Demonstrating Research Impact: Measuring Return on Investment with an Impact Framework

Demonstrating Research Impact:
Measuring Return on Investment with
an Impact Framework
Dr. Nancy Carter & Rob Chatwin
Nova Scotia Health Research Foundation
CES National Conference
June 9, 2013
Toronto, Ontario Canada

Workshop Objectives
Understanding of the basic concepts of
impact evaluation
Understanding of CAHS framework
Opportunity to apply the framework

Different Evaluation Needs
Evaluation for
Accountability
Evaluation for
Advocacy
Evaluation for
Learning
Comprehensive
Evaluation
= Our Target
External
audience
Mission
linked
Identify
‘best’

Impact evaluation
Assesses the changes , both the intended and unintended, that
can be attributed to a particular intervention,
Are structured to answer the question:
How would outcomes such as participants’ well-being have
changed if the intervention had not been undertaken?
Seek to answer cause-and-effect questions.
Look for the changes in outcome that are directly attributable to
a program / intervention / policy

What contextual factors matter
when evaluating your program?
How do you define impact in your
context?

Making an Impact
A Preferred Framework and Indicators
to Measure Returns on Investment in Health Research
Full Report available at
http://www.cahs-acss.ca/e/assessments/completedprojects.php
Canadian Academy of Health Sciences
Académie canadienne des sciences de la santé

Why ROI in Health Research?
 )

The Challenge
 Is there a “best way”
(method) to evaluate the
impacts of health research
in Canada & are there ‘best
metrics’ for assessing those
impacts (or improving
them)?
 Useful to a full range of
funders/research types
 Compatible with what is
already in place in Canada
 Transferrable to
international comparisons
 Able to identify the full
spectrum of potential
impacts

Results Chain Logic Framework
CAHS Model Logic Framework

Activities
Produce
Results
That influences
decision making
in …
That affects
something…
That
contributes to
something…
Impact
Logic Frame

Impact Categories
CAHS Framework
Advancing Knowledge
Research Capacity Building
Informing Decision Making
Health Impact
Broad Economic & Social Impacts

USING THE CAHS FRAMEWORK AND INDICATORS

Health Services Research
Health
Industry
Economic
and Social
ProsperityDeterminants of
HealthPublic
Information,
Groups
KnowledgePool
Improvements
in Health and
Well-being
Healthcare
Appropriateness,
Access, etc.
Prevention and
Treatment
Health
Status,
Function,
Well-being,
Economic
Conditions
Initiation and Diffusion of Health Research Impacts
Global
Research
Research
Capacity
Impacts feed back into inputs for future research
Government
Research
Agenda
Interactions/Feedback
ResearchResults
Other
Industries
Advancing
Knowledge
Capacity Building
Informing Decision
Making
Health Benefits
Economic Benefits
Canadian
Health
Research
•Biomedical
•Clinical
•Health
Services
•Population
and Public
Health
•Cross-pillar
Research
42

Appropriate Use of the Framework
understanding the logic model and impact categories
FRAMEWORK Health
R&D
Primary
Outputs/
Dissemination
Secondary
Outputs
Adoption Final
outcomesIMPACT
CATEGORIES
Advancing
Knowledge
• New
molecular
technique
developed
• Publication of research
results in a journal
Research
Capacity
• Research
PhD gained by
team member
• Further research
in Industry
Informing
Decision
Making
• Discussions between
researchers and pharma
define direction of
pharma research
• Pharma company
initiates research
program to
develop a drug
• Drug developed
passed for use by
the health system
Health
Impacts
• Adoption by the
health system
causes increased
cost of drugs
• Decreased re-
admission for
condition
• Reduced
condition burden
in the population
Broad
Economic and
Social Impacts
• Employment in
the pharma
company
• Sales of drugs
by pharma
• Improved
workplace
productivity
• Social and
economic benefit
of “wellness”

