Research Evidence: Barriers and Facilitators to Uptake
There are various barriers and facilitators to the uptake of research evidence. Many users of research evidence (e.g. programme managers and implementers) operate in an environment with unique pressures and imperatives. Their timelines for action can be very short, they operate within challenging and dynamic environments driven by multiple in-country and external factors and stakeholders, and their expertise in applying or balancing different inputs to solve problems may be limited.
Barriers that have been identified range from access barriers to data and research; lack of enabling institutional systems and support mechanisms for research and individual barriers as described below.
- Perception about research evidence among practitioners: How do practitioners balance evidence with other competing influences?10 This can include practitioners lacking a clear idea of where to access relevant, tailored information to suit their needs, how to distinguish quality of evidence sources, and how to ultimately use it.11 After all, “evidence speaks with many voices,” and any one piece of evidence might have multiple different (and even contradictory) interpretations and implications.12 Findings may also be ambiguous and lack precise estimates of intended effects.13
- Organizational culture: How does an organization make decisions? How does information flow within an organization? What are its abilities to interact with research evidence?14,15 ‘Groupthink’ or an attitude of “how we do things around here” can also slow or distort the use of research evidence. The prevailing administrative context may also shield programme managers, implementers or technical officers from researchers’ advocacy, and they may feel no accountability to the broader community.
- The low skills (especially research or evidence appraisal skills) among practitioners, either to assess research evidence or to balance it against competing sources of influence.
- The perceived cost and timeliness of research. Given the short time horizons that many practitioners have to make decisions, research could be considered too expensive, too time-consuming or too much of a luxury to have real practical value.
- Information overload. Practitioners, programme managers and implementers may become overwhelmed by the sheer number of information sources; or become persuaded by other influences (e.g. lobbyists or other interest groups who have financial resources, abilities, and/or insider knowledge on advancing a particular agenda).
- Separation of specific fields into ‘silos’. Across health and development sectors/silos, institutional competition and rivalry is often rife. Not only are organisations forced by donors to compete for funding, some institutions may be required to compete for credibility and/or mandates in a given area. Different topic-based silos, sectors and institutions also frequently lack a common culture or language that are essential to collaborate more effectively. This may provoke hesitation or reluctance by some institutions for inter-sectoral collaboration, for fear of exposure to informed peers or valid criticism.
acilitators leading to wider adoption of the research evidence may include:
- National necessity is frequently observed to be the critical driver for the uptake and application of research evidence. When a national or provincial health system undergoes a specific change of policy or experiences new/emerging health needs, the exigencies of the situation frequently lead to an active search for relevant research evidence to guide implementation in new areas.
- Researchers may also ‘reframe’ current practice issues to align with the existing evidence base or emerging national priorities. Framing an implementation problem is often an essential step in KT activities (e.g. a policy brief) and can bring together many different types of evidence to respond to a particular practice or implementation need.
- Strengthening the capacity of practitioners to: demand research evidence that responds to and supports their needs; and to access, assess, adapt and apply research evidence in their daily work.16
- Researchers collaborating with practitioners to generate essential information, to encourage active sharing, and identify pressing priorities.
- Creating targeted messaging (e.g. policy briefs, press releases) emphasizing the role that research evidence can play in contributing to better programmes or improved interventions.17 Research evidence can be communicated more effectively by turning them into compelling stories. For example, by contrasting ‘the costs of action versus those of inaction’ the likelihood of evidence influencing decision-making may be much higher.
- Researchers pursuing personal contact with practitioners and developing trust. Trust built from personal relationships can be a vital ingredient connecting the worlds of research and practice.