The evidence does not speak for itself: The role of research evidence in shaping policy change for the implementation of publicly funded syringe exchange programs in three US cities
The evidence does not speak for itself: The role of research evidence in shaping policy change for the implementation of publicly funded syringe exchange programs in three US cities
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DOI：
10.1016/j.drugpo.2015.04.008
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发表时间：
2015-07-01
影响因子：
4.4
通讯作者：
O'Rourke, Allison
中科院分区：
文献类型：
--
作者：
Allen, Sean T.;Ruiz, Monica S.;O'Rourke, Allison
背景：存在大量文献探讨研究证据在政策变革过程中的利用。从这项工作中，许多研究表明，政策变革利益相关者主要通过工具、概念和/或符号应用将研究证据应用于变革过程，或者根本不使用。尽管对政策变革过程的研究很广泛，但对注射吸毒者 (IDU) 中艾滋病毒预防结构性干预措施实施相关变革过程中研究证据的作用的理解仍存在缺陷。本研究考察了研究证据在美国三个城市（马里兰州巴尔的摩、宾夕法尼亚州费城和华盛顿特区）实施公共资助的注射器交换服务的政策变革过程中的作用。方法：对每个研究城市的主要利益相关者（n = 29）进行了深入的定性访谈。利益相关者被问及政策变更过程中所在城市的历史、社会、政治和科学背景。针对与研究证据应用相关的共同主题，对访谈内容进行了转录和分析。 结果：在巴尔的摩和费城，减低危害支持者使用的研究证据应用类型学方法（分别是工具性方法和象征性/概念性方法）推动了确保实施注射器交换服务的政策变革的动力。研究证据的应用在华盛顿不太成功，因为政策制定者对注射器交换计划实施的影响有不同的看法，而且政策变革的反对者在政策变革讨论中错误地使用了证据或根本没有使用证据。 结论：研究证据的类型学应用有助于理解政策变革过程，但当社会政治因素使立法过程复杂化时，其功效就会不足。减少危害的倡导者可能会受益于了解如何有效地将研究证据整合到政策变革过程中，以应对影响政策变化的无数因素。 (C) 2015 年作者。由 Elsevier B.V. 出版
Background: A breadth of literature exists that explores the utilization of research evidence in policy change processes. From this work, a number of studies suggest research evidence is applied to change processes by policy change stakeholders primarily through instrumental, conceptual, and/or symbolic applications, or is not used at all. Despite the expansiveness of research on policy change processes, a deficit exists in understanding the role of research evidence during change processes related to the implementation of structural interventions for HIV prevention among injection drug users (IDU). This study examined the role of research evidence in policy change processes for the implementation of publicly funded syringe exchange services in three US cities: Baltimore, MD, Philadelphia, PA, and Washington, DC.Methods: In-depth qualitative interviews were conducted with key stakeholders (n = 29) from each of the study cities. Stakeholders were asked about the historical, social, political, and scientific contexts in their city during the policy change process. Interviews were transcribed and analyzed for common themes pertaining to applications of research evidence.Results: In Baltimore and Philadelphia, the typological approaches (instrumental and symbolic/conceptual, respectively) to the applications of research evidence used by harm reduction proponents contributed to the momentum for securing policy change for the implementation of syringe exchange services. Applications of research evidence were less successful in DC because policymakers had differing ideas about the implications of syringe exchange program implementation and because opponents of policy change used evidence incorrectly or not at all in policy change discussions.Conclusion: Typological applications of research evidence are useful for understanding policy change processes, but their efficacy falls short when sociopolitical factors complicate legislative processes. Advocates for harm reduction may benefit from understanding how to effectively integrate research evidence into policy change processes in ways that confront the myriad of factors that influence policy change. (C) 2015 The Authors. Published by Elsevier B.V.