Abstract

For health researchers who seek more research use in policy making to improve health and healthcare, working with the news media may represent an opportunity, given the media's pivotal role in public policy agenda-setting. Much literature on science and health journalism assumes a normative stance, focusing on improving the accuracy of news coverage. In this study, we investigated journalists' perspectives and experiences. We were particularly interested in learning how health researchers could work constructively with journalists as a means to increase research use in policy making. Qualitative methods were used to conduct and analyze interviews with experienced newspaper journalists across Canada, with children's mental health as a content example. In response, study participants emphasized journalistic processes more than the content of news coverage, whether children's mental health or other topics. Instead, they focused on what they thought researchers needed to know about journalists' roles, practices and views on working with researchers.

Newspaper journalists balance business and social responsibilities according to their respective roles as editors, columnists and reporters. In practice, journalists must ensure newsworthiness, relevance to readers and access to sources in a context of daily deadlines. As generalists, journalists rely on researchers to be expert interpreters, although they find many researchers unavailable or unable to communicate with public audiences. While journalists are skeptical about such common organizational communications tools as news releases, they welcome the uncommon contributions of those researchers who cultivate relationships and invest time to synthesize and communicate research evidence on an ongoing basis. Some appealed for more researchers to join them in participating in public conversations.

We conclude that there are opportunities for policy-oriented health researchers to work constructively with newspaper journalists - by appreciating journalists' perspectives and by taking seriously some of their suggestions for engaging in public conversations - and that such engagement can be a means to increase the use of research evidence in policy making and thereby improve health and healthcare. [To view the French abstract, please scroll down.]

Health researchers often hope to see the best available research evidence used in public policy making to improve health and healthcare. Journal articles frequently begin with a lament over research-policy "gaps" and end with the refrain that policy makers should use more research evidence. A burgeoning theoretical and empirical literature delineates factors that may increase the use of research evidence in clinical, administrative and legislative policy making (Innvaer et al. 2002; Grol and Grimshaw 2003). However, advocates for evidence-based policy may not always appreciate the many influences on the policy process that regularly outweigh the influence of research evidence (Lavis et al. 2003). For many researchers, policy making effectively remains a "black box." For those who wish to see more research used in policy making, learning more about what goes on inside this black box is an essential starting point.

The news media offer a window into the black box of policy making. Their participation in the public policy process is extensive, so much so that they are considered by some to be de facto political institutions (Cook 1998). Specifically, the news media help set the policy agenda by focusing public attention on certain issues at the expense of others (Glynn et al. 1999; Kingdon 2003). The process of agenda-setting involves multidirectional influences among the public, policy makers and the news media as issues emerge and recede (Soroka 2002). Yet, there are limits to the media's influence. They may determine what the public and policy makers think about, but they do not necessarily determine what the public and policy makers think (Cohen 1963; Glynn et al. 1999).

Even with the advent of radio, television and the Internet, newspapers remain influential as the medium of record (Siegel 1996). Historically founded as partisan political fora, Canadian newspapers have become a vital communications medium for a small population dispersed across a large country (Rutherford 1978). Newspapers such as the Globe and Mail serve national audiences, while myriad newspapers serve regional audiences, including the Toronto Star, which has the highest daily circulation in Canada (Audit Bureau of Circulations 2005). Despite the proliferation of newspapers (and other media), coverage of the most salient issues for Canadians remains relatively consistent across the country (Soroka 2002), as do journalists' practices and perspectives, including in Quebec (Pritchard and Sauvageau 1999).

The scholarly literature on journalism is disparate, but one unifying feature of it is that authors from many disciplines adopt a normative stance on what journalism ought to do (Zelizer 2004). In the literature on science journalism in general, much conversation focuses on improving the accuracy of news coverage (Weigold 2001). News coverage is the subject of particular scrutiny and criticism in the literature on health journalism (Entwistle and Watt 1999). Health researchers note that media campaigns can facilitate significant changes in health behaviour and health services utilization (Grilli et al. 2004; Snyder et al. 2004). Health researchers have also established that news coverage of therapeutic risks and benefits can be inaccurate or incomplete, raising concerns that media can encourage inappropriate changes in behaviour and services utilization (Moynihan et al. 2000; Cassels et al. 2003). Consequently, many health researchers suggest interventions to make news coverage less "sensational" and more "evidence-based," for example, by training journalists in the critical appraisal of research evidence (e.g., Oxman et al. 1993; Larsson et al. 2003; Moynihan 2003; Schwartz and Woloshin 2004).

