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Evidence-informed practice and practice-informed evidence: Knowledge exchange for core public health functions Implementation in BC

Principal investigators:

Marjorie MacDonald and Allan Best

Co-investigators:

Ted Bruce, Anne George, Trevor Hancock, Craig Mitton, Bernadette Pauly, Michael Pennock, Roger Wheeler

Funder:

Canadian Institutes of Health Research (CIHR)
BC Ministry of Healthy Living and Sport (MoHLS)
Vancouver Island Health Authority (VIHA)

Funding period:

May 2008 – April 2010


Knowledge translation and exchange are important elements in the implementation of the British Columbia Core Functions in Public Health framework. The purpose of this study is to identify, implement and evaluate appropriate Knowledge to Action (KTA) strategies to support the use of evidence in core program development and implementation and to compare the process and outcomes across health authorities. The two core programs that were collaboratively selected with the participating health authorities (Vancouver Island Health Authority, Interior Health Authority, & Vancouver Coastal Health Authority) are Food Safety and Unintentional Injury Prevention.

This two year project was funded by the Canadian Institutes of Health Research (CIHR), with additional funding provided by the BC Ministry of Healthy Living and Sport and the Vancouver Island Health Authority. This project was conducted at a time when concerns were raised about the inability of the Canadian public health system to meet the growing needs of the population and address potential public health emergencies. One issue of concern was the gap between health-related research and practice, and the lack of evidence-informed practice and policy. Many reasons have been put forth to explain this situation, but in the field of public and population health, an argument was made that most of the evidence is not very practice-based and thus neither relevant to nor useable by practitioners and policy makers. The title of our project, containing the terms evidence-informed practice and practice-informed evidence indicated our dual concern with ensuring that practice is informed by the best possible evidence, and that the evidence is relevant and useful to practice.

Methodology

The implementation of core programs in the British Columbia public health system can be thought of as a sophisticated and iterative knowledge exchange process. Building on our Michael Smith Foundation for Health Research Team Start Up Grant and our efforts to develop a team of public/population health researchers and decision makers, this research project engaged the team members in a participatory research approach to study the integral knowledge exchange elements of core program implementation.

Each health authority established their own knowledge exchange processes and performance improvement plans, and each had different resources allocated to this. This created the opportunity for a “natural experiment” to study:

a) variations in how evidence is used to support program development and improvement;
b) the most effective knowledge to action (KTA) strategies; and
c) the impact of the strategies and the use of evidence on common indicators.

Guided by systems theory, an ecological perspective, and a comprehensive KTA framework, participatory case studies were conducted in three BC health authorities in which local researcher – knowledge user collaborations had been established. Methods included key informant interviews, focus groups, document reviews, meeting observations and questionnaires. The outcomes of interest in this study were the core program implementation and enhanced local capacity to use evidence in planning and service delivery.

Contact

For more information about the Knowledge to Action Research Project please contact Wanda Martin, () Project Coordinator.

Dissemination

CPHA 2011

Evidence Informed Practice and Practice Informed Evidence: Implementation of BC Core Public Health Program on Unintentional Injury Prevention

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