uncovering the mechanisms of research capacity development
TRANSCRIPT
REVIEW Open Access
Uncovering the mechanisms of researchcapacity development in health and socialcare: a realist synthesisJo Cooke1, Paolo Gardois2 and Andrew Booth3*
Abstract
Background: Research capacity development (RCD) is considered fundamental to closing the evidence–practicegap, thereby contributing to health, wealth and knowledge for practice. Numerous frameworks and models havebeen proposed for RCD, but there is little evidence of what works for whom and under what circumstances. Thereis a need to identify mechanisms by which candidate interventions or clusters of interventions might achieve RCDand contribute to societal impact, thereby proving meaningful to stakeholders.
Methods: A realist synthesis was used to develop programme theories for RCD. Structured database searches wereconducted across seven databases to identify papers examining RCD in a health or social care context (1998–2013).In addition, citation searches for 10 key articles (citation pearls) were conducted across Google Scholar and Web ofScience. Of 214 included articles, 116 reported on specific interventions or initiatives or their evaluation. Theremaining 98 articles were discussion papers or explicitly sought to make a theoretical contribution. A coreset of 36 RCD theoretical and conceptual papers were selected and analysed to generate mechanisms thatmap across macro contexts (individual, team, organisational, network). Data were extracted by means of ‘If-Then’statements into an Excel spreadsheet. Models and frameworks were deconstructed into their original elements.
Results: Eight overarching programme theories were identified featuring mechanisms that were triggered acrossmultiple contexts. Three of these fulfilled a symbolic role in signalling the importance of RCD (e.g. positive role models,signal importance, make a difference), whilst the remainder were more functional (e.g. liberate talents, release resource,exceed sum of parts, learning by doing and co-production of knowledge). Outcomes from one mechanism producedchanges in context to stimulate mechanisms in other activities. The eight programme theories were validated withfindings from 10 systematic reviews (2014–2017).
Conclusions: This realist synthesis is the starting point for constructing an RCD framework shaped by theseprogramme theories. Future work is required to further test and refine these findings against empirical datafrom intervention studies.
Keywords: Research capacity development, Realist synthesis, Evaluation, Leadership, Training
* Correspondence: [email protected] of Health and Related Research, University of Sheffield, Regent Court,30 Regent Street, Sheffield S1 4DA, United KingdomFull list of author information is available at the end of the article
© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, andreproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link tothe Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Cooke et al. Health Research Policy and Systems (2018) 16:93 https://doi.org/10.1186/s12961-018-0363-4
BackgroundNational policy and financial investment across the globeindicates overwhelming support for building research cap-acity in healthcare systems. Enhanced capacity is believedto promote problem solving [1], reduce the gap betweenevidence and practice [2, 3], and promote health gains [4].It is considered a powerful and cost-effective way of ad-vancing healthcare and development [5] and, if done well,can improve collaboration between high- and low-incomecountries [1] and address health inequalities [6]. UnitedKingdom policy highlights that the ‘best’ health researchpromotes the health and wealth of the nation [7].Despite overwhelming support in the research litera-
ture and policy documents, research capacity develop-ment (RCD) is poorly defined, and conceptually elusive[8]. Undertaking a conceptual review of the literature,Condell and Begley define research capacity-building, acomponent of RCD, as “a funded, dynamic interventionoperationalised through a range of foci and levels to aug-ment ability to carry out research or achieve objectives inthe field of research over the long-term, with aspects ofsocial change as an ultimate outcome” [8]. This defin-ition highlights that RCD is complex and operates at anumber of structural levels, including individual, team,organisational and within networks [9], and includes arange of ‘interventions’ [10] or foci of activity. RCD ac-tivities are often conducted in parallel and can be inter-related. Research training, fellowships and mentorshipschemes, for example, can be planned and evaluatedseparately, but in practice are often linked [11] and addvalue to each other. RCD ‘interventions’ may includeprocesses such as priority-setting [12], but equally canincorporate structural changes in organisations, for ex-ample, developing an information technology infrastruc-ture [13, 14]. Structural and process interventions canlink to outcomes of their own but can also produce afertile environment for other RCD initiatives. Collect-ively and separately, they achieve the common goal ofstimulating ‘more research done well’.The challenge of understanding RCD and how it oper-
ates is compounded by the fact that RCD is often seenas a means to an end [9] rather than an end in itself.From this perspective, means are the skills and structuralenhancements that enable research to be conducted withthe ultimate ‘end’ or goal of RCD in healthcare being tochange practice and systems to improve health [13]. Set-ting the criteria for impact to this level makes it evenmore challenging to understand ‘what works’ in RCD.Although targeting improved health as the goal givesmore value and ‘meaning’ to RCD activity, it necessitateslong and convoluted causal chains, making it even moredifficult to attribute impact. It also requires consider-ation of the nature and quality of how RCD interven-tions are performed, whether they are ‘meaningful’ and
whether they can produce change in practice. Nuyens,for example, suggests that how priority-setting is under-taken influences how meaningful it is, and whether re-search is subsequently used in practice [15].The literature on RCD reflects its elusive and
chameleon-like quality and how difficult it is to measureand attribute impact [16]. Reports and case studies ofRCD interventions in health do exist but evidence oneffectiveness is inconclusive. Many evaluations fall shortof being able to determine the impact on healthcaresystems and thus demonstrate meaningful RCD. Suchlimitations may, in turn, reflect shortcomings in the the-oretical underpinning of RCD interventions [16].Further complexity is added when considering the re-
lationship between RCD and knowledge mobilisation(KM). RCD focuses very much on empowering and en-abling different levels of the health research system toconduct research. KM focuses further downstream –once the capacity is in place, to what extent can the re-search that has been generated change practice? Manyhealth systems display an evolutionary or developmentalaspect to these activities; in the United Kingdom, for ex-ample, antecedent investment in research and develop-ment support units has started to deliver the capacity tomobilise knowledge through networks such as the Col-laborations for Leadership in Applied Health Researchand Care (CLAHRCs). However, typically, RCD and KMco-exist and interact given that new requirements identi-fied from KM will feed into subsequent requirements forspecific reconfigurations of research capacity.In summary, RCD can be categorised as a complex
intervention, what Willis et al. describe as “a set of pur-posefully coordinated components that target multiplelevels and sectors of a system, that operate both inde-pendently and inter-dependently, and that interact in thecontexts in which they are implemented” [17]. Realist ap-proaches offer an ideal methodology for understanding,evaluating and planning such interventions.Numerous models suggest how RCD works [1, 9, 14,
18–21]. However, few models address underlying mecha-nisms for what works, and why, across a range of con-texts, in achieving a meaningful impact on healthservices and systems. No attempt has been undertakento link existing RCD models, nor to develop theories ina systematic way from them.The objective of this realist synthesis is to address
what are the mechanisms that support meaningful RCDthat are triggered across diverse contexts, specifically atindividual, team, organisation or network level, as de-scribed in conceptual and theoretical papers? We aimto isolate mechanisms that are activated across andwithin diverse contexts in order to develop programmetheories that will identify and test causal chains in RCDprogrammes.
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 2 of 22
MethodsThis paper reports on a work package within a largerprogramme of work on reviewing the RCD literature inhealth and social care. The wider programme aims to ana-lyse both the conceptual papers and intervention studies.This paper reports on the first stage of this research,namely a realist synthesis of theoretical and conceptualpapers to develop programme theory at a macro level. Arealist synthesis seeks to explain and unpack the mecha-nisms by which an intervention works (or fails to work); itseeks to advance a potential explanation, as opposed to adefinitive judgement, about how interventions (in this caseresearch capacity development activities) achieve theiroutcomes [22]. By mechanisms we mean the responsesthat the ‘active’ components within an intervention stimu-late, either individually or collectively, within participants.We explore these mechanisms by first identifying an ac-cessible explanation of how the intervention is understoodto work, known as a ‘programme theory’, derived from theresearch literature, official documents or stakeholderexplanations.A realist approach recognises that the context within
which an intervention is delivered is “complex, multi-fa-ceted and dynamic” [23]. It challenges the assumption,implicit in conventional systematic review methodology,that the same intervention will work in the same way indifferent contexts. Realist logic seeks to articulate state-ments along the lines of ‘IF Context A includes… THENMechanisms X, Y, Z are activated LEADING TO Out-come O1’ – these statements are technically known as‘CMO Configurations’ or ‘CMO chains’.The work described in this study seeks to identify
mechanisms that are activated across a variety of con-texts operating at different levels (individual, team, or-ganisational, network) within the health research systemto achieve either desirable or unintended outcomes. Sub-sequent work will seek to map evidence from empiricalstudies to the theoretical framework. The realist synthe-sis method was supported by systematic mapping meth-odology. A core set of theoretical and conceptual paperson RCD was analysed in order to generate mechanismsand map these across macro contexts (individual, team,organisational, network) in order to develop programmetheories.