In addition to this prescriptive literature, there is also an emerging literature on mutually beneficial associations between journalists and researchers (Nelkin 1987; Dunwoody 1999). Many journalists obtain story ideas from articles in high-impact academic health and science journals and from the authors of these articles (van Trigt et al. 1995). Journalists also describe seeking researchers to ensure accurate coverage and interpretation of research findings (Weiss and Singer 1988; Geller et al. 2005). Many academic journals promote news coverage by providing journalists with advance news releases and embargoed articles (Kiernan 1998; Woloshin and Schwartz 2002). In turn, news coverage can increase the impact of researchers' work. When scientific articles receive prominent newspaper coverage, subsequent scientific articles cite the authors significantly more frequently (Phillips et al. 1991; Kiernan 2003). Interestingly, newspaper articles can accurately convey health researchers' results and claims, even to the point of mirroring researchers' own claims overemphasizing benefits and under-representing risks of new health technologies, suggesting that researchers can be complicit in conveying exaggerated messages (Bubela and Caulfield 2004).

Given the abundant critiques and the evident reciprocity, surprisingly few studies have investigated research coverage issues from journalists' perspectives (Zelizer 2004). In this study, we investigated newspaper journalists' views on working with researchers. We were particularly interested in learning how policy-oriented researchers could work constructively with journalists as a means to increase research use in policy making and thereby to improve health and healthcare. Using qualitative methods, we conducted and analyzed interviews with experienced newspaper journalists across Canada, with children's mental health as a content example. We chose this content example because mental health problems are arguably the leading health problems that Canadian children face after infancy, yet public policy often fails to reflect the best currently available research evidence on effective prevention and treatment options (Waddell et al. 2005). Furthermore, children's mental health problems can generate intense news coverage, such as during public debates about youth crime (Doob and Cesaroni 2004). This study is part of a larger project investigating the use of research evidence in public policy making, using the example of children's mental health to explore interactions among policy makers, journalists and researchers (Waddell et al. 2005).

Methods

We purposively selected journalists at daily newspapers who had an interest in children and who had experience covering children's mental health issues. We defined children's mental health broadly to include topics in health, education, social affairs or justice. We sought editors, columnists and beat reporters at national newspapers (with mandates to cover all regions across Canada) and regional newspapers (with mandates mainly in a single region). Quebec newspapers were not included, owing to lack of capacity to conduct or translate interviews in French. McMaster University and the University of British Columbia provided ethical approval for procedures to obtain informed consent and to protect participants' confidentiality.

Data collection comprised semi-structured interviews with participants (Miles and Huberman 1994; Denzin and Lincoln 2002). Interviews were conducted in 2000. The lead author (or trained research staff) interviewed participants in their own settings for 60 to 90 minutes. We inquired about journalists' experiences in general using open-ended questions, then probed about their experiences with researchers. All interviews were taped and transcribed verbatim. Field notes and interview transcripts were organized using secure file systems and QSR NUD*IST qualitative software (Gahan and Hannibal 1998).

Three authors (CW, JNL, JA) reviewed transcripts as the study proceeded to identify basic concepts and to reformulate questions as needed. We stopped collecting data when conceptual saturation was reached. Three authors (CW, CAS, TBG) conducted the main data analysis using the constant comparative approach that underpins grounded theory methods (Strauss and Corbin 1998). We independently reviewed each transcript, identified basic concepts discussed and created an electronic database with codes for each concept. We then explored our different interpretations and together identified themes emerging from the data. Throughout, we made constant comparisons with the interview transcripts and the coding to ensure that themes were broadly representative, were particularly compelling or lent coherence to the overall thematic analysis. Another author (JNL) independently reviewed several transcripts to verify the thematic analysis. The entire team then reviewed the analysis, explored different interpretations and agreed on a final selection of themes. Throughout the study, our interdisciplinary team ensured a diversity of theoretical perspectives including child psychiatry, health policy, political science and the social sciences more generally. This diversity enabled us to challenge our assumptions and interpretations at every stage.

