Research outcomes informing the selection of public health interventions and strategies to implement them: A cross-sectional survey of Australian policy-maker and practitioner preferences.

BACKGROUND: A key role of public health policy-makers and practitioners is to ensure beneficial interventions are implemented effectively enough to yield improvements in public health. The use of evidence to guide public health decision-making to achieve this is recommended. However, few studies have examined the relative value, as reported by policy-makers and practitioners, of different broad research outcomes (that is, measures of cost, acceptability, and effectiveness). To guide the conduct of research and better inform public health policy and practice, this study aimed at describing the research outcomes that Australian policy-makers and practitioners consider important for their decision-making when selecting: (a) public health interventions; (b) strategies to support their implementation; and (c) to assess the differences in research outcome preferences between policy-makers and practitioners. METHOD: An online value-weighting survey was conducted with Australian public health policy-makers and practitioners working in the field of non-communicable disease prevention. Participants were presented with a list of research outcomes and were asked to select up to five they considered most critical to their decision-making. They then allocated 100 points across these - allocating more points to outcomes perceived as more important. Outcome lists were derived from a review and consolidation of evaluation and outcome frameworks in the fields of public health knowledge translation and implementation. We used descriptive statistics to report relative preferences overall and for policy-makers and practitioners separately. RESULTS: Of the 186 participants; 90 primarily identified as policy-makers and 96 as public health prevention practitioners. Overall, research outcomes of effectiveness, equity, feasibility, and sustainability were identified as the four most important outcomes when considering either interventions or strategies to implement them. Scores were similar for most outcomes between policy-makers and practitioners. CONCLUSION: For Australian policy-makers and practitioners working in the field of non-communicable disease prevention, outcomes related to effectiveness, equity, feasibility, and sustainability appear particularly important to their decisions about the interventions they select and the strategies they employ to implement them. The findings suggest researchers should seek to meet these information needs and prioritize the inclusion of such outcomes in their research and dissemination activities. The extent to which these outcomes are critical to informing the decision of policy-makers and practitioners working in other jurisdictions or contexts warrants further investigation.

Disseminating health research to public health policy-makers and practitioners: a survey of source, message content and delivery modality preferences.

BACKGROUND: Understanding the views of policy-makers and practitioners regarding how best to communicate research evidence is important to support research use in their decision-making. AIM: To quantify and describe public health policy-makers and practitioners' views regarding the source, content and form of messages describing public health research findings to inform their decision-making. We also sought to examine differences in preferences between public health policy-makers and practitioners. METHODS: A cross sectional, value-weighting survey of policy-makers and practitioners was conducted. Participants were asked to allocate a proportion of 100 points across different (i) sources of research evidence, (ii) message content and (iii) the form in which evidence is presented. Points were allocated based on their rating of influence, usefulness and preference when making decisions about health policy or practice. RESULTS: A total of 186 survey responses were received from 90 policy-makers and 96 practitioners. Researchers and government department agencies were the most influential source of research evidence based on mean allocation of points, followed by knowledge brokers, professional peers and associations. Mean point allocation for perceived usefulness of message content was highest for simple summary of key findings and implications, and then evidence-based recommendations and data and statistical summaries. Finally, based on mean scores, policy-makers and practitioners preferred to receive research evidence in the form of peer-reviewed publications, reports, evidence briefs and plain language summaries. There were few differences in scores between policy-makers and practitioners across source, message content or form assessments or those with experience in different behavioural areas. CONCLUSIONS: The findings should provide a basis for the future development and optimization of dissemination strategies to this important stakeholder group.

Increased use of knowledge translation strategies is associated with greater research impact on public health policy and practice: an analysis of trials of nutrition, physical activity, sexual health, tobacco, alcohol and substance use interventions.

