Sowing What We Know: Research Utilisation and the Diffusion of Innovation Dorothy Scott, Kerry Lewig & Mary Salveron, Australian Centre for Child Protection, University of SA

Donald Schon, 1983 “In the varied topography of professional practice, there is a high, hard ground, where practitioners can make effective use of research-based theory and techniques, and there is a swampy lowland where the situations are confusing ‘messes’ incapable of technical solution. The difficulty is that the problems of the high ground, however, great their technical interest, are often relatively unimportant to clients or the larger society while in the swamp are the problems of greatest human concern.” “In the varied topography of professional practice, there is a high, hard ground, where practitioners can make effective use of research-based theory and techniques, and there is a swampy lowland where the situations are confusing ‘messes’ incapable of technical solution. The difficulty is that the problems of the high ground, however, great their technical interest, are often relatively unimportant to clients or the larger society while in the swamp are the problems of greatest human concern.”

Translating Research into Policy and Practice My early interest in this was aroused by John Bowlby’s attachment research My early interest in this was aroused by John Bowlby’s attachment research –Example of policy resistance –Example of practice success

Classic Cases … Sister Elizabeth Kenny – maverick nurse and the polio epidemic of the 1930s Sister Elizabeth Kenny – maverick nurse and the polio epidemic of the 1930s Sir Richard Doll – eminent UK epidemiologist who established the link between smoking and lung cancer Sir Richard Doll – eminent UK epidemiologist who established the link between smoking and lung cancer

Evidence Based Practice The past decade has witnessed a growing emphasis on evidence based practices and policies across a wide variety of fields including health care, criminal justice, education and management. (Dopson, Locock, Gabby et al, 2003) The past decade has witnessed a growing emphasis on evidence based practices and policies across a wide variety of fields including health care, criminal justice, education and management. (Dopson, Locock, Gabby et al, 2003)

Drivers of Evidence Based Practice and Policy political imperatives for practical evidence of what works political imperatives for practical evidence of what works greater justification of resources directed into research greater justification of resources directed into research accountability to the tax paying public accountability to the tax paying public quality improvement through efficiency and effectiveness (Davies, Nutley & Walter, 2005; Walshe & Rundall, 2001) quality improvement through efficiency and effectiveness (Davies, Nutley & Walter, 2005; Walshe & Rundall, 2001)

Conceptual/Instrumental Huberman (1992) distinguishes between conceptual use of research (facilitates change in knowledge, understanding and attitudes) and instrumental research use (changes in practice and policy) Huberman (1992) distinguishes between conceptual use of research (facilitates change in knowledge, understanding and attitudes) and instrumental research use (changes in practice and policy)

The challenge … “The challenge is to promote uptake of innovations that have been shown to be effective, to delay spread of those that have not yet been shown to be effective, and to prevent uptake of ineffective innovations.” (Haines & Donald, 2002, p.4)

Inter- disciplinary Areas Knowledge Utilisation: philosophy, science and applied social research Diffusion of Innovation: rural sociology, medical sociology, communication studies and marketing

Three related fields 1. Knowledge management 2. Organisational change 3. Diffusion of innovation

Knowledge Management Largely focussed on ICT but growing interest in types of knowledge and the processes by which knowledge is gained, assimilated and circulated within organisations (Nutley et a; 2002; Nonaka & Takeuchi, 1995)

Organisational Change Seeks to understand the barriers to change and to develop successful change management strategies at the individual, group and organisational levels (Nutley et al, 2002)

Diffusion of Innovation Explores factors relating to the: Explores factors relating to the: - adopter of the innovation - characteristics of the innovation - social networks of the adopter - environmental characteristics - characteristics of the promoters of innovation - patterns of diffusion (eg centralised or decentralised)

Enabling Factors Successful implementation of evidence into practice requires attention to: - practitioners - organizational context - nature of evidence for EBP - method(s) of implementation (Barwick et al, 2005, p38)

Practitioner Facilitators links between researchers and practitioners links between researchers and practitioners participation in post graduate study participation in post graduate study practitioner involvement in research practitioner involvement in research support from colleagues support from colleagues autonomy autonomy practicality practicality ease of use or ‘effort’ ease of use or ‘effort’ conformity with status quo conformity with status quo

Organisational Facilitators Organisation’s Absorptive capacity: –existing knowledge and skills base –related technology –‘learning organization’ culture –proactive leadership focused on sharing new knowledge (Greenhalgh et al, 2004)

Greenhalgh et al (2004) continued: Organisation’s Receptive Context for Change: Organisation’s Receptive Context for Change: –strong leadership –clear strategic vision –good managerial relations –visionary staff in pivotal positions –climate conducive to risk taking –effective data capture systems

Inter-professional issues Social and cognitive boundaries between different professions retard the spread of innovation as individual professions operate within unidisciplinary communities of practice. (Ferlie, Fitzgerald, Wood & Hawkins, 2005)

Nature of Evidence Advantage in cost effectiveness Advantage in cost effectiveness Compatible with current work practices Compatible with current work practices Low in complexity Low in complexity Adaptable to practitioner needs Adaptable to practitioner needs Program fidelity maintained through implementation, careful modifications Program fidelity maintained through implementation, careful modifications Researcher credibility Researcher credibility

Implementation Methods Knowledge of core components Knowledge of core components Knowledge of barriers to change Knowledge of barriers to change Early involvement of all stakeholders Early involvement of all stakeholders Support of local champions Support of local champions Time for people to absorb innovation and connect to their needs Time for people to absorb innovation and connect to their needs Generating context specific knowledge in shared way Generating context specific knowledge in shared way (Fixsen et al, 2005; Schorr, 2004; Theis et al, 2000)

Key Conclusions Research utilisation is not a linear process as previously understood Research utilisation is not a linear process as previously understood Major challenge is not dissemination or training but implementation in complex organisational contexts Major challenge is not dissemination or training but implementation in complex organisational contexts Importance of careful design of change process Importance of careful design of change process

Key Questions What should count as evidence? What should count as evidence? How much research merits changing practice and policy? How much research merits changing practice and policy? Will research priorities be guided by effectiveness or efficiency? Will research priorities be guided by effectiveness or efficiency? Do service users have a voice and if so, how? Do service users have a voice and if so, how?

Child Protection: From Research to Action Plan 1. Literature review and research audit 2. Retrospective study of child protection research re possible factors associated with impact 3. Prospective study of child protection research to test propositions derived from retrospective study and literature from other fields

Child Protection: Steps in Diffusion of Innovation Retrospectively and prospectively investigate examples of diffusion of innovation where there are “good enough” grounds to believe they are - effective - efficient - transferable - sustainable