Sonia Wutzke: Good morning everyone. I’d firstly just like to of course acknowledge the traditional owners of the land on which we meet and pay my respects to elders past and present. Good morning and welcome to you all. I realise that this is a rather competitive time slot, so we feel quite honoured that you’re actually here and rather under pressure to perform, but we will do our best.
What we’re here today is to talk about really the value of partnership research in increasing the use of evidence in research and policy. We’re using the Australian Prevention Partnership Centre as a case study for that. Just a quick acknowledgement of the funding partners of the Australian Prevention Partnership Centre and I’ll tell you a little bit more about who we are and what we do in a minute. The way we’ve structured today is a little bit of a presentation and then some input from our panel. So I might introduce them first, get those kind of formalities out of the way and then allow us to do the presentations. We are really hoping for you to engage in the conversation as much as you feel able to. I’m looking aimlessly because there was a microphone there, but it’s now a roving microphone, which is fantastic. So welcome, roving microphone.
Let me please introduce then our speakers. To my immediate left is Dr. Sam Rowbotham. Sam is a research fellow with the Prevention Centre and she’s based at Menzies Centre for Health Policy at Sydney University. She has a background in psychology with a strong interested in health related research. To her immediate left is Professor Billie Giles-Corti. Billie is at the Urban Futures Enabling Capability Platform director at RMIT University and an honorary professorial fellow at the University of Melbourne. So Billie has several decades of working with a multidisciplinary team of researches and post-graduate research students studying the impact of the built environment Billie is an NHMRC senior principal research fellow and honorary fellow of both the Planning Institute Australia and the Public Health Association, and in 2008 was a Fulbright Senior Scholar.
Professor Adrian Bauman, in the middle of our panel, is a sesquicentenary professor of public health and director of the Prevention Research Collaboration at the University of Sydney. He has academic expertise in all aspects of the primary prevention of chronic disease with an emphasis on physical activity, epidemiology, population level interventions, and policy research. Adrian is lead of the rapid response evaluation capacity of the Australian Prevention Partnership Centre.
To Adrian’s left we have Dr. Jo Mitchell, welcome Jo. Jo is the director of the Centre for Population Health in New South Wales Health and in this role she’s responsible for leading the development, implementation, and evaluation of health promotion policy and strategy at the state level. Jo has a post-graduate diploma in nutrition and dietetics, a master of public health from the University of Sydney, and a doctorate in public health from Flinders University.
Last, but not least, Paul [Kelly 00:03:52]. Dr. Paul Kelly is on the end of our panel here. Paul is a public health physician epidemiologist, and health service executive. He’s currently the chief health office for the ACT and deputy director general of population health in the ACT government directorate. He’s also an honorary professor at the AMU Medical School and also a member of the Australian Health Protection Principal Committee, and the NHMRC Council. Now, formalities over, wonderful, stellar crew that are going to help us talk today about partnership research.
We’ve got an hour and a half together, I don’t know how engaged you all will be, but we’re hoping there’ll be so much conversation we’ll just keep going for that period of time. The way we’ve structured is that I’m going to briefly just introduce why we’re here as a centre and how we operate in terms of facilitating partnership research. I’m going to hand it over to Sam to talk a little bit about our evaluation and what we’ve learned so far when we reflect back on the time that we’ve had so far. Then I’m going to hand it over to the panel and we’ve posed each of them the same three questions to think back from their perspective how working in partnership has or hasn’t worked for them. Then of course hopefully we’re hoping that there’ll be lots of time at the end for you to ask us questions, give us your ideas, any insights, and to challenge us on this model of research.
So that’s how we’re going to run the day. I’m really hoping this will be really interactive, so if there’s something that just doesn’t make sense, please raise your hand and we’ll stop and do our best to try and bring people together. Just by way of introduction, I’ve just got a few slides here about why we’re here and how we’re operating. The first, and I don’t need to probably really emphasise this point significantly, is that we all know that evidence is really valued and really critical to good policy and good practise. But of course there’s often a gap between the creation of this evidence and its use. Lots of different reasons and today is not to go through and debate all the different reasons why that occurs, but suffice it to say, there’s just a lot of issues around timeliness, relevance of research and how it can and can’t be used to influence policy and practise. Recognising those challenges though, there’s increasing amount of evidence that cross-sectoral, multidisciplinary partnership research is a really critical way of effectively encouraging the use of research in policy and practise. I emphasise here that I think that’s especially the case when the issues being address are complex. So from my perspective, my focus is on the prevention of lifestyle related chronic diseases, which I don’t think I need to convince the group here, are incredibly complex situation.
So being able to have multi-sectorial cross-disciplinary people coming with different views of the world to come together to try and unpack and better understand that problem, is the way that we’re focusing our research. I did like this quote, I won’t read it out, but at the bottom of that slide, just from a publication in 2007, just really emphasising that we’re trying to move away from that kind of linear, “I will do something, it will be wonderful, you will pick it up and use it,” to something that is more of a co-creation joint effort. The NHMRC has established partnership centres for better health. The aim of these centres is to tackle the most complex public health problems by a large scale national policy practise research collaborations. Each of the centres, I said there, there is actually now three in existence, we were established in June 2013, the first with a focus on cognitive decline was established six months before us, and the third, with a focus on health system sustainability, was established just few months ago.
We now have three of these initiatives. They each have their own theme, but are really established around a common set of objectives and I’ve listed them here, around collaboration, evidence synthesis, dissemination, implementation, and capacity building. I would pause there and say I actually think this is a really bold initiative from NHMRC, a real significant commitment to this model of research that is quite new. Other countries are going this way and I think that we’re all … Sort of our initial reactions is that things are positive, mind you, but part of what today is about, to get these guys’ input, so I might be slightly biassed and I’ll admit that.
The Australian Prevention Partnership Centre, [inaudible 00:09:21] the second of those three partnership centres. Who we are, we are administered by the Sax Institute, our work is co-produced by researchers, health system practitioners, and policy makers, and our purpose of being is really to identify new systemic approaches to improve the prevention of chronic disease. It’s a national collaboration, currently there’s about 150 different individuals involved in the Centre. I’m based at the Sax Institute, I’m deputy director of the Centre and at the Sax institute, we have the coordinating centre who really try and bring this group of people together.
At the outset, our centre was the funding partners and the academics who came on board, a greater broad work plan that would see us nice and busy for the next five years. Some 37 projects are now underway across the collaboration, which is great, means things are really busy, lots happening. The key really to what we’re doing is really trying to bring those 37 projects together into a collective whole that is greater than the sum of the parts.
This, I think it is a tad blurry, but suffice it to say, it’s a wonderful image and I can give it to you in a non-blurry way. Just to talk a little bit about how we work. So we’ve got all these people across all states and territories and we are working with every state and territory health department, as well as the Australian government department of health. We have tried our best to try and bring in non-health sector and I think that that has been trickier than we probably anticipated, with lots of staff movement. I think it’s in our next phase, I think for me personally, that will be a big focus.
For now, in terms of our structure and our governance, we have three entities that really drive our leadership and governance. One of those is our governance authority. The governance authority is the funding partners and I listed them in the initial acknowledgements slide. The funding partners are NHMRC, New South Wales Health, ACT Health, HCF, private health insurer, and also the Commonwealth Department of Health. So that group meet at least four times a year to really have input and I say approval to the budget, but it’s not a … To me, certainly, it doesn’t feel like a … I can’t think of the right word. I was going to say servant and that doesn’t seem quite appropriate, but it’s a very collaborative engagement around what are the priorities, how should we focus the research. So that’s the governance authority.
We also have a leadership executive, there’s seven people in that including a director, Andrew Wilson, who is probably known to many of you and also myself as deputy director, and another five chief investigators and funding partners who come together regularly to really be stewards of the dollars, and the deliverables, and the accountability of the programme of work.
