Beyond “Two Cultures”: Guidance for Establishing Effective Researcher/Health System Partnerships

Document Type : Original Article

Authors

1 School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada

2 Health Services Integration, Winnipeg Regional Health Authority, Winnipeg, MB, Canada

3 Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada

4 eHealth Centre of Excellence, Centre for Family Medicine, Kitchener, ON, Canada

Abstract

Background
The current literature proposing criteria and guidelines for collaborative health system research often fails to differentiate between: (a) various types of partnerships, (b) collaborations formed for the specific purpose of developing a research proposal and those based on long-standing relationships, (c) researcher vs. decision-maker initiatives, and (d) the underlying drivers for the collaboration.
 
Methods
Qualitative interviews were conducted with 16 decision-makers and researchers who partnered on a Canadian major peer-reviewed grant proposal in 2013. Objectives of this exploration of participants’ experiences with health system research collaboration were to: (a) explore perspectives and experience with research collaboration in general; (b) identify characteristics and strategies associated with effective partnerships; and (c) provide guidance for development of effective research partnerships. Interviews were audio-recorded and transcribed: transcripts were qualitatively analyzed using a general inductive approach.
 
Results
Findings suggest that the common “two cultures” approach to research/decision-maker collaboration provides an inadequate framework for understanding the complexity of research partnerships. Many commonlyidentified challenges to researcher/knowledge user (KU) collaboration are experienced as manageable by experienced research teams. Additional challenges (past experience with research and researchers; issues arising from previous collaboration; and health system dynamics) may be experienced in partnerships based on existing collaborations, and interact with partnership demands of time and communication. Current research practice may discourage KUs from engaging in collaborative research, in spite of strong beliefs in its potential benefits. Practical suggestions for supporting collaborations designed to respond to real-time health system challenges were identified.
 
Conclusion
Participants’ experience with previous research activities, factors related to the established collaboration, and interpersonal, intra- and inter-organizational dynamics may present additional challenges to research partnerships built on existing collaboration. Differences between researchers and KUs may pose no greater challenges than differences among KUs (at various levels, and representing diverse perspectives and organizations) themselves. Effective “relationship brokering” is essential for meaningful collaboration.

Highlights

 

 

Watch the Video Summary here. 

 

Keywords

Main Subjects

Full Text

 

 