Initial scoping of the literatureIn 2005, a scoping review, Re:Cap – Identifying theEvidence Base for Research Capacity Development inHealth and Social Care [10], was commissioned by theNational Coordinating Centre for Research Capacity De-velopment, in partnership with the National SteeringCommittee of Research and Development Support Units,to “identify, map, and describe the literature available toinform research capacity development (RCD) activities in
health and social care, and to inform the work of RDSUs[Research and Development Support Units]” (the thenUnited Kingdom regional research and development sup-port units) [10]. A scoping review is “a preliminary assess-ment of the potential size and scope of the availableresearch literature” [24] and does not seek to conduct for-mal assessments of evidence quality. One component ofthe scoping review sought to identify existing RCDmodels, frameworks and theories. Four limitations wereidentified for this component of the wider scoping review,namely (1) models, frameworks and theories were derivedfrom a heterogeneous range of sources and disciplinesmaking comparison and specific application to health andsocial care problematic, especially as some models origi-nated from outside the context of research capacity; (2) norecognised procedures existed for identifying models,frameworks and theories in a systematic way; (3) timeconstraints did not permit a formal attempt to examine anempirical base for each identified model, framework ortheory; and (4) related to (3), there was limited opportun-ity to link the theories identified to eight RCD activities(Box 1) prioritised for the scoping review. Several yearslater, two authors of the original scoping review (JC &AB), working with a trained information specialist (PG),therefore sought to return to the topic area to consolidateopportunities identified from the quantity and characteris-tics of the literature in order to extend the conceptualthinking that underpins RCD.A considerable body of literature describes models for
RCD together with evaluations of specific individualRCD activities. However, none of the identified studiessought to explore beneath the level of actual interven-tions to examine the mechanisms by which interventionsmight achieve their intended effects. We hypothesisedthat some of these effects would be specific to the con-text of research capacity.
Search strategyStructured database searches were conducted across sevendatabases (MEDLINE, EMBASE, ASSIA, CINAHL, ERIC,PsycInfo, and Web of Science) to identify papers thatexamined RCD in a health or social care context. Searcheswere conducted across the period 1998–2013. In addition,given the diversity of terminology, 10 key articles wereselected from the original Re:CAP review [10] and desig-nated as ‘citation pearls’. Citation searches were thenconducted across Google Scholar and Web of Science forarticles citing these conceptual works.
Inclusion/exclusion criteriaFor inclusion in the initial review project a paper should:
1. Describe an RCD model/theory/framework OR
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 3 of 22
2. Evaluate a model/theory/framework cited fromelsewhere OR
3. Report an evaluation of an intervention that wasbased on or cites model/theory/framework
AND
4. Be specific to a health or social care setting5. Be published in English between 1999 and 2013
Note that subsequent phases of the project requiredvalidation and refreshment of the original dataset to ex-tend coverage between 2014 and 2017. For details seebelow.
KeywordsThe Research question was formulated according to theBeHeMoTH question structure [25]. This formulation isspecifically designed to help to specify theory-related lit-erature searches, as follows:
Be – Behaviour of Interest: RCD (including eightspecific interventions: Prioritisation; Mentoring forresearch; Research leadership; Research facilitation;Research skills training; Funding (including bursariesand fellowships); Networks and collaborations;Infrastructure).H – Health Context: Health and social care.E – Exclusions: Capacity development for other(non-research) purposes; Models of RCD not tried orproposed for a health and social care context.MoTh – Models or Theories: operationalised as ageneric ‘model* or theor* or concept* or framework*’strategy together with named models or theories ifrequired. Illustrative keywords are given in Table 1.
Key citation pearlsA list of 10 previous models identified for the Re:CAPproject [1, 6, 9, 14, 18–21, 26, 27] (designated as ‘citationpearls’) was searched in 2014 using Google Scholar, Webof Science and Scopus. Supplementary search approachesproved of particular importance given the significantvariation in terminology and the update role of the review.In addition, reference lists of included articles were exam-ined for additional references not retrieved by the databasekeywords search. An update procedure was conducted,specifically for systematic reviews, in December 2017 (seethe section Validation and refreshment of programme the-ories below).
Date and language restrictionsPapers were published between 2000 and 2015. OnlyEnglish language papers were considered given theintended target audience for the review findings.
Quality assessmentNo accepted instruments have been developed to assessthe theoretical sufficiency of conceptual papers. Ouroverall goal was interpretative (configurative), not aggre-gative [28], so we did not exclude any studies based onstudy quality alone. However, we did examine includedpapers in relation to their perceived proximity to theUnited Kingdom context for which we were producingthe review [29].
Data extractionData were extracted on author, year, country, contextand, where appropriate, RCD activity and study type. Forthis work package, articles with RCD theories, modelsand frameworks were used to extract causative relationsof components within them in the form of ‘If-Then’statements. The level at which the activity was described
Table 1 Summary of search strategies and search terms
Research Capacity development Health and social care Models, etc.
Research AND ‘capacity development’ OR ‘capacitybuilding’ OR ‘capacity evaluation’ OR‘community development’ OR‘community building’ OR ‘buildingcommunities’
AND Not specified on health/socialcare databases
AND model* OR theor* ORconcept* OR framework*
prioritis* OR prioritiz* OR mentor* ORleader* OR facilitat* OR training OR ORfunding OR bursaries OR fellowship*OR network* OR collaboration* ORinfrastructure*
On non-health/social caredatabases:Health OR Nurs* OR MedicalOR doctor OR paramedic* ORtherapy OR therapist ORPhysiotherap* OR ‘social work*’
NEAR/ SAME/ ADJ/WITHa
‘capability’ OR ‘capacity’ OR ‘productivity’OR ‘output’ OR ‘strategy’.
Research capacity
Researcher development
Researcher career*aAccording to Database functionality
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 4 of 22
as taking place was also extracted (individual, team, or-ganisation and network level). These data were extractedinto Excel sheets.
Data synthesisAccessing the programme theoriesCareful reading and re-reading of identified conceptualpapers was undertaken individually by two investigators(AB, JC). Particular attention was focused on identifyingcausal chains by which an RCD programme or specificintervention might achieve either proximal (e.g. know-ledge or skill gains) or long-term gains (i.e. improve-ments in health, increases in wealth or the achievementof an evidence-formed organisation or society). Datawere extracted as If-Then statements into an Excelspreadsheet [30].In cases of uncertainty, the If-Then statements, and
proposed causal links, were discussed within the team.Chains of If-Then statements were constructed to yieldinsights on overall generic RCD approaches. A furthercomplexity related to the level at which particular activ-ities might be targeted, for example, at an individual,team, organisation or network level. If-Then statementswere grouped by level of targeted intervention, withmechanisms that occurred at more than one contextuallevel being identified. In line with realist approaches, theteam reasoned that similarities in mechanism, as op-posed to the actual activities themselves, would extendacross all levels of operations (context), to enableprogramme theory building.
Validation and refreshment of programme theoriesAn essential feature of the realist synthesis method is theprocess of validating the original programme theoriesagainst a further independent dataset. Citation searcheswere repeated for the 10 citation pearls in December 2017and all reviews published between 2014 and 2017 meetingthe original inclusion criteria and exhibiting a recognisabledegree of systematicity were analysed for confirmatoryand original programme theory.
ResultsLiterature baseThe literature search was conducted across nine data-bases. Potentially relevant articles (n = 2763) were identi-fied from searching electronic databases, and 14additional potentially relevant articles were identifiedfrom follow-up of models and framework papers in-cluded in the earlier Re:CAP scoping review (the desig-nated ‘citation pearls’). Of the potentially relevantarticles, 2081 were excluded because their primary focuswas not on RCD, leaving 682 potentially relevant papersfrom electronic databases; 468 articles were subsequentlyexcluded at abstract stage, being either not relevant, only
available in abstract form or written in a language otherthan English and 214 articles from electronic databaseswere retained, 116 of which reported on specific inter-ventions or initiatives or their evaluation. A subset of 98articles were discussion papers or explicitly sought tomake a theoretical contribution. These 98 articles wereread carefully by one of the review team (JC/AB) and,where the study was considered appropriate to the re-view question, selected for data extraction. A final list of36 conceptual papers, reflecting consensus between thereviewers, were ultimately included. Figure 1 outlinesthe PRISMA diagram.The 36 papers (Table 2) reflected international interest
in RCD, with prominent players including the UnitedKingdom (n = 11), Australia (n = 6), the United States ofAmerica (n = 5), Canada [31] and Canada/United Statescombined [27] (North America). Five papers representedinternational perspectives, typically in the form of litera-ture reviews. Low- and middle-income countries wererepresented by five collective papers and individual pa-pers from Bangladesh [5], Liberia [20] and South Africa[21]. Primary care was the most prevalent field of re-search (n = 12), with nursing (n = 10), health and healthservices research (n = 9) also being well represented.Three papers examined allied health (n = 3) and the finalpaper looked at public health [21]. Collectively, the pa-pers represented all the identified activities of RCD, withricher papers yielding programme theory relating tothree or more activities (Table 2).Given that the aim of the project was interpretative
and explanatory it was not considered necessary to com-prehensively sample every possible RCD model, frame-work or theory. Instead, we were looking to constructtheory and therefore employed a purposeful samplingapproach described as ‘intensity sampling’. In the con-text of a research synthesis, intensity sampling involvesselecting papers that are “excellent or rich examples of thephenomenon of interest, but not highly unusual cases…cases that manifest sufficient intensity to illuminate thenature of success or failure, but not at the extreme” [32].This method of sampling appears particularly appro-priate given that the intent of realist synthesis is todelve into inconsistencies of evidence in order tobuild programme theories to offer to policy-makers[29]. Sampling was operationalised through initial se-lection of the 10 citation pearls and, subsequently,through selection of articles that specifically sought totheorise or conceptualise RCD.
Literature classificationThe final list of included studies comprised 36 theor-etical and conceptual papers (Table 2). The includedliterature reflected a wide range of environments and
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 5 of 22
settings within which RCD might take place. The ap-plied context for this synthesis meant we were par-ticularly interested in United Kingdom-based studies,although Australia and the United States were par-ticularly well represented. Primary care as a contextwas particularly prominent. Reasons for this may betemporal, with acute hospital infrastructures being ata later stage of development than primary care coun-terparts, related to saleability, with primary care orga-nisations and networks being more able to facilitateactionable change, or may relate to external develop-ments and priorities. We also identified papers thatdescribed North–South partnerships as exemplars ofcollaborations or networks.
