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Home >>Other NIHR Research >>School for Public Health Research >>Cultures of evidence in non-health sectors

Cultures of Evidence beyond the Health Sector: Understanding policy decision-making in English local government for improving action on the social determinants of health. Project 1: Review and synthesis: cultures of evidence in non-health sectors

Project title

Cultures of Evidence beyond the Health Sector: Understanding policy decision-making in English local government for improving action on the social determinants of health. Project 1: Review and synthesis: cultures of evidence in non-health sectors

Project reference

SPHR-LSH-PH1-LAR

Final report date

01 April 2014

Project start date

01 June 2012

Project end date

31 October 2013

Project duration

17 months

Project keywords

Evidence-Based Practice; Organisational Culture; Policy Making; Qualitative Research

Lead investigator(s)

Dr Karen Lock, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (Reader in Public Health)

Collaborators

Dr Theo Lorenc, Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine
Mrs Elizabeth McGill (nee Tyner), Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine
Dr Gemma Phillips, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine
Dr Mark Petticrew, Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine
Dr Fred Martineau, Department of Global Health and Development, London School of Hygiene and Tropical Medicine
Mr Steven Duffy, York Health Economics Consortium, University of York

Project objectives

Design

Systematic review.

Objectives

To review and synthesize the evidence on the use of research or evidence in local decision-making in non-health sectors. The review will include studies of any design, qualitative or quantitative, which examine decision-makers’ attitudes, perceptions or behaviours. The following policy sectors will be included: housing; urban planning and regeneration; policing and community safety; transport; licensing; trading standards (the following will be excluded: healthcare; public health; education; social care).

Changes to project objectives

No substantive changes. The scope of the review with respect to specific policy sectors has been clarified explicitly.

Brief summary

Background

It is important to understand the decision-making process, and the role of research evidence within it, across sectors other than health, as interventions delivered within these sectors may have substantial impacts on public health and health inequalities.

Methods

Systematic review of qualitative evidence. Twenty-eight databases covering a range of sectors were searched. Studies were eligible if they included local decision-makers in a policy field relevant to the social determinants of health (including housing, transport, urban planning and regeneration, crime, licensing, or trading standards), were conducted in a high-income country, and reported primary qualitative data on perceptions of research evidence. Study quality was assessed and a thematic synthesis undertaken.

Results

Sixteen studies were included, most using interview designs, and most focusing on planning or transport policy. Several factors are seen to influence decision-makers’ views of evidence, including: practical factors such as resources or organisational support; the credibility of the evidence; its relevance or applicability to practice; considerations of political support or feasibility; and legislative constraints. There are limited data on how evidence is used: it is sometimes used to support decision-making, but also to lend legitimacy to decisions which have already been made.

Conclusion

While cultures of evidence in non-health sectors are similar to those in health in some ways, there are some key differences, particularly as regards the political context of decision-making. Intersectoral public health research could benefit from taking into account non-health decision-makers’ needs and preferences, particularly around relevance and political feasibility.

Plain English summary

Due to the importance of intersectoral working and policy-level interventions in promoting health in Local Government, we need to understand non-health decision-makers’ practices and views, particularly about the use of research evidence.
Decision-makers in non-health sectors value evidence which is credible and relevant to practice, and feel that much existing research evidence does not meet these needs.
In some sectors, laws and regulations may limit the extent to which evidence can be used to inform decisions.
Evidence may often be used tactically to justify and legitimise decisions post hoc. Hence, increasing the uptake of research evidence may make limited difference to the quality of decisions.
Public health policy-makers and practitioners should be aware that other sectors may have different cultures of evidence.
While cultures of evidence in non-health sectors are similar to those in health in some ways, there are some key differences, particularly as regards the political context of decision-making. Intersectoral public health research could benefit from taking into account non-health decision-makers’ needs and preferences, particularly around relevance and political feasibility.

Dissemination

Published articles

Lorenc T, Tyner EF, Petticrew M, Duffy S, Martineau FP, Phillips G, et al. (2014) Cultures of evidence across policy sectors: systematic review of qualitative evidence. The European Journal of Public Health. 2014:doi: 10.1093/eurpub/cku038
http://eurpub.oxfordjournals.org/content/24/6/1041

Conference presentations

Lorenc T, Tyner E, Petticrew M, Duffy S, Martineau F, Phillips G, Lock K. Cultures of evidence among decision-makers in non-health fields: Systematic review of qualitative evidence. Department of Health Services Research and Policy: 25th Anniversary Celebration. 12 Nov 2013. (poster)
Tyner E, Lorenc T, Petticrew M, Duffy S, Martineau F, Phillips G, Lock K. Cultures of evidence among decision-makers in non-health fields: Systematic review of qualitative evidence. Public Health Science Conference (The Lancet). London, 29 Nov 2013. (poster)
Lorenc T, Phillips G. Evidence beyond the health sector. NIHR SPHR Annual Scientific Meeting. London, 8 Oct 2013.
Tyner E, Lorenc T, Petticrew M, Duffy S, Martineau F, Phillips G, Lock K. Cultures of evidence among decision-makers in non-health fields: A systematic review of qualitative evidence and implications for the utilisation and impact of academic research. LSHTM Annual Symposium 2013: Maximising Research Impact. London, 24 Sept 2013. (poster)
Lorenc T, Tyner E, Petticrew M, Duffy S, Martineau F, Phillips G, Lock K. Cultures of evidence among decision-makers in non-health fields: Systematic review of qualitative evidence. 21st Cochrane Colloquium. Québec City, 19 – 23 Sept 2013. (poster)
Lorenc T, Tyner E, Petticrew M, Duffy S, Martineau F, Phillips G, Lock K. Cultures of evidence among decision-makers in non-health fields: Systematic review of qualitative evidence. Society for Social Medicine 57th Annual Scientific Meeting. Brighton, 11 – 13 Sept 2013. (poster)

Workshops and seminars

Lock K. The nature of evidence for “healthy planning”. ESRC Seminar Series: Evidence, Governance and Policies for Health and Planning, Bristol, 29 Jun 2015. (presentation)

Public involvement

This project was one of two linked projects. This one was a systematic literature review. We did not have explicit PPI for the review, although we used the practitioner involvement in the linked projects to inform the types of policy sectors and its applications for this review.

Impact

The peer review paper has just been published on 27th March 2014.

We have tweeted the link and will be able to report on both citations impact, but also social media impact in 3-6 months.

When presenting the work at conferences and in meetings, we have found that it has stimulated a lot of discussion. In particular it has raised awareness amongst public health practitioners about the challenges of working in a Local Government setting.

This project was funded by the National Institute for Health Research School for Public Health Research (project number SPHR-LSH-PH1-LAR).

Department of Health Disclaimer

The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the NIHR School for Public Health Research, NIHR, NHS or the Department of Health.