References

  1. Oliver K, Innvar S, Lorenc T, Woodman J, Thomas J. A systematic review of barriers to and facilitators of the use of evidence by policymakers. BMC Health Serv Res. 2014;14.. doi:10.1186/1472-6963-14-2
  2. Traynor R, Dobbins M, DeCorby K. Challenges of partnership research: Insights from a collaborative partnership in evidence-informed public health decision making. Evid Policy. 2015;11(1):99-109. doi:10.1332/174426414X14043807774174. 
  3. Smits PA, Denis JL. How research funding agencies support science integration into policy and practice: an international overview. Implement Sci. 2014;9:28. doi:10.1186/1748-5908-9-28
  4. Tetroe JM, Graham ID, Foy R, et al. Health research funding agencies' support and promotion of knowledge translation: an international study. Milbank Q. 2008;86(1):125-155. doi:10.1111/j.1468-0009.2007.00515.x
  5. Rummery K. Healthy partnerships, healthy citizens? An international review of partnerships in health and social care and patient/user outcomes. Soc Sci Med. 2009;69(12):1797-1804. doi:10.1016/j.socscimed.2009.09.004
  6. Wildridge V, Childs S, Cawthra L, Madge B. How to create successful partnerships-a review of the literature. Health Info Libr J. 2004;21(Suppl 1):3-19. doi:10.1111/j.1740-3324.2004.00497.x
  7. Boaz A, Hanney S, Jones T, Soper B. Does the engagement of clinicians and organisations in research improve healthcare performance: A three-stage review. BMJ Open. 2015;5(12):e009415. doi:10.1136/bmjopen-2015-009415
  8. Rycroft-Malone J, Wilkinson J, Burton CR, et al. Collaborative action around implementation in collaborations for leadership in applied health research and care: Towards a programme theory. J Health Serv Res Policy. 2013;18(3 suppl):13-26.
  9. Jagosh J, Bush PL, Salsberg J, et al. A realist evaluation of community-based participatory research: Partnership synergy, trust building and related ripple effects. BMC Public Health. 2015;15:725. doi:10.1186/s12889-015-1949-1
  10. Jagosh J, Macaulay AC, Pluye P, et al. Uncovering the benefits of participatory research: Implications of a realist review for health research and practice. Milbank Q. 2012;90(2):311-346. doi:10.1111/j.1468-0009.2012.00665.x
  11. McCloughen A, O'Brien L. Interagency collaborative research projects: Illustrating potential problems, and finding solutions in the nursing literature. Int J Ment Health Nurs. 2006;15(3):171-180.
  12. Taylor-Robinson DC, Lloyd-Williams F, Orton L, Moonan M, O'Flaherty M, Capewell S. Barriers to partnership working in public health: a qualitative study. PLoS One. 2012;7(1):e29536. doi:10.1371/journal.pone.0029536
  13. Smith KE, Bambra C, Joyce KE, Perkins N, Hunter DJ, Blenkinsopp EA. Partners in health? A systematic review of the impact of organizational partnerships on public health outcomes in England between 1997 and 2008. J Public Health (Oxf). 2009;31(2):210-221. doi:10.1093/pubmed/fdp002
  14. Cargo M, Mercer SL. The value and challenges of participatory research: strengthening its practice. Annu Rev Public Health. 2008;29:325-350. doi:10.1146/annurev.publhealth.29.091307.083824
  15. National Research Council (NRC). Enhancing the effectiveness of team science.Washington: National Academies Press; 2015.
  16. Bowen S. The relationship between Engaged Scholarship, Knowledge Translation and Participatory Research. In: Higginbottom G, Liamputtong P, eds. Using participatory research methods in qualitative research. Sage Publications; 2015.
  17. Sibbald S, Kothari A, Rudman D, et al. Partnerships in public health: Lessons from knowledge translation and program planning. Can J Nurs Res. 2012;44(1):94-119.
  18. Walter I, Davies H, Nutley S. Increasing research impact through partnerships: evidence from outside health care. J Health Serv Res Policy. 2003;8(suppl 2):58-61. doi:10.1258/135581903322405180
  19. Scott C, Seidel J, Bowen S, Gall N. Integrated health systems and integrated knowledge: Creating space for putting knowledge into action. Healthc Q. 2009;13:30-36.
  20. Canadian Institutes of Health Research (CIHR). Guide to knowledge translation planning at CIHR: Integrated and end-of-grant approaches. Ottawa, CIHR
  21. Talbot C, Talbot C. Bridging the academic - policy-making gap: Practice and policy issues. Public Money and Management. 2015;35(3):187-194. doi:10.1080/09540962.2015.1027491.
  22. Kothari A, Maclean L, Edwards N, Hobbs A. Indicators at the interface: Managing policymaker-researcher collaboration. Knowledge Management Research and Practice. 2011;9(3):203-214. doi:10.1057/kmrp.2011.16
  23. King G, Servais M, Forchuk C, et al. Features and impacts of five multidisciplinary community-university research partnerships. Health Soc Care Community. 2010;18(1):59-69. doi:10.1111/j.1365-2524.2009.00874.x
  24. Pinto RM, Spector AY, Rahman R, Gastolomendo JD. Research advisory board members' contributions and expectations in the USA. Health Promot Int. 2015;30(2):328-338. doi:10.1093/heapro/dat042
  25. Brazil K, Ozer E, Cloutier MM, Levine R, Stryer D. From theory to practice: Improving the impact of health services research. BMC Health Serv Res. 2005;5:1.
  26. Sibbald SL, Tetroe J, Graham ID. Research funder required research partnerships: A qualitative inquiry. Implement Sci. 2014;9:176-014-0176-y. doi:10.1186/s13012-014-0176-y
  27. Salsberg J, Parry D, Pluye P, Macridis S, Herbert CP, Macaulay AC. Successful strategies to engage research partners for translating evidence into action in community health: a critical review. J Environ Public Health. 2015;2015:191856. doi:10.1155/2015/191856
  28. Kothari A, Sibbald SL, Wathen CN. Evaluation of partnerships in a transnational family violence prevention network using an integrated knowledge translation and exchange model: A mixed methods study. Health Res Policy Syst. 2014;12:25. doi:10.1186/1478-4505-12-25
