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Promoting Evidence-Based Health Policy, Programming, and Practice for Seniors: Lessons from a National Knowledge Transfer Project*

Published online by Cambridge University Press:  31 March 2010

Carol L. McWilliam ,
Moira Stewart ,
Judith Belle Brown ,
John Feightner ,
Mark Rosenberg ,
Gloria Gutman ,
Margaret Penning ,
Miriam Stewart ,
Robyn Tamblyn  and
Grace Morfitt
Carol L. McWilliam*
Affiliation:
University of Western Ontario
Moira Stewart
Affiliation:
University of Western Ontario
Judith Belle Brown
Affiliation:
University of Western Ontario
John Feightner
Affiliation:
University of Western Ontario
Mark Rosenberg
Affiliation:
Queen's University
Gloria Gutman
Affiliation:
Simon Fraser University
Margaret Penning
Affiliation:
University of Victoria
Miriam Stewart
Affiliation:
University of Alberta
Robyn Tamblyn
Affiliation:
Royal Victoria Hospital and McGill University
Grace Morfitt
Affiliation:
University of Western Ontario
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être addressées à : Carol L. McWilliam, MScN, EdD, University of Western Ontario, Faculty of Health Sciences, Room SH2345, Somerville House, London, ON N6A 3K7, Tel.: (519) 661-2111, ext. 82221, Fax: (519) 661-4189. ([email protected])
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Abstract

In response to Canada's pressing need for effective evidence-based policy, services, and practices specific to seniors, national leaders representing all concerned stakeholders designed and implemented a National Consensus Process to promote spread, exchange, choice, and uptake of research evidence on social and health issues associated with an aging population. This article presents the innovative methods and evaluation of this three-year project, illuminating for all constituencies the challenges and opportunities associated with promoting seniors' independence through collaborative knowledge transfer efforts. A total of 198 organizations and 65 individuals were surveyed at baseline, throughout the intervention, immediately post-intervention, and one year post-intervention. Knowledge from 783 studies was spread to 63,387 people, 90 per cent of whom reported knowledge exchange. Over 50 per cent of stakeholders reported using the research evidence, although processes for facilitating knowledge choice did not achieve consensus. Significant knowledge uptake occurred in two of the four research theme areas.

Résumé

En réponse au besoin pressant de politiques, de services et de pratiques documentés, efficaces et adaptés aux aînés, les chefs de file nationaux représentant les diverses parties intéressées ont conçu et mis en place un Consensus national pour promouvoir la propagation, l'échange, le choix et l'adoption de recherches sur des questions sociales et de santé inhérentes à une population vieillissante. Ce document présente les méthodes innovatrices et un examen de ce projet de trois ans, faisant ressortir dans tous les cas les défis et les occasions associés à la promotion de l'autonomie des aînés par le biais d'échange de connaissances entre divers groupes. Pendant la durée du programme, immédiatement après et un an plus tard, on a enquêté auprès de 198 organismes et de 65 personnes. Les connaissances tirées de 783 études ont été communiquées à 63 387 personnes, parmi lesquelles 90 % ont déclaré avoir échangé ces connaissances. Plus de 50 % des parties intéressées ont signalé avoir utilisé les résultats des recherches bien que les méthodes employées pour orienter les choix n'aient pas donné lieu à un consensus. Une application importante de connaissances s'est produite à partir de deux des quatre thèmes de recherche.

Keywords

research disseminationevidence-based policy and serviceapplied health services researchknowledge transferagingdiffusion de la recherchepolitiques et services documentésrecherche appliquée en services de santétransfert de connaissancesvieillissement
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 22 , Issue 4 , Winter/Hiver 2003 , pp. 415 - 430
Copyright
Copyright © Canadian Association on Gerontology 2003

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Footnotes

*

Funding support for this research and development project was received from the National Health Research and Development Program, Health Canada, between April 1998 and July 2001. The results and conclusions are those of the authors. No official endorsement by the funding bodies is intended, nor should it be inferred. The authors also wish to acknowledge the contributions of the National Consensus Committee members and the thousands of concerned Canadians who participated in the CNCP in the interest of all seniors.

