McMaster Health Forum, McMaster University, Hamilton, Ont.
CMAJ. 2010 Jun 15;182(9):E350-61. doi: 10.1503/cmaj.081164. Epub 2010 May 3.
Many international statements have urged researchers, policy-makers and health care providers to collaborate in efforts to bridge the gaps between research, policy and practice in low- and middle-income countries. We surveyed researchers in 10 countries about their involvement in such efforts.
We surveyed 308 researchers who conducted research on one of four clinical areas relevant to the Millennium Development Goals (prevention of malaria, care of women seeking contraception, care of children with diarrhea and care of patients with tuberculosis) in each of 10 low- and middle-income countries (China, Ghana, India, Iran, Kazakhstan, Laos, Mexico, Pakistan, Senegal and Tanzania). We focused on their engagement in three promising bridging activities and examined system-level, organizational and individual correlates of these activities.
Less than half of the researchers surveyed reported that they engaged in one or more of the three promising bridging activities: 27% provided systematic reviews of the research literature to their target audiences, 40% provided access to a searchable database of research products on their topic, and 43% established or maintained long-term partnerships related to their topic with representatives of the target audience. Three factors emerged as statistically significant predictors of respondents' engagement in these activities: the existence of structures and processes to link researchers and their target audiences predicted both the provision of access to a database (odds ratio [OR] 2.62, 95% CI 1.30-5.27) and the establishment or maintenance of partnerships (OR 2.65, 95% CI 1.25-5.64); stability in their contacts predicted the provision of systematic reviews (OR 2.88, 95% CI 1.35-6.13); and having managers and public (government) policy-makers among their target audiences predicted the provision of both systematic reviews (OR 4.57, 95% CI 1.78-11.72) and access to a database (OR 2.55, 95% CI 1.20-5.43).
Our findings suggest potential areas for improvement in light of the bridging strategies targeted at health care providers that have been found to be effective in some contexts and the factors that appear to increase the prospects for using research in policy-making.
许多国际声明都敦促研究人员、政策制定者和医疗保健提供者合作,努力弥合低收入和中等收入国家研究、政策和实践之间的差距。我们调查了 10 个国家的研究人员,了解他们参与此类工作的情况。
我们调查了在 10 个低收入和中等收入国家(中国、加纳、印度、伊朗、哈萨克斯坦、老挝、墨西哥、巴基斯坦、塞内加尔和坦桑尼亚)的每一个国家进行与千年发展目标相关的四项临床领域(疟疾预防、避孕妇女护理、腹泻儿童护理和结核病患者护理)研究的 308 名研究人员。我们重点关注他们参与了三项有希望的桥梁活动,并研究了这些活动与系统层面、组织层面和个人层面的关联。
接受调查的研究人员中,不到一半的人报告说他们参与了以下三项有希望的桥梁活动中的一项或多项:27%的人向目标受众提供了对研究文献的系统评价,40%的人提供了对其主题研究产品的可搜索数据库的访问权限,43%的人与其目标受众的代表建立或维持了与主题相关的长期合作伙伴关系。有三个因素被证明是研究人员参与这些活动的显著预测因素:将研究人员与其目标受众联系起来的结构和流程的存在,既预测了数据库的访问权限(比值比[OR]2.62,95%置信区间[CI]1.30-5.27),也预测了伙伴关系的建立或维持(OR 2.65,95%CI 1.25-5.64);其联系人的稳定性预测了系统评价的提供(OR 2.88,95%CI 1.35-6.13);管理人员和公共(政府)决策者是其目标受众之一,预测了系统评价的提供(OR 4.57,95%CI 1.78-11.72)和数据库的访问权限(OR 2.55,95%CI 1.20-5.43)。
我们的研究结果表明,根据针对医疗保健提供者的桥梁策略,有一些策略在某些情况下是有效的,同时也考虑到了增加在政策制定中使用研究的可能性的因素,这为改进提供了潜在的方向。