Evidence in policy and practice: what kinds of research designs?

Summary: Over-generalization of the ‘effectiveness hierarchy’, and echoes of past paradigm wars about methodology, persist in generating conflicting judgements about the value of different research designs for evidence-based practice. A range of ways in which the worth of research is actually judged, and might be judged, are elaborated. The article then focuses on specific examples of the use of research, considering the kinds of evidence which could usefully support practice with carers, and the evidence which has been used to justify policy (the National Service Framework) for older people. The article concludes by using ideas about complex adaptive systems to illustrate similarities between uses of evidence in policy and individual practice.

Findings: Fundamentally, considerations which affect our judgements about the worth of research relate to the values expressed in the process of conducting the research, and the likely usefulness of the results. Inboth policy and practice, a whole range of research evidence can be, and is, used to support values, identify and understand problems, inform negotiations, and suggest solutions, without necessarily determining action to be taken in particular cases.

Applications: The article is a contribution to the ongoing debate about evidence-based practice in social care. It aims to clarify concepts and realities and thus promote an approach to this issue which remains rigorous but is inclusive with regard to both methods and stake aholders.