Heaton Janet, Day Jo, Britten Nicky
Institute of Health Research, University of Exeter Medical School, St Luke's Campus, Exeter, Devon, EX1 2SL, UK.
Implement Sci. 2016 Feb 20;11:20. doi: 10.1186/s13012-016-0383-9.
In 2008, the National Institute for Health Research (NIHR) began funding a major 5-year pilot research programme of translational research in England, establishing nine 'Collaborations for Leadership in Applied Health Research and Care' (CLAHRCs). A number of evaluations were carried out to examine whether or not the various collaborations worked as intended and why. In this paper, we examine what the theory of co-production adds to understanding of processes of knowledge creation and translation we observed in one of the CLAHRCs.
A case study of a successful knowledge translation project was identified from our wider realist evaluation of the mechanisms of closer collaboration at play in the CLAHRC. In the project, a computer simulation model of an emergency pathway for acute ischaemic stroke was built to explore if and how the time between the onset and treatment of the condition could be minimised by redesigning the pathway. The aim of the case study was to improve our understanding of the nature and workings of the mechanisms of closer collaboration that were associated with the more successful projects by examining the relevance of the theory of co-production. Qualitative methods of analysis were used to explore the fit between the mechanisms of closer collaboration we observed in the realist evaluation and the principles of co-production we identified from the literature.
We found a close fit between the nine mechanisms of closer collaboration at work in the project and the principles of co-production (active agents; equality of partners; reciprocity and mutuality; transformative; and facilitated). The successful style of collaborative working exemplified by the project was consistent with a strong form of co-production.
In our view, the theory of co-production provides useful insights into what it is about the qualities of collaborative working that inspire the requisite mechanisms for generating knowledge that is translated into practice. The theory provides a potentially useful basis for future knowledge translation programmes and projects in applied health research in a range of contexts.
2008年,英国国家卫生研究院(NIHR)开始资助一项为期5年的大型转化研究试点项目,在英格兰建立了9个“应用健康研究与护理领导力合作中心”(CLAHRCs)。开展了多项评估,以检验各合作中心是否按预期运作以及原因。在本文中,我们探讨协同生产理论如何增进对我们在其中一个CLAHRC中观察到的知识创造和转化过程的理解。
从我们对CLAHRC中发挥作用的更紧密合作机制的更广泛的现实主义评估中,确定了一个成功的知识转化项目的案例研究。在该项目中,构建了急性缺血性中风急诊路径的计算机模拟模型,以探讨是否以及如何通过重新设计路径来缩短病情发作与治疗之间的时间。该案例研究的目的是通过检验协同生产理论的相关性,增进我们对与更成功项目相关的更紧密合作机制的性质和运作的理解。采用定性分析方法,探讨我们在现实主义评估中观察到的更紧密合作机制与我们从文献中确定的协同生产原则之间的契合度。
我们发现项目中起作用的9种更紧密合作机制与协同生产原则(积极主体;伙伴平等;互惠互利;变革性;以及便利性)高度契合。该项目所体现的成功的合作工作方式与一种强有力的协同生产形式相一致。
在我们看来,协同生产理论为以下问题提供了有益的见解:合作工作的哪些特质激发了将知识转化为实践所需的机制。该理论为未来一系列背景下应用健康研究中的知识转化计划和项目提供了潜在的有用基础。