Cultures of evidence among decision-makers in non-health fields: systematic review

Article type
Authors
Lorenc T1, Tyner E1, Petticrew M1, Duffy S2, Martineau F1, Phillips G1, Lock K1
1London School of Hygiene & Tropical Medicine, UK
2Centre for Reviews and Dissemination, University of York, UK
Abstract
Background: Many non-health public policy sectors may have impacts on population health outcomes. Decision-makers’ views about research evidence are less well understood in these sectors than in healthcare or public health.

Objectives: To systematically review data on decision-makers’ views about research evidence in non-health sectors.

Methods: Systematic review of qualitative evidence. A range of database sources were searched. Studies were included if: they included local policy-makers or practitioners in transport, housing, urban planning and regeneration, crime and policing, or licensing; and reported qualitative data on views, beliefs or experiences regarding research evidence. Study findings were synthesized using a grounded-theory thematic analysis approach.

Results: Sixteen studies were included. Several factors are reported to impact on decision-makers’ use of evidence. These include practical issues such as capacity and organisational factors. However, the relevance and usefulness of research studies appear to be more important. The scope of decision-making is often constrained by political feasibility or acceptability, or by legislation or guidance, which mean that the use of evidence may not be practicable. Local decision-makers appear to mainly use evidence tactically to support policy choices, and are often sceptical about the evidence-based policy agenda.

Discussion: Compared to healthcare or public health, cultures of evidence in non-health sectors present distinct issues. The findings of this review indicate the need for a broader perspective on evidence use, which takes into account the whole decision-making process, and the interaction of academic research with more informal and situated forms of knowledge. Linear models of ‘knowledge translation’ may not capture the complexity of potential relations between knowledge and practice, and the wide variation in decision-makers’ understandings of the concept of evidence. The findings call into question the assumption that increasing the uptake of research evidence is likely to lead to better decisions.