Transcript Communicating Research to Policy Workshop, IPTK, 30 May 2011

NATIONAL HEALTH PROMOTION CONFERENCE 2011,
Cititel, Mid Valley, K. Lumpur, 10-11 October 2011.
“Translating Research
into Health Practices”
Dr. Sulaiman Che Rus, Public Health Physician (Epidemiology);
Hjh. Zawaha Idris, Health Education Officer,
Institute for Health Behavioural Research (IPTK),
Ministry of Health, Malaysia.
1
Presentation Outline
History of Research.
Definitions of related terms.
Factors affecting Translating Research
into Practice.
Recommendations to researchers on
communication.
Case studies of disseminating local
research findings.
2
Ibn al-Haytham (Alhazen),
965–1039, Basra
Early pioneer in
development of
scientific
method
Sculpture by Olin Levi Warner (1896)
"Research
holding the
torch of
knowledge"
TERM:RESEARCH
Old French – “recerchier –
search.”
Middle French – “recerche - “to
go about seeking/to investigate
thoroughly.”
1577 – Earliest recorded use of
term.
RESEARCH:DEFINITION
“the search for knowledge, or
as any systematic investigation,
to establish novel facts, solve
new or existing problems, prove
new ideas, or develop new
theories, usually using a
scientific method.”
(Wikipedia)
RESEARCH:DEFINITION
“Any gathering of data,
information and facts for
the advancement of
knowledge.”
(Martin Shuttleworth 2008)
EVIDENCE
Includes everything that is used to
determine or demonstrate the truth of an
assertion.
Accumulated through observations of
phenomena that occur in the natural world,
or which are created as experiments in al
laboratory or other controlled conditions.
TRANSLATING RESEARCH
Evidence-Based Policy:
- Spread from Evidence-based Medicine (EBM):
- First coined by Guyatt, 1992.
- “the conscientious, explicit and judicious us of
the current best evidence in making decisions about
the care of individual patients”.
(Sackett, 1996)
- Concern relationship between research
evidence, practice and policy.
9
TRANSLATING RESEARCH
Evidence-based policy and practice has
grown in interest.
Recent studies suggest that there is both the
potential to negotiate and communicate the
research findings.
Most problematic is the gulf between those
who commission the research and those who
conduct it, and the suppose ultimate
beneficiares.
(Hovland, 2003)
10
TRANSLATING RESEARCH
Knowledge Translation (KT).
Translating Research into Practice
(TRIP).
Getting Research into Policy and
Practice (GRiPP).
TRANSLATING RESEARCH
“A dynamic and interactive process that
includes the synthesis, dissemination,
exchange and ethically sound
application of knowledge to improve
health, provide more effective health
services and products and strengthen
the health care system.”
(CIHR 2007)
POLICY
“A set of decisions to pursue
courses of action aimed at
achieving defined goals for
improving the health situation”.
(WHO)
13
POLICY
“Plans or statements issued by
authority that are designed to
direct decisions or actions”.
(East-West Center, 2010)
14
POLICY
1. Technical Policies:
“Plans or statements directing how various
health and population interventions should
be delivered (e.g. Hypertension protocol).
2. Allocation Policies:
“Plans or statements from legislative or
executive authorities related to the
organization of systems (e.g., Health), the
actors involved, or the generation and use
of resources.”
15
POLICYMAKERS (DECISION-MAKERS)
“Individuals who have the
power to make laws, set
policies, affect regulations and
practices, or allocate
resources”.
East-West Center, 2010
16
POLICYMAKERS IN MINISTRY OF HEALTH
Cabinet (Prime Minister)
Post-Cabinet (Minister of Health)
Mesyuarat Pagi (KSU)
JDPKK (KSU & KPK)
JK Teknikal (KPK)
PROGRAMMES (Directors)
17
PROBLEMS OF TRANSLATING
RESEARCH TO POLICIES
Validity of research.
Inadequate policy relevant research.
Lack of access to research findings by
policymakers.
Poor understanding of policy process
by researchers.
Ineffective communication strategies
by researchers.
18
PROBLEMS OF TRANSLATING
RESEARCH TO POLICIES
Lack of linkages/understanding/ support of
research target group.
Ignorance/inability of policymakers of the
existence or importance of research findings.
Policymakers being dismissive,
unresponsive or incapable of using research
findings.
Other implications – socio-political,
economic and cultural.
Validity of knowledge, censorship, and
ideology.
19
RESEARCHERS &
POLICYMAKERS GAP
Case study in 7 countries:
- Many researchers were skeptical about
the extent to which research findings were
adopted.
