Translating research into policy for oral health and chronic disease

Using research in policy development is a complex process in which policy makers encounter numerous barriers. An evidence-based process is essential to improve policy strategies on oral health and chronic disease.

Developing evidenced-based policy is crucial for creating change. However, the translation of research into policy is not a linear process; it is a complex network of social, political and economic factors that agitate, interact and constantly change. A study conducted by the Australian Government suggests that research production alone will not result in health care system changes. Despite this knowledge, an evidence–policy gap still exists.

Chronic diseases continue to be one of the largest burdens on global health resources and are expected to increase while health care resources continue to lag behind. One factor determined to affect many chronic diseases is oral health. Links between poor oral health and chronic diseases are well documented with research demonstrating that poor oral health increases an individual’s risk of developing cardiovascular disease, diabetes and cognitive impairment. When analysing the citations of oral health and chronic disease health policy in Australia, only 27.6% of these references were from peer-reviewed research. Evidence-based strategies must be developed to ensure research is used in the development and implementation of policy.

To determine the current strategies used to translate research on oral health and chronic disease into health policies, we interviewed 12 federal and state policy makers for oral health and cardiovascular disease, diabetes and cognitive impairment. We identified several barriers that policy makers encounter during policy development.

Barriers to implementing evidence-based policy

Political factors were identified as barriers to the development and implementation of policy, with political will and funding priorities of the serving government affecting the identification of policy issues. Funding often determines if policies are implemented and sustainable, which ultimately affects their ability to influence change. A policy can be developed, but not seen as a priority by the serving government and therefore not funded or implemented. There is often a dissonance between state and federal government funding, which affects funding and implementation of policy. This can defer responsibility of policy implementation to another jurisdiction and ultimately stagnate the policy process.

Policy makers have identified numerous additional barriers when accessing peer-reviewed research during policy development. These include the huge volume of information and a lack of research summaries available, an inconsistency in the reporting of data outputs, and a lack of comprehensive oral health datasets and open access articles. This results in a disconnect that limits successful evidence-based policy development on the link between general health and oral health.

What can be done about it?

These barriers highlight the limitations experienced by policy makers. However, enablers have also been identified that can be used to influence policy development.

Developing strategic relationships with various stakeholders is an effective avenue to influence policy development and result in change. This has been demonstrated in studies investigating the use of evidence in public health policy. As one policy maker we interviewed stated:

“I think the relationship part of it is very important. Having a relationship with an expert in dementia for example to ring them and say I’ve got to wrap up this problem in the next couple of days, can you give me any tips on who to speak to or what to look at.”

Advocacy has also been identified as a powerful tool to influence government with policy makers reporting the importance of evidence when advocating to government. Interestingly, policy makers spoke about the importance of providing research that not only identifies the problem but also offers a solution.

“…we are looking for research to both give us options for what we could possibly do to solve a problem but also to build the case for ministers and for government around why they would want to invest in a particular issue.”

Opinion

The translation of evidenced-based research into health policy is critical. Disturbingly, current research found that it can take 17 years to translate research into practice. The treatment of chronic diseases is a growing systemic global health issue that will affect financial, social and community health outcomes. To improve the prevention and treatment of chronic diseases such as cardiovascular diseases, diabetes and cognitive impairment, it is imperative that evidence of the links between poor oral health and general health are translated into health policy through evidence-based research strategies. To ignore the flaws in the policy process is to ignore the impact of prevention and the value of the public health dollar. Accountability is vital for policy development success and can be achieved by improving evidence-based research strategies and processes.

Kelsey Ingram is a PhD candidate at the University of Newcastle and clinical project officer at Monash Health Dental Services.

Professor Janet Wallace is an honorary professor at the University of Newcastle and is the chief investigator of Senior Smiles.

The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated. 

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