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Health and Advocacy: What Are the Barriers to the Use of Evidence in Policy?

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The Politics of Evidence-Based Policy Making

Abstract

There is now a large literature on the barriers to the use of research evidence in policy and practice. I analyse the literature critically, identifying a tendency to bemoan the evidence-policy gap without using policy theory and empirical policy studies to inform the analysis. I identify the ways in which policy theories can be used to improve health policy analysis. I draw on two case studies: tobacco policy, to demonstrate a relatively successful (but ongoing) project, by tobacco control advocates, to turn the identification of a health problem into a proportionate policy response; and, the role of ‘improvement science’ which focuses on how practitioners use evidence on the ground or at the ‘street level’.

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Notes

  1. 1.

    Take the example of health policymaking initiatives in Ontario. Lomas and Brown (2009: 912) describe the decision by funded academic centres to balance their own research interests with those of government, and to give some reports to government 60 days before they are released to the public. This describes the compromises of which scientists should be aware of, but not what to do or if these actions are appropriate or effective. See also van Egmond et al. (2011: 31) on the oxymoronic need for ‘close distance’; for scientific public bodies to be near enough to government departments to know their agenda, but far enough to look impartial (as in the tale of Goldilocks, this may involve trial and error rather than a blueprint).

  2. 2.

    Systematic reviews identify the word ‘broker’ but the individual studies to which they refer do not add up to a coherent account of who they are or what their role is (Dobbins et al. 2009: 2; Ritter 2009: 72; Lewig et al. 2010: 476; El-Jahardi et al. 2012: 9; Jack et al. 2010; Jönsson et al. 2007: 8; Ettelt and Mays 2011: 58; Hanney et al. 2003: 15–6; Chambers et al. 2012: 144; van Egmond et al. 2011: 34).

  3. 3.

    This is a problem to note when articles make casual reference to policy theories (van Egmond et al. 2011: 29 on the ACF) and with insufficient focus on the theory to make the analysis useful to people unfamiliar with it Blackman et al. 2012: 49; Haynes et al. 2011: 567; Hinchcliff et al. 2011 and Hunsmann 2011 on multiple streams). Even the more thorough studies devote a short paragraph to each approach (Hanney et al. 2003: 5–6).

  4. 4.

    This is not to say that RCTs have no place in policymaking—indeed, UK policy scholars such as John et al. (2013) explore their value in multiple interventions, while the UK’s Behavioural Insights Team extols their virtue in more general terms (Haynes et al. 2012).

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  1. University of Stirling, Stirling, UK

    Paul Cairney

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Cairney, P. (2016). Health and Advocacy: What Are the Barriers to the Use of Evidence in Policy?. In: The Politics of Evidence-Based Policy Making. Palgrave Pivot, London. https://doi.org/10.1057/978-1-137-51781-4_3

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