We also have an international scientific advisory committee and Diane [Finegood 00:12:33] is here somewhere, who many of you have heard speak. Diane’s a member of a very small, but a very elite group of people who we connect with a couple of times a year to really give us confidence that the science of what we’re doing is good and that it is good value for our partners.
In terms of actually keeping this initiative alive, a very key part of that is a coordinating centre that I mentioned briefly. There’s about six people in that groups who sit at the SAS Institute, do a number of things, but mainly lots about getting the projects up and running, making sure the budget’s all in line, and that people are delivering. Some of our panel might say, I think the kind of accountability and reporting is a little bit more intense than a more traditional NHMRC funding. I actually think that’s okay, we want to show as a centre that we’re doing something that’s big and good, and that our partners are getting a return on their investment.
We also have, of course, standing capacities. We’ve establishes these four kind of units of expertise, hubs of expertise. One around a rapid response evaluation that Adrian leads. We have a synthesis capacity which looks at doing more traditional reviews of evidence, but also, we’ve innovated in that space and now a key service in that area is around dynamic simulation modelling and bringing in experience as well as research data into better understanding problems. We have a communications and valuing prevent capacity, which is a really … These are kind of not necessarily blocks of people, but they just are concentrations of expertise around different needs of different people. I’m missing my fourth one. Oh, the system science and implementation capacity, which is based at La Trobe University with Allen Shield, with a focus on really increasing capacity around systems science and a lot of work around network analysis. That’s sort of a hub of people.
Finally, the last kind of layer in that inner circle of cogs is really the project teams. They’re everywhere across the country, slightly at times, it does feel a tad like herding cattle, but everyone’s out there, everyone’s engaged, wearing multiple hats, but one of our challenges is really trying to bring people together into this whole. That’s structurally how we operate.
In that image that you’ve got there, we’ve got those cogs in the Centre which I think are really like the backbone, the hub, the thing that just keeps us functioning. We’re saying that those are leading to the six elements that are in the dark grey aspect of that diagram, which are really what we’re seeing as what our partnership strategies are. What are we doing to facilitate that partnership with the ultimate aim of achieving the outer circle of that image, which is around really developing new knowledge and methods, making available policy relevant advice, and ultimately, of course, being able to influence decision making.
So what I’m just going to do, I’m going to whip through this next bit just quickly because I think we’d rather get on to hearing other people’s perspectives, but what I’ve just done now is really just listed our strategies for partnership research. We’re very fortunate, we’ve been given a decent amount of money, it’s $22.6 million over a five year period. That includes in kind as well and that’s actually an increasing amount of in kind and when I say in kind, I mean people like Jo and Paul who actually give up a lot of their time, and you guys don’t get counted, I don’t think, you just do it for the love of it. The academics just do it for the love of it.
They just do it for the love of it. Somehow, we managed to get time in the busy schedules of people like Jo and Paul who really are critical to our programmes. So there’s a decent amount of money, but with that, that means that we are [unable 00:16:30] to deliver on these strategies that we think make the partnership what it is. I’m just going to run through them quickly, I’d rather talk more about them later with you, if you’d rather.
In terms of partnerships, that strategy, there’s a lot around there, around … I’ve listed it at the bottom, but the five years of funding, and we’re really hoping that that will increase to a longer term funding, we really do need that time to establish the relationships and the trust between the academic researchers and the system based researchers. We create opportunities, many opportunities, for exchange and repeated interaction so people get to know each other, understand where each other are coming from.
I’ve listed there knowledge co-production, we actually make it a prerequisite from all of our projects that funding is only made available if the project team can demonstrate that they are a mixed group. That it’s not just the academics driving the research, it’s not just the police driving the research, we want people to come together as a collective to come up with the research questions, implement, and communicate. People do that at varying levels and I completely take that and I understand that, but it’s certainly something we’re trying to encourage people to do.
I note there too, a flexible work plan. I think I did say it, at the outset, there was a work programme agreed between the funding partners and us as the recipients of the funding, which was great, but what we’ve been able to … We’ve been give the permission and flexibility to adapt that to changing needs. So, that’s done in partnership with our partners, a conversation, project X that looked like a good idea three years ago, not quite certain it’s a good idea now, why don’t we refocus? And that’s been very well accepted, which has been great.
Knowledge integration, this is a key aspect of what we do. So we really want don’t want us to be just 37 separate projects, there’s common themes, there’s learning that can influence each other and come together. So we have designated roles of the learning and development manager and also a communications team, which is now about two and a half full time people. Which is just luxury if you’ve been in an academic environment, to have access to skilled communications people who can help you with your messaging and deciphering of the complexity of what you’re doing. That’s a great asset, I think, and has been made available through the model.
Just briefly around engagement, obviously resourcing is significant. I think the co-funding is actually really critical, as well. There’s skin in the game. We’ve got NHMRC, the dollars provided by NHMRC have been matched by our funding partners, so they’ve got skin in the game from the outset, so they want to make sure that they get something in return from that. That’s okay, I think that’s appropriate, that really encourages the research to be relevant.
Just quickly then, capacity and skills we see is a really essential element of what we do. Again, we’ve got our learning and development manager, it’s a .6 position. We also have a full time manager of systems, thinking, and capacity building. Again, a lot about targeted skills training for our researchers, but also trying to encourage them to do policy and practise research, relevant research, but also trying to up skill people working in policy about how to access and use research. We’ve been fortunate enough that we’ve been able to make available scholarships, PhD and Master level, and we’ve also set up a research network which I personally am very proud of and I think it works really well. So we have a number of very, very busy, very senior academics who lead the partnership, but it’s that kind of next layer down of the early to mid career researchers who … [inaudible 00:20:31], I think from personal experience, you kind of can bounce around an academic institution trying to find a mentor and support. So we’ve created a structure for that. This group, there’s probably about 45, 50 of them, come together face to face as much as we can afford, but we really encourage them to try and talk to each other and get support from each other. That’s been a really nice advantage of having this sort of critical mass that we can bring that group together.
The last thing I just wanted to mention was adaptive learning and improvement. We do have a comprehensive evaluation framework. It’s really coming together really nicely and it’s really looking at … Ultimately, what we’re trying to do is improve the prevention of chronic disease, but we’re also testing this model of partnership research. So the evaluation framework has been set up in a way that we’re hoping that we can unpack and better understand the model and what is and isn’t working. So, that’s sort of on a big level, but also on a day to day basis, we get feedback, formal and informal, when we ask for it, when we don’t ask for it, we get this feedback and we do our best to try and adapt and be as responsive as we can as an evolving institution.
That’s me, just a bit about us. I might pass onto Sam just to give you a bit about reflections and then we’ll see if there’s any points for clarification.
Sam: Yeah. Okay. As Sonia’s mentioned, we’ve got a really comprehensive evaluation framework and we’ve developed it drawing on learnings from development evaluation and contribution analysis. The actual framework consists of a range of different evaluation questions, some of them are kind of broad, overarching questions about how we’re functioning as a partnership centre as a whole and how we’re doing things like integrating systems thinking into our work, and how the partnership centre as a whole is being implemented and what we think we’re achieving from that. Then we also have specific evaluation questions directed at the various domains that Sonia’s just introduced to you. So we’ve got questions around what activities and strategies are being implemented across the Centre. So from those hubs of activity that Sonia described like our coordinating centre, our standing capacities, and then we’ve got questions around the specific domains, so knowledge co-production, capacity and skills, and so on. Then around our longer term outcomes, around new knowledge and methods, implementable policy relevant advice, et cetera.
