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Disseminating research findings to impact policy. Jitendra Khanna Technical Editor The WHO Reproductive Health Library.  "Ta mard sukhan na gufta baashed       Aib-o-hunarish na hufta baashed" Sheikh Saadi (Till a man says something, both his strong and weak points remain hidden). .

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disseminating research findings to impact policy

Disseminating research findings to impact policy

Jitendra Khanna

Technical Editor

The WHO Reproductive Health Library

 "Ta mard sukhan na gufta baashed      Aib-o-hunarish na hufta baashed"Sheikh Saadi

(Till a man says something, both his strong and weak points remain hidden).

  • Review some basic principles of communication and information dissemination
  • Explore channels of dissemination for peers and other stakeholders
  • Some exercises


  • Based on
    • HRP communication workshops
    • Turning research into practice
    • Institute of Health Economics report (2008)
science in iran
Science in Iran
  • Iran increased its publication output nearly tenfold from 1996 to 2004 (Institute for Scientific Information)
  • Iran ranks 49th for citations, 42nd in paper output, and 135th for citations per paper
  • According to a British government study (2002), Iran ranked 30th in the world in terms of scientific impact.
  • In 2008, Iran ranked 32, 46 and 56 in Chemistry, Physics and Biology, respectively, in the world.
          • from Wikipedia, 2009
generally speaking
Generally speaking….
  • Many problems – not as many sure solutions
  • May have solutions – but no direct power to implement
  • Knowledge – this today that tomorrow
  • Knowledgeismoney (and power)
  • The big gap – researchers and public
  • The many brokers – noise or clarity?
  • Power of science – or weaknesses?
  • Interests – supportive and vested
  • Others
research to policy some basics questions
Research to policy: some basics questions
  • Whose idea was it anyway?
  • Was there interest in it before and during the conduct of research?
  • Does the research group have credibility?
  • Where were the results published?
  • Who is opposed to the idea?
  • Is there capacity to implement the intervention?
  • What are the risks in implementing it?
information dissemination
Information dissemination

The circulation or wide dispersal of information.


what is communication
What is communication?

"Any act by which one person gives to, or receives from, another personinformation about that person's needs, desires, perceptions, knowledge, or affective states. Communication may be intentional or unintentional, may involve conventional or unconventional signals, may take linguistic or nonlinguistic forms, and may occur through spoken or other modes."

National Joint Committee for the Communicative Needs of Persons with Severe Disabilities, 1992

key points about communication
Key points about communication
  • Exchange – two-way
  • Information (but reflects knowledge)
  • Intentional or unintentional
  • Linguistic or nonlinguistic
  • Needs, wants, perceptions, knowledge
shannon s model
Information source






Noise source

Shannon's model
  • Claude E. Shannon conceptualized the communication theory model in the late 1940s.
  • It remains central to communication study today.
adapted model of communication
Adapted model of communication













quality of communication
Quality of communication
  • Varies, depending on
    • Use of effective skills and strategies
    • Understanding of audience(s)
    • Use of correct channels
  • Skills can be learnt
going from a to b and back
Going from A to B… and back
  • Means of transport (information channel)
  • Timing (hook for the story)
  • Information about B (know the audience)
    • Culture
    • Likes / dislike
    • History
  • Risks (What can go wrong)

Research is part of a process of knowledge production, management and use.

a research institution is a knowledge factory
A research institution is a "knowledge" factory

Output: information

Input: information



the policy and execution grinding mill
The policy and execution grinding mill

Analyses of threats and benefits



Policy and communication





worlds apart
Worlds apart
  • Since both research and policy-making are complex activities and very different from each other, mutual understanding requires concisions effort.
    • A generalization made based on research by Fox and Oxman (2001)
dealing with people
Dealing with people
  • Do we really make, and use reason in, all our choices?
  • Philadelphia project
  • Cornell study (Schouffle 2004)
  • Video on choices
exercise 1
Exercise 1
  • Speaker
  • Interviewer
  • Observer
interpersonal communication
Interpersonal communication

Conflict occurs

when communication fails

insight no 1
Insight No. 1

If people perceive an attack, they will defend themselves.



Vicious circle of attack and defence



Communication seeks to better understand other viewpoints and

not necessarily

to agree with them.

