Relationship between evidence and policy: a case of evidence-based policy or policy-based evidence?

The use (or non-use) of evidence in health policy is an issue of growing interest and concern among both academic researchers and policy makers. Most public health research is government funded, yet the extent to which its findings are used to shape and inform policy is variable in the extreme. Part of the problem lies in the nature of the evidence itself and the extent to which it addresses the complexities of the issue being researched. However, part of it also lies in the way that evidence gets communicated and transmitted to those intended to benefit from, or act on, it. This paper reviews such matters and argues in favour of research that is more attuned to the needs of policy makers and practitioners. To achieve this, a paradigm shift is needed in the way in which research is produced and consumed. Rather than academics exclusively setting the agenda, a new approach to knowledge co-creation is overdue whereby researchers, and those they are seeking to address, work together to define the research questions, agree the methods, and assess the implications of the data analysis and findings for policy and practice.