scholarly journals Understanding the implementation of evidence-informed policies and practices from a policy perspective: a critical interpretive synthesis

2020 ◽  
Author(s):  
Heather L Bullock ◽  
John N Lavis ◽  
Michael G Wilson ◽  
Gillian Mulvale ◽  
Ashleigh Miatello

Abstract Background: The fields of implementation science and knowledge translation have evolved somewhat independently from the field of policy implementation research, despite calls for better integration. As a result, implementation theory and empirical work do not often reflect the implementation experience from a policy lens nor benefit from the scholarship in all three fields. This means policy-makers, researchers and practitioners may find it challenging to draw from theory that adequately reflects their implementation efforts.Methods: We developed an integrated theoretical framework of the implementation process from a policy perspective by combining findings from these fields using the critical interpretive synthesis method. We began with the compass question: how is policy currently described in implementation theory and processes and what aspects of policy are important for implementation success? We then searched 12 databases as well as grey literature and supplemented these documents with other sources to fill conceptual gaps. Using a grounded and interpretive approach to analysis, we built the framework constructs, drawing largely from the theoretical literature and then tested and refined the framework using empirical literature.Results: A total of 7850 documents were retrieved and assessed for eligibility and 34 additional documents were identified through other sources. Eighty-two unique documents were ultimately included in the analysis. Our findings indicate that policy is described as: 1) the context; 2) a focusing lens; 3) the innovation itself; 4) a lever of influence; 5) an enabler/facilitator or barrier; or 6) an outcome. Policy actors were also identified as important participants or leaders of implementation. Our analysis led to the development of a two-part conceptual framework, including process and determinant components. Conclusions: This framework begins to bridge the divide between disciplines and offers a new way of thinking about implementation processes at the systems level. It offers researchers, policy-makers and implementers with a new way of thinking about implementation and can be used for planning or evaluating implementation efforts.

2020 ◽  
Author(s):  
Heather L Bullock ◽  
John N Lavis ◽  
Michael G Wilson ◽  
Gillian Mulvale ◽  
Ashleigh Miatello

Abstract Background: The fields of implementation science and knowledge translation have evolved somewhat independently from the field of policy implementation research, despite calls for better integration. As a result, implementation theory and empirical work do not often reflect the implementation experience from a policy lens nor benefit from the scholarship in all three fields. This means policymakers, researchers and practitioners may find it challenging to draw from theory that adequately reflects their implementation efforts.Methods: We developed an integrated theoretical framework of the implementation process from a policy perspective by combining findings from these fields using the critical interpretive synthesis method. We began with the compass question: how is policy currently described in implementation theory and processes and what aspects of policy are important for implementation success? We then searched 12 databases as well as grey literature and supplemented these documents with other sources to fill conceptual gaps. Using a grounded and interpretive approach to analysis, we built the framework constructs, drawing largely from the theoretical literature and then tested and refined the framework using empirical literature.Results: A total of 11,434 documents were retrieved and assessed for eligibility and 35 additional documents were identified through other sources. Eighty-six unique documents were ultimately included in the analysis. Our findings indicate that policy is described as: 1) the context; 2) a focusing lens; 3) the innovation itself; 4) a lever of influence; 5) an enabler/facilitator or barrier; or 6) an outcome. Policy actors were also identified as important participants or leaders of implementation. Our analysis led to the development of a two-part conceptual framework, including process and determinant components. Conclusions: This framework begins to bridge the divide between disciplines and offers a new way of thinking about implementation processes at the systems level. It offers researchers, policymakers and implementers with a new way of thinking about implementation and can be used for planning or evaluating implementation efforts.


2021 ◽  
Author(s):  
Heather L Bullock ◽  
John N Lavis ◽  
Michael G Wilson ◽  
Gillian Mulvale ◽  
Ashleigh Miatello