References

Abelson, J., Lomas, J., Eyles, J., Birch, S., & Veenstra, G. (1995). Does the community want devolved authority? Results of deliberative polling in Ontario. Canadian Medical Association Journal, 153, 403–478.Google Scholar
Argote, L., & Ingram, P. (2000). Knowledge transfer: A basis for competitive advantage in firms. Organizational Behavior and Human Decision Processes, 82, 150–169.Google Scholar
Bland, C.J., Meurer, L.N., & Maldonado, G. (1995). A systematic approach to conducting a non-statistical metaanalysis of research literature. Academic Medicine, 70, 642–653.Google Scholar
Broner, N., Franczak, M., Dye, C., & McAllister, W. (2001). Knowledge transfer, policy making and community empowerment: A consensus model approach for providing public mental health and substance abuse services. Psychiatric Quarterly, 72, 79–102.Google Scholar
Browman, G.P., Levine, M.N., Mohide, E.A., Hayward, R.S.A., Pritchard, K.I., Gafni, A., & Laupacis, A. (1995). The practice guidelines development cycle: A conceptual tool for practice guidelines development and implementation. Journal of Clinical Oncology, 2, 502–512.Google Scholar
Bryant, T., Raphael, D., Brown, I., Wheeler, J., Herman, R., Houston, J., Hussain, M., Lanphier, C., Lightfoot, B., McClelland, B., McIntosh, B., Stevens, I., & Weisbeck, F. (2001). Opening up the public policy analyses process to the public: Participatory policy research and Canadian seniors' quality of life. Canadian Review of Social Policy, 48, 35–58.Google Scholar
Buxton, M., & Hanney, S. (1996). How can payback from health services be assessed? Journal of Health Services Research and Policy, 1(1), 35–43.Google Scholar
Canadian National Consensus Project [CNCP]. (1998). CNCP home page. Retrieved September 19, 2003, from http://publish.uwo.ca/~cmcwill/NCP/Google Scholar
Chalmers, I., & Altman, D. (Eds.). (1995). Systematic reviews. London: BMJ Publishing.Google Scholar
Chappell, N. (Ed.) (2000). Setting an evidence-based policy agenda for seniors' independence [Special issue]. Canadian Journal on Aging, 19(Suppl.1).Google Scholar
Charles, C., Schalm, C., & Semradek, J. (1994). Involving stakeholders in health services research: Developing Alberta's resident classification system for long-term care facilities. International Journal of Health Services, 24, 749–761.CrossRefGoogle ScholarPubMed
Charleton, B.G. (1996). The uses and abuses of meta-analysis. Family Practice, 13, 397–401.Google Scholar
Cochrane Centre / Oxford Regional Health Authority / Department of Clinical Epidemiology and Biostatistics, McMaster University / Hamilton-Wentworth Department of Public Health Services. (1992). How to do a critical appraisal of a review article. Hamilton, ON: Hamilton-Wentworth Department of Public Health Services.Google Scholar
Cook, D.J., Guyett, G.H., Laupacis, A., Sackett, D.L., & Goldberg, R.J. (1995). Clinical recommendations using levels of evidence for antithrombotic agents. Chest, 108, S2275–S2280.Google Scholar
Cook, D.J., Mulrow, C.F., & Haynes, R.B. (1997). Systematic reviews: Synthesis of best evidence for clinical decisions. Annals of Internal Medicine, 126, 376–380.Google Scholar
Edwards, L. (2000). Power and influence in the making of British budgets. In Finkelstein, (Ed.), Transparency in public policy (pp. 143–166). New York: St. Martin's Press.Google Scholar
Eysenck, H.J. (1994). Meta-analysis and its problems. British Medical Journal, 309, 789–792.Google Scholar
Fong, S. (1994). Youth-to-youth sexual health education programs: A critical appraisal of evaluation studies and a brief discussion of descriptive studies. Toronto: Toronto Department of Public Health.Google Scholar
Freire, P. (1973). Education for critical consciousness. New York: Seabury Press.Google Scholar
Grimshaw, J.M., Eccles, M.P., Walker, A.E., & Thomas, R.E. (2002). Changing physician behavior: What works and thoughts on getting more things to work. Journal of Continuing Education for Health Professionals, 22, 237–243.Google Scholar