FABRIC
Focused
Appropriate
Balanced
Robust
Integrated
Cost-effective

CAHS / NSHRF Impact Evaluation Framework
Research Activity
That produces
results
That Influence
decision making in…
That affect
healthcare, health
risk factors, & other
health determinants
That contribute to
changing health, well-
being & economic and
social prosperity
ResearchResults
KnowledgePool
Consultation&Collaboration
Global Research
Nova Scotia Health
Research
• Bio-medical
• Policy, Services
Outcomes
• Partnership
Programs
• Student
Programs
Nova Scotia
Government
(DHW)
District Health
Authorities
(DHAs)
Nova Scotia
Health
Status and
function,
well-being ,
economic
conditions
Improved Health
of Nova Scotians
Societal &
Economic
Improvements
Universities
Impacts link back into inputs for future research
StrongHealthResearchEnterprise
Public
Vibrant Research
Community
Health Research
ExcellenceNova Scotia
Research Capacity
• REDI
• Knowledge
• Evaluation
External Influences: Interests, Traditions, Technical Limitations, Political dynamics
Foundation for
Informed
Decisions
Workshops,Presentations&Events
Public
Awareness
FundedResearch,Grants,&Awards
Partnerships&Collaborations
LearningOpportunities
InformationProducts&reports
Health
Status and
function,
well-being,
economic
conditions
Impact Framework
Canadian Health Research
Research Capacity
• Health Industry
• Other Industries
• Government
• Research Decision
Making
• The Public, Public
Groups
Health Care
Prevention &
Treatment
Determinants
of Health
Improvements in
health and well-being
(disease prevalence
and burden)
Economic & social
prosperity

Demonstrating Research Impact: Measuring
Return on Investment with an Impact
Framework
PARTICIPANT WORKBOOK
Prepared by: Dr. Nancy Carter, and Mr. Rob Chatwin in collaboration with
the National Alliance of Provincial Health Research
Organizations – Impact Analysis Group (NAPHRO-IAG)

Demonstrating Research Impact: Measuring Return on Investment with an Impact Framework
CES Conference – June 9, 2013
2
INTRODUCTION
This workbook is intended to assist you in applying your learning to your context. The workbook is
aligned to the slide presentation and we encourage you to jot down notes and thoughts as we go
through the workshop.
This workshop could not have been possible without the support of members, of the NAPHRO-IAG
including representatives from:
Newfoundland and Labrador Manitoba
Nova Scotia Saskatchewan
Quebec Alberta
Ontario British Columbia
WORKSHOP OBJECTIVES
The purpose of this workshop is to share our learning in demonstrating impact in a health research
environment. This framework with contextualizing can be used across sectors.
Understanding of the basic concepts of impact evaluation.
Understanding of Canadian Academy of Health Services (CAHS) Framework.
Opportunity to apply the framework to your context
Workshop links to CES Competencies for Canadian Evaluation Practice:
Technical Practice
Situational Practice
Notes:

3
Why Evaluate Impact?
There are many reasons to evaluate. Whether you are working in a program that is being evaluated or
evaluating policy on the environment, it is important to know why you are evaluating.
Question: Think about your context. If you were to conduct an evaluation why would you be
doing it? Write down your thoughts.
There are many reasons why programs, services and policies are evaluated. Each has their own reasons
for being and so are the reasons to evaluate. Generally, reasons for evaluating can be summarized into
three categories
Learning
Advocacy
Accountability

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Example:
NAPHRO-IAG is focused on assessing the impact of funded health research provincially so nationally
NAPHRO can:
advocate for the health research enterprise in Canada and the provinces / territories;
account for our services; and to
learn the best ways to achieve our missions.
Question: Think about your organization – What is/are the evaluation need(s)? Who owns those
needs? Write down your thoughts…
Types of questions that can be asked related to the need for evaluation are listed below.
Accountability: Are we having the impact we said we would have?
Learning: Can our resources be used for greater impact?
Advocacy: Why is our impact important?
With clarity on why you are evaluating, thought must be given to the different ways / methods that can
be used to evaluate the outcomes or impact of the activities.
Evaluation Methods / Approaches / Tools
Econometric approaches and methods are the application of mathematics, statistical methods, and,
more recently, computer science, to economic data and is described as the branch of economics that
aims to give empirical content to economic relations.
Introductory economics textbooks have described econometrics as allowing economists to sift through
mountains of data to extract simple relationships.
Econometrics is the unification of economics, mathematics, and statistics. This unification produces
more than the sum of its parts. Econometrics adds empirical content to economic theory allowing
theories to be tested and used for forecasting and policy evaluation.

