CPH SPC - secure.cihi.ca · CPH SPC Canadian Population Health Initiative Initiative sur la santé...

Canadian Institute for Health Information

Institut canadien d’information sur la santé

CPH SPCCanadian Population

Health InitiativeInitiative sur la santé de lapopulation canadienne

An Environmental Scanof Research Transfer

Strategies

Prepared by:

Canadian Population Health Initiativeof the

Canadian Institute for Health Information

February, 2001

An EnvironmentalScan of Research

Transfer Strategies

Contents of this publication may be reproduced in wholeor in part provided the intended use is for non-commercialpurposes and full acknowledgement is given to the CanadianInstitute for Health Information.

Canadian Institute for Health Information377 Dalhousie StreetSuite 200Ottawa, OntarioK1N 9N8

Telephone: (613) 241-7860Fax: (613) 241-8120www.cihi.ca

ISBN: 1-896104-76-2

2001 Canadian Institute for Health Information

Cette publication est disponible en français sous le titre : « Analyse de la conjoncturedes stratégies de transfert de la recherche, février 2001 » ISBN 1-896104-77-0

http://www.cihi.ca

Acknowledgements

The Canadian Population Health Initiative is grateful to all the organizations that providedinformation and feedback for this report:

� Applied Research Branch, Human Resources Development Canada� Caledon Institute of Social Policy� Canadian Centre for Policy Alternatives� Canadian Council on Social Development� Canadian Health Services Research Foundation� Canadian Institute for Advanced Research� Canadian Policy Research Network� Centre for Health Economics and Policy Analysis, McMaster University� Centre for Health Services and Policy Research, University of British Columbia� Health Evidence Application and Linkage Network� Health Services Utilization and Research Commission, Saskatchewan� Institute for Clinical and Evaluative Sciences� Institute for Work and Health� Kennedy School of Government, Harvard University� Manitoba Centre for Health Policy and Evaluation, University of Manitoba� Parkland Institute, University of Alberta� Population Health Research Unit, Dalhousie University

About the Canadian Institute for Health Information

Created by Canada's Health Ministers in 1994, the Canadian Institute for HealthInformation is a national, independent, not-for-profit organization whose mandate is tocoordinate the development and maintenance of a comprehensive and integrated approachto health information for Canada. To this end, the Institute provides and coordinates theprovision of accurate and timely data and information required for:

• establishing sound health policy;• effectively managing the Canadian health system; and• generating public awareness about factors affecting good health.

The Canadian Population Health Initiative (CPHI) became part of CIHI in 1999 under theRoadmap Initiative.

Table of Contents

Executive Summary .................................................................................................i

1. Introduction ......................................................................................................1

2. Methodology.....................................................................................................2

3. Major Findings...................................................................................................3A. Target Audience ......................................................................................3B. Timing....................................................................................................6C. Method ..................................................................................................9

4. Conclusion......................................................................................................14

Appendix A—Participating Organizations ............................................................... A–1

A n E n v i r o n m e n t a l S c a n o f R e s e a r c h T r a n s f e r S t r a t e g i e s

C a n a d i a n P o p u l a t i o n H e a l t h I n i t i a t i v ei

Executive SummaryKnowledge about factors affecting thehealth of individuals and communities caninfluence policy and improve the healthand well-being of Canadians. To ensurethat research evidence on thedeterminants of health informs policy anddecision-making, effective strategies forknowledge transfer and policyengagement are needed. Such strategiesneed to identify the population healthresearch needs of decision-makers and toengage them in using the results ofresearch on the determinants of health.

To identify a range of strategies fortransfer of research knowledge, theCanadian Population Health Initiative(CPHI) conducted an environmental scanof strategies used by government andnon-government organizations. Thisreport examines knowledge transferstrategies of 17 organizations involved inhealth or social research and/or policy.The strategies used by theseorganizations were analyzed according tothree criteria: target audience (WHO wasengaged), timing (WHEN during theresearch process did this engagementoccur) and method (HOW was the targetaudience engaged).

The scan of these organizations foundthat, although their target audiencesvaried, organizations shared the samegoal—to have their research results andpolicy options attended to by those whowould make practical use of them inpolicy and decision-making. Specificaudiences included policy think tanks,government departments, regional healthboards and the media. With respect totiming, organizations engaged decision-makers at various stages of the researchprocess, from the initial identification ofresearch priorities through to outreach

programs after the research wascompleted. Finally, the methods used toengage audiences ranged from the use ofweb sites and computer models toemploying spokespersons and researchtransfer officers.

Based on the study findings, it wasconcluded that dissemination ofpopulation health research findings mustbe targeted at a wide variety ofindividuals and organizations. Following isa list of existing and potential targetaudiences for population health research,including a brief rationale for engagingeach group:

� Government departments emphasizinghealth and social services are potentialcollaborators.

� Policy organizations conducting similarresearch have establishedcommunication networks withdecision-makers.

� International organizations addcredibility and prestige.

� Professional organizations (particularlyin the health field) provide access tonew audiences.

� General public advocates to decision-makers.

� Community organizations providecommunity support and assist indissemination.

� Business community is a key influenceon the workplace.

� Regional health authorities and healthcare providers allocate health careservices and identify relevant targetsfor information and service delivery.

Timing is an essential element ofpopulation health research transfer. Asthe environmental scan demonstrates,decision-makers should be engaged early


C a n a d i a n P o p u l a t i o n H e a l t h I n i t i a t i v ei i

on and this relationship maintainedthrough all phases of the research, a goalthat can be achieved through the ongoinguse of collaborative working groups.Funders of population health research canincorporate policy relevance as a criterionfor research funding—for example, byhaving decision-makers and researchersjointly make funding choices. Evaluatingthe effectiveness of knowledge transferstrategies also allows researchers andfunding bodies to enhance the policyrelevance of research on continuousbasis.

The scan identified the need for a rangeof outputs appropriate to various target

audiences. Additionally, a number ofspecific methods were highlighted forencouraging the uptake of researchfindings by policy and decision-makers,including:

� effectively using web sites;� building a research transfer strategy

into each project;� establishing formal links and

partnerships with policy- and decision-makers;

� employing specialists in researchtransfer; and

� sponsoring empirical investigations onthe transfer of research findings.


