Finding the Tipping Point: Uncovering the Hidden Process of Adopting Research Evidence

Purpose:  Calls for evidence-based practice continue to increase, yet a large gap exists in our knowledge about how policymakers and practitioners make use of research evidence.  While most research dissemination studies investigate processes mandated by a particular authority (such as medical societies directing practitioners towards a certain approach), little is known about how research evidence is selected and used in settings where organizational actors encourage the voluntary adoption of certain beliefs and practices.  This paper describes how a statewide public-private network of community-level coalitions selected and disseminated a body of scientific research to improve child and family health.

Method:  Using a case study approach, we analyzed legislation, primary source documents from 11 years of meetings and interview data from key informants involved in the research selection and dissemination process.  Data were analyzed using content analysis and identification of critical turning points in the research selection and dissemination process.  The research team used a collaborative process allowing the researchers to compare, discuss and negotiate emergent findings.  Findings were checked with coalition members as they were developed.

Results:  Three key findings emerged from the analysis.  First, state-level network leaders did not mandate the adoption of a particular set of research findings or evidence-based programs.  Rather, the state network collaborated with community-level coalitions to choose among various empirical frameworks.  Second, the research evidence that was selected focused less on the substantive problems experienced by communities (e.g., substance abuse, emotional and behavioral problems, child abuse) and more on the causes, or causal framework, for these multiple problems.  The selection of this research was contingent on the fact that it could transcend the political and social concerns of any particular community group and so was seen as usable by all members of the coalition.  Third, selection of research evidence at the community-level is more a social and cultural process of finding and sharing a “common language” rather than one based solely on the scientific credibility of the research, although the legitimacy of the research was one consideration in the selection process.

Implications:  In communities with complex networks of organizations and actors with sometimes conflicting goals, selecting research evidence to improve child and family health is not a straightforward process.  Voluntary adoption of research evidence in community coalitions is as much a social process as it is a rational one based on the integrity of the research.  Researchers, policymakers and organizational leaders should consider the social processes associated with research use, including how research can be used to reduce inter-organizational conflict and create commonality among health and human service providers.