Mobilising knowledge in public health : analysis of the functioning of the Scottish Public Health Network
The extent to which the knowledge mobilisation potential of public health networks is actually achieved in their functioning has not been previously studied. There are prescriptions from policy documents and from research literature as to the form networks in health should take and the way they should operate. However, there has been little research connecting the nature of the networks and the manner in which they function to their knowledge mobilising ability. Constituted in 2006, the Scottish Public Health Network (ScotPHN), which is the primary vehicle in Scotland for mobilising public health knowledge and informing policy and practice, constitutes the location for this study investigating this knowledge mobilisation and how networks function in public health. Feedback from the consultation conducted prior to the formation of ScotPHN was obtained. Interviews were conducted with the members of the ScotPHN steering group, a project group and the stakeholder group. Two ScotPHN steering group meetings were also attended by the author as an observer. The consultation feedback, transcripts of the interviews and those of steering group meetings were analysed using the constructivist version of the grounded theory approach. The process involved coding and abstracting codes to categories and themes. The emerging themes were reviewed in the light of existing literature on networks and knowledge mobilisation. These themes were then used to develop a model to understand how the network operates and consequently mobilises knowledge. The study shows that prior to its formation ScotPHN was expected to address the fragmentation of the public health workforce; significantly enhance links amongst existing public health networks; support ground level knowledge exchange amongst practitioners and significantly enhance multisectorial working. None of these expectations appear to have been met. ScotPHN has, however, managed to fill the gap left by the demise of the Scottish Needs Assessment Programme (SNAP). ScotPHN’s structure and the manner in which it is controlled lead to it being akin to a policy community rather than an issue network. The generic public health concerns of the steering group and the selective nature of the project group prevent it from functioning as an issue network. The dominance of people from the medical profession also causes a social closedness in the ScotPHN steering group. The limited multisectorial participation in its activities results in: a lack of constructionist learning; limited inclusion of the social context of knowledge; and a deficit of Mode 2 knowledge mobilisation. In the context of knowledge conversion there is some evidence of externalisation but no socialisation. ScotPHN is not a network that can be classed as a community of practice. This study highlights how health policies, which have advocated the establishment of networks, could derive considerable guidance from research into how networks actually function. With respect to the knowledge mobilisation activity of these networks the study finds that top-down and prescribed structures are unable to capture the transdisciplinarity and diverse intellectual frameworks that contribute to public health knowledge. It is seen that the hierarchical network structures can undermine the engagement of actors from the less represented sectors. Additionally the study finds that the established patterns of professional power and control further hinder multisectorial engagement.