C a n a d i a n P o p u l a t i o n H e a l t h I n i t i a t i v e1

1. IntroductionThe Canadian Population Health Initiative(CPHI) supports research that advancesan understanding of the determinants ofhealth for the Canadian population andarticulates policy options to improvepopulation health, reduce health inequitiesand improve the health and well-being ofCanadians.

In 1997, following a recommendation bythe National Forum on Health, a CPHIpilot project brought together talentedresearchers and decision makers fromacross Canada to help bridge leading-edgeresearch and policies related to populationhealth. The 1999 federal budget providedCPHI with additional financial support of19.9 million dollars over four years.

VisionCPHI’s vision is to mobilize pan-Canadianefforts to achieve a better understandingof how various factors interact to affectthe health of individuals and communities,and to support the development ofpolicies aimed at reducing inequities andimproving the health and well-being ofCanadians. This vision is achievedthrough research, infrastructuredevelopment, policy analysis andknowledge transfer and reporting.

GoalsMore specifically, CPHI’s goals are to:

� generate new knowledge on thedeterminants of health;

� build research capacity andscholarship in population healthscience that complementsinvestments by other fundingagencies;

� contribute to the development ofpopulation health information systems

� analyze and synthesize populationhealth research findings and promoteknowledge transfer and uptake bydecision makers;

� undertake policy analysis and developpolicy options;

� stimulate public debate and dialogueon the determinants of health; and

� develop reports and disseminateresearch findings to decision makersand the public.

About This StudyIn support of its vision and goals, CPHIconducted an environmental scan ofresearch transfer strategies used byorganizations involved with health orsocial research and policy that also havean emphasis on knowledge transfer. Thesample included government and non-governmental organizations, as well asgroups doing basic and policy research.

Underlying this study is the convictionthat researchers and key decision-makersmust interact to create and sustaininterest in and uptake of researchfindings. Ideally, the two groups will formongoing, collaborative relationships thatguide the research and policy-makingprocess. CPHI’s goal in undertaking thisenvironmental scan was to identifymodels of such interactions as one meansof informing and shaping its ownknowledge brokering activities.



2. MethodologyThe aim of the environmental scan was toidentify successful models of theresearch-policy exchange that could beused in developing CPHI’s knowledgetransfer activities. With this in mind, CPHIsurveyed a cross-section of 17 researchorganizations from the academic, policythink tank and governmental sectors todevelop a catalogue of strategies fortranslating research results into policy.Participating organizations shared acommon focus on health or socialresearch and policy and an emphasis onknowledge transfer.

To determine the key elements of theseorganizations’ dissemination strategies,three broad questions were posed:

� WHO do you engage? (targetaudience)

� WHEN during the research process doyou engage your audiences? (timing)

� HOW do you engage them? (method)

Responses were grouped into the abovecategories and analyzed for theirrelevance to CPHI’s mandate. Telephoneor e-mail interviews were also conductedwith all but two organizations to obtainadditional information on how theyengaged relevant decision makers withtheir research results.

The following organizations participatedin the study (a brief description andcontact information for each organizationis provided in Appendix A):

� Applied Research Branch, HRDC (ARB)� Caledon Institute of Social Policy (CI)� Canadian Centre for Policy

Alternatives (CCPA)� Canadian Council on Social

Development (CCSD)

� Canadian Health Services ResearchFoundation (CHSRF)

� Canadian Institute for AdvancedResearch (CIAR)

� Canadian Policy Research Network(CPRN)

� Centre for Health Economics andPolicy Analysis (CHEPA)—McMasterUniversity

� Centre for Health Services and PolicyResearch (CHSPR)—University of BritishColumbia

� Health Evidence, Application andLinkage Network (HEALNet)

� Health Services Utilization andResearch Commission (HSURC)—Saskatchewan

� Institute for Clinical and EvaluativeSciences (ICES)

� Institute for Work and Health (IWH)� Kennedy School of Government

(KSG)—Harvard University� Manitoba Centre for Health Policy and

Evaluation (MCHPE)—University ofManitoba

� Parkland Institute (PI)—University ofAlberta

� Population Health Research Unit(PHRU)—Dalhousie University



3. Major FindingsFollowing is an overview of key findingsfrom the environmental scan.Presentation of these findingscorresponds to the three broad questionsoutlined above.

A. Target AudienceAn important issue for participatingorganizations was identifying the mosteffective targets or receptors for theirresearch findings. Target audiencesvaried, although the end goal for theorganizations was the same: to ensurethat their research findings and suggestedpolicy options reached those who couldmake practical use of them.

A brief description of each of the majortarget groups identified in the study isprovided below.

WHO� policy think tanks� government departments� international organizations� regional health boards� professional organizations� the public� media� community organizations� business groups� alumni� universities� clinicians, employees and

other professionals

Policy Think TanksSome of the organizations surveyedmaintain formal affiliations with policygroups, permitting an ongoing exchangeof research priorities and dissemination ofresults. This approach serves not only tobroaden the research-policy discourse,

but also ensures a wide audience forresearch findings as well as the policydirections indicated by these findings.

Government DepartmentsA number of organizations interact withgovernment departments, some of whichare outside their traditional network. Forexample, the Applied Research Branch(ARB) of Human Resources andDevelopment Canada (HRDC) has closelinks with departments such as HeritageCanada, Industry Canada and HealthCanada, as well as with provincial andregional counterparts. In one of itsworking papers, the Institute of Work andHealth (IWH) recommended cross-departmental governmental initiatives as ameans to more effective transfer ofresearch findings.1

Government representatives may alsoserve on advisory boards that helpdetermine research priorities. Forexample, the Board of Trustees of theCanadian Health Services ResearchFoundation (CHSRF) includes ex officiorepresentation from Health Canada. Thisnot only allows for expert advice onpolicy-relevant research but also createsan ongoing link between policy makersand researchers. The faculty at theKennedy School of Government (KSG)includes many former senior governmentrepresentatives. Heritage Canada andHRDC are currently co-funding a projectat the Caledon Institute (CI) and bothdepartments sit on an advisory committeethat guides the project. Severalresearchers at the Canadian Institute forAdvanced Research (CIAR) participate ingovernment advisory bodies such as theFederal/Provincial/Territorial AdvisoryCommittee on Population Health.

