Knowledge-to-Action (KTA) Models Fit for purpose? or What

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Connecting evidence, policy and practice in
an era of austerity, complexity and
decentralised decision making
Maps, routes and shoes
Sandra Nutley
[email protected]
The inspiration
• ‘Arguably the role of social research becomes more
important to guide practice in an era of austerity
than one of affluence’ (SRA, UK, 2010)
• ‘There seems to be broad [bipartisan] agreement:
We need an evidence-based system to guide future
budget decisions that assesses the relative
performance and impact of all government
programs’ (Center for American Progress, USA, July 2011)
Underpinning rationale:
Evidence-based policies and practices ‘more likely to be
better informed, more effective and less expensive’
Familiar concerns
“There is nothing a politician likes
so little as to be well-informed.
It makes decision making so
complex and difficult.”
(John Maynard Keynes)
“For me, politics shouldn’t be some
mind-bending exercise. It’s about
what you feel in your gut”
(David Cameron, April 2011)
Possibly not so familiar concerns
Mitton et al 2007
• ‘There is actually very little
evidence that can adequately
inform what KTE strategies work
in what contexts’ (p 756)
• ‘KTE, at least as conceptualised to
date, simply does not fit with the
underlying politics of health
policymaking’ (p 757)
1. Policy and practice context
2. Knowledge-to-action (KTA) thinking, models
and initiatives
3. Implications for connecting evidence, policy
and practice
1. Policy and practice context
Financial austerity
Outlook for Scottish public expenditure
Source: Christie Commission 2011
• Concurrent huge
increase in demand
for public services due
to demographic and
social pressures
• Conclusion: Radical
reform required.
Continuing to deliver
services using current
models won’t work
Austerity: more a threat than opportunity?
• Job cuts for researchers in
government
• Research and evaluation
budgets slashed
• Researchers & evaluators
having to do more with less
But
• Research impact demands have
raised status of applied/policyrelated research in universities
• Politicians still reach for
research as a tactic
‘One person's
riot is another’s
research grant’
Complexity: ‘wicked’ nature of many
social problems
• Social problems often interdependent
with complex causal relationships
• Knowledge base for understanding
problems and possible solutions often
uncertain, fragmented and contested
• Stakeholders may hold divergent and
extreme views, and be unfamiliar with
and resist other perspectives
Head, 2008
Complexity: public service systems
• Various combinations of hierarchy, market,
community and network approaches to service
delivery
• Greater decentralisation of decision making, service
commissioning and procurement in many countries
• E.g. Growing complexity of education systems due
to:
– Diversity of stakeholder preferences and expectations
– More decentralised and flexible governance structures
– Additional layers of governance at international and
transnational levels
– Rapidly changing and spreading ICTs
OECD/CERI, 2007
2. KTA thinking, models and
initiatives
Forms of research use
Direct (instrumental)
– Knowledge-driven
– Problem-solving (or engineering)
Indirect (conceptual)
– Social interaction
– Enlightenment (or percolation)
Symbolic
– Political
– Tactical
Source: Weiss 1979
Impact often occurs via indirect & subtle routes,
which may involve symbolic use along the way
Importance of
early years
Restorative justice
Importance
of informal
carers…
Choose life
suicide policy
The happiness
and well-being
agenda…
Enhancing
self-care…
Harm reduction
in substance
misuse…
Three generations of knowledge to
action (KTA) thinking
• Knowledge transfer
• Knowledge
exchange
• Knowledge
integration
• Knowledge a product –
degree of use a function of
effective packaging
• Knowledge the result of
social & political processes –
degree of use a function of
effective relationships and
interaction
• Knowledge embedded in
systems and cultures –
degree of use a function of
effective integration with
organisations and systems
Source: Best et al 2009
Good at…
…moving us away from ideas
of research as “answers”, which need to be
packaged
… problematising “knowledge transfer”
Begins to emphasise…
• The importance of context, networks & systems;
• Social and collective learning, and unlearning;
• Interaction with other types of knowledge (tacit;
experiential; political awareness);
• ‘Use’ as an adaptive process - not an event;
• Non-individualised embedded uses of research;
• Inherent non-linearity of systems.
Knowledge required for effective policies and
services
• Know-about problems: the nature and
formation of social problems.
• Know-what works: what policies, strategies or
interventions will bring about desired
outcomes
• Know-how (to put into practice): e.g.
knowledge about effective programme
implementation.
• Know-who (to involve): e.g. getting
stakeholder buy-in and building alliances for
action.
• Know-why (requirements of action):
relationship between values & policy/practice.