5
Bibliometric approaches and methods quantitatively analyze scientific and technological literature. The
term was coined by Alan Pritchard in a paper published in 1969, titled Statistical Bibliography or
Bibliometrics?
He defined the term as "the application of mathematics and statistical methods to books and other
media of communication". Citation analysis and content analysis are commonly used bibliometric
methods. While bibliometric methods are most often used in the field of library and information
science, bibliometrics have wide applications in other areas. In fact, many research fields use
bibliometric methods to explore the impact of their field, the impact of a set of researchers, or the
impact of a particular paper. Bibliometrics are used to quantify research impact.
Performance measurement approaches and methods is the process of collecting, analyzing and/or
reporting information regarding the performance of an individual, group, organization, system or
component. It can involve studying processes/strategies within organizations, or studying engineering
processes/parameters/phenomena, to see whether outputs are in line with what was intended or
should have been achieved.
Question: What performance measures are used in your context?
Logic model approaches and methods which are also known as a logical framework, theory of change,
or program matrix, is a tool used most often by managers and evaluators of programs to describe the
theory underlying a program. Logic models are usually a graphical depiction of the logical relationships
between the resources, activities, outputs and outcomes of a program. While there are many ways in
which logic models can be presented, the underlying purpose of constructing a logic model is to assess
the "if-then" (causal) relationships between the elements of the program. For example: if the resources
are available for a program, then the activities can be implemented, if the activities are implemented
successfully then certain outputs and outcomes can be expected.

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Theory of Change defines all building blocks required to bring about a given long-term goal. This set of
connected building blocks–interchangeably referred to as outcomes, results, accomplishments, or
preconditions is depicted on a map known as a pathway of change/change framework, which is a
graphic representation of the change process.
A Theory of Change would not be complete without an articulation of the assumptions that stakeholders
use to explain the change process represented by the change framework. Assumptions explain both the
connections between early, intermediate and long term outcomes and the expectations about how and
why proposed interventions will bring them about. Often, assumptions are supported by research,
strengthening the case to be made about the plausibility of theory and the likelihood that stated goals
will be accomplished. Stakeholders value theories of change as part of program planning and evaluation
because they create a commonly understood vision of the long-term goals, how they will be reached,
and what will be used to measure progress along the way.
A Theory of Change is a specific and measurable description of a social change initiative that forms the
basis for strategic planning, on-going decision-making and evaluation. The methodology used to create a
Theory of Change is also usually referred to as Theory of Change, or the Theory of Change approach or
method. So, when you hear or say “Theory of Change”, you may mean either the process or the result.
Like any good planning and evaluation method for social change, it requires participants to be clear on
long-term goals, identify measurable indicators of success, and formulate actions to achieve goals.
A Theory of Change provides a roadmap to get you from here to there. If it is good and complete, your
roadmap can be read by others and show that you know how to chart your course. This is helpful with
constituents, staff, partners’ organizations and funders.
More importantly, if it is good and complete, you have the best chance of making the change in the
world you set out to make and of demonstrating your successes and your lessons along the way.
A theory of change should do the following:
Set out the underlying logic of the intervention, specifying each link in the theoretically
predicted causal chain.
Outline the planned program inputs, activities, expected outputs and desired intermediate and
final outcomes
Include possible spill-over effects, both positive and negative.
It should also include
List the potential program participants and all other affected persons, along with the timelines
involved and any indicators being used to monitor change.
Question: What is your programs theory of change?

