The who, what, where, when and why of engaging with policymakers: A critical reflection
Abstract
Improving relationships between researchers and policymakers is one element of knowledge mobilisation that has proven to increase the translation of research into policy. However, researchers report they find it difficult to engage policymakers with research. In this article, a personal narrative approach was used to analyse my experience, as a PhD candidate, when engaging policymakers to participate in a qualitative research study. A total of 93 contacts were made in an attempt to recruit policymakers; these contacts consisted of both policymakers and knowledge brokers. The experience of contacting and engaging with policymakers identified barriers other researchers may experience and offers enablers to assist when engaging policymakers. This reflective approach resulted in the development of the five following themes: who you know, what ifs, when is it enough, where is the research going and why value is important. These five themes can act as a guide for researchers when preparing to engage policymakers into research.
1 INTRODUCTION
Knowledge mobilisation is an evolving field that has progressed from linear models of knowledge translation to complex, systems thinking approaches.1 Knowledge mobilisation is often described as messy and highly relational.2 Improving relationships between researchers and policymakers have been identified as one of the factors needed to increase the translation of research into policy.3 While knowledge mobilisation is a progressive field there is still much that needs to be learnt about the relationships between policymakers and researchers. Knowledge brokers can play an important role in this relational process by connecting researchers and policymakers, relaying information and facilitating knowledge mobilisation.3
The translation of research into health policy is crucial to improving health outcomes.4 The Ottawa Charter for Health Promotion states that building healthy public policy is needed to improve population health as political factors can either be harmful to or beneficial to health.5 Policies are strongly connected to health promotion and disease prevention with policy change proven to sustain health promotion strategies.6
Relationships between researchers and policymakers are critical to producing relevant research that is translated into policy and has proven to increase the use of research by policymakers.7, 8 While these findings have resulted in funding models increasingly requiring cocreation between policymakers and researchers, researchers continue to find it difficult to engage policymakers in research.7, 9-11 Solutions to barriers researchers experience are offered in the literature but there is currently no research that offers a personal experience of engaging with policymakers.9, 10 Personal narrative can bring insight by investigating the researcher's involvement within the research.12 Using an individual's experience as the content of narrative research can result in data that is rich with insight and illustrate dynamics present in a particular phenomenon.13 Narrative research makes use of an individual's experience, conversation and personal writing; these experiences invite reflection and reflexivity.14 Narrative research is an interpretive process that qualitative researchers use to elicit change; this approach is valuable in health and social sciences where it can effect change in policy and practice.15-17
In this paper, a personal narrative approach has been used to explore the processes utilised when recruiting policymakers into a qualitative study. Reflection and reflexivity were used to provide insight and analysis of my experiences and provide information relating to how recommendations were made to assist other researchers when engaging policymakers in their research. This narrative approach offers a unique perspective that contributes to the progressing field of knowledge mobilisation and the relationships between researchers and policymakers.
2 METHOD
Narrative research is the study of how individuals experience the world and stems from a social constructivist perspective where meaningful knowledge is gained through engagement in social interactions and collaborations.18, 19 This paper used a narrative approach to explore my experiences as a PhD candidate within the world of health policy, with the aim of identifying enablers and addressing barriers researchers may encounter when interacting with policymakers. While there is no methodological standard for narrative research, Polkinghorne defines narrative analysis as ‘studies whose data consists of actions, events and happenings but whose analysis produces stories’.17, 20 These stories can include autobiographical writing which comprised the data for this study.21 The analysis of my interactions with policymakers and knowledge brokers follows Polkinghorne's definition of narrative analysis and therefore is the methodological approach for this paper.
2.1 Context
As part of my PhD project, this personal narrative was completed simultaneously during the process of completing semi-structured interviews, with oral health, cardiovascular disease, diabetes and cognitive impairment policymakers in Australia. Policymakers were recruited to this study to ascertain the knowledge mobilisation pathways they use when developing policy. This study contributes to my PhD project which is investigating the translation of oral health research into cardiovascular disease, diabetes and cognitive impairment health policy as research has demonstrated associations between poor oral health and these chronic diseases.22
Initial contact, engagement and interviews with policymakers occurred from April 2021 through to November 2021, in the form of emails, zoom video conversations and telephone conversations. During this 8 month process, I made notes weekly about the challenges, frustrations, successes and solutions identified when contacting and engaging with policymakers. I discussed these challenges and frustrations with my PhD supervisors which resulted in the identification of new approaches to engage policymakers. This paper outlines and analyses these experiences when engaging with policymakers.
