Making evidence fit: how knowledge managers facilitate the use of research in public health decision making

Objectives: This paper will explore the mechanisms used by knowledge managers to make evidence useful for local decision makers when they commission and plan public health interventions. Knowledge manager is the collective... [ view full abstract ]

Objectives: This paper will explore the mechanisms used by knowledge managers to make evidence useful for local decision makers when they commission and plan public health interventions. Knowledge manager is the collective term we use for people whose role requires them to gather, and re-present ‘evidence’ to support organisational decision making. The data below is drawn from a larger National Institute for Health Research project that studied how, when, where and by whom research evidence (and other information) is used in commissioning and planning cycles.

Methods: Using a mixed methods cross-comparative case study design, data on the use of research evidence across two sites was collected and analysed using a realist approach. The two sites compared evidence use in different policy contexts (across a purchaser-provider split in England, and through joint planning in Scotland). Data included eleven in-depth interviews with knowledge managers across both cases, observations at meetings and documentary analysis.

Results: Our findings indicate that evidence is typically not readily applicable to the problem at hand, but needs to be made to ‘fit’ for local commissioning and planning purposes by knowledge managers. Favoured sources and types of evidence are used and formats (and people) for sharing this evidence are pre-selected. We identified two mechanisms that are used by knowledge manager to make evidence fit: localising (relating it to local context and needs) and tailoring (presenting actionable messages). This led to the exclusion of other types of evidence, those who provide it and different presentation formats in our two case study sites.

Conclusions: We argue that the pivotal role of knowledge managers has been underestimated as they are instrumental in what evidence enters the local commissioning and public health planning processes and in what format. We conclude that ‘what evidence is seen to fit’ is not only about the nature of the evidence, but its mobilisation; and what is valued, so useful evidence and valid knowledge is intrinsically tied to where it is used and by whom.