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      Experience of Kenyan researchers and policy-makers with knowledge translation during COVID-19: a qualitative interview study

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          Abstract

          Objectives

          Researchers at the KEMRI-Wellcome Trust Research Programme (KWTRP) carried out knowledge translation (KT) activities to support policy-makers as the Kenyan Government responded to the COVID-19 pandemic. We assessed the usefulness of these activities to identify the facilitators and barriers to KT and suggest actions that facilitate KT in similar settings.

          Design

          The study adopted a qualitative interview study design.

          Setting and participants

          Researchers at KWTRP in Kenya who were involved in KT activities during the COVID-19 pandemic (n=6) were selected to participate in key informant interviews to describe their experience. In addition, the policy-makers with whom these researchers engaged were invited to participate (n=11). Data were collected from March 2021 to August 2021.

          Analysis

          A thematic analysis approach was adopted using a predetermined framework to develop a coding structure consisting of the core thematic areas. Any other theme that emerged in the coding process was included.

          Results

          Both groups reported that the KT activities increased evidence availability and accessibility, enhanced policy-makers’ motivation to use evidence, improved capacity to use research evidence and strengthened relationships. Policy-makers shared that a key facilitator of this was the knowledge products shared and the regular interaction with researchers. Both groups mentioned that a key barrier was the timeliness of generating evidence, which was exacerbated by the pandemic. They felt it was important to institutionalise KT to improve readiness to respond to public health emergencies.

          Conclusion

          This study provides a real-world example of the use of KT during a public health crisis. It further highlights the need to institutionalise KT in research and policy institutions in African countries to respond readily to public health emergencies.

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          Most cited references20

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          A systematic review of barriers to and facilitators of the use of evidence by policymakers

          Background The gap between research and practice or policy is often described as a problem. To identify new barriers of and facilitators to the use of evidence by policymakers, and assess the state of research in this area, we updated a systematic review. Methods Systematic review. We searched online databases including Medline, Embase, SocSci Abstracts, CDS, DARE, Psychlit, Cochrane Library, NHSEED, HTA, PAIS, IBSS (Search dates: July 2000 - September 2012). Studies were included if they were primary research or systematic reviews about factors affecting the use of evidence in policy. Studies were coded to extract data on methods, topic, focus, results and population. Results 145 new studies were identified, of which over half were published after 2010. Thirteen systematic reviews were included. Compared with the original review, a much wider range of policy topics was found. Although still primarily in the health field, studies were also drawn from criminal justice, traffic policy, drug policy, and partnership working. The most frequently reported barriers to evidence uptake were poor access to good quality relevant research, and lack of timely research output. The most frequently reported facilitators were collaboration between researchers and policymakers, and improved relationships and skills. There is an increasing amount of research into new models of knowledge transfer, and evaluations of interventions such as knowledge brokerage. Conclusions Timely access to good quality and relevant research evidence, collaborations with policymakers and relationship- and skills-building with policymakers are reported to be the most important factors in influencing the use of evidence. Although investigations into the use of evidence have spread beyond the health field and into more countries, the main barriers and facilitators remained the same as in the earlier review. Few studies provide clear definitions of policy, evidence or policymaker. Nor are empirical data about policy processes or implementation of policy widely available. It is therefore difficult to describe the role of evidence and other factors influencing policy. Future research and policy priorities should aim to illuminate these concepts and processes, target the factors identified in this review, and consider new methods of overcoming the barriers described.
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            Generalization in quantitative and qualitative research: myths and strategies.

            Generalization, which is an act of reasoning that involves drawing broad inferences from particular observations, is widely-acknowledged as a quality standard in quantitative research, but is more controversial in qualitative research. The goal of most qualitative studies is not to generalize but rather to provide a rich, contextualized understanding of some aspect of human experience through the intensive study of particular cases. Yet, in an environment where evidence for improving practice is held in high esteem, generalization in relation to knowledge claims merits careful attention by both qualitative and quantitative researchers. Issues relating to generalization are, however, often ignored or misrepresented by both groups of researchers. Three models of generalization, as proposed in a seminal article by Firestone, are discussed in this paper: classic sample-to-population (statistical) generalization, analytic generalization, and case-to-case transfer (transferability). Suggestions for enhancing the capacity for generalization in terms of all three models are offered. The suggestions cover such issues as planned replication, sampling strategies, systematic reviews, reflexivity and higher-order conceptualization, thick description, mixed methods research, and the RE-AIM framework within pragmatic trials. Copyright 2010 Elsevier Ltd. All rights reserved.
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              Health policy-makers' perceptions of their use of evidence: a systematic review.