The focus of this paperThis paper focuses on 36 conceptual and theoreticalpapers (Table 2), including papers containing some formof framework or model of RCD. Models and frameworkswere handled in the same way and were deconstructedinto their original elements (in the form of If-Then state-ments). Thus, hypothesised relationships were not privi-leged within the original deconstruction but emergednaturally from the synthesised data.A process of discussion and consensus led to identifica-
tion of eight overarching programme theories, identifyingmechanisms triggered across multiple (i.e. at least morethan one) macro contexts (Table 3). Several programmetheories recognise RCD as a collaborative effort facilitating
Fig. 1 Flowchart for the systematic review following the PRISMA reporting methodology
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 6 of 22
Table
2The36
stud
ieswith
includ
edresearch
activities,aim
ofstud
yandindicativeIf-Then
statem
ents
Autho
r(Year)[Ref]
Con
text
Discipline
Includ
edresearch
activities
Aim
ofstud
yIndicativeIf-Then
s
1.Albert&
Mickan(2003)
[4]
Australia
Prim
aryCare
Training
Toprop
oseaparadigm
shift
inthe
conten
tof
capacity-buildingas
astep
towards
closingthegaps
betw
een
research,p
olicyandpractice
IFresearch
ideasandim
plem
entatio
nstrategies
arediscussedandtranslated
across
severalo
rganisationalcon
texts
andcultu
res,TH
ENresearch
influen
ces
practice
2.Breenet
al.
(2005)
[21]a
SouthAfrica
PublicHealth
Leadership,N
etworks,Resou
rces,
Training
Toseek
improved
unde
rstand
ing
ofho
wRC
Bcanbe
achieved
andto
prop
oseaframew
orkto
improve
unde
rstand
ingandde
liveryandto
achievebe
tter
cong
ruen
cebe
tween
expe
ctations
andou
tcom
esrelatin
gto
RCB
IFinvestmen
tisinadeq
uate
and
incentives
inapprop
riate,THEN
organisatio
nsareun
ableto
sustainRC
Dbe
yond
thelifespanof
aspecificproject
3.Coe
net
al.
(2010)
[31]
Canada
Health
andHealth
Services
Research
Infrastructure,Leadership,
Networks
Toexplorepo
tentialfor
anexpand
edconcep
tualisationof
research
infrastructure,that
specifies
itslargely
assumed
qualities
whilstextend
ingto
articulatetheinteractiverelatio
nships
amon
gtang
ibleandintang
ible
system
sandstructures
unde
rlying
centre
functio
ning
IForganisatio
nalleade
rsde
velopan
approp
riate
organisatio
nalresearch
cultu
re,THEN
mem
berscollabo
rate
onresearch
IFresearchersshareaparticular
research
iden
tity,TH
ENresearchersacqu
ireasense
ofbe
long
ingor
a‘ready-madeaffinity
grou
p’
4.Con
dell&
Begley
(2007)
[8]
International
Nursing
Fund
ing,
Leadership,Training,
Tocond
uctaconcep
tanalysisof
capacity-buildingandits
relatio
nship
toresearch
IForganisatio
nsen
gage
indynamicRC
Dactivities,THEN
organisatio
nscanachieve
sustainabilityandultim
atelyeffect
social
change
5.Con
net
al.
(2005)
[49]
UnitedStates
ofAmerica
Nursing
Fund
ing,
Prioritisation
Tode
scrib
ethesuccessof
one
scho
olof
nursingin
movingfro
mhaving
noNIH
fund
ingto
being
ranked
intop20
scho
olsforNIH
fund
ingforconsecutiveyears
IFstaffin
grantsupp
ortservices
areno
tinvolved
ingraduate
stud
ented
ucation
orresearch
presen
tatio
nmaterials,THEN
thisconveysaclearmessage
abou
tthe
impo
rtance
ofprep
aringcompe
titive
grantapplications
IFan
organisatio
nfre
quen
tlycommun
icates
abou
tgrantactivity,THEN
theorganisatio
ncultivatesan
environm
ent
thatiscond
uciveto
high
research
prod
uctivity
6.Coo
ke&Green
(2000)
[50]
International
Nursing
Research
Prioritisation,
Training
Toiden
tifyfactorsthat
might
affect
theresearch
capacity
ofde
partmen
tsof
nursingin
high
ered
ucation,
and
tomakerecommen
datio
nsto
enablede
partmen
tsto
develop
theircapacity
toun
dertakeresearch
IFnu
rseed
ucatorsareen
couraged
topu
rsue
furthe
rqu
alificatio
ns,p
articularly
high
erde
grees,TH
ENteaching
stafffeel
ableto
engage
inresearch
activity
7.Coo
keet
al.
(2005)
[9]a
UnitedKing
dom
Prim
aryCare
Networks,Training
Tode
velopthede
bate
arou
ndRC
Bby
sugg
estin
gaframew
orkfor
planning
change
andmeasurin
gprog
ress,b
ased
onsixprinciples
ofRC
B
IForganisatio
nssupp
ortresearch
‘close
topractice’,THEN
stakeholdersperceive
that
research
isuseful
IForganisatio
nsde
veloplinkage
s,partne
rships
andcollabo
ratio
ns,THEN
organisatio
nscanbu
ildup
intellectual
capital(know
ledg
e)andsocialcapital
(relatio
nships)
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 7 of 22
Table
2The36
stud
ieswith
includ
edresearch
activities,aim
ofstud
yandindicativeIf-Then
statem
ents(Con
tinued)
Autho
r(Year)[Ref]
Con
text
Discipline
Includ
edresearch
activities
Aim
ofstud
yIndicativeIf-Then
s
IForganisatio
nsbu
ildup
intellectualcapital(know
ledg
e)andsocial
capital(relatio
nships),TH
ENtheirabilityto
doresearch
isenhanced
IFresearch
fund
ersinclud
econtinuity
and
sustainabilityin
fund
ingprovision,TH
ENorganisatio
nscanmaintainandcontinue
newlyacqu
iredskillsandstructures
toun
dertakeresearch
8.Coo
keet
al.
(2015)
[12]
UnitedKing
dom
Health
andHealth
Services
Research
Fund
ing,
Leadership,N
etworks,
Prioritisation,
Training
Toillustratetheuseof
collabo
rative
priority-settingin
aUnitedKing
dom
research
collabo
ratio
n(Collabo
ratio
nandLeadership
inApp
liedHealth
Research
andCare–CLA
HRC
)
IFresearch
netw
orks
iden
tify‘needs-led,
meaning
ful’research
projects,THEN
research
isconsidered
timely
IFresearch
netw
orks
harnessflexible
resources(peo
ple,fund
s,skills),THEN
research
canbe
respon
sive
IFresearch
leadership
isrespon
sive
and
transformative,TH
ENresearch
canbe
co-produ
ced
9.DelMar
&Askew
(2004)
[18]a
Australia
Prim
aryCare
Fund
ing,
Networks,Training
Toprom
oteinterven
tions
forfamily/
gene
ralp
racticeRC
Bby
describ
ing
successful
internationalexamples
(e.g.d
iseasesandillne
ssresearch
aswellasprocessresearch);mon
itor
output
ofresearch;increasenu
mbe
rof
research
journals;encou
rage
and
enableresearch
skillsacqu
isition
(includ
ingas
partof
profession
altraining
);streng
then
academ
icbase;
andprom
oteresearch
netw
orks
and
collabo
ratio
ns)
IFgo
vernmen
tshave
family
med
icine
research
ontheiragen
das(asshow
nby
fund
ingforRC
Bandforresearch
activity
itself),TH
ENgo
vernmen
tssend
aclear
message
toclinicalandacadem
iccommun
ities
that
family
med
icine
research
isim
portantandworthyof
supp
ort
10.Edw
ards
etal.
(2009)
[51]
LMICs
Nursing
Research
Fund
ing,
Men
torin
g,Training
Toiden
tifylong
-stand
ingbarriersto
nurses’eng
agem
entin
research
and
todiscussstrategies
toen
ableLM
ICnu
rses
tolead
research
ofhigh
relevance
tolocaland
internationalp
olicy
decision
saffectingpo
pulatio
nhe
alth
IFresearchersaregivenop
portun
ities
toworkalon
gsidesenior
researchers,bo
thon
-site
andby
distance,THEN
they
can
discusswaysto
balanceresearch
with
teaching
,clinicalandadministrative
demands
11.Farmer
&Weston
(2002)
[19]a
Australia
Prim
aryCare
Fund
ing,
Men
torin
g,Networks
Toprop
oseaconcep
tualmod
elto
assistprim
arycare
RCBinitiatives
IFresearch
fund
ersem
ploy
awho
lesystem
approach
providingfund
ingand
resourcesat
multip
lelevels,THEN
practitione
rscanen
terthesystem
atan
approp
riate
level,andthen
prog
ress
toa
high
erlevelo
fresearch
capacity
IFresearch
fund
ersaccommod
ate
diversity,THEN
practitione
rsde
velop
research
interestsin
topics
ofon
going
person
alinterest
IFresearch
fund
ersprovideprotectedtim
eforresearch,TH
ENindividu
alsparticipatein
research
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 8 of 22
Table
2The36
stud
ieswith
includ
edresearch
activities,aim
ofstud
yandindicativeIf-Then
statem
ents(Con
tinued)
Autho
r(Year)[Ref]
Con
text
Discipline
Includ
edresearch
activities
Aim
ofstud
yIndicativeIf-Then
s
12.Fen
tonet
al.
