Research as Intervention in Heart Health Promotion

Article excerpt

ABSTRACT

Background: Capacity building in health promotion has traditionally involved training interventions to support knowledge, skill and resource building for effective practice. However, there is a need to understand how research can be used to support capacity building and practice.

Methods: Findings are based on a parallel case study comprising qualitative analysis of 66 key informant interviews from five provincial heart health projects (Manitoba, Prince Edward Island, Ontario, Saskatchewan, and Newfoundland and Labrador) as part of the Canadian Heart Health Dissemination Project.

Findings: Results indicate research was used primarily to monitor and report results about health promotion capacity and dissemination to stakeholders, and contribute to participatory processes. Respondents noted that research as intervention had an influence on five areas of health promotion capacity and practice: increased heart health promotion knowledge/skills; improved programming, planning and prioritizing; increased motivation for (heart) health promotion initiatives; and cultivation of relationships as well as buy-in.

Interpretation: Research was a complementary capacity-building activity, although it did not directly increase program implementation. These findings contribute to linking researchers, practitioners and community decision-makers in the process of enhancing health promotion practice.

MeSH terms: Research activities; intervention studies; ability; health promotion

While capacity building in health promotion has traditionally involved targeting interventions to develop specific skills, resources and knowledge for more effective practice, there is some evidence to suggest that research processes can be considered instruments of capacity building.1 There are a number of studies in the broad field of health care examining how results of research studies or systematic reviews can be purposefully transferred and incorporated into clinical practice.2-4 However, despite the fact that participation in a research process may alter both performance and outcome,5 few empirical analyses of research as intervention (RAI) exist.

The Canadian Heart Health Initiative (CHHI), of which this study forms a part, was designed to address the epidemic of cardiovascular disease through research, intervention and policy. The dissemination phase of the CHHI (mid-1990s to 2005) was designed to extend best practices as well as undertake research to understand factors affecting organizational capacity for health promotion. This paper draws on five completed dissemination projects: Ontario (ON), Manitoba (MB), Prince Edward Island (PEI), Newfoundland and Labrador (NL) and Saskatchewan (SK). While these projects did not identify RAI as their primary objective, all explicitly incorporated research activities into capacity-building interventions targeting a range of public health staff and volunteers. This situation provides a unique opportunity to investigate: 1) to what extent have research activities served as interventions?; and 2) how have these activities influenced organizational capacity and (heart) health promotion practice?

One of the few health promotion studies that demonstrated the use of RAI was the Data-Based Intervention Research program undertaken to build capacity within state health agencies tor translating cancer prevention and control science into practice.6 This program enhanced capacity to analyze and disseminate data, and effectively plan and target interventions for high-risk populations. In the Canadian context, COMMIT's research (Community Intervention Trial for Smoking Cessation) supported intervention activities and planning through issue framing, establishing community norms, and supporting advocacy.7 COMMIT also illustrated that its research feedback process increased stakeholder research commitment.1 COMMIT researchers subsequently advocated for investigations of RAI in health promotion, although none has been completed to date. …