Development and implementation of a new model for research support for municipal healthcare - a qualitative study

Maria Bjerk^1*Oddvar Førland²Lars Bergersen³Lars Jørun Langøien¹Lillebeth Larun¹

• ¹Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
• ²Centre for Care Research, Western Norway University of Applied Sciences,, Bergen, Norway
• ³Bergen Kommune, Bergen, Norway

Abstract Background: Evidence-based practice means making decisions based on evidence which takes account of experiences, values and preferences of employees and users. Fragmentation of services, technological limitations, lack of workforce, cultural resistance, resource constraints and distance between academia and practice can make the utilisation of evidence in health and social care services challenging. This study aimed to provide new insights into the development and implementation of a model for research support for decision-makers in municipal healthcare. Methods: We used a qualitative design to explore stakeholders' experiences with development and implementation of the model for research support. We included minutes from several meetings and evaluation forms from the participating municipalities, ranging from the start of the project in January 2021 to the end of the project in January 2024. We conducted a thematic analysis, and the textual data were coded into categories and mapped according to the constructs of the consolidated framework for implementation (CFIR). Results: The stakeholders in the municipalities expressed need for a support model to apply research in prioritising, planning and decision making. There were barriers to implementing the model due to complex and broad research questions. The researchers needed to navigate between methodological thoroughness and practical usability. The participants from the municipalities reported lack of structure, funding, competence and incentives to apply the evidence. They also struggled with dissemination and implementation of the results from the research summaries. Facilitating factors were political and administrative commitment, availability of research findings in plain language, a learning-by-doing approach through meetings and seminars working on real-world 3 municipal challenges, and a structured collaboration between municipality employees and academics. Conclusions: The study indicates that research support for decision-makers in the application of systematic reviews can be useful for evidence-based decision-making in municipal healthcare. However, implementing the model is resource-demanding, considering the use of time and personnel, both from the municipalities' and research institutions' point of view. Future research is needed to assess the effectiveness of the research-based support model towards better decision-making in municipalities and improved patient care.