Cargando…

Making sense of the evidence in population health intervention research: building a dry stone wall

To effectively tackle population health challenges, we must address the fundamental determinants of behaviour and health. Among other things, this will entail devoting more attention to the evaluation of upstream intervention strategies. However, merely increasing the supply of such studies is not e...

Descripción completa

Detalles Bibliográficos
Autores principales: Ogilvie, David, Bauman, Adrian, Foley, Louise, Guell, Cornelia, Humphreys, David, Panter, Jenna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733100/
https://www.ncbi.nlm.nih.gov/pubmed/33298470
http://dx.doi.org/10.1136/bmjgh-2020-004017
_version_ 1783622209209630720
author Ogilvie, David
Bauman, Adrian
Foley, Louise
Guell, Cornelia
Humphreys, David
Panter, Jenna
author_facet Ogilvie, David
Bauman, Adrian
Foley, Louise
Guell, Cornelia
Humphreys, David
Panter, Jenna
author_sort Ogilvie, David
collection PubMed
description To effectively tackle population health challenges, we must address the fundamental determinants of behaviour and health. Among other things, this will entail devoting more attention to the evaluation of upstream intervention strategies. However, merely increasing the supply of such studies is not enough. The pivotal link between research and policy or practice should be the cumulation of insight from multiple studies. If conventional evidence synthesis can be thought of as analogous to building a wall, then we can increase the supply of bricks (the number of studies), their similarity (statistical commensurability) or the strength of the mortar (the statistical methods for holding them together). However, many contemporary public health challenges seem akin to herding sheep in mountainous terrain, where ordinary walls are of limited use and a more flexible way of combining dissimilar stones (pieces of evidence) may be required. This would entail shifting towards generalising the functions of interventions, rather than their effects; towards inference to the best explanation, rather than relying on binary hypothesis-testing; and towards embracing divergent findings, to be resolved by testing theories across a cumulated body of work. In this way we might channel a spirit of pragmatic pluralism into making sense of complex sets of evidence, robust enough to support more plausible causal inference to guide action, while accepting and adapting to the reality of the public health landscape rather than wishing it were otherwise. The traditional art of dry stone walling can serve as a metaphor for the more ‘holistic sense-making’ we propose.
format Online
Article
Text
id pubmed-7733100
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-77331002020-12-21 Making sense of the evidence in population health intervention research: building a dry stone wall Ogilvie, David Bauman, Adrian Foley, Louise Guell, Cornelia Humphreys, David Panter, Jenna BMJ Glob Health Analysis To effectively tackle population health challenges, we must address the fundamental determinants of behaviour and health. Among other things, this will entail devoting more attention to the evaluation of upstream intervention strategies. However, merely increasing the supply of such studies is not enough. The pivotal link between research and policy or practice should be the cumulation of insight from multiple studies. If conventional evidence synthesis can be thought of as analogous to building a wall, then we can increase the supply of bricks (the number of studies), their similarity (statistical commensurability) or the strength of the mortar (the statistical methods for holding them together). However, many contemporary public health challenges seem akin to herding sheep in mountainous terrain, where ordinary walls are of limited use and a more flexible way of combining dissimilar stones (pieces of evidence) may be required. This would entail shifting towards generalising the functions of interventions, rather than their effects; towards inference to the best explanation, rather than relying on binary hypothesis-testing; and towards embracing divergent findings, to be resolved by testing theories across a cumulated body of work. In this way we might channel a spirit of pragmatic pluralism into making sense of complex sets of evidence, robust enough to support more plausible causal inference to guide action, while accepting and adapting to the reality of the public health landscape rather than wishing it were otherwise. The traditional art of dry stone walling can serve as a metaphor for the more ‘holistic sense-making’ we propose. BMJ Publishing Group 2020-12-09 /pmc/articles/PMC7733100/ /pubmed/33298470 http://dx.doi.org/10.1136/bmjgh-2020-004017 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Analysis
Ogilvie, David
Bauman, Adrian
Foley, Louise
Guell, Cornelia
Humphreys, David
Panter, Jenna
Making sense of the evidence in population health intervention research: building a dry stone wall
title Making sense of the evidence in population health intervention research: building a dry stone wall
title_full Making sense of the evidence in population health intervention research: building a dry stone wall
title_fullStr Making sense of the evidence in population health intervention research: building a dry stone wall
title_full_unstemmed Making sense of the evidence in population health intervention research: building a dry stone wall
title_short Making sense of the evidence in population health intervention research: building a dry stone wall
title_sort making sense of the evidence in population health intervention research: building a dry stone wall
topic Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733100/
https://www.ncbi.nlm.nih.gov/pubmed/33298470
http://dx.doi.org/10.1136/bmjgh-2020-004017
work_keys_str_mv AT ogilviedavid makingsenseoftheevidenceinpopulationhealthinterventionresearchbuildingadrystonewall
AT baumanadrian makingsenseoftheevidenceinpopulationhealthinterventionresearchbuildingadrystonewall
AT foleylouise makingsenseoftheevidenceinpopulationhealthinterventionresearchbuildingadrystonewall
AT guellcornelia makingsenseoftheevidenceinpopulationhealthinterventionresearchbuildingadrystonewall
AT humphreysdavid makingsenseoftheevidenceinpopulationhealthinterventionresearchbuildingadrystonewall
AT panterjenna makingsenseoftheevidenceinpopulationhealthinterventionresearchbuildingadrystonewall