Findings

Participants comprised 12 newspaper journalists who each had five years' experience or more covering a range of topics related to children's mental health. These topics included child development, children's services, healthcare, school programs, social affairs and youth justice. Editors, columnists and beat reporters were equally represented. National dailies were included, but most were regional dailies from different parts of Canada. Newspapers had mean weekday circulations over 200,000 and mean weekend circulations over 300,000 (Audit Bureau of Circulations 2005).

Our questions were framed in terms of children's mental health. Participants acknowledged that stories about children appealed to newspaper readers, and commented that children's coverage was often polarized between stories about "gifted" or "cute" children and troubled children. Other than this, however, study participants were disinclined to discuss the content of news coverage, whether children's mental health, children's health or children's content. Instead, they focused on what they thought researchers needed to know about journalists' roles, practices and views on working with researchers. In presenting these three generic themes that constitute our findings, we have selected quotations from participants that provide the clearest expression of each theme.

Journalists' roles within newspapers

As with any business, newspapers must generate profit to remain viable. Editors, in particular, assume responsibility for both the commercial and editorial success of newspapers. However, they are quick to assert their independence to create editorial policy: "The only model that works is to serve the readers first and worry about the advertisers second." Conversely, some columnists and reporters suggest that their role is simply to "fill the news hole," the space that remains after advertising placement.
Newspapers are fascinating. What happens here every day is a collision between the quasi-intellectual process and the manufacturing process, which starts with our deadlines and ends with production of the newspaper. It's a chaotic environment where many people with different interests and different expertise compete for the relatively limited space in the newspaper. - Editor A

Newspaper journalists also vigorously embrace social responsibilities: "We still see ourselves as having a social conscience." Editorial policy can cultivate an activist culture in a newsroom. If an editor "takes sides," then "politicians have to respond." Meanwhile, columnists and reporters can draw attention to "inequities that should be addressed by government." Many reporters engage in social activism based on a sense of responsibility to their sources and their readers: "As a human being, you want to save them; as a reporter, you're there to tell their story." Most reporters could cite news stories that "sparked debate in the legislature" or led to "direct changes in legislation."

We made it the centrepiece of the election. They tried pretty hard to ignore it but it's on our agenda and we're hammering it. - Editor B

Within the newspaper hierarchy, journalists balance their business and social responsibilities according to their respective roles as editors, columnists and beat reporters. Editors assume a central role, selecting stories to appeal to a diverse readership in order to sell newspapers, increase advertising revenue and ensure profitability. Prominent coverage usually reflects the editor's perspective: "If the word comes down that the editor is interested in something, you can be assured that it gets more and more coverage." Columnists and beat reporters also perform distinct roles. Columnists are distinguished by autonomy from routine news coverage. They consider it a privilege to "have the same assignment for 10 years," in which they can pursue interests beyond the nominal topic of their column and can employ their position to exercise persuasion: "One column can stop an idea from gaining power." Like columnists, beat reporters gain experience and autonomy, but they must still pitch their stories to editors who make the final news judgments.

We had a huge debate in this city about the anti-homophobia campaign in the schools. All the local churches met as a group and said, "We want homophobia stopped now." Then one parent said, "I'm pulling my kids out of the public system and putting them in private school. You can't tell my kids that homosexuality is normal." This one parent happened to be a retired football player. Guess what the lead was on that story? We argued, but the editor overruled us. That retired football player became more important than all those churches. - Reporter D

The daily practice of newspaper journalism

The principles of newsworthiness and relevance to readers underlie journalistic practice. Many stories are event-based: "We are controlled by what happened yesterday." Yet, it is axiomatic to journalists that only extraordinary events are newsworthy: "If someone's not doing something out of the ordinary, it's not news." Journalists describe using their "noses," or intuition, as the basis for deciding whether events are newsworthy: "We're trying to make sense of a chaotic world." Along with newsworthiness, however, it is axiomatic that newsworthy events must be relevant to newspaper readers: "What does it mean to the woman serving coffee at the doughnut shop?" When choosing to pursue a story, journalists also ensure that many readers are affected.
It's subconscious by now. The main question is whether the issue affects patient care, whether it'll do harm or do good. I get those answers by talking to people who need the services. Then I judge whether it's just one patient or whether this affects a lot of people. - Reporter E

The relentless pressure of daily deadlines forces journalists to decide quickly whether events are both newsworthy and relevant to readers. Journalists throughout the newspaper hierarchy must respond to breaking news: "If an airplane hits the CN Tower, in 15 minutes all rules are off." Within hours of receiving an assignment a journalist may have to learn wholly new content, find sources for corroboration and interpretation and file the story by deadline: "Or else the paper goes without me." With deadlines looming, developing a viable story is often a matter of chance. Beat reporters and columnists increase their odds by building reliable networks of trusted sources who will respond quickly: "I'm plugged into the best people in the country."

