NCCDH participates in international summit to discuss solutions-based research approach
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May 20, 2016
Sparking Population Health Solutions: Research for a Healthier Future International Summit was held April 25-28, 2016 in Ottawa, Ontario. This was a unique event. Not only was the room filled with an audience of diverse experiences from many parts of the world, but the environment was one where debate and disagreement was encouraged and followed through with discussion. There were many things that took people out of the comfort zone of traditional research approaches, and in many ways, it felt like an event filled with challenges – to think, feel, and act differently when it comes to finding solutions to complex population health problems. These are the things that have stuck with me and will hopefully stick with you as you crawl out of your own comfort zone.
“Knowledge translation usually starts with evidence. Instead, we should start with the idea that needs to be informed, and then assess what evidence is needed. Not all knowledge is suitable for translation, and we should not expect researchers to translate their knowledge because they are not well trained to do that.” Considering my title is “Knowledge Translation Specialist", this really shook me out of my comfort zone! Mark Petticrew from the London School of Hygiene and Tropical Medicine was the source of this wisdom. For me, this spoke to the need for partnership between researchers, practitioners, and knowledge translators (like me!). The existence of evidence isn’t enough to change practice. Knowledge comes from a diverse set of partners, and equity-focused knowledge translation requires multiple partners along with a willingness to acknowledge that it is not about mobilizing ‘‘what we know’’ but more about ‘‘how we know". It might not be a matter of needing or producing “more” evidence, but maybe instead looking at what problem to work on instead of what population to fix.
“Professionally designed interventions address professionally designed problems. We need to move more towards practical wisdom that connects people to context, whereas traditional science tends to pull these two apart and assign blame.” Jennie Popay of Lancaster University challenged us to look to other sources for solutions that matter. Immediately I thought about the role of Indigenous knowledge and how community-based participatory research contributes to intervention research. We need to involve people with the lived-experience of inequities in research to figure out what is important to them and how to address it. There are different ways of knowing, and different types of evidence to inform action.
“We need to move beyond stifling interventions and towards system-activating interventions. Not achieving the target isn’t just about lack of resources or focus or skill.” Penny Hawe from the University of Sydney stated this in the spirit of tackling innovative approaches to research and interventions. Penny wrote a paper about the complexity of interventions and how important it is that knowledge generated for interventions recognizes the changing context of implementation. Relationships between researchers and communities need to be created and nurtured, being careful not to label something a failure too quickly because it hasn’t had a chance to take off. Better connecting researchers, communities, practitioners, and decision makers in more meaningful ways is the way forward to solutions. Learning from failure is also key to inform innovative approaches.
“It is unethical to give somebody a copy of the food guide when they are living in their car.” As a dietitian, this spoke directly to me. June Matthews of Brescia University College related this to me as something she tells her students every year. It reminded me of a 1999 research paper called “Prisoners of the Proximate” about the tendency to address individual lifestyle factors when purporting to address population health. I have often said that my time as a dietitian is ill-spent talking about food. We need to move past addressing and researching proximate lifestyle factors, and recognize that solutions need to be broad and complex if we are to improve population health. Individual lifestyle interventions are often not complex, and therefore are not well suited for solving complex problems like population health equity.
Let’s talk about interventions! How do we shift implementation and research focus to interventions that address health equity? We want to hear from you! Send me your thoughts and ideas and join the online conversation on Health Equity Clicks.