- Policy makers and managers were
themselves skeptical about the about the
usefulness of research findings.
(COHRED, 2000)
20
NARROWING RESEARCHERS &
POLICYMAKERS GAP
Need for mutual trust and respect between
researchers and decision-makers.
Recognize each other strengths, weakness,
likes and dislikes.
Involve decision-makers in early stage of
research development and planning.
Address how research results are
communicated and disseminated.
Disseminate research findings to variety of
audience fort advocacy.
(Tan Sri Ismail Merican, 2006)
21
RECOMMENDATIONS TO
RESEARCHERS
Involve policymakers in planning, progress
& review of results.
Conduct practical, service implementation
research.
Communicate easy-to-read reports &
articles.
Provide details of findings to programme
managers.
Use multiple media to communicate.
22
Put a face to research findings.
Network with advocates, programme
administrators and officials.
Be willing to consider options and
alternatives in the face of disagreement.
Provide timely report within planning
cycles.
Think through the research findings and
recommendations.
Be persistent and positive.
23
COMMUNICATION &
DISSEMINATION CHECKLIST
Understand policy makers information
needs.
Construct research results in a way that
makes ideas useful (e.g., timely reports,
use of non-technical language, executive
summaries).
Develop clear policy recommendations
in research products.
Promote policy entrepreneur skills.
24
Develop a systematic dissemination
strategy (including advocacy and campaign
techniques).
Build channels of communications (websites, publications, media liaison).
Organize workshops, conferences and
other public or professional events.
Tailor & target research to user groups &
stakeholders.
25
LOCAL RESEARCH UPTAKE
8th Malaysia Plan:
– 57 research projects at the cost of RM13
million.
– IRPA funded 21 projects at cost of RM41
million.
– Five Patents registered and 4 products
commercialized.
9th Malaysia Plan(2006-2010):
– RM90 million allocated for research
projects.
26
Case Studies of
Research Uptake By
IPTK
27
INSTITUT PENYELIDIKAN
TINGKAHLAKU KESIHATAN (IPTK)
Formally formed in November 2005.
Staff – 5 Health Education Officers (2 S48,
2 S44 and One S41).
Major research conducted (Principal
Researcher - Pn. Zawaha):
1. Food Poisoning in Kelantan, 2007.
2. KAP of National Service Trainees (PLKN)
in Selangor, 2008.
3. H1N1 Community Surveys, 2009.
4. Perceptions of Dengue Control
Programme, 2010.
FOOD POISONING IN SCHOOLS
OF KELANTAN - 2007
Study conducted in collaboration with JKN
Kelantan & MOE.
Comparative study of all 29 school canteens
with food poisonings (2004-2006) and without
food poisonings (29 schools) in Kelantan.
Study scope:
- Microbial contamination of foods & utensils.
- Personal hygiene of food handlers.
- Food premise inspections.
- KAPs.
29
SIGNIFICANT FINDINGS
 Varying degrees (90 – 10%) of
microbial contaminations of food,
water, utensils & food handlers.
 Unsatisfactory hygiene status of
more than 60% among the school
canteens.
 50% of Food Handlers had poor
KAP scores .
30
RECOMMENDATIONS &
ACTIONS
 The importance of food safety and hygiene highlighted.
 Decisions of JKN & MOE:
o Food handlers need medical examinations &
certifications.
o Compulsory attendance by food handlers on trainings
of food handlings health education.
 Presentations:
o 6th National Health Conference, USM, Kelantan,
2009.
o Persidangan Komunikasi Kesihatan Kebangsaan,
2008.
o JKN Kelantan, Bahagian Kualiti Makanan & Bahagian
31
Kawalan Penyakit, KKM, 2008.
HRBS AMONG PLKN TRAINEES
SELANGOR - 2008/2009
Study conducted in all 9 PLKN Camps in
Selangor, 12/2008-7/2009:
o 6025 trainees participated.
Study conducted in collaboration with MOH
and MOD.
Report:
o Disseminated to Deputy MOH, KPK &
TKPK (P&ST).
o Presented to MOH Programme officers in
April 2011.
o 13 NIH Scientific Meeting, 2010.
32
SIGNIFICANT FINDINGS
 Male trainees - higher high risk
behaviours related to smoking,
alcohol, drug abuse and sex.
 Female trainees - higher prevalence
of incomplete meals and lower stress
coping skills.
 Adequate physical activity among all
trainees was unsatisfactory.
