The power (of evidence) to persuade Therese Riley Centre of Excellence in Intervention and Prevention Science (CEIPS) CEIPS is supported by the Victorian Government

What I plan to talk about? Evidence – And persuasion – of ‘social factors’ influencing health – Based Practice OR Practice-based evidence – Infrastructure/s for sustainable social change Take home message

Persuasion and Evidence The importance of ‘facts’ as drivers for policy change – What is the most influential type of evidence? – What are the killer fact/s? Evidence about what?

Evidence of social factors influencing health Evidence of the problem – ‘causes of the causes’ Evidence of the solution – interventions that work Evidence of the interaction between interventions and their contexts - complex or systems interventions

Evidence Based Practice OR Practice Based Evidence The problem of low take up of research evidence. Practice as the site of knowledge translation rather than the site of knowledge co-production Fox (2000) summarises the arguments as – Practitioners know what they are doing so leave them to it – Practitioners lack knowledge and must be taught good practice – New model of research is needed – Practice Based Research

Practice Based Evidence Making visible the otherwise invisible contexts of practice: implementation Privileging contexts and complexity

Evidence Infrastructure/s The creation of metric’s that fully account for the impact/s of practice – Describing what it is – Guiding what it could be Collection of outcome data – did it work? Was it worth it?

Evidence Infrastructure/s Practitioners collecting and analyzing scientific grade practice data Data feedback systems designed to monitor and improve practice Organizations encouraging experimentation (trial and error)

Evidence Infrastructure/s “Research to help more practitioners reframe their work and reclaim their structural change capabilities is needed. Policy- makers have to invite appropriate action; practitioners have to be enabled to take it; the public has to support it, or better, demand it in the first place” (Hawe, 2009).

Take Home Message ‘UNLESS someone like you cares [about evidence] a whole awful lot, nothing is going to get better. It’s not.’ (Dr Seuss, The Lorax)

References Bowen,S., Zwi, A. B.,. Sainsbury, P., and Whitehead, M. (2009) Killer facts, politics and other influences: what evidence triggered early childhood intervention policies in Australia? Evidence & Policy: A Journal of Research, Debate and Practice 5(1): CSDH (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva, World Health Organization. Dr Seuss (1971) The Lorax, Random House, New York. Fox, N. (2003) Practice-based Evidence: Towards Collaborative and Transgressive Research, Sociology, 37: Hawe, P. (2009) The Social Determinants of Health: How can a Radical Agenda Be Mainstreamed? Canadian Journal of Public Health, 100 (4): Hawe, P., Sheill, A. and Riley, T (2009) Theorizing Interventions as Events in Systems, American Journal of Community Psychology, 43(3/4): Hawe, P.,Shiell,A., Riley, T. and Gold L (2004) Methods for Exploring Implementation Variation and Local Context within a Cluster Randomised Community Intervention Trial, Journal of Epidemiology and Community Health, 58 (9): Riley, T. and Hawe, P. (2009) A typology of practice narratives during the implementation of a preventive, community intervention trial, Implementation Science, 4 (1):80.