7
Implementation evaluation approaches and methods are a form of evaluation that focuses on what
happens in a program as it is delivered and documents the extent to which interventions are being
implemented as intended.
Balanced scorecards
The balanced scorecard (BSC) is a strategy performance management tool - a semi-standard structured
report that can be used by programs to keep track of activities by the staff to monitor the consequences
arising from these actions. The BSC concept as put forth by Drs. Robert S. Kaplan and David P. Norton is
now seen as helping organizations articulate strategy in actionable terms. It provides a road map for
strategy execution, for mobilizing and aligning executives and employees, and making strategy a
continual process.
Case studies are a descriptive or explanatory analysis of a person, group or event. An explanatory case
study is used to explore causation in order to find underlying principles. Case studies may be prospective
(in which criteria are established and cases fitting the criteria are included as they become available) or
retrospective (in which criteria are established for selecting cases from historical records for inclusion in
the study).
Another suggestion is that case study should be defined as a research strategy, an empirical inquiry that
investigates a phenomenon within its real-life context. Case study research can mean single and multiple
case studies, can include quantitative evidence, relies on multiple sources of evidence, and benefits
from the prior development of theoretical propositions.
Question: What case studies come to mind for demonstrating impact in your program?
Summary:
It is vitally important that evaluators understand the importance of context and the reason an
evaluation is taking place. In health research, the environment is changing and there is a need for
Provincial Health Research Organizations to understand (learning), communicate (advocacy), and report
(accountability) to continue to support the health research enterprise provincially and nationally.
The reason NAPHRO organizations are evaluating is to assess the impact our funding has had / is having
on the socio-economic wellbeing of our provincial populations – Canadians. We are using multi-
methods in our work. The methods outlined above are some of the ways we are assessing impact.

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Impact Evaluation Concepts
Assessing the impact of social programs and policies is vitally important. We need a way to demonstrate
and report on the relationships between inputs (resources / $’s) and the outputs (the goods and
services provided / produced), and the outcomes or impacts the program / policy / service is having.
There are multiple stakeholders with interest in these relationships.
Impact Evaluation is about how the program / policy / intervention affects the target population, the
intended outcomes, objectives and purpose. Impact Evaluation helps us to answer key questions for
evidence-based policy making: what works, what doesn’t, where, why and for how much? It has
received increasing attention in policy making in recent years in both Western and developing country
contexts.
Originally more oriented towards evaluation of social sector programs in developing countries, notably
conditional cash transfers, impact evaluation is now being increasingly applied in other areas such
government departments of agriculture, energy and transport, health and others.
In contrast to outcome monitoring, which examines whether targets have been achieved, impact
analysis involves a counterfactual analysis that is, a comparison between what actually happened and
what would have happened in the absence of the intervention / program / service.
In other words, impact evaluations look for the changes in outcome that are directly attributable to a
program / service / policy.
Impact Evaluation
Impact evaluation assesses the changes, both the intended and unintended that can be attributed to a
particular intervention. Impact evaluations are structured to answer the question: How would
outcomes such as participants’ well-being have changed if the intervention had not been undertaken?
Impact evaluations seek to answer cause-and-effect questions and look for the changes in outcomes
that are directly attributable to a program / intervention / policy.
Key concepts here are:
Context
Intention
Attribution
Contribution
Counterfactual

9
Context
When doing evaluation it’s important to understand your context - the environment you are working in;
the program you are part of.
Question: What contextual factors matter when evaluating your program?
Question: How do you define impact in your context?

10
Intention relates to what the program intends to bring about. This is usually program outcomes.
Program outcomes a planned yet sometimes, there are unintended consequences
(unanticipated or unforeseen consequences), which are outcomes that were not intended.
Question: Describe the intention of your program.
Attribution aims to assess the amount of change, that can really be attributed to the program
Useful questions to consider include the following:
What is the observed change in outcomes of interest?
To what extent can the observed outcomes be attributed to the intervention in question?
What contextual factors or external influences, such as the social or cultural setting, political or
economic trends, and parallel interventions or other stakeholder actions, are likely to have
influenced outcomes?
If causes or assumptions vary, what alternative causal hypotheses might there be for observed
outcomes?
Questions: What are the challenges for attribution in your context?
What are the confounding factors that have to be considered when making
attributions about your program?

