academics have also considered how policy – in the sense of larger-calibration decisions about the delivery and management of services at a population level – could be based on, or informed by, prove [5, half-dozen]. For Cochrane and his heirs, the goal of EBM was to bring about the abandonment of harmful and ineffective interventions, and the adoption of interventions shown to be constructive for clinical outcomes. This was to be achieved by implementing findings from systematic reviews and meta-analyses of robust effect evaluations, ideally randomised trials [7–10].

However, this straightforward narrative of evaluation-based EBP modelled on medicine has long existed in a broader landscape of initiatives to foster closer and more than effective links between research and policy (or between researchers and policy-makers). In the UK, for example, these ideas tin exist traced back at least to the Rothschild experiment, evaluated past Kogan and Henkel in 1983 [xi]. The aim of this funding initiative was to enable the health research system to reply to policymakers' priorities for inquiry [12]. The experiment was largely abased, which Kogan and Henkel ascribed to cultural differences between researchers and policymakers, the need for interaction, and other barriers [12, 13]. Contempo publications, once more in the United kingdom of great britain and northern ireland, from the Authorities Office for Science take provided guides for both academics and policymakers who wish to engage with the other group [14, fifteen], and there is increasing interest inside academic and higher education bodies generally about how academics may be able to increment their impact, the nature of this impact, and implications of the 'touch on calendar' [16–18]. Withal, the tenor of these publications withal tends to focus on promoting the utilise of academic inquiry, rather than studying the practices of knowledge product and policymaking and implementation.

Every bit a result, specific questions near the apply of enquiry within policy take become divorced from a broader perspective on policy-making. Many researchers in what may be termed 'applied enquiry' fields use terms similar 'knowledge translation', 'knowledge exchange', or 'evidence use' without providing clear definitions of what knowledge is part of which decision-making process [19–21]. The upshot has been a loss of clarity with respect to how bear witness is supposed to improve conclusion-making, what constitutes and defines 'evidence' and 'policy', and which processes and outcomes are targeted by political or academic efforts. Nevertheless, both EBM and EBP have achieved substantial financial and political back up, and substantial weight by the creation of a collection of organisations dedicated to producing evidence-based policy and practice recommendations, guidelines, and best do statements, such as the What Works centres [22]. For health policy and health management in particular, there remains a prominent soapbox about moral, upstanding, political, and oftentimes fiscal imperatives to use evidence to brand the best (value) decisions [23] – without, ideally, disenfranchising non-expert publics [24]. The study of the use of evidence in policy varies from negative to positive advancement, from simplistic to complex understandings of the processes involved, from uncritical technical approaches to highly cynical commentary. Broadly, practitioners and academics have focused on facets of the apply of testify past policymakers and practitioners, have written polemics encouraging colleagues to do so [23, 25–29], identified barriers and facilitators into evidence employ [thirty, 31], and designed interventions to increase the employ of evidence by policymakers [32]. Testify-based policy and practice, knowledge translation, and related concepts accept become touchstones across a vast range of disciplines – well-nigh sub-disciplines in their own correct, with canons and conceptual toolkits of their ain.

While much of this piece of work remains mainly theoretical (due east.g., [33]), there is a chop-chop growing empirical prove base on barriers and facilitators of evidence use. Some idea of the extent and nature of this literature can be gained by looking at systematic reviews. 3 reviews are particularly relevant hither [30, 31, 34]; their methods, findings, and conclusions are summarised in Tabular array 1.

Table 1 Comparing iii systematic reviews on evidence-based policy

Full size table

Common findings beyond all three include the importance of personal relationships and contacts between decision-makers and researchers, and the need for research to be clearly and accessibly presented. Cultural and practical barriers to the employ of evidence by policy-makers are identified. Finally, all three make the point that policymakers' definitions of evidence exercise non match academic constructions of 'bear witness'. All iii reviews also betoken to gaps in the literature as priorities for farther inquiry, only differ in their identification of these gaps. Orton focuses on the need for evaluation research of strategies to increase the uptake of research show [31], while Innvær et al. [34] and Oliver et al. [30] are both more circumspect, pointing out that despite the size of the evidence base of operations, much virtually policy-makers' attitudes to inquiry evidence remains unclear. Innvær et al. show how the limited available evidence mainly describes policymakers' beliefs and attitudes, rather than bodily behaviours, and hence cannot be used equally a basis to make potent recommendations [34]. Perhaps more than importantly, both reviews notation that at that place are few grounds by which to brand firm recommendations or conclusions nigh the process, bear upon, or effectiveness of enquiry in policy. Only rarely is enough detail known about the policy process to exist able to comment usefully: for example, who are the chief actors, where are decisions made, and how evidence fits into the process.