So we’re trying to look at not only what we’re doing and what we’re achieving, but also how what we’re doing contributes to what we’re achieving. We’re trying to map out what it is that works, what doesn’t work so well, and what we can do to improve both within the life of this centre and going forward, and to share that learning beyond our partnership centre. We do that using a whole range of different data collection methods. As Sonia just mentioned, some of them are more immediate and responding to feedback that’s coming in on a day to day basis. Or there’s a more formal evaluation or activities that are scheduled for particular times and throughout the life of the partnership. As you can see there, there’s a whole range of methods, so using things like key performance interviews and social network analysis, using key informant interviews. So a really comprehensive set of data sources to help us really evaluate our centre in detail.
One of those I’d just like to touch on briefly is our partnership survey. This is a survey that will be done three times, I think, over the life of the partnership centre. The first one, the baseline, which we did in 2015 and the follow up was September 2016 and we’ll do one again early next year. This partnership survey is really lead by Dr. [inaudible 00:24:27] who sits within the rapid response evaluation capacity with Adrian. The results of the first year are in and it has allowed us to see how we’ve improved over that period. It’s really quite a comprehensive survey, assesses a variety of domains of partnership research and it’s really about trying to see how the partnership and the process and the engagement in the partnership is tracking over time and to really identify areas for improvement.
These are just some top-line results from that survey. As you can see, there’s five main domains and these are composite scores across those domains. The first four, leadership, governance, resource allocation, and collaboration, they’re scored out of 35 and the final domain of staff engagement is scored out of 49. You see from the dark green and the light green bars that we’ve improved across all of those domains across the two periods of time and our biggest improvement looks like it’s around staff engagement with the partnership centre. That’s notable because we, after the first partnership survey and the first round of key informant interviews that followed quite shortly after that, we implemented a number of actions to really improve engagement with the Centre and attend to making sure that people can engage and feel engaged with the work that we’re doing across our broad network.
There’s a lot more detail within this actual partnership survey and I’m happy to talk to that later if need be, but what I’d like to do now is just provide some kind of broader reflections on our experience as a whole across the different domains that Sonia introduced. I’m really focusing on those ones on the inner grey circle, so things like partnerships and knowledge co-production because they’re really about our processes and our strategies, and where the learning is about how we’re doing as a centre as a whole. We hope that they will then contribute to our actual outcomes.
So in terms of partnership research, we found that personal relationships are particularly important in this kind of partnership and those personal relationships, particularly preexisting relationships between academics and policy makers and practitioners, were really, really key to getting things off the ground and allowing work to happen and enabling the successes that we’ve had so far as a centre. One challenge that’s been identified is kind of going beyond those personal relationships sometimes and having a deeper embedding within the organisations that we’re working with. So a challenge has been that if someone moves out of a role within a government department, it can be difficult then to carry on that relationship because of them are personally based. That’s something that we’re working on and trying to find out how we can embed those partnerships more deeply.
In terms of knowledge co-production, people really have valued knowledge co-production and see it as being really important to ensuring their research is relevant, but I’ve also identified it as challenging. So for both academics and policy makers, it represents for some a different way of working. For others, it’s a way that they’ve been working for a very long time, for some it’s much newer. There are challenges on both sides, people working different contexts with different time constraints, and different cultures of working. One challenge there has been around moving from more contractual and commissioned relationships between researchers and government departments to a true more co-production mode where they develop the research questions and things together.
One thing that we’ve identified is that actually having a mix of both of those things might be beneficial, so to ensure that we’re meeting needs of funders as well as the research programmes is to have a mix of those things. Our system dynamic model [inaudible 00:28:20] a kind of really successful example of knowledge co-production where policy makers and researchers were engaged together right from the beginning to develop systems dynamic models and a number of those have now been developed. Jo might talk more to that later.
In terms of knowledge integration, this is something that has been challenging. There’s a lot of projects across the Centre and in the key informant interviews that we undertook last year, we found that there was a sense sometimes that people didn’t quite see how they all fitted together. So that’s something where we’ve put a lot of work into starting to pull things together and be able to tell the story across projects as well as within projects. We’ve got a number of really great knowledge integration products and we’ve had some really good feedback around those. So kind of getting the knowledge out there in ways that are accessible.
Engagement, as well, can be challenging, again because of the size of the Centre. So we’ve got fantastic investigators across the Centre in both academic and policy environments who are really, truly engaged with the work at the Centre. In terms of the practical realities, people are geographically dispersed, they’ve got other commitments, they’ve got their own centres of excellence, and their own post docs to support, and so on. That was identified as a challenge to remain engaged while also dealing with those pressures and that resourcing is really key to that engagement. The fact that we provide funding for projects, provide support in terms of the coordinating centre, supports with administration, travel bookings, reportings, all of those kinds of things is really key to helping people remain engaged. The strategic communication was valued here, too.
Then capacity and skills. As Sonia’s mentioned, we’ve had a whole range of events and we’ve had some really good feedback around those events and people have identified specific skills and feel like they’re getting skills as well as their network building, those things have been valued from the various events. Then finally, our adaptive learning improvement, as Sonia’s mentioned, has really allowed us to attend to how we’re going as a centre and to change course where needed and to adapt over time. So that approach has been really valuable while still also being challenging to maintain that cycle of continuous data collection and learning from that.
So, I’m going to hand back to Sonia now to just take questions at this point before we hand over to the speakers. Thank you.
Sonia: Thanks, Sam. So I think before we just get … We have posed the panel three questions each, but are there any points of clarification or comments anyone wanted to make now?
Audience question: Could you just clarify the three centres and are they different focus … Do they have different focus, each of the three centres?
Sonia: Yep. The first one, you’re going to test me here, the first one is cognitive decline and something or other, it’s probably got a more formal name than that, lead by Professor [Sukhul 00:31:26] at Sydney University. The focus is cognitive decline, but the structure is the same as ours, so having a governance authority, a number of projects, capacity building, communications. So that’s their structure. You’ve got us, the Australian Prevention Partnership Centre, our focus on chronic disease prevention. Now, the third one, I’m going to say health systems sustainability. Well done. Which is professor Jeffrey Braithwaite at Macquarie University University. So, different focus, but similar structure and there are four overarching goals of each of the Centre, from NHMRC’s perspective around synthesis, capacity building, et cetera. So there’s kind of common structure, common ideal goals, but a different focus, if that makes sense.
Speaker 5: And a common funding formula, I guess, over the other [crosstalk 00:32:21]-
Sonia: Yeah, that’s good. So, common funding formula, having being that NHMRC contributes X amount of dollars and that’s matched by, for want of a better term, industry partners, which are these guys. Whether there’s more partnership centres to come, I don’t know. Let’s not discuss if anyone knows what’s happening at the moment, federal funding for research. Is there any other questions? Okay, we might then just move on to our panel. Of course, you can ask questions later.
In terms of the panel, we’ve posed them these three questions. There’s probably more, but we thought we’d keep it polite and they’re all going to behave and be as nice as possible, but we do want them to be honest. So, I’ll open it to them and then at the end if there’s any other questions, we can ask them as well. For no other reason, I might go in the order you’re sitting, is that all right, Billie?
Billie: Okay, so my role in the Partnership Centre is to be responsible for the non-health sector. As Sonia said, I am not the urban futures enabling capability platform director at RMIT. My job is to enable the capability of the university to solve complex urban problems. That reflects the work that I was meant to be doing with TAPPC is not to be talking so much to the health sector, although the health sector is involved in my project, which is developing a national livability index or indicators, but it was really the job was to try and work with the non-health sector. So, in some ways that’s been somewhat easy because I have a centre of research excellence and we’ve had significant funding from TAPPC, but actually the work has involved much more funding because we’ve been able to cobble together the other work that we’re doing.
