Charities should get good at research uptake

Every school child knows that vitamin C prevents scurvy. But how long was it from when James Lind, a Scottish naval surgeon, made that important discovery in 1747 until the British Navy started providing fruit juice to sailors? At that time, scurvy was killing more sailors than military action, so answer is surprising. It was 38 years.

‘Research uptake’ as this has become known, is hard. Luckily it’s becoming a discipline in its own right, which looks at both its strands: uptake by governments in policy, and uptake by front-line practitioners. Charities and charitable funders produce research and insights which we aim to have ‘taken up’ in both strands.

The scurvy story shows how it’s not enough ‘just’ to be right – even if the insight is vitally important to national security and cheap to implement. This year’s BBC Reith Lecturer, the doctor Atul Gawande, talked about how his Indian grandmother died of malaria well after chloroquine was discovered to be a prophylaxis. The news must travel to where it’s needed.

Research uptake in front-line practice is greatly aided if the research is readily digestible. The five-a-day campaign gains traction because we can all remember it and can count to five: the campaign to limit the number of grams of salt we eat per day didn’t because it’s too hard to count. Medical colleges and regulators provide doctors with clinical practice guidelines (CPGs), brief papers about handling particular situations precisely designed as ‘vectors’ for research evidence to get into a doctor’s busy day. They improve care, mainly because they’re simple: they’re normally about two pages long, address a specific situation and show which suggestions are based on solid evidence versus which are our best guess based on the available research.

Perhaps more charities which deliver services could experiment with codifying procedures into guides for front-line workers. This of course raises the question of how to ensure that research is absorbed into them, and here too there is much to learn. An analysis of the uptake of biomedical research funded by the Wellcome Trust into CPGs found that it tends to take about eight years – a finding corroborated by similar studies elsewhere.

Perhaps oddly, there seems to be more analysis of research uptake by governments in less developed countries than in our own. Development economists Abhijit Banerjee and Esther Duflo identify three major barriers, based on their work in 18 countries. Ignorance is the easiest to address, since it can be solved by good events, publications and press. Inertia (‘you’re right but it’s just too hard to change’) and ideology (the proposed solution being politically unacceptable) are rather harder. J-PAL which they founded at the Massachusetts Institute for Technology and its sister NGO Innovations for Poverty Action find that success in influencing government to act on research increases if they involve officials long before research begins. Similarly, the Department for International Development has guidelines for its grantees on increasing research uptake, which stresses that it is a social process in which relationships are important.

Perhaps third sector organisations can deliberately note when they succeed and fail in getting research taken up by other organisations, and in absorbing it themselves, so that over time we hone our research uptake skills.

This article was first published in Third Sector magazine.

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