The structure of this paper is equally follows. First, cartoon on a dataset from a recent systematic review of barriers and facilitators [30], we offering a high-level overview of the literature on evidence utilize in health policy, drawing out broad theoretical and definitional commitments. This newspaper does not primarily consider the findings of those studies, which are summarised higher up and ready out in more detail elsewhere [xxx]. We too depict on like findings about policymakers in not-health fields [35]. We set these information in the context of the wider theoretical literature about bear witness and policy, cartoon insights from policy sciences. Secondly, nosotros aim to identify and challenge some of the more normative assumptions which are widely prevalent (if often implicit) in the EBP literature, especially the following: that the policy-show 'gap' needs 'bridging'; that policy is commonly not based on whatever information; that policy requires enquiry evidence, preferably evaluative intervention research evidence; and that if more evidence were used in policy making, policy would exist meliorate. Finally, we brand suggestions for a new agenda for EBP inquiry.

We are not advocating confronting EBP. On the opposite, we believe that ameliorate policy decisions would exist a desirable upshot, and that testify ought to play a role in those decisions. Rather, our conclusions from this critical review of the literature are about EBP research, rather than EBP itself. Researchers have directed their attention at how to increase the affect of their own outputs, rather than on understanding the processes behind policy change. The support for EBP is non as single-minded or vociferous as it was. Reflecting on this historical tendency, and reasons behind any such shift, we nowadays our novel contribution to the literature: an illumination of the discourse effectually EBP by comparison theories, methods, and substantive approaches with those from other fields, and on this basis propose new directions for EBP enquiry.

Review: evidence-based policy inquiry

Below, we describe some of the underlying concepts and approaches available to researchers attempting to understand the relationship between inquiry and policy processes.

Theoretical underpinnings

Innvær et al. described how the literature at the time fell into two camps [34]; those supporting the 'two-communities' hypothesis, which explores whether barriers to inquiry utilisation are mainly driven by cultural or institutional differences between researchers and decision-makers, and those cartoon on Carol Weiss's typology of ways of using evidence [36, 37]. Policy and bookish actors were conceptualised as opposing sets of actors, with dissimilar priorities, languages, practices, and priorities. For proponents of this perspective, 'bridging' this gap becomes a priority. It seems probable, nevertheless, that insisting on the beingness of this 'gap' may polarize previously neutral actors; and indeed this fence fails to recognise that this may be a Uk-specific problem (cf. to Dutch studies).

Models of the enquiry and policy processes are, as noted by previous theorists of EBP, rarely fabricated explicit in evaluations of applied research. Where implicit, a simple 'pipeline' model is usually assumed (i.east., that the more than research is carried out and the higher the quality, the bigger the effect on policy and practice) [38–41].

A large new theoretical strand within health policy focuses on cognition brokerage/translation as a framework for understanding use of evidence [42–46]. This model can be seen as an extension of Weiss's 'instrumental use' model, or 'enlightening' and 'strategic apply' of bear witness, describing the influence of enquiry on policy, and is linked to ideas about 'coproduction' and 'user involvement' [47].

Weiss and Caplan are nevertheless major influences on the field of EBP research, but the degree to which these contributions are appropriately exploited is debatable. The linear (direct utilize) model is usually perceived to be superior, quite contrary to Weiss' argument that policymakers idea enlightening (indirect) use could offer more than. This message is often disregarded past research (and researchers) in the field, namely that researchers need to reflect on the common view that policymakers are interest-oriented and indifferent to evidence. Barriers to use of inquiry are equated with barriers to directly use of research, while the broader concept of enlightening (indirect) employ is rarely seen as equally relevant and useful.

While this is still widespread, theoretical learning from other fields is filtering into the debate. Researchers in policy studies have long seen the policy process itself as a contested arena of negotiation [48, 49]. The messy, complex, and serendipitous nature of policymaking is described by Kingdon [fifty], Weiss [51], Simon [52], and Lindblom [53], amongst others. These scholars accept contributed ideas such as punctuated equilibrium [54], policy 'windows' and 'streams' [50] or 'stages' [48], bounded rationality [55], and incrementalism [53]. Notwithstanding, the degree to which these models are used in planning and conducting empirical enquiry is debateable. As Lomas notes, one reason why these may have been resisted by EBP researchers is because they offering niggling assist and no tools to help the aspiring policy-advisor [56].