So we have a centre of research excellence and that has in each state that we’re working, in Western Australia, in Victoria, and Queensland, policy advisory groups that were made up of the non-health sector as well as the health sector. So it sort of made it a bit easier. With TAPPC, what we were able to do though is to bring in the commonwealth. Just to give you a sense, working with the commonwealth non-health sector that would be around cities, which is really where this work sits, we’ve had four departments, we’ve had four ministers, we’ve had many, many, many more changes in personnel, and we’ve had four prime ministers. That’s actually really important because when we changed to a liberal government, we first had Tony Abbott, he wasn’t interested at all in cities and now we’ve got Malcolm Turnbull who is interested in cities, but we’re not really sure whether he’ll survive in the long term, so there’s all this sort of ambivalence about what we’re doing, in a sense. It’s been a really big challenge.
Now, the way that the partners get involved, at the very beginning, we got them involved in talking about how we should shape our projects. So, we’ve been defining livabilities through a health lens and so we wanted … With the TAPPC particularly interested in chronic disease, so we were interested in indicators around walk ability, around transport, around public open space, in our broader livability work around employment, social infrastructure. But what we did for TAPPC, we added in the food environment, access to healthy food, and access to alcohol, and that’s quite important because actually, planners don’t have much of a focus on where food outlets should be or around alcohol. Funnily enough, that’s been a major finding that we’ve done, we’ve discovered that there is very little planning policy around those areas.
At the very beginning of the project, what people said to us is that we should make sure that the project is policy relevant. So develop indicators related to our indicators of livability, make it policy relevant. That was really important, so we changed the project immediately, we did a policy analysis in each of the states around each of our indicators. So, it really did influence what we did. What we did find, as I said, one of the major findings is that there was so little policy around food and alcohol in planning policy.
When we’re doing research, I’ve been wondering for a while, how do we get research translation? So, what do we need to do as researchers? We’ve come up with the key things, interdisciplinary research teams because we don’t know everything about the sectors that we’re trying to influence. Then involving policy makers and practitioners, answering policy relevant questions, understanding the policy world, which is why we did the policy analysis which was so important. Using designs, study designs that are policy relevant. Adopting dissemination strategies with knowledge brokers, advocates, and lobbyists, it’s been fantastic having the TAPPC working with us because they’ve really been able to amplify our findings. Providing training for researchers and having different award systems.
We’ve looked at the literature and that’s what we have to do as researchers, but actually, what I’ve discovered doing this work in particular that I think, and it’s came up in the evaluation, there needs to be something on the other side in terms of the partners. Now, I think what we’ve been trying to do is work with policy makers who aren’t really interested in health and I think we’ve stepped very tentatively in doing that, engaging them. We’ve had long term relationships, but our CRE advisory groups now are quite on board with what we’re doing. With the federal department, they’re a new group of policymakers, so we weren’t going to ask them to write an MOU when we started, so we didn’t have a formal relationship. I think that has been a major problem related to the fact that there was a personal relationship with the people we were dealing with, fantastic people at the beginning, pretty good people next stage, and then is started to … It’s really hard to keep up with that, particularly because it was in Canberra. Having to go to Canberra and keep that relationship going, particularly because they actually didn’t know what was happening either. With all the changes going at the federal level, they’re also not sure about it and they’re also very worried about their ministers and making sure that they’re doing what the ministers want.
It’s actually, I think, that whole idea where we could have improved is to have a formal relationship. I think with partners, I’ve looked at the literature on this because I’m trying to understand how do you … I’ve looked at what we need to do as researchers, but what do the partners need to do and one of the things the literature says is that they need to be aware of the pressures that we’re under, as well. We’re trying to beg them to be involved with us and to do things that are relevant, but people need … So that we can have this mutual respect about the pressures we’re under as well as what they’re under and we need to be, as researchers, making sure that we’re interested in the validity of research, but we have to make sure that it’s relevant. So we have to change what we do, but they sort of need to understand. It needs to be this two-way communication, is what the literature says, because it’s the personal relationships that determine what we get to know about the policy world. If we don’t have a good relationship and it’s not a two-way relationship, they’re the ones that can tell us what is important so that we can have more effective insights into the policy world.
The other thing that I looked at in the literature was, it’s interesting when policymakers are asked who do they trust as experts. What they say is that the academics that people regard as trustworthy and that’s really important if you’re going to share what’s going on in the policy world. Those who have got competence, integrity, and benevolence. When they’re talking about benevolence, what they talk about is the commitment to the policy reform agenda, the ability to … When there’s an ugly compromise about what the policy ends up with, not to go into the media and bag them, but actually to be supportive when they’ve sort of made some progress. It’s so easy to be critical, but it’s very hard for, in that policy process, to get what they want and what you want. I think that’s been interesting.
I think that there’s another side to it and I think that those things equally apply to what … There’s not research on this, what makes a good policymaker to work with. I think the same thing applies, a good policymaker to work with is competent, has integrity, and is benevolent. I guess benevolent to the stresses that we’re under as researchers about the pressures that we’ve got to still publish, but still engage. To keeping us informed so that we know what’s going on. So I think there’s two sides to the coin that will actually help produce this better relationship between policymakers, practitioners, and academics.
Okay. I think I’ve covered the main points. I think that in terms of what needs to happen, I think more formal commitments, and I think that maybe they can’t do right there at the very beginning. I think when you start out these things, I think it comes once you’ve had the relationship, then move towards a long term commitment. As I said, what I found with the CRE, we have got now these long term commitments and we are able to get to the next stage. Because it is a relationship, it’s a relationship with the organisation and it’s your credibility. I think we have to be policy-relevant as researchers or we’re not going to get any influence at all.
I was at a very interesting meeting with Don Nutbeam and Jon Hyde from Victoria, and someone who had worked with [Whitlam 00:42:09] government, and what they said was really disturbing to me, that so much research is completely irrelevant to them. Even commission researched academics is so irrelevant and so we are so afraid or we don’t know what to do, we can’t actually provide advice about that. Which I thought was really disturbing for us as academics. I think the only way that you can get insights into understand what’s a good policy or what’s potential is the relationship and I think we should have all the answers, but if you’re working closely with policy makers, you can share the results with them and you can work together and say, “Well what could we do?” Then your recommendations could include insights from the policy makers that you’re working with. So I think that’s really critically important. I think we have to think about very carefully as academics about the ways that we communicate our results. It’s been so fantastic having a TAPPC team, [Marge 00:43:05] and others, to help us to communicate those findings in ways that’s relevant.
I think the other thing that I’ve discovered is, and it’s time consuming and it has to be funded, is it’s really … You have to be available. You have to be responsive and you have to turn up to all the events that they organise. Others organise their policy maker colleagues and that means I go to things on transport, on planning, on all sorts of things that are outside of health, but you have influence because you turn up and then you get to know people, and you build not just the relationship with one people, but a range of a different people who are in the sectors that we’re trying to influence. I think they’re the sorts of things that we need to be thinking about. Thank you.
Adrian: Good morning. I’ve had a long history in programme evaluation in public health and health promotion, and complex programme evaluation, and some of the work that I’ve done has lead me to be in charge of the rapid response evaluation capacity of TAPPC and I’m going to talk about that in terms of partnerships. But I’m going to define it in terms of seven types of error that we could make. How many people here have heard of type one and type two errors in statistics? In other words, detecting defects that don’t exist and failing to detect defects when they do exist. I’m going to give you five more, but not as errors, more as learnings, that’s what we call them in evaluation.
Type three, type 3A error is making partnerships that don’t exist or cease to exist once you’ve started to make them. When we were forming as the Prevention Partnership Centre, we formed very good research partnerships with ANPHA, the Australian National Preventive Health Agency and with evaluating a suite of projects organised by primary care units known as Medicare Locals in five states and territories across Australia. As we formed, politics changes, governments changed, and those entities ceased to exist, so we were left having developed a whole bunch of evaluation capacity in things that were no longer there. So that’s type 3A.
Type 3B is not making partnerships that should exist and one of the challenges we’ve had is cross-sectoral partnerships. Working in prevention means we’re working outside of the health sector with much of what we do and cross-sectorally has been difficult to work in through the partnerships. Even making partnerships with all jurisdictions in Australia has been difficult because we’ve been funded only by a few of them. Those are challenges and we need to make those partnerships work better in the way that Billie has done well with transport and urban planning specifically across other sectors and agencies.