I have to file at 5:00. Maybe I didn't get the assignment until 10:00. Maybe I didn't figure out what the story was and what it needed until 12:00. So I have maybe three hours to get the expert. If the expert calls me back the next day, it doesn't matter. The story's gone to bed. - Reporter F

Views on working with researchers

Journalists describe themselves as generalists, interested in numerous topics. Therefore, even experienced columnists or beat reporters do not claim to be specialists: "We're not experts on anything other than journalism." Rather, their job is to "leverage expertise." As generalists, they depend on experts such as researchers to help them interpret newsworthy events: "We have to rely on people we trust." Journalists acknowledge that "it takes patience to be an expert" because "some academics have the utter inability to suffer fools, and many reporters are lurching into assignments as fools."
This researcher would get angry that the newspaper would write a story about curing cancer with toothpaste, or something like that. He'd say, "But it's not in a reputable journal. Why did you put it in the paper?" Nobody here is an expert in cancer research. We can't determine whether it's a reputable journal or not. - Reporter F

To truly assist journalists, researchers must not only be available but also able to explain complex ideas in simple terms, "to make the salient points clear, like a bell ringing." Furthermore, researchers must be able to explain their ideas to the average newspaper reader: "Those numbers need a face." Journalists encounter many researchers who doubt that newspapers can effectively convey complex ideas in "a 14-inch story that sums up years of work" for "the equivalent of a grade eight readership." Consequently, journalists prize those researchers who can communicate with the public: "Researchers who talk like human beings are like gold!"

Probably the most difficult task for a reporter is translating the research from jargon into plain language. Researchers will come up with a conclusion, but they won't necessarily know what it means to people, how it's going to affect their lives. Some are wonderful translators. Those are the ones who make life a joy for scribes like me. - Reporter G

Research organizations commonly employ communications tools such as news releases, which "often lead directly to story ideas," particularly if quantitative data are involved, because "journalists are dazzled by numbers." Journalists also appreciate research organizations that provide lists of researchers who are willing to be contacted. However, news releases meet with skepticism because newsrooms are regularly inundated with "sophisticated statistical summaries" from advocacy groups with "political purposes." Research organizations are not exempt from this skepticism.

I'm quite skeptical of academic studies as a rule. People have an interest in promoting a certain outcome so they can get more funding. I think that many non-issues are perpetrated on the public. I feel that it's my job, if I can, to try to assess what is good information and what is bogus. - Reporter H

Despite their innate skepticism, journalists are receptive to researchers who share their personal beliefs: "There are some people who talk the same language I do, and I feel an instant rapport with them." Some researchers are known as "missionaries" or "crusaders" because they cultivate relationships with journalists and invest considerable time to synthesize and communicate research evidence on a continuing basis. Journalists welcome these uncommon contributions, which complement their own efforts "to carry on certain important conversations of the culture." Appreciating the disincentives within research organizations - "doing a lot of media work doesn't help anyone's academic career" - journalists nevertheless appeal for more researchers to join the conversation as "public intellectuals."

In general, journalism is an intellectual pursuit. It's about the dissemination of knowledge. In my view, good academics also publish papers that can be read by people other than academics. Many academics would not accept that, but what you write should be understood by policy makers, and if policy makers can understand it, we can. After all, we're in the same business. We're all looking for solutions to problems as they arise. - Editor B

Discussion

Our study participants primarily focused on what they thought researchers needed to know about journalists' roles, practices and views on working with researchers. Newspaper journalists balance business and social responsibilities according to their respective roles as editors, columnists and beat reporters. In practice, journalists must ensure newsworthiness, relevance to readers and access to sources in a context of daily deadlines. As generalists, journalists rely on researchers to be expert interpreters, although they find many researchers unavailable or unable to communicate with public audiences. While journalists are skeptical about such common organizational communications tools as news releases, they welcome the uncommon contributions of those researchers who cultivate relationships and invest time to synthesize and communicate research evidence on an ongoing basis. Some appealed for more researchers to join them in participating in public conversations.

