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What Constitutes Evidence in Public Health?

What Constitutes Evidence in Public Health?. Presented by David Hunter Professor of Health Policy and Management 16 th January 2014. What we Already Know. Improving health and wellbeing, and tackling inequalities and the social determinants of health

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What Constitutes Evidence in Public Health?

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  1. What Constitutes Evidence in Public Health? Presented by David Hunter Professor of Health Policy and Management 16th January 2014

  2. What we Already Know • Improving health and wellbeing, and tackling inequalities and the social determinants of health • Are complex, ‘wicked issues’: cross-cutting, multi-factorial, multi-levelled • Occur against a backdrop of performance pressures to meet targets across sectors & agencies • Have to contend with a patchy, thin evidence-base – poor fit to local context, often contested • Experience a disappointing uptake of evidence-based changes

  3. http://www.ted.com/talks/ben_goldacre_battling_bad_science.htmlhttp://www.ted.com/talks/ben_goldacre_battling_bad_science.html

  4. Key Issues • Many factors get in the way of using research • We know little about what makes research get adopted or not • Promoting close interaction between researchers and end users is critical • Being clear who the end users are

  5. Problems with the Term ‘Evidence’ • What is evidence? • Hierarchy of evidence – is a typology more appropriate? • Whose evidence? • Is ‘knowledge’ a better term? • How much do these debates matter anyway?

  6. Scientific findings do not fall on blank minds that get made up as a result. Science engages with busy minds that have strong views about how things are and ought to be. • Michael Marmot (2004) British Medical Journal

  7. Pathways to Evidence-Informed Policy and Practice • Linear model • Interactive model

  8. Linear Model • Evidence/knowledge is a product • Uni-directional flow from producers to research users • Knowledge is generalisable across contexts

  9. Policy-Makers’ Sources of Evidence • Experts’ evidence (including consultants and think tanks) • Evidence from professional associations • Opinion-based evidence (including lobbyists and pressure groups) • Ideological evidence (including party think tanks, manifestoes) • Media evidence • Internet evidence • Lay evidence (including constituents’ and citizens’ experiences) • ‘Street’ evidence (including urban myths, conventional wisdom) • Research evidence

  10. Interactive Model • Embracing knowledge from multiple sources: research, theory, practice • Promoting close interaction between researchers and end-users in a co-production/co-creation approach • Context is important • Effective uptake is not only a function of the science but also the degree to which the purveyor of knowledge is viewed as a credible witness • Relationships are key to use and application of knowledge • Dissemination of results through traditional academic channels is not enough – the media utilised must fit the audience

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