Sharing health knowledge province-wide

Dr. Stephen Bornstein is the Director of the Newfoundland & Labrador Centre for Applied Health Research and Program Director for the Contextualized Health Research Synthesis Program (CHRSP). The Centre works with decision makers in the provincial health system to identify pressing issues that require research evidence to inform decision making. CHRSP then works with these health system partners to provide a timely synthesis of the best available evidence that has been contextualized to take into account the unique conditions in this province.

Sometimes one of the best ways to influence positive change is to make sure that like-minded people have a chance to communicate with one another. Knowledge mobilization and transfer is one of the keys to the Centre’s success.

The Contextualized Health Research Synthesis Program (CHRSP) was introduced by NLCAHR in 2007 as a seven-step process aimed at processing existing health research to find practical solutions to improve the health of the people of Newfoundland & Labrador.

The first step of the CHRSP process is simple: the Centre consults with the senior leaders of the four Regional Health Authorities and the Department of Health to figure out their needs. “We start by asking them what they want to know about,” says Dr. Bornstein. “We ask them what decisions they are going to have to make in the next year, and where they think scientific evidence will be useful.”

From there, Dr. Bornstein and his team collaborate to identify and prioritize research topics. This list, sometimes reaching up to 50 topics, is reviewed and filtered down to a few of the most pressing and researchable questions. “These are their questions, not ours,” he says. “Our role is to pick the topics on which good research exists and to shape the issues into answerable questions.”

With a solid research question in hand, CHRSP builds a team for each project. Each team has two leaders: a lead scientist, often from outside the province, and a lead decision maker. Each team also includes local researchers and a few key players appointed by our health organizations for their specialized knowledge and experience related to the topic. The team then proceeds to locate the best and most up-to-date research studies on the chosen topic, emphasizing systematic reviews, meta-analyses and health technology assessments, and to synthesize their findings. What is distinctive about this process is that it “contextualizes” the research. It takes the findings from a wide range of studies and teases out those that are pertinent to the specific challenges and capacities of the health system and the populations of Newfoundland & Labrador.

In a way, CHRSP is like the ultimate sorting system; strategically sifting through a convoluted array of data and compressing it into something tangible, usable, and concrete to help the province’s health officials make evidence-informed decisions. “There’s no point in telling health officials we need to buy a $10 million machine to solve a problem if we can’t afford one,” says Dr. Bornstein. “Instead, we tell them the next best solution, one that is scientifically credible, effective, and relevant for our population and resources.”

Once the research is contextualized, CHRSP interprets the evidence, summarizing it into a 40-page “Evidence in Context” report. Since its inception, CHRSP has developed reports on a diverse range of health solutions, from creating residential treatment centers for youth with complex needs to improving community-based service models for seniors.

What makes CHRSP uniquely innovative is not only do they contextualize research, they also consistently engage with the province to assess what these needs are. “The advantage of having health officials on the team is they are fully engaged,” Dr. Bornstein says. “This makes it much easier to get their attention for the results, mostly because you don’t have to sell them at all. These are their results, too.”

As for the success of the program here in Newfoundland and Labrador, Dr. Bornstein is positive. “Our stakeholders actually do pay attention,” says Dr. Stephen Bornstein. “They change the way they go about things based on our findings, and that is a very rewarding feeling,” he concludes. “It is rare for researchers to see their work make a real difference, but this program does that.”