Although, if you keep an

open mind, you may achieve

agreement as well.

insight no 2
Insight No. 2

Listening is more than just waiting quietly for your turn to speak.

the art of listening
The "art" of listening
  • maintain an attitude of ‘inquiry’ and interest
  • gently probe to understand the other
  • draw out the other’s reasoning
  • ask for examples
  • check your understanding
  • listen with an open mind
  • refrain from preparing to destroy the other’s argument or promote your own agenda
insight no 3
Insight No. 3

To really understand someone else's viewpoint you have to be able to get out of your own logic and into theirs.


understanding other people s logic
Understanding other people’s logic
  • Assume that people are rational
    • People behave "rationally" based on their internal logic:
      • how they see things
      • self-interest, which they are working to maximize
      • their important concerns
  • Other helpful assumptions
    • Other people are going to see things differently from you
    • You can understand those differences and their likely impact
  • The BLM syndrome
the anatomy of action communication
Logic of actions is based on

personal factors




of events

Self interests



Professional values


Beliefs and


The anatomy of action/communication

Action taken


action and communication
Action and communication


the invisible side of communication

inquiry open closed questions
InquiryOpen/closed questions
  • Open
    • don’t influence the answer (transmit interest)
    • seek information
  • Closed:
    • seek agreement/disagreement
    • don’t draw information
the ladder of inference
The ladder of inference

“Our ability to achieve the results we truly desire is eroded by our thinking that:

  • our beliefs are the truth
  • the truth is obvious
  • our beliefs are based on real data
  • the data we select are the real data.”

Senge et al. The fifth discipline fieldbook.

insight no 4
Insight No. 4

To influence someone you have to be able to speak their language.

insight no 5
Insight No. 5

Humility works!

in presenting your point of view
In presenting your point of view:
  • state assumption
  • explain reasoning
  • explain context
  • give examples
  • invite testing of your assertions
  • reveal where you are least clear
  • avoid being defensive

(allow yourself to be vulnerable)

the nature of knowledge
The nature of knowledge

and information…..

"REAL science depends on the dispassionate search for truth."
        • Robert K. Merton, Sociologist
information vs knowledge
Internal process




Shapes behaviours

“True, justified beliefs”

“Sum of what is known”




Relates to media



“Facts provided”

“What is conveyed…”

Information vs knowledge
Communication is to information/knowledge as packaging and transportation are to goods
  • Knowledge is a product that needs to be managed
knowledge management
"Knowledge" management

“We have managedmoney and buildings and people and energy. Now we need also tomanage the most precious commodity of the 21st century knowledgeand know how.”

J A Muir Gray, Director, Research and Development.

NHS Executive Anglia and Oxford, Oxford.

BMJ, 26 September, 1998 (Volume 317)

Knowledge management is about using people as a resource
  • Information management is about using instruments, data, journals, media – what is exchanged between people
examples of underutilization of knowledge
Examples of underutilization of knowledge
  • In Mexico 14 out of 22 hospitals in Mexico City were not using magnesium sulfate for the management of eclampsia (A WHO study)
  • In the USA, patients received 55% of recommended care and quality varied by medical condition - 79% of recommended care for senile cataract to 11% of recommended care for alcohol dependence (McGlynn 2003)
  • 20-30% of patients may get care that is not needed or care that could be potentially harmful (Schuster 2005)
purpose of research communication
Purpose of research communication
  • Ensuring that all stakeholders are aware of and use research evidence to inform their health and health-care decision-making.
some questions to ask
Some questions to ask
  • What should be transferred?
  • To whom should research knowledge be transferred?
  • By whom should research knowledge be transferred?
  • How should research knowledge be transferred?
  • With what effect should research knowledge be transferred?
  • Knowledge ripe (synthesized) for transmission/ implementation? –
  • Proteus phenomenon – diminishing effect size
    • Why systematic reviews are important
  • Type and quality of evidence
    • Single study (observational – RCT)
    • Systematic review
  • Urgency of situation/opportunity cost
  • Relevance to local setting
    • In time
    • Context
    • Setting in which evidence was generated
to whom 1
To whom  1
  • Peers (for researchers)
    • Co-workers
    • Colleagues in the organization/university
    • Researchers in your field
    • Researchers in other fields
  • Issues
    • Which journal
      • International, regional, local
      • Reputation, prestige, impact factor
    • International meetings?
to whom 2
To whom?  2
  • Policy-makers
    • Government leaders/officials
    • Decision-makers
    • Regulators
    • Industry
  • Programme managers
  • Patients/public
  • Donors
by whom
By whom?
  • Whose responsibility is it anyway?
  • Researchers and brokers
  • "Dr Fox Effect"

