1. Increasing engagement with evidence in healthcare: a case study in capacity building
Abby Sabey and Issy Bray Senior Teaching Fellows CLAHRC West

2. How Evidence Can Reach New Audiences
Capacity building is about increasing research activity and skills and is an important part of building the evidence base for practice.
In the next 10 mins we will be telling you how we have engaged new audiences in using or understanding healthcare evidence – audiences as diverse as staff in local authority housing departments, to commissioners, to the public – which has been our approach to building capacity in health research and changing the evidence culture in these sectors.
How Evidence Can Reach New Audiences

3. What is CLAHRC West?
For those who may not know about CLAHRCs – CLAHRC stands for Collaboration for Leadership in Applied Health Research and Care and there are 13 CLAHRCs around the country which bring together universities and local NHS organisations to carry out and implement applied health research so as to improve health and healthcare in the populations they serve.
The way in which they were set up has been described as a natural experiment (Soper et al 2013) and there has been freedom to interpret the brief flexibly in each area – so at CLAHRC West which covers a large area with Bristol at the centre, there is a research team addressing themes such as chronic health conditions and mental health
There is also an evaluation team who work across the region to support good practice in evaluation and build an evaluation culture across services and commissioning.
And cross cutting themes of patient and public involvement and our own theme of capacity building.

4. Capacity building
Started in September 2014 with a broad remit to build capacity in research
Two senior lecturers and one professor seconded from academic positions (part-time)
We took a qualitative and quantitative approach to investigating ‘demand and supply’ – who needed health research training and who was already supplying it?
We began in Sept 2014 with an open brief to build capacity in health research and started out with a qualitative approach to exploring demand for research training as well as some data collection about existing training providers which I’ll say a few words about next

5. Setting up the programme
Capacity building programme:
31 courses (May 2015-Dec 2016)
Team experience and network
Existing provision
EB culture and training needs
We started with gaining a quick impression of the EB culture and training needs in our partner organisations – to understand the culture of evidence use and need for training in this area.
Key contacts in our main partner organisations were interviewed in Dec 2014 to gain a rapid insight into the evidence and research needs of staff. This revealed the acceptance of EBP but some very real practical constraints to making it happen such as staffing levels and budget cuts, as well as an apathy and lack of confidence in certain staff groups, which mean many staff do not engage beyond their compulsory pre-registration training.
This exercise suggested there would be benefit in working at a grass roots level to change perceptions across the workforce.
Alongside this we also scoped existing provision of research training by contacting all the local universities and identifying relevant courses as well as local trust and online provision for NHS staff.
Lastly we filtered this data through our own experiences as academics with many years of teaching HCPs and EBP to help inform decisions about the type of courses to run. We were also keen to consider the local health research environment and areas in which we could deliver cutting-edge training which you will see in the next few slides.
These three elements were completed by March 2015 and we began to deliver training in May In the following 18 months we delivered 31 courses and the programme is ongoing – a further 25 courses are running this year.

6. CLAHRC West Courses (May 2015 - Dec 2016)
Getting your Article Published
Project Evaluation for Voluntary Sector
Using Evidence to Lead
Finding the Evidence
Critical Appraisal
Public Health Economics: Social Return on Investment
Service Evaluation
Questionnaire Design
Statistics
These are some of the courses we have run to give an idea of the range.
Using and Understanding Evidence for the Public
Realist Evaluation
Writing for a Lay Audience
Genetics and Epigenetics for Public Health

7. CLAHRC West Courses Getting your Article Published
Project Evaluation for Voluntary Sector
Using Evidence to Lead
Finding the Evidence
Critical Appraisal
Public Health Economics: Social Return on Investment
Service Evaluation
Questionnaire Design
Statistics
There is a strong drive for organisations to evaluate their services. We set up Introduction to Service Evaluation to provide those people with the right skills
Using and Understanding Evidence for the Public
Realist Evaluation
Writing for a Lay Audience
Genetics and Epigenetics for Public Health