33
RECOMMENDATIONS
An integrated & comprehensive health
promotion & prevention program for
secondary schools to address identified
problems:
Cigarette, drug and substance abuse
especially among male students.
Promotion of physical activity &
enhancement of related physical facilities
in the schools and community.
34
RECOMMENDATIONS &
ACTIONS
Promotion of healthy eating.
Introduction of sexual health education.
Mental health especially on stress coping
skills.
Actions: Family Health Development
Division, MOH has incorporated the
findings for the development of health
education materials for adolescents.
35
COMMUNITY SURVEYS
ON H1N1
Studies conducted in May & July, Klang Valley
& Sept/Oct. 2009 Nation-wide.
Klang Valley Community Surveys:
o May – 1460 respondents.
o July - 2302 respondents.
o Sept/October (5 consequentive weeks) –
6567 respondents nation-wide.
Study scope:
o Knowledge on HIVI and control.
o Perceptions on control by Ministry of Health.
36
FINDINGS & ACTIONS
More than 90% worried of H1N1.
Knowledge on disease, mode of spread
and prevention had increased with
subsequent surveys.
Need for emphasis on hand washings
and cough etiquettes.
 Actions: MOH used the survey results to
monitor the effectiveness of control
programme.
FGDs ON DENGUE
CONTROL - 2010
1. FGDs Among Public Health Staff on Dengue
Control Measures, Selangor, March 2010.
o Conducted among serving PPKPs, PKAs
and Labourers in Petaling District.
o Study conducted with the blessings of JKNS
and Petaling Health District.
Report:
o Full report given to District Health Office and
JKN Selangor.
o Presentations to MOH including VBDCP and
JKNS
38
RECOMMENDATIONS
o Community Complacency:
Innovative, client centred and risk communication
approaches need to be utilised for individual and
community empowerment for the control of dengue:
o Messages directed at local community should contain
relevant local statistics and risk information.
o Development of messages must be based on need
assessment of the local community.
o Community engagement in dengue control strategies
requires more than just information giving but also needs
processes for encouraging meaningful community
participation founded on the understanding of community
attitudes and beliefs.
39
o Dengue Control Programme:
- The issue of field leadership need to be resolved. Location of
Aedes beeding sites in outbreaks by PKA to be supervised.
- Team Work Needed:
•
Discussion on situational analysis & strategies for control.
•
Plan both short and long term strategies.
•
Enforcement efforts - Regular and simplified.
•
Coordination with local authorities to be enhanced.
- Innovations:
•
Placing Mobile units at outbreak areas.
•
Rental of vehicles.
40
CONCLUSION
Seize unexpected opportunities;
Local experiences showed the need to
involve policymakers to determine the
needs and early problem identifications.
Nevertheless, knowledge and skills on
communication do contribute towards
translating research into policies.
Be Creative with recipes for research
translation;
41
WAY FORWARD
Pay great attention to the results of each
translational step, and
Multiple factors affect uptake of research
findings into policies:
- Strengthen research capability &
capacity;
- improve dissemination of research for
different audience;
- strengthen networking.
42
INTERLINKED NETWORK
UP the line to superiors & sponsors;
DOWN the line to programme managers &
other front line practitioners;
ACROSS the lines to fellow colleagues;
and
OUTREACH to service users, their
support network & organised client group.
43
“It is not enough to be
busy. The question is:
what are we busy about?”
Henry David Thoreas
44
REFERENCES
Crewe E, Young J. Bridging Research and Policy: Context, Evidence and
Links. London: Overseas Development Institute, September 2002.
Exchange. Communicating health research: How should evidence affect
policy and practice. Number 5, April 2005. Access at
http//www.healthcomms.org.
Haines A, Kuruvilla S, Borchert M. Bridging the implementation gap
between knowledge and action for health.
Hj. Nordin Saleh. Getting Research into Policy and Practice and Policy
Making Process. Lectures, 30 May 2011.
Last JM. A Dictionary of Public Health. New York: Oxford University
Press, 2007.
Shuttleworth, Martyn (2008).”Definition of Research”. Experiment
Resources. Experiment-Research.com. Retrieved 14 August 2011.
Tan Sri Dato Seri Dr. Hj. Mohd. Ismail Merican. Getting Research into
Policy and Practice. 9th NIH Scientific Meeting, 18 September 2006.
Tan Sri Dato Seri Dr. Hj. Mohd. Ismail Merican. Translating Research into
Practice and Policy. 6th National Pharmacy Research and Development
Conference 2010.
Wikipedia. Research. Accessed at http//www.wikipedia/research. Retrieved
5 September 2011
45