              The empirical basis for theories and common wisdom regarding how to improve appropriate use of research evidence in policy decisions is unclear. One source of empirical evidence is interview studies with policy-makers. The aim of this systematic review was to summarise the evidence from interview studies of facilitators of, and barriers to, the use of research evidence by health policy-makers. We searched multiple databases, including Medline, Embase, Sociofile, PsychLit, PAIS, IBSS, IPSA and HealthStar in June 2000, hand-searched key journals and personally contacted investigators. We included interview studies with health policy-makers that covered their perceptions of the use of research evidence in health policy decisions at a national, regional or organisational level. Two reviewers independently assessed the relevance of retrieved articles, described the methods of included studies and extracted data that were summarised in tables and analysed qualitatively. We identified 24 studies that met our inclusion criteria. These studies included a total of 2041 interviews with health policy-makers. Assessments of the use of evidence were largely descriptive and qualitative, focusing on hypothetical scenarios or retrospective perceptions of the use of evidence in relation to specific cases. Perceived facilitators of, and barriers to, the use of evidence varied. The most commonly reported facilitators were personal contact (13/24), timely relevance (13/24), and the inclusion of summaries with policy recommendations (11/24). The most commonly reported barriers were absence of personal contact (11/24), lack of timeliness or relevance of research (9/24), mutual mistrust (8/24) and power and budget struggles (7/24). Interview studies with health policy-makers provide only limited support for commonly held beliefs about facilitators of, and barriers to, their use of evidence, and raise questions about commonsense proposals for improving the use of research for policy decisions. Two-way personal communication, the most common suggestion, may improve the appropriate use of research evidence, but it might also promote selective (inappropriate) use of research evidence.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2022
                1 June 2022
                1 June 2022
                : 12
                : 6
                : e059501
                Affiliations
                [1 ]departmentPolicy Engagement & Knowledge Translation Unit , KEMRI-Wellcome Trust Research Programme Nairobi , Nairobi, Kenya
                [2 ]departmentHealth Systems and Research Ethics , KEMRI-Wellcome Trust Research Programme , Kilifi, Kenya
                [3 ]departmentNuffield Department of Medicine , University of Oxford , Oxford, Oxfordshire, UK
                [4 ]departmentPopulation Health , KEMRI-Wellcome Trust Research Programme Nairobi , Nairobi, Kenya
                [5 ]departmentHealth Policy and Systems Research , KEMRI-Wellcome Trust Research Programme , Kilifi, Kenya
                [6 ]departmentHealth Services Unit , KEMRI-Wellcome Trust Research Programme Nairobi , Nairobi, Kenya
                [7 ]departmentDepartment of Health Policy and Research , Ministry of Health , Nairobi, Kenya
                [8 ]departmentHealth Economics Research Unit , KEMRI-Wellcome Trust Research Programme Nairobi , Nairobi, Kenya
                Author notes
                [Correspondence to ] Ms Fatuma Hassan Guleid; fguleid@ 123456kemri-wellcome.org
                Author information
                http://orcid.org/0000-0002-8103-8136
                http://orcid.org/0000-0003-1000-1771
                http://orcid.org/0000-0002-7427-0826
                Article
                bmjopen-2021-059501
                10.1136/bmjopen-2021-059501
                9160583
                35649617
                89ed96cb-02ac-4aac-9053-97eed446201d
                © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:  https://creativecommons.org/licenses/by/4.0/.

                History
                : 26 November 2021
                : 17 May 2022
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100010269, Wellcome Trust;
                Award ID: 092654
                Award ID: 215745
                Categories
                Health Policy
                1506
                2474
                1703
                Original research
                Custom metadata
                unlocked
                free

                Medicine
                covid-19,health policy,public health
                Medicine
                covid-19, health policy, public health

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