Opportunistic evidence: evidence-based policy in the setting of the Australian Government's chlamydia screening pilot

2012 ◽  
Vol 36 (1) ◽  
pp. 57
Author(s):  
Simon R. Crouch
Keyword(s):  
Systematic Review ◽  
Health Policy ◽  
Systematic Reviews ◽  
Policy Development ◽  
Good Health ◽  
Chlamydia Screening ◽  
Evidence Based ◽  
Policy Decisions ◽  
Evidence Based Policy

Objective. Chlamydia prevention and control form a significant part of the Australian Government’s sexual health policy. This paper examines the evidence for policy development and in particular the role of systematic reviews in evidence-based policy. Methods. The author undertook a review of the literature on evidence-based policy. The major theories for evidence-based policy were then linked to the Australian Government’s main chlamydia policy. Results. A systematic review on chlamydia screening has been influential in policy development, but like all systematic reviews its validity must be assessed. It has been suggested that methodological appropriateness and the question being asked are perhaps more important than study design per se. Partnerships between researchers and policymakers are important but it should be noted that experts have their own particular biases. Policymaking can also be determined by political ideologies. Conclusions and implications. The publication of a systematic review has provided a good summative evaluation of chlamydia screening that has been built upon through partnerships with researchers. The resulting chlamydia screening pilot will provide further evidence for future policy; however, a variety of sources are required to develop robust policy directions. What is known about the topic? Systematic reviews are often considered to be the best evidence on which to base policy decisions. In practice it is not always the case that best evidence is used to form policy. As well as systematic reviews, which are not always infallible, there are many other factors that affect the development of national health policy. What does the paper add? This paper provides a consideration of the role of systematic reviews in policy-making, as well as some of the pitfalls to this approach. As an example, it provides the Australian Government’s policy on chlamydia control and looks at other factors that may have contributed to the development of this policy. What are the implications for practitioners? All practitioners involved in policy decisions should consider the evidence-base from which their policies are derived. They should understand the sound basis of the systematic review while accepting that other pressures may affect the processes leading up to the formation of good health policy.

The privileged role of researchers in “evidence-based” policy: implications and engagement of other voices

2015 ◽  
Vol 15 (4) ◽  
pp. 181-191 ◽  
Author(s):  
Alison Ritter
Keyword(s):  
Drug Policy ◽  
Policy Development ◽  
Policy Implications ◽  
Research Translation ◽  
Evidence Based ◽  
Research Knowledge ◽  
Content Type ◽  
Evidence Based Policy ◽  
Ordinary Citizens

Purpose – This paper starts from the familiar premise of evidence-based policy, and examines the active role that researchers play in policy development processes. The interactive nature of much research translation immediately suggests the need to consider the dynamic way in which problems come to be understood, which is explored in this paper. Furthermore, the integration of research knowledge with the knowledges of “ordinary” citizens is a key challenge. The paper aims to discuss these issues. Design/methodology/approach – This paper represents a synthesis of recent studies conducted by the author and her colleagues along with other drug policy literature. Findings – The interactive and dialogic processes that researchers engage with, whether as knowledge brokers or participants in elite policy development forums, have implications for how policy problems (and solutions) come to be constituted. Four perspectives and theoretical approaches are briefly outlined: research design; policy processes; problematization; and critical social sciences analyses. These offer different ways of seeing, understanding and analyzing the relationship between problems, policy solutions and the policy processes. Yet all have lessons for the ways in which research evidence and researchers constitute policy. This needs to sit alongside the role of other drug policy stakeholders – notably the “ordinary” citizen. It is argued that the elite role of research can be tempered with engagement of ordinary citizens. While it can be challenging to reconcile general public views about drugs with the evidence-base, deliberative democracy approaches may hold some promise. Originality/value – This paper draws together a number of central themes for drug policy processes research: where the evidence-based policy paradigm intersects with participatory democracy; how problems are constituted; and the privileged role of research and researchers.

scholarly journals Determining the influence of intervention characteristics on implementation success requires reliable and valid measures: Results from a systematic review