Type four error, or type four learning, is making partnerships that aren’t partnerships. It’s very difficult to make a partnership, a good partnership takes a long time of developing trust, reciprocity, mutual respect of understanding of the values of the researcher and the academic and the policy maker, and then working co-production from that position. So when you’re in new on the block prevention partnerships, and it’s difficult form those partnerships instantly, it doesn’t just happen, you don’t just add water, come to a partnership and, “Oh, we’ll be partners.” It doesn’t happen that way and that means that the TAPPC idea is a long term investment in developing evaluation capacity for prevention across agencies and jurisdictions, ideally in the long term.
Type five error is really evaluability. Somebody comes to you with an evaluation idea for a programme that’s already started and the program’s not really ready to be evaluated, and that’s where the reciprocity and mutual respect come into play. Because if we advise, “Well you shouldn’t really be doing that,” and there are pressure to do that on the other side, it becomes a complex task.
Type six error is the error committed by most researchers, many in academia, which is not understanding the policy maker’s context. As Diane [Finegood 00:47:51] says so eloquently, policy makers work at two speeds, the speed of light and glacially, and researchers work at neither of those speeds, ever. So you actually have to develop a way of being responsive in absolutely real time. When they say they want an evidence based review by Monday week, they mean really by a couple of days before that if possible and just because you say it’ll take four months to do, that’s not a way in which the partnership’s going to thrive, you’ve got to understand the pressures on policy makers. The kinds of evidence they need are not necessarily … Or are a subset, or are a reinterpretation of the evidence that we present academically. So those are some differences in understanding context as part of that shared agenda, in order to have co-production.
Finally, type seven error, or type seven learning, which is one thing that surprised me in the Prevention Partnership Centre. We were developed as a rapid response evaluation in capacity. So we’re like rapid response evaluation rangers, they’re in their rangers suit ready to slide down our fireman’s poles and go out and solve evaluation problems in the real world. But so far, we haven’t had any rapid requests. Now, it doesn’t mean we’re still sitting around waiting for something to happen because we’ve been involved in a lot of more complex evaluation thinking, but the rapid response, we’re about to develop a policy in X or about to implement something in a particular jurisdiction, or about to do something relevant to prevention, how do we evaluate that? That’s an important kind of a question that won’t be funded anywhere else, the evaluation capacity for that won’t come out of traditional NHMRC types of funding or other funding, so this is a new model for doing that kind of work and that’s an important dimension that I think the rapid response evaluation capacity could still do. We won’t work at the speed of light, but we will work rapidly. Thank you.
Jo Mitchell: Okay. I love that, glacial or the speed of light, welcome to my world. Sorry, I’m just getting my notes up. I’m a policy maker and I work within a bureaucracy and we’ve been involved in this Partnership Centre since the beginning and we actually fund $2.5 million worth of skin, which goes into the Centre, and so that’s a lot of money for us and so it is a significant investment. Our involvement, I have a personal involvement, I’m involved in some five projects, my team are involved in probably up to another five projects. Our office of preventive health, which is part of our family, are also involved in other projects, and my colleagues in the Centre for [inaudible 00:51:22] evidence are involved in yet other projects, as well. So, we’ve got a lot of involvement, it’s very clear to say.
My sense is that the projects that I’ve been involved in, they’re different, they also have different impacts. So one is, in fact, a modelling project, which I’ll talk a little bit about later. This modelling project has helped to inform what we’re doing in our childhood overweight and obesity work to meet our New South Wales Premier’s target for us there. We use that and we will continue to use it again and again and again. Other projects have come from really surprising places. For example, we have an IT system which we built to help us to implement projects at scale across New South Wales. When we presented it one day to some of the academics in TAPPC, they got really excited and we didn’t quite know why. So now we’re looking at a project, well, we’re involved in a project with them, and the interesting thing about this project is that it’s actually quite philosophical for us about, how do we measure the work that we do? That’s important because we’re system managers and we need to see progress in some of our statewide programmes, but it’s also made us stop to think about the way in which we measure our influences, how we do the work, as well. So what are the positives and negatives of that in terms of quality practise for our programmes.
The work that we’re involved in is relevant to us, some more than others, and in ways that we couldn’t really anticipate. On a really personal level, there’s that question about the time that you put in and it is a lot of time that we are involved in this work. One of the really great things, which I didn’t anticipate, was that sort of sense of input and excitement that you get from being involved in such projects where you, for me, where I get my head away from the every day policy work and start to think much more broadly about prevention and the endeavour that we’re collectively on and how this work actually contributes to building credibility for prevention, as well. So, it’s engaging and energising, as well.
What works for us is being involved at an early stage. That’s important, but the other side of that is that the policy window needs to be open. Now I’ll talk about some of the modelling work. We were approached to be involved in an alcohol modelling project, system dynamics modelling, looking really interesting. Our centre had just taken on responsibility for prevention of alcohol related harm, so it looked like a good way of learning about the field, but also in a really innovative way. It was great, it was really exciting, we did a lot of collaborative work with our clinicians as well as academics. We built the model and that’s kind of where it stopped for us, not because it’s a good thing, but I think I just learned that we had type 3B error, which … That we were the health system policy partners, but we hadn’t actually involved the other part of our … Not our bureaucracy, but government bureaucracy that looks after alcohol policy, for example, so the big [levers 00:54:55] around alcohol. So, that was an error for us because our interest was about what the health system could do, but it transgressed that into bigger questions.
However, with the overweight and obesity modelling, that’s much more useful for us because we have got the imperata from government to be looking at what are some of the broader things that we need to do. We need to be involved, but then also there needs to be right conditions, I suppose, for us to be able to take on those learnings in a very meaningful way. I agree that a researcher’s priority and a policy maker’s priority don’t often align and I’m still smarting from a particular occasion where I was at a partnership meeting and made a comment from a government perspective X, Y, and zed, and was told by a researcher, “Oh, that’s just the wrong question.” “That’s not the right question to be asking, you need to be asking this instead.” It was very much from the perspective of dismissing what is our reality in working with government about the government of the day and putting those policies into place as well. So I think that is actually about that sort of understanding of the different roles that we all play and that for us, research can be a really useful lever in terms of changes, but it’s also about incrementalism for us, as well, about putting known things into practise and doing them much more broadly, as well.
I think that there are just times when our interests don’t align and we just need to acknowledge that, that’s not the case. I think finally what I’ll say, because I think I’ve got about a minute left, is that enduring relationships and trust are important and I think one of the benefits for us in New South Wales with the Centre is that with some of the researchers, we’ve had those long term relationships. So we’ve had those opportunities to understand each other and get to know each other, which has been very positive, but one of the very exciting things about the Centre too, is that it’s actually opened up the doors for us to meet new researchers who have different ways of thinking. I now find that there’s a broader range of research experts that I can call up in a way that I’ve not been able to do before and ask for the really rapid advice, but again, I think it’s the not underestimating the time that it takes, but also the trust, the mutual trust and respect to be able to take advantage of those relationships as well.
Paul Kelly: Thank you. I’ll touch on some of the things others have said, but then try to add my own perspective. I’m a policy maker, but I have an academic background, I think that’s one of the key things that I’ve taken from the Centre and others have already talked about it is that change that we need to have in these partnership ideas, which is not about knowledge translation, and this has been touched on before, it’s not about bright shiny ideas the researchers come up with in their own academic setting and then sell to government. That’s not what this partnership centre is about, this is about knowledge, this is a new way, it’s about knowledge brokerage, as one of the terms that’s been used for this sort of thing. It relies on people that can actually put a foot in both camps. I feel I’m one of those and the people on this panel are also … All four us, that’s something that we really share, and Sonia and [Andrew 00:59:12] as well from the Centre, and others, but that’s been a crucial component of it, I think. People that have worked in government and understand how government works or have worked as researchers very closely with government in partnerships before, I think that’s been one of the key things. It’s been mentioned before, you just can’t add water and have a partnership. So that’s that.