(2001,2007)[52,53]
UnitedKing
dom
Prim
aryCare
Networks
Toreflect
ontheun
derstand
ingof
netw
orks
from
organisatio
nalscien
ceandho
wthisun
derstand
ingcaninform
thede
velopm
entandevaluatio
nof
prim
arycare
research
netw
orks
IFresearchersde
mon
strate
socialisation,
team
workandop
enne
ss,
THEN
researchersresistthetend
ency
towards
grou
pthink
andop
enup
oppo
rtun
ities
fortheexchange
ofideas
andknow
ledg
e
13.Fitzge
rald
etal.
(2003)
[54]
UnitedStates
ofAmerica
Nursing
Men
torin
g,Networks
Todiscusstw
opaed
iatriccriticalcare
clinicalnu
rsespecialists’p
articipationin
acollabo
rativeresearch
team
ledby
university
faculty
IFhealthcare
professio
nalsareinclud
edas
anintegralpartof
theresearch
team
,TH
ENhealthcare
professio
nalsreceive
mentoringinmanyaspectsof
theresearch
process
IFhealthcare
professio
nalsarepu
lledaw
ayfro
mtheirclinicalun
itto
engage
inresearch
respon
sibilities,TH
ENotherstaff
may
resent
theintrusionor
see
involvem
entintheprojectasfrivolous
whenthey
areleftwith
moreworkor
with
outready
accessto
consultatio
n
14.G
adsby(2011)
[16]
LMICs
Health
andHealth
Services
Research
Fund
ing,
Networks,Training
Toinform
unde
rstand
ingof
RCS,and
how
toconsider
theeffectiven
essof
theseinitiatives
byexam
ining(1)
unde
rstand
ings
ofandapproaches
toRC
S,and(2)different
waysin
which
RCSismon
itoredandevaluated
IFdo
norssupp
ortindividu
alcapacity
developm
entat
theexpe
nseof
system
capacity
developm
ent,TH
ENindividu
als
from
LMICsleaveforb
etterjob
selsewhere
15.G
olen
koet
al.
(2012)
[55]
Australia
Allied
Health
Infrastructure,Leadership
Tode
scrib
eandanalysealliedhe
alth
senior
manager
perspe
ctives
ofho
worganisatio
nalfactorsim
pact
onRC
B
IFstaffaresupp
ortedfro
mastaff-tim
eperspectiveto
doresearch,THEN
staffare
motivated
toparticipateinresearch
IFstaffreceiverecogn
ition
forresearch
participation,
THEN
staffaremotivated
toparticipatein
research
16.G
reen
etal.
(2007)
[56]
UnitedKing
dom
Nursing
Research
Leadership,N
etworks,Training
Toevaluate
different
approaches
toRC
Dandto
answ
er:‘How
doun
iversity
departmen
tsde
veloptheresearch
capacity
oftheirnu
rsing/midwifery
staff,what
approaches
dothey
use,andwhy
are
outcom
esas
they
are?
IFresearchersform
alliances
betw
een
novice
andexperienced
researchers,TH
ENorganisatio
nsachieveabalancebetween
capacitydevelopm
entandleading-edge
developm
ent
17.Jen
erette
etal.
(2008)
[6]a
UnitedStates
ofAmerica
Nursing
Research
Networks
Tode
scrib
ethemod
elsof
research
collabo
ratio
nem
erging
from
theYale-
How
ardPartne
rshipCen
teron
Redu
cing
Health
Disparitiesby
SelfandFamily
Managem
ent
IFpartne
rsde
mon
strate
effective
commun
icationandaresensitive
tothe
historyandun
ique
characteristicsof
the
partne
ringinstitu
tionas
wellasits
popu
latio
n,TH
ENinvestigatorssuccessfully
completeprojectson
timeanddeliver
subsequent
presentatio
nsandpu
blications
18.Joh
nson
etal.
(2005)
[20]a
Libe
riaHealth
andHealth
Services
Research
Infrastructure,Training
Topresen
tan
RCBmod
elto
streng
then
HIV/AIDSservicede
liverysystem
throug
haprop
osed
Libe
ria–U
nitedStates
ofAmericaresearch
partne
rshipthat
focuseson
establishing
andstreng
then
ing
HIV/AIDSservicede
liverysystem
IFparticipantperceivesthesalienceof
the
North–Sou
thpartnership,TH
ENthe
participantisreadyto
participatein
research
IFparticipantsarereadyto
participatein
research,THEN
theirorganisatio
n
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 9 of 22
Table
2The36
stud
ieswith
includ
edresearch
activities,aim
ofstud
yandindicativeIf-Then
statem
ents(Con
tinued)
Autho
r(Year)[Ref]
Con
text
Discipline
Includ
edresearch
activities
Aim
ofstud
yIndicativeIf-Then
s
infrastructureanden
hancingresearch
andapplicationskillsof
Libe
rian
scientistsandprofession
als
sustains
itsresearch
activities
19.Jon
eset
al.(2003)
[26]a
Australia
Prim
aryCare
Training
Tode
term
inege
neralp
ractition
ers’
research
training
need
sandthe
barriersto
involvem
entin
research
IFGPs
perceive
that
they
dono
tpo
ssess
thene
cessaryresearch
skills,TH
ENthey
arereluctantto
engage
inresearch
20.Lansang
&Den
nis
(2004)
[1]a
LMICs
Health
andHealth
Services
Research
Fund
ing,
Infrastructure,
Men
torin
g,Networks,Training
Toreview
thebroadapproaches
takento
RCBandthelikelihoo
dthat
theseeffortswillprovesustainable
IFresearch
fund
ersprom
ote‘learning
bydo
ing’approaches,suchas
developm
ental
orseed
grants,hands-ontraining
inon
goingresearch
prog
rammes
ormentorshipprog
rammes,THEN
practitionersareencouraged
toparticipate
inresearch
IFde
veloping
coun
triesde
velop
partnerships
andnetworks
with
developed
coun
triesor
otherd
evelop
ingcoun
tries,
THEN
theircollectiveou
tputsaregreater
than
thesum
oftheirisolatedefforts
21.Levineet
al.
(2013)
[13]
UnitedStates
ofAmerica
Health
andHealth
Services
Research
Fund
ing,
Infrastructure,Men
torin
g,Networks,Training
Tostud
ytw
oRC
Bprog
rammes
with
similargo
alsandto
expand
upon
the
know
ledg
ebase
ofstrategies
and
approaches
toRC
Dandthus
provide
abe
tter
unde
rstand
ingof
contextual
factorsthat
may
influen
cetheefficacy
ofRC
Dstrategies
IForganisatio
nsde
velopgo
odexternal
andinternalhe
alth
services
research
partne
rs,THEN
they
canbu
ildresearch
capacity
IForganisatio
nsareableto
build
onor
leverage
larger
organisatio
nalchang
es,
THEN
they
canachievesuccessful
RCB
22.M
acfarlane
etal.
(2005)
[14]a
UnitedKing
dom
Prim
aryCare
Fund
ing,
Infrastructure,Leadership,
Networks,Training
Toiden
tifykeystructural,d
evelop
men
tal
anden
vironm
entalcharacteristicsassociated
with
successful
andsustaine
dinvolvem
ent
inresearch,and
toinform
natio
nalstrateg
yforRC
Bin
prim
arycare
IForganisatio
nsprod
uceamission
statem
entthat
acknow
ledg
esthevalue
ofresearch,THEN
GPs
developaresearch
practice
23.M
ahmoo
det
al.
(2011)
[5]
Bang
lade
shHealth
andHealth
Services
Research
Fund
ing,
Prioritisation
Toiden
tifyprob
lemsfacedby
ahe
alth
research
institu
tein
Bang
lade
sh,d
escribe
twostrategies
develope
dto
addressthese
prob
lems,andiden
tifytheresults
after
3yearsof
implem
entatio
n
IForganisatio
nsdevelopamon
itoringand
evaluatio
nframew
ork,TH
ENdo
norsdo
notexertan
influence
over
organisatio
nal
research
priorities
24.N
chinda
(2002)
[57]
LMICs
Health
andHealth
Services
Research
Training
Tode
scrib
esomeexpe
riences
inRC
Sover
thelastfew
decade
sandto
prop
ose,
from
these,mechanism
sforsustainableRC
B
IFreturningresearcherslearnne
wskills
andtechniqu
eswhe
ntraining
overseas,
THEN
theseresearchersrequ
ireaccess
toapprop
riate
equipm
entandresources
whe
nreturningto
theirow
ninstitu
tions
25.N
orth
American
Prim
aryCareResearch
Group
(2002)
[27]a
North
America
Prim
aryCare
Infrastructure,Leadership,M
entorin
g,Training
Topresen
tapo
sitio
npape
rto
guide
developm
entof
astrategicplanning
process
IFacadem
icleadersun
derstand
the
research
processandthetype
sof
infrastructureservices
andskillsrequ
ired
tosupp
ortasuccessful
inde
pend
ent
investigator,THEN
organisatio
nscan
iden
tifyexpe
rienced
investigatorswilling
tosupp
orteach
othe
randto
men
tor
othe
rs
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 10 of 22
Table
2The36
stud
ieswith
includ
edresearch
activities,aim
ofstud
yandindicativeIf-Then
statem
ents(Con
tinued)
Autho
r(Year)[Ref]
Con
text
Discipline
Includ
edresearch
activities
Aim
ofstud
yIndicativeIf-Then
s
26.N
uyen
s(2007)
[15]
International
Health
andHealth
Services
Research
Prioritisation
Tolook
atmajor
issues
emerging
from
coun
tries’expe
riences
insettingpriorities
durin
gthepast15
yearsandat
the
challeng
esstillto
beaddressed
IFnatio
nalo
rganisations
institu
tea
bottom
-upapproach
tothe
gene
ratio
nof
research
priorities,TH
ENa
context-sensitive
andcultu
rally
sensitive
processof
priority-settingoccurs
27.O
’Byrne
&Sm
ith(2011)
[58]
UnitedKing
dom
Nursing
Facilitation,
Infrastructure,Leadership,
Men
torin
g,Networks,Prio
ritisation
Toiden
tifymod
elsused
toprovidelocal
research
oppo
rtun
ities
andthereb
yde
velopresearch
capacity
and
capabilityin
clinicalnu
rses
intheUnitedKing
dom
Iforganisatio
nsprioritiseexpansionof
research
initiatives
forn
ursesandallocates
resourcesforanaccompanying
infrastructure,TH
ENorganisatio
nsachievesuccessfulRC
B
28.Pickstone
etal.