1 Lavis J.N., Farrant M.S.R. and Stoddart G.L. Barriers toEmployment-Related Healthy Public Policy (Working Paper69) (Toronto: IWH, 1999).



International OrganizationsMany organizations are able to raise theirprofile and acquire greater legitimacy inthe eyes of policy makers through theirinvolvement with international groups.These affiliations can also broaden thepolicy applications of research, potentiallyaffecting an even greater number ofpeople. The Canadian Policy ResearchNetwork (CPRN) has developed aninternational network of researchers andundertaken joint international projects andhealth policy conferences. CIAR helpedpioneer the widely used “networkingparadigm,” which “removes artificialbarriers between disciplines to tackle bigquestions drawing from a wide variety offields.” The participation of a number ofinternationally known researchers on theIWH research advisory committeepromotes links to the internationalresearch community, thereby enhancingopportunities for research transfer.

Regional Health BoardsIn general, research is more easilyaccommodated into local policy makingwhen regional health boards are activelyinvolved in research projects. The Centrefor Health Services and Policy Research(CHSPR) has direct project involvementwith two regional health boards in BritishColumbia and hopes to expand itsinvolvement in the near future.Responding to a high turnover rate ofhealth district CEOs, an external audit ofthe Health Services Utilization andResearch Commission (HSURC)recommended that health boards prepareorientation packages to raise awarenessamong incoming CEOs about the boardsas a source of, and potential partner in,health research.

Professional OrganizationsIn addition to creating new audiences fordissemination, ties to professional

organizations can help ensure thatmembers of the profession adhere to setpolicies. As well, working with membersof the health professions to establishresearch priorities increases the likelihoodthat the realities of everyday practice willbe reflected. HSURC’s external reviewrecommended closer ties to theSaskatchewan Medical Association, theprofessional nursing association and thechiropractic association. The Institute forClinical and Evaluative Sciences (ICES)specifically gears some of its outputstowards health professionals, includingthe medical students and residents whoare the profession’s future decision-makers. ICES publishes decision aids,tools, technical reports, a research“digest” geared towards physicians and aseries of Practice Atlases and an AtlasReport. To expand its reach, theorganization has forged links with otherhealth-centered organizations, such as theOntario Hospital Association and theHeart and Stroke Foundation of Ontario.

The PublicSome public policy organizations attemptto influence policy makers indirectly byadvertising and otherwise making theirfindings known to the general public. Forexample, although the Parkland Institute(PI) does not target government directly,it has gained a high profile in Alberta bypublicizing and disseminating its researchfindings widely. A key element of theorganization’s success is providingaccessible, easy-to-read products thathelp bridge the gap between theacademic community and the public. Twoof its publications are widely available inAlberta: Shredding the Public Interest andClear Answers. The Canadian Council onSocial Development (CCSD) has adopteda similar strategy, using the media togenerate public debate and providingpublicly accessible resources, including a



free statistical service on their web site(the Centre for International Statistics).

MediaTo ensure wide public dissemination ofresearch findings, many organizationsmaintain close links with the media. KSGhas been particularly effective in thisregard, working rigorously to keep themedia abreast of newsworthydevelopments through press releases,personal calls and web presentations. Aswell, the School sponsors a monthlyfaculty press luncheon, inviting reportersto hear faculty members speak aboutissues of news interest.

Community OrganizationsAlthough community groups seldom makepolicy decisions with far-reachingimpacts, they can make a practicalcontribution to the policy optionsproposed by research organizations. CI isone organization that undertakes majorprojects in partnership with communitygroups. With the support of the TrilliumFoundation, CI undertook the SocialPartnership Project, which was designedto promote economic and social well-being by building a body of knowledgeabout social partnerships between privatebusiness and non-profit organizations, andby encouraging further research in thearea. In addition to highlighting thebenefits of community partnerships, theproject also points out some of thepitfalls. One of the project’s outputs—the“Community Stories” series—influencedmany policy-making groups includingHRDC, which is one of the project’sfounders. Funding from the Departmentof Justice’s National Crime PreventionCentre allowed CI to develop a series ofcommunity stories on crime preventionthrough social development.

The Canadian Centre for PolicyAlternatives (CCPA) often joins forceswith community groups to influencedecision-makers indirectly. For instance,CCPA’s Education Project providesstudent, teacher and parent groups withinformation about the effects ofrestructuring and corporate involvementon public education in Ontario. CCPA’sstrategy was to target community groups,who would then lobby the government tomake policy changes. The project provedvery successful in raising variouseducation issues in the publicconsciousness.

The Population Health Research Unit(PHRU) received funding from CHSRF todevelop information materials on how touse the Internet to locate researchinformation on children’s health and socialservices. It worked in association withthe United Way, the Nova Scotia Child-Care Connection and the GrowingTogether program of North Dartmouth,along with various health boards.

Business GroupsThere are a number of benefits toworking with private businesses. Largercorporations, in particular, can be asource of funding for large-scale projectsand research endeavours and also can actas “natural laboratories” for studyinginfluences on the lives of workers. Fromthis perspective, the heads of businessescan be considered as important decision-makers.

The Health Evidence, Application andLinkage Network (HEALNet) is conductingresearch on the application of evidence-based information at the level of theworkplace. To this end, it has developeda workplace risk assessment andergonomic model for use in the autosector as a tool to reduce injury and



assist production engineers. Two of theorganization’s computer models, CLINT(Clinical Integrator) and CTF Prevent,were so successful at helping physiciansand patients make evidence-baseddecisions that they were commercializedby a private corporation. Now usedwidely in the United States and Alberta,the models will soon be available inSaskatchewan.

