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Reversing the pipeline? Implementing public health evidence-based guidance in english local government

Overview of attention for article published in Implementation Science, May 2017
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (93rd percentile)
  • High Attention Score compared to outputs of the same age and source (86th percentile)

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76 X users

Citations

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29 Dimensions

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108 Mendeley
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Title
Reversing the pipeline? Implementing public health evidence-based guidance in english local government
Published in
Implementation Science, May 2017
DOI 10.1186/s13012-017-0589-5
Pubmed ID
Authors

Lou Atkins, Michael P. Kelly, Clare Littleford, Gillian Leng, Susan Michie

Abstract

In the UK, responsibility for many public health functions was transferred in 2013 from the National Health Service (NHS) to local government; a very different political context and one without the NHS history of policy and practice being informed by evidence-based guidelines. A problem this move presented was whether evidence-based guidelines would be seen as relevant, useful and implementable within local government. This study investigates three aspects of implementing national evidence-based recommendations for public health within a local government context: influences on implementation, how useful guidelines are perceived to be and whether the linear evidence-guidelines-practice model is considered relevant. Thirty-one councillors, public health directors and deputy directors and officers and other local government employees were interviewed about their experiences implementing evidence-based guidelines. Interviews were informed and analysed using a theoretical model of behaviour (COM-B; Capability, Opportunity, Motivation-Behaviour). Contextual issues such as budget, capacity and political influence were important influences on implementation. Guidelines were perceived to be of limited use, with concerns expressed about recommendations being presented in the abstract, lacking specificity and not addressing the complexity of situations or local variations. Local evidence was seen as the best starting point, rather than evidence-based guidance produced by the traditional linear 'evidence-guidelines-practice' model. Local evidence was used to not only provide context for recommendations but also replace recommendations when they conflicted with local evidence. Local government users do not necessarily consider national guidelines to be fit for purpose at local level, with the consequence that local evidence tends to trump evidence-based guidelines. There is thus a tension between the traditional model of guideline development and the needs of public health decision-makers and practitioners working in local government. This tension needs to be addressed to facilitate implementation. One way this might be achieved, and participants supported this approach, would be to reverse or re-engineer the traditional pipeline of guideline development by starting with local need and examples of effective local practice rather than starting with evidence of effectiveness synthesised from the international scientific literature. Alternatively, and perhaps in addition, training about the relevance of research evidence should become a routine for local government staff and councillors.

X Demographics

X Demographics

The data shown below were collected from the profiles of 76 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 108 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 108 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 22 20%
Student > Ph. D. Student 20 19%
Student > Master 9 8%
Student > Bachelor 7 6%
Other 6 6%
Other 15 14%
Unknown 29 27%
Readers by discipline Count As %
Medicine and Dentistry 19 18%
Psychology 14 13%
Nursing and Health Professions 9 8%
Social Sciences 7 6%
Economics, Econometrics and Finance 4 4%
Other 17 16%
Unknown 38 35%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 42. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 June 2018.
All research outputs
#976,435
of 25,371,288 outputs
Outputs from Implementation Science
#129
of 1,809 outputs
Outputs of similar age
#19,531
of 324,606 outputs
Outputs of similar age from Implementation Science
#5
of 38 outputs
Altmetric has tracked 25,371,288 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,809 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.9. This one has done particularly well, scoring higher than 92% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 324,606 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 93% of its contemporaries.
We're also able to compare this research output to 38 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 86% of its contemporaries.