The document discusses moving Canada's public health system toward being more evidence-based. It outlines barriers to and facilitators of evidence-based decision making. It also describes the development of an online resource called health-evidence.ca to help decision makers access and apply research evidence more easily. Focus groups provided input that was used to design the site, which will be evaluated in a 3-year study to quantitatively measure the impact of knowledge transfer strategies.

1. Moving Toward an Evidence-Based
Public Health System in Canada
Maureen Dobbins RN, PhD, Kara DeCorby, MSc,
Donna Ciliska, RN, PhD, Helen Thomas, RN, MSc,
and the Knowledge Transfer Research Team
Translating Research into Practice
July 14, 2004

2. Setting the Scene
• Knowledge transfer from a theoretical perspective
• Findings from current studies
• Looking to the present and future
• Strategic planning for progress
Translating Research into Practice
July 14, 2004

3. Knowledge Transfer and Uptake Framework
Knowledge Persuasion Decision Implementation Confirmation
Research Evidence-based Research Outcomes
Dissemination Decision-making Utilization
Innovation
characteristics
Dissemination type of decision
strategies
values/beliefs
Individual evidence
Organizational
characteristics culture
characteristics
decision-making style
type of innovation
Environmental
characteristics
Translating Research into Practice
July 14, 2004

4. Barriers to Evidence Based Decision Making
• Time
• Availability of research results
• Resources to implement research findings
• Relevance
• Timeliness (having research when needed)
(Ciliska et al, 1999)
Translating Research into Practice
July 14, 2004

5. Facilitators of Evidence Based Decision Making
Systematic reviews overcome barriers
• Time (82%)
• Timeliness (62%)
• Relevance (46%)
• Availability of research results (30%)
• Resources to implement research (22%)
Translating Research into Practice
July 14, 2004
(Ciliska et al, 1999)

6. Facilitators (cont’d)
Significant Predictors of Use
• Position in organization
• Critical appraisal skills
• Reviews easy to use
• Expectation to use reviews in future
(Dobbins et al, 2001)
Translating Research into Practice
July 14, 2004

7. Other Important Characteristics
• Perception that research is relevant to decisions
• Perception that the organization values the use of
research evidence
• Routine reading of the literature
• Overcome issues of time
(Dobbins et al, 2001)
Translating Research into Practice
July 14, 2004

8. Questions for target users:
• What are decision makers’ preferences for receiving
research evidence?
• How can we promote use and overcome barriers to
use?
• How can ownership of knowledge be distributed
amongst users?
Translating Research into Practice
July 14, 2004

9. Sample
• Canadian public health and health promotion
decision makers:
• CMOHs and MOHs
• Program managers/directors/coordinators
• Federal and provincial/territorial government
decision makers
• Executive directors, program/project
coordinators in NGOs
Translating Research into Practice
July 14, 2004

10. Results (interviews)
• 54 Decision-makers
• Representation from most provinces/territories
• Representation from all decision-making levels
Translating Research into Practice
July 14, 2004

11. User’s Preferences
• Short summaries
• Access to full document
• Divided on issue of hard copy vs. electronic
• Commentary, and rating of methodological quality
• Need practical, implementation-related information
• E-mailed updates
• Interest in being able to indicate areas of interest so
that only relevant research is received
Translating Research into Practice
July 14, 2004

12. Challenges faced by decision makers:
“I don’t need to hear a lot about what further research needs to be
done or a lot of tentativeness. I have to make decisions today...I
think that reality has to be taken into account when research
findings are presented to decision makers...It simply doesn’t help
me to know all of the problems.”
“we’re flooded with information. The information age has meant a
lot in information and so absolutely anything that is done needs an
executive summary and provide the information in a short and
sweet format and it needs to be very clear.”
Translating Research into Practice
July 14, 2004

13. Designing and Testing a Strategy:
• Incorporation of decision makers’ preferences
• Consultation with marketing and graphic design
firm
• Distribution to focus group participants
Translating Research into Practice
July 14, 2004

14. Overview of focus groups:
• 9 focus groups in 7 Canadian cities: Halifax, Montreal,
Ottawa, Winnipeg, Calgary, Edmonton, Vancouver, Oct 2002 -
Jan 2003
• 5-7 participants
• Range of decision making levels
• Semi-structured interview guide
• Audiotaped sessions with interview notes
Translating Research into Practice
July 14, 2004

15. What decision makers liked most:
• Length, writing style, plain language use
• Could pass it on without having to ‘translate’
• 2-page synthesis of each review
• Issue framed in a Canadian context
• Implications spelled out
• Contact information for asking questions
Translating Research into Practice
July 14, 2004

16. Main theme - Time
Key features: Challenges:
– credibility – information management
– high quality design – skill building
– customizability – list serves not universally
– applicability appealing
– timeliness
– reliability & consistency
– accessibility
Translating Research into Practice
July 14, 2004

17. High Quality Design
Content Format
• current • well-written
• all info dated • concise
• jargon-free • understandable to all
• transparent • well-organized
• + and - findings • lends itself to quick visual
• ranked by strength scanning
• cost data
• Canadian
Translating Research into Practice
July 14, 2004

18. Products:
• Online resource to be launched in September 2004 as
an interactive web site
URL: www.health-evidence.ca
web site is part of a multi-component strategy for
– Knowledge translation
– Supporting users in accessing and interpreting research
evidence
– Facilitating connections among users
– Facilitating connection between researchers and users
Translating Research into Practice
July 14, 2004

19. Implications:
• Opportunities to receive updates of new research in a
program area
• Contact information for authors and document links where
available
• Venue to facilitate online communities of practice
Translating Research into Practice
July 14, 2004

20. Translating Research into Practice
July 14, 2004

21. Translating Research into Practice
July 14, 2004

22. Translating Research into Practice
July 14, 2004

23. Translating Research into Practice
July 14, 2004

24. Translating Research into Practice
July 14, 2004

25. Next Steps:
• maintain and market the online registry
• refine the site’s functionality and locate and reach potential
users
• a 3-year, CIHR-funded RCT evaluating effectiveness of
knowledge transfer strategies among public health and health
promotion decision makers across Canada
• First evaluation of its kind in Canada to evaluate
quantitatively the impact of a knowledge broker
Translating Research into Practice
July 14, 2004