Of course, many of these are theories almost policy, rather than analysis tools to help advisors [57]. Cairney argues that policy analysts tend to use concepts, such as the policy bicycle, which have been rejected by policy scholars. We would authorize this statement by restricting the rejection of such theories to within science and technology studies and policy sciences – these ideas are still common currency within wellness policy amid other fields [58].

The influence of these ideas on the health field is perhaps increasing, with applications of ethnographic methods [59] and actor-network theory practical to EBP [60]. Withal, the majority of studies still employ over-uncomplicated theoretical models [61]. Asserting the existence of and describing and prescribing interventions to close the 'enquiry-policy gap' is a stance which, we debate, is likely to perpetuate and even create gaps between the professions.

Focus of the inquiry

The main focus of much theoretical and empirical work in EBP has traditionally been, implicitly or explicitly, on research evidence uptake, primarily peer-reviewed research carried out past university-based academics [xxx, 31]. However, a third of studies included in our review examined non-research information, for example, public wellness surveillance data, strategic needs assessments and other bear on assessments, geographic information systems [62], or other non-research evidence [63–65]. This suggests that policymakers translate and utilise 'evidence' in a broad sense, which is normally non acknowledged past academic commentators [7, 10].

The reviews described above included a minority of studies which aimed to depict the policy procedure in item, often using a case-study arroyo. Frequently, these focused on the use of a particular type of evidence such as economic evaluations [66] or the part of a specific piece of evidence [sixty, 67]. Few attempt a descriptive contextualisation or ethnographic understanding of the policy procedure, with exceptions, east.one thousand., [68–71]. Virginia Berridge'due south seminal work on the NHS and comparative health policy evolution uses historical methods to understand these processes and develop theory effectually them [72]. Others have taken empirical ethnographic approaches to sympathise, for example, how health decision-makers conceptualise and use bear witness [73, 74]. With these exceptions, very few studies have, equally yet, taken anthropological or historical approaches to understanding the office of evidence or research in policy.

Research in the area thus focuses primarily on how to increase uptake of research, on designing and evaluating interventions aiming to increase enquiry use, and on identifying barriers and facilitators of inquiry utilize by policymakers [74–76]. This pattern of research on evidence use skews the debate by focusing on infrequent cases of research use in policy-making, rather than the normal discharging of statutory business organisation. Every bit Kogan and Henkel noted, attempts to improve employ of evidence tin can "fail to note how in those areas of policy where information are diffuse, and analyses most likely to be strongly influenced past value preferences, problems must be identified collaboratively betwixt policy-maker and scientist. It failed to acknowledge that policy makers have to work hard to place problems, to specify research that might help solve them, and to receive and use the results of enquiry" [11]. While a comment evaluating the Rothschild experiment, the suggestion that EBP inquiry does not reflect the range of knowledge-producing or policy-making processes can also be levied at much of the bookish work subsequent to this of import report.

Focusing on the use of enquiry evidence as well allows researchers to sidestep the rest of the policy process and avoid the context of determination-making more than widely. Near studies focus on unmarried elements of the policy-making process – broadcasting of evidence, sources, and types of source, noesis transfer, and priority setting – rather than trying to characterise the process equally a whole. EBP research could draw here on an extensive inquiry literature in policy analysis from political science, starting with studies of what is called 'the policy bike' or 'a stages approach' [39, 77]. Such studies can analyse who is making which decisions, about what, and when; the stardom between practice, direction, governance, and policy is rarely spelt out [78]. Articulate definitions of policy, use of research, and decision making has been encouraged for over 60 years, merely remains evasive [79].

Methods

Considerable theoretical work has gone into producing taxonomies of factors influencing the utilisation of evidence, e.chiliad., [36, 80]. However, these rich theoretical discourses are not reflected in the bulk of the empirical literature, which, despite its latitude with respect to the sectors and categories of testify types studied, finds fairly consistently that the main factors affecting use of show are (a) admission to relevant and articulate information and (b) practiced relationships between researchers and research users. This may be due to the methods used in the studies: most use but interviews or surveys to enquire researchers and policy-makers about their perceptions about show use; very few apply methods such as participant ascertainment to observe how evidence is actually used in exercise, or effort to find documentary proof of research use (with exceptions; [76]). These lists, while important, cannot on their ain lead us to an improved understanding of the role of evidence in the jigsaw of the policy procedure.

