Elephants make for good metaphors – the elephant in the room, the blind men and the elephant – but sometimes, only a mixed metaphor will do. Last week, our blog jumped into an active and timely conversation about dissemination largely fueled by excellent posts from Bill Gardner and Austin Frakt. (See our previous post and the originals from Gardner and Frakt here, here, and here.) The discussion is timely because more and more people seem to be seeing the translation elephant in the room and yet, without impugning the foresight or eyesight of either author, we all seem to be touching different (and equally important) parts of this particular beast.  What is clear, and certainly not new, is the importance of translation, its many challenges and the need to better recognize the effort it takes move evidence into action. We agree that journals like Health Affairs and others play an important role in evaluating and translating evidence (Gardner) – and we need to be even more timely in our response to policymaker and media needs (Frakt). Blogs and social media are one means to achieve this timeliness, but as Gardner so aptly points out,

“Spending time writing a blog, flying to Washington, reading policy briefs, debating on G+, and tracking the health policy twitter stream is time not spent writing for Science... Whatever we may want scientists to do, intensive selection processes are reproducing a culture of specialists who single-mindedly devote themselves to sub-disciplinary problems. ”
Our suggestion is that writing for peer review journals cannot be the only rewarded aim by the research enterprise and academic institutions. In an era of diminishing resources and the very real threat of constrained funding and diminishing esteem for the value of evidence in our public discourse, our old mores of valuing “writing for Science” (or any other journal) as the be-all and end-all are dangerously short sighted. We fail to reward and promote translation and impact at our own peril. There appears to be some growing consensus on this point among our key stakeholders. In a survey of members and nonmembers we fielded this September, all audiences agreed on the top four most important activities that AcademyHealth should focus on (% responding important or extremely important). They were:
    1. Connecting researchers, policymakers, and practitioners (93%)
    2. Promoting the importance and value of health services research (91%)
    3. Disseminating health services research findings (89%)
    4. Advocating for funding for health services research (87%)
Further, when respondents ranked the top three issues affecting their work, the second and third fell squarely in the domain of this translation discussion, namely, the effectiveness of research to inform policy and the timeliness of research to inform policy or practice. For AcademyHealth to realize its vision – to improve health and health care by generating new knowledge and moving knowledge into action – we must execute on each of these fronts.  Peer reviewed publication, traditional “push” dissemination, newer dissemination modalities and more and better convening and hands on learning opportunities are all part of the solution – but none stands alone. Going back to Gardner’s post:
"I am totally for "the more high-touch approaches of implementation science." The revolution in social media is making it easier for a health quant on the Canadian coastline to converse with a journalist in Washington or a foundation president in Palo Alto. Perhaps [AcademyHealth] could accelerate the formation of networks that cross strata and time zones through sponsorship of events that brought together researchers, journalists, and policy makers."
Just last week, we convened our board to brainstorm around these very issues. How do we support and facilitate better translation? How do we create sustainable programs to bring policymakers and researchers together around timey policy issues? How can we better engage decision makers in a discussion of their current needs – both to inform the field and to provide an opportunity to discuss the most timely and relevant research available on the topic? The staff and board discussed a number of strategic options and we are reviewing and updating our plans as I type.  But what do you think?  What could we do that might be “out of the box” and bold? That could challenge us to overcome the well known barriers to effective translation? We expect to begin communicating the results of those discussions to members and the broader HSR community early next year. Because, while none of these activities is easy, or without significant investments of time and talent, each is vitally important to improving health and health care in the long term. This post was written by Lisa Simpson, AcademyHealth's president and CEO
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