I’ve been involved with this process from the very first meeting. The NHMRC brought out a guy from Canada who’d been involved in this type of arrangement before in Canada, and I went to the first meeting. It was really exciting and fascinating what was being proposed, but when they started to talk about the quantum of money, I thought, “There’s no way I can be part of that,” so I gave a few ideas and left, thinking I would never have anything else to do with the group. Then I got a phone call from Jonathan [Lomaz 01:00:06], this fellow from Canada, who said, “No, no, we really want a small jurisdiction, how much can you afford?” The contribution from [ACT 01:00:13] Health is in the 22 million or so that’s there plus in-kind contributions, relatively small, but for me, it’s 50% of the research funding that I have in population health, so it’s a big commitment from our point of view.
In terms of in-kind, we’ve tripled what we thought would be given in that way because of the interest and the relevance of the work, so that’s something that’s been really important. It’s great being a small jurisdiction, being included, and all along there’s been an equality of influence, regardless of that small contribution, which has been very much appreciated. The whole idea sharing and the embedding research with embedded capacity building has been a crucial component and very positive. I’ve said this before at meetings, I think there’s been a tangible change in the landscape during that period, since 2011 or so since we had that first conversation in the NHMRC building in Canberra, to now.
How much TAPPC has been a driver of that, it’s hard to quantify, but I think it’s definitely been part of that change and a key change agent, at least, in those of us that have been involved. Through us, outside the health sector, and beyond into government, certainly in the ACT context, it’s been like that. There’s been a real appreciation for the change of what research can do and how it can be involved in this type of work, so that’s been really positive.
My one little case study is the Louise story. So Louise works with me, she’s an epidemiologist in the population health division in ACT Health. She is one of the people that’s been fortunate to be funded by the Centre with a scholarship. So she works part time on research, but still remains embedded in ACT Health. She’s been remarkable and the support that’s come from the Centre and beyond the Centre for her work, has been quite extraordinary. Essentially, I’ve suggested, I’m one of her supervisors and there’s others associated from the Centre that her supervisors, we will suggest something or someone we’ve heard of through the Centre’s partnerships, broader partnerships, and she’ll immediately email them, very cheekily, and say, “Oh, would you like to be involved?” And they’ve all said yes. So now we’ve got this incredible support network doing dynamic systems based modelling in relation to gestational diabetes. As impressively, she’s actually been able to call on key clinicians throughout the ACT Health workforce and beyond, well beyond the partnership in the northern territory, other parts in New South Wales, and et cetera, and they’ve been engaged, and they’ve seen how this sort of thing can work and be changing in the way that they view this particular issue. It’s really quite exciting.
Co-production, co-design, co-benefit, mutual respect, all of those things have been mentioned before, that’s worked really well. I think in terms of the challenging, I work at light speed and glacial speed, every day, sometimes at the same time, and that’s a really great thing … Thanks Diane for that, I’m going to use it a lot. That has been challenging. This has been a slow process. As I mentioned, that first meeting was in 2011, it’s only really, I think, in the last 12 months that we’ve really seen a huge blossoming of the work from the Centre. That’s the reality, it takes time to build up these sort of things, it’s a very complex arrangement. Because it was new to NHMRC and I sit on council, so I know the kind of discussions that go on. I can’t talk about all of those, but this was a risk.
The previous head of NHMRC was really pushed into this by the politics of the national government of the day, around partnerships, very uncomfortable space for NHMRC, it’s hard to measure this stuff, all this stuff that’s happened in the last four years, how do you measure it? Is it working? Don’t know. Where are the papers? I think there was only five in the first year or something like that, from this big centre. How is the track record progressing for all the major researchers? Billie and Adrian both sort of touched on that. It’s a risk for them, as well. It was a risk for us in terms of putting funding into this new concept, as well, as partners, so those things were tricky.
The other one which I’ll be honest about is that the loan rangers didn’t always have silver bullets. We look to these guys as the experts and sometimes they actually didn’t have the answer. Initially, that was disappointing, but then we realised there actually wasn’t an answer so we had to work together, co-production for co-benefit, to find an answer, but that was tricky in the start. I’ll finish with one thing, this was a slide that Diane Finegood showed in the session the other day about … This is talking in a different context, but what she was talking about was, we can either let things happen or we can make them happen on a continuum, or we can help things happen. I think the TAPPC has been a helper. It’s about negotiation, influencing, enabling. It’s about diffusion and knowledge transfer and knowledge brokerage, it’s not forcing things to happen and it’s not just sitting back and saying, “Well that would be a great thing to happen, but we’re not going to be involved with it.”
For all those reasons, it’s been a terrific thing to be involved with and I look forward to answering questions. Thank you.
Sonia: Okay, thank you to all our wonderful speakers, very entertaining. It’s now over to you guys if there’s some questions that you have of our panel members or any comments, or advice you’d like to offer. There is a roving mic. I can’t see him, there he is.
Audience member: Hi, I’m Rebecca Davey, Arthritis ACT, so it’s nice to hear Paul speak. I have worked in the clinical field, government, both the commonwealth and ACT level, and I think this is sort of a fairly common story, particularly in the ACT, but I don’t think it’s unique to the ACT. Now, in NGO land, both [inaudible 01:06:56] and on the ground type of work, and in all my years, so in the last … Well, since 2011, I’ve been at the [Pink 01:07:05] body and on the ground work, stuff in NGO world, and I haven’t heard anything about this, so it’s really exciting to hear about it. I was just wondering on comment about, the NGO world is kind of like that third sector out there, we’re sitting on data, on programmes that need to be evaluated properly, we find it really hard to tap into academia world, we don’t have the time to do that, we don’t have the time to make the relationships, we also don’t have the money. I wear so many hats in my current role, so I was just wondering if there’s any comments about tapping into that NGO world of information, straight from probably [RC 01:07:46] experts rather than just gaining the data that we respond to or provide to government.
Billie: Yeah, that’s a great question. I have a view, but do one of you want to … I think there are NGO partners involved in TAPPC and that includes the Heart Foundation, for one, so I don’t know if there’s others, but we work a lot with Planning Institute of Australia and Heart Foundation in our work. I think that you’ve got the same problem as us is that we, academics, and that’s part of the understand the pressures that academics are under, we’re pressured to bring in our own income, our own salaries, many of us [inaudible 01:08:30] funding. We have to get publications, we have to charge infrastructure, so that’s not something that … We don’t have a choice, a lot of our team members really like to do things on the cheap, but the university requires us to pay overhead, so there are realities for us. I think that is a reality that the NGO sector needs to understand. For us, and I think a lot of people, would be keen to get involved, but that is a problem.
One way that you can more easily get involved with academics is coming up jointly with student projects because if you’ve got data, they are a terrific source of an opportunity and often we’re looking for good partners to partners with, but you do need to allocate the time to make that possible, to facilitate that potential. I think students, either master’s students, internships, or PhD students working with the NGO sector would be a really great way that it could be done more easily. I think one has to have a realistic view about how much time academics could contribute if it’s gratus.
Adrian:Very quickly, agree with Billie about the monetization of academic time and that’s a problem for all of us. We’ve had long relationships and again, it’s the relationship building. With the Heart Foundation in New South Wales and nationally with the Cancer Council of New South Wales, so that relationship over time has lead us to apply for and succeed in getting partnership grants and other forms of funding. The relationship is still a key thing, it’s building it incrementally with academics and with academic institutions over the long term. That kind of trust and long term relationship applies just as much to NGOs as it does to public sector agencies.
