Public Health and Policy, University of Liverpool, Liverpool, Merseyside, United Kingdom.
PLoS One. 2011;6(7):e21704. doi: 10.1371/journal.pone.0021704. Epub 2011 Jul 26.
The use of research evidence to underpin public health policy is strongly promoted. However, its implementation has not been straightforward. The objectives of this systematic review were to synthesise empirical evidence on the use of research evidence by public health decision makers in settings with universal health care systems.
To locate eligible studies, 13 bibliographic databases were screened, organisational websites were scanned, key informants were contacted and bibliographies of included studies were scrutinised. Two reviewers independently assessed studies for inclusion, extracted data and assessed methodological quality. Data were synthesised as a narrative review.
18 studies were included: 15 qualitative studies, and three surveys. Their methodological quality was mixed. They were set in a range of country and decision making settings. Study participants included 1063 public health decision makers, 72 researchers, and 174 with overlapping roles. Decision making processes varied widely between settings, and were viewed differently by key players. A range of research evidence was accessed. However, there was no reliable evidence on the extent of its use. Its impact was often indirect, competing with other influences. Barriers to the use of research evidence included: decision makers' perceptions of research evidence; the gulf between researchers and decision makers; the culture of decision making; competing influences on decision making; and practical constraints. Suggested (but largely untested) ways of overcoming these barriers included: research targeted at the needs of decision makers; research clearly highlighting key messages; and capacity building. There was little evidence on the role of research evidence in decision making to reduce inequalities.
To more effectively implement research informed public health policy, action is required by decision makers and researchers to address the barriers identified in this systematic review. There is an urgent need for evidence to support the use of research evidence to inform public health decision making to reduce inequalities.
大力提倡将研究证据应用于公共卫生政策制定。然而，其实施并非一帆风顺。本系统评价的目的是综合具有全民医疗保健系统环境下公共卫生决策者使用研究证据的实证证据。
为了定位合格的研究，筛选了 13 个文献数据库，扫描了组织网站，联系了关键信息提供者，并仔细审查了纳入研究的参考文献。两名评审员独立评估研究的纳入情况、提取数据和评估方法学质量。数据以叙述性综述的形式进行综合。
纳入了 18 项研究：15 项定性研究和 3 项调查。它们的方法学质量参差不齐。它们设置在一系列国家和决策制定环境中。研究参与者包括 1063 名公共卫生决策者、72 名研究人员和 174 名具有重叠角色的人员。决策过程在不同的环境中差异很大，并且被关键参与者有不同的看法。各种研究证据都被获取。然而，没有关于其使用程度的可靠证据。其影响往往是间接的，与其他影响因素竞争。使用研究证据的障碍包括：决策者对研究证据的看法；研究人员和决策者之间的差距；决策文化；决策的竞争影响；以及实际约束。克服这些障碍的建议方法（但大多未经测试）包括：针对决策者需求的研究；研究清楚地突出关键信息；以及能力建设。几乎没有证据表明研究证据在减少不平等方面在决策中的作用。
为了更有效地实施基于研究的公共卫生政策，决策者和研究人员需要采取行动，解决本系统评价中确定的障碍。迫切需要证据支持使用研究证据为公共卫生决策提供信息，以减少不平等。