AlumniOne of the ways schools engage decisionmakers is by maintaining links with theiralumni. KSG has a separate departmentdedicated to communicating with alumni,some of who have gone on to serve incabinet positions and as advisors topresidents.

UniversitiesMany of the organizations in the scan arepart of or have formal affiliations withuniversities (e.g. IWH, PHRU, MCHPE,CHEPA, CHSPR) and/or some of theirmembers have university appointments(e.g. CIAR, HEALNet, CPRN). Suchconnections serve to broaden the spheresof influence of researchers and lendcredibility to these organizations.

B. TimingAnother important element of knowledgetransfer strategies is timing—at whatpoint in the research process shouldefforts be made to create ties withpotential users?

As Lomas has argued,2 research is aprocess and not a product. In fact, it hasbeen shown that early and ongoinginvolvement of relevant decision-makersin the conceptualization and conduct of a

2 Lomas, J. “Connecting Research and Policy” IsumaSpring 2000, p. 140.

research investigation is the bestpredictor of application of findings.

Many of the organizations participating inthe scan have adopted this approach anduse various means to involve relevantdecision-makers early in the research andknowledge transfer cycle. The followingdiscussion presents a number ofexamples demonstrating the importanceof proper timing in strategies to engagedecision-makers—before the researchbegins, during the research process andafter the research is completed.

WHENBefore the research begins:� environmental scanning� outreach program� policy review panels

During the research process:� working groups

After the research is completed:� study release strategies� parliamentary process� follow-up evaluation

� Before the research begins:This scan of the dissemination strategiesof government and non-governmentpolicy research organizationsdemonstrated the importance of involvingtarget audiences early on in the researchprocess. Organizations participating in thescan made it a priority to actively solicitinput on research needs and conduct athorough study of research gaps beforeinitiating their research.

Environmental ScanningHSURC has developed a model of“environmental assessment” that isinitiated before research begins. Itinvolves scanning the broad political,



social and economic environments todetermine current trends and gaps in theresearch, thus ensuring that the researchwill be timely and relevant. As well,HSURC keeps abreast of media reportsrelated to health through its in-housenews clipping service (“Health Clips”).Research Transfer Officers play a key rolein environmental assessment,3 interactingregularly with important stakeholders tofind out what issues are relevant now andwill be in the future. All HSURC staffparticipate in the information gatheringprocess, contacting the CEOs andutilization coordinators of health districts,union and other professional organizationleaders, government staff and electedrepresentatives, and others in the healthsystem. Research Transfer Officerscoordinate these efforts, compiling theinformation into concise reports thatassist the Board in establishing researchpriorities.

ARB also uses a method of environmentalscanning, examining existing research andconsulting with policy makers andexperts. The goal is to determine thecurrent state of knowledge and identifyresearch gaps in particular issue areas.Large survey and data collection activitiesare undertaken once knowledge transfergaps have been identified.

CHSRF works in partnership with itsBoard of Trustees, which includes exofficio government members and expertsin dissemination, to determine researchpriorities in advance of the studies beingconducted. Research themes areestablished through a nationalconsultation process.

3 A full description of the role and function of ResearchTransfer Officers is provided below under “Method ofEngagement.”

Policy Review PanelsAnother strategy used by CHSRF is toevaluate project proposals through a MeritReview Panel, rather than a traditionalpeer review committee. Half the panel ismade up of other researchers who helpdetermine the merits of the proposal on ascientific and methodological basis. Theremainder of the panel is made up ofdecision-makers, who help to ensure thepolicy relevance of the research.

Outreach ProgramsOther groups take a proactive approachthrough outreach programs. For example,PHRU attends meetings of communityand government groups to identifyresearch projects. PHRU representativesalso visit school boards, First Nations’reserves and community groups to findout about their needs and how they canbe of assistance. The Executive Directorof CHSRF conducts cross-country tours,holding regional workshops and strategicdiscussions to determine relevant areasfor research and to establish an ongoingexchange between decision makers andresearchers.

� During the research process:Participating organizations maintained theinvolvement of stakeholder groups overthe course of the research process byinviting their participation in a variety ofworking groups. Some examples areprovided below:

Working GroupsHSURC involves key stakeholders byinviting them to serve as members ofproject working groups. The organizationrecruits from stakeholder groups to helpdevelop research questions, therebyinvesting these groups in the researchprocess right from the start. Stakeholdersare involved throughout the research



process and recommend changes as itproceeds. This helps to ensure effectivedissemination of findings once the studiesare completed.

At one time, CHEPA used annual policyconferences as its main disseminationtool, bringing together policy-anddecision-makers to hear the results ofresearch. Although CHEPA receivedpositive feedback about theseconferences, they were discontinued infavour of stakeholder workshops. As aresult, CHEPA has saved money (theconferences were much more expensivethan the workshops). As well, theliterature shows that smaller, interactivegroups involving researchers and policy-and decision-makers are much moreeffective as a transfer tool than passivepresentation of research results.

ICES maintains a Stakeholder AdvisoryCommittee, with representatives of 30organizations, to suggest ideas forresearch initiatives and to undertakeongoing transfer of research findings. Aswell, the organization holds regularmeetings of a Ministry of Health ICESLiaison Committee to determine theMinistry’s information needs and researchpriorities.

� After the research is completed:Participating organizations identified anumber of strategies for makingstakeholders aware of the results of theresearch after it was completed. Theseincluded:

Study Release StrategiesVarious strategies are employed when thefinal results of research are about to bereleased. For example, IWH attempts tointegrate research findings and link themwith broad themes, rather than releasingstudies one by one. Lomas, cited above,

writes that too often findings from singlestudies are disseminated in the absenceof a larger policy context. The challengefor researchers and funding agencies is toensure that policy focussed summary andsynthesis of research knowledge becomesthe unit of research transfer.

The timing of final release is important.For example, the CCPA released itsMissing Pieces publication on theinsensitivity of the media to certain socialeffects of policy at the same time as theMaclean’s annual report cards onuniversities. As a result, many journalistslinked the study to the universities’ reportcards to show gaps in the magazine’sevaluation of the schools.

