Embedded research and development – design for RU- for policy & practice change

HOW TO GUIDE ON RESEARCH & DEVELOPMENT: THE EMBEDDED APPROACH

Problems of getting research into practiceThe usual research - dissemination model1. Research “discovers” solutions, then try to2. “Market” to busy decision-makers & practitioners

Is necessary, but not sufficient, as not:1. start from needs of policy-makers & practitioners2. a typical service context – so not replicable3. Evidence products; guidelines, tools - for scale-up.

To change policy and practice, best embed research within MoH programme - priorities, policies & sites

Embedded R and D – design for RU- policy and practice change at scale

Intervention- trial & qualitative & costing studies

Evidence-based intervention-package design to be effective, replicable & sustainable

Communications & RU - COMDIS H Service Delivery

Communication related activities include: • Priority setting-coordination meetings, MoH• Technical working group – eg draft guidelines• Steering group, approval, decision to scale up

Evidence products (synthesise existing & new K):• Clinical, operational, planning etc. guidelines

WHO level of evidence & strength of recommendation

• Training modules & tools – used in scale-up• Policy briefs, case studies• Peer-reviewed papers

• See the COMDIS Communications Handbook

Research Uptake (RU)

• The policy and practice change

- objectives outcomes achieved

Four stages of research & development:with the policy-makers and users•1. Design and develop, evidence based

review, and if required explanatory research

•2. Pre-test and pilot the intervention package guidelines, modules, registers and other tools

•3. Implement and trial the intervention/ package

•4. Support policy and practice change (RU) – go to scale in country, and X countries

Stages of Embedded R and DStages of Embedded R and D – leading to policy and practice change (RU)

Embedded R and D for CVD-diabetes in primary care

Similarly in Pakistan, Nigeria, Tanzania & Swaziland

NCDs – CVD-diabetes primary care

Lunchtime IVI Antibiotics!

Antibiotic Misuse & drug resistance Project

ZHEJIANG PROVINCE CDC AND UNIVERSITY

COMDIS CHINA AND LEEDS

China Cardiovascular disease prevention

and control deskguide

Identify and manage cardiovascular disease or risk

Draft 1 of 6.1.11

CVD risk - DiabetesDrafted clinical & lifestyle guidesPilot on-goingCluster RCT to start April

Design the service delivery package within policies and context - so likely replicable and sustainable