Evidence use in equity focused health impact assessment: a realist evaluation

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dc.contributor.authorTyler, Ingrid
dc.contributor.authorPauly, Bernie
dc.contributor.authorWang, Jenney
dc.contributor.authorPatterson, Tobie
dc.contributor.authorBourgeault, Ivy
dc.contributor.authorManson, Heather
dc.date.accessioned2020-11-25T23:11:12Z
dc.date.available2020-11-25T23:11:12Z
dc.date.copyright2019en_US
dc.date.issued2019
dc.description.abstractBackground Equity-focused health impact assessment (EFHIA) can function as a framework and tool that supports users to collate data, information, and evidence related to health equity in order to identify and mitigate the impact of a current or proposed initiative on health inequities. Despite education efforts in both the clinical and public health settings, practitioners have found implementation and the use of evidence in completing equity focussed assessment tools to be challenging. Methods We conducted a realist evaluation of evidence use in EFHIA in three phases: 1) developing propositions informed by a literature scan, existing theoretical frameworks, and stakeholder engagement; 2) data collection at four case study sites using online surveys, semi-structured interviews, document analysis, and observation; and 3) a realist analysis and identification of context-mechanism-outcome patterns and demi-regularities. Results We identified limited use of academic evidence in EFHIA with two explanatory demi-regularities: 1) participants were unable to “identify with” academic sources, acknowledging that evidence based practice and use of academic literature was valued in their organization, but seen as less likely to provide answers needed for practice and 2) use of academic evidence was not associated with a perceived “positive return on investment” of participant energy and time. However, we found that knowledge brokering at the local site can facilitate evidence familiarity and manageability, increase user confidence in using evidence, and increase the likelihood of evidence use in future work. Conclusions The findings of this study provide a realist perspective on evidence use in practice, specifically for EFHIA. These findings can inform ongoing development and refinement of various knowledge translation interventions, particularly for practitioners delivering front-line public health services.en_US
dc.description.reviewstatusRevieweden_US
dc.description.scholarlevelFacultyen_US
dc.description.sponsorshipWe would like to thank Laura Rosella, Maureen Dobbins, and Sanjeev Sidhartheran for their advice and contributions to the funding application for this research and Janet Hatcher Roberts for her ongoing engagement and support. We would like to thank Areeta Bridgehoman for her significant contributions to the early work and Jahanara Khatun for her support. Many thanks to our knowledge users, participating public health units and EFHIA team members for their dedication to the process, without whom this research would not have been possible. Funding This research is funded by the Canadian Institute for Health Research (CIHR). The research was conducted independently of the funders. CIHR had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.en_US
dc.identifier.citationTyler, I., Pauly, B., Wang, J., Patterson, T., Bourgeault, I., & Manson, H. (2019). Evidence use in equity focused health impact assessment: a realist evaluation. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-6534-6en_US
dc.identifier.urihttps://doi.org/10.1186/s12889-019-6534-6
dc.identifier.urihttp://hdl.handle.net/1828/12393
dc.language.isoenen_US
dc.publisherBMC Public Healthen_US
dc.subjectHealth inequity
dc.subjectEquity engagement
dc.subjectEvidence use
dc.subjectPublic health practice
dc.subjectRealist evaluation
dc.subjectKnowledge translation
dc.subjectCanadian Institute for Substance Use Research (CISUR)
dc.subject.departmentSchool of Nursing
dc.titleEvidence use in equity focused health impact assessment: a realist evaluationen_US
dc.typeArticleen_US

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