(2008)
[59]
UnitedKing
dom
Allied
Health
Fund
ing
Tode
scrib
ethenature
ofRC
Bin
allied
health
profession
sandto
explorethe
vision
ofRC
BusingtheUnitedKing
dom
asan
exam
ple
IFprofessio
nalsreceivesustainedtargeted
fund
ingto
releasethem
toun
dertake
research,THEN
professio
nalsareableto
resistworkloadpressures
29.Priestet
al.
(2007)
[60]
UnitedKing
dom
Nursing
Networks
Toexplorenu
rsinglecturers’RC
Dthroug
htheiren
gage
men
tas
co-researche
rsin
alarger
case
stud
yproject
IForganisatio
nsiden
tifyaspecificpe
rson
asaresearch
contact,TH
ENstaffinterested
inresearch
involvem
entfeelableto
approach
thatperson
30.Raghu
nath
etal.
(2004)
[61]
UnitedKing
dom
Prim
arycare
Fund
ing,
Networks,Training
Toexplorethemeaning
,und
erstanding
,usefulne
ssandreality
ofmultid
isciplinary
research
inprim
arycare
andprovide
exam
ples
IFexternalassessmen
tprovides
definable
indicatorsof
success,TH
ENorganisatio
nsareableto
demon
strate
accoun
tabilityand
valueform
oney
31.Riedet
al.
(2005,2006,2007)
[62,63,64]
Australia
Prim
arycare
Networks,Training
Toun
derstand
thebackgrou
ndandskills
ofthemem
bershipandto
tailorSouth
AustralianPrim
aryHealth
CareResearch
Network(SARN
et)services
tomem
bers’
need
s
IForganisatio
nsutilise
awho
lesystem
approach
toRC
B,TH
ENdiverseindividu
als
areencouraged
toparticipateinresearch
activities
32.Sarre
&Coo
ke(2009)
[65]
UnitedKing
dom
Prim
arycare
Infrastructure,Leadership,Training
Toprovidepracticalsupp
ortto
prim
ary
care
organisatio
nsthroug
hthe
developm
entof
indicatorsagainstwhich
toplan
andmeasure
prog
ress
ofRC
Dat
anorganisatio
nallevel
IFRC
Doccursatdifferent
structurallevels,
includ
ingchange
andsustainable
developm
entinindividu
als,team
sand
organisatio
ns,THEN
itcandemon
strate
clearlinks
totheeffectivenessandqu
ality
ofhealthcare
organisatio
nsinimproving
health
andwell-b
eing
33.Seg
rottet
al.
(2006)
[66]
International
Nursing
Facilitation,
Prioritisation,
Training
Torepo
rtacriticalo
verview
ofnu
rsing
RCDin
academ
icde
partmen
ts,m
ajor
barriersto
RCD,and
capacity-building
strategies
from
theliterature,andto
exam
inethewider
contextwith
inwhich
capacity-buildingtakesplace
IFde
partmen
tshave
aflexibleapproach
toresearch
activities,THEN
researchersare
giventhecreativespaceto
pursue
their
ownresearch
interestsalon
gsidecore
research
priorities
34.Steph
enset
al.
(2011)
[67]
UnitedStates
ofAmerica
Health
andHealth
Services
Research
Fund
ing,
Leadership
Tosynthe
sise
andsharewhathasbe
enlearne
dabou
tRC
Bto
help
organisatio
nsandinstitu
tions
developanden
hance
theirability
toplan
andcond
ucthe
alth
services
research
andob
tain
fund
ingfor
theirresearch
IForganisatio
nssecure
departmen
tal
andinstitu
tionalleade
rshipsupp
ortfor
capacity-buildingactivities,THEN
this
facilitates
future
research
activities
IFresearch
leadersde
mon
strate
how
ade
partmen
t/organisatio
n’sexistin
gexpe
riences
canbe
used
toleverage
andbu
ildan
interdisciplinaryteam
in
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 11 of 22
Table
2The36
stud
ieswith
includ
edresearch
activities,aim
ofstud
yandindicativeIf-Then
statem
ents(Con
tinued)
Autho
r(Year)[Ref]
Con
text
Discipline
Includ
edresearch
activities
Aim
ofstud
yIndicativeIf-Then
s
health
services
research,THEN
potential
participantsbe
comeless
scep
tical
abou
tthevalueof
health
services
research
35.Van
Weel&
Rosser
(2004)
[68]
International
Prim
aryCare
Networks,Training
TosummariseWorld
Organisationof
Family
Doctors(W
onca)conferen
cediscussion
sandpresen
trecommen
datio
nsprop
osed
byconferen
ceattend
ees
from
34coun
tries
IFresearch
team
sdisplayresearch
achievem
entsto
policy-makers,he
alth
fund
ers,andacadem
icleaders,TH
ENpo
licy-makersandothe
rshave
agreaterpe
rcep
tionof
therelevanceof
that
research
IFatig
htlinkiscreatedbe
tween
clinicalpracticeandaresearch
environm
ent,TH
ENclinicians
and
policy-makerswillpe
rceive
thegreaterrelevanceof
research
toclinicalpractice
36.W
hitw
orth
etal.
(2012)
[3]
UnitedKing
dom
Allied
Health
Facilitation,
Fund
ing,
Leadership,
Men
torin
g,Networks,Training
Toou
tline
acompreh
ensive
mod
elde
velope
dandsuccessfullyim
plem
ented
byspeech
andlang
uage
therapistsin
North
EastEngland
IForganisatio
nsacknow
ledg
ethe
developm
entalstage
atwhich
the
practitione
rispo
sitio
ned,
THEN
organisatio
nscanarrang
esuitable
pathwaysinto
theresearch
pathway
LMICslow-an
dmiddle-incomecoun
tries,NIH
Nationa
lInstitutes
forHealth
,RCB
research
capa
city-building,
RCDresearch
capa
city
developm
ent,RC
Sresearch
capa
city
streng
then
ing
NB.
Foramorecompletelistof
If-Th
ensseeAdd
ition
alfile1
a Cita
tionpe
arls–keyarticles
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 12 of 22
Table
3Overarching
prog
rammetheo
riesforRe:CAP(Expande
d)‘Label’
Elem
entsof
prog
rammetheo
ryLine
sforfurthe
rinqu
iryfro
mmid-range
theo
ryExam
pleof
source
data
Research
capacitywillbe
effected
if…“Thiswas
wha
tweachieved…
.”“Thisiswha
tIthink…
.”