Another noticeable feature of the evidence base is the emphasis given to researchers' own views of research utilisation, for example, a written report aiming to look at everyday working practice, such as that of Taylor-Robinson et al. [81], samples primarily health inequalities/public health academics and practitioners rather than conclusion-makers themselves (such as councillors or executives), even though they themselves describe lack of contact betwixt academics and policymakers as a bulwark to use of prove. The bulk of academic studies in EBP inquiry are, unsurprisingly, written by and for academics, with niggling interest of policy-makers every bit co-authors; indicating that policy-makers are not involved in developing or carrying out relevant inquiry.

Underlying assumptions of this research and critical reflections

This overview of the literature provides a starting betoken for a more than critical engagement with the empirical literature on EBP. We provide a broad-brush characterisation of parts of the literature which helps to depict out mutual assumptions across the field as a whole and enable critical reflection on them. We focus on three such assumptions: 1) that the policy-evidence 'gap' needs 'bridging'; 2) that policy is ordinarily not based on whatever data, and policy requires research show, preferably evaluative intervention research; and 3) that greater employ of evidence in policy-making will produce better outcomes at a population level. It is past no means the case that these assumptions are universally shared among EBP researchers, or that we are the first to place these bug [61, 82, 83]. Even so, a large proportion of the available research however rests on an uncritical acceptance of these assumptions. Below, we describe the issue of these assumptions, justify our rejection of them, and discuss the implications of taking a more disquisitional approach.

Supposition 1: that a policy-evidence 'gap' exists

The 'prove-policy gap' is a widely-acknowledged structure in policy-related enquiry, asserting the existence of two separate communities with their own ecosystems and languages [61, 83–85]. Much of the 'knowledge translation' literature, which attempts to take a broader perspective on EBP, fails to question the assumption that noesis and practice are two separate practices, and the 'joining' or 'bridging' of these (depending on the authors' preferred metaphor) is the task of EBP researchers; see, e.thousand., [20, 61, 83, 84, 86]. Withal, as Choi recognizes, evidence – and those associated with evidence – is only i vox amid many [87]. We exercise not yet know how to brand that vox more helpful nor more than influential.

Recently, a shift away from this dichotomous debate has been fabricated, with concepts such as 'noesis translation' or 'transfer' being replaced by ideas well-nigh 'learning', 'contribution', and co-product [88]. These ideas frame the relationship between research and policy every bit a two-way negotiation in which both partners learn from the other – pragmatically and politically a pace towards an equality of prioritisation and experience. Certainly, this represents a greater openness to seeing a broader range of data types as relevant – including, for example, contextual, descriptive data as well as evaluations and other forms of research evidence. Too often, notwithstanding, this debate is hijacked past methodologists from opposing camps wishing to defend their own method in the face of criticism – whether real or perceived, eastward.m., [89, 90]. Without clear definitions of 'show' and 'bear on' or 'learning', these studies contribute to negative stereotypes on both sides, and perpetuate the gap they aim to bridge.

Assumption two: that policy is usually not based on evidence

Despite the increased literature in the area, there is a surprising lack of evidence most how much evidence policymakers use. Studies have largely reported policymakers' perceptions of their usage (due east.m., [91]), acknowledge that it is impossible to tell how much evidence was used past policy participants [92], or rely on cocky-reported measures [93]. EBP researchers have tended to interpret this absence of any contradictory evidence equally a confirmation of their belief that policymakers do non employ testify. This is both grossly unfair to policymakers who take been shown to draw on a wide range of information sources [39], hugely over-simplifies the relationship between evidence and policy, and, of class, contradicts the avowed principles of EBP researchers; viz, that beliefs ought to be based on evidence [76].

Implicit in the 'barriers and facilitators' approach is an assumption that if these factors were alleviated, research uptake would increase. However, this is to miss the key point, which is that most research in the surface area studies the use of research evidence by policymakers, not what knowledge or information policymakers utilize. This subtle shift in accent opens up new avenues of enquiry. Other information than research evidence might be more relevant and timely, two factors seen as top facilitators for policymakers' use of testify [94]. Policymakers may prefer to employ local information or intelligence such as patient or practice level data, or that held by local councils (due east.g., datasets of rent, criminal offense, and transport) [95]. Information technology seems likely that these sources of information accept been undervalued by evaluation methodologists, who often value trial data above other types. A more than naturalistic arroyo using empirical methods to study policymakers in vivo, would excogitate of evidence every bit one of many influences on a determination.

