Preface by John Lavis

John Lavis

John Lavis MD, PhD, holds the Canada Research Chair in Evidence-Informed Health Systems at McMaster University. His research focuses on how to support the use of research evidence in health policy making, both in high-income countries like Canada and in a broad range of countries internationally. He founded and continues to direct the McMaster Health Forum, an agent of change that empowers health system policymakers and stakeholders to set agendas, take well-considered actions, and communicate the rationale for actions effectively. He founded and oversees the continuous updating of Health Systems Evidence, the world’s most comprehensive free access point for high-quality evidence about how to strengthen or reform health systems.

The Health & Society Scholars (HSS) program at the University of Wisconsin at Madison has done the academic community a great service by capturing the knowledge-exchange experiences of their scholars. In fact, the interviews with the scholars should be a must read for the directors of PhD programs and the supervisors of post-doctoral fellows and junior faculty in the “health and society” field (and all applied health fields for that matter). The spectrum of topics addressed by the scholars means there’s “something for everyone,” ranging from the management of respiratory conditions to addressing childhood obesity or lead poisoning to tackling health disparities. And the spectrum of approaches used by the scholars, and their examples of how something little grew into something big or something big had to be whittled down to something manageable, mean that everyone can find a “way in.”

Three points struck me as being particularly salient when I read the interviews:

One point hit me as perhaps a case of American exceptionalism, in that I’ve not heard it raised so consistently as a concern in any of the other countries—either in other high-income countries or in low- and middle-income countries—where I study knowledge exchange. The concern is that knowledge exchange could be interpreted as “advocacy” and suffer the consequences of this interpretation in academic environments that pride themselves on objectivity or neutrality. Most countries are comfortable with the notion that there is an important role to be played by those who attempt, in a way that is both systematic and transparent, to support the use of research evidence. If you’re only promoting your own research (not the best available research evidence on the full spectrum of questions on a particular issue) or you’re being neither systematic (“Here’s a study I happened to find”) nor transparent (“I own the company whose app I’m promoting”), then I can see there’d be a problem. But in a climate where there is currently such a high degree of politicization of such a broad range of topics, as is the case in the United States right now, I can also see that there would be much greater concern about drawing a line between knowledge exchange and advocacy.

Interestingly, two key points were touched on only briefly (in the case of the first point) or not at all (for the second point) in the interviews:

But on both points I think the HSS program directors got it right in creating a “let’s try it” climate. I was very moved by the scholars’ descriptions of their initial trepidation in trying this at all and of both their growing confidence that they can engage in knowledge exchange and their emerging commitment to finding ways to do so as they progress in their careers. I salute the vision of the program directors and hope I one day have the chance to witness the impacts of the scholars they’ve nurtured.