Table 4.

Factors influencing impacts of research on policy and practice (across case studies)

Facilitators	Barriers
Nature of the intervention	Poorly defined interventions without a clear purpose and outcomes
Simplicity of intervention. Easy to explain and has a clear rationale	“… it was almost an impossible project and it was starting from no base. (EU1 – Making Connections)
Capacity of intervention to be packaged and ‘agents’ trained in its delivery	Use of intervention approaches that are difficult to replicate in other settings and target groups
“It’s very structured, very organized – it comes with comprehensive teaching notes and instruction and people keep in contact – even though people aren’t employed by Mental Health First Aid Australia in Melbourne, they refer to, what I call the mother ship, on a regular basis and keep in close contact…” (EU2 - Mental Health First Aid)
Can be easily replicated and scaled-up
Organization change approaches
“…we developed – the policy compliance procedure an annual audit of the records of the patients who were on the ward at the day so you’ve got an annual reporting of whether procedures are being complied with.” (EU3 - Nicotine Dependent Inpatients)
Integration into usual practice
“I think that really the key things are that the program was integrated into the core business of the service…the very fact that you have ongoing dedicated support from trained workers, that that’s clearly a key component of the success of the program…” (EU 1 - Smoking Cessation in Indigenous Communities)
Project aligned to the priorities of policy makers and practitioners with adaptations made over time to meet needs
“…so it was really from someone in the [Department]head office making that remark that then led to the other project which was never what we envisaged but it was still a very good idea.”. (CI - Mental Health First Aid)
Effective partnerships
Partnerships formed through research projects led to deeper relationships and further policy driven research	Inability to form partnerships with key influencers and end-users
““It has influenced our research direction for my colleagues… it’s promoted a bit more inter-professional research opportunities” (CI - Stroke and Falls)	“So they did try and form different partnerships, but that’s a very fractured and continues to be a very fractured area to work in.” (EU – Making Connections)
Continuity and partnerships between researchers and end-users from the inception of projects facilitated dissemination, ownership and use of the findings.
“…relationship between [Chief Investigator] and the Local Area Health Service, definitely strengthened, and I think that has been demonstrated by that second demonstration grant.” (EU2 - Pedometer and Cardiac Rehab)
Leadership and champions
Multiplier effect of leadership “So I guess having champions in an area health service… just infects the whole system if you like because if one area is doing it rigorously from a research perspective and building on the research.” (EU4 - Nicotine Dependent Inpatients)	No clear alignment with potential leaders in the field of interest who can advocate for project findings
Research quality
High research quality and credibility	Poor research quality
“… based on those early trials, it gives you confidence to say, well we know it worked.”(EU3 – Mental Health First Aid)	“…the clear finding to me was it should never have been funded” (EU - Making Connections)
“ And, also, the fact of having it published in the Peer Review Journal…in the Cochrane Review which I think that’s very influential that review in terms of setting the agenda for what kind of interventions will be funded in Australia and internationally in falls prevention. I think that’s really important.” (EU1- Tai Chi and Falls)	Projects findings did not provide definitive answers, needed to be considered alongside a body of evidence about effective interventions. “…you can see because it’s a kind of a mixed finding, so people think, oh, that’s too hard” (CI Walk to School)
Dissemination approaches
Use of active dissemination strategies such as discussion of findings at workshops between researchers and end-users. “So it’s got a lot of dissemination through talks we’ve done all over the place, nationally and overseas.... A lot of it would be things like departmental seminars” (CI - Mental Health First Aid)	Findings not tailored to end-users needs
	Poor links with policy makers and practitioners networks “When I first read it, I thought I don’t know anything about this.” (EU - Making Connections)
A range of ‘knowledge transfer’ products produced, e.g., short reports highlighting key findings and recommendations, well packaged project resources, websites, etc.
“[About publishing in open access journals] Anyone can go onto the Web and find it and get the full text of it for free. And we did that deliberately as a strategy because we wanted the findings available to anyone… And the website now is a major dissemination source and the report of this study is there on that website.” (CI –Mental Health First Aid)
End-users acted as ‘knowledge brokers’ facilitating dissemination of project findings within their sector “…we had a.... busy email list there with a lot of sharing, a lot of questions. We realized that there was a real need for trying to skill up clinicians in how to work with people in addressing nicotine dependence.” (EU4 - Nicotine Dependent Inpatients)
Contextual issues
Supportive policy context for addressing the issues with the release of project findings fitting well with some policy cycles (Smoke Free Workplace Policy, Falls Prevention Policy)	Political instability and poor timing Frequent changes in health ministry positions, health service restructures and poor fit with some policy cycles.
“they'd had a whole practical level of working with hospitals to try to get this stuff to happen, they were able to help us compose the performance criteria.” (EU3 – Nicotine Dependent Inpatients)	“And, then, a lot of the restructuring within area health services and within the department…had an impact on getting the falls plan out.” (EU1 – Tai Chi and Falls)
Mechanisms and structures in place to profile findings and implement recommendations, e.g., Policy relevant forums involving key end-users	Limited sector capacity and resources, e.g., lack of funds to implement the findings in some sectors:
“I have a link now with the Heart Foundation and the Heart Foundation and Stroke Foundation are now more closer working together; it’s largely come out of this work as well so the National Stroke Foundation with having round tables at the time of this project ”(CI - Falls and Stroke)	“…it’s not because we actually get funding, it’s just because we have a farm safety group here made up of a mix of farmers, Essential Energy, CWA, Department of Primary Industries and a few other groups that have literally kept this alive.” (EU1 - Rural Hearing Conservation)
Ensuring good fit with organizational culture and ways of working
“…in environments that have already got established sort of chain of command and specific behaviors and expectations, and then go in and start telling people what to do. It doesn’t work. And often I went in and did a lot of it in the beginning to show them that it wasn’t a great deal of work.” (EU3 - Nicotine Dependent Inpatients)
Alignment with policy priorities
“…when these clinical practice guidelines came out, there was greater take up… because they had already done the ground work.” (EU3 - Nicotine Dependent Inpatients)
Confluence of events
“When it went to the United States, a very important thing… Virginia Tech massacre. And there’d been this student who had a mental illness and nobody did anything about it…that was then an external event that had an influence on its spread to America.” (CI - Mental Health First Aid)