Assumption iii: that utilise of more inquiry evidence by policymakers would lead to 'better' policy

We are non the first to note that "[t]he supposition that the use of evidence would improve the outcome of the policy process remains relatively untested past whatever grade of empirical analysis" [96–98]. The absenteeism of robust evaluation evidence showing that evidence utilisation actually leads to amend outcomes is widely admitted. The bulk of the intervention evidence in EBP uses only research utilisation or uptake as an issue (or, in some cases, merely attitudes and intentions regarding research use). Nonetheless, it is still widely claimed that decisions made in partnership between "politicians and researchers & lay people are more likely to result in positive health outcomes" [86] and many researchers continue to advocate for increased utilise of research testify [99].

Such claims, where they are not treated as automatically self-evident, are usually supported either by anecdotal cases of increased evidence apply leading to better outcomes, or by studies of the impacts of bear witness use on process measures such equally transparency of decision-making [100]. However, the value of procedure-oriented goals is surely questionable, if they cannot be shown to atomic number 82 to improved health, wellbeing, social, or other outcomes for the putative beneficiaries of the policy in question. The typologies of 'research impact' which take dominated much work in this area (e.g., [101]) are of limited value without a more than open up debate about the correct metrics for evaluating EBP, based on a realistic view of the currently existing evidence base of operations [102]. Moreover, much of the commentary around the 'impact agenda' focuses on the aspect of academic performance management, without wider exam of its connexion to policy and knowledge practices and theories [16].

Even in the absence of robust evaluation information, information technology is clear that many of the existing theoretical rationales for how prove utilisation is supposed to improve outcomes are inadequate. If the pipeline model of research use were correct, it would exist possible to demonstrate the bear on of research on policy and the value of research would be judged on its contribution to policy and its quantifiable impact [25]. This model "fails the practitioner because the literature on which guidelines are based constitutes an unrepresentative sample of the varied circumstances and populations in which the intervention might be usable or unusable" [38].

New directions for EBP enquiry

Above, we depict iii assumptions commonly found in the EBP literature. We critically discuss the reasons we believe these assumptions are flawed, and show how the existing inquiry conducted on the basis of these assumptions is likely to fail to answer the about pressing problems in EBP. Hither, we draw how these assumptions can class the basis for a new programme of research aiming to understand the human relationship between scientific discipline and policy. Nosotros explore the implications of re-framing future studies in a new direction, and suggest more explorative perspectives and participative methods.

Firstly, the assumption that the policy-evidence 'gap' needs 'bridging'. Most of the studies identified perpetuate the division between the 'two communities' in one manner or another. Approaching researchers and policy-makers separately and request them for their accounts of evidence use may be likely to produce these conflicting accounts; similarly, request researchers well-nigh their perceptions of what policy-makers do may not be the most sensitive way of exploring policy processes. It would be more than interesting, and more novel, to approach policymakers from an unprejudiced stance, to draw their activities, and to identify how they populate policy areas and steer policies through [53]. Of course, we are not the start to suggest this [56, 97] – but these studies are generally the exception rather than the rule.

Secondly, the assumption is often held that policy is usually not based on any data, and policy requires research evidence, preferably evaluative intervention research. Past concerning themselves with questions such every bit "how [can] the tension between scientific rigour and timely relevance to policy-making be handled" [103], EBP researchers often fail to acknowledge their lack of cognition nearly forms and models of the affect and contributions of testify to policy processes, which tin lead to the creation of unhelpful straw men.

Finally, the unspoken corollary to both these assumptions is that greater use of evidence in policy-making will produce 'amend policy' and better outcomes at a population level. Leaving aside the question of what constitutes 'ameliorate' in a self-plain political and therefore value-driven terrain, for researchers to convincingly argue for the increased use of bear witness in policy making, they must be able to demonstrate the benefits of doing and so. The growth of the 'practical research' sector claims to address this, but often restricts output to vague and untested policy and research recommendations, nigh which there is no evidence of effectiveness [99]. If the effects of these policy and research recommendations are non evaluated these could be misguided at best [104].

Therefore, nosotros argue that the following issues are of outstanding importance and could form the footing for a new agenda of EBP research:

1. 1.