In our study, an overarching finding was that participants emphasized journalistic processes more than the content of news coverage. We interpreted this emphasis as an indication that our findings may generalize to other health areas and may therefore have generic implications for policy-oriented health researchers. Our findings on journalists' roles and perspectives were consistent with those from a more general Canadian survey, although this survey did not investigate journalists' perspectives on researchers (Pritchard and Sauvageau 1999). Our participants effectively suggested practical routes of engagement for researchers: target like-minded editors, columnists and beat reporters according to the roles they each play; respect newsworthiness, reader relevance and daily deadlines; and be available and prepared to communicate clear research messages arising from syntheses of bodies of research knowledge on a continuing basis. We recognize that not all researchers can or should engage with journalists. Researchers may view the extraordinary events that merit news coverage as anecdotal outliers. They may struggle with the difficulties inherent in summarizing complex topics for public audiences, and may experience discomfort at being asked to comment on issues that they have not reviewed in detail. The immediate responses that journalists require may be antithetical to the measured pace of research work. Researchers should not underestimate the effort required. We were nevertheless encouraged that study participants welcomed researchers to join them in participating in public conversations.

We also interpreted our findings in light of the literature on science and health journalism that takes a normative stance on improving the quality of news coverage (Zelizer 2004; Weigold 2001; Entwistle and Watt 1999). For health journalism in particular, remedies such as research appraisal training for journalists have been suggested to improve the accuracy and completeness of research coverage (e.g., Oxman et al. 1993; Larsson et al. 2003; Moynihan 2003; Schwartz and Woloshin 2004). Health news coverage can be inaccurate or incomplete, with important consequences for health and healthcare at times (e.g., Cassels et al. 2003). However, our findings imply that the suggested remedies may also be incomplete if they do not take journalists' roles, practices and views into account. For example, there may be inherent limitations in how much even dedicated health journalists can apply specialized research training, given the competing demands they face. Our study participants also indicated that as generalists they relied on researchers to be the expert interpreters. Others have found a similar reliance on expert interpreters (Weiss and Singer 1988). Yet, our study participants also experienced many researchers as unavailable or unable to communicate with public audiences. This finding suggests that researchers, too, need to be part of the remedy for improving health news coverage.

Other literature has explored mutually beneficial associations between researchers and journalists (Nelkin 1987; Dunwoody 1999). To date, much of this literature has investigated the ephemeral contacts that arise when single studies are released to the news media (e.g., Phillips et al. 1991; van Trigt et al. 1995; Kiernan 2003). In addition to such contacts, however, our participants indicated that they appreciated relationships with researchers who invest time to synthesize and communicate research evidence on a continuing basis. Other studies have similarly concluded that researcher- journalist relationships were crucial for accurate and ethical news coverage of such complex health topics as genetic discoveries (Geller et al. 2005), and that researchers bore some responsibility for ensuring that news coverage was constructive (Bubela and Caulfield 2004). Ongoing relationships with journalists appear to offer a constructive opportunity for policy-oriented health researchers to go beyond the promotion of single studies to convey more nuanced interpretations of bodies of research evidence in the service of improving health and healthcare.

Further research would help both to consolidate the currently disparate literature on journalism (Zelizer 2004) and to test hypotheses raised by a formative, qualitative study such as ours. Researchers may be part of the remedy for improving health coverage. New research should investigate researchers' perspectives and should evaluate the role of factors such as media training for researchers that may facilitate engagement, or organizational tenure and promotion disincentives that may impede it. Beyond promoting single studies, researchers may be influential when they engage in ongoing relationships with journalists. New research should evaluate the quality of the research messages and syntheses conveyed by researchers who do engage and could investigate how ongoing relationships might assist journalists to communicate with the public about nuanced health topics, such as the determinants of health, or nuanced healthcare topics, such as primary care reform.