ByActivity
PT1.‘Exceeding
thesum
oftheparts’
Individu
als/organisatio
ns/networks
realiseacontrib
ution
that
they
areun
likelyor
less
likelyto
achievein
isolation
SocialNetworkand
OrganisationalThe
ory
Com
mun
ityof
Practice[69]
SocialCapital
“Buildingresearch
capacityisacomplex
challeng
ean
dneedsto
bethough
tof
asaho
listic
process.Each
constituent
partisvitaltothesuccessof
the
who
le,and
isinextricablyinterlinked
with
allthe
others–agestalt-like
phenom
enon
inwhich
thewho
leisgreaterthan
thesum
ofits
parts”[70]
PT2.‘Learningby
doing’
Individu
als/organisatio
nsprototypeor
practiseactivities
requ
iredforsubseq
uent
fullen
gage
men
t,andsequ
entially
learnthroug
hcycles
ofreflection
Expe
rientialLearningMod
el[55,61]
Learning
Organisation
“‘Learningby
doing’approaches,usuallyin
theform
ofdevelopm
entalo
rseed
gran
ts,han
ds-ontraining
inon
goingresearch
programmes
ormentorshipprogrammes,areeffectiveapproaches
that
complem
ent
academ
icdegree
offerings.Theyarealso
mostappropriate
forbuilding
capacityon
the‘dem
and’sid
eso
that
thosewho
useresearch
finding
sun
derstand
andappreciate
theirvaluein
improvinghealth
outcom
es”[1]
SocialCapital
Learning
Organisation
“Trainingshould
bean
dshould
remainon
eof
thecentralfociw
hen
partnerships
areaw
arded.Training
youn
gscientistsin
thecontextof
such
ongoingprojectsisirreplaceable(so-called‘learning
bydoing’)an
dleadsto
arapidacquisitionan
ddevelopm
entof
research
skillsan
dexperience”
[57]
PT3.1‘Liberatingthetalents’
Individu
als/organisatio
nsreleasethedo
rmantpo
tentialo
ftheirskillsandexpe
rience
Bourdieu
’sTheo
ryof
Practice1977
“Amorefocusedapproach
canaccelerate
progressin
buildingcapacityan
dallowsresearchersan
dteachersto
developtheir‘natural
talents’”
[70]
PT4.‘Releasing
resources’
Resourcesprovided
toovercomeindividu
al/organisational
inhibitio
nandactas
afocusforactivity,and
inform
ationis
freelyshared
abou
ttheseop
portun
ities
Lewin
Mod
elof
Chang
e(Unfreeze/Chang
e/Freeze)
SocialCapital
“Evidenceof
resource
investmentfro
mtheorganisationto
supportpump-
primingof
research,e.g.researchsupportsessions,pum
p-primingmon
eyforpre-protocolor
pilotwork”
PT5.‘Cop
rodu
cing
know
ledg
e’Individu
als/organisatio
nsshareideasandknow
ledg
ede
velopm
entthroug
hne
tworks
andpartne
rships
Beresford[71]
Cop
rodu
ction[72,73]
SocialChang
e
“Eng
agingotherstakeholders–such
asserviceusers,commun
itymem
bers,
health
practitionersan
dpolicy-makers–ishelpfulfor
settingrealisticgoals,
meetinglocalp
rioritiesan
daddressin
gresource
issues.Thisrequiresextensive
participationan
dhencemoreresources”[74]
“Anewkind
ofproductionof
know
ledgeisem
erging
.Thisnewmodelof
know
ledgeproductioniscalled‘Mode2’...M
ode2know
ledgeproductionis
characterized
asmulti-professio
nald
riven,allowingideasan
dknow
ledgeto
begeneratedan
dreflected
upon
within
research
groups
which
combine
heterogeneousskillsan
dexperience.Within
Mode2,research
grouping
schan
gefro
mprojectto
projectan
dtend
towards
non-hierarchical,
networking
arrang
ements”[52]
Symbolic
PT6.‘Feelingthat
youaremaking
adifference’
Individu
als/organisatio
nspe
rceive
that
research
hasan
impact
onhe
alth/w
ealth
/kno
wledg
ecreatio
n/tackling
ineq
ualities
SocialChang
e“Bothnu
rses
hadneverbeen
involved
inresearch
before
butwereactively
interested
intaking
partas
they
perceivedthat
theresearch
processwould
directlybenefit
patientsin
theshortan
dlong
term
,aswella
sgiving
them
theopportun
ityto
learnaboutresearch
throughaproblem-based
approach”[61]
PT7.‘Mod
ellingpo
sitivebe
haviou
rs’
Individu
alsob
servethepo
sitiveim
pact
ofinvolvem
entin
research
byothe
rsin
theorganisatio
n“The
bestaspect
oftheworksho
pwas
having
accessto
senior
GPacadem
ics
–as
rolemodels–an
dmeetingearly
career
researchers—
asreassurance”
“Rolemodellingfro
macadem
icsan
dresearch-m
indedregistrarswas
influential.Itwas
good
todiscover
that
academ
icswereno
tscary!”[75]
PT8.‘Signalling
impo
rtance
and
makingresearch
core
busine
ss’
Individu
alspe
rceive
that
involvem
entin
research
isavalid
activity
inrelatio
nto
compe
tingprioritieswith
intheorganisatio
nSocialNorms
“Som
esawnextstages
asaboutconsolidation,
makingsurethat
gainswere
hard-wiredin
andthat
senior
man
agersthem
selves
wereproactive,forexam
ple
inoperationa
lizingresearch
objectives
throughtheappraisalsystem”[76]
“The
Office
ofResearch
staff…
dono
tbecomeinvolved
ingraduate
student
educationor
research
presentationmaterials.
Thesupportservices
provide
instrumentala
ssistan
cean
dconvey
aclearmessage
abouttheimportan
ceof
preparingcompetitivegran
tapplications”[49]
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 13 of 22
Table
4Review
s(2014–2017)used
tovalidateprog
rammetheo
ries
Autho
r(Year)[Ref]
Con
text
Discipline
Aim
ofstud
yIndicativeIf-Then
s
Borkow
skietal.(2016)[33]
System
aticReview
Allied
Health
Toevaluate
theeviden
ceto
increase
unde
rstand
ingof
factorsthat
couldinfluen
ceAHresearch
cultu
re,in
additio
nto
iden
tifying
theen
ablersandbarriersforAH
profession
alsto
cond
uctresearch
IFindividu
alsareableto
iden
tifyinvolvem
entin
multip
leresearch
activities
andiden
tifyresearch
intheirjobde
scrip
tions,THEN
they
willhave
confiden
cein
theirresearch
skillsandabilities
IFindividu
alsiden
tifyaprob
lem
that
need
schanging
,TH
ENthey
getinvolved
inresearch
activities
Deanet
al.(2017)[77]
LMICs
Health
andHealth
Services
Research
Tocritically
analysecollectivehe
alth
RCSeffort
regardingthelevel,type
,coh
esionandconcep
tual
soph
isticationof
thecurren
teviden
cebase
IFLM
ICsareto
ownresearch
cond
uctedin
theirow
ncontext,TH
ENreflexivity
ontheapprop
riatene
ssof
particular
research
fortheircoun
tryshou
ldbe
encouraged
Ekerom
aet
al.(2015)[78]
LMICs
Health
andHealth
Services
Research
Toiden
tifyed
ucationaland
othe
rinterven
tions
that
workedforclinicians,the
ircharacteristicsandho
wthey
may
have
worked
IFno
vice
researchersreceivemen
torin
gfro
mexpe
rienced
researchers,TH
ENno
vice
researchers
succeedin
research
activities
IFindividu
alsworktoge
ther
inde
sign
ated
research
team
s,TH
ENindividu
alsaresuccessful
inresearch
activities
Franzenet
al.(2017)[48]
LMICs
Health
andHealth
Services
Research
Toiden
tifyandcritically
exam
inethemainapproaches,
strategies
andtren
dsin
health
RCDandconsolidate
keythinking
inorde
rto
iden
tifyamorecohe
rent
approach
IForganisatio
nsde
velopandshareadatabase
ofresearchers,TH
ENresearchersareableto
netw
orkwith
each
othe
rIForganisatio
nsde
velopLM
ICun
iversity
research
training
capacity
using‘trainthetraine
r’prog
rammes,
THEN
individu
alsfeelableto
engage
with
health
research
Gagliardietal.(2014)[36]
System
aticReview
Know
ledg
eTranslation
Toreview
literaturein
managem
entandsocialsciences
andiden
tifyessentialcom
pone
ntsof
men
torin
gprog
rammes
that
couldbe
adaptedforknow
ledg
etranslationmen
torship
IFapreliminaryworksho
pisused
toconvey
know
ledg
epriortomentoring,TH
ENmentoringcan
reinforcethatpriorkno
wledg
e
Hub
eret
al.(2015)[79]
System
aticreview
Health
andHealth
Services
Research
Toreview
toolsandinstrumen
tsto
aidhe
alth
RCD
initiatives
inselectingapprop
riate
toolsand
instrumen
tsfordata
collectionwith
intheirrespective
context
IFnatio
nalo
rganisations
payattentionto
the
sustainabilityof
prog
rammes
andim
pact
evaluatio
n(e.g.param
etersof
patient
care
orsocietalaspects),
THEN
research
meetstheneedsof
thelocalpop
ulations
Kahw
aet
al.(2016)[80]
LMICs
Health
andHealth
Services
Research
Toexplorede
finition
s,concep
ts,app
roache
sand
framew
orks
forRC
B,to
iden
tifyframew
orks
for
evaluatin
gRC
Bin
healthcare,and
tode
scrib
ekey
challeng
esrelatedto
RCBin
LMICs
IFleadership
operates
atan
individu
alandateam
level,TH
ENsenior
researcherssupp
ortjunior
researchers
andcham
pion
thedevelopm
entof
institutio
nalsup
ports
forresearch(includ
ingprotectedtim
eforresearch)
IForganisatio
nsofferon
goingtraining
,men
torin
gand
supe
rvision,sharingof
skillsandexpe
rtiseas
wellas
providingop
portun
ities
toapplyacqu
iredskills,TH
ENindividu
alsde
velopresearch
skills,self-assuredn
essand
apo
sitiveattitud
etowards
doingandusingresearch
IFresearch
questio
nsaregeneratedinconsultatio
nwith
users(practition
ersandotherservice
providers,and
policy-makers),THEN
researchersprod
uceresearch
that
isrelevant
toprevailinghealth
issuesandconcerns
IForganisatio
nssupp
ortapprop
riate
dissem
ination,
THEN
thisen
hances
thesocialim
pact
ofresearch
and
ensuresthat
iteffectivelyinfluen
cespractice
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 14 of 22
Table
4Review
s(2014–2017)used
tovalidateprog
rammetheo
ries(Con
tinued)
Autho
r(Year)[Ref]
Con
text
Discipline
Aim
ofstud
yIndicativeIf-Then
s
IForganisatio
nsestablishessentialresearchstructures
andprovideop
portun
ities
toapplyandextend
know
ledg
eandskillsgained
into
practice,TH
ENorganisatio
nscanachievecontinuity
andsustainability
IForganisatio
nsinvolveacadem
icandmanagem
ent
stafftosupervise
andmanageprojects,provide
protected
timeforresearch,createresearch
positions,and
enhance
know
ledg
eabou
tand
accessto
research
fund
ing
oppo
rtunities,TH
ENorganisations
supp
ortp
articipationin
research/related
capacity-buildinginitiatives
IFresearchersde
veloppartne
rships
andlinkage
sand
thus
expand
intellectualand
socialcapital,TH
ENthis
facilitates
theexchange
ofresearch
skills,know
ledg
eandexpe
rtise
Lode
etal.(2015)[34]
System
aticReview
Nursing
Toiden
tifyandevaluate
eviden
ceof
clinicalnu
rses’
RCBin
practice
IForganisatio
nsstreng
then
nurses’beliefinthevalueof
research
andof
research
team
s,TH
ENnu
rses
will
participateinresearch
activities
Mug
aboet
al.(2015)[81]
LMICs(Africa)
Health
andHealth
Services
Research
Tocontrib
uteto
RCDeffortsby
providinginsigh
tsfro
mdifferent
approaches
that
couldbe
appliedto
othe
rlocatio
nsandto
encouragemorecompleterepo
rting
ofsuch
initiatives
IForganisatio
nsde
velopastrong
institu
tional
infrastructure,TH
ENorganisatio
nssucceedin
securin
gresearch
fund
ing
IFexpe
rienced
researchersmen
torno
vice
researchers
onpu
blications,THEN
novice
researchersareableto
publishtheirresearch
inhigh
profile
international