Sometimes it is important to alertstakeholders about the upcoming releaseof study findings. For example, HSURC’sResearch Transfer Officer prepared astakeholder information package includingpast research and the new study. Twostakeholder meetings were held, one inRegina and one in Saskatoon, just prior tothe general release of the study. Becausethey received a “heads up” about thefindings before the release of the study,stakeholders were able to respondeffectively to media requests forinformation about the policy implicationsof the research.

Parliamentary ProcessSome policy groups, such as CCSD andCCPA, meet with Members of Parliamentbefore important bills are passed toadvise them on their impact. They use asevidence some of the research findingstheir organization has produced.

Follow-up/EvaluationAnother post-research strategy is toensure adequate follow-up to determinethe impact of an organization’s products



on policy. Through its DevelopmentFund—Communications InfrastructureDevelopment Grants, CHSRF is solicitingproposals for one-time funding of projectsby research organizations to improve theirresearch dissemination capacity. Finalreports must set out a process forevaluating how effective the project wasin turning research into policy. As well,the IWH routinely evaluates the impact ofthe information it delivers in the makingof policy.

C. Method:Recognizing that no single disseminationmethod will be effective in all situations,most of the organizations in the scanused a variety of means to engagedecision-makers. As the examples belowillustrate, the target audiences and themessages that need to be conveyedgenerally shape the methods used tointeract with decision-makers.

HOWElectronic Products� web sites� computer models

Tailored Products/Messages� accessible research products� integrated messages� student essay contest

Specialized Personnel� charismatic spokesperson� research transfer officers

Research, Collaboration andCapacity Building� training and review� joint projects� sub-specialized research centres� research on transfer strategies� transfer strategy requirements� capacity building

Membership

� Electronic Products

Web SitesEach of the organizations surveyedmaintains an extensive web site thatprovides visitors with information aboutcurrent research projects, prior researchand, in some cases, statistical services.CHSPR maintains a current e-networknews service, featuring short updatesabout research projects and corporateactivities, as well as notices of newpublications, discussion papers,roundtable notes, commentaries andupcoming events. In addition to postingnews releases, CIAR’s web site containsgeneral program descriptions, anoverview of the organization’s objectivesand activities, and detailed profiles ofprogram members. News releases arealso posted on the web site.

Computer ModelsSome policy research organizationssystematically use computer and othermodels to turn research results intopolicy. If they are user-friendly, thesemodels allow decision makers toconveniently apply research in anaccessible format. HEALNet developslarge-scale data linkage and informationapplication systems to help decision-makers use their research. CLINTsoftware used by HEALNet providesimmediate Internet access to selectedinformation for enhancing the decision-making capabilities of patients, providersand health care organizations.4 For healthcare organizations, CLINT is able toperform continuous quality audits,assessment, and improvement based onknowledge and application access anduse. The software was so popular inAlberta during its trial period that it was 4 Dr. Robert Hayward, now of the Centre for Evidence-Based Medicine at the University of Alberta, developedthe software program CLINT (Clinical Integrator) forHEALNet.


C a n a d i a n P o p u l a t i o n H e a l t h I n i t i a t i v e1 0

later commercialized and is now soldwidely in the United States and Canadathrough the InfoWard Corporation.

Another successful program in the area ofpopulation health is POPULIS (PopulationHealth Information System). Developedby the Manitoba Centre for Health Policy,POPULIS focuses on the relationshipbetween health and the use of health careservices. It provides information to helpRegional Health Authorities (RHAs) assessand respond to questions on such issuesas patterns of surgery corresponding withneeds, the relative needs of nursing homebeds versus hospital beds, access tohealth care across different socio-economic groups and physician supply.POPULIS tracks all health care servicesused by the people in a particular area,regardless of what health care facilitywas used, and allows for sub-groupingsof communities within each RHA. Onebenefit of the program is that it permitsbaseline assessments to be made beforeRHAs make changes to their health caredelivery system, providing a referencepoint against which future policy orprogram decisions can be measured.

Like CLINT, POPULIS has receivedsubstantial positive feedback andextensive recognition. It is currently inuse by the universities of Victoria, Albertaand Dalhousie, and other universities areplanning to make use of it in the future.Unlike CLINT, however, there have beenno plans to commercialize the POPULISsoftware.

Other models initiated by HEALNetinclude the Health and Safety BalancedScorecard. In association with the IWH,the program was developed to provide aconcise overview of health and safety inan organization and helps workplacesfocus strategy on key determinants. It

can also help operationalize a health andsafety strategy, communicate it up anddown an organization, provide essentialdata for operational managers, andcontribute to the improvement of healthand safety outcomes. Indicators can becustomized to any workplace. Yetanother model developed by IWH andHEALNet is the Performance AssessmentTool to help employers evaluate theirworkplace with respect to worker stress.These models assist in integratingresearch findings into policy in aconvenient and systematic way that isaccessible to decision makers.

� Tailored Products/Messages

Accessible Research ProductsAs discussed earlier, many groups try toensure that their research products areaccessible to a wide audience. Forexample, Alberta’s PI produced two“popular” studies for which there was ahigh level of public demand. ICES makesits Practice Atlas and Atlas Reports seriesaccessible to a variety of stakeholders,including policy makers and clinicians.Research staff in CIAR’s PopulationHealth, Human Development andEconomic Growth area have collaboratedon books designed to serve the needs ofa broad audience, including policymakers, other academics and the generalpublic. Some organizations specialize inpublishing pithy reports on issues ofbroad public interest. For example, CCPAissues an Alternative Federal Budget tocoincide with the release of the officialfederal budget.

Integrated MessagesOne strategy for reaching specificaudiences is to tailor messages targetingtheir particular areas of concern. This canbe achieved by synthesizing multipleresearch results, rather than relying on



one or two sources of evidence.Addressing thematic issues by applyingmeta-synthesis approaches (high-levelconceptual integration) serves to integratethe evidence base and develop newinsights into issues. The experience ofmany organizations suggests that mostpolicy audiences are seeking integratedinformation and new knowledge aboutissues of concern to them.