Grimshaw, J.M., Shirran, L., Thomas, R.E., Mowat, G., Fraser, C., Bero, L., Grilli, R., Harvey, E.L., Oxman, A.D., & O'Brien, M.A. (2001). Changing provider behaviour: An overview of systematic reviews of interventions. Medical Care, 39, II-2–II-45.Google Scholar
Guyatt, G.H., Sackett, D.L., Sinclair, J., Hayward, R., Cook, D.J., & Cook, R.J. (1995). Users' guides to the medical literature, IX: A method for grading health care recommendations. Evidence-Based Medicine Working Group. Journal of the American Medical Association, 274, 1800–1804.Google Scholar
Habermas, J. (1984). The theory of communicative action (Vol. 1). Boston: Beacon Press.Google Scholar
Habermas, J. (1987). The theory of communicative action (Vol. 2). Boston: Beacon Press.Google Scholar
Habraken, H., Janssens, I., Soenen, K., Van Driel, M., Lannoy, J., & Bogaert, M. (2003). Pilot study on the feasibility and acceptability of academic detailing in general practice. European Journal of Clinical Pharmacology, 59, 253–260.CrossRefGoogle ScholarPubMed
Haskell, R.E. (2001). Transfer of learning: Cognition, instruction and reasoning. New York: Academic Press.Google Scholar
Health Canada. (1995). Seniors' independence research program and Canada's drug strategy [Request for proposales, competition for programs of applied research]. Ottawa: Author.Google Scholar
Health Canada, Canadian Task Force on Periodic Health Examination. (1994). The Canadian Guide to Clinical Preventive Health Care. Ottawa: Canada Communications Group.Google Scholar
Hoddinott, S., & Bass, M. (1986). The Dillman total design survey method: A sure-fire way to get high survey return rates. Canadian Family Physician, 32, 2366–2368.Google Scholar
Kavanagh, K.H. (1995). Collaboration and diversity in technology transfer. In Backer, T.E., David, S.L., & Soucey, G. (Eds.), Reviewing the behavioural science knowledge base on technology transfer. Rockville, MD: National Institute on Drug Abuse [NIDA].Google Scholar
Lamb, S., Greenlick, M.R., & McCarty, D. (Eds.). (1998). Bridging the gap between practice and research: Forging partnerships with community-based drug and alcohol treatment. Washington, DC: National Academy Press.Google Scholar
Lewis, S., Battista, R., Lomas, J., & Ross, E. (1998). Canada needs an evidence-based decision-making trade show. Canadian Medical Association Journal, 158, 210–212.Google Scholar
Liddle, J., Williamson, M., & Invig, L. (1996). Method for evaluating research and guideline evidence. Sydney, Australia: New South Wales Health Department.Google Scholar
Lomas, J. (1991). Words without action? The production, dissemination and impact of consensus recommendations. Annual Review of Public Health, 12, 41–65.Google Scholar
Lomas, J. (1993). Making clinical policy explicit: Legislative policy making and lessons for developing practice guidelines. International Journal of Technology Assessment in Health Care, 9, 11–25.Google Scholar
Lomas, J. (1997). Research and evidence-based decision making. Australian and New Zealand Journal of Public Health, 21, 439–440.Google Scholar
Lomas, J. (1998). Social capital and health: Implications for public health and epidemioogy. Social Science and Medicine, 47, 1181–1188.Google Scholar
Mathurin, C. (1997). The diffusion of research results: The role of the dissemination of scientific information. Ottawa: Health Canada, Division of Aging and Seniors.Google Scholar
McWilliam, C. (1997). Using a participatory research process to make a difference in policy on aging. Canadian Journal on Aging, 16(Suppl.), 70–79.Google Scholar
Milimo, J., Norton, A., & Owen, D. (1998). The impact of PRA approaches and methods on policy and practice: The Zambia PPA. In Holland, J. & Blackburn, J. (Eds.), Whose voice? Participatory research and policy change (pp. 103–111). London: Intermediate Technology Publications.Google Scholar
Milio, N. (1983). Primary care and the public's health: Judging impacts, goals, and policies. Lexington, MA: Lexington Books.Google Scholar