2021 ◽  
Vol 2 ◽  
pp. 263348952199419
Author(s):  
Cara C Lewis ◽  
Kayne Mettert ◽  
Aaron R Lyon
Keyword(s):  
Systematic Review ◽  
Psychometric Properties ◽  
Systematic Reviews ◽  
Quality Measures ◽  
Measure Development ◽  
Relative Advantage ◽  
Design Quality ◽  
High Quality ◽  
Evidence Strength

Background: Despite their inclusion in Rogers’ seminal diffusion of innovations theory, few implementation studies empirically evaluate the role of intervention characteristics. Now, with growing evidence on the role of adaptation in implementation, high-quality measures of characteristics such as adaptability, trialability, and complexity are needed. Only two systematic reviews of implementation measures captured those related to the intervention or innovation and their assessment of psychometric properties was limited. This manuscript reports on the results of eight systematic reviews of measures of intervention characteristics with nuanced data regarding a broad range of psychometric properties. Methods: The systematic review proceeded in three phases. Phase I, data collection, involved search string generation, title and abstract screening, full text review, construct assignment, and citation searches. Phase II, data extraction, involved coding psychometric information. Phase III, data analysis, involved two trained specialists independently rating each measure using PAPERS (Psychometric And Pragmatic Evidence Rating Scales). Results: Searches identified 16 measures or scales: zero for intervention source, one for evidence strength and quality, nine for relative advantage, five for adaptability, six for trialability, nine for complexity, and two for design quality and packaging. Information about internal consistency and norms was available for most measures, whereas information about other psychometric properties was most often not available. Ratings for psychometric properties fell in the range of “poor” to “good.” Conclusion: The results of this review confirm that few implementation scholars are examining the role of intervention characteristics in behavioral health studies. Significant work is needed to both develop new measures (e.g., for intervention source) and build psychometric evidence for existing measures in this forgotten domain. Plain Language Summary Intervention characteristics have long been perceived as critical factors that directly influence the rate of adopting an innovation. It remains unclear the extent to which intervention characteristics including relative advantage, complexity, trialability, intervention source, design quality and packaging, evidence strength and quality, adaptability, and cost impact implementation of evidence-based practices in behavioral health settings. To unpack the differential influence of these factors, high quality measures are needed. Systematic reviews can identify measures and synthesize the data regarding their quality to identify gaps in the field and inform measure development and testing efforts. Two previous reviews identified measures of intervention characteristics, but they did not provide information about the extent of the existing evidence nor did they evaluate the host of evidence available for identified measures. This manuscript summarizes the results of nine systematic reviews (i.e., one for each of the factors listed above) for which 16 unique measures or scales were identified. The nuanced findings will help direct measure development work in this forgotten domain.

scholarly journals Brief Psychotherapy for Depression: A Systematic Review and Meta-Analysis

2012 ◽  
Vol 43 (2) ◽  
pp. 129-151 ◽  
Author(s):  
Jason A. Nieuwsma ◽  
Ranak B. Trivedi ◽  
Jennifer McDuffie ◽  
Ian Kronish ◽  
Dinesh Benjamin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Problem Solving ◽  
Cognitive Behavioral Therapy ◽  
Systematic Reviews ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Cognitive Behavioral ◽  
Evidence Based ◽  
Brief Psychotherapy ◽  
Problem Solving Therapy

Objective: Because evidence-based psychotherapies of 12 to 20 sessions can be perceived as too lengthy and time intensive for the treatment of depression in primary care, a number of studies have examined abbreviated psychotherapy protocols. The purpose of this study was to conduct a systematic review and meta-analysis to determine the efficacy of brief psychotherapy (i.e., < 8 sessions) for depression. Methods: We used combined literature searches in PubMed, EMBASE, PsycINFO, and an Internet-accessible database of clinical trials of psychotherapy to conduct two systematic searches: one for existing systematic reviews and another for randomized controlled trials (RCTs). Included studies examined evidence-based psychotherapy(s) of eight or fewer sessions, focused on adults with depression, contained an acceptable control condition, were published in English, and used validated measures of depressive symptoms. Results: We retained 2 systematic reviews and 15 RCTs evaluating cognitive behavioral therapy, problem-solving therapy, and mindfulness-based cognitive therapy. The systematic reviews found brief psychotherapies to be more efficacious than control, with effect sizes ranging from −0.33 to −0.25. Our meta-analysis found six to eight sessions of cognitive behavioral therapy to be more efficacious than control (ES −0.42, 95% CI −0.74 to −0.10, I2 = 56%). A sensitivity analysis controlled for statistical heterogeneity but showed smaller treatment effects (ES −0.24, 95% CI −0.42 to −0.06, I2 = 0%). Conclusions: Depression can be efficaciously treated with six to eight sessions of psychotherapy, particularly cognitive behavioral therapy and problem-solving therapy. Access to non-pharmacologic treatments for depression could be improved by training healthcare providers to deliver brief psychotherapies.

