Tuesday, 4 November 2014

Knowledge exchange: just do it (but be mindful of what you say). Part 3 of the KE blog series

Posted by Peter van der Graaf

In the last two blogs about knowledge exchange Avril and Mandy did a great job outlining the opportunities and pitfalls of academics working with public health practitioners and commissioners to get research into practice (or practice into research as a more subversive strategy). “Putting yourself in the shoes of service partners”, “connecting with people in different ways”, “demystifying the language” all makes sense but how do you do it? The toolkit provides plenty of ideas but until you put those ideas in practice your translational research skills are still untested.

AskFuse was set up in June last year to ‘just do it’ (incidentally a research manager was hired with strong connections to the American company that came up with the slogan): ask our policy and practice partners what evidence they need and then find academics in Fuse who can help them access or develop that evidence in a timely, useful manner and in a usable format. Almost 16 months and 100 enquiries later, there certainly seems to be an appetite for working together.

That doesn’t mean pitfalls no longer exist: procurement procedures can trip up the best laid proposals, reorganisations are still not conducive for collaborative research, academic language can be intimidating and impenetrable, and academics can be just as invisible to each other as they can be for policy and practice partners.

However, having conversations seems to be at the heart of any successful (and unsuccessful) collaboration. Moreover, what happens in these conversations is key. Below is a hypothetical conversation between a Fuse academic and health practitioner based on similar experiences within AskFuse. What this exchange highlights is not only the stereotypical views that exist on different sides of the fence but more importantly the ability to change our views about doing research with policy and practice partners. That doesn’t mean academic rigour and peer reviewed publications are out of the window. 'Rigorous' is after all an adjective not a verb, and changing a health policy or intervention is what ultimately improves public health, not journal ratings or citation indexes.

In a sunny office somewhere in the North East:

Public Health practitioner in Local Authority: I would like to know if my child obesity programme in schools is going to work before I ask commissioners to sink millions of pounds into it.
Fuse researcher: No problem. What you need is a full RCT with three arms after a feasibility and pilot study, followed up by a mixed methods impact evaluation after 24 months.

Practitioner: Great! When will I have the results and what will it cost me?

Researcher: Only £1.2 million pounds and 7 years of research.

Practitioner: But I need to convince the elected member in the Council, who decides on my budget, in 6 months’ time and I have only £15,000 available for research within my million pound intervention programme.

Researcher: Right, so what you really want to know is: do the children in my programme lose weight. What? You are already measuring this within the programme? And you have comparable data available through the National Child Measurement Programme? This is highly unusual! You are also more interested in why children do or do not engage with the various activities on offer? Why didn’t you say so! All you need is a process evaluation: some interviews with delivery staff, group interview with some of the children and parents and Bob is your uncle! We can even use some comparable data from a previous research project to inform the questions and speed up the research design process.

Practitioner: Fantastic! I am sure if you write a short outline to explain this to my boss, nothing too fancy you know: just bullet points and a nice picture or story will do, we can find a way around those nasty procurement procedures. I might even invite a colleague from the neighbouring local authority to join in as he is doing something similar and also has some funding hidden away from his colleagues in other departments, who are all too keen to get their hands on our ring-fenced budgets. He is quite busy at the moment but is available in eight months’ time.
Researcher: But wait a minute: you said there was no money and time? How do we know if your colleague will still be interested eight months down the line and how will we know if the research findings will apply to his patch? Surely his boss will have different ideas about spending that money. 

Practitioner: I think that’s where we will need a full RCT. Wasn’t there something about complex interventions mentioned in an earlier Fuse blog?

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