11
Contribution is the degree to which an intervention/program/policy is one of the causes of an observed
change.
Contribution analysis comprises the following successive steps:
1) Set out the cause–effect question(s) which must be addressed.
2) Draw up a carefully reasoned theory of change, identifying potential influencing factors and
outlining the different links in the theory of change and the risks and assumptions associated
with them.
3) Gather existing evidence on the theory of change (i) for observed results, (ii) for each of the
links in the results chain, and (iii) for the other influencing factors.
4) Assemble and assess the contribution story, outlining whether an intervention was
implemented as planned, what the role of external factors was, and whether the predicted
theory of change and expected results occurred.
5) Seek out additional evidence to reinforce the credibility of the contribution story.
6) Revise and strengthen the contribution story.
7) In complex settings, assemble and assess the complex contribution story.
Counterfactual is a comparison between what actually happened and what would have happened in the
absence of the intervention.
Through developing the attribution and contribution story you have developed the counterfactual
comparison.
Example:
As provincial health organizations we have extensive documentation and data to build the attribution
and contribution stories. We know that we contribute to the health research enterprise and we strive
to communicate this to our stakeholders. We use evaluation methods to zero in on the attribution
question: “To what extent can observed / intended outcomes (changes in the health research
enterprise) be attributed to the intervention of funding provincial health research.”
To help NAPHRO members to work together to assess impact the CAHS model was adopted. This allows
us to work provincially yet be able to evaluate in a consistent way to yield information on a national
level. This allows our organization to advocate the benefits of health research.
Question: Can your organization /policy / program develop the impact story?

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Question: What are the challenges you face in demonstrating impact of your program?

13
Making an Impact: A Preferred Framework and Indicators to Measure Returns on Investment in
Health Research
The framework was created in 2004 by the Canadian Academy of Health Sciences (CAHS), a non-profit
charitable organization providing science based information to governments. CAHS uses a unique
collaboration of six health disciplines and the full spectrum of academic health sciences to provide
science based information. This is a collaborative, multidisciplinary body and not an advocacy group.
NAPHRO members participated in the development of the model.
For more information on CAHS go to: http://www.cahs-acss.ca/
The full report available at: http://www.cahs-acss.ca/e/assessments/completedprojects.php
The CAHS Framework was developed for health research due to:
Lack of public understanding of the value of research applicability to current issues in health.
Concern about accessible, affordable, high quality health care in a publicly funded system.
Need to adequately measure & meaningfully convey benefits of health research to policy-
makers & public.
Increasingly common view that health care / health research is a cost-driver consuming an ever
greater share of resources at expense of other sectors.
Concern about expenditure accountability in both the public and private sectors in Canada and
abroad.
Changing and evolving research environment in Canada.
Lack of consensus on how and when to best evaluate return on research expenditures.
Questions from policy makers about tangible results attributable to recent increases in public
investment in health research e.g. CIHR, CFI, CRC programs.
Uncertainty about appropriateness of Canada’s health research expenditures versus those of
analogous contributions in other industrialized countries.
Need to acquire appropriate evidence to strike right funding balance between investigator-
initiated “discovery” & targeted “strategic” health research.
The challenge for CAHS was finding the best way to evaluate the impacts of health research in Canada
that would be useful to a full range of stakeholders, compatible with what was already in place in
Canada, transferrable to international comparisons and be able to identify a full spectrum of potential
impacts.
Some of the complex issues that CAHS faced in developing the framework relate to attribution issues
and the time lags between research activity and impact.

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The CAHS Framework – (refer to Appendix 1 for a larger version)
The framework tells the story of health research and what the intention of health research is. It is based
on a logic frame or results chain and is accompanied by a set of impact indicator categories.
The Logic Model
The traditional logic model of inputs, activities, outputs and outcomes can be mapped to the CAHS
framework.
Question: Does this kind of framework fit for your context? Why or why not?

15
Indicators
Having a framework is only one part of the puzzle. Indicators are needed to facilitate measurement.
An indicator can be defined as something that helps us to understand where we are, where we are going
and how far we are from the goal. Therefore it can be a sign, a number, a graphic and so on. It must be a
clue, a symptom, a pointer to something that is changing. Indicators are presentations of measurements.
They are bits of information that summarize the characteristics of systems or highlight what is happening
in a system.
Question: Think about your program and identify indicators of success.
Impact Categories
The CAHS Framework has identified five impact categories for use with the framework. For each
category, indicators have been grouped in sub categories.