Student Essay ContestsSome organizations, such as PI, sponsorstudent essay contests to increaseawareness among future decision makersabout the Institute and its work.

� Specialized Personnel

SpokespersonsMany groups benefit from having well-known and charismatic leaders serve astheir spokesperson. Leaders with a strongreputation for research integrity andpolicy savvy are frequently invited by themedia to comment on various issues andare often featured speakers at policyresearch forums.

Research Transfer OfficersMany groups employ Research TransferOfficers (RTOs) with specializedknowledge in communications,journalism, public relations, etc., whoseresponsibility is to create and maintainlinks with decision-makers. At HSURC forexample, RTOs interact regularly withdecision- makers and stakeholders, andare proactive in determining the policypriorities of communities.

� Research, Collaboration and CapacityBuilding

Training and ReviewTo help bridge the gap betweenacademics and decision makers,organizations such as CHSRF and CHEPA

train their researchers on how tocommunicate more effectively. Somegroups, such as HSURC and CPRN,undergo regular external reviews to gaugethe effectiveness of their transferstrategies. Recommendations made byHSURC’s 1998 external reviewcommittee on improving theorganization’s research transfer capacitywere implemented promptly.

Joint ProjectsAs discussed earlier, many organizationsundertake joint projects with decision-makers including, for example, CHSPR’sprojects with local health boards andICES’ projects with the Ministry ofHealth. One of the recommendationsmade by HSURC’s external reviewcommittee was that in-kind contributionsbe used as a method of engaging partnerswho are not otherwise able to afford jointsponsorship of research. All CHSRF-funded projects must include a decision-maker partner and many projects receivesome funding from a decision-makingorganization. Other joint projects arecollaborations between research groupsand funding agencies, such as thepartnership between CHSR and CIHR forcoordinating knowledge transfer efforts.

Sub-specialized Research CentresA few organizations have created sub-specialized research branches or separatecentres. CPRN operates three separateresearch networks, in Health, Work andFamily. A fourth branch, Corporate,initiates research projects transcending allthree networks. A director, who isresponsible for developing the researchagenda and disseminating researchfindings, heads each network. KSG is afederation of separate policy centres,each in charge of a different area ofresearch. Included in the federation arethe Malcolm Wiener Center for Social



Policy, the Institute of Politics and theHauser Center for NonprofitOrganizations.

Research on Transfer StrategiesSome organizations are directly involvedin the study of research transferstrategies. For example, CPRN is currentlyundertaking a Policy Research Project toexplore ways of improving relationshipswithin the policy research community andmaking policy research infrastructurework more effectively. CPRN hopes todevelop a model of “common space”that will encourage agenda sharing,support coordinated research, facilitatepersonal and professional exchanges andpromote linkages.

CHSRF sponsors CommunicationsInfrastructure Development Grants thatprovide funding to research organizationsfor improving their policy transfercapacity. HEALNet is currently sponsoringa program to solicit and fund projects on“Decisions and Evidence: Uptake ofEvidence in Multiple Level Decision-Making.” The forthcoming results of theprogram will help research organizationsraise their visibility among decision-makers. CHEPA has an active researchprogram on policy decision-making,including the factors that influence howthese decisions are made.

Transfer Strategy RequirementsFor many organizations—such as CPRNand PI—research transfer strategies are

incorporated into projects as a regularrequirement. HSURC commits one quarterof its budget to the dissemination andimplementation of its research findings.

Capacity BuildingGroups such as CHSPR build capacitywithin policy making organizations as ameans of ensuring that decision makersare able to make effective and continueduse of research data. As an extension ofLomas’ linkage and exchange model ofdeveloping early and continued relationswith stakeholders during the entireresearch process, capacity building mayinvolve strengthening research capacity inpartner organizations. For example,CHSPR attempts to foster independencein external partner groups, by giving themthe skills to investigate other issues ofinterest. PHRU issues briefs, such as“How to Read a Paper: Statistics for theNon-statistician,” to inform decision-makers on how to make use of research.

MembershipIWH’s membership program is targeted toWorkman’s Compensation Boards, one ofthe most important audiences for theirresearch. Launched in 1999, the programhas both Canadian and Americanmembers.

Table 1 summarizes the strategiesdiscussed above, and indicates whichorganizations in the scan employparticular approaches.



Table 1. Summary of Research Transfer Strategies

STRATEGY ORGANIZATION

Government Departments ARB, KSG, IWH,CIARInternational Organizations CPRN, IWH, CIARRegional Health Authorities CHSPRProfessional Organizations ICES, IWHPublic PIMedia KSGCommunity Organizations CI, CCPA, PHRUBusiness Groups HEALNet

Target Group(Who is engaged?)

Research Alumni KSGEnvironmental Scanning HSURC, ARBOutreach Programs PHRU, CHSRFReview Panels CHSRFWorking Groups CHEPA, HSURC, ICESStudy Release Strategies CCPA, HSURCParliamentary Process CCPA, CCSD

Timing(When are they

engaged?)

Follow-up/Evaluation CHSRF, IWHWeb Site ICES, CHSPR, IWH, CIARComputer Models HEALNet, CHEPA, IWHAccessible Research Products CIAR, CCPA, ICES, PIWide Variety of Outputs ICES,CIARIntegrated Messages IWHStudent Essay Contests PIResearch Transfer Officers HSURCTraining and Review CCPA, CHEPA, CHSRF, CPRN, HSURCJoint Research Projects CHSPR, CHSR, CIHR, HSURC, ICESSub-Specialization KSG, CPRNResearch on Transfer Strategies CPRN, CHSRF, CHEPA, HEALNetTransfer Strategy Requirements RN, PI, HSURCCapacity Building CHSPR, PHRU

Method(How are they

engaged?)

