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Embedded research and development – design for RU - for policy & practice change HOW TO GUIDE ON RESEARCH & DEVELOPMENT: THE EMBEDDED APPROACH.

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Presentation on theme: "Embedded research and development – design for RU - for policy & practice change HOW TO GUIDE ON RESEARCH & DEVELOPMENT: THE EMBEDDED APPROACH."— Presentation transcript:

1 Embedded research and development – design for RU - for policy & practice change HOW TO GUIDE ON RESEARCH & DEVELOPMENT: THE EMBEDDED APPROACH

2 Problems of getting research into practice The usual research - dissemination model 1.Research “discovers” solutions, then try to 2.“Market” to busy decision-makers & practitioners Is necessary, but not sufficient, as not: 1.start from needs of policy-makers & practitioners 2.a typical service context – so not replicable 3.Evidence products; guidelines, tools - for scale-up. To change policy and practice, best embed research within MoH programme - priorities, policies & sites

3 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

4 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

5 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

6 STAGE 1 Design and develop service delivery package in line with MoH national priorities STAGE 2 Pre-test and pilot package (e.g. guidelines, materials and research tools) STAGE 3 Implement and evaluate the intervention STAGE 4 Support both policy and practice change (RU) nationally and internationally Stages of Embedded R and D Stages of Embedded R and D – leading to policy and practice change (RU)

7 STAGE 1 Evidence-b review & generic clinical and life-style guides & package developed China, adapted in line MoH rural insurance and public health package policies STAGE 2 Pilot package guidelines, materials. Revision of design of the trial China STAGE 3 Implement and evaluate intervention cluster RCT STAGE 4 Support both policy and practice change - evidence products - nationally and internationally Embedded R and D for CVD-diabetes in primary care Similarly in Pakistan, Nigeria, Tanzania & Swaziland

8 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 CVD risk - Diabetes Drafted clinical & lifestyle guides Pilot on-going Cluster RCT to start April Design the service delivery package within policies and context - so likely replicable and sustainable


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