Wilson, M. G., Rourke, S. B., Lavis, J., Bacon, J., & Travers, R. (2011). Community capacity to acquire, assess, adapt and apply research evidence: A survey of Ontario’s HIV/AIDS sector. Implementation Science, 6(54), 1-6. doi:10.1186/1748-5908-6-54 http://www.implementationscience.com/content/pdf/1748-5908-6-54.pdf
Abstract
Background: Community-based organizations (CBOs) are important stakeholders in health systems and are increasingly called upon to use research evidence to inform their advocacy, program planning, and service delivery. To better support CBOs to find and use research evidence, we sought to assess the capacity of CBOs in the HIV/AIDS sector to acquire, assess, adapt, and apply research evidence in their work.
Methods: We invited executive directors of HIV/AIDS CBOs in Ontario, Canada (n = 51) to complete the Canadian Health Services Research Foundation’s « Is Research Working for You? » survey.
Findings: Based on responses from 25 organizations that collectively provide services to approximately 32,000 clients per year with 290 full-time equivalent staff, we found organizational capacity to acquire, assess, adapt, and apply research evidence to be low. CBO strengths include supporting a culture that rewards flexibility and quality improvement, exchanging information within their organization, and ensuring that their decision-making processes have a place for research. However, CBO Executive Directors indicated that they lacked the skills, time, resources, incentives, and links with experts to acquire research, assess its quality and reliability, and summarize it in a user-friendly way.
Conclusion: Given the limited capacity to find and use research evidence, we recommend a capacity-building strategy for HIV/AIDS CBOs that focuses on providing the tools, resources, and skills needed to more consistently acquire, assess, adapt, and apply research evidence. Such a strategy may be appropriate in other sectors and jurisdictions as well given that CBO Executive Directors in the HIV/AIDS sector in Ontario report low capacity despite being in the enviable position of having stable government infrastructure in place to support them, benefiting from long-standing investment in capacity building, and being part of an active provincial network. CBOs in other sectors and jurisdictions that have fewer supports may have comparable or lower capacity. Future research should examine a larger sample of CBO Executive Directors from a range of sectors and jurisdictions.
Community based organizations are key stakeholders in the health system. They provide community-focused programs and services but uniquely they also have a key advocacy role. The authors wished to examine their capacity to find and use relevant and high quality research evidence so that community health programs, services, and advocacy are informed by the best available evidence. The question arose since the literature has established that community based organizations face a number of barriers to effective research use including: « the complexity of research evidence, organizational barriers, lack of available time, poor access to current literature, lack of timely research, lack of experience and skills for critical appraisal, unsupportive culture for research, lack of actionable messages in research reports, and limited resources for implementation. »
The authors used Ontario’s community based HIV/AIDS organizations as a study group. They invited 51 HIV/AIDS organizations to participate y answering a questionnaire that evaluated their ability to acquire, assess, adapt and apply research evidence. They received responses form 25 organizations. Although most organizations most indicated that they have a corporate culture that is supportive of research use, responses confirmed that the organizations’ ability to acquire, assess, adapt and apply research evidence was low although they did identify they had a higher ability to obtain and use research evidence through peer networks, grey literature and web sites.
The authors conclude that if community based organizations are to participate fully in our health system then there is an onus on that system to build capacity to engage with research so that community programs, services and advocacy is based on the best available evidence. « Efforts to build capacity among [community based organizations] should also draw on key facilitators for supporting the use of research evidence that have been cited for other groups of stakeholders, such as ongoing interactions between researchers, managers, and policy makers and ensuring research is available in a timely manner. »
Key points for discussion:
- It may seem redundant but it is important to point out that community based organizations are key players in Canada’s health system. The traditional medical establishment is privileged in discussions about the health system and community based organizations are often overlooked. They provide key front line health and wellness services. Indeed, 47% of United Way of York Region funding goes to mental health services and more to social determinants of health such as poverty and immigration.
- The CHSRF survey tool used in this study assess an organization’s ability to acquire, assess, adapt and apply research evidence. These are important abilities but it would be more holistic to also inquire about a community based organization’s ability to disseminate the research and knowledge embedded in its programs and services. Community based organizations have lots of experiential knowledge that is frequently well evaluated but their ability to disseminate this to other organizations is likely limited by time and a culture of service as opposed to research.
- The authors miss an opportunity to discus the role of knowledge intermediaries in making academic research accessible to community based organizations. They cite « key facilitators » but define these as researchers, managers, and policy makers. The authors could have given a nod to knowledge intermediaries embedded either in the community or the university (such as RIR knowledge brokers) among the examples of « key facilitators ».
- A major critique here: all the authors are academic. This is another example where academics studied community instead of partnering with community to co-produce knowledge. The authors acknowledge that efforts to support the use of research evidence by community based organizations will require in-depth consultation to develop approaches that reflect their specific needs; however, « consultation with » falls short of collaborating with for mutual benefit.
As an additional note, John Lavis’ group at McMaster University (Hamilton, Ontario) is a leader in the production, study and application of systematic reviews, primarily in the health field. He holds a Canada Research Chair in Knowledge Transfer and Exchange. Get to know his work by visiting his Program in Policy and Decision Making.
RIR is producing this journal club series as a way to make the evidence on KMb more accessible to knowledge brokers and to create on line discussion about research on knowledge mobilization. It is designed for knowledge brokers and other knowledge mobilization stakeholders. Read the article available free at the link above. Then come back to this post and join the journal club by posting your comments.