Membership IWH

LegendARB Applied Research Branch, HRDCCIAR Canadian Institute for Advanced ResearchCCPA Canadian Centre for Policy AlternativesCCSD Canadian Council on Social DevelopmentCHEPA Centre for Health Economics and Policy AnalysisCHSPR Centre for Health Services and Policy ResearchCHSRF Canadian Health Services Research FoundationCI Caledon Institute of Social PolicyCPRN Canadian Policy Research NetworkHEALNe Health Evidence, Application and Linkage NetworkHSURC Health Services Utilization and Research CommissionICES Institute for Clinical and Evaluative SciencesIWH Institute for Work and HealthKSG Kennedy School of GovernmentPHRU Population Health Research UnitPI Parkland Institute



4. ConclusionPopulation health research is conceptuallyand technically complex. It is not an easytask for researchers to ensure that theirresearch findings are readily accessible toand understood by policy makers andothers who might use this knowledge.Yet, by definition, population healthresearch is policy oriented. For populationhealth research to contribute to policiesthat reduce inequities and improve thehealth and well being of Canadians,research findings must be transferredfrom researchers to policy- and decision-makers. To accomplish this, there mustbe interaction between these two groups.

CPHI seeks to generate new knowledgeon the determinants of health. Just asimportant as creating new knowledge,however, is synthesizing the informationand transferring it in a digestible form tothose who shape policy and makedecisions affecting health. One of CPHI’saims is to support and create forums andvehicles for researchers and decision-makers to exchange information and buildenduring linkages.

This scan of research organizationsinvolved in health/social services researchand knowledge transfer has identified abroad range of research transferstrategies and processes that haveimproved research-policy linkages andencouraged the uptake of new knowledgeby decision makers. For the purposes ofthis scan, it has been useful to considerthe successful linkages and exchangesbetween researchers and decision makersin terms of who, when and how to targetimportant messages from the researchfindings.

Taken together, the experiences of theseorganizations represent a valuable tool kitfor CPHI and others in applying research

knowledge to policies that will affect thehealth and well-being of Canadians.Below are some of the key strategies andtechniques identified in this scan formaking population health researchrelevant to policy needs.

Who to engage:� For the most effective transfer of

population health research findings, awide variety of partners should beengaged, with specific audiencestargeted, depending upon the issuesunder study.

� Policy organizations should developcollaborative links with one another.

� A wide range of governmentdepartments should be targeted—notonly those in the health field, but anydepartment that deals with social orother determinants of populationhealth.

� Links with international communitiesshould be pursued as they lendlegitimacy to population healthresearch and facilitate internationalcomparisons.

� Professional organizations both withinand outside the health sector areimportant target groups as they canbe influential in policy development.

� The broader public is a useful partnerfor effecting indirect research transferto decision- makers.

� Closer ongoing linkages with themedia can be achieved through regularmeetings, news releases, etc.

� Community organizations can beeffective partners in joint projects asthey represent, and have access to,wider audiences.

� The business community is animportant target for research transfersince members are important decision-makers in the workplace, globalization



and the shift to a knowledge-basedeconomy, all of which are majorfactors affecting the health ofpopulations.

When to engage:� Engagement with stakeholders and

decision-makers should take placeearly on and be continuous throughoutthe research process.

� Environmental scanning is an effectivetool for surveying the political, socialand economic environments in orderto set research priorities.

� Decision-makers should be involved atthe earliest possible stage, forexample, on panels that evaluatefunding priorities and make researchfunding decisions. This kind ofpartnership in setting directions forresearch increases the chances ofresearch results being used bydecision-makers.

� The impact of the research on policy-and decision-makers should beevaluated following the release ofresults.

� Government officials should be briefedabout relevant research before the

passage of bills that may affectpopulation health.

How to engage:� Use working groups rather than

conferences to encourage dialoguewith those who may turn researchresults into policy.

� To maximize the uptake of policymessages, produce a variety ofoutputs, including pamphlets forcommunity groups and the public,technical reports for other researchersand popular publications.

� Develop a concise, readable format forresearch findings

� Build a research transfer strategy intoeach project.

� Establish formal links/partnershipswith interested organizations and keypolicy actors.

� Employ a research transfer specialist.� Create easy-to-use computer models

to assess and address thedeterminants of population health andinvolve decision-makers in this task.

� Sponsor research specifically on thetransfer of population health findings.

Appendix A

Participating Organizations

C a n a d i a n P o p u l a t i o n H e a l t h I n i t i a t i v eA–1

Unless otherwise indicated, organizations were contacted by telephone or e-mail and askedto describe the specific strategies they used to engage policy makers with their researchresults (other than strategies listed on their web sites).

Population Health Research Unit, Dalhousie University Department of CommunityHealth and Epidemiology (PHRU)• A government-funded academic research institute affiliated with Dalhousie University

that seeks to provide “efficient and effective support services for population-basedresearch.”

• The Province of Nova Scotia has supplied PHRU with complete Medicare, Pharmacareand hospital files suitable for research purposes. The PHRU also has access to WorkersCompensation records and a variety of other data sources, including clinical databasesand large-scale population surveys.

• Contact: 902-494-3860 www.mcms.dal.ca/gorgs/phru

The Caledon Institute of Social Policy (CI)• A private, non-profit social policy think tank with charitable status, supported primarily

by Toronto’s Maytree Foundation.

• CI’s work covers a broad range of social policy areas including income security (e.g.,pensions, welfare, child benefits, Employment Insurance, benefits for Canadians withdisabilities), taxation, social spending, employment development services, socialservices and health.

• Seeks to inform social policy experts and policy-makers on issues and developments inCanadian social policy.

• Contact: 613-729-3340 www.caledoninst.org

Institute for Work and Health (IWH)• An independent, non-profit research organization whose mission is to research and

promote new ways to prevent workplace disability, improved treatment, optimalrecovery and safe return-to-work.

• Research Transfer is one of the two core businesses of the IWH and is targeted atclinicians and the broader health care community, workplace stakeholders and policy-makers.

• Contact: 416-927-2027 www.iwh.on.ca

Canadian Council on Social Development (CCSD)• A self-supporting, non-profit research organization focussing on concerns such as

income security, employment, poverty, child welfare, pensions and government socialpolicies.

