Pathways to “Evidence-Informed” Policy and Practice: A Framework for Action

0600 T he contemporary public health effort sees much debate about the concepts of " evidence " and " the evidence base " , and the usefulness and relevance of such terms to both policymaking and practice. A key challenge to public health is to better contextualize evidence for more effective policymaking and practice. Theory on the translation of research fi ndings into policy and practice, and on knowledge utilization, offers only part of the solution to this complex task. The policymaking context is highly political and rapidly changing, and depends on a variety of factors, inputs, and relationships. In this article, we propose that an " evidence-informed policy and practice pathway " can help both researchers and policy actors navigate the use of evidence (Figure 1). The pathway illustrates different types of evidence and their uses in health policymaking, and proposes that specifi c capacities, such as an individual's skills, experience, and participation in networks, infl uence the adoption and adaptation of evidence in practice. The pathway to " evidence-informed " policy and practice involves three active stages of progression, infl uenced by the policy context. The three stages are (1) sourcing the evidence, (2) using the evidence, and (3) implementing the evidence. The pathway also involves decision-making factors and a process which we have termed " adopt, adapt, and act ". Once adopted, evidence about implementation is usually adapted or changed before use in the policy context. Policy actors and practitioners rightfully need to understand and decide how best this evidence should be acted upon in each circumstance. Each stage in this pathway is underpinned by a variety of individual-, organizational-, and system-level values. To formulate the evidence-informed policy and practice pathway presented in this paper, we reviewed relevant literature from health, public policy, and the social sciences. Fundamental to the transfer of evidence into policy and practice is diffusion, the process by which an innovation is communicated over time among members of a social system (classical diffusion) [1]. In this paper we consider innovation to be the policy idea. Studies of innovation in health-care organizations by Lennarson Greer [2] proposed that diffusion theory helps us understand the following: (1) how individuals within an organization receive, adopt, and adapt evidence; (2) the organizational factors that constrain or facilitate the adoption or implementation of the evidence; and (3) the interests and values at play within organizations that infl uence …