journals
Nortonet
al.(2016)[35]
System
aticReview
PublicHealth
Toiden
tifyevaluatedstrategies
used
byorganisatio
nsandprog
rammede
velope
rsto
build
theprog
ramme
evaluatio
ncapacity
oftheirworkforce,and
tode
scrib
esuccessfactorsandlesson
slearne
d
IForganisatio
nsde
mon
strate
that
evaluatio
nisan
organisatio
nalfocus
orpriority,TH
ENindividu
alswill
consider
involvem
entin
evaluatio
nto
beim
portant
IForganisatio
nsem
bedevaluatio
ninto
workprocesses
throug
hpo
licyandproced
ures
that
upho
ldevaluatio
nexpe
ctations,THEN
organisatio
nsde
mon
strate
strong
evaluatio
nleadership
AHAllied
Health
,LMICslow-an
dmiddle-incomecoun
tries,RC
Bresearch
capa
city
build
ing,
RCDresearch
capa
city
developm
ent,RC
Sresearch
capa
city
streng
then
ing
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 15 of 22
academic engagement in health systems. Therefore, forexample, the ‘more than sum of parts’ includes valuingand recognising as an asset, the contribution that each in-dividual brings to the partnership, enabling discussion andjoint thinking, access to different networks, and dividingworkload across disciplines. This promotes respectful andmeaningful discussion that can lead to trust and on-goingdialogue and can be underlying mechanisms throughoutdiverse interventions, for example, in priority-setting,grant writing groups, communities of practice, knowledgetransfer partnerships and doctoral training networks. Add-itionally, the resulting outcome provides a new contextthat can activate other mechanisms, for example, ‘copro-duction of research’ and ‘learning by doing’. Thus, the out-come of one mechanism can produce the context tostimulate mechanisms in others. Reviewing theprogramme theories in Table 3 reveals that they formchains of ‘context (C) – mechanism (M) – outcome (O)’,where the outcome of one part of the chain shapes a sub-sequent context within which to stimulate the mechanismin others in the RCD programme. Similarly, ‘liberating tal-ents’, ‘learning by doing’ and ‘releasing resources’ formchains, which may be usefully harnessed when developingfellowship and secondment interventions, for example.A major finding from the qualitative synthesis and
analysis was that many activities fulfil an emblematic(symbolic) role in signalling the importance of RCDwithin the organisations, networks or teams. Therefore,for example, the ‘protected time’ or ‘buy out from otherresponsibilities’ interventions initially seem to serve aninstrumental role in freeing staff from their other dutiesin order to participate in research. On closer examin-ation, however, it is clear that such activities are equallyimportant in demonstrating to staff within an organisa-tion that research is important and should be consideredan organisational/system priority. Similarly, the develop-ment of small funding schemes in research networks or
organisations, engagement in writing workshops and thepromulgation of mentorship schemes assume signifi-cance beyond their monetary value in signalling that re-search is valued and hence an activity in which it islegitimate for staff to engage. A common trigger for allmechanisms is ‘making a difference’, which can stimulatemotivation in stakeholders across the RCD programme,and can be seen as a community building exercise.
Validation and refreshment of programme theoriesCitation searches for the 10 citation pearls in December2017 identified a further 10 systematic reviews publishedbetween 2014 and 2017 that met our original inclusioncriteria (Table 4). Collectively, these covered all the RCDactivities (Box 1) and reflected the diversity of contextsidentified in the original dataset (e.g. high- (n = 5) andlow- and middle-income countries (n = 5); allied health[33], nursing [34], public health [35], and health andhealth services research (n = 6), etc.). A new additionwas in the emerging field of knowledge translation [36].Again, the papers represented all the identified activitiesof RCD (Box 1), yet, since they were all reviews, theywere more likely to describe multiple activities than theoriginal dataset (Table 5).
Table 5 Activities identified in reviews (2014–2017)
Author (Year) [Ref] Research capacity development activitiesincluded
Borkowski et al. (2016) [33] Infrastructure, Leadership, Mentorship,Training
Dean et al. (2017) [77] Infrastructure, Networks, Training
Ekeroma et al. (2015) [78] Mentoring, Networks, Training
Franzen et al. (2017) [48] Leadership, Mentoring, Networks, Training
Gagliardi et al. (2014) [36] Mentoring
Huber et al. (2015) [79] Infrastructure
Kahwa et al. (2016) [80] Funding, Infrastructure, Leadership, Mentoring,Networks, Training
Lode et al. (2015) [34] Funding, Leadership, Networks, Training
Mugabo et al. (2015) [81] Infrastructure, Mentoring, Training
Norton et al. (2016) [35] Infrastructure, Leadership, Training
Box 1 Activities undertaken in research capacitydevelopment (RCD) (from Re:CAP [10])
1. Prioritisation: Developing research priorities from consensus
views of informed participants.
2. Mentoring: where an experienced, highly regarded person
(the mentor) guides another individual (the mentee) in the
development and examination of their own ideas, learning,
and personal and professional development.
3. Leadership: the process of influencing group activities
towards the achievement of RCD goals.
4. Research facilitators: individuals whose role is explicitly to
promote and enable the conduct of a research by those with
limited research experience.
5. Training: interventions that aim to increase skills and
knowledge.
6. Funding to develop RCD including bursaries and
fellowships.
7. Networks and collaborations: structures and functions that
support people to work together to improve knowledge
transfer, innovation, a research process or an output.
8. Infrastructure: a range of activities used to enhance support
of RCD.
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 16 of 22
The identified reviews confirmed the originalprogramme theory, adding a nuanced understanding ofmany RCD activities. However, the new dataset did notidentify any new strands of programme theory, possiblyindicating that theoretical saturation had been reached.Evaluation, debatably an RCD activity in its own right,emerged as increasingly prominent in the recent litera-ture. However, evaluation was considered to be a subtextto all the other activities and was not included as anadditional activity. Future conceptual models should en-sure that they feature evaluation, albeit to be handleddifferently from other activities.
DiscussionMany governments and global partnerships invest consid-erable funds to support RCD in healthcare, and it is amoral and ethical imperative to develop, shape and evalu-ate such activity [37] in order to plan and attain thedesired effect, and to justify continued funding [16]. Thisunique realist synthesis of the conceptual literature onRCD has uncovered mechanisms that operate beneathsuch activities which, we suggest, can function across andwithin different structural levels with an emphasis ofmeaningful societal impact. We suggest that theprogramme theories developed here might help to planand demonstrate cohesion and alignment across structurallevels. Several authors recognise that RCD activities needto take place concurrently at a number of different levels[1, 8, 13], with many calling for a ‘whole systems’ approachto RCD [3, 19]. We propose that the programme theoriesdeveloped here could act as a guide for application acrossthe diverse individual, organisational and network levels inorder to promote synergy and ensure RCD activities ‘pull’in the same direction.Social change is the ultimate outcome for RCD [8]. The
programme theories presented here, particularly thosedescribed as ‘symbolic’, can provide visible mechanisms ofhow RCD might influence culture, leadership and motiv-ation. Many of these mechanisms have foundations intheories of social change and social capital, and provide anexplanation of how interventions that adopt such anapproach can engender a research culture within organisa-tions and networks, and reciprocity and leadership inindividuals.Our programme theories resonate with others that
explain how research activity can promote impact inhealthcare organisations and communities [38, 39, 40].Whilst training in research traditionally includes researchmethods, data collection and analysis skills, the co-pro-duction programme theory suggests diverse skills of crossboundary working, negotiation and creative practices inknowledge production [39]. Researchers using aco-productive approach are more likely to align research
with stakeholder and organisational objectives [1] andform dynamic partnerships using assets from different or-ganisations and networks [38] to make a difference.Under what circumstances are RCD interventions
most likely to achieve their intended effect? Our analysishas identified several principal components from a the-oretical perspective:
1) RCD interventions may act as a catalyst forreleasing potential research energies from withinindividuals and organisations. This is most clearlyseen in the programme theories that relate to‘Exceeding the sum of the parts (PT1)’, ‘Liberatingthe talents (PT3)’ and ‘Releasing resources (PT4)’.The implication is that, without such triggers, theorganisation and individuals remain essentially inertor slow moving with regard to their engagement inresearch activities.
2) RCDs must meet criteria for observability, meaningthat current and potential participants must be ableto perceive potential and actual benefits from theirinvolvement. This is most clearly seen in thecollective programme theories labelled as symbolic(or emblematic), i.e. ‘Feeling that you are making adifference (PT6)’, ‘Modelling positive behaviours(PT7)’ and ‘Signalling importance (PT8)’. However,it is additionally present within the ‘Learning bydoing (PT2)’ programme theory, where trainers andtrainees receive almost synchronous confirmation ofpersonal growth and skills acquisition.