We conclude that there are opportunities for policy-oriented health researchers to work constructively with newspaper journalists - by appreciating journalists' perspectives and by taking seriously some of their suggestions for engaging in public conversations - as a means to increase the use of research evidence in policy making and thereby improve health and healthcare. Given the news media's importance in public policy agenda-setting, our current findings imply that researchers can contribute to public policy debates about salient issues. In previous research, we also found that research use in policy making could be enhanced if researchers engaged in public debates (Waddell et al., in press). There are compelling reasons for researchers to engage, amid increasing calls for scientific accountability to the public (Black and Carter 2001). As one of our participants noted, journalists and researchers share a common purpose: "We're all looking for solutions." Ultimately, journalists and researchers, together with policy makers, are accountable to the person "serving coffee at the doughnut shop" for how well they achieve this common purpose.


Participer au débat : points de vue des journalistes sur la collaboration avec les chercheurs

Résumé

Pour les chercheurs en sant√© qui veulent promouvoir une utilisation accrue des r√©sultats de recherche dans l'√©laboration des politiques afin d'am√©liorer la sant√© et les soins de sant√©, travailler avec les m√©dias peut permettre d'atteindre cet objectif, √©tant donn√© le r√īle crucial que jouent les m√©dias dans l'√©tablissement des politiques publiques. Une bonne partie du journalisme scientifique et ax√© sur la sant√© est de nature normative et met l'accent sur l'am√©lioration des nouvelles pr√©sent√©es. Dans cette √©tude, nous explorons les points de vue et les exp√©riences des journalistes. Nous voulions surtout d√©couvrir comment les chercheurs en sant√© pouvaient travailler de mani√®re constructive avec les journalistes en vue d'accro√ģtre l'utilisation des r√©sultats de recherche dans l'√©laboration des politiques. Nous avons employ√© des m√©thodes qualitatives pour effectuer et analyser des entrevues avec des journalistes d'exp√©rience au Canada, et avons utilis√© la sant√© mentale des enfants comme exemple de contenu. Les participants √† l'√©tude, quant √† eux, ont mis davantage l'accent sur les proc√©d√©s journalistiques que sur le contenu des reportages, qu'il s'agisse de sant√© mentale des enfants ou d'autres sujets. Ils ont pr√©f√©r√© insister sur ce que, selon eux, les chercheurs devaient savoir √† propos des r√īles, des pratiques et des opinions des journalistes sur la collaboration entre les deux groupes.

Les journalistes jonglent avec des responsabilit√©s commerciales et sociales dans leurs r√īles respectifs de r√©dacteurs, chroniqueurs et reporters. Dans la pratique, cependant, ils doivent s'assurer que leurs reportages m√©ritent de figurer dans les journaux et qu'ils soient pertinents pour les lecteurs; ils doivent √©galement avoir acc√®s √† des sources afin de pouvoir respecter leurs √©ch√©ances quotidiennes. En tant que g√©n√©ralistes, les journalistes se fient √† l'expertise des chercheurs en fait d'interpr√©tation, bien qu'ils constatent que bon nombre d'entre eux sont peu disponibles ou sont incapables de communiquer avec le public. Tandis que les journalistes font preuve de scepticisme √† l'√©gard d'outils organisationnels courants comme les communiqu√©s de presse, ils aiment beaucoup les contributions des chercheurs qui cultivent des relations et qui prennent le temps de synth√©tiser les r√©sultats de recherche et de les communiquer sur une base continue. Plusieurs journalistes ont lanc√© un appel invitant davantage de chercheurs √† se joindre √† eux et √† prendre part √† des conversations publiques.

Nous concluons en disant que les scientifiques qui effectuent des travaux de recherche axés sur les politiques de santé ont des occasions de collaborer de manière constructive avec les journalistes - en prenant en considération les points de vue de ces derniers et en accordant une attention sérieuse à leur invitation à participer à des conversations publiques - et qu'un tel échange peut permettre d'augmenter l'utilisation des résultats de recherche dans l'élaboration de politiques et, par le fait même, d'améliorer la santé et les soins de santé.

About the Author

Charlotte Waddell, MSC, MD
Assistant Professor, Children's Mental Health Policy and Services
Department of Psychiatry
University of British Columbia,
Vancouver, BC

Professeure adjointe, Politiques et des services de santé mentale pour enfants
Département de psychiatrie
Université de la Colombie-Britannique
Vancouver, C.-B.

Jonathan Lomas, MA
Chief Executive Officer
Canadian Health Services Research Foundation
Ottawa, ON

Directeur général
Fondation canadienne de la recherche sur les services de santé
Ottawa, ON

John N. Lavