Developing an online knowledge sharing platform and community of practice for health professionals: Experiences from C-WorKS developed in North East England and Yorkshire during COVID-19.

BACKGROUND: Although knowledge sharing online has been recognised as an important strategy for health professionals to apply research findings to their practice, limited research exists on how to develop and implement these platforms to help facilitate collaboration and knowledge sharing. OBJECTIVES: This study evaluated an online knowledge sharing platform and community of practice developed in the North East of England and Yorkshire during COVID-19 to support UK health and care professionals to reduce the impact of the wider consequences of COVID-19. METHODS: Semi-structured interviews with stakeholders (n = 8) and users of C-WorKS (n = 13), followed by an online survey (n = 19) among a wider group of users to analyse knowledge use. RESULTS: Interview and survey findings highlighted several strengths, weaknesses, opportunities and threats to support future development of online knowledge sharing platforms. DISCUSSION: Online knowledge sharing supports six 'pillars' of successful research and innovation partnerships. This requires distributed forms of leadership and linking of different knowledge sharing strategies, and careful combination of platforms with communities of practice. CONCLUSION: Online knowledge sharing provides pragmatic and timely strategies for health professionals in the UK to apply research evidence to their practice. Our study provides generalisable, practical insights in how to develop and implement a knowledge sharing platform.

Leading co-production in five UK collaborative research partnerships (2008-2018): responses to four tensions from senior leaders using auto-ethnography.

BACKGROUND: Despite growing enthusiasm for co-production in healthcare services and research, research on co-production practices is lacking. Multiple frameworks, guidelines and principles are available but little empirical research is conducted on 'how to do' co-production of research to improve healthcare services. This paper brings together insights from UK-based collaborative research partnerships on leading co-production. Its aim is to inform practical guidance for new partnerships planning to facilitate the co-production of applied health research in the future. METHODS: Using an auto-ethnographic approach, experiential evidence was elicited through collective sense making from recorded conversations between the research team and senior leaders of five UK-based collaborative research partnerships. This approach applies a cultural analysis and interpretation of the leaders' behaviours, thoughts and experiences of co-production taking place in 2008-2018 and involving academics, health practitioners, policy makers and representatives of third sector organisations. RESULTS: The findings highlight a variety of practices across CLAHRCs, whereby the intersection between the senior leaders' vision and local organisational context in which co-production occurs largely determines the nature of co-production process and outcomes. We identified four tensions in doing co-production: (1) idealistic, tokenistic vs realistic narratives, (2) power differences and (lack of) reciprocity, (3) excluding vs including language and communication, (4) individual motivation vs structural issues. CONCLUSIONS: The tensions were productive in helping collaborative research partnerships to tailor co-production practices to their local needs and opportunities. Resulting variation in co-production practices across partnerships can therefore be seen as highly advantageous creative adaptation, which makes us question the utility of seeking a unified 'gold standard' of co-production. Strategic leadership is an important starting point for finding context-tailored solutions; however, development of more distributed forms of leadership over time is needed to facilitate co-production practices between partners. Facilitating structures for co-production can enable power sharing and boost capacity and capability building, resulting in more inclusive language and communication and, ultimately, more credible practices of co-production in research. We provide recommendations for creating more realistic narratives around co-production and facilitating power sharing between partners.

Co-production practice and future research priorities in United Kingdom-funded applied health research: a scoping review.

BACKGROUND: Interest in and use of co-production in healthcare services and research is growing. Previous reviews have summarized co-production approaches in use, collated outcomes and effects of co-production, and focused on replicability and reporting, but none have critically reflected on how co-production in applied health research might be evolving and the implications of this for future research. We conducted this scoping review to systematically map recent literature on co-production in applied health research in the United Kingdom to inform co-production practice and guide future methodological research. METHODS: This scoping review was performed using established methods. We created an evidence map to show the extent and nature of the literature on co-production and applied health research, based on which we described the characteristics of the articles and scope of the literature and summarized conceptualizations of co-production and how it was implemented. We extracted implications for co-production practice or future research and conducted a content analysis of this information to identify lessons for the practice of co-production and themes for future methodological research. RESULTS: Nineteen articles reporting co-produced complex interventions and 64 reporting co-production in applied health research met the inclusion criteria. Lessons for the practice of co-production and requirements for co-production to become more embedded in organizational structures included (1) the capacity to implement co-produced interventions, (2) the skill set needed for co-production, (3) multiple levels of engagement and negotiation, and (4) funding and institutional arrangements for meaningful co-production. Themes for future research on co-production included (1) who to involve in co-production and how, (2) evaluating outcomes of co-production, (3) the language and practice of co-production, (4) documenting costs and challenges, and (5) vital components or best practice for co-production. CONCLUSION: Researchers are operationalizing co-production in various ways, often without the necessary financial and organizational support required and the right conditions for success. We argue for accepting the diversity in approaches to co-production, call on researchers to be clearer in their reporting of these approaches, and make suggestions for what researchers should record. To support co-production of research, changes to entrenched academic and scientific practices are needed. Protocol registration details: The protocol for the scoping review was registered with protocols.io on 19 October 2021: https://dx.doi.org/10.17504/protocols.io.by7epzje .

