In the era of evidence-based medicine, it is now widely accepted that health research should directly inform clinical care. If a new trial shows that a drug can significantly reduce the risk of a myocardial infarction, the expectation is that the researchers will disseminate the evidence and clinicians will act on the new findings. Although considerations in health policy decisions are vast, translating research relevant to health policy is similarly important, particularly at a time when many local, state, and federal policy makers are making many high-consequence decisions. The extent to which policy makers, and even the judiciary, are (or are not) using research evidence in their work is being increasingly scrutinized.1 The National Research Council and others have argued that evidence needs to have a “seat at the table” in policy deliberations.2
“Professors, We Need You!”
The role of researchers in the process of stimulating evidence-based policy making remains controversial. Last year, columnist Nicholas Kristof3 wrote a New York Times commentary headlined, “Professors, We Need You!” The editorial, which criticizes scholars for not doing enough to produce and disseminate research that is relevant to the important issues of our time, ignited a debate on the relevance of academic research in public policy. Kristof criticized not the professors’ research methods but, instead, their impotence in efforts to close the gaps between their findings and those who can use them. Kristof and other national pundits asked scholars to take advantage of the increasing number of tools available to educate the public and policy makers, particularly social media platforms like Twitter and Facebook.3 But are current approaches to dissemination getting in the way of answering Kristof’s call?
The traditional model of academic publishing has unique advantages for disseminating discoveries. Peer review ensures that what gets published is both rigorously executed and scientifically important. As the information environment becomes more crowded, journals are uniquely positioned to help audiences sift through “information noise” and sort “junk” from “high-quality evidence.” Journals have also developed business models that are self-sustaining. Paywalls restricting content on journal Web sites and subscription models prevent journals from encountering the same demise that many traditional news sources have suffered as a result of the recent push for “free information.”
Despite the strengths of academic publishing, this model falls short on several key translation and dissemination metrics. First, scholarly content is written for scientific audiences, not general audiences. Effective translation requires providing target audiences (i.e., policy makers) the context and meaning to understand new scientific findings. Journals and university press offices attempt to overcome this barrier by issuing press releases, but even then, press releases focus on scientific findings and may not effectively convey actionable perspectives for policy makers. Second, dissemination that relies on press releases depends on the editorial prerogatives of the news media. If new findings do not have widespread public appeal—or lack timeliness with current news events—they are unlikely to receive media attention. Moreover, scientific evidence is rarely published at the moment when decision makers are focused on a related policy issue. Yet, when the evidence does become salient, journals and university press offices do not routinely look back and disseminate “old evidence.” Third, the economic model that sustains academic journals also creates a direct access barrier for a key audience. Most policy makers lack direct access to journal Web sites and their content.
Social Media for Translation and Dissemination
So, what about Kristof’s call for academics to use new tools like social media? Social media could be used as a tool to help overcome some of the barriers to translation and dissemination that are inherent in academic publishing. Yet, despite appeals for scholars to embrace social media, academics have been reluctant to join the “social media revolution.” We conducted an experimental survey of university faculty who conduct health policy research and found that they are deeply ambivalent about and largely unfamiliar with opportunities to harness social media to communicate, disseminate, or translate findings.4 Researchers’ concerns with social media represent a clear obstacle to widespread adoption. Some are troubled by the prospect that social media dissemination might not adequately filter out “junk” or poor-quality research. Moreover, these faculty members worry how social media activity, even for disseminating scholarship, fits into academic norms and that its use could slip towards “advocacy,” which in turn could be considered a threat to both real and perceived scientific rigor.4
Notwithstanding researchers’ worries, there are other important considerations. Social media has emerged as a key component of public communication across multiple domains, and it creates new opportunities for the communication of research evidence to various stake holders. Blogs and microblogs, such as Twitter, serve as examples of how research findings can be targeted and communicated to highly specialized and relevant audiences. These platforms can also serve as a vehicle to filter and curate news and research results. Trusted voices on social media can elevate and translate complicated or nuanced findings. Social media platforms are faster, briefer, and sometimes less formal than traditional media, but can also provide rich information by way of pushing followers (usually via direct Web links) to original research articles. Academic publishers have begun to utilize social media to amplify and communicate health research: Most, if not all, of the high-impact medical and scientific journals are active on social media. Some journals now encourage manuscript authors to enroll in third-party programs that help researchers and funders to improve the visibility and impact of their published articles through social media.
Social media likely extends the reach of information—including policy-relevant health care scholarship—beyond narrow audiences such as the regular readers of health care journals.5 Using data compiled by Altmetric (London, United Kingdom), a commercial application that measures the social and traditional media presence of scholarly publications, we identified the research articles with high visibility from a selection of scholarly general medical journals with varying Web of Science impact factors. In Table 1, we show the reach of articles on social media, defined by number of social media users to whom direct links to various research articles were “pushed.” For each journal, the top articles reached more than one million people on Twitter. The reach is likely higher because these measures do not include tweets that direct users to secondary coverage of research articles, such as a newspaper article or blog post.
Trusted Intermediaries as Knowledge Brokers
With the compelling need to disseminate evidence, the important question is not whether researchers should be engaged in the process of evidence translation but, rather, how can they do so in a way that improves the most efficient use of the best available evidence to answer the most timely policy questions of the moment? It is not clear that all researchers will or should respond to Kristof’s call to action by turning to social media to disseminate their own work. Instead, researchers could engage and communicate with trusted intermediaries who can serve as curators of information, identifying scholarship of high quality to share with larger audiences. Multiple studies have demonstrated that such knowledge brokers can elevate the credibility of research while also limiting the barriers (including time, interest, and skills) that researchers face in the effort to disseminate translatable evidence to decision makers.6 Universities, journals, and other research organizations can serve as these intermediaries that policy makers seek and need. Universities and university institutes in particular are uniquely positioned to become trusted information intermediaries. Journals can adapt their translation strategies to develop content that packages research in a format that has context and meaning for policy makers. They can also use social media to enhance their dissemination to key audiences. However, it is unlikely that they will shift their focus away from the latest, newly published evidence toward what is timely and salient for decision makers. University institutes with access to scholars and experts are well positioned to fill this role. Blogs, research briefs, and novel dissemination strategies that include, but are not limited to, social media could elevate the role of scholars and evidence in public policy debates.
Investing in Strategies to Promote Effective Research Translation
To harness the opportunities of social media, research institutions will need to make a conscious and systematic investment to develop social media strategies that focus on known factors of effective knowledge translation, such as salience, timeliness, quality, and rigor.7 Research funders are beginning to emphasize translation and dissemination. And research institutions, by way of internal investments in translation and dissemination, may therefore be able to enhance the ability of their members to secure extramural funding.
While some of the barriers to such social media adoption by academic health researchers will surely fade as the technology becomes more universal and familiar, significant room remains to improve and foster the development of channels between research, researchers, and policy makers. Social media may serve as one such channel, but we cannot expect that researchers will participate in this enterprise to best meet the public’s need for evidence-based policies without partnership from organizations that have developed the capacity and knowledge to curate evidence and communicate it using these new technologies.
Acknowledgments: The authors wish to acknowledge David Asch, MD, MBA, who reviewed and provided helpful feedback for an earlier version of this manuscript, and Jane Seymour, who assisted with manuscript preparation.
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