1. ∂ School of Medicine Pharmacy & Health

2. What Constitutes Evidence in Public Health? Presented by David Hunter Professor of Health Policy and Management 16 th January 2014

3. ∂ School of Medicine Pharmacy & Health What we Already Know Improving health and wellbeing, and tackling inequalities and the social determinants of health  Are complex, ‘wicked issues’: cross-cutting, multi-factorial, multi-levelled  Occur against a backdrop of performance pressures to meet targets across sectors & agencies  Have to contend with a patchy, thin evidence-base – poor fit to local context, often contested  Experience a disappointing uptake of evidence-based changes

4. ∂ School of Medicine Pharmacy & Health http://www.ted.com/talks/ben_goldacre_battling_ bad_science.html

5. ∂ School of Medicine Pharmacy & Health Key Issues  Many factors get in the way of using research  We know little about what makes research get adopted or not  Promoting close interaction between researchers and end users is critical  Being clear who the end users are

6. ∂ School of Medicine Pharmacy & Health Problems with the Term ‘Evidence’  What is evidence?  Hierarchy of evidence – is a typology more appropriate?  Whose evidence?  Is ‘knowledge’ a better term?  How much do these debates matter anyway?

7. ∂ School of Medicine Pharmacy & Health Scientific findings do not fall on blank minds that get made up as a result. Science engages with busy minds that have strong views about how things are and ought to be. Michael Marmot (2004) British Medical Journal

8. ∂ School of Medicine Pharmacy & Health Pathways to Evidence-Informed Policy and Practice  Linear model  Interactive model

9. ∂ School of Medicine Pharmacy & Health Linear Model  Evidence/knowledge is a product  Uni-directional flow from producers to research users  Knowledge is generalisable across contexts

10. ∂ School of Medicine Pharmacy & Health Policy-Makers’ Sources of Evidence  Experts’ evidence (including consultants and think tanks)  Evidence from professional associations  Opinion-based evidence (including lobbyists and pressure groups)  Ideological evidence (including party think tanks, manifestoes)  Media evidence  Internet evidence  Lay evidence (including constituents’ and citizens’ experiences)  ‘Street’ evidence (including urban myths, conventional wisdom)  Research evidence

11. ∂ School of Medicine Pharmacy & Health Interactive Model  Embracing knowledge from multiple sources: research, theory, practice  Promoting close interaction between researchers and end-users in a co-production/co-creation approach  Context is important  Effective uptake is not only a function of the science but also the degree to which the purveyor of knowledge is viewed as a credible witness  Relationships are key to use and application of knowledge  Dissemination of results through traditional academic channels is not enough – the media utilised must fit the audience