3 RESULTS
Of the 93 contacts made during the process of recruiting policymakers into a research study 33 contacts were policymakers; of these, five had a professional connection to a member of the research team, 13 were contacted through e-introductions or by referral of a knowledge broker and 15 were cold contacts. As seen in Table 1 the response rate of policymakers was 60%, however, responses did not always result in an interview. While three policymakers did initially respond agreeing to participate in the interview, three follow up emails were sent with no response. A fourth policymaker advised they were not allowed to participate in the interview as per their place of employment.
| Total contacted n | Responses received n | Provided information n (% of total contacted) | |
|---|---|---|---|
| Professional contacts | 14 | 13 | 10 (71%) |
| Cold contacts | 46 | 21 | 7 (15%) |
| Knowledge brokers (total) | 60 | 34 | 17 (28%) |
| Total contacted n | Responses received n | Participated in the interview n (% of total contacted) | |
|---|---|---|---|
| Professional contacts | 18 | 15 | 10 (55%) |
| Cold contacts | 15 | 5 | 2 (13%) |
| Policymakers (total) | 33 | 20 | 12 (36%) |
The remaining 60 contacts made were with knowledge broker colleagues or organisations who were thought to have contacts with policymakers. Of these 60 contacts, 14 had a professional relationship with a member of the research team or were introduced to me by a personal contact, 46 were cold contacts and the response rate was 57%. While the response rate was 57% only 28% of respondents provided policymaker contacts.
The combined total of personal or introduced contacts between both policymakers and knowledge brokers was 32, 28 responded with a response rate of 88%. Of these 28 policymakers and knowledge brokers 20 participated in the interview or provided contacts of policymakers. The combined total of both policymakers and knowledge brokers who were approached with no introduction or connection to the research team was 61 with a response rate of 43%. While 26 people responded only 35% of these respondents provided policymaker contacts or agreed to an interview. A total of 68 chronic disease policymakers and knowledge brokers were contacted, and 25 oral health policymakers and knowledge brokers were contacted. A total of 12 oral health or chronic disease policymaker contacts ended in research participation.
The findings of this study identified barriers that I encountered when engaging policymakers in qualitative research and offers enablers to assist other researchers in this process. Themes were developed as a recommendation when approaching policymakers to participate in research. The themes identified were: who you know (the importance of contacts and introductions), ‘what ifs’ (addressing your concerns as a researcher), where is the research heading (what is your overall aim and how this impacts policymakers), when is it enough (how long do you attempt to contact policymakers) and why value is important (giving value to your research).
3.1 Who you know
Initially only oral health policymakers were identified and suggested to the research team. One explanation of this result is that I and my supervisors are from dental backgrounds with multiple personal connections to oral health policymakers and knowledge brokers. As can be seen in the results a personal connection led to a higher response rate than cold contacts and 43 more contacts were made among chronic disease policymakers and knowledge brokers to recruit a similar number of participants. Trust in individuals is of noted importance in knowledge mobilisation activities and this study highlights the advantage relationships provide when trying to engage policymakers in research.23, 24 Inversely, I found it difficult to identify and make contact with chronic disease policymakers which resulted in a higher rate of cold contacts being made in this area to produce a similar result. The identification of chronic disease policymakers relied greatly on knowledge brokers and again many of these were unknown to me and attempts were made through cold contacts. This experience found that the relationship to a policymaker did not have to be direct, it could be through another contact who the researcher may have never met, however, if the introduction to the policymaker came through a person who was known to them, the experience was they were more likely to respond and participate. This identified an enabler for researchers to utilise when approaching policymakers to participate in research.
Knowledge brokers were a great resource in identifying policymakers, however one barrier experienced through this method, was the identification of knowledge brokers rather than policymakers. On multiple occasions knowledge brokers would recommend a contact or make an e-introduction asking their colleague to participate in the research when they did not meet the inclusion criteria. There seemed to be confusion around identifying individuals who influence policy and those who contribute content and develop policy. What could be seen as a difficult situation was made into an opportunity. When it was clear, the contact did not meet the inclusion criteria they were asked if they had any policymaker contacts that could contribute. This experience resulted in the reformatting of emails with the inclusion criteria clearly repeated twice. This emphasis reduced the confusion of who could participate and identified another enabler for researchers.
3.2 What ifs
Initially, I was apprehensive about contacting policymakers, expressing concerns that not enough participants would be recruited and policymakers would not be interested in contributing to this research. I also found it intimidating as a PhD candidate to reach out to policymakers and knowledge brokers with public profiles. This apprehension diminished as policymakers responded, knowledge brokers were willing to offer contacts and interviews were thus conducted. These positive experiences increased confidence and highlighted the importance of knowing the value of your research. The decision was made to acknowledge the challenges and frustrations, but to focus on the successes and solutions. This resulted in what was felt to be a deeper, richer learning experience.
3.3 Where is the research going
A participant information statement was provided to each participant before the research began and an introduction to the research being conducted was again included at the beginning of the interview. Each participant had questions beyond the information provided most often requiring clarity about the intended dissemination of research. Policymakers wanted to know that their identity would be protected in the event of publication. In each instance, this led to a conversation and decisions were made and agreed on by both myself and the policymaker. These included: not identifying policymakers by state or territory, not identifying policymakers as state or commonwealth policymakers and not identifying the number of individual oral health or chronic disease policymakers. Due to the limited number of policymakers in oral health and chronic diseases identification of participants was a concern. Deidentification of participants created a challenge, where the protection of participants' identities must be upheld while maintaining the integrity of the data collected.25 The responsibility to guard these identities and foster relationships with policymakers, was a choice I made and felt to be imperative. Oliver et al., concluded that relationships and trust were recognised facilitators to the implementation of research into policy.24 Research suggests that trust can have a profound effect on knowledge exchange, but a gap remains on how to build and manage trust.23 Choosing to safeguard the identity of policymakers is seen as an important enabler to engaging with policymakers for this study and for future studies.