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Impact Category Definitions
Advancing knowledge indicators and metrics include measures of research quality, activity, outreach
and structure. We have also identified some aspirational indicators of knowledge impacts using data
that are highly desirable but currently difficult to collect and/or analyze (such as an expanded
relative‐citation impact that covers a greater range of publications, including book‐to‐book citations and
relative download‐rates per publication compared to a discipline benchmark).
Research capacity‐building indicators and metrics fall into subgroups that represent personnel
(including aspirational indicators for improving receptor and absorptive capacity), additional
research‐activity funding and infrastructure.
Informing decision‐making indicators and metrics represent the pathways from research to its
outcomes in health, wealth and well‐being. They fall into health‐related decision‐making (where health
is broadly defined to include health care, public health, social care, and other health‐related decisions
such as environmental health); research decision‐making (how future health research is directed);
health‐products industry decision‐making; and general public decision‐making. We also provide two
aspirational indicators for this category (media citation analysis and citation in public policy
documents).
Health‐impact indicators and metrics include those on health status, determinants of health and
health‐system changes, and they include quality of life as an important component of improved health.
Determinants of health indicators can be further classified into three major subcategories: modifiable
risk factors, environmental determinants, and modifiable social determinants.
Broad economic and social impacts are classified into activity, commercialization, health benefit
(specific costs of implementing research findings in the broad health system), well-being, and social-
benefit indicators (socio-economic benefits)
Notes:

17
CAHS Model Example Indicators:
Advancing knowledge
Categories Indicator Description
Quality Relative citation impact Compares the citation rate with the relevant world
average.
Activity Publication counts Simple counting of outputs that can be useful for new
researchers who have no publication record to allow for
citation analysis.
Outreach Co-author analysis Determining the proportion of publications that are co-
authored internationally, nationally, with industry and
other disciplines.
Contextual
Structural
Relative Activity Index Determining the fields of research in which a unit is
most strongly focused.
Aspirational Research Diffusion Based on end-of-grant reports on uptake of research.
Research capacity‐building
Personnel Numbers of research and
research-related staff in
Canada
Generally broken down in to researchers, research
assistants and other staff.
Funding Levels of additional
research funding
Funding from external sources that can be attributed to
the capacity built in an organization.
Infrastructure Grants ($) The amount of dollars of infrastructure funding pulled
in by a research project.
Aspirational Receptor capacity The ability of those in policy and administrative
positions to take research findings and use them
program and policy development.
Informing decision‐making
Health Related Use of research in guidelines Analyzing citations to research in clinical and service
guidelines
Research
Related
Requests for research to
support policy
Requests for jurisdictional reviews, literature reviews,
best practices
Health
Products
Consulting to Industry Number of researchers approached

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Industry
General Public Public Lectures given Lectures given to public audiences
Aspirational Media citation analysis Analyzing mentions of research in newspapers
Health‐impact
Health Status Morbidity
Mortality
Quality-adjusted mortality
Prevalence & Incidence
PYLL – Potential Years Life Lost
QALYs – Quality Adjusted Life Years
Determinants
of Health
Modifiable risk factors
Social determinants
Environmental determinants
Smoking, driving habits
Education levels, social cohesion
Air pollution levels
Determinants
of Health
Services
Acceptability
Accessibility
Appropriateness
Competence
Continuity
Effectiveness
Efficiency
Safety
Self-reported patient satisfaction
Wait times
Adherence of clinical guidelines
Civil law suits against the health system
Self-reported continuity
Admission / discharge rates
Actual vs. expected length of stay
Hospital acquired infections
Broad economic and social impacts
Activity Economic rent The economic benefits (in $) of employing people in
health research rather than in another capacity.
Commercialization Licensing returns ($) Dollars spent on licensing patents held by
organizations / individuals.
Health Benefit Health benefits in QALYs
per health care dollar
Improvements in health measured through QALYs
gained and divided by the cost of achieving that
health gain.
Well-being Happiness As measured using established survey techniques for
happiness – depression.
Social Benefits Socio-economic status Identifying the socio-economic status of individuals in
Canada.