   Refocus inquiry on influences on and processes of policy rather than how to increase the corporeality of evidence used. Researchers in political and policy studies, anthropology and history of policy, and science and engineering science studies have provided a wealth of insights and rich empirical data on the functioning (or otherwise) of the policy-making process [13, 53, 56, 68–70, 88, 105–108]. Understanding the daily lives and activities of policy actors tin bring fresh insights into how 'evidence' is conceptualised, the potential roles it may play, and how it fits with the other drivers and triggers which bear on policy [95, 109]. Understanding the roles of infrequent individuals, such as policy entrepreneurs, and networks in the policy process is also recognised as a key research expanse [3, 110, 111].

   • Dialogue betwixt these fields has non been very extensive or productive and then far, largely due to scepticism on the part of policy scientists, e.one thousand., [108], and a lack of engagement with this body of theory and empirical data, with recent exceptions [112, 113]. To take simply 1 example, policy researchers observe that policies rarely have a consistent and well-defined goal or aim; rather, "solutions get joined to bug" in a provisional and largely haphazard mode, with the aforementioned policy taking on unlike goals at unlike times or in dissimilar contexts [fifty, 114]. If this is the case, the question of how researchers can evaluate whether or not the policy has attained its goal, and use the results of this evaluation to inform future policy development, is largely moot.

2. ii.

   Determine what data and evidence is unremarkably used as part of policy processes. Every bit nosotros signal out to a higher place, it is likely that the needs and practices of policymakers are rarely the discipline of rigorous study, and are certainly more complex and nuanced than can be captured in surveys. Using 'research' and 'policy' as one-size-fits-all concepts underestimates the variety of activities and outputs involved in each type of procedure. A legislative manoeuvre is very dissimilar from a local tailoring of licensing hours; practical health enquiry aiming to develop interventions near a specific condition is worlds away from contemplative studies of models of theories of change. Elucidation of the relationships at both ends of the spectra ought to be a research priority, in identify of the dichotomising of activities every bit 'research' or 'policy'. Furthermore, attention to context is vital; pressures faced by researchers and policymakers in low- and middle-income countries may be very different from those in Western settings. Finally, as argued above, although similar barriers and facilitators are often identified across policy settings [35], there is variation of practices and processes beyond policy areas. Analysis of these variations would be a whole research calendar in itself. A subtler estimation of context, 'policy', and 'research' are necessary to understand processes, influences and impacts, and indeed to develop any meaningful abstractions and generalisations – should these be possible, which is by no means sure. A compromise betwixt the complexity of policy making and development of useful frameworks needs to be found.

3. 3.

   These questions are likely to crave a broader range of methodologies than commonly applied. Experimental, ethnographic, and conceptual studies all need to be applied to empathise the touch of evidence on policy and policy processes more generally. Novel theoretical approaches could be phenomenological, psychosocial, or interpretive [115–117].

4. iv.

   Develop conceptual clarity around and metrics to evaluate 'affect' of research on policy and populations. Without clear methods to understand how policy works and how it changes in response to information, it will exist impossible for researchers to know whether they take had an effect on policy. Research usage could take many forms, from agenda-setting, to provision of policy options, to challenging debates, or refuting arguments. Impact could therefore exist a alter in policy, consistency in policy, changes in population level outcomes. Measures proposed thus far tend to focus on citations or mentions of work by policymakers. We feel this addresses but a narrow aspect of potential impacts, namely awareness of research, which may not translate into action. Furthermore, this metric-led approach tends to ignore the indirect means past which research and evidence of all kinds fit into policy – whether past sustaining the status quo, or by leading to decisions for change. More attention to the variety of impacts and furnishings leading from research may help to develop this fence.

5. five.

   Finally, our analysis of the literature suggests that new methods and organisations aiming to bring the processes of enquiry and policy closer together are probable to farther our agreement of the relationship between these 2 types of activities. Co-creation and co-product of knowledge are lauded every bit a more democratic, and potentially more useful, blazon of learning action than many other knowledge exchange events [118]. If universities were to provide assist for local policymakers in the analysis of existing information, a human relationship of mutual do good could start to develop – an stop in itself, co-ordinate to reviews of barriers and facilitators of evidence utilize [30, 34]. Moreover, such organizations would provide natural laboratories for studying the part of institutional and organizational factors on the practices of policy formation and implementation, noted in our review as probable to affect evidence utilise.

