Paper: What factors influence evidence use in policy? An updated systematic map

 Abstract  [ REVIEW | Article in Press ]

In 2014, a large systematic map found that relational factors were amongst the most frequently reported facilitators of evidence use in policy. Since then, there has been a growth in evidence-use initiatives and research, many of which have attempted to address relational factors. In this timely updated map, we describe the current state of research about which factors influence evidence use in policy. A search strategy combining ‘evidence’, ‘barriers and facilitators’ and ‘policy/policymakers’ was used to identify studies across 15 electronic databases between 2012 and 2022. Studies were screened for those that include empirical data about evidence use in policy. Data extraction enabled descriptive analyses characterising studies in terms of focus, topic area, setting, and types of factors influencing use. Two thousand, one hundred and ninety-nine studies were included, a 20-fold increase over 10 years. The most commonly reported factors influencing use were the relevance of evidence, and then organisational (resources, skills, personnel and managerial support). A large number of studies reported on evidence-use interventions (n = 877) of which 379 were evaluations. Findings may indicate a shift towards relational and systemic thinking about evidence use. There appears to be a growing recognition of the resourcing, work, time, and workforce required to embed evidence use within and between organisations. With this huge growth in the literature, particularly in new evidence use interventions being tested across policy sectors, continued review and mobilisation is necessary to effectively inform the design and implementation of evidence use interventions and research.

Oliver, K., Malin, J., Akerlof, K.L. et al. What factors influence evidence use in policy? An updated systematic map. Humanities and Social Sciences Communications. (2026). 
https://doi.org/10.1057/s41599-026-08391-6

Not a citation for Hodges' model, but I am grateful to Prof. Oliver and co-authors for being able to assist with data extraction using EPPI-Reviewer Screening Wizard. The preceding patience and guidance to complete the coding tasks was also invaluable in being transferable. I learned a great deal and it has been perversely reassuring (disheartening!) to see that the path to final publication is also 'circuitous' for academics.^  An additional lesson is building on existing work and publication (Oliver, 2014) to revisit a method and research question. (Updates to follow).

Previously: 'map' : 'systematic' : 'policy'

^A conclusion, much shared I believe: academic publishing is systematically dysfunctional.

Enough Nurses - Special Collection c/o Journal of Research in Nursing

"JRN is pleased to introduce this online special collection of papers. Edited by Jane Ball, this collection comprises previously published papers and reviews that give a taste of the constellation of issues that contribute to having 'enough nurses'. They illustrate the complexity and interdependency of the many elements that must be addressed to achieve the elusive goal of having the right staff, in the right place, at the right time."

My source: https://twitter.com/JRN_latest/status/985889478882578432

Money and Mental Health [ii] OVERSTRETCHED, OVERDRAWN, UNDERSERVED

Following on from - Money and Mental Health [i] Impact of Mass Unemployment Events (MUEs)

I have been familiar with the relationship between mental health and finance since student days in the late 1970s. Debt was and remains a profound and common problem. This can exacerbate existing mental health problems or it be the trigger - the straw that breaks the camel's back. From the report:

One in four people with a mental health problem is also in problem debt, and half of people in financial difficulties have a mental health problem (p. 13).

Finance still has this impact whether it is a lack of basic financial skills (literacy), life chances and opportunity or attributed to bad luck. Speaking of 'luck': I have frequently felt angry and frustrated with government policy. It is common sense and statistically inevitable that within the population there will be people who are vulnerable to addiction of many sorts. Why make it easier for those who are vulnerable to potentially loose everything? Not only that but money impacts all those in vulnerable groups, not just people in work. When we talk of health inequality what is the biggest factor? I've come across instances of elderly people receiving scam mail and not just the 'odd' post. While within Hodges' model below I have family as a resource, sadly this can also be part of a problem.

'Productivity' looms large in the report and draws a rueful smile here. In the NHS productivity and its increase is a constant requirement. In the general economy UK productivity is low and seemingly stuck. Successive governments have failed and now with Brexit productivity is still on life-support.

In the report 'financial fragility' is a very useful construct (as with circumstantial, rather than careless overspending). The public sector is also highlighted in this regard:

Forecasts suggest that 5.4 million public sector workers, one in six of the UK workforce, will be worse off in 2020 than they were in 2010 (p.16).

Before you view the report itself and the small conceptual sampling in Hodges' model, the report refers to the hidden epidemic that this report seeks to highlight and represent. This government and successive, nationally and globally need to get to grips - somehow - with the hidden economy - parts of which are blatantly obvious in the subterfuge around tax avoidance. This is another relationship that operates upon us all - employed, unemployed, young and aged - and which Hodges' model can also help illuminate.


Evans, K., Holkar, M., Murray, N. (2017) OVERSTRETCHED,OVERDRAWN, UNDERSERVED: financial difficulty and mental health at work, The Money and Mental Health Policy Institute, May 2017.