Abstract Background: The fields of implementation science and knowledge translation have evolved somewhat independently from the field of policy implementation research, despite calls for better integration. As a result, implementation theory and empirical work do not often reflect the implementation experience from a policy lens nor benefit from the scholarship in all three fields. This means policymakers, researchers and practitioners may find it challenging to draw from theory that adequately reflects their implementation efforts.Methods: We developed an integrated theoretical framework of the implementation process from a policy perspective by combining findings from these fields using the critical interpretive synthesis method. We began with the compass question: how is policy currently described in implementation theory and processes and what aspects of policy are important for implementation success? We then searched 12 databases as well as grey literature and supplemented these documents with other sources to fill conceptual gaps. Using a grounded and interpretive approach to analysis, we built the framework constructs, drawing largely from the theoretical literature and then tested and refined the framework using empirical literature.Results: A total of 11,434 documents were retrieved and assessed for eligibility and 35 additional documents were identified through other sources. Eighty-six unique documents were ultimately included in the analysis. Our findings indicate that policy is described as: 1) the context; 2) a focusing lens; 3) the innovation itself; 4) a lever of influence; 5) an enabler/facilitator or barrier; or 6) an outcome. Policy actors were also identified as important participants or leaders of implementation. Our analysis led to the development of a two-part conceptual framework, including process and determinant components. Conclusions: This framework begins to bridge the divide between disciplines and provides a new perspective about implementation processes at the systems level. It offers researchers, policymakers and implementers a new way of thinking about implementation that better integrates policy considerations and can be used for planning or evaluating implementation efforts.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Heather L. Bullock ◽  
John N. Lavis ◽  
Michael G. Wilson ◽  
Gillian Mulvale ◽  
Ashleigh Miatello

Abstract Background The fields of implementation science and knowledge translation have evolved somewhat independently from the field of policy implementation research, despite calls for better integration. As a result, implementation theory and empirical work do not often reflect the implementation experience from a policy lens nor benefit from the scholarship in all three fields. This means policymakers, researchers, and practitioners may find it challenging to draw from theory that adequately reflects their implementation efforts. Methods We developed an integrated theoretical framework of the implementation process from a policy perspective by combining findings from these fields using the critical interpretive synthesis method. We began with the compass question: How is policy currently described in implementation theory and processes and what aspects of policy are important for implementation success? We then searched 12 databases as well as gray literature and supplemented these documents with other sources to fill conceptual gaps. Using a grounded and interpretive approach to analysis, we built the framework constructs, drawing largely from the theoretical literature and then tested and refined the framework using empirical literature. Results A total of 11,434 documents were retrieved and assessed for eligibility and 35 additional documents were identified through other sources. Eighty-six unique documents were ultimately included in the analysis. Our findings indicate that policy is described as (1) the context, (2) a focusing lens, (3) the innovation itself, (4) a lever of influence, (5) an enabler/facilitator or barrier, or (6) an outcome. Policy actors were also identified as important participants or leaders of implementation. Our analysis led to the development of a two-part conceptual framework, including process and determinant components. Conclusions This framework begins to bridge the divide between disciplines and provides a new perspective about implementation processes at the systems level. It offers researchers, policymakers, and implementers a new way of thinking about implementation that better integrates policy considerations and can be used for planning or evaluating implementation efforts.


BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038927
Author(s):  
Meena Putturaj ◽  
Sara Van Belle ◽  
Bart Criel ◽  
Nora Engel ◽  
Anja Krumeich ◽  
...  

IntroductionPatient rights are “those rights that are attributed to a person seeking healthcare”. Patient rights have implications for quality of healthcare and acts as a key accountability tool. It can galvanise structural improvements in the health system and reinforces ethical healthcare. States are duty bound to respect, protect and promote patient rights. The rhetoric on patient rights is burgeoning across the globe. With changing modes of governance arrangements, a number of state and non-state actors and institutions at various levels play a role in the design and implementation of (patient rights) policies. However, there is limited understanding on the multilevel institutional mechanisms for patient rights implementation in health facilities. We attempt to fill this gap by analysing the available scholarship on patient rights through a critical interpretive synthesis approach in a systematic scoping review.MethodsThe review question is ‘how do the multilevel actors, institutional structures, processes interact and influence the patient rights implementation in healthcare facilities? How do they work at what level and in which contexts?” Three databases PubMed, LexisNexis and Web of Science will be systematically searched until 30th April 2020, for empirical and non-empirical literature in English from both lower middle-income countries and high-income countries. Targeted search will be performed in grey literature and through citation and reference tracking of key records. Using the critical interpretive synthesis approach, a multilevel governance framework on the implementation of patient rights in health facilities which is grounded in the data will be developed.Ethics and disseminationThe review uses published literature hence ethics approval is not required. The findings of the review will be published in a peer-reviewed journal.Registration numberPROSPERO 2020 CRD42020176939


