Transcript Dia 1

Evidence and good practice in
mental health promotion – an
area of conflict between scientific
and practical demands?
Promotion of Mental Health – Improving
Practice and Policy
8-9th of October 2009
Ilse Julkunen
[email protected]
17.7.2015
THL Ilse Julkunen
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Knowledge is the most valuable resource
available to policy makers to achieve
improved health and well-being around the
world
Knowledge for Development
World Bank´s 1999 World Development Report
Themes to adress
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Practice and practical demands
Evidence of what?
Knowledge Challenges
Critical components in developing innovative
learning - good practices
The virtue of having method-driven,
objective, systematically produced general
knowledge becomes a vice when we are
led to mistakenly believe that such
knowledge is sovereign with respect to
practice.
(Thomas A Scwandt 2002, 198: Evaluation practice reconsidered)
Practical inquiry
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John Dewey ”pattern of inquiry” (1938);
It is based on a pragmatic paradigm that
sees commonsense as well as scientific
knowledge as means to improve human
practices. It emphasises that the scientific
goal is to create knowledge of the practical
that is practical to the practical.
Practice
The concept of practice is an assemblage comprising a
variety of processes
(Alexander Styhre, Gothenburg university)
Both early and and contemporary pragmatists reject
the idea of a certain truth that can be discovered
through logical analysis or revelation, and are more
interested in knowledge gained through experiences.
Because of this understanding knowledge is shaped by
multiple experiences, and this becomes a central value
(Pragmatist Feminism)
I seriously believe that a bit of fun helps thinking
and tends to make it pragmatical (Charles Peirce 1922)
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The main aim is to create scientific
knowledge that has practical value
Another aim is to generate practical
knowledge through empirical studies on a
local level
Cf Göran Goldkuhl, Linköping university (What does it mean to
serve the citizens in e-services?)
To do research is a practical activity
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Even though the practice is uncertain, chaotic and
changing, it is still the reality where we must solve
central problems that appear.
The process is analogical whether we talk about
everyday activities or research. In both situations it
is a question of problemsolvingprocesses.
It is time to raise the value of the practical needs in
knowledge production
said John Dewey already in 1929
Grasping the complexity..
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We pay too much attention towards how
the services SHOULD function
Instaed we should focus on HOW the
services function
Invisible mechanisms; culture
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Providing a diagnosis is itself a miniature
treatment carrying its own effect and one that
can shape the long term outcomes of illness
(Brody & Waters 1980)
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Logical models as tools for grasping
processes
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Logical models: www.innonet.org ,
www.uwex.edu/ces/pdande/evaluation/evallogicmod
el.html
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http://www.onthepoint.ca/kec/know.htm
Knowlton & Phillips: The Logic Model Guidebook
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Some hints from Ray Pawson
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Intensify evalaution of programme staged
(what are pre-ignition effects? Are eaitinglists a help or hindrance?)
Study dropping-out (which occurs at all
points in the chain) rather than outcome
destinations
Study mature programmes and their
history
3.10.2009
Ilse Julkunen
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The innovative nature of science
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Popper concluded that scientific theories are only
hypotheses and may be falsified and replaced any day.
Consequently, what is important for the growth of
science is not the confirmation but the attempted
falsification of theories.
For the practitioner this means that he or she should
always continue to test complex ramifications of theories
and test them in as many different types of situations as
possible.
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Haluk Soydan 2007
The challenge of time
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Social and behavioural change happens
slowly and painstakingly, a series of
measures is required to bring about
profound and lasting change
Methods of evaluation research are not
always up to scratch in being able to identify
the crucial elements.
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Ray Pawson (2009) Reducing Plague by Drowning Witches:
Locating the Real Mechanisms of Change in Social and
Health Interventions
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The challenge of capabilities
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While the actual beings and doings as well as the
changing of beings and doings are more or less
directly measurable, the dimensions that really
counts ethically, the powers, freedoms, and
agency of clients to live a life they have reason to
value, is possibly rather latent, unobservable and
interdependent. These powers, the capabilites of
people, are the mechansims that indicate change.
If we take this perspective seriously, its is not
programs that work. Rather what works is the
underlying reasons and resources that they offer
subjects that generate change (Pawson 2002)
How do we look at knowledge
creation?
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Do we look at knowledge as knowledge
transfer or as co-production of knowledge?
For research to be useful it not only needs to
be credible but actionable as well
Knowledge cannot be apprehended solely as a
stocked market that can be transferred from one
person to another irrespective from where it
came
The starting point is that knowledge forms
through interaction with people when people
have the possibility to encounter
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Learning spaces
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Reflective benchmarking is a question of creating
learning spaces (Nonaka et al 2000).