What makes a 'successful' collaborative research project between public health practitioners and academics? A mixed-methods review of funding applications submitted to a local intervention evaluation scheme.

BACKGROUND: The national Public Health Practice Evaluation Scheme (PHPES) is a response-mode funded evaluation programme operated by the National Institute for Health Research School for Public Health Research (NIHR SPHR). The scheme enables public health professionals to work in partnership with SPHR researchers to conduct rigorous evaluations of their interventions. Our evaluation reviewed the learning from the first five years of PHPES (2013-2017) and how this was used to implement a revised scheme within the School. METHODS: We conducted a rapid review of applications and reports from 81 PHPES projects and sampled eight projects (including unfunded) to interview one researcher and one practitioner involved in each sampled project (n = 16) in order to identify factors that influence success of applications and effective delivery and dissemination of evaluations. Findings from the review and interviews were tested in an online survey with practitioners (applicants), researchers (principal investigators [PIs]) and PHPES panel members (n = 19) to explore the relative importance of these factors. Findings from the survey were synthesised and discussed for implications at a national workshop with wider stakeholders, including public members (n = 20). RESULTS: Strengths: PHPES provides much needed resources for evaluation which often are not available locally, and produces useful evidence to understand where a programme is not delivering, which can be used to formatively develop interventions. Weaknesses: Objectives of PHPES were too narrowly focused on (cost-)effectiveness of interventions, while practitioners also valued implementation studies and process evaluations. Opportunities: PHPES provided opportunities for novel/promising but less developed ideas. More funded time to develop a protocol and ensure feasibility of the intervention prior to application could increase intervention delivery success rates. Threats: There can be tensions between researchers and practitioners, for example, on the need to show the 'success' of the intervention, on the use of existing research evidence, and the importance of generalisability of findings and of generating peer-reviewed publications. CONCLUSIONS: The success of collaborative research projects between public health practitioners (PHP) and researchers can be improved by funders being mindful of tensions related to (1) the scope of collaborations, (2) local versus national impact, and (3) increasing inequalities in access to funding. Our study and comparisons with related funding schemes demonstrate how these tensions can be successfully resolved.

Co-production in local government: process, codification and capacity building of new knowledge in collective reflection spaces. Workshops findings from a UK mixed methods study.

BACKGROUND: Co-production of research evidence is valued by local government to improve effective decision-making about public services in times of austerity. However, underlying structural issues of power (so-called 'dark shadows of co-production') challenge this ambition with limited evidence on how to embed research use sustainably. In this paper we reflect on mechanisms for increasing co-production in local government. METHODS: This paper presents findings from a Health Foundation funded research project that explored how a culture of evidence use to improve population health could be embedded in UK local government. Five linked work packages were undertaken using mixed methods. In this paper, we report the views of UK local authority staff who participated in four workshops (n = 54), informed by a rapid literature review and an online scoping survey. RESULTS: We identified five themes that facilitate public health evidence use in local government: (1) new governance arrangements to integrate national and local policies, (2) codifying research evidence through local system-wide approaches and (3) ongoing evaluation of programmes, and (4) overcoming political and cultural barriers by increasing absorptive capacity of Local Authorities to embed co-produced knowledge in their cognitive structures. This requires adaptive governance through relationship building between academic researchers and Local Authority staff and shared understanding of fragmented local policy making, which are supported by (5) collective spaces for reflection within local government. CONCLUSIONS: Creating collective spaces for reflection in between government departments allows for iterative, interactive processes of co-production with external partners that support emergence of new governance structures to socially action the co-produced knowledge in context and build capacity for sustained evidence use.

Challenges, opportunities and solutions for local physical activity stakeholders: an implementation case study from a cross-sectoral physical activity network in Northeast England.

BACKGROUND: Increasingly, national policy initiatives and programmes have been developed to increase physical activity (PA). However, challenges in implementing and translating these policies into effective local-level programmes have persisted, and change in population PA levels has been small. This may be due to insufficient attention given to the implementation context, and the limited interactions between local policy-makers, practitioners and researchers. In this paper we use a case study of a cross-sectoral network in Northeast England, to identify the local-level challenges and opportunities for implementing PA policies and programmes, particularly the updated 2019 UK PA guidelines. METHODS: Five focus groups (n = 59) were conducted with practice partners, local policy-makers and researchers during an initial workshop in April 2018. Through facilitated discussion, participants considered regional priorities for research and practice, along with barriers to implementing this agenda and how these may be overcome. During a second workshop in December 2018, overarching findings from workshop one were fedback to a similar group of stakeholders, along with national policy-makers, to stimulate feedback from delegates on experiences that may support the implementation of the UK PA guidelines locally, focusing on specific considerations for research, evidence and knowledge exchange. RESULTS: In workshop one, three overarching themes were developed to capture local challenges and needs: (i) understanding complexity and context; (ii) addressing the knowledge and skills gap; and (iii) mismatched timescales and practices. In workshop two, participants' implementation plans encompassed: (i) exploring a systems approach to implementation; (ii) adapting policy to context; and (iii) local prioritising. CONCLUSIONS: Our findings suggest that academics, practitioners and policy-makers understand the complexities of implementing PA strategies, and the challenges of knowledge exchange. The updated UK PA guidelines policy presented an opportunity for multiple agencies to consider context-specific implementation and address enduring tensions between stakeholders. An organically derived implementation plan that prioritises PA, maps links to relevant local policies and supports a context-appropriate communication strategy, within local policy, practice and research networks, will help address these. We present 10 guiding principles to support transferable knowledge exchange activities within networks to facilitate implementation of national PA policy in local contexts.

