Health Research Policy and Systems

Health Research Policy and Systems

Policy briefs are a relatively new approach to packaging research evidence for policymakers. The first step in a policy brief is to prioritise a policy issue. Once an issue is prioritised, the focus then turns to mobilising the full range of research evidence relevant to the various features of the issue. Drawing on available systematic reviews makes the process of mobilising evidence feasible in a way that would not otherwise be possible if individual relevant studies had to be identified and synthesised for every feature of the issue under consideration. In this article, we suggest questions that can be used to guide those preparing and using policy briefs to support evidence-informed policymaking. These are: 1. Does the policy brief address a high-priority issue and describe the relevant context of the issue being addressed? 2. Does the policy brief describe the problem, costs and consequences of options to address the problem, and the key implementation considerations? 3. Does the policy brief employ systematic and transparent methods to identify, select, and assess synthesised research evidence? 4. Does the policy brief take quality, local applicability, and equity considerations into account when discussing the synthesised research evidence? 5. Does the policy brief employ a graded-entry format? 6. Was the policy brief reviewed for both scientific quality and system relevance?

About STP This article is part of a series written for people responsible for

making decisions about health policies and programmes and for those who support these decision makers.

Health Research Policy and Systems 2009, 7(Suppl 1):S13 http://www.health-policy-systems.com/content/7/S1/S13

to help such people ensure that their decisions are well-informed by the best available research evidence. The SUPPORT tools and the ways in which they can be used are described in more detail in the Introduction to this series [1]. A glossary for the entire series is attached to each article (see Additional File 1). Links to Spanish, Portuguese, French and Chinese translations of this series can be found on the SUPPORT website http:// www.support-collaboration.org. Feedback about how to improve the tools in this series is welcome and should be sent to: STP@nokc.no.

Scenarios Scenario 1: You are a senior civil servant and have been sent a policy brief that describes the research evidence about an issue that is of growing concern to the Minister. You are responsible for ensuring that the policy brief profiles research evidence in a way that informs different elements of the issue and recognises the importance of drawing on both local and global evidence. You want to ensure that the policy brief won’t place the Minister in an awkward position by making a recommendation that is not politically or economically feasible.

Scenario 2: You work in the Ministry of Health and have been given a few hours to prepare an assessment of a policy brief that has been sent to the Ministry on a high-priority issue. All that you have been told is that this policy brief is different in a number of ways to the type of policy brief that you have pro- duced in the past including the way in which it profiles research evidence about a problem, the options and implementation con- siderations, and the fact that it does not conclude with a specific recommendation.

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Scenario 3: You work in an independent unit that supports the Ministry of Health in its use of research evidence in policymak- ing. You are preparing a policy brief for both the Ministry and key stakeholders to profile what is known and not known about a problem, options for addressing it, and implementation con- siderations. You have been told to prepare the brief in a system- atic way and to report the methods and findings in a transparent and readily understandable way, but you want guidance on how to be both thorough and efficient in your work.

Background For policymakers (Scenario 1), this article suggests a number of questions that they might ask themselves or their staff to consider when assessing a policy brief. For those who support policymakers (Scenarios 2 and 3), this article suggests a number of questions to guide the assess- ment of a policy brief or the preparation of one.

Three major shifts have occurred recently in the focus of many efforts to package research evidence for policymak- ers. Firstly, there has been a shift from packaging single studies to packaging systematic reviews of studies that

address typical policy-relevant questions. A number of research groups, including the SUPPORT collaboration http://www.support-collaboration.org/, now produce policymaker-friendly summaries of systematic reviews. These summaries always highlight the key messages from the review but some of them, like SUPPORT summaries, also address considerations related to quality, local appli- cability, and equity [2]. This shift has made it easier for policymakers to scan broadly across large bodies of research evidence. And it has also enabled them to extract what they need to know easily from particular systematic reviews that directly address key features of any policy issue of interest.

Secondly, there have been more recent complementary efforts to package systematic reviews (together with local research evidence) in the form of a new product – the pol- icy brief – which mobilises the best available research evi- dence on high-priority issues [3]. For policy briefs, the starting point is the issue and not the related research evi- dence that has been produced or identified. Once an issue is prioritised, the focus then turns to mobilising the full range of research evidence addressing the different fea- tures of the issue concerned. These include the underlying problem, options to address the problem, and key imple- mentation considerations. Drawing on available system- atic reviews makes the process of evidence mobilisation feasible in a way that would not otherwise be possible if single studies had to be identified and synthesised for all the features of the issue. In this article, we have restricted our use of the term ‘policy brief’ to those products match- ing this description exactly. But the term has also been applied elsewhere to many other types of products pre- pared by those supporting policymakers. The appropria- tion of this term by those involved in producing and supporting the use of research evidence reflects perhaps their increasing orientation to the needs and contexts of policymakers.

Evidence-packaging mechanisms and policy briefs in par- ticular have been developed largely as a response to the findings of systematic reviews of factors influencing the use of research evidence in policymaking [4,5]. Three fac- tors in particular have emerged as significant. These are: 1. Timing or timeliness, 2. Accordance between the research evidence and the beliefs, values, interests, or political goals and strategies of policymakers and stakeholders, and 3. Interactions between researchers and policymakers.

Having access to both a stock of the summaries of system- atic reviews and policy briefs helps to address the need that policymakers have for timely inputs to policymaking processes [6]. Review summaries and policy briefs can typ- ically be produced in days and weeks rather than the months or years required to prepare a systematic review

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