• Know-whether having any impact:
monitoring, evaluation and accountability
Knowledge-to-action (KTA) models
• A bewildering array of models, frameworks and theories (63
models identified by Ward et al 2009)
• Drawn from wide range of disciplines - very varied levels of
evidential support
• Most models reflect first or second generation thinking
• Models focused on a spectrum of concerns (Davies et al 2011):
Increasing the use
of explicit (what
works) knowledge
Implementation frameworks
Creating environment that
encourages engagement with
wide variety of knowledge
Interactional frameworks
Most KTA models clustered towards the lefthand side of this spectrum
KTA process often viewed as an iterative cycle,
especially when concerned with instrumental use
(Jones et al 2009)
Knowledge-to-action initiatives
Many and varied:
International/national/local focus
Policy/practice focus
Individuals/groups/organisations/systems focus
Top down
Evidence to practice
No child left
behind (NCLB),
USA
Bottom up
Practice to evidence
Centre for
Center for Court Project Oracle,
Effective Services, Innovation, NY, London
Ireland
USA
NB: Researcher/university driven initiatives still often based on
knowledge push models (Qi & Leven, 2011)
3. Implications for connecting
evidence, policy and practice
Those wishing to negotiate the
research use/impact terrain…
• Need good maps of the policy/practice context
at different levels of detail
Context matters: factors explaining use/non-use
•
•
•
•
•
Political culture factors – e.g. shared or conflicting values,
adversarial or consensual political frameworks, extent of
deference to technical expertise
Policy domain factors – e.g. settled or contentious problems,
actors, structures and issue histories
Coordination and integration capacities – e.g. extent of
central control, system capacities for policy development and
implementation
Organisational capacities and processes – e.g. supply of
analytical skills, receptivity to outside information, routine
requirements and procedures
Cross-sectoral relationships – institutionalisation of crosssectoral processes such as bridging organisations and
networks
Head (2011)
Those wishing to negotiate the
research use/impact terrain…
• Need good maps of the policy/practice context
at different levels of detail
• Will find many generic route guides, not all of
which are based on fieldwork!
• Often not clear what routes to pursue in which
context
• And to complicate matters, researchers need
to decide which shoes they want to wear…
Researcher rightly take different stances in
relation to policy/practice
• The consensual approach – working with
the grain of current policy/practice.
• The critical and contentious approach –
“keeping the system honest”.
• Paradigm challenging – subverting current
thinking and perhaps proposing new
principles for action.
There are some schemas of the relationship
between certain routes and aspects of context
that are worthy of further consideration and
development
Contandriopoulos et al 2010
Models of use in relation to cost-sharing and polarisation
dimensions of the context
Fazekas & Burns 2011
In the meantime, some general guidance
based on RURU’s work
Research Unit for Research Utilisation (RURU) –
developing cross-sector knowledge on research use
Generic features of effective practices to
increase research use
 Research must be translated - adaptation of findings to specific
policy and practice contexts
 Ownership is key – though there are exceptions where
implementation is received or perceived as coercive
 Need for enthusiasts - champions - personal contact is most
effective
 Contextual analysis - understanding and targeting specific
barriers to, and enablers of, change
 Credibility - strong evidence from trusted source, inc.
endorsement from opinion leaders
 Leadership - within research impact settings
 Support - ongoing financial, technical & emotional support
 Integration - of new activities with existing systems and activities
Source: Nutley et al 2007
Thank You!
[email protected]
Research Unit for Research
Utilisation (www.ruru.ac.uk –
new website coming soon!)
Key references
• Best A, Terpstra JL, Moor G, Riley B, Norman CD, Glasgow RE, (2009)
"Building knowledge integration systems for evidence-informed
decisions", Journal of Health Organization and Management, 23(6): 627 641
• Contandriopoulos, D., Lemire, M., Denis, J-L. & Tremblay, E. (2010)
“Knowledge Exchange Processes in Organizations and Policy Arenas: A
Narrative Systematic Review of the Literature” The Milbank Quarterly
88(4): 444-83.
• Davies HTO, Powell A, Ward V and Smith S (2011) Supporting NHS Scotland
in developing a new Knowledge-to-Action Model, Unpublished report
available from University of St Andrews
• Fazekas M & Burns T (2011) Exploring the complex interaction between
governance and knowledge, A draft EDU/CERI paper, OECD
• Head B (2008) “Assessing network-based collaborations” Public
Management Review, 10(6): 733-749
• Head B (2011) “Comparative Analysis of Research/Policy Relationships –
challenges and agendas”, presentation to panel on the comparative study
of EBPP, IRSPM conference, Dublin, 12 April
References (cont.)
• Jones et al (2009) Knowledge, policy and power: six dimensions of the
knowledge-development policy interface, London: ODI
• Mitton et al (2007) “Knowledge transfer and exchange: Review and
synthesis of the literature”, The Milbank Quarterly 85(4):729-768
• Nutley, S.M., Walter, I., & Davies, H.T.O. (2007) Using evidence: how
research can inform public services. Policy Press. Bristol.
• Puttick R ed (2011) Using evidence to improve social policy and practice:
perspectives on how research and evidence can influence decisionmaking, London: Alliance for Useful Evidence/NESTA
• Ward, V., House, A., & Hamer, S. (2009) “Developing a framework for
transferring knowledge into action: a thematic analysis of the literature”
Journal of Health Services Research and Policy 14: 156-164.
• Weiss CH (1999) “The interface between evaluation and public policy”,
Evaluation 5(4): 468-486
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