Translating evidence into practice Conference EMCDDA Lisbon, 6 – 8 may 2009 Prof dr H.F.L. Garretsen Tranzo, Tilburg University

Translating evidence into policy: - What is evidence, what evidence is needed - How to ensure that evidence is translated into policy - What factors hamper or facilitate the knowledge transfer?

What is evidence and what evidence is needed -Scientific research -Professional knowledge and experiences - Experiences/preferences of clients

Experiences/preferences of clients Professional knowledge and experiences Scientific research

Actors in case of policy: Researchers, professionals and “business minder” for the demand side. For instance local government, neighbourhood associations, and/or patients' associations

In developing drug policy many elements are crucial, but research should be an important input. (Pompidou Group, 2004) How to incorporate scientific evidence into the policy-making process?

Scientific evidence: Scientific evidence on effectiveness and on how effects are achieved. Preferably information from rct’s and meta-analyses If sufficient information is not yet available and in case of new interventions/policy measures: new (evaluation-) research is desirable.

Evaluation of interventions: Choose the most suitable research design – In the first instance that is not always a rct. However, if the intervention seems promising: rct and qualitative process evaluation are needed.

Evidence does not spread automatically Increasing amount of evidence is available but often not used. “there is a need to clarify the role, position and responsibilities of each actor involved” (Pompidou Group, 2004)

Knowledge-synthesis: a method to translate evidence into practice Builds on body of thought of systematic reviews. Combination of: Scientific evidence Policy options Information on important context variables

Information sources knowledge- synthesis: Scientific evidence: rct’s, meta-analyses, qualitative research Policy options + policy making: Interviews, policy memoranda + other documents Context variables: Interviews, contacts with organisations + individual consultations

Transfer of knowledge: Should be a programmatic and active approach. Timing and topicality are essential. Stakeholders should be involved.

Translating evidence into practice: Most important: Continuous and active communication, exchange of information, between producers of knowledge and users of knowledge. Hampering and facilitating factors may be distinguished.

Producers and users of knowledge motivated enough? Radical changes in behaviour of both producers and users of knowledge is needed. (Haines et al, 2004, Maynard, 2007, Garretsen et al, 2005, 2007)

Users of evidence Might not be able to unlock scientific knowledge Might not have the time and facilities Might lack incentives to work evidence based Are not motivated to use evidence – Not part of core function, evaluation seen as superfluous, do not have the power to use results, afraid of results..

Producers of evidence Insufficient knowledge of practice and of context Might not (be able to) offer knowledge in a user- friendly way. Might lack incentives to translate results into practice Are not motivated to do so: publishing in high impact journals and guiding Ph.D. studies has priority

Commitment of all parties involved is essential. Good communication between researchers and policy advisors/ other professionals is necessary. Mechanisms that can promote interactions between these groups more systematically should be strengthened.

Act sensibly; don’t jump on a moving train all together

Use adequate equipment to really bridge the gap

Academic collaborative centres example of good practice? Permanent co-operation between university, organisations such as health centres and sometimes local authorities. Main activities: research and knowledge exchange. Participants invest in long term partnerships on a “win – win basis”. Regular contacts between researchers and policy advisors/other professionals as equal partners.

Translating evidence into practice: Knowledge-synthesis is an important tool. A great deal is known about the process of knowledge transfer. Key success factor: Communication between producers and users of knowledge, Continuous and active exchange of information is a prerequisite!