Performing collaborative research: a dramaturgical reflection on an institutional knowledge brokering service in the North East of England.

BACKGROUND: To increase the uptake of research evidence in practice, responsive research services have been developed within universities that broker access to academic expertise for practitioners and decision-makers. However, there has been little examination of the process of knowledge brokering within these services. This paper reflects on this process within the AskFuse service, which was launched in June 2013 by Fuse, the Centre for Translational Research in Public Health, in North East England. The paper outlines the challenges and opportunities faced by both academics and health practitioners collaborating through the service. METHODS: The authors reflected on conversations between the AskFuse Research Manager and policy and practice partners accessing the service between June 2013 and March 2017. Summary notes of these conversations, including emails and documents relating to over 240 enquiries, have been analysed using an auto-ethnographic approach. FINDINGS: We identified five challenges to knowledge brokering in an institutional service, namely length of brokerage time required, limits to collaboration, lack of resources, brokering research in a changing system, and multiple types of knowledge. CONCLUSIONS: To understand and overcome some of the identified challenges, we employ Goffman's dramaturgical perspective and argue for making better use of the distinction between front and back stages in the knowledge brokering process. We emphasise the importance of back stages for defusing destructive information that could discredit collaborative performances.

Localising and tailoring research evidence helps public health decision making.

BACKGROUND: Published research evidence is typically not readily applicable to practice but needs to be actively mobilised. OBJECTIVES: This paper explores the mechanisms used by information professionals with a specific knowledge mobilisation role to make evidence useful for local decision making and planning of public health interventions. METHODS: Data are drawn from a NIHR project that studied how, when, where and by whom published research evidence is used in commissioning and planning across two sites (one in England and one in Scotland). Data included 11 in-depth interviews with information professionals, observations at meetings and documentary analysis. RESULTS: Published research evidence is made fit for local commissioning and planning purposes by information professionals through two mechanisms. They localise evidence (relate evidence to local context and needs) and tailor it (present actionable messages). DISCUSSION: Knowledge mobilisation roles of information professionals are not recognised and researched. Information professionals contribute to the 'inform' and 'relational' functions of knowledge mobilisation; however, they are less involved in improving the institutional environment for sustainable knowledge sharing. CONCLUSION: Information professionals are instrumental in shaping what evidence enters local decision making processes. Identifying and supporting knowledge mobilisation roles within health libraries should be the focus of future research and training.

How do public health professionals view and engage with research? A qualitative interview study and stakeholder workshop engaging public health professionals and researchers.

BACKGROUND: With increasing financial pressures on public health in England, the need for evidence of high relevance to policy is now stronger than ever. However, the ways in which public health professionals (PHPs) and researchers relate to one another are not necessarily conducive to effective knowledge translation. This study explores the perspectives of PHPs and researchers when interacting, with a view to identifying barriers to and opportunities for developing practice that is effectively informed by research. METHODS: This research focused on examples from two responsive research schemes, which provide university-based support for research-related enquiries from PHPs: the NIHR SPHR Public Health Practitioner Evaluation Scheme1 and the responsive research service AskFuse2. We examined enquiries that were submitted to both between 2013 and 2015, and purposively selected eight enquiries for further investigation by interviewing the PHPs and researchers involved in these requests. We also identified individuals who were eligible to make requests to the schemes but chose not to do so. In-depth interviews were conducted with six people in relation to the PHPES scheme, and 12 in relation to AskFuse. The interviews were transcribed and analysed using thematic framework analysis. Verification and extension of the findings were sought in a stakeholder workshop. RESULTS: PHPs recognised the importance of research findings for informing their practice. However, they identified three main barriers when trying to engage with researchers: 1) differences in timescales; 2) limited budgets; and 3) difficulties in identifying appropriate researchers. The two responsive schemes addressed some of these barriers, particularly finding the right researchers to work with and securing funding for local evaluations. The schemes also supported the development of new types of evidence. However, other barriers remained, such as differences in timescales and the resources needed to scale-up research. CONCLUSIONS: An increased mutual awareness of the structures and challenges under which PHPs and researchers work is required. Opportunities for frequent and meaningful engagement between PHPs and researchers can help to overcome additional barriers to co-production of evidence. Collaborative models, such as the use of researchers embedded in practice might facilitate this; however, flexible research funding schemes are needed to support these models.