scholarly journals Contextual influences on the role of evidence in health policy development: what can we learn from six policies in India and Nigeria?

2017 ◽  
Vol 13 (1) ◽  
pp. 59-79 ◽  
Author(s):  
Tolib Mirzoev ◽  
Mahua Das ◽  
Bassey Ebenso ◽  
Benjamin Uzochukwu ◽  
Bindiya Rawat ◽  
...  
Keyword(s):  
Health Policy ◽  
Policy Development ◽  
Contextual Influences

Can Complexity Move UK Policy beyond ‘Evidence-Based Policy Making’ and the ‘Audit Culture’? Applying a ‘Complexity Cascade’ to Education and Health Policy

2011 ◽  
Vol 60 (1) ◽  
pp. 20-43 ◽  
Author(s):  
Robert Geyer
Keyword(s):  
Health Policy ◽  
Policy Making ◽  
Policy Response ◽  
Evidence Based ◽  
Visual Metaphor ◽  
Negative Effects ◽  
Audit Culture ◽  
Education And Health ◽  
Evidence Based Policy ◽  
The Uk

For much of the twentieth century UK public policy has been based on a strong centralist, rationalist and managerialist framework. This orientation was significantly amplified by New Labour in the 1990s and 2000s, leading to the development of ‘evidence-based policy making’ (EBPM) and the ‘audit culture’ – a trend that looks set to continue under the current government. Substantial criticisms have been raised against the targeting/audit strategies of the audit culture and other forms of EBPM, particularly in complex policy areas. This article accepts these criticisms and argues that in order to move beyond these problems one must not only look at the basic foundation of policy strategies, but also develop practical alternatives to those strategies. To that end, the article examines one of the most basic and common tools of the targeting/audit culture, the aggregate linear X-Y graph, and shows that when it has been applied to UK education policy, it leads to: (1) an extrapolation tendency; (2) a fluctuating ‘crisis–success' policy response process; and (3) an intensifying targeting/auditing trend. To move beyond these problems, one needs a visual metaphor which combines an ability to see the direction of policy travel with an aspect of continual openness that undermines the extrapolation tendency, crisis–success policy response and targeting/auditing trend. Using a general complexity approach, and building on the work of Geyer and Rihani, this article will attempt to show that a ‘complexity cascade’ tool can be used to overcome these weaknesses and avoid their negative effects in both education and health policy in the UK.

scholarly journals El uso de la información en los procesos de políticas: Tensiones epistemológicas y del contexto decisional en la Política Nacional de Evaluación de la Educación en México

2019 ◽  
Vol 27 ◽  
pp. 13 ◽  
Author(s):  
Liliana Valladares
Keyword(s):  
National Policy ◽  
Educational Evaluation ◽  
Educational Policies ◽  
Evidence Based ◽  
Policy Cycle ◽  
Evidence Based Policy

One of the objectives of the National Policy for Educational Evaluation in Mexico (PNEE) is to support the design of educational policies based on the information provided by the evaluation results. This paper argues that the use of information in policy processes is undergoing a strong debate about the role of knowledge in public decisions. This debate is addressed through the description of five tensions that are presented in the epistemological and decisional dimensions associated with the policy cycle. It is proposed that the analysis and reflection around these tensions can enrich the understanding of the evidence-based policy approach and contribute, with new theoretical elements, to the design of the actions and measures proposed by 

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