3.4 When is it enough
Clarke and Braun's method of reflective thematic analysis was utilised for the qualitative interviews paralleling this study, so it was determined to also apply Braun and Clarke's approach to data saturation.26, 27 Qualitative data produces ‘rich, complex, “messy” data’27 where the meaning of this data is found within the researcher's interpretive practices.27 Theoretically new themes could continually be revealed from the data making a predetermined data saturation point impossible.28, 29 As a junior researcher it was exciting to identify common themes from the data collected; although this was initially a daunting task, identifying new themes became motivating.
The decision to stop recruiting policymakers was made on two considerations. The first consideration was the identification of no new themes during the data collection process that answered the questions of the study. This approach relies on the researcher's interpretive analysis associated to the purpose and goals of the study.27 It was found during the last two interviews the processes and knowledge of the policymakers interviewed aligned with the answers of the previous 10 interviews. Second, it was determined to cease contacting policymakers when the same policymakers were repeatedly identified, and no new policymakers were indicated; or multiple attempts to contact identified policymakers resulted in no response. It was disappointing when effort made to connect with policymakers resulted in no response or when a response was received but there was no commitment to participating in an interview. It became apparent that this should not be taken personally as it began to impede my confidence and limit my motivation to contact remaining policymakers. It has been demonstrated that resilience in qualitative research along with critical reflection can improve the qualitative research process and is a finding of this study.30
3.5 Why value is important
The value of the research to the policymaker was identified as a possible enabler of participant involvement and is needed to be made clear in the initial contact. This required reframing emails depending on whether an oral health or chronic disease policymaker was being contacted. Oral health policymakers consistently commented how important and needed the research being conducted is. Despite lack of time being documented as a barrier of policymakers being involved in research, this study found that the value of the research was stronger than this barrier among oral health policymakers.31 Conversely, not all chronic disease policymakers that were interviewed were aware of the links between poor oral health and cardiovascular disease, diabetes and cognitive impairment; this is not a criticism, but further evidence of the importance of value of the research to the policymaker. A lack of oral health knowledge among health policymakers has been identified in other areas of health in the United States; however, this area has not been investigated among Australian policymakers.32
4 DISCUSSION
Engaging with policymakers is a critical element of knowledge mobilisation and has proven to increase the translation of research into policy which is needed for health promotion and disease prevention strategies that will improve population health.3, 5 However, this can prove frustrating to researchers when there is a lack of insight and guidance on how to best engage with policymakers. Reflecting on my experiences engaging policymakers into research has produced insight that can assist researchers in this endeavour as seen in Table 2.
Build trust with policymakers through:
|
Cleary communicate the:
|
Demonstrate confidence by:
|
When engaging policymakers into research, researchers should source personal contacts of policymakers. The highest rate of response was seen when policymakers had a relationship to myself, my supervisors or an e-introduction was made from someone they knew. These initial contacts need to be made ensuring the value of the research and the value of the policymaker's perspective is clearly communicated. A lack of time has been identified as a barrier for policymakers and this study demonstrates that creating value may be an enabler to engaging policymakers that overcomes this demonstrated barrier.33
This study identified the importance of building trust with policymakers and one enabler to this was protecting each policymakers' identity. This resulted in conversations with policymakers before the interview began and mutual decisions were made to protect the identity of each participant. Transparency has been indicated as a strategy to build trust during knowledge mobilisation activities.23
This experience has demonstrated the challenges and successes I encountered when engaging policymakers into a qualitative research study. These results have highlighted barriers that other researchers may face and offers enablers to overcome them. The five themes: who you know, what ifs, where is the research going, when is it enough and why value is important can act as a guide to assist researchers in preparing to engage policymakers into research. These themes demonstrate the benefit of utilising professional contacts when contacting policymakers and knowledge brokers, communicating the value of your research to potential participants and disclosing how the results of your study will be disseminated. The importance of confidence in communicating your research and displaying transparency with participants were also findings of this study.
ACKNOWLEDGEMENTS
The author would like to thank Dr. Melanie Hayes, Associate Professor Michelle Irving and Associate Professor Janet Wallace for their supervision and proofreading of this paper. Open access publishing facilitated by The University of Newcastle, as part of the Wiley - The University of Newcastle agreement via the Council of Australian University Librarians.
FUNDING INFORMATION
The author received no financial support for the research, authorship or publication of this article.
CONFLICT OF INTEREST
The author reports there are no competing interests to declare.