Moreau, C.P., Lehmann, D.R., & Markman, A.B. (2001). Entrenched knowledge structures and consumer responses to new products. Journal of Marketing Research, 37(8), 14–29.Google Scholar
Mowatt, G., Foy, R., Grimshaw, J.M., & Sobrevilla, A. (2001). Local consensus processes: Effects on professional practice and health care outcomes (Cochrane protocol). Cochrane Library, Issue 3. Retrieved September 19, 2003, from http://www.health.library.mcgill.ca/database/cochrane.htmGoogle Scholar
Mulrow, C.D., Cook, D.J., & Davidoff, F. (1997). Systematic reviews: Critical links in the great chain of evidence. Annals of Internal Medicine, 126, 389–391.Google Scholar
Naylor, C.D. (1995). Grey zones of clinical practice: Some limits to evidence-based medicine. Lancet, 345, 840–842.CrossRefGoogle ScholarPubMed
Orosz, E. (1994). The impact of social science research on health policy. Social Science and Medicine, 39, 1287–1293.Google Scholar
Oxman, A., Cook, D., & Guyatt, G. (1994). Users' guides to the medical literature, V: How to use an overview. Evidence-Based Medicine Working Group. Journal of the American Medical Association, 272, 1367–1371.Google Scholar
Prochaska, J., & DiClemente, C.C. (1992). Stages of change in the modification of problem-behaviors. In Hersen, M., Eisler, R.M., & Miller, P.M. (Eds.), Progress in behaviour modification (pp. 184–214). Sycamore, IL: Sycamore Press.Google Scholar
Prochaska, J., DiClemente, C., & Norcross, J. (1992). In search of how people change: Applications to addictive behaviours. American Psychologist, 47, 1102–1114.Google Scholar
Putnam, R.D. (1995). Bowling alone: America's declining social capital. Journal of Democracy, 6, 65–78.Google Scholar
Reid, A. (1996). What we want: Qualitative research. Canadian Family Physician, 42, 387–389.Google Scholar
Rogers, E. (1995). Diffusion of innovations (4th ed.) London: Free Press.Google Scholar
Rosser, W.W. (2001). The place of guidelines and their means of dissemination. Canadian Journal of Clinical Pharmacology, 8(Supp.A), 34A–38A.Google Scholar
Smith, M.B. (1996). Psychology in the public interest: What have we done? What can we do? In Lorion, R.P., Iscoe, I., DeLeon, P.J., & VandenBos, G.R. (Eds.), Psychology and public policy: Balancing public service and professional need (pp. 99–113). Washington, DC: American Psychological Association.Google Scholar
Social capital [Editorial]. (2001). Isuma: Canadian Journal of Policy Research, 1, 6–7.Google Scholar
Tenkasi, R.V., & Mohrman, S.A. (1995). Technology transfer as collaborative learning. In Backer, T.E., David, S.L., & Soucy, G. (Eds.), Reviewing the behavioural science knowledge base on technology transfer. Rockville, MD: NIDA.Google Scholar
Torres-Gil, F., & Wray, L. (1993). Funding and policies affecting geriatric rehabilitation. Clinics in Geriatric Medicine, 9, 831–840.Google Scholar
Tu, K., & Davis, D. (2002). Can we alter physician behaviour by educational methods? Lessons learned from studies of the management and follow-up of hypertension. Journal of Continuing Education for Health Professionals, 22, 11–22.Google Scholar
Veatch, R.M. (1991). Consensus of expertise: The role of consensus of experts in formulating public policy and estimating facts. The Journal of Medicine and Philosophy, 16, 427–445.Google Scholar
Veenstra, G. (2001). Social capital and health. Isuma: Canadian Journal of Policy Research, 2, 72–81.Google Scholar
Weiss, C.H. (Ed.). (1992). Organizations for policy advice: Helping government think. Newbury Park, CA: Sage.Google Scholar
Williams, F., & Gibson, D.V. (Eds.). (1990). Technology transfer: A communication perspective. Newbury Park, CA: Sage.Google Scholar
Woolf, S.H., & George, J.N. (2000). Evidence-based medicine: Interpreting studies and setting policy. Hematology and Oncology Clinics of North America, 14, 761–784.CrossRefGoogle ScholarPubMed
Wortman, P.M., Vinokur, A., & Sechrest, L. (1988). Do consensus conferences work? A process evaluation of the NIH consensus development program. Journal of Health Politics, Policy and Law, 13, 469–498.Google Scholar