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Using the CAHS Framework and Indicators - Refer to Appendix 2, 3, 4
Define and prioritize specific evaluation question(s).
Use the framework to determine where to look for impacts
Based on question(s) choose the impact categories (and subcategories) of interest: advancing
knowledge, capacity building, informing decision making, health impacts, and broad economic and
social impacts.
Be as specific as possible about where impacts are expected to occur and at what level (individual,
group, institution, and provincial, federal, international).
Choose (or develop) attractive and feasible indicators and metrics from the appropriate categories
of interest that will address the evaluation questions at the right level
Choose sets of indicators that are appropriate.
Indicators vs. Metrics
Indicators ‘indicate’ impact; they do not attempt to quantify that impact
Metrics are ‘numeric indicators’; they allow putting some numbers on impact
A combination of indicators and metrics are recommended
FABRIC – Use the FABRIC Acronym to consider your indicators. Indicators should be:
Focused on the organization’s objectives that will use them
Appropriate for the stakeholders who are likely to use the information
Balanced to cover all significant areas of work performed by an organization
Robust enough to cope with organizational changes (such as staff changes)
Integrated into management processes
Cost-effective (balancing the benefits of the information against collection costs)
Attractiveness and Feasibility
Attractiveness:
Validity – does the indicator or metric reasonably reflect the underlying concept or construct
that it is intended to measure?
Relevance – does the indicator or metric relate directly to a critical aspect of the research?
Behavioural impact – does the indicator or metric drive behaviour in a particular direction? Is it
likely to result in any negative, unintended consequences? Does it create “perverse incentives?”
Transparency – is the methodology, and are the strengths and weaknesses relating to the
indicator or metric, readily apparent?
Coverage – does the indicator or metric cover a large proportion of output from research to be
assessed?
Recency – do the data relate to current research performance, or look over a longer timescale?

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Methodological soundness – is the calculation of the metric sound and statistically robust?
Replicability – can others reproduce the indicator or metric, and can it be used year on year in a
comparable fashion?
Comparability – do other organizations collect comparable information or have targets to
benchmark against?
Feasibility:
Data availability ‐ do the data required to derive indicators or metrics exist, and do both the
analysts and those being assessed have access to it?
Cost of data – how expensive is it to purchase the data outright or obtain on license?
Compliance costs – how labour intensive is it to extract/obtain the data?
Timeliness – can the data be obtained / provided relatively quickly?
Attribution – can the data be discretely ascribed to the unit being assessed? Direct attribution is
ideal, but unlikely given current knowledge and methods; using attribution as a concept is
important, as it provides a link between the impact seen and the research.
Avoids gamesmanship – does the indicator or metric provide scope for special interest groups or
individuals to game the system?
Interpretation – can the data be open to misinterpretation or misuse by commentators and/or
actors using the evaluation findings?
Well‐defined – does the metric have a clear, unambiguous definition so that data will be collected
consistently, and so that the measure is easy to understand and use?
Notes:

21
Some of the resources used to develop this workshop:
Canadian Association of Health Services (2009). “Making and Impact: A Preferred Framework and
Indicators to Measure Returns on Investment in Health Research”. Report of the Panel on
Investments in Health Research.
Scriven, M. (2008). "A Summative Evaluation of RCT Methodology: & An Alternative Approach to Causal
Research." Journal of MultiDisciplinary Evaluation 5(9): 11-24. Available at
http://survey.ate.wmich.edu/jmde/index.php/jmde_1/article/view/160/186
Mayne, J. (ed) (2012). Contribution Analysis: Coming of Age? Evaluation, Special Issue, 18(3), 270-280
Mayne, J. (2008). Contribution Analysis: An Approach to Exploring Cause and Effect, ILAC Brief 16.
Available at http://www.cgiar-
ilac.org/files/publications/briefs/ILAC_Brief16_Contribution_Analysis.pdf
Mayne, J. (2012). Making Causal Claims, ILAC Brief No. 26: The Institutional Learning and Change
Initiative. Available at http://www.cgiar-
ilac.org/files/publications/mayne_making_causal_claims_ilac_brief_26.pdf
Mayne, J. (2011). Contribution Analysis: Addressing Cause and Effect. Evaluating the Complex. R.
Schwartz, K. Forss and M. Marra, Eds, Transaction Publishers: 53-96.
Wikipedia and Google search for Impact evaluation concepts and theories
If you have questions or comments and want to get in touch with either Nancy or Rob please contact
via email at:
Nancy.Carter@gov.ns.ca
Robert.Chatwin@gov.ns.ca

