Fulone Izabela, Barreto Jorge Otavio Maia, Barberato-Filho Silvio, de Carvalho Marcel Henrique, Lopes Luciane Cruz
Pharmaceutical Sciences Graduate Course, University of Sorocaba, UNISO, Sorocaba, Brazil.
Fiocruz School of Government, Fiocruz Brasília, Oswaldo Cruz Foundation, Brasília, Brazil.
Front Pharmacol. 2020 Jan 21;10:1470. doi: 10.3389/fphar.2019.01470. eCollection 2019.
Knowledge translation (KT) is an effective strategy that uses the best available research evidence to bring stakeholders together to develop solutions and improve public health policy-making. Despite progress, the process of deinstitutionalization in Brazil is still undergoing consolidation, and the changes and challenges that are involved in this process are complex and necessitate evidence-informed decision-making. Accordingly, this study used KT tools to support efforts that aim to improve the care that is available to deinstitutionalized people with severe mental disorders in Brazil.
We used the Supporting Policy Relevant Reviews and Trials tools for evidence-informed health policymaking and followed eight steps: 1) capacity building; 2) identification of a priority policy issue within a Brazilian public health system; 3) meetings with policy-makers, researchers and stakeholders; 4) development of an evidence brief (EB) that addresses the problem of deinstitutionalization; 5) facilitating policy dialogue (PD); 6) the evaluation of the EB and PD; 7) post-dialogue mini-interviews; and 8) dissemination of the findings.
Capacity building and meetings with key informants promoted awareness about the gap between research and practice. Local findings were used to define the problem and develop the EB. Twenty-four individuals (policy-makers, stakeholders, researchers, representatives of the civil society, and public defense) participated in the PD. They received the EB to subsidise their deliberations during the PD, which in turn were used to validate and improve the EB. The PD achieved the objective of promoting an exhaustive discussion about the problem and proposed options and improved communication and interaction among those who are involved in mental health care. The features of both the EB and PD were considered to be favorable and helpful.
The KT strategy helped participants understand different perspectives and values, the interpersonal tensions that exist among those who are involved in the field of mental health, and the strategies that can bridge the gap between research and policy-making. The present findings suggest that PDs can influence practice by promoting greater engagement among stakeholders who formulate or revise mental health policies.
知识转化（KT）是一种有效的策略，它利用可得的最佳研究证据，促使利益相关者共同制定解决方案并改善公共卫生政策制定。尽管已取得进展，但巴西的非机构化进程仍在巩固之中，这一过程中涉及的变化和挑战十分复杂，需要基于证据的决策。因此，本研究使用知识转化工具来支持旨在改善巴西严重精神障碍非机构化患者可获得的护理的工作。
我们使用支持政策相关综述和试验工具进行基于证据的卫生政策制定，并遵循八个步骤：1）能力建设；2）确定巴西公共卫生系统内的一个优先政策问题；3）与政策制定者、研究人员和利益相关者会面；4）编写一份解决非机构化问题的证据摘要（EB）；5）促进政策对话（PD）；6）对证据摘要和政策对话进行评估；7）对话后进行小型访谈；8）传播研究结果。
能力建设以及与关键信息提供者的会面提高了对研究与实践之间差距的认识。利用当地的研究结果来界定问题并编写证据摘要。24人（政策制定者、利益相关者、研究人员、民间社会代表和公设辩护人）参与了政策对话。他们收到证据摘要以辅助其在政策对话期间的审议，而这些审议又被用于验证和完善证据摘要。政策对话实现了促进对该问题进行详尽讨论、提出备选方案以及改善参与精神卫生保健人员之间沟通与互动的目标。证据摘要和政策对话的特点都被认为是有利且有帮助的。
知识转化策略帮助参与者理解不同的观点和价值观、精神卫生领域相关人员之间存在的人际紧张关系，以及能够弥合研究与政策制定之间差距的策略。目前的研究结果表明，政策对话可以通过促使制定或修订精神卫生政策的利益相关者更多地参与来影响实践。