THE DOCTOR FOX LECTURE: A PARADIGM OF EDUCATIONAL SEDUCTIONDonald H. Naftulin, M.D., John E. Ware, Jr., and Frank A. DonnellyJournal of Medical Education, vol. 48, July 1973, p. 630-635

the channels 1
The channels -1
  • For peers (information)
    • Journals
    • Meetings
    • Newsletters
    • Listservs
    • Etc.
  • For peers (behaviour change beyond policy)
    • Educational outreach (vs self-learning)
    • Opinion leaders
    • Audit and feed-back
    • Etc.
the channels 2
The channels -2
  • Policy- and decision-makers
    • Policy briefs
    • Press releases
      • Radio/TV
      • Print media (newspapers, magazines)
    • Dissemination workshops and meetings
    • Personal contact
  • Publics
    • Internet
      • Listservs
      • Facebook?
    • Docudramas
    • Infotainment
    • Telephone
    • Celebrity ambassadors
  • Planned dissemination efforts works better
    • Time it well
  • Know your hurdles
    • (Evidence for interviews and focus groups)
  • Know your supporters


  • Select media/interventions
    • (Evidence for effectiveness generally weak)
  • Follow the plan
  • Evaluate
reaching out to masses
Reaching out to masses
  • Publics are often ignored as a stakeholder
  • Video
what effect
What effect?
  • Proactively listen to what comes back
  • Measure your success
    • Success may be slow
    • "Reason" may be less common than assumed
  • Evidence is often lacking
  • Evaluate
  • Keep at it
  • Plan for use of knowledge before staring research
  • Involve as many potential stakeholders as possible (including end-users)
  • Plan for effective communication strategies (including training of researchers in communication skills)
  • Evaluate impact
  • Group 1 - Researchers
    • Key messages
    • Stakeholders
    • Strategy (elaborate)
  • Group 2 – Policy-makers
    • Process for implementation
    • SWOT analysis
    • Strategy (elaborate)
  • Strengths: Plus points of the findings.
  • Weaknesses: Potentially harmful attributes of the findings.
  • Opportunities: External conditions that are helpful to achieving impact.
  • Threats: External conditions that could do damage.
  • Adult learning: Adults don’t like being told…prefer to be part of decision-making
  • “Change is difficult” – why?
  • Low-cost interventions preferred – but what about opportunity cost?
  • Want best for less --- realistic?
  • Science being sidelined? Us health insurance company policies
  • Why harsh approaches to BC are a no no?
  • RCTs best for intervention studies?
“Everyone has been made for some particular work, and the desire for that work has been put in every heart.”
  • Jalal ad-Din Rumi

Thank you

From: New Scientist

"Knowledge resides in the user and not in the collection [of information]. It is how the user reacts to a collection of information that matters." -- Churchman, C.W. (1971). The Design of INQUIRING SYSTEMS: Basic Concepts of Systems and Organization, Basic Books, New York, NY, p. 10.
  • To understand key insights that affect the quality of IPC.
  • To identify skills and attitudes associated with those insights.
  • To increase awareness of one’s own effectiveness in IPC through practice, observation and feedback.
communication related terms used in research dissemination
Communication-related terms used in research dissemination
  • Communication
  • Information dissemination
  • Knowledge transfer
  • Knowledge transfer and exchange
  • Knowledge translation
hrp philosophy
HRP philosophy

For a research institution, the job is not over until research findings:

  • have been peer-reviewed and published
  • have been disseminated to all audiences (including lay)
  • (where applicable) have led to policy impact.
the view from the other side
The view from the other side
  • Quality (credibility) of evidence
  • Extent of benefit
  • Costs and opportunity cost