• Contact: 613-236-8977 www.ccsd.ca

http://www.mcms.dal.ca/gorgs/phru

http://www.caledoninst.org

http://www.iwh.on.ca

http://www.ccsd.ca


Institute for Clinical Evaluative Sciences (ICES)• A non-profit, independent organization of researchers funded by the provincial

government that is dedicated to improving the efficiency and effectiveness of healthcare for residents of Ontario.

• Its purpose is to gather and analyze health care data that could serve as a catalyst forchange, providing information and evidence that can serve as a compass for healthpolicy makers.

• Contact: 416-480-4055 www.ices.on.ca

Health Evidence Application and Linkage Network (HEALNet)• One of the federal Network of Centres of Excellence, HEALNet is dedicated to putting

research to work for health decision makers and information users in the health systemand the workplace.

• Focuses on research that optimizes health services research transfer and the use of thebest available evidence in decision making.

• Research addresses the health information needs of consumers/citizens, commercialorganizations, health care providers, health managers, administrators and policymakers.

• Contact: 905-525-9140 (ext. 22282) www.healnet.mcmaster.ca/nce

Canadian Health Services Research Foundation (CHSRF)• An independent, non-profit corporation that was established in 1996 through a $65

million federal grant. It was charged with sponsoring research and applying researchfindings to the management of health services.

• Its objectives are to identify research gaps and needs, define priorities in the field ofhealth services research, fund research projects, and to promote best practices ofhealth service delivery and the communication of research outcomes.

• Contact: 613-728-2238 www.chsrf.ca

Canadian Centre for Policy Alternatives (CCPA)• An independent, non-profit research organization funded primarily through

organizational and individual membership.

• Promotes research on economic and social policy issues from a progressive point ofview.

• Contact: 613-563-1341 www.policyalternatives.ca

http://www.ices.on.ca

http://www.healnet.mcmaster.ca/nce

http://www.chsrf.ca

http://www.policyalternatives.ca


Applied Research Branch—Human Resources and Development Canada (ARB)• Branch of the federal government that generates policy-relevant research to guide

HRDC in developing creative solutions to labour market, employment, human capitaldevelopment, income security, social development, labour adjustment and workplaceinnovation issues and problems.

• Establishes HRDC’s research and survey priorities, seeks evidence on the nature ofCanada’s human development issues through research and policy analysis, andassesses the impact of possible policy interventions.

• Contact: www.hrdc-drhc.gc.ca

Health Services Utilization and Research Commission—Saskatchewan(HSURC)• An arm’s length, government-funded agency with a mandate to assess Saskatchewan’s

health system and make recommendations for evidence-based change. It is also theprovincial health research granting agency.

• Contact: 306-655-1500 www.sdh.sk.ca/hsurc

Manitoba Centre for Health Policy and Evaluation (MCHPE)—University of Manitoba• A unit in the Faculty of Medicine at the University of Manitoba that conducts research

on the way health care services is used by Manitobans.

• It examines patterns of illness in the population, and studies how people use healthcare services as well as the factors that affect health.

• It is funded mostly by Manitoba Health under a five-year plan.Contact: 204-789-3819 www.umanitoba.ca/centres/mchpe

Canadian Institute for Advanced Research (CIAR)• A non-profit research corporation with charitable status.

• A research institute dedicated to the advancement of basic knowledge—how and whythings happen in nature and in the human community—and to the implications of thisknowledge for the everyday world.

• Included in the CIAR is the Population Health Program that seeks to understand howsocial, economic, environmental, cultural and genetic factors, together with health care,determine the health status of whole populations.

• Contact: 416-971-4251 www.ciar.ca

http://www.hrdc-drhc.gc.ca

http://www.sdh.sk.ca/hsurc

http://www.umanitoba.ca/centres/mchpe

http://www.ciar.ca


Parkland Institute (PI)—University of Alberta• A research network within the Faculty of Arts at the University of Alberta with a

mandate to “conduct research on economic, social, cultural, and political issues facingAlbertans and Canadians; publish research and provide informed comment on publicissues; sponsor conferences and colloquia; bring together the academic and non-academic communities; and train graduate students.”

• The Institute is not a lobby group. They do not stress particular policy alternatives, butrather just inform public debate.

• Contact: 780-492-0417 www.ualberta.ca/PARKLAND

Centre for Health Economics and Policy Analysis, McMaster University (CHEPA)• A research institute associated with McMaster University that is funded in equal parts

by the university, the Ontario Ministry of Health, and outside sources (largely privatefoundations and corporations from both within and outside the health sector).

• Its mission is “to promote a collegial and supportive interdisciplinary environment inwhich decisions made through consensus foster excellence in acquiring, producing andcommunicating socially-relevant knowledge in the fields of health economics and healthpolicy analysis.”

• They do this through research and educational programs. They also take requests fromgroups and individuals outside the university for advice and consultation on healtheconomics and policy analysis issues.

• Contact: 905-525-9140 (ext. 22122) www.chepa.mcmaster.ca

Centre for Health Services and Policy Research—University of British Columbia(CHSPR)• A research branch of the University of British Columbia that endeavours to “stimulate

scientific enquiry into issues of health in population groups and ways in which healthservices can best be organized, funded and delivered.”

• Its goal is to “encourage and promote first-class research by facilitating thedevelopment of cross-disciplinary approaches.”

• Contact: 604-822-4810 www.chspr.ubc.ca

Kennedy School of Government, Harvard University (KSG)• A federation of research centres and individual faculty associated with Harvard

University whose mission is to “strengthen democratic governance around the world bytraining people for public leadership and by helping to solve problems of public policy.”

• Contact: 617-495-9378 www.ksg.harvard.edu

Canadian Policy Research Network (CPRN)• A non-profit policy research organization with charitable status that is funded by

government, foundations and corporations.

• Its mission is to “create knowledge and lead public debate on social and economicissues important to the well-being of Canadians.”

• Contact: 613-567-7640 www.cprn.org

http://www.ualberta.ca/PARKLAND

http://www.chepa.mcmaster.ca

http://www.chspr.ubc.ca

http://www.ksg.harvard.edu

http://www.cprn.org

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