The Active Living Research 2013 Conference: Achieving Change across Sectors: Integrating Research, Policy, and Practice

Achieving Change Across Sectors: Integrating Research, Policy, and Practice (C. D. Economos) The 2013 Active Living Research (ALR) Annual Conference brought together a network of individuals from research, policy, and practice to exchange data, experiences, and aspirations toward building a more active-friendly national landscape. There were evidence generators, evidence users, and those who do a bit of both. Primarily a generator, I also find myself at the intersection when called upon to inform policy or to implement evidence-based practice. My own approach to research has become more interdisciplinary and participatory to generate evidence that is inclusive and relevant to policy debates, so the conference theme created a comfortable atmosphere for me. The rich dialogue among attendees exemplified the commitment of many to uphold our individual roles, varied at times throughout our careers, in designing and implementing evidence-based public health strategies and policies to promote effective and sustained action. What becomes exceedingly clear when sectors are brought together is that the system is interdependent—evidence informs policy development and practice, and evaluating policy implementation and practice-based interventions generates new evidence. The cycle is continuous. Public health has several health priorities that require thoughtful and careful collaborations between researchers, practitioners, and policymakers across many sectors. Perhaps most pressing is the fact that we have an obesity epidemic caused by environments and policies that encourage overconsuming and underexpending energy. The urgency of addressing the epidemic compels a variety of policy-related actions that reach far and deep within the population. To maximize impact, these actions must be feasible, synergistic, cost-effective, free of unintended adverse consequences, and based on the best available evidence. From the perspective of an evidence generator, the following questions are contemplated on a regular basis: What is the status of the evidence? How do we go forward in the absence of complete evidence? What types of studies are required to fill the gaps and expand the evidence base? What are the disciplines that would enrich a research study? Who should participate in the research process? How do we communicate useful results to people who can use them? From the perspective of a policymaker or practitioner (or evidence user), the questions begin once a body of evidence exists: How can the data be combined and compiled to inform decision makers and stakeholders about the value and importance of evidence and how it could inform a particular policy decision? What type of methods should be used to evaluate the impact of new policy implementation? To address these questions and others, the Institute of Medicine’s Bridging the Evidence Gap report explains how various forms of evidence are used in evidence-based public health decision making. A closer look at the types of evidence and how it’s used in policymaking illustrates the range of information often taken into account by policymakers and suggests an expanded role for evidence generators. For example, when conducting a controlled trial in a community with multilevel outcomes, it is important to pay attention to the knowledge, ideas and interests, and opinions and views of the community as well as costs and resources used. A variety of distinct pieces of evidence (quantitative and qualitative) and sources of knowledge have meaning and can ultimately inform policy. This generally makes the results more meaningful for the community and their representatives. Different types of evidence can be merged with specific capacities, such as an individual’s skills, experience, and participation in networks, to influence the adoption and adaptation of evidence in practice. At the organizational levels, capacity is often visible leadership, Christina D. Economos, PhD, is at Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts. James F. Sallis, PhD, is with Active Living Research, University of California, San Diego, San Diego, California. NiCole R. Keith, PhD, is at the Department of Kinesiology, Indiana UniversityPurdue University, Indianapolis, Indiana. Jimmy Newkirk, BS, is with the National Physical Activity Society, Coats, North Carolina.