2006 ◽  
Vol 1 (4) ◽  
pp. 427-435 ◽  
Author(s):  
MARTIN POWELL

What Works in Tackling Health Inequalities? Pathways, Policies and Practice through the Lifecourse S. Asthana and J. Halliday Bristol: Policy, Press, 2006Health Action Zones: Partnerships for Health Equity M. Barnes, L. Bauld, M. Benzeval, K. Judge, M. Mackenzie, H. Sullivan Abingdon: Routledge, 2005Health Inequality: An Introduction to Theories, Concepts and Methods M. Bartley Cambridge: Polity, 2004Status Syndrome: How your Social Standing Directly Affects your Health and Life Expectancy M. Marmot London: Bloomsbury, 2004These four texts on health inequalities are all very different books written by leading commentators with different academic backgrounds. This review will concentrate on the policy perspective that may be of most interest to many readers of this journal. It is also arguably the Achilles heel of the health inequalities literature. According to policy makers, much current research on health inequalities was of little use to policy making, and public health researchers have been criticized for political naivety, for lacking understanding of how policy is made, and for having unrealistic expectations (Petticrew et al., 2004: 815–816). Similarly, Klein (2003) points to the problems of ‘making policy in a fog’. The first two texts under review focus on policy and are written by policy analysts.


2018 ◽  
Vol 3 (1) ◽  
pp. e000485 ◽  
Author(s):  
Phillip Baker ◽  
Corinna Hawkes ◽  
Kate Wingrove ◽  
Alessandro Rhyl Demaio ◽  
Justin Parkhurst ◽  
...  

IntroductionGenerating country-level political commitment will be critical to driving forward action throughout the United Nations Decade of Action on Nutrition (2016–2025). In this review of the empirical nutrition policy literature, we ask: what factors generate, sustain and constrain political commitment for nutrition, how and under what circumstances? Our aim is to inform strategic ‘commitment-building’ actions.MethodWe adopted a framework synthesis method and realist review protocol. An initial framework was derived from relevant theory and then populated with empirical evidence to test and modify it. Five steps were undertaken: initial theoretical framework development; search for relevant empirical literature; study selection and quality appraisal; data extraction, analysis and synthesis and framework modification.Results75 studies were included. We identified 18 factors that drive commitment, organised into five categories: actors; institutions; political and societal contexts; knowledge, evidence and framing; and, capacities and resources. Irrespective of country-context, effective nutrition actor networks, strong leadership, civil society mobilisation, supportive political administrations, societal change and focusing events, cohesive and resonant framing, and robust data systems and available evidence were commitment drivers. Low-income and middle-income country studies also frequently reported international actors, empowered institutions, vertical coordination and capacities and resources. In upper-middle-income and high-income country studies, private sector interference frequently undermined commitment.ConclusionPolitical commitment is not something that simply exists or emerges accidentally; it can be created and strengthened over time through strategic action. Successfully generating commitment will likely require a core set of actions with some context-dependent adaptations. Ultimately, it will necessitate strategic actions by cohesive, resourced and strongly led nutrition actor networks that are responsive to the multifactorial, multilevel and dynamic political systems in which they operate and attempt to influence. Accelerating the formation and effectiveness of such networks over the Nutrition Decade should be a core task for all actors involved.


Author(s):  
Lotte De Schrijver ◽  
Tom Vander Beken ◽  
Barbara Krahé ◽  
Ines Keygnaert

(1) Background: Sexual violence (SV) is a major public health problem, with negative socio-economic, physical, mental, sexual, and reproductive health consequences. Migrants, applicants for international protection, and refugees (MARs) are vulnerable to SV. Since many European countries are seeing high migratory pressure, the development of prevention strategies and care paths focusing on victimised MARs is highly needed. To this end, this study reviews evidence on the prevalence of SV among MAR groups in Europe and the challenges encountered in research on this topic. (2) Methods: A critical interpretive synthesis of 25 peer-reviewed academic studies and 22 relevant grey literature documents was conducted based on a socio-ecological model. (3) Results: Evidence shows that SV is highly frequent in MARs in Europe, yet comparison with other groups is still difficult. Methodologically and ethically sound representative studies comparing between populations are still lacking. Challenges in researching SV in MARs are located at the intrapersonal, interpersonal, community, societal, and policy levels. (4) Conclusions: Future research should start with a clear definition of the concerned population and acts of SV to generate comparable data. Participatory qualitative research approaches could be applied to better grasp the complexity of interplaying determinants of SV in MARs.


Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3615
Author(s):  
Robert Akparibo ◽  
Richmond Nii Okai Aryeetey ◽  
Evans Atiah Asamane ◽  
Hibbah Arabah Osei-Kwasi ◽  
Elysa Ioannou ◽  
...  

Urbanisation in Ghana could be negatively impacting the state of food security, especially in economically vulnerable groups. Food supply, safety, and quality are all aspects of food security which could be impacted. We conducted a scoping literature review to understand the nature and magnitude of evidence available on the urban food security situation in Ghana. A literature search was conducted in Medline, CINAHL, Embase, Global Health, Scopus, Web of Science, Africa Wide Information and Google Scholar to identify relevant peer-reviewed and grey literature. 45 studies, mainly cross-sectional surveys/food samples analysis, met the inclusion criteria. The majority of studies were concentrated in the Greater Accra Region (n = 24). Most studies focused on food safety and quality (n = 31). Studies on supply and stability were, however, scarce. Qualitative research methods were uncommon in the included studies. The existing literature on food security are concentrated in two regions: The Greater Accra and Ashanti regions. Future studies exploring food security in urban Ghana should focus on exploring the lived experiences and perceptions of food insecurity and food stability by urban-dwellers using qualitative methods. The evidence suggesting that the safety/quality of foods sold in Ghanaian markets is poor should be a concern to consumers and policy makers.


2019 ◽  
Vol 15 (4) ◽  
pp. 245-265 ◽  
Author(s):  
David I. Pickup ◽  
Robert M. Bernard ◽  
Eugene Borokhovski ◽  
Anne C. Wade ◽  
Rana M. Tamim

Introduction. This paper provides an overview of the information retrieval strategy employed for two meta-analyses, conducted by a systematic review team at Concordia University (Montreal, QC, Canada). Both papers draw on standards first articulated by H.M. Cooper and further developed by the Campbell Collaboration, which promote a comprehensive approach to systematically searching an extensive array of resources (bibliographic databases, print resources, citation indices, etc.) in order to locate both published and unpublished research. The goal is to verify if searching comprehensively through multiple resources retrieves studies that are unique, and hence, improve the overall representativeness of a diverse body of literature. We also analyze the sensitivity and specificity of the results by data source. Methods. In order to determine the source sensitivity, we consider percentage of results from each source retrieved for full-text review. In order to determine the source specificity, we derive a percentage from the total number of studies included in the final meta-analysis compared against the overall number of initial results found. Results. Results demonstrate the need to search beyond the subject-specific databases of a particular discipline as unique results can be found in many places. Databases for related disciplines provided 129 unique includes to each meta-analysis, and multidisciplinary databases provided 44 and 99 unique includes for the two meta-analyses in question respectively. Manual search techniques were much more sensitive and specific than electronic searches of databases and yield a higher percentage of final includes. Discussion. The results demonstrate the utility of a comprehensive information retrieval methodology like that proposed by the Campbell Collaboration, which goes beyond the main subject databases to locate the full range of information sources, including grey literature.


2007 ◽  
Vol 16 (4) ◽  
pp. 294-298 ◽  
Author(s):  
David McDaid

AbstractTo provide an overview of the economic impact of poor mental health in the workplace and assess the extent to which economic evaluation has been used to further the case for investment in workplace based mental health programmes. Rapid scoping review of published and grey literature. The socio-economic costs of poor mental health in the workplace are substantial but conservative, as few studies have included productivity losses from work cutback, as well as absenteeism. While few economic evaluations of workplace based mental health interventions were identified, the available evidence base suggests that they have the potential to be highly cost effective. Much of this evidence may be from the US and be less applicable elsewhere; it may also have been solely published in company documents making assessment of methodological quality difficult. The potential economic case for workplace based mental health interventions appears good. More collaboration between policy makers and the private sector would help facilitate rigorous and transparent economic evaluations. A number of evaluations are planned. The challenge is to build on these initiatives, in order to address what remains a major gap in our knowledge on the economics of mental health.


Sign in / Sign up

Export Citation Format

Share Document