What follows is drawn from the report above - with a couple of additions:

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group - population

[May THE KNOWLEDGE ECONOMY]  (including nursing) MENTAL HEALTH hidden epidemic ... over two thirds (67%) of employees who are struggling financially report at least one sign of poor mental health that could affect their ability to function at work loss of sleep, poor concentration, reduced motivation, preoccupation Increased risk taking (impact - occupation...?) Guilt/shame Anxiety Low self-esteem Anger Frustration Fear Low mood Self-harm Suicidal ideation Insomnia Panic attacks Depression, Lethargy/apathy Substance misuse [... starts here!]

PRODUCTIVITY Physical effects of anxiety, stress, alcohol, smoking (increase, relapse), other substance misuse physical fragility (lack of resilience) Nearly half (45%) of all working days lost to ill health were a result of stress in 2015/16 – adding up to 11.7 million days across the economy. work access to:   "on-site exercise facilities, healthy  food and rest spaces" hidden morbidity

Influence of individual mental health on colleagues, team morale and cohesiveness fear of bailiffs - seen by others at my door pressure on relationships conflict at work family breakdown shame, guilt, stigma social support, friends, family, colleagues

WORK THE ECONOMY "Money and Mental Health will set out the case for employers to provide practical support to employees experiencing financial difficulty, and how this could boost the mental health, wellbeing and resilience of their workforce." "financial fragility" Creditor action poor performance, punctuality, reliability disciplinary action OCCUPATION HEALTH services - counselling / advice Individual's awareness of Rights the hidden economy

Thanks and Acknowledgement to The Money and Mental Health Policy Institute

Nursing: magnetic Force 5

Back in 2009 I came across a post - Nurse magnets crucial for recruitment and retention about the 14 Forces of Magnetism:

In 1983, the American Academy of Nursing conducted a survey of 163 hospitals to learn why some hospitals attracted and retained well-qualified nurses who were devoted to quality patient care.

The 14 Forces are listed and described by the ANCC. The forces themselves include:

• Force 1 Quality of Nursing Leadership
• Force 2 Organizational Structure
• Force 3 Management Style
• Force 4 Personnel Policies and Programs
• Force 5 Professional Models of Care
• Force 6 Quality of Care
• Force 7 Quality Improvement
• Force 8 Consultation and Resources
• Force 9 Autonomy
• Force 10 Community and the Hospital
• Force 11 Nurses as Teachers
• Force 12 Image of Nursing
• Force 13 Interdisciplinary Relationships
• Force 14 Professional Development

The professional, organizational, and political (policy) emphasis of the 14 forces is obvious and becomes clear when each is weighed in terms of where it sits within the domains of h2cm.

Try it as an exercise. ...

Recruitment is ALL about magnetism.

If you are unsure, ask a magnet about the meaning of retention.

Demographics are already applying pressure upon these forces of magnetism. Not just when referred to explicitly in the USA within organizational media; but globally. Demographics is another magnet - it approaches with increasing force.

From here in the UK (and readers elsewhere) we have to exercise care when models are mentioned. While the theorists and philosopher's of nursing nail their definitions to the mast (h2cm?) there remains a models muddle, not just in the variety of models of care, but in the levels at which they operate. This is not a criticism, it's an observation - consider Force 5:

Force 5: Professional Models of Care
There are models of care that give nurses the responsibility and authority for the provision of direct patient care. Nurses are accountable for their own practice as well as the coordination of care. The models of care (i.e., primary nursing, case management, family-centered, district, and holistic) provide for the continuity of care across the continuum. The models take into consideration patients’ unique needs and provide skilled nurses and adequate resources to accomplish desired outcomes.

In the US in particular 'models of care' (moc) often refer to finance and accountability of costs (the market process), in the UK moc might refer to commissioning. In Force 5 the addition of 'Professional' (as the original author's no doubt recognized) is crucial. If you repeat the above exercise, plotting Force 5 on the Health Care Domains Model then you see how Force 5 works for nursing and remains to this day a great achievement as a yardstick for quality, assurance and retentive power.

In the almost 30 years since the research on the 14 Forces, I do wonder though if there is a need to imbue the following with magnetic properties:

• person-centred care;
• self-care;
• carers and public engagement;
• prevention;
• public (mental) health
• and informatics?

Yes, many of the above can be assumed to lie within the existing Forces 1-14. Health and social care are not static. Nursing has much to contend with from the level of the individual practitioner through to the group within an organization. The 14 Forces of Magnetism are well established in the USA and deservedly so, they clearly deliver.

In the political and economical heat of an economic recession, however; magnets may reach their particular^* Curie point. Then they cease to work.

The constant bangs and knocks of change, the incessant hammering of party politics and the 'market' on the door of "high quality nursing care" can also take its toll on magnetism.

Nursing needs to take care.

Related post on Healthcare IT News:

Top 10 trends for 2011 include IT, new care models

*OK it should be constant, but like our patients these magnets are not all the same - they have varying levels of vulnerability.