8. CLAHRC West Courses Getting your Article Published
Project Evaluation for Voluntary Sector
Using Evidence to Lead
Finding the Evidence
Critical Appraisal
Public Health Economics: Social Return on Investment
Service Evaluation
Questionnaire Design
Statistics
Public Health Economics: SROI for the Real World: SROI is different from traditional health economics (aimed at Local Authorities rather than NHS)
Using and Understanding Evidence for the Public
Realist Evaluation
Writing for a Lay Audience
Genetics and Epigenetics for Public Health

9. CLAHRC West Courses Getting your Article Published
Project Evaluation for Voluntary Sector
Using Evidence to Lead
Finding the Evidence
Critical Appraisal
Public Health Economics: Social Return on Investment
Service Evaluation
Questionnaire Design
Statistics
Getting your article published, helped people from masters students to experienced clinicians to get their work published
Using and Understanding Evidence for the Public
Realist Evaluation
Writing for a Lay Audience
Genetics and Epigenetics for Public Health

10. CLAHRC West Courses Getting your Article Published
Project Evaluation for Voluntary Sector
Using Evidence to Lead
Finding the Evidence
Critical Appraisal
Public Health Economics: Social Return on Investment
Service Evaluation
Questionnaire Design
Statistics
One of the more unique things we’ve done is running courses about evidence for the public, run jointly with the PPI team
Using and Understanding Evidence for the Public
Realist Evaluation
Writing for a Lay Audience
Genetics and Epigenetics for Public Health

11. CLAHRC West Courses Getting your Article Published
Project Evaluation for Voluntary Sector
Using Evidence to Lead
Finding the Evidence
Critical Appraisal
Public Health Economics: Social Return on Investment
Service Evaluation
Questionnaire Design
Statistics
Conversly, some more cutting edge topics were aimed more at a more academic audience. For example, the Realist Evaluation course has been run now at Bristol Uni, UWE and Bath Uni
Using and Understanding Evidence for the Public
Realist Evaluation
Writing for a Lay Audience
Genetics and Epigenetics for Public Health

12. CLAHRC West Courses Getting your Article Published
Project Evaluation for Voluntary Sector
Using Evidence to Lead
Finding the Evidence
Critical Appraisal
Public Health Economics: Social Return on Investment
Service Evaluation
Questionnaire Design
Statistics
Finally, although participants from the Voluntary Sector had attended several of our courses, we developed a version of Service Evaluation specifically for the Voluntary sector
Using and Understanding Evidence for the Public
Realist Evaluation
Writing for a Lay Audience
Genetics and Epigenetics for Public Health

13. Sectors of participants
In the first 18 months we trained 350 participants. The earlier courses attracted mostly healthcare professionals, but we were also very keen to engage CCGs, the voluntary sector and Local Authorities, which we did over time (point out voluntary 18%, LA 18%, CCG 6%). We still need to improve engagement with primary (3%) and community (4%) healthcare professionals.
We have reached a wide range of jobs both in and outside of healthcare e.g. police commissioner, Penny Brohn (local cancer charity), citizens advice bureau

14. Geographical Reach Bristol 50% Pan-CLAHRC West area 20%
Outside CLAHRC West area 5%
KEY:
A – Gloucestershire B – S. Glos. C – Bristol D – North Somerset E – Bath & NE Somerset F – Wiltshire G – Swindon
This map shows the CLAHRC West patch, Bristol is labelled C – and where we have reached different audiences.
Clearly Bristol is an important centre in terms of healthcare and research – with 2 large teaching hospitals, and 2 universities
50% participants worked for organisations based in Bristol
However, a further 20% work in organisations that span the CLAHRC patch e.g. the largest was a mental health trust, others included organisations like the Academic Health Science Network
More recently we’ve had people attending from Local Authorities in Truro and Bournemouth, which suggests that we’re offering something that people can’t access elsewhere

15. What we’ve learned Free! Bite-size training Inter-professional groups
Small groups (interactive)
Non-academic setting
Highly relevant/timely for practice
Core team with complementary skills
Bringing in experts e.g. realist evaluation
Anecdotal evidence of impact
The key message is that you can open up ideas about evidence and research methods to new audiences by making things small and bite-size, and highly applied to immediate practical concerns. And having mixed, interprofessional groups facilitates openness, as does the non-academic setting.