Table 1.

Potential barriers to the transformative impact of evidence.

Source Authors

Stage of evidence use	Actor motivations
	Truth-seeking	Sense-making	Utility-maximizing
1. Evidence production	Evidence gaps create uncertainties	Imbalance of causal and actionable evidence	Status quo actors influence evidence production
2. Evidence uptake	Uncertainties contest need for policy/practice change	Evidence not matching actors’ prior beliefs	Actors’ interests guide evidence provision or uptake
3. Influence of evidence on policy and practice decisions	Low evidence accumulation prevents innovation	Available evidence does not match actors’ needs	Powerful status quo actors limit influence of evidence
4. Effects of evidence-informed policies and practices	Unintended effects due to siloed evidence base	Ineffectiveness due to mismatch with needs of targeted actors	Implementation deficits due to neglect of interests of key actors
5. Evidence feedback	Time lags and missing data/ tools in evaluation of effects	Scientific and experiential evaluations diverge	Status quo interests impede appropriate feedback