Waddell Charlotte, Lavis John N, Abelson Julia, Lomas Jonathan, Shepherd Cody A, Bird-Gayson Twylla, Giacomini Mita, Dan Offord David R
Mental Health Evaluation and Community Consultation Unit, Department of Psychiatry, University of British Columbia, 2250 Wesbrook Mall, Vancouver, BC, Canada V6T1W6.
Soc Sci Med. 2005 Oct;61(8):1649-57. doi: 10.1016/j.socscimed.2005.03.032. Epub 2005 Apr 26.
Many researchers hope to see the best available research evidence used in policy-making to address important public problems. However, policy often appears to be based on anything but the research evidence, as the problem of conduct disorder (or severe antisocial behaviour in children) shows. In Canada, few children receive effective prevention or treatment programs, and incarceration is overused, despite evidence that it is ineffective and potentially harmful. Using the example of conduct disorder, we investigated why policy-making has not reflected the research evidence, examining research use in the context of competing influences on the policy process. Qualitative methods were used to analyze data from interviews with thirty-two politicians and senior civil servants. Our allegiance to rationality wavered as we listened to policy-makers who contended with the inherent ambiguity in the policy process. They told us that they managed institutional constraints including fragmentation across levels and sectors of government, and the long-term effects of fiscal restraint. They also reconciled the competing interests of stakeholders' priorities, the public's response to negative events involving children and the media's role in shaping this response. Ideas about youth violence were morally charged, but policy-makers remained committed to improving children's lives. Day-to-day, policy-makers obtained most of their information internally and informally. Research evidence was valued and used, but as just one source of ideas and information among many. In this environment of ambiguity, creative civil servants formed partnerships with trusted researchers in order to change policy. Our findings suggest that the use of research evidence in policy-making could be enhanced if researchers learned about the competing influences on the policy process, formed research-policy partnerships, challenged the incentives within research institutions, and engaged in public debates about important problems, such as child antisocial behaviour.
许多研究人员希望看到在政策制定过程中运用可获取的最佳研究证据来解决重要的公共问题。然而，正如品行障碍（或儿童严重反社会行为）问题所显示的那样，政策往往并非基于研究证据。在加拿大，尽管有证据表明监禁无效且可能有害，但很少有儿童能获得有效的预防或治疗项目，而且监禁被过度使用。以品行障碍为例，我们调查了为何政策制定没有反映研究证据，在对政策过程有竞争影响的背景下审视研究的运用情况。我们采用定性方法分析了对32位政治家和高级公务员的访谈数据。当我们聆听那些应对政策过程中固有模糊性的政策制定者的讲述时，我们对理性的信念动摇了。他们告诉我们，他们要应对制度性约束，包括政府各层级和部门间的碎片化，以及财政紧缩的长期影响。他们还要协调利益相关者优先事项的相互竞争的利益、公众对涉及儿童的负面事件的反应以及媒体在塑造这种反应中的作用。关于青少年暴力的观点带有道德色彩，但政策制定者仍致力于改善儿童的生活。日常工作中，政策制定者大多从内部和非正式渠道获取信息。研究证据受到重视并被使用，但只是众多观点和信息来源之一。在这种模糊的环境中，有创造力的公务员与值得信赖的研究人员建立伙伴关系以改变政策。我们的研究结果表明，如果研究人员了解对政策过程的竞争影响、建立研究 - 政策伙伴关系、挑战研究机构内部的激励机制，并参与关于重要问题（如儿童反社会行为）的公开辩论，那么在政策制定中对研究证据的运用可能会得到加强。