3) RCDs must secure the engagement andcommitment of their stakeholders and beneficiaries.Such commitment may be overtly signalled throughexplicit strategies or statements on research,through the celebration of achievements andthrough the provision of protected time from thedemands of competing activities (‘Signallingimportance PT8). It can also be secured by co-creation opportunities through ‘Releasing resources(PT4)’ and ‘Coproducing knowledge (PT5)’ withadded opportunities for ‘Feeling that you aremaking a difference (PT5)’.
4) Possible linkages and C-M-O chains are emerging,where the outcome of one mechanism stimulatesanother within the programme architecture, andcan act as leverage within it. For example, themechanisms that are symbolic (PT6–8) maynurture a research culture that acts as a backdropto other activities (P1–7). Variation in this culturalbackdrop can be conceived as the effect of adimmer switch [41] by which the range ofoutcomes of the symbolic mechanisms havecorrespondingly greater or lesser influence onassociated RCD activities. The more evident a
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 17 of 22
research culture, the more assets/resources thatculture is able to bring to the RCD architectureand, correspondingly, the more power releasedwithin the dimmer switch to stimulate a range ofmechanisms across the programme.
Thus, the findings from this realist synthesis of theconceptual RCD literature offer a starting point for con-structing a RCD framework shaped by these programmetheories. Future work should include exploration, elabor-ation and iterative refinement of these programme the-ories through exploration with other theory (somesuggestions are included in Table 3), and testing againstempirical data from intervention studies [42, 43].
StrengthsWe have taken a first step in developing components ofan overarching theory to determine what works forwhom to accomplish ‘more research done well’. Searcheswere conducted across a wide range of databases andwere supplemented by exhaustive reference checkingand citation tracking. The 36 conceptual and theoreticalpapers we identified are derived from diverse settingsand describe RCD activities at multiple levels, strength-ening confidence in the identification of candidatemechanisms. All major RCD activities are identifiable inboth the included set of papers and in the validation setof recent reviews with which we tested our initial find-ings. Our realist-based approach offers an opportunityfor a more nuanced understanding of how interventionsmight work and, indeed, in understanding circumstancesin which they may not, which goes beyond the merepresence or absence of a specific intervention, a seren-dipitous bundle of collective interventions or a tailoredpackage of synergistic initiatives.
LimitationsThe systematic mapping process was subject to time andresource constraints and was primarily conducted byone investigator. Validation of a 20% sample was per-formed by the other two investigators to sensitise teammembers to the characteristics of the evidence base. Theteam reached a consensus on what should be recognisedas constituting a model, theory or framework but didnot distinguish between these three contested terms.The articles studied for the presence of programme the-ory were purposively sampled from a wide range of can-didate studies and were selected to represent diversesettings and contexts and because of the perceived rich-ness of their data.Our preliminary findings have already been shared with a
group of nine National Health Service organisations whomeet to promote organisational development in RCD,called ACORN (Addressing Capacity in Organisations to
do Research Network) [44]. Individuals were able to com-ment on the extent to which these programme theories fitwith their practical experience of RCD.Potential implications, based upon our theoretical
frameworks, for those planning RCD at different con-textual levels are given in Box 2.
ConclusionsRealist evaluation approaches are increasingly commonwhen evaluating specific interventions in RCD [45, 46,47]. Other authors are further using innovative literaturereview methods in order to explore development strat-egies for RCD [48]. We believe that this is the first timethat the innovative approach of realist synthesis has beenapplied to conceptual papers on RCD in order to isolatethe underpinning RCD programme theories. The valueof this approach is in drilling down beneath the activitiesof a programme to identify the mechanisms that are de-ployed therein.This review found that, collectively and individually,
RCDs engage with multiple defined programme theoriesto achieve their potential impact. Such programme theor-ies have a role in developing new RCD interventions, inmodifying existing initiatives, and in creating a compre-hensive evaluation framework against which to measureachievements. We have been able to tentatively explorehow C-M-O might link to develop ‘trigger’ chains andspeculate how symbolic mechanisms may link to interven-tional ones. This needs to be explored further within inter-vention studies. Our initial work requires furtherdevelopment to extend the analysis and thus cover a fullrange of RCD interventions, mapping both activities andevaluation measures by intervention, stage in the develop-ment lifecycle, and by programme theory.Our investigation represents an overt attempt to capital-
ise on the utility of realist synthesis for the specific tasksof theory generation and subsequent exploration of poten-tial mechanisms. Gough et al. [28] characterise the poten-tial contributions of synthesis in general in terms ofgenerating, exploring and testing (G-E-T) of theory. Asubsequent stage of this project is therefore to test theseemergent concepts with reference to empirical studies,either relating to research capacity as a composite activityor to the individual interventions by which we characteriseresearch capacity activities. Planned outcomes from thesubsequent stages of this project include identifying whichmechanisms are associated with specific types of interven-tion and the development of an evaluation frameworkwith which to assess the achievements of general RCDprogrammes and their constituent interventions.Our novel evidence-based model identified 36 concep-
tually rich papers relevant to RCD. Although we acknow-ledge that other papers hold the potential to inform our
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 18 of 22
Box 2 Potential implications when planning RCD
Funding bodies
� Develop research priority-setting mechanisms to release resources to fund research that can ‘make a difference’. Priorities should be
agreed between stakeholders to co-produce knowledge that will have an impact on health and wealth.
� Develop funding opportunities to support ‘learning by doing’ opportunities for individuals, to compliment more formal research
training.
� Fund career pathways and liberate talents through actively seeking individuals with potential, and fund coaching and mentorship to
maximise this.
� Fund appointments between healthcare and academic organisations to support partnerships that exceeds sum of parts and co-
production of research, and provide positive role models.
� Develop funding calls to a release resource and signal importance of research activity within healthcare organisations. For example,
through a matched funding model in large research programmes, and protected time agreed with managers in ‘learning by doing’
opportunities.
� Fund novel methods of research dissemination that promote action in clinical and healthcare practice so that the research findings
can make a difference, and signal importance of implementing research knowledge into practice.
Healthcare organisations
� Signal the importance of research activity within the organisation through job descriptions, mission statements, training and R&D
strategies. Support business plans in order to release resources that will include protected research time and ring-fenced research
resources.
� Recognise and celebrate positive research behaviours in clinical academic staff, managers and services through award schemes and
communication channels.
� Enable mentoring and coaching schemes to be undertaken in their organisation in order to release potential talent and support
learning by doing activities.
� Seek and support ‘learning by doing’ programmes as well as more traditional research training opportunities.
� Develop a needs and assets register to recognise and liberate talent.
� Develop a sense of ownership and commitment to research activity, through co-creation of research ideas, observable instances of
quick wins and impact success stories, to demonstrate research that makes a difference.
� Work proactively in partnership with other organisations, networks and academic institutions to maximise synergies, coproduction,
‘learning by doing’ opportunities.
Individuals:
� Recognise the personal, organisational and long-term benefits from their own involvement in research to make a difference and to
demonstrate positive research behaviours.
� Seek and use leaning by doing opportunities.
� Support release of their own talents, and that of others around them. Be both a mentor and a mentee. Use coaching opportunities
to release their own potential.
� Work with managers to negotiate protected time to signal importance of research alongside practice.
� Develop skills to support coproduction of research, and plan research activity that has an impact on practice to make a difference.
� Are able to develop skills and knowledge through practical involvement in research activities, including alignment to organisational
objectives.
Cooke et al. Health Research Policy and Systems (2018) 16:93 Page 19 of 22
theory development, particularly in relation to the charac-teristics of individual interventions, we believe that wehave identified the more common and significantprogramme theories that relate to RCD. We anticipatethat further exploration will reveal a point of theoreticalsaturation and may help in identifying some of the nu-ances or, indeed, disconfirming cases, associated with spe-cific RCD initiatives. Ultimately, we hope that theconceptual framework presented in this paper will con-tribute to the demonstration of long-term outcomes inhealth, wealth and knowledge as commissioners and ser-vice providers work together to increase RCD.
Additional file
Additional file 1: The 36 studies describing conceptual models,frameworks or theory for research capacity development. (DOCX 35 kb)
AbbreviationsKM: knowledge mobilisation; RCD: research capacity development;Re:CAP: Research Capacity – A scoping review to identify the evidence-basefor Research Capacity development in health and social care
FundingThe authors of this paper were funded and supported by the NationalInstitute for Health Research (NIHR) Collaboration for Leadership in AppliedHealth Research and Care Yorkshire and Humber (NIHR CLAHRC YH)(www.clahrc-yh.nihr.ac.uk). The views and opinions expressed are those ofthe authors, and not necessarily those of the National Health Service, theNIHR or the Department of Health.
Availability of data and materialsThe datasets used and/or analysed during the current study are availablefrom the corresponding author on reasonable request.
Authors’ contributionsJC and AB conceived the study. PG conducted the subject searches andpursued the citation pearls. All three authors undertook study selection. JCand AB extracted data from included studies. All authors participated in theanalysis and the interpretation of review findings. All authors read andapproved the final manuscript.
Ethics approval and consent to participateNot relevant, this is a literature review with no primary research data or datafrom human subjects.
Consent for publicationNo individual person’s data in any form.
Competing interestsThe authors declare that they have no competing interests.
Publisher’s NoteSpringer Nature remains neutral with regard to jurisdictional claims in publishedmaps and institutional affiliations.
Author details1NIHR CLAHRC Yorkshire & Humber, Research Capacity and EngagementProgramme Management, 11 Broomfield Road, Sheffield S10 2SE, UnitedKingdom. 2Department of Public Health and Pediatrics, University of Turin,Turin, Italy. 3School of Health and Related Research, University of Sheffield,Regent Court, 30 Regent Street, Sheffield S1 4DA, United Kingdom.
Received: 7 April 2018 Accepted: 17 August 2018
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