Friday 18 June 2021

When, what and how to engage and disseminate research evidence during a pandemic?

Posted by Peter van der Graaf, Teesside University, Jenni Lynch, University of Hertfordshire, and Liz Such, University of Sheffield, three NIHR Knowledge Mobilisation Research Fellows

In this blog, we share lessons from working with local authorities on the development of action learning sets (bringing people together to reflect on research evidence) when they are faced with the many challenges of COVID-19.

Why do we need action learning? 
(Best-laid plans)

We know that local authorities value research evidence to improve their decision-making about public services in times of austerity; however, making evidence fit for purpose and getting it actively used in local government remains challenging.

So, we decided to test a potential new approach to knowledge mobilisation by convening and supporting action learning sets (ALS) across three local authorities (Hertfordshire, Gateshead and Doncaster Councils). This was supported by the NIHR Centre for Engagement and Dissemination (NCED), which not only aims to share knowledge and outputs from NIHR-funded research, but to develop the evidence base about “what works” in knowledge mobilisation.

The ALS would bring together a group of approximately 15 stakeholders in each local authority, including public health and social care commissioners, front-line practitioners, third-sector representatives, service users and local academics to reflect on research related to a priority topic of their choice. Using deliberative dialogue, including structured questioning and reflection, participants explored different types of knowledge and relationships between knowledge producers, users and mobilisers. By applying this approach, the ALS aimed to help mobilise research and other forms of knowledge on wellbeing and equity in local government into collectively agreed action plans.

As we started discussions with our local authority partners in Spring 2020, the full implications of the COVID-19 pandemic hit. Despite various attempts to start the ALS we regrettably had to decide to abandon the project in its current form. In this blog, we share our lessons from working with the local authorities on the development of ALS during a pandemic and what this means for future knowledge mobilisation activities from NCED when engaging with public health and social care. Our reflections focus on the when, what and how of knowledge mobilisation with local authorities.

Research capacity during a pandemic: unethical conversations? (When)

What the pandemic taught us is that when public health and social care research is most needed (e.g. to inform the response to COVID-19), capacity for using this research is very limited. With local authority staff being spread thin and reassigned to other parts of their councils, it was not feasible and even borderline unethical to ask them to join and prepare for action learning set (ALS) meetings. In particular senior staff within local government, who are key participants for the ALS, were in some cases absent from our early conversations. A serious question was posed: 
"How could we mobilise research evidence to help local government in their response to COVID-19, when they hadn’t got the time or mind space to even look at a one-page summary brief?"
We tried to make the process more accessible by moving the ALS meetings online, involving smaller groups to optimise interaction (five instead of 15 participants) and shorter sessions, with individual activities and reflection time between sessions. This helped to some extent to engage with local authority partners, but the capacity problem remained and even short online meetings where often not feasible for senior staff. However, it illustrated the value of a blended approach to ALS with a potential combination of online and face-to-face sessions to allow stakeholders to engage differently at various times in the process. We also urged them to consider topics that were immediately relevant to their current situation, e.g. working virtually through the pandemic.

The need for relevant evidence (What)


The Hertfordshire County Council Social Work team chose to reflect on how to interpret the Mental Capacity Act and apply strengths-based approaches when discharging patients from hospitals into the care of local authorities (discharge to assess pathways). Strengths-based approaches are a collaborative process between service users and providers to determine an outcome that draws on the person’s strengths and assets. We found a small number of NIHR funded studies but also identified useful knowledge from other sources, such as a Health Services and Delivery Research (HS&DR) Evidence Synthesis Centre Topic Report, which provided a systematic review of evidence on different strengths-based approaches within adult social work, and guidance documents produced by a law firm.

Knowledge Mobilisers Assemble!
Similarly, Gateshead Council selected the topic of community-based approaches to public health, focusing on how to implement these approaches with staff within the Council across different departments by applying a whole system approach. We were able to identify relevant work through our network of NIHR-funded Knowledge Mobilisation Research Fellows. For example, researchers at the University of Hertfordshire had teamed up with Hertfordshire County Council to set up a whole systems programme team and developed a joint masterclass on the topic that summarised the latest evidence.

This illustrated a need to tap into a wide range of databases that included studies and evidence from sectors beyond health and links to a network of knowledge mobilisers to access ongoing work and publications that were not routinely published on scientific databases. We plan to support this in the development of our own website as Knowledge Mobilisation Research Fellows united in the Knowledge Mobilisation Alliance.

Localising and tailoring of evidence: the value of dialogue (How)

Thirdly, our conversations with partners about the planning of the action learning sets (ALS) demonstrated that local authority staff value conversations with academic researchers about the meaning of research and how-to tailor evidence to their local needs. Evidence is made fit for local commissioning and planning purposes by localising it (relating evidence to local context and needs) and tailoring it (presenting actionable messages). ALS provide a mechanism for this translational activity and a collaborative space for local authority staff to take time out from their busy jobs and reflect on research evidence (and other types of knowledge).

Constructive dialogue was seen as most useful in supporting decision
 making, instead of researchers parachuting in with findings   
Various staff members in local government who we talked to were already research active, engaging with research through conferences and some by undertaking PhD studies themselves. They were already mobilising local intelligence, national data and tacit knowledge in their decision making. Instead of academic researchers parachuting in with their research findings, constructive dialogue about the meaning of different types of knowledge - and where researchers and practitioners worked together as equal partners - was seen as most useful for supporting local government decision making. Facilitated conversations over a series of meetings would enable them to effectively blend different types of knowledge together to inform the commissioning of health and social care services.

Being humble and open to challenge and dialogue are key components of any knowledge mobilisation strategy for engaging with local authorities and dissemination of health research findings.


More commentary on action learning sets and engaging with local authorities in knowledge mobilisation below:
  • Van der Graaf P, Cheetham M, Redgate S, Clare H, Adamson A. Co-production in local government: process, codification and capacity building of new knowledge in collective reflection spaces. Workshops findings from a UK mixed methods study. Health Research Policy and Systems. 2021 Jan;19(12). https://rdcu.be/cesKm
  • Van der Graaf P, Blank L, Holding E, Goyder E. What makes a ‘successful’ collaborative research project between public health practitioners and academics? A mixed-methods review of funding applications submitted to a local intervention evaluation scheme. Health Research Policy and Systems. 2021 Jan;19(1):1-3. https://rdcu.be/cdWGC

Images:
  1. "… of Mice And Men …" by Kristian Bjornard via Flickr.com, copyright © 2010: https://www.flickr.com/photos/bjornmeansbear/4294131461 (CC BY-SA 2.0)
  2. Pat Loika, CC BY 2.0, via Wikimedia Commons

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