To follow some definitions from an olde book.

Frontline or tightrope?

As the various media outlets and commentators discuss health care, nursing, medicine and social care they often refer to the frontline -

Where exactly is the frontline these days (and nights)?

Who is on the frontline?

Is the frontline always visible?

Is there a 2nd, 3rd or 4th line?

Are there any gaps in the frontline?

Is it twisted at any point?

When health care economics is squeezed
how does this affect the frontline?

Does the frontline have an optimal tension?

If the frontline is Lean, in lean times
does it have a harmonic?

How has the frontline changed over
the past 20 years?

How is our frontline forecasting?

Is there space on that (front-) line for
partners, information technology,holistic
bandwidth, values, policy, safety ..., ....?

All doodles welcome.

Holistic bandwidth (and the dangers) of political care

The attack on MP Stephen Timms here in the UK highlights not only the ongoing importance of personal safety for public service personnel, but how much politicians value their constituency work. It is no accident that these sessions are called "surgeries".

The politician meets not just a citizen, but a political obligation and duty to care. In the media reports it was interesting to hear of how much satisfaction MPs get from their constituency work. Listening to the reporting and debate prompted me to realise that although politicians vary in how well they engage and empathise with their constituents the problems they are asked to deal with covers a broad holistic spectrum. Consider this listing written by Tony Wright MP:

• The education system
• The transport system
• The social services
• Health services
• Housing
• The environment
• Government bodies
• The justice system
• Immigration and asylum
• Finances and employment
• Trade unions
• The media

I am a community nurse five days a week.

Our MPs are community politicians one day a week with 'Constituency Friday'.

So to The Rt Hon. Stephen Timms (and his staff) I wish you a speedy recovery and congratulations on the extent of you and your peer's constituency work.

Holistic in a word and deed.

Congratulations also to the Green Party on the success of their leader Caroline Lucas MP.

BBC R4 Friday 8th Jan: NHS Punters Speak Out

This programme (episode 1) is on BBC Radio 4 on Friday 11.00:

With the help of dissatisfied NHS patients, Liz Barclay asks if the growing popularity of online feedback can really make a difference to standards of health care and treatment.
The culture of customers offering brickbats and bouquets to service providers has now extended beyond hotels and coffee chains to the NHS. Hospital rating websites invite patients to grade their hospital stay out of five stars, and to leave comments about the care they received.
Liz invites NHS patients who have used one of these patient rating websites to discuss their experiences and puts their points to the hospitals where they were treated.
She asks if the idea of online feedback can be really be applied to our health service and if it can genuinely improve standards of care. Critics suggest the sites are merely window-dressing and that NHS patients are not 'consumers'. Some health professionals claim that the sites can easily just become places where personal scores are settled against NHS staff.

<->

Introductions to Hodges' model for different audiences -

"Patiency" (person-centred care)	Health, Social Care professionals (inc. all in a student capacity)
The Public, Citizens	Managers, Policy Makers

These introductions will be re-written for the new website and represent possible projects for volunteers / students...?

The 'Health Career' - records and symmetry breaking: Admin vs Clinical needs?

In my nursing career to date and over the past 18 months I've been involved in some complex clinical cases involving profound physical, mental and social aspects of care.

Such complexity given the rise of long-term chronic medical conditions, multiple diagnoses and an ageing population is not uncommon. What is more remarkable is simultaneously reading on the records management and other informatics mail lists questions regarding the retention of specific types records within health care, social care, schools and the human resource departments of other organisational settings.

From the perspective of Hodges' model and the notion of a health career you wonder about the efficiency of administration - and legislation - versus the potential future utility of 'archived' clinical records. Clinical records from 20 years ago and less have frequently been destroyed and you are left to consider the possible relevance of that information to the care delivered in the here and now? This is particularly acute for reasons of the following:

• the increase in dementia and an individual's capacity to account for their past care;
• the increase in fractured family histories;
• the likelihood of significant past care episodes and medical events relevant to future episodes: 1) cancers; 2) psychological problems; 3) negative life experiences;
• the use of the medical record (health career) to inform someone's life story (and not just as a 'therapeutic intervention').

Is there an argument for a re-appraisal of retention schedules? Factors to consider might include:

• the shift to digital collection, storage, archiving and ever improving retrieval technologies;
• the use of semantic search - and intelligent (context - discipline-based) applications;
• the ability of the individual to decide on the longevity of their records;
• the advice of specific patient groups - Alzheimer's; Multiple Sclerosis; HIV / Aids...;
• the transition of an individual record to an item of historical interest;
• the ongoing emphasis upon collaborative care, self-care and personal health records;
• Archiving - shift from paper-centric to inclusion of digital media?

What do you think?

Additional links:

DoH Records Management - Information Policy

DoH (2006) Records management: NHS code of practice

Personal Health Record