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  • Author or Editor: Katherine E Smith x
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This chapter discusses the role of ideas in policy making. The existence of conflicts between evidence-based and ideological approaches to politically contentious issues is widely recognised. However, for policy issues — such as public health — in which there seems to be rather more of a consensus about the overarching objectives, it seems less obvious how or why ‘politics’ might obstruct the use of evidence within policy making. Indeed, the majority of civil servants and politicians in a post-1997 UK context have signed up to taking an evidence-based approach to improving population health and reducing health inequalities. The existence of such a cross-sector consensus suggests that public heath might be one area in which evidence-based policy and practice are feasible. Yet, disappointingly, most assessments of public health policies continue to conclude that they are not evidence-based. A popular explanation for this disjuncture is that it results from communicative, institutional, and cultural gaps between researchers and policy makers.

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Studies exploring how and why evidence informs decisions (or not) often focus on perceived cultural, communicative and institutional gaps between research producers and users. More recently, there has been a growing interest in exploring how political differences between competing ‘policy networks’ might shape research utilisation. Drawing on two public health case studies, this paper highlights the multiplicity of divisions informing knowledge translation, arguing that this calls into question the appropriateness of prioritising professional or political divisions. It concludes by outlining how complexity theories might be employed to develop more sophisticated ways of conceptualising the relationships between research, policy and practice.

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The past two decades witnessed the international consensus around the idea that health policy decisions should be ‘evidence-based’. These efforts have stimulated a wealth of studies explicitly concerned with understanding the use of research evidence in policy. The majority of such studies suggest there are few examples of public health policy outcomes that might reasonably be labelled ‘evidence-based’. Only a small number of these studies seek to explore how political dynamics interacted with evidence to shape policy outcomes. Here, we draw on two empirical case studies of efforts to promote public health evidence to decision makers (protection from secondhand smoke in Europe and tackling health inequalities in England), to highlight the primacy of ‘policy networks’ and ‘advocacy’ for understanding the role of evidence in achieving policy change. Reflecting on our empirical findings, we argue that the policy networks literature usefully foregrounds the roles that diverse ‘policy actors’ can play in connecting research and policy. However, our case studies also suggest that popular accounts of policy networks, such as Haas’ ‘epistemic communities’ and Sabatier and Jenkins-Smith’s Advocacy Coalition Framework (ACF), overstate the role of core values in driving policy network efforts, while underplaying the role of advocacy, leadership, network communication and trust, scientific consensus, political context and strategic policy trade-offs in network success. We conclude by arguing for further efforts to connect analyses of policy networks and evidence use. We also reflect on the implications of our findings for those seeking to employ evidence to effect policy change.

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Concerns about the limited influence of research on decision making have prompted the development of tools intended to mediate evidence for policy audiences. This article focuses on three examples, prominent in public health: impact assessments; systematic reviews; and economic decision-making tools (cost-benefit analysis and scenario modelling). Each has been promoted as a means of synthesising evidence for policy makers but little is known about policy actors’ experiences of them. Employing a literature review and 69 interviews, we offer a critical analysis of their role in policy debates, arguing that their utility lies primarily in their symbolic value as markers of good decision making.

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