Sonia: Thanks. Another question? [inaudible 01:10:27]
Audience member: Good day, I’m Russel McGown from the Consumer Movement, the Health Consumer Movement, also from the ACT as it happens, but I work nationally and globally as well. I think there’s another hidden resource that you’re missing here and that’s the pro-bono contributions from citizens. I wonder if the panel could comment on how they can incorporate those into their partnerships. The NGO sector is one way because many of us do volunteer, provide pro-bono assistance through NGOs, but there is capacity for us to get directly involved in these sorts of partnerships and I just wonder if you’ve thought about how you do that effectively.
Sonia: I’ll make one comment there is that from us, the Prevention Partnership Centre, there’s room to improve there, definitely. The Cognitive Decline Partnership Centre, it’s a really key element of how they’re operating, so I completely agree and I think there is [inaudible 01:11:29] to do so.
Jo: One of the projects that I’m involved in with [Penny Hall 01:11:34] is relation to building in citizen science as well. This is a new project that in its very developmental phase. I can’t talk a lot about the detail of it, but one of the elements of this too is about building a constituency for prevention. Because remember that we’ve talked a lot about individual projects, but part of what this is about as a whole is looking at understanding and being able to describe the prevention system from a range of angles, so not just from policy makers, but also from community and people perspective, as well as governments, et cetera. We’re building towards having that bigger picture, so I think this work will be very, very interesting for us and help to take us down a slightly difference route, as well.
Billie: Can I just add one other thing? That’s to say that the other thing is technology. I think technology is going to allow us to more easily engage with the community. I think people often use, in my area, soft GIS where they get the community to upload areas … I’ve just done one in Melbourne about areas that women feel unsafe around the city. So you end up with a geo spatial layer of where women feel unsafe, then there could be intervention that’s done. I think the technology that’s been coming online now will allow us to engage with the community much more.
Audience member: Thank you. I’m Nikki Welch from [inaudible 01:13:08] Regional Public Health. I have some [inaudible 01:13:10] from the comments, from Don Nutbeam and Jim Hyde about the use of evidence in policy. In my policy work, what I struggle with is the gap between evidence-based advice on implementation and Paul, I’ve had a lot of use from your article reflecting on your trip to New York and how implementation was done in New York and all the steps that they went through. I wondered what it might take to increase that kind of level of engagement across both policy and researchers to do some more work in terms of policy implementation?
Paul: Someone’s read my article, so I [crosstalk 01:13:53]. Thank you. Actually, it’s an online platform if anyone’s interested, Frontiers in Public Health, about 2,496 people have read that, last time I saw, I have the analytics. So, thank you for the comment. It’s absolutely crucial and that’s why I went to New York was to actually ask them not what they did so much, but how they did it, how the hell did they manage to do all that stuff? I learned a lot, as you’ve seen in the article. That is one of the projects of the Centre is a lot of it’s about implementation and there’s a couple of specific projects which are looking at our healthy weight initiative in the ACT, three projects, four now, I think. So that was all about timing, it was one of those things that was just starting at about the time when the partnership formed and I’ll put my hand up, I was the one that asked Adrian to come and tell us how to evaluate this thing we were already doing and he said, “Don’t do that.” No, he didn’t actually, but it was a difficult task.
Yeah, it’s all about implementation and I think that’s one of the key learnings that will come with time from the Centre. The other thing, if I may, just to comment on another key component we haven’t really touched on so much is about building the compelling case for prevention, that’s a key component of the work of the Centre. That’s all about actually trying to, if it’s at all possible, to get some key messages like [Sandro 01:15:24] and [Bromlin 01:15:26] did at the [inaudible 01:15:27] session, for those that were there, that was remarkable, and the epidemiologist, I’ve forgotten his name now, the smoking guy. All three of them were able to crystallise complicated things, which are complex, and distil them into simple messages. Jo and I, and Jo’s bosses, have had a lot of the conversations about that. We need those simple messages to be able to go to our policy environment to make the compelling case as to why these things are important. Having 100 papers and lots of references and a big complicated document is not the way to do it. That’s a key thing that we’re trying to achieve here for a number of the projects that we’re doing.
Jo: Look, just on a really practical level, we went to our independent liquor and gaming organisation to sort of say, our local health districts have been providing feedback on alcohol development proposals, for example, what’s the best way for us to do that, that’s going to actually make a difference? It was very neat, they said, “We want to know what the research evidence is, so just have a statement which sort of says this systematic review shows X, Y, and zed. Give us the local data in terms of hospitalizations, for example, and don’t forget the anecdote, because it’s the anecdote that can actually really give the flavour for it.” What that does for me is makes me think about the way that we communicate in public health and so the working the [comms 01:17:06] capacity, I think, is one of the things that’s going to help us to do that better. As a good public health practitioner, it’s not enough for me to have those sort of high level statements, I know that we need to have that data to back it up underneath, but in our communication, we need to be much clearer and much quicker to the point.
Adrian: The Partnership Centre allows the capacity for innovation and innovation is really a learning process over time. We do things that would never happen or be funded otherwise. That’s because we have an obligatory mandate to do research that relevant to policy and nowhere else is that funded. Over time, this will eventually change the research landscape so that researchers in universities hopefully will be subject to different metrics other than just traditional academic citations by their peers, but other kinds of impacts and other kinds of ways in which funding agencies from government and NGOs will actually fund our research. If this starts that process, then that’s an important piece. For example, in the context of the question doing implementation research, assessing scalability and scale, assessing reach, are really important policy questions and rarely funded currently.
Billie: I was very fortunate in the first part of my career, I was working with Health Way, the West Australian health promotion foundation, and it was absolutely a true partnership because they fully funded us and our job was to work with them in partnership to come up with their strategy and their evaluation. They funded lots of little projects, we used to evaluate all their little projects, we’d build to capacity, it was quite an amazing model actually. But, I think what my observation is, in terms of, a lot of academics don’t know what to do in the same way that you don’t know what to do. I think just to say something really controversial, the trouble with systematic reviews is that you often throw out in systematic reviews all of the studies that are really useful because they’re not tidy. Things that make a difference are … You often want to control things, that what you do in a systematic review, it’s difficult, but I think one of the things I find really frustrating is that it’s baby in bathwater stuff.
You throw out the baby with the bathwater and people go to consultants who use our evidence, they ring us up to talk to us about what should be done, and then they turn that into advice to government about what government should do, having used all of our advice for free. So I wonder where that … It’s just the way it works. That’s truly the way it works and they’ve got the courage to just say, “This is what you should do.” My thought is that, I think better relationship, like true partnership, the same way that we’re trying to build [inaudible 01:19:52] partnerships, a proper relationship based on trust, investment, got to pay, but people pay a lot of money to consultants to give them advice like that. They’re working at lightening speed and I think that’s a big problem for us in the academy is all the pressures that we’re under. We’re not fully funded, then we’re scrambling around fitting this in to other things that we’re doing, but if you fully fund groups, then I think there’s a potential to get good advice based on a partnership.
Also, putting in place the evaluation to see what works. I think it was mentioned on Monday about what they’re doing in Finland now, what do they call it? Experimental policy, where you don’t really know, it’s like a natural experiment, you don’t really know if it’s going to work, but you put in place all the evaluation tools to work out whether it is working and putting in an early warning system so you can stop it if it’s not working. That would be my thought is I think we are weak on that, but I think we could do better through better partnerships.
Audience member: Hi, Monica from Melbourne. Thank you for your presentation. As an outsider to the Centre, thank you for your website, really useful to get a handle of all the things that are going on. I think your investment in comms is wonderful, that report, [inaudible 01:21:12] manual report, but that was really terrific for an outsider. I’ve snuck in on a few webinars, if more people outside the system could do that, that’s perhaps useful. My question is along the lines of where the NGOs and where the citizens, I think one of the first slides said academics, policy makers, and practitioners, where do the practitioners fit in? Or the practise …
Jo: I can give an example of that. I think that practitioners fit in at the project level. So for example, we’ve had a number of our staff who have taken leads been lead joint investigators in projects, including one of the staff members, or a couple of staff in the office of preventive health, learning all about system dynamic modelling, for example. As well as we’ve got a project which is around our IT system, which I mentioned, which is engaging with all of our local health district, health promotion manager as well. Then it’s actually an ethnographic study, so there’s a lot of participation through those processes as well.
