NOTE: Order of Health Departments in presentation (from west to east):A = PeelB = TorontoC = Durham
We have completed a 3-year, collaborative research study in partnership with three Ontario public health departments. Funding was provided by CIHR 'Partnerships for Health Systems Improvement' grant and each of the partner health departments.
We aimed to investigate tailored Knowledge Brokering strategies for assisting public health staff in developing the skills needed to access and apply relevant research evidence to evidence-informed decisions in practice. Overall, our objective was to enhance capacity for and facilitate contexts conducive to evidence-informed decision making (EIDM).
We used case study methodology and tailored the intervention to the needs of each “case” (health department). A Knowledge Broker and the research team provided training workshops and worked with specific staff teams to address practice-based issues in the health departments in an evidence-informed way. Quantitative and qualitative data were collected at three time points; baseline data analysis further directed the interventions.
Description of partners and their roles:Three Ontario Public Health DepartmentsPartners contributed to designing intervention, coordinating data collection, interpreting results
Our analysis indicated that the intervention impacted staff knowledge and skills, as well as affected program decisions and organizational structure. Our analysis of skills assessment and online survey data, collected at baseline and follow-up, indicated improvement in overall staff understanding of EIDM. Qualitative interview and Knowledge Broker reflective journal data further corroborated that this new knowledge and skill set were being incorporated into health department work.
Note: Based on quick interpretation (i.e. not statistically significant) of EIDM Skills Tool for only 2 HU’s (comparing baseline and follow-up) because still in final phase of data collection for Case B.
But even with decision-maker involvement, we still encounter challenges:
Partnerships for Health System Improvement: Facilitating Evidence-informed Public Health Decision-making
Maureen Dobbins, PhDKara DeCorby, MScLori Greco, MHScRobyn Traynor, MScPartnerships for HealthSystem ImprovementFacilitating evidence-informed PublicHealth decision making
PHSI Program● Integrated KT program● Collaborative partnerships betweenresearchers & decision-makers● Applied research – findings of interest tobroader health care systemBackgroundBackground -- Objectives -- Methods -- Results -- ConclusionsCPHA 2013Monday June 11th
Study Purpose● To enhance capacity for & facilitate contextsconducive to EIDMResearch Questions1. What is the impact of a KT strategy onknowledge, capacity & behaviour forEIDM?2. What contextual factors facilitate /impede impact?Background -- Objectives -- Methods -- Results -- ConclusionsCPHA 2013Monday June 11th
MethodsCase Study● Three cases: Ontario health departments● Tailored KT intervention, involving/delivered by aKnowledge Broker (KB)Data Collection● Quantitative & qualitative; triangulation● Three time points: baseline, interim, follow-upBackground -- Objectives -- Methods -- Results -- ConclusionsCPHA 2013Monday June 11th
Health Department PartnersCase AContext• Large, diverse population served• Strong MOH/AMOH vision for EIDM• EIDM strategic priority• Resources committed for EIDMIntervention• Sept 2010 – Jun 2012• KB on site, 2 d/wkMentored Rapid Review teamsProvided training in EIDM skills & methodsParticipated in EIDM-related events (meetings,journal clubs, presentations)One-on-one consulting (outside of teams)Background -- Objectives -- Methods -- Results -- ConclusionsCPHA 2013Monday June 11th
Case BContext• Large, urban centre served• MOH committed to EIDM• Manager „champions‟ supporting project• EIDM strategic priorityIntervention• Apr 2011 – Feb 2013• KB combination of on/off-site: 2 d/wkMentored staff teamsProvided training in EIDM skills & methodsParticipated in workshops & meetingsAdvised Senior Management TeamHealth Department PartnersBackground -- Objectives -- Methods -- Results -- ConclusionsCPHA 2013Monday June 11th
Case CContext• Medium-size, mixed urban/rural populationserved• Commitment from MOH and executivemembers.Intervention• Apr 2011 – Dec 2012• KB available off-site*: 2 d/wk (*on-site 2 d/mon)Mentored staff teamsProvided training in EIDM skills & methodsParticipated in workshops & meetingsAdvised RKEC on developing department-widePolicy/Procedure for EIDM and EIDM GuidebookHealth Department PartnersBackground -- Objectives -- Methods -- Results -- ConclusionsCPHA 2013Monday June 11th
Define thequestionSearch forevidenceAppraisethe qualityInterpretAssessapplicabilityDecisionCPHA 2013Monday June 10thBackground -- Objectives -- Methods -- Results -- ConclusionsSteps of EIDM
Case A Case B Case C• 18 Rapid Reviews• All-staff EIDM trainingprovided• KB facilitated /contributed to CriticalAppraisal Club.• Presentations ofresearch to staffcolleagues & SeniorManagement• 5 questions/reviews• Additional divisionaltraining delivered (e.g.half-day workshops)• Presentations toSenior Management• Abstracts submitted topresent research• 5 questions/reviews• EIDM Policy &Procedure developed& approved• RKEC presentations• All-staff trainingdeliveredTotal ActivitiesBackground -- Objectives -- Methods -- Results -- ConclusionsCPHA 2013Monday June 11th
ResultsEIDM Skills & Knowledge● Improved ability to:Identify where to begin a literature searchApply study results to a given scenarioIdentify strengths/weaknesses of quality assessment● No change (or decline in) ability to:Simply state study results in plain languageJudge the strength of a search strategyInterpret clinical meaningfulness of study resultsBackground -- Objectives -- Methods -- Results -- ConclusionsCPHA 2013Monday June 11th