Category Archives: Library

Public health interventions may offer society a return on investment of £14 for each £1 spent

By NHS National Institute for Health Research (2017)

Each £1 invested in public health interventions could offer an average return on investment to the wider health and social care economy of £14.

This systematic review looked at 52 studies where the return on each £1 ranged from -£21.3 to £221. Legislative interventions such as sugar taxes, and health protection interventions such as vaccination programmes, gave the highest returns on investment. Interventions such as anti-stigma campaigns, blood pressure monitoring and early education programmes, provided smaller (but still favourable) returns. National campaigns offered greater returns than local campaigns. Falls prevention provided the quickest return, within 18 months.

These findings apply to high-income countries. There are some limitations to the data, as a variety of calculation techniques were used and the quality of the included studies varied. However, these are unlikely to alter the direction or approximate size of these effects. The study shows how cost-effective public health interventions can be and should inspire future research into how to better implement what is already known.

Click here to view the systematic review

Evidence based policy making and the ‘art’ of commissioning – how English healthcare commissioners access and use information and academic research in ‘real life’ decision-making: an empirical qualitative study

Wye, L. et al. BMC Health Services Research, 2015; 15: 430

Click here to view this full text article

Abstract

Background
Policymakers such as English healthcare commissioners are encouraged to adopt ‘evidence-based policy-making’, with ‘evidence’ defined by researchers as academic research. To learn how academic research can influence policy, researchers need to know more about commissioning, commissioners’ information seeking behaviour and the role of research in their decisions.

Methods
In case studies of four commissioning organisations, we interviewed 52 people including clinical and managerial commissioners, observed 14 commissioning meetings and collected documentation e.g. meeting minutes and reports. Using constant comparison, data were coded, summarised and analysed to facilitate cross case comparison.

Results
The ‘art of commissioning’ entails juggling competing agendas, priorities, power relationships, demands and personal inclinations to build a persuasive, compelling case. Policymakers sought information to identify options, navigate ways through, justify decisions and convince others to approve and/or follow the suggested course. ‘Evidence-based policy-making’ usually meant pragmatic selection of ‘evidence’ such as best practice guidance, clinicians’ and users’ views of services and innovations from elsewhere. Inconclusive or negative research was unhelpful in developing policymaking plans and did not inform disinvestment decisions. Information was exchanged through conversations and stories, which were fast, flexible and suited the rapidly changing world of policymaking. Local data often trumped national or research-based evidence. Local evaluations were more useful than academic research.

Discussion
Commissioners are highly pragmatic and will only use information that helps them create a compelling case for action.Therefore, researchers need to start producing more useful information.

Conclusions
To influence policymakers’ decisions, researchers need to 1) learn more about local policymakers’ priorities 2) develop relationships of mutual benefit 3) use verbal instead of writtencommunication 4) work with intermediaries such as public health consultants and 5) co-produce local evaluations.

#StatusOfMind: social media and young people’s mental health and wellbeing

By Royal Society for Public Health (19th May 2017)

The report includes a league table of social media platforms according to their impact on young people’s mental health. YouTube tops the table as the most positive with Instagram and Snapchat coming out as the most detrimental to young people’s mental health and wellbeing.

Click here to download this report

Evidence-based policymaking is not like evidence-based medicine, so how far should you go to bridge the divide between evidence and policy?

Cairney, P. et al.  Health Research Policy & Systems, 2017; 15: 35

Click here to view this article

There is extensive health and public health literature on the ‘evidence-policy gap’, exploring the frustrating experiences of scientists trying to secure a response to the problems and solutions they raise and identifying the need for better evidence to reduce policymaker uncertainty. We offer a new perspective by using policy theory to propose research with greater impact, identifying the need to use persuasion to reduce ambiguity, and to adapt to multi-level policymaking systems.

We identify insights from secondary data, namely systematic reviews, critical analysis and policy theories relevant to evidence-based policymaking. The studies are drawn primarily from countries such as the United States, United Kingdom, Canada, Australia and New Zealand. We combine empirical and normative elements to identify the ways in which scientists can, do and could influence policy.

We identify two important dilemmas, for scientists and researchers, that arise from our initial advice. First, effective actors combine evidence with manipulative emotional appeals to influence the policy agenda – should scientists do the same, or would the reputational costs outweigh the policy benefits? Second, when adapting to multi-level policymaking, should scientists prioritise ‘evidence-based’ policymaking above other factors? The latter includes governance principles such the ‘co-production’ of policy between local public bodies, interest groups and service users. This process may be based primarily on values and involve actors with no commitment to a hierarchy of evidence.

We conclude that successful engagement in ‘evidence-based policymaking’ requires pragmatism, combining scientific evidence with governance principles, and persuasion to translate complex evidence into simple stories. To maximise the use of scientific evidence in health and public health policy, researchers should recognise the tendency of policymakers to base judgements on their beliefs, and shortcuts based on their emotions and familiarity with information; learn ‘where the action is’, and be prepared to engage in long-term strategies to be able to influence policy; and, in both cases, decide how far you are willing to go to persuade policymakers to act and secure a hierarchy of evidence underpinning policy. These are value-driven and political, not just ‘evidence-based’, choices.

Index of Grey Literature and Alternative Sources and Resources

By Public Health England (2017)

This list has been compiled to help librarians and researchers, particularly in Public Health, to find resources that fall into this category and flag up alternative sources for queries not easily resolved by the clinical / medical database model.

NIHR Funding Opportunities for Public Health Research

A Research Design Service North West event

16 March 2017, 9.30am-2.30pm

The Foresight Centre, Liverpool

This RDS NW seminar is for health and social care professionals and researchers in the North West of England who want to develop and submit a Public Health Research application for funding. Those thinking of other NIHR research funding streams will also benefit from attending.

What will you get from the day?

 For those intending to develop and submit an application to NIHR, this event will highlight:

  • the funding opportunities available
  • the application process
  • what funders are looking for in a submission
  • the importance of a well-defined research question
  • how to design a study to answer your research question effectively
  • building a team of collaborators
  • the support that RDS NW can provide in the preparation of your application

What do I need to do?

 As this event is aimed at those wanting to develop and submit a research funding application, we ask that:

  • you have a clear idea of your research question
  • you are prepared to discuss your idea with an RDS adviser
  • you let us know what the type(s) of specialist advice you will need (if known) in advance so that we can ensure an adviser is available to help you.

For more information please visit the RDS NW website events page here.

To register your place please book here.

Research Design Service North West
Central Coordinating Office
Tel: +44 (0) 1524 593209
Follow the Research Design Service on Twitter: @NIHR_RDS.

Evidence-based medicine meets democracy: the role of evidence-based public health guidelines in local government

Kelly, M.P. et al (2017) Journal of Public Health. pp. 1–7 doi:10.1093/pubmed/fdx002

In 2013, many public health functions transferred from the National Health Service to local government in England. From 2006 NICE had produced public health guidelines based on the principles of evidence-based medicine. This study explores how the guidelines were received in the new environment in local government and related issues raised relating to the use of evidence in local authoritites.

Methods

In depth, interviews with 31 elected members and officers, including Directors of Public Health, from four very different local government organizations (‘local authorities’).

Results

Participants reported that (i) there were tensions between evidence-based, and political decision-making; (ii) there were differences in views about what constituted ‘good’ evidence and (iii) that organizational life is an important mediator in the way evidence is used.

Conclusions

Democratic political decision-making does not necessarily naturally align with decision-making based on evidence from the international scientific literature, and local knowledge and local evidence are very important in the ways that public health decisions are made.

Click here to view this article