Meeting the Challenge of the “Know-Do” Gap; Comment on “CIHR Health System Impact Fellows: Reflections on ‘Driving Change’ Within the Health System”

Document Type: Commentary

Author

Newcastle University, Newcastle, UK

Abstract

Bridging the ‘know-do’ gap is not new but considerably greater attention is being focused on the issue as governments and research funders seek to demonstrate value for money and impact on policy and practice. Initiatives like the Canadian Institutes of Health Research (CIHR) Health System Impact (HSI) Fellowship are therefore both timely and welcome. However, they confront major obstacles which, unless addressed, will result in such schemes remaining the exception and having limited impact. Context is everything and as long as universities and research funders privilege peer-reviewed journal papers and traditional measures of academic performance and success, novel schemes seeking to break down barriers between researchers and end users are likely to have limited appeal. Indeed, for some academics they risk being career limiting. The onus should be on universities to welcome greater diversity and nurture and value a range of academic researchers with different skills matched to the needs of applied health system research. One size does not fit all and adopting a horses for courses approach would go a long way to solving the conundrum facing higher education institutions. At the same time, researchers need to show greater humility and acknowledge that scientific evidence is only one factor shaping policy and practice. To help overcome a risk of ideology and opinion triumphing over evidence, attention should be devoted to encouraging citizens to get actively involved in research. Research funders also need to give higher priority to how policy can be made to stick if the ‘know-do’ gap is to be closed.

Keywords

Main Subjects


  1. Sim SM, Lai J, Aubrecht K, et al.  CIHR Health System Impact Fellows: Reflections on “driving change” within the health system. Int J Health Policy Manag. 2019;8(6):325-328. doi:10.15171/ijhpm.2018.124
  2. Lewis S, Russell A. Being embedded: A way forward for ethnographic research. Ethnography. 2011;12(3): 398-416.
  3. Marshall M, Pagel C, French C, et al. Moving improvement research closer to practice: the Researcher-in-Residence model. BMJ Qual Saf. 2014;23:801-805. doi:10.1136/bmjqs-2013-002779
  4. Cheetham M, Wiseman A, Khazaeli B, et al. Embedded research: a promising way to create evidence-informed impact in public health? J Public Health. 2018;40(Suppl 1):i64-i70.
  5. McAteer J, Di Ruggiero E, Fraser A et al. Bridging the academic and practice/policy gap in public health: perspectives from Scotland and Canada. J Public Health. 2018. doi:10.1093/pubmed/fdy127
  6. Hunter DJ, Frank J. Making research matter: Comment on “Public spending on health service and policy research in Canada, the United Kingdom, and the United States: a modest proposal.”. Int J Health Policy Manag. 2017;7(4):353-355. doi:10.15171/ijhpm.2017.97        
  7. Davies P. Evidence-based policy at the Cabinet Office. Overseas Development Institute;  2005. Impact and Insights Series.
  8. Hunter DJ. Perspective: Evidence-informed policy: In praise of politics and political science. Public Health Panorama. 2016;2(3):268-272.
  9. Oliver K, Kothari A, May N. The dark side of coproduction: do the costs outweigh the benefits of health research? Health Res Policy Syst. 2019;17(1):33. doi:10.1186/s12961-019-0432-3
  10. Cairney P, Oliver K. How should academics engage in policymaking to achieve impact? Poli Stud Rev. 2018. doi:10.1177/1478929918807714
  11. Nuño-Solinis R. Are Healthcare organisations ready for change? Comment on “Development and content validation of a transcultural instrument to assess organisational readiness for knowledge translation in healthcare organisations: The OR4KT.” Int J Health Policy Manag. 2018;7(12):1158-1160. doi:10.15171/ijhpm.2018.95
  12. World Health Organisation. Leading Health System Transformation to the Next Level. Expert Meeting, Durham, UK, July 12-13. Copenhagen: WHO Regional Office for Europe; 2018.
  13. oaz A, Davies H, Fraser A, et al. What Works Now? Evidence-Informed Policy and Practice. Bristol: Policy Press; 2019.