Peradventure due to the political, financial, and ethical pressures on health policymakers to brand good decisions, health policy leads the way in forming collaborative organisations to conduct research. Funders in the UK and Netherlands have developed specific types of collaborative engagement organisations (e.g., Collaborations for Leadership in Practical Health Research and Intendance, CLARHCs, or the health funder ZonMw), which aim to bring practitioners and researchers together for mutual do good. There are examples of institutions which specifically allow researchers and policymakers to learn about each other'southward priorities and ways of working [56, 119]. In general, however, the literature higher up suggests that in that location are insufficient opportunities and incentives to class links with policymakers directly.

Conclusions

The existing literature on EBP has certainly contributed to the desirable outcome of better policy decisions and acceptance that evidence ought to play a role in those decisions. Now, nosotros believe it is time for researchers to reverberate on their assumptions, develop new perspectives, and use other methods to tackle the problems of EBP. There is a common lack of clarity about what researchers sympathise every bit 'policy', which tin can encompass decision making, project implementation and evaluation, and service reconfiguration. In that location is, in general, little evidence about direction and organisation, despite these being potentially major factors affecting the policy process [120]. The assumptions governing the design and outcomes of inquiry into policy will probably be significantly different in different institutional areas. Information technology is often non clear what constitutes 'a decision', nor who is involved in it, or whether research prove is relevant or timely. This muddles and prevents whatever date with discussions about what constitutes skillful and bad policy; or indeed how evidence ought to exist used.

Rather than attempting to develop a one-size-fits-all (pipeline) model, research in this expanse should revert to observational methods with in-depth descriptions of practices and their inherited processes and provide an empirical basis for theoretical evolution which can inform future activities. Instead of repeating studies of perceptions of barriers and facilitators of use of research prove, appropriate methods must be used to answer questions nigh when, why, how, and who finds what type of knowledge sound, timely, and relevant at different stages of the policy wheel.

The position of researchers who wish to influence policy is untenable unless at that place is engagement with the questions outlined above. We would besides argue that researchers who abet for modify (for case, via policy and practice recommendations) without evaluating the (probable) touch on of these changes may have a limited effect at best. At worst, they create distance between policy and research by demonstrating an understanding of the context within which they would like their newly-generated cognition to exist used. Without agreement the complex processes of policy and knowledge mobilisation, researchers who make policy and exercise recommendations may but be ignored. Ultimately, the part of researchers is not to judge the 'quality' of policy making on the basis of how much of their research is used. This stance is both unhelpful and divisive, blinding researchers to the important questions raised above regarding the types of information used, by whom, for what purpose, and nether which circumstances. Rather, our part equally scientists ought to be to investigate the processes surrounding the use of evidence and policy activities more widely and to disseminate findings in order to assist others make informed decisions, of all kinds.

Abbreviations

EBM:

Evidence based medicine

EBP:

Bear witness based policy.

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Acknowledgements

We give thanks colleagues who have read and commented on the draft version, and the editor and reviewers for their extremely helpful comments.

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Affiliations

1. School of Social Sciences, University of Manchester, Bridgeford Street, Manchester, M13 9PL, Uk

   Kathryn Oliver

2. Section of Science, Applied science, Engineering and Public Policy (STEaPP), University College London, 66-72 Gower Street, London, WC1E 6BT, Great britain

   Kathryn Oliver & Theo Lorenc

3. Kinesthesia of Social Sciences, Oslo University College, P.O Box 1084, Blindern, 0317, OSLO, Norway

   Simon Innvær

Corresponding author

Correspondence to Kathryn Oliver.

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Competing interests

The authors declare no competing interests. This study was non supported by any funding bureau.

Authors' contributions

All authors contributed to the conception, design, and analysis of the data which underpins this disquisitional review. All authors contributed to the development of the argument and the last manuscript. All authors read and approved the terminal manuscript.

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Oliver, Yard., Lorenc, T. & Innvær, S. New directions in evidence-based policy enquiry: a critical analysis of the literature. Health Res Policy Sys 12, 34 (2014). https://doi.org/10.1186/1478-4505-12-34

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• Received: 17 March 2014

• Accepted: 30 June 2014

• Published: 14 July 2014

• DOI : https://doi.org/10.1186/1478-4505-12-34

Keywords

• Critical analysis
• Prove-based policy
• Knowledge utilization
• Science and engineering studies

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