Demonstrating Research Impact:
Measuring Return on Investment
with an Impact Framework
Workbook Appendices

Health Services Research
Health
Industry
Economic
and Social
ProsperityDeterminants of
HealthPublic
Information,
Groups
KnowledgePool
Improvements
in Health and
Well-being
Healthcare
Appropriateness,
Access, etc.
Prevention and
Treatment
Health
Status,
Function,
Well-being,
Economic
Conditions
Global
Research
Research
Capacity
Impacts feed back into inputs for future research
Government
Research
Agenda
Interactions/Feedback
ResearchResults
Other
Industries
Advancing
Knowledge
Capacity Building
Informing Decision
Making
Health Benefits
Economic Benefits
Canadian
Health
Research
•Biomedical
•Clinical
•Health
Services
•Population
and Public
Health
•Cross-pillar
Research
42
Appendix 2

Appropriate Use of the Framework
understanding the logic model and impact categories
FRAMEWORK Health
R&D
Primary
Outputs/
Dissemination
Secondary
Outputs
Adoption Final
outcomesIMPACT
CATEGORIES
Advancing
Knowledge
• New
molecular
technique
developed
• Publication of research
results in a journal
Research
Capacity
• Research
PhD gained by
team member
• Further research
in Industry
Informing
Decision
Making
• Discussions between
researchers and pharma
define direction of
pharma research
• Pharma company
initiates research
program to
develop a drug
• Drug developed
passed for use by
the health system
Health
Impacts
• Adoption by the
health system
causes increased
cost of drugs
• Decreased re-
admission for
condition
• Reduced
condition burden
in the population
Broad
Economic and
Social Impacts
• Employment in
the pharma
company
• Sales of drugs
by pharma
• Improved
workplace
productivity
• Social and
economic benefit
of “wellness”
Appendix 3
Activities Outputs Outcomes Impact

Appendix 4: Using the Framework – understanding the logic model and impact categories
Framework Activities Produce Results That influences
decision
making in…
That affects
something
That
contributes to
something…
Impact
Categories

Appendix 5: CAHS / NSHRF Impact Evaluation Framework
Research Activity
That produces
results
That Influence
That affect
healthcare, health
risk factors, & other
health determinants
That contribute to
changing health, well-
being & economic and
social prosperity
ResearchResults
KnowledgePool
Consultation&Collaboration
Global Research
Nova Scotia Health
Research
• Bio-medical
• Policy, Services
Outcomes
• Partnership
Programs
• Student
Programs
Nova Scotia
Government
(DHW)
District Health
Authorities
(DHAs)
Nova Scotia
Health
Status and
function,
well-being ,
economic
conditions
Improved Health
of Nova Scotians
Societal &
Economic
Improvements
Universities
Impacts link back into inputs for future research
StrongHealthResearchEnterprise
Public
Vibrant Research
Community
Health Research
ExcellenceNova Scotia
Research Capacity
• REDI
• Knowledge
• Evaluation
Foundation for
Informed
Decisions
Workshops,Presentations&Events
Public
Awareness
FundedResearch,Grants,&Awards
Partnerships&Collaborations
LearningOpportunities
InformationProducts&reports
Health
Status and
function,
well-being,
economic
conditions
Impact Framework
Canadian Health Research
Research Capacity
• Health Industry
• Other Industries
• Government
• Research Decision
Making
• The Public, Public
Groups
Health Care
Prevention &
Treatment
Determinants
of Health
Improvements in
health and well-being
(disease prevalence
and burden)
Economic & social
prosperity

Appendix 6: Framework Worksheet
Activity
That produces
results
That Influence
That affects…… That contributes to …Context

Activity
That produces
results
That Influence
That affect…… That contribute to …
Initiation and Diffusion of…
Impacts link back into inputs for …
Impact Framework
Appendix 7: Framework Worksheet

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