When lack of evidence informs policy and the public debate: experiences from a systematic review on shared physical custody

Session: 

Oral session: Knowledge translation and communicating evidence (5)

Date: 

Monday 17 September 2018 - 11:40 to 12:00

Location: 

Carrick 2

All authors in correct order:

Blaasvær N1, Nøkleby H1
1 The Norwegian Institute of Public Health, Norway
Presenting author and contact person

Presenting author:

Nora Blaasvær

Contact person:

Nora Blaasvær
Heid Nøkleby
Abstract text
Background: Systematic reviews often include few or no studies, or studies of low quality, so the findings are uncertain. This can be a disappointing result for commissioners. In 2016, the Norwegian Directorate for Children, Youth and Family Affairs commissioned the Norwegian Institute of Public Health to synthesize research on the effects of shared physical custody for children. Early on, the review group realized that the report would not allow us to draw firm conclusions about the effects of shared custody, due to the nature of the question, inclusion criteria, methods and application of GRADE. Yet, we believed that it was important to write a report that could contribute to the discussion and would be useful.

Objectives:
1) Write a report that is useful to the interest groups within the area even though the evidence was thin and the effect uncertain.
2) Visit the different interest groups after publishing the report to explore if it was useful to them and why.

Methods: We took time early in the project to familiarize ourselves with the topic and debates in the field of shared physical custody. In dialogue with the commissioner, experts and parents' groups we chose to write a report that explained the topic, the debate, the existing research and our evaluation of it, as well as discussing the different implications due to the uncertainty of the evidence.
After the report was delivered we visited decision makers, professionals working hands-on with families, and parents' groups, to explore how they were interpreting and using our findings. We also conducted a simple analysis of the media debate before and after publishing the report.

Results and Conclusions: Systematic reviews that arrive at findings with a large degree of uncertainty in the evidence can contribute, nonetheless, to debate and be useful to stakeholders. The feedback from the different interest groups was that the report helped to clear up misunderstandings, and stakeholders now had an agreed platform from which to discuss implications for practice. The report has been a foundation for new guidelines for decision makers.

Patient or healthcare consumer involvement: We worked closely with different interest groups throughout the report process. We also participated in a number of debates and conferences with the commissioner to discuss research in this field.

Relevance to patients and consumers: 

Before writing the report we knew that the included research was limited. In order to write a useful report we spent time getting to know the field and debate surrounding the topic. We contacted and communicated closely with both stakeholders, specialists working directly with families and parental interest groups. We believe that this allowed us to write a report that answered relevant questions and aided in calming an unproductive debate by creating a shared understanding from which to communicate.