Learning and adapting new knowledge requires a
common shared ground (home base).
Learning does not happen in vacuum, but
depends on the circumstances and the context
where people meet (history is present).
Management Challenges for
Self-Renewing Development
Knowledge
Management of
Leadership
Management
Work Organization
Personal
Mastery
Resource
Management
Team
Learning
Knowledge
Creation
Processes
Mental
Modelling
Shared
Vision
Management
of Networks
Systems
Thinking
Strategic and Visionary
Management
© Markku Markkula
Closeness, co-production an open
innovation
Organising sustainable innovation is grounded in four
principles (Steven Weber (2004)):
1.
2.
3.
4.
Mandating people to test; motivation and encouragement
Interchange of knowledge between actors; through eprocesses
Splitting the process into parts (modularity), the parts are
handled separately and the results are collated
Creating a flexible and well-organised adminstration;
general rules, how to participate, how to do decisions and
how to maintain the process
Services do not produce social
outcomes; people do
Cummins & Miller 2007
Users not just as informants but actively
taking part in both developing and
evaluating the outcome
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A ”Living Lab” is a ...
citizen-business-public partnership
operating in real life/work environment
providing user-driven innovation service
PEOPLE
ACADEMY
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© 2005 Nokia
V1-Filename.ppt / yyyy-mm-dd / Initials
INDUSTRY
GOVERN.
(The term ”Living Lab” was created by Bill Michell, MIT, around 1995)
1. How is practice identified and
conceptualised?
2. How is practice evaluated
in its context?
5. How is the dissemination
of the practice promoted?
1.
Tunnistaminen
5.
Levittäminen,
käyttöönotto
4. How is practice tested in
the learning network?
Hyvän
käytännön
oppimisverkosto
4.
Dialoginen
validointi
2.
Arviointi
3.
Kuvaaminen
3. How is practice
condensed and published?
Good practice process
www.goodpractice.fi
The hybrid nature
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The good practice process is about identifying, evaluating
and condensing good practice, analysing it critically and
validating it through dialogue and promoting its
implementation. This is not always a linear process. That
is why the figure describing the good practice process, is a
hybrid presentation.
An example of the hybrid nature of the process is that
you can start to describe good practice even before it has
been assessed. Ideas of good practice can also start to
spread to a wider audience from a local level.
Ilse Julkunen
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Good practice – program theory
Effectivity through dialogues
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THL's good practice process is built upon the framework
of democracy-driven dialogue. It enhances bottom-up
knowledge creation. It builds on creating researchmindedness among practitioners and on enhancing
knowledge creation on different levels.
The holistic process consists of different elements such
as identification, evaluation, condensation, validation
and dissemination.
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Knowledge about practice
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It is not the practice itself but rather knowledge about it
that can be transferred (such as descriptions of good
practices).
If a practice is to be applied elsewhere, this should take
place in a context that is sufficiently similar to the context
where the practice originally proved to be functional and
effective.
To implement and apply a practice is a process where the
practice and its context are co-produced. The more
humans and other elements a practice is constituted by,
the more likely it changes when it is applied elsewhere
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Inno village
OPISTO
-tuutorit
-kirjasto
TECNICAL
PANKKI
PLATFORM
MULTIFORM
NETWORKS
VILLAGERS
SERVICES
KIOSKI
TORI
NEW
SERVICES
VILLAGE SUPPORT ACTIVITIES
Inno-college
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Knowledge and competence
Coordiantion of different good practice paradigms
Inno tutors: a competence community accessible for
all
 Organises development, evaluation,
condensation and implementation
 Learning network support
Inno library
 Continuously updating methods for evaluation,
development and implementation
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Future good practice
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The Good practice process is possible to enlarge
and build to a manylevel, dynamic process.
Collecting and creating knowledge and sharing
knowledge is essential
This requires development of an electronic
innovation environment and development of
learning networks.
The platform serves as a support for producing
innovations and applying new innovations.
To conclude
The aims of knowledge management are to collect all
relevant information and intellectual capital into a
common system, and provide equal access to that
information, ensuring that it can be synthesized with local
needs. Such a system enables members of the public health
community directly with thier peers on matters of mutual
interest (effective practices).
Public health practitioners should share and exploit
experiental knowledge in a much direct way through
communities of practice – informal networks linking
individuals and groups who share common professional
interests and who benefit from frequent exchanges of
knowledge.
Edward Mullen (2008) Evidence-Based Policy and
social work in health and mental health.
Thank you for listening!
[email protected]
www.goodpractice.fi