Exploring societal impact: “You need to listen and be flexible.”
As part of 50Ȼ’s strategic partnership with The Association of Universities in the Netherlands (VSNU), we’re interviewing researchers from a whole range of disciplines about their experiences of creating societal impact through research.
In this interview, we speak to , assistant professor at the Department of Health Sciences, Vrije Universiteit Amsterdam, and the Dutch national project manager of Care for Obesity. She works on the improvement of care for children with obesity in order to better their health and quality of life now and in the future.
You’re a strong supporter of combining research, policy and practice. Can you tell us a bit about how you do this in your own work?
It's an ongoing process that, in the Netherlands, we call valorisation. And it's there in all stages of our research.
From the very beginning, when we think of a research question, we get input from people in practice and from people that the research may impact to understand what the research question should be.
Then, when we execute the research, we involve the target groups for the research. In this case, that means we involve children with obesity and their parents, we involve healthcare professionals that treat these children, and we involve policymakers who influence the local organisation of healthcare interventions.
Finally, we contribute to implementing the results of our research in collaboration with societal partners. This last step is really important. The process doesn’t stop once you're done with the research, the results are there, and you have your publication for a scientific journal prepared – implementation should not be forgotten. And it won’t happen by accident or as a natural result of your work. You really have to push for it.
So we’re working on societal impact throughout the entire research process. And I believe that’s vital because if you only look at it in the last phase, you’ll have missed a lot of opportunities to make the research more relevant and more impactful.
Do you measure the societal impact of your work? And if so, how?
We don't measure it, as such. But I do look at the number and kinds of collaborations we have as this gives an indication of the reach and impact we can have.
We have an increasing number of different types of organisations that we collaborate with and we're always widening our scope. We started out with healthcare professionals, patients, and insurance companies. And then eventually we added municipalities and policymakers in different fields. Then healthcare professionals from more fields. And all the while, we’ve been increasing engagement with patients – the children – and their families too.
We’ve found that as time has gone on and the more research we’ve done, the more partners we’ve sought out. And that’s the measure of success I’m seeing at the moment – that we’ve got more and more productive partnerships that are helping us to ensure our research has an impact.
Of course, I’m aware that collaboration in itself is not the impact we’re ultimately aiming for. Our aim is healthier children – but that's something that's really hard to measure, in the sense of knowing to what extent we’ve contributed to progress. So we’re not measuring that – yet.
That’s an impressive variety of organisations and stakeholders that you work with. Could you tell us a bit about how those relationships developed?
The collaborations we’ve established grew organically from the research path we’ve followed over time. I started out looking at the national guidelines for the diagnosis and treatment of obesity. My professor, at the time, was the chairman of the development of this guideline, and our question was, “What’s the next step?”
We discussed it with the Ministry of Health, who said the next step should be to develop this guideline into a national healthcare standard – which is more geared towards practice. And having looked at a number of other healthcare standards, we saw that they had usually been developed in collaboration with patients, healthcare professionals and healthcare insurance. So we decided to do the same.
And through this work, it then became clear that research was needed to enable the reimbursement of this care. So, we started to collaborate with the Dutch National Institute for Healthcare Insurance.
After a few more additions, and once we had the healthcare standard established, we then had feedback that it would be a good idea if we would develop the standard into a national model – something that could be used as a blueprint for people to follow at a local level. And this national model was made together with municipalities – so that added another layer of collaboration.
This has continued to grow and change over a number of years. We couldn’t have known 10 years ago what we know now. We couldn’t have predicted the research we would end up doing. I think it’s been vital in building these collaborations that we’ve been able to listen to the people and organisations involved and flex our plans to accommodate their feedback and input.
When people come to work for me now, one of my key questions is: "How flexible are you?" Because if they’re not flexible, the way we work just isn’t going to work for them.
You’ve spoken about how you involve patients and partners in the research process. What about communicating results? What approach do you take?
At the end of the process, we communicate with a number of different groups in mind. For example, the children that we do the research with, their parents, the public, healthcare professionals, policymakers and, of course, fellow researchers. And each group needs its own approach.
For the children, we make a one-page summary in really easy-to-understand language, which thanks them for taking part and also simply explains the results of the research. And then, for a broader audience of children, we seek media opportunities. So, for example, last year, we had an item in the national youth news broadcast that's on every day.
For parents, we try to get media attention too. And when we're in the national or local media, of course, it's also read and seen by people from policy and practice, as well as by fellow scientists. It’s a great means of getting across our message and it also tends to create a snowball effect – once you're in the news, on the radio, in the newspapers, journalists have you on their shortlist of numbers and they call you again and again.
For healthcare professionals, we additionally took a whole different route. For example, we’ve developed tip sheets, a web tool, and workshops to help them understand how to use our model.
In addition, for policymakers, we make implementation tools that they can use locally, as well as easy evaluation tools. We even made a short movie they can watch to help them quickly understand our messages.
And of course, last but not least, we publish in scientific journals and attend conferences to reach our fellow researchers.
That sounds like it takes an incredible amount of work and dedicated time, but also specialist skills in communicating with so many audiences. How do you manage that?
Yes, it definitely takes time. But you also have to know how to go about it. I probably have an advantage in this regard because I was a journalist for 10 years.
As a journalist, I was taught that you have to write as though you’re explaining something to your old aunt. That's the level that's needed for a broad audience to understand it. And it’s a very different approach from writing a scientific paper, but I believe that with a bit of practice anyone can do it. It’s about changing your mindset and imagining the person you’re explaining it to.
Why do you think societal impact is important and what’s your advice to early career researchers who want to create an impact with their work?
For me, societal impact is crucial, vital. It's what I get out of bed for in the morning, not the impact factor publications or more citations in higher-rated journals. It's the societal impact and the changes I can see are needed.
I think our research can help achieve those changes. By doing that, we can help improve the lives of people – in my case the lives of children with obesity – and help decrease socioeconomic health differences in society. I think that’s something very important for researchers and, more broadly, universities to aim for.
It’s difficult for early career researchers at the moment because the reward system is very much geared towards publications, impact factors, and so on. I don’t feel that that’s fair. I don’t think it’s the way it should be.
In the Netherlands, by law universities have three tasks. One is research, one is education, and one is valorisation (societal impact). And as far as I’m aware, those three tasks are not prioritised one over the other. So, that's what we should be doing as academic professionals and that's what we should also be held accountable for or be rewarded for. But that's not the way it's working at the moment
I got a question only yesterday from a PhD student in my department. She told me she loves the way I work and my ideas for valorisation, but she wanted to know how to start a conversation about it with her supervisor. She was concerned they wouldn’t want her to put time or funding towards it. She was essentially asking, “How can I frame this so that they’ll let me do it?”
At the moment, I find my advice for early career researchers ends up being: Make sure you reserve plenty of time for this work if you want to do it, but realise you might not get rewarded by your academic institution for it. Essentially I feel I’m telling them, prepare to be disappointed.
And to me, this seems wrong. Early career researchers need to be encouraged. They need real-life examples of how to do it. They need time and support from their supervisors. And, of course, they also need acknowledgement and reward for the work.
There's so much satisfaction to be gained in striving for societal impact. And there's so much to gain for society. If we don't reward this, fewer people will do it or it will be done less intensively, and that's a big loss for society.
About Jutka Halberstadt
Jutka Halberstadt, PhD, is assistant professor childhood obesity at the department of health sciences at the Vrije Universiteit Amsterdam in The Netherlands. As the national project manager of Care for Obesity, that is commissioned by the Dutch Ministry of Health, she works on improving integrated health care for children with overweight and obesity and their parents.
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