BACKGROUND: Greater use of knowledge translation (KT) strategies is recommended to improve the research impact of public health trials. The purpose of this study was to describe (1) the research impact of setting-based public health intervention trials on public health policy and practice; (2) the association between characteristics of trials and their research impact on public health policy and practice; and (3) the association between the use of KT strategies and research impacts on public health policy and practice. METHODS: We conducted a survey of authors of intervention trials targeting nutrition, physical activity, sexual health, tobacco, alcohol or substance use. We assessed the use of KT strategies aligned to domains of the Knowledge-To-Action Framework. We defined "research impact" on health policy and practice as any one or more of the following: citation in policy documents or announcements, government reports, training materials, guidelines, textbooks or court rulings; or endorsement by a (non)governmental organization; use in policy or practice decision-making; or use in the development of a commercial resource or service. RESULTS: Of the included trials, the authors reported that 65% had one or more research impacts. The most frequently reported research impact was citation in a policy document or announcement (46%). There were no significant associations between the effectiveness of the intervention, trial risk of bias, setting or health risk and trial impact. However, for every one unit increase in the total KT score (range 0-8), reflecting greater total KT activity, the odds of a health policy or practice research impact increased by approximately 30% (OR = 1.30, 95% CI: 1.02, 1.66; p = 0.031). Post hoc examination of KT domain scores suggests that KT actions focused on providing tailored support to facilitate program implementation and greater use of research products and tools to disseminate findings to end-users may be most influential in achieving impact. CONCLUSIONS: Trials of public health interventions frequently have public health impacts, and the use of more comprehensive KT strategies may facilitate greater research impact.

How to optimise public health interventions: a scoping review of guidance from optimisation process frameworks.

BACKGROUND: Optimisation processes have the potential to rapidly improve the impact of health interventions. Optimisation can be defined as a deliberate, iterative and data-driven process to improve a health intervention and/or its implementation to meet stakeholder-defined public health impacts within resource constraints. This study aimed to identify frameworks used to optimise the impact of health interventions and/or their implementation, and characterise the key concepts, steps or processes of identified frameworks. METHODS: A scoping review of MEDLINE, CINAL, PsycINFO, and ProQuest Nursing & Allied Health Source databases was undertaken. Two reviewers independently coded the key concepts, steps or processes involved in each frameworks, and identified if it was a framework aimed to optimise interventions or their implementation. Two review authors then identified the common steps across included frameworks. RESULTS: Twenty optimisation frameworks were identified. Eight frameworks were for optimising interventions, 11 for optimising implementation and one covered both intervention and implementation optimisation. The mean number of steps within the frameworks was six (range 3-9). Almost half (n = 8) could be classified as both linear and cyclic frameworks, indicating that some steps may occur multiple times in a single framework. Two meta-frameworks are proposed, one for intervention optimisation and one for implementation strategy optimisation. Steps for intervention optimisation are: Problem identification; Preparation; Theoretical/Literature base; Pilot/Feasibility testing; Optimisation; Evaluation; and Long-term implementation. Steps for implementation strategy optimisation are: Problem identification; Collaborate; Plan/design; Pilot; Do/change; Study/evaluate/check; Act; Sustain/endure; and Disseminate/extend. CONCLUSIONS: This review provides a useful summary of the common steps followed to optimise a public health intervention or its implementation according to established frameworks. Further opportunities to study and/or validate such frameworks and their impact on improving outcomes exist.

"He who pays the piper calls the tune": Researcher experiences of funder suppression of health behaviour intervention trial findings.

BACKGROUND: Governments commonly fund research with specific applications in mind. Such mechanisms may facilitate 'research translation' but funders may employ strategies that can also undermine the integrity of both science and government. We estimated the prevalence and investigated correlates of funder efforts to suppress health behaviour intervention trial findings. METHODS: Our sampling frame was lead or corresponding authors of papers (published 2007-2017) included in a Cochrane review, reporting findings from trials of interventions to improve nutrition, physical activity, sexual health, smoking, and substance use. Suppression events were based on a previous survey of public health academics. Participants answered questions concerning seven suppression events in their efforts to report the trial, e.g., [I was…] "asked to suppress certain findings as they were viewed as being unfavourable." We also examined the association between information on study funder, geographical location, targeted health behaviour, country democracy rating and age of publication with reported suppression. FINDINGS: We received responses from 104 authors (50%) of 208 eligible trials, from North America (34%), Europe (33%), Oceania (17%), and other countries (16%). Eighteen percent reported at least one of the seven suppression events relating to the trial in question. The most commonly reported suppression event was funder(s) expressing reluctance to publish because they considered the results 'unfavourable' (9% reported). We found no strong associations with the subject of research, funding source, democracy, region, or year of publication. CONCLUSIONS: One in five researchers in this global sample reported being pressured to delay, alter, or not publish the findings of health behaviour intervention trials. Regulation of funder and university practices, establishing study registries, and compulsory disclosure of funding conditions in scientific journals, are needed to protect the integrity of public-good research.