Earlier this month we at Evidence for Action (E4A) celebrated the sixth anniversary of our open and rolling Call for Proposals. Over the last six years we’ve grown and learned and adapted to best support research teams rigorously evaluating the health and equity impacts of programs and policies in an effort to guide/inform action and decision-making.
We’ve learned something from every Letter of Intent (LOI) and Full Proposal (FP) we’ve reviewed – the breadth of interventions operating in the U.S., the types of research questions of interest to our applicants and decision-makers, the approaches being taken to try and answer those questions, the struggles faced by our applicants, and much more.
"I learn something every day from this program, including from our grantees about what works and why, from my colleagues about what makes for compelling evidence, and from our broader team about the many layers of structural racism and how to combat it. Each kernel has relevance to different aspects of my life outside of E4A." - Laura Gottlieb, E4A Associate Director
All of these learnings have shaped the way we think about our funding and our mission, as well as the way we operate - informing how we conduct outreach to potential applicants, review applications, make funding decisions, support our applicants and grantees, refine our CFP and more.
Below we share some of those learnings and insights from the E4A team. We’re excited to see what the future will bring.
Supporting Applicants Through Technical Assistance
From the very beginning of E4A, the core of our mission has been to fund rigorous research that informs decision-making to improve population health and equity. Our “gold standard” has been that a study is designed in such a way that positive or null results could be equally informative in decision-making. As our director Nancy Adler says, “It is possible to learn as much from what doesn’t work as from what does.”
As more applications were received and reviewed, we recognized that some really interesting ideas and research questions were being submitted by applicants outside of the traditional academic research space. But the research designs didn’t always meet our criteria.
We launched our Technical Assistance services to support a broader range of applicants who are asking important and actionable research questions in designing studies that meet our standards for rigor.
"We’ve sought to expand our network of applicants beyond traditional R-01 research and academic institutions and engage investigators from a wider range of practice-based and learning institutions." - May Lynn Tan, E4A Assistant Deputy Director
"One way the program has evolved is in the recognition that if we wanted to see work coming from the community beyond academics yet want rigor to make evidence compelling to policy makers, we needed to create a way for that to happen. The start of the matching program that brought together community with researchers and also the technical assistance service to sharpen methods has been a way to encourage and support community-initiated research." - David Vlahov, E4A co-Director
Engaging Communities in the Research Process
What has also become clear to us over the years, is that engaging the community and incorporating community voice over the entire course of a research project, from research question development to conducting the study to disseminating and acting on the findings can lead to better, more actionable research.
"Collaboration among stakeholders is something I value. Stakeholders are members of the communities that we are part of and aim to support. Diversity of opinions, backgrounds, and thought provides more value irrespective of the endeavor.” - Dakota Cintron, E4A Postdoctoral Scholar
"I’ve learned a lot about the challenges of conducting research in the real world (vs a lab setting) and the importance of thinking through contingency plans in advance. I actually think a lot of pitfalls can be avoided by developing stronger relationships between researchers and the people who have an effect on or are affected by an intervention at the onset of a project. Many of the issues that arise can be attributed to a lack of understanding about how an intervention is implemented or mistrust between the researchers and community members. We haven’t previously required these kinds of relationships, although we’ve always rewarded applicants who demonstrate they exist, but I think we’re moving in that direction as we come to better appreciate just how important they are for the success of a project on many different levels." - Erin Hagan, E4A Deputy Director
"There is sometimes a disconnect between what we as a grants team think is critical to advancing a Culture of Health and what communities know will be meaningful. I don’t think our program was initially designed to weigh the latter over the former. We’re now starting to do better about listening and committing to community voices, but we have a long way to go to do that well.” - Laura Gottlieb, E4A Associate Director
Ensuring Evidence Reaches Decision-Makers
"When we began, our emphasis was on getting the word out about the E4A funding opportunity. Now as results become available from projects we have supported, we are more engaged with the dissemination of findings so that they can inform and advance action, particularly in relation to racial justice and health equity." - Nancy Adler, E4A Director
Over the years we’ve learned a lot about the hurdles to applying research to policy and practice, and how to overcome them. For example, journals often have a bias against publishing null findings, and academic institutions may undervalue dissemination outside of high impact journals (grey literature publications, media placements, infographics, social media campaigns, etc.). To alleviate some of these tensions, we provide funding to support dissemination efforts and require grantees to build dissemination into their project timeline, as well as offering direct assistance to our grantees in the form of communications trainings, development of elevation plans, and added capacity from our own staff and contractors.
"My biggest surprise was the tension some researchers face in disseminating their findings outside the academic setting. Many journals and academic institutions actively discourage researchers from sharing their work in formats and venues that are accessible to the general public. This is in conflict with our program priorities and can create friction in terms of ensuring adequate time, resources and skills are accounted for in a grant from the onset and in meeting program expectations prior to completion of the project." - Erin Hagan, E4A Deputy Director
We continue to evolve our thinking and implement our learnings around dissemination, hoping to get research into the hands of those that can use it to have the biggest positive impacts on health, wellbeing, and equity.
"One thing that seems to set us apart from other funders is our emphasis on dissemination and how seriously we take the ‘4Action’ part of the program. I’d like to ‘graduate’ more and more E4A researchers who feel confident and savvy in stepping outside of their comfort zone to disseminate their findings beyond academic audiences to have real world impacts." - Natalie DiRocco, E4A Grantee Manager
Advancing Racial Equity
As we reflect on our own learnings and look to the future, it is clear that we will continue to fund rigorous, actionable research and work with our grantees to share those findings with the people who can affect change and improve population health and wellbeing. It is also clear that the opportunity to move the needle the most and improve population health rests in addressing structural racism and advancing racial equity. So, as we move forward we will more explicitly focus on how the projects we fund can advance racial equity, which will be reflected in an updated Call for Proposals we’ll be releasing early this Fall.
"My personal goals for working with philanthropy are to fundamentally change the way it operates, so it is supporting transformative solutions and not perpetuating problems. For the first time in my career I’m seeing some indication that true change may be afoot. The work we’re doing to shift the focus on E4A to center racial equity feels more thoughtful and purposeful than past efforts I’ve witnessed. Having said that, there is still A LOT of work to do, and the results remain to be seen; but I’m hopeful that E4A will become a research funding program that really helps advance racial equity in meaningful (even if incremental) ways." - Erin Hagan, E4A Deputy Director
"Hopefully after the last year, absolutely everyone recognizes the need for health equity research and the pressure to deliver evidence we can use for policies and other decision making. The type of population health equity research E4A supports is so needed, and E4A often supports projects that I doubt would be easily funded via other mechanisms. My hope is that both the E4A funding model and the research we've funded are 'contagious' -- inspiring others to build on this. No doubt there are many ways to improve on our approach and the findings of our grantees - but it starts by thinking broadly about the factors that drive health and health equity and by insisting on rigorous methods to figure out how to move towards equity." - Maria Glymour, E4A Associate Director
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