Paul: I already talked about the Louise story, so I would classify Louise as a practitioner, she’s an epidemiologist, so she’s not a point of care clinical person, but she is practising epidemiology. A number of my staff here in the front row, make me nervous, and they’re also practitioners in a health promotion sense, but back to Louise, again, she’s managed to engage the head of the endocrinology and diabetes service in ACT health, looking after all of 60 or more stuff and influence that remarkably. The head of neonatology, the head of obstetrics, so they’re three really big areas of the clinical service in the ACT, which frankly, I thought they would have nothing to do with this. We kind of asked them but expect them to not quite make the meeting or whatever, but they’ve been engaged all the way through and very strongly engaged. So I think the answer to the question is, if you look at the website, you’ll see the people and it looks like it’s just high level policy and lots of professors, but under both of those wings are the next level that’s been mentioned and the level below in terms of really practical people on the ground and young people that are really learning from this. I have great hope that they are the ones that will change the paradigm in the future.
Audience member:[inaudible 01:23:56] as a practitioner [inaudible 01:24:00]. Our programme that we run is government funded, but not one of the funding partners and my question is, how much time would the Australian Prevention Partnership Centre be willing to invest for a long term project? So we’ve got four and a half years of funding, but we don’t know what we’re looking for. We’re looking for a [inaudible 01:24:21] prevention metrics, we’re trying to prove ROI in that space for our funders and for funders in other state government entities that are licencing our materials currently. So that was my question is, how far is the APPC willing to go to deliver on some projects? Because we don’t know what we’re looking for.
Sonia: I love it when no one looks at me. [crosstalk 01:24:45] Sorry that I missed that person at the back, so we’ll do that next. Look, I’m very biassed, but we were always established with the view that it’s a long term investment and so, basically, we’re committed, if people are prepared to come to the table, we see this as an ongoing thing. Especially, I can only talk on behalf of our Centre, we think there’s a huge gap in the Australian landscape at the moment around prevention, there’s not an Independent [Pink 01:25:13] body that can try and collectively bring our knowledge together, so we think we have that space or we’d like to grow that space, so we are prepared to think long term. If you have an idea, I’ll give you my card. Sorry, where did this gentleman go? Thank you.
Audience member: Thank you very much. My name’s Stephen [Ginsburgh 01:25:32], I’m a director of the Sydney North Primary Health Network. I don’t know how many people here are old enough to remember Vance Packard’s, The Hidden Persuaders, but something I find as a practitioner, I’m a GP, is that we’re very poor, we were trained in many ways, but we’re not advertisers. I’m just wondering, to pick up on your point, how much we could leverage off pro-bono in the advertising, in the professional advertising world, and that’s not to dumb down the communications teams that work in all of our organisations, but we need a tagline, we need lots of taglines. I’m just wondering, anyone here know someone in the advertising industry who feels kindly inclined? I really do think we need taglines.
Paul: I want a whole bunch of double, triple, quadruple, or whatever it was that was said this morning. It’s that sort of simplicity, you’re right, and it has been great work, and again, in the front of the audience is the person that’s leading that work within the Centre. It’s something we started on and have had some progress, but there will be many more of these products in the next year because Jo and I are going to push it because that was a promise that we had from the start is, give us the three things, with the context, Jo described it earlier, that can be used at the local level, and the national level, and the international level.
As I said, back to the [inaudible 01:27:06] this morning, there were three excellent examples of that, taking complex economic arguments and making them into a small circle with a few stop signs and caution signs, and throwing it back at the economists and saying, “No, for the very reasons you’re telling us we can’t do anything about sugar sweetened beverage techs, that’s why we need to do it.” So they’re the sort of things that we can get. Again, as Jo said really well, is that as policy makers and people working in government, we have to have the absolutely solid evidence under that because they will come back at us for that. In the meantime, we have to all be repeating those same messages over and over again, just like advertisers do, you’re quite right. It’s something we’re not trying to do properly, and that’s been a great element at the Centre to have that capacity in there as well, which we’ve talked about.
Sonia: I’ll add too, to that, that one of our projects that’s been mentioned briefly with Penny Hawe is really trying to better understand the science of communicating about the science of prevention and public health, and we’ve just established a partnership with the Centre for Public Awareness of science at [ANU 01:28:19], so they’re a really creative, innovative mob who I think will give us some good ideas. A project that was mentioned earlier and compelling case for prevention, that has a whole armoured around, no pressure to my comms manager, around creative messaging. So we think there is a gap there. I really want to see us on the [Gruen 01:28:38] transfer and that challenge, how do you make prevention sexy? That’s my goal. You’ve got 15 months to get there, [Miles 01:28:48], so look out for the Gruen Transfer. If anyone knows anyone like that, we would like to meet.
Billie: The Gruen Transfer would be great.
Audience member: Hi, my name’s [Adina 01:29:05] and I guess this session has really articulated a lot of the things that are constantly going through my mind. So, I’ve been fortunate enough to have been working in a ever evolving research capacity in an NGO and have recently embarked on a PhD in order to further develop my research skills, as well. You mentioned that you hope that the next generation or the people coming in will take on this effort and I’m just wondering what you would recommend for someone like myself who has got a health promotion background, who is now doing a PhD, who is working actually in a unit with predominantly clinicians who are also in research. Yeah, I’m just quite inspired, but also not sure where to go and what to do, and I would love some advice.
Paul: [inaudible 01:30:08] Anyone who saw Mark [Lamore’s 01:30:10] start to the conference and talked about the people with the grey hair, the grey beards, and also the ones that can’t grow grey beards, I’m that one. Yeah, anyway, you’re the future and what you’re doing is exactly correct. Having people embedded in service, however that is, in non-government or in government, or in the hospitals, or in the primary care networks, or any of those places, who are engaged with academia from the start, it sets you up to be one of these knowledge brokers into the future. I think it’s wonderful to hear that you’re doing that. I’ve tried to encourage my own staff to think about those things and I’ve had a couple of successes, Louise I’ve mentioned, but there’s been others. We’ve also hosted people within, so that’s the other opportunity is for people to come from academia into our policy and practise world. Develop those feet in both camps, that’s so important, I think, that understanding of the pressures of both ends. Do what you’re doing, that’s what I’d say.
Billie: One other thing is that you could also be thinking about as a PhD student, you can usually supervise other students, so a part of your role could be capacity building to bring other people into your organisation to be doing policy relevant, practise relevant, sort of studies. I think there’s opportunities there. Often, master’s students, honours students, things like that, so that would create the next generation coming through as well. [inaudible 01:31:46] Yeah.
Sonia: Great, I think we might call it quits there. Two things I wanted to say. One is that I’ve just been passed a note to say that apparently our new partners are already working on a pitch for the Gruen, so fantastic. I didn’t even ask and that just got absorbed, fantastic. I really just wanted to end with thanks to our lovely panellists, thank you all for coming. We genuinely think partnership research has great potential, yes of course there’s challenges and I don’t think we can emphasise enough the value of relationships, trust, and mutual respect. Go forth and let’s not make any of Adrian’s errors. [crosstalk 01:32:25] Thank you.
A panel discussion at the World Congress on Public Health provided insights into the value of partnership research in increasing the use of research evidence in policy. Panellists Dr Sam Rowbotham, Professor Billie Giles-Corti, Professor Adrian Bauman, Dr Jo Mitchell, and Dr Paul Kelly share their experiences of working in partnership.