Shaping Research to Create More Social Impact

(Illustration by iStock/z_wei)

A recent article on the uses and limits of research in advancing public health points out that while history shows us the importance of generating evidence, evidence alone has never been enough. Many advocacy efforts related to public health and medicine have had to take concrete steps beyond publishing in academic journals to make evidence count in decision-making scenarios. Physician experts, for example, have played an active role in reducing nuclear proliferation by explaining medical and scientific facts about nuclear war to policy makers and the public. Efforts like this show how researchers can help foster greater social impact by working hand-in-hand with people who make real-world decisions.

In our own work, we strive to close gaps in health outcomes between Canadian children with disabilities and their peers. These children often lack the information, spaces, support, or adapted infrastructure to access and engage in physical activity, putting them at greater risk of chronic diseases. Our approach to using research to drive action includes strategically reviewing policies that affect the outcomes for children with disabilities and their families; identifying academic literature that may address challenges we see; integrating evidence from youth with disabilities, parents, and organizations; and then shaping this evidence into action. Unlike more-passive methods of research generation, we aim to provide decision makers with a comprehensive view of the problems at hand, co-design research processes with interest groups, and reflect local experiences as part of the evidence we generate.

This approach has translated into things like policy materials that support municipal committees, and a digital database that makes information on inclusive activities available for children with disabilities and their families. Resources like these make the needs and experiences of people with disabilities relevant and accessible to both those who make investment decisions about public spaces and those who use them.

We believe researchers working in public health—and beyond—can do much more to make their insights drive social impact. Below are three takeaways from our own work.

1. See Communities as Experts

To ensure that evidence truly serves the public, researchers need to see communities as dynamic, expert citizens, instead of static end-users. This means working closely with them from the beginning, rather than waiting to translate knowledge as a last stage (or forgoing translation altogether). Otherwise, there’s a real risk of generating evidence that doesn’t address the community’s needs, isn’t timely, or isn’t relevant for the current scenario and goes unused as a consequence.

The community we aim to support includes children with disabilities, their caregivers, service providers, civil society organizations, and policy makers across a variety of disciplines, including urban planning, recreation, and education. Depending on the situation, we might work with one or more of these groups to determine the specific type of academic review that's most relevant to their needs. For example, we have made use of rapid reviews when there is an urgent need to use research to inform policy needs; scoping reviews when it will suffice to understand current knowledge; and systematic reviews when the occasion requires a more-rigorous assessment of options and when the timeframe allows.  

These different groups also help shape the engagement strategies, data outputs, and services we develop in response to research findings. For example, we recently organized a forum to discuss evidence on childhood disabilities, with a focus on human rights. Children with disabilities, their parents, service providers, organizations with shared mandates, and trusted decision makers came together to understand human rights-related concerns, as well as to determine what evidence to gather and the best way to frame it for the policy process. The resulting evidence kit included academic evidence; expert opinions; the priorities of organizations working closely with children with disabilities; and poetry, stories, and pictures capturing the experiences of youth with disabilities. This collaborative process also informed a “policy dialogue”—a face-to-face meeting between policy makers and others—to convey the findings from the evidence kit in a deliberative, constructive environment.

_{This poem by Niko Yannakis, reflecting his experience as a young person with a disability, was included in an evidence kit designed to help policy makers better understand local accessibility challenges. (Courtesy of Lai et al.)}

2. Encourage Collaborative Research

To make the research process more dynamic—and therefore more effective—it’s important to take another look at the research lifecycle. Traditionally, the lifecycle of research is one-directional; researchers generate evidence, and then present this evidence to communities and decision makers. Funding often follows this expectation, with a focus on evidence dissemination. However, working with communities and decision makers to generate evidence that serves their needs is an iterative process. Supporting this method requires that we transform research culture such that establishing sustained relationships with communities becomes a core value—complete with funding to build capacity for researchers to pursue a wider scope of activities.

In our Canadian context, new research funding models and reward systems like Creative Professional Activities incentivize researchers to take time to develop effective partnerships with the public health system. They also give clinical researchers the freedom to generate outputs that impact different levels of practice (such as clinical or policy), rather than relying exclusively on peer-reviewed publication.

More and more funders are incentivizing researchers to engage this way, but there’s still a capacity gap. We believe the field should adopt approaches like these with more vigor so that researchers are better equipped to engage in transformational activity and work across sectors.

3. Build Institutional Demand

Increasing the demand for evidence is important in making cross-sector collaboration sustainable, but there are some significant barriers. For one, government, service organizations, and other practitioner timelines usually aren’t aligned with research timelines. In addition, research isn’t always easily accessible; it’s often hidden behind academic journal paywalls and in couched in technical jargon. Regardless of how well the evidence meets academic gold standards, it’s not always accessible to decision makers when they need it, in a form they can understand.

One way to overcome these challenges is by making use of resources and partnerships that embed researchers within institutions for policymaking and program implementation. For example, Jonathan, a co-author of this article, took part in a program funded by the Canadian Institute for Health Research that embeds early-career researchers in health systems to help solve challenges, tailoring research to real-time organizational needs. As a fellow, he worked with a community health clinic that serves adults with autism and intellectual disabilities. Together, they built a program evaluation for the clinic that was relevant to the delivery of health care, while retaining some of the rigor traditional research studies require. Programs like these are a win-win: Organizations get in-house, high-level expertise for a fraction of the cost of hiring a research consultant, and researchers build their capacity to develop more-engaged and useful research solutions.

Another way to create demand for evidence is by evolving institutional cultures to embrace rapid-learning models, where service providers can use data usually reserved for research reports right away. This results in ongoing and incremental changes in service provision, with continuous cycles of reflection to inspire process and outcome improvements. Government organizations, nonprofits, and private-sector service providers that adopt a learning culture, are deeply interested in evidence-informed practice, and generate their own practice-informed evidence will have more appetite for designing research questions that aim to answer real-time problems, while also building a bank of useful evidence.

For researchers working on social issues like public health, it’s worth remembering that evidence alone has never been enough. By seeing communities as experts, encouraging collaborative research, and building institutional demand, both researchers and research funders can better shape knowledge for action and effectively fuel the social change we seek.

Read more stories by Jonathan Lai, Keiko Shikako-Thomas & Ebele R. I. Mọgọ.