Dr Jane Cloke is deputy for the Director of NIHR Applied Research Collaboration for the North West Coast, supporting the development of the research themes and engaging with ARC NWC partners and stakeholders. Along with Professor Mark Gabbay, Jane worked with colleagues in Liverpool PCT to establish LivHIR, the Liverpool Health Inequalities Research Institute, developing a programme of work focused on addressing health inequalities experienced by the people of Liverpool. This laid the foundation for CLAHRC and now ARC NWC, working collaboratively to co-produce applied research designed to reduce health inequalities and improve the health of our region’s population. Currently working on knowledge mobilisation and evaluation (the how, what, why and who); connected research communities and knowledge equity; developing a framework for evaluating impact of applied health research.
Dr Lucy Melville-Richards, Lecturer Mental Health Nursing, Bangor University, @BangorUniLucy gained her PhD in 2016 exploring the role of boundary objects, shared things and ideas, in implementation through the first iteration of NIHR NHS-university partnerships, CLAHRCs. She has collaborated with NIHR ARC NWC to examine the Health Inequalities Assessment Tool (HIAT) as a boundary object (https://forequity.uk/hiat/). In 2022 she joined Dr Myra Piat’s team at The Douglas Institute of Mental Health Research, McGill University, to investigate the experience of facilitation during the implementation of Canada’s mental health recovery guidelines in a CIHR PHSI funded study. An implementation coaching module will be developed and embedded within The Walk the Talk Toolkit (https://walkthetalktoolkit.ca/) as an outcome.
Lucy is an RMN and splits her time between lecturing in mental health nursing at Bangor University, doing research, and working on an acute CAMHS unit. She lives, practises, and plays in North Wales.
The Health Inequalities Assessment Toolkit (HIAT) was developed to support those involved in health research to integrate a focus on health inequalities and public involvement. Our study focuses on bringing together the concepts of boundary objects and brokers-as-bricoleurs to explain the implementation of the HIAT within a research capacity building programme.
Our study explored the extent to which (i) HIAT operated as a boundary object; and (ii) the ideal conditions to nurture and enhance its effectiveness during knowledge mobilisation. A qualitative approach was employed to analyse two data sets: semi-structured focus groups and telephone interviews; alongside secondary data from an evaluation of the wider research programme within which the capacity building was situated. Data was thematically analysed incorporating the properties of a boundary object as an analytic framework: meaningfulness, convergence, resonance, and authenticity.
Four main themes identified:
(1) Generating convergence through creating a focus;
(2) Reconciling differences to create a common language;
(3) Workshop facilitators: boundary brokers-as-bricoleurs; and,
(4) Thoughts into action.
The HIAT operated as a boundary object, enabling individuals across the different project teams to galvanise around the issue of health inequalities, explore collaboratively, and incorporate equity within service evaluations.
Our findings highlight the importance of involving brokers with an ability to improvise and mobilise around the HIAT, using their expertise to translate and interpret across boundaries and emphasise shared goals. Reflecting on this, a modified tool with additional resources beyond socio-economic causes has been launched as a forum to consider health inequalities from diverse perspectives for use beyond UK health and social care research.