  29. Rathbun A. The benefits and difficulties of academic collaboration. Am J Hosp Palliat Care. 2004;21(5):337-339.
  30. Stanton TK. New times demand new scholarship: Opportunities and challenges for civic engagement at research universities. Educ Citizsh Soc Justice. 2008;3(1):19-42. doi:10.1177/1746197907086716
  31. Bowen S, Martens PJ. The need to know team. Demystifying knowledge translation: learning from the community. J Health Serv Res Policy.  2005;10(4):203-211.
  32. Bullock A, Morris ZS, Atwell C. Collaboration between health services managers and researchers: making a difference? J Health Serv Res Policy. 2012;17(Suppl 2):2-10. doi:10.1258/jhsrp.2011.011099.
  33. Golden-Biddle K, Reay T, Petz S, et al. Toward a communicative perspective of collaborating in research: The case of the researcher-decision-maker partnership. J Health Serv Res Policy. 2003;8(Suppl 2):20-25. doi:10.1258/135581903322405135
  34. Pinto RM. What makes or breaks provider-researcher collaborations in HIV research? A mixed method analysis of providers' willingness to partner. Health Education and Behavior. 2013;40(2):223-230. doi:10.1177/1090198112447616
  35. Pinto RM, McKay MM, Escobar C. "You've gotta know the community": Minority women make recommendations about community-focused health research. Women Health. 2008;47(1):83-104. doi:10.1300/J013v47n01_05
  36. Casey M. Partnership--success factors of interorganizational relationships. J Nurs Manag. 2008;16(1):72-83. doi:10.1111/j.1365-2934.2007.00771.x
  37. Kothari A, Wathen CN. A critical second look at integrated knowledge translation. Health Policy. 2013;109(2):187-191. doi:10.1016/j.healthpol.2012.11.004
  38. Bartunek JM, Rynes SL. Academics and practitioners are alike and unlike: The paradoxes of academic-practitioner relationships. Journal of Management. 2014;40(5):1181-1201. doi:10.1177/0149206314529160
  39. Bowen S, Botting I, Huebner LA, et al. The potential of physician assistants to support primary care: Evaluating their introduction at 6 primary care and family medicine sites. Implementation evaluation of six Manitoba sites. Can Fam Phyician. 2016;62:e268-e277. 
  40. Thomas DR. A general inductive approach for evaluating qualitative evaluation data. Am J Eval. 2006;27(2),237-246.
  41. Neal JW, Neal ZP, VanDyke E, Kornbluh M. Expediting the analysis of qualitative data in evaluation: A procedure for the rapid identification of themes from audio recordings (RITA). Am J Eval. 2015;36(1):118-132. doi:10.1177/1098214014536601
  42. Strauss A, Corbin J. Basics of qualitative research: grounded theory procedures and techniques. Newberry Park: Sage Publications; 1990.
  43. Patton MQ. Qualitative research and evaluation methods. 3rd ed. Thousand Oaks: Sage Publications; 2002.
  44. Hofmeyer A, Scott C, Lagendy L. Researcher-decision-maker partnerships in health services research: Practical challenges, guiding principles. BMC Health Serv Res. 2012;12:280. doi:10.1186/1472-6963-12-280.
  45. McCann M. The challenges encountered during a collaborative research project. J Ren Care. 2007;33(3):139-143.
  46. Henderson J, Sword W, Niccols A, Dobbins M. Implementing stakeholder-informed research in the substance abuse treatment sector: Strategies used by connections, a Canadian knowledge translation and exchange project. Subst Abuse Treat Prev Policy. 2014;9:21. doi:10.1186/1747-597X-9-21.
  47. Wehrens R. Beyond two communities - from research utilization and knowledge translation to co-production? Public Health. 2014;128(6):545-551. doi:10.1016/j.puhe.2014.02.004.
  48. Bornbaum CC, Kornas K, Peirson L, et al. Exploring the function and effectiveness of knowledge brokers as facilitators of knowledge translation in health-related settings: a systematic review and thematic analysis. Implement Sci. 2015;10:162. doi:10.1186/s13012-015-0351-9
  49. Evans S, Scarbrough H. Supporting knowledge translation through collaborative translational research initiatives: 'bridging' versus 'blurring' boundary-spanning approaches in the UK CLAHRC initiative. Soc Sci Med. 2014;106:119-27. doi:10.1016/j.socscimed.2014.01.025
  50. Wooding S, Hanney SR, Pollitt A, Grant J, Buxton MJ, Project Retrosight Team. Understanding factors associated with the translation of cardiovascular research: a multinational case study approach. Implement Sci. 2014; 21;9(1):47. doi:10.1186/1748-5908-9-47
  51. Panel on Return on Investment in Health Research. Making an Impact: A Preferred Framework and Indicators to Measure Returns on Investment in Health Research. Ottawa, Canada, ON: Canadian Academy of Health Sciences;2009.
  52. Buxton M, Hanney S. How can payback from health services research be assessed? J Health Serv Res Policy. 1996;1(1):35-43.
  53. Kuruvilla S, Mays N, Walt G. Describing the impact of health services and policy research. J Health Serv Res Policy. 2007;12(suppl 1):S1-23-31. doi:10.1258/135581907780318374.
  54. Lavis J, Ross S, McLeod C, Gildiner A. Measuring the impact of health research. J Health Serv Res Policy. 2003;8(3):165-170. doi:10.1258/135581903322029520
  55. King G, Servais M, Kertoy M, et al. A measure of community members' perceptions of the impacts of research partnerships in health and social services. Eval Program Plann. 2009;32(3):289-299. doi:10.1016/j.evalprogplan.2009.02.002
  56. Greenhalgh T, Fahy N. Research impact in the community-based health sciences: An analysis of 162 case studies from the 2014 UK research excellence framework. BMC Med. 2015;13:232. doi:10.1186/s12916-015-0467-4

Files

History

  • Receive Date: 09 December 2015
  • Revise Date: 30 May 2016
  • Accept Date: 31 May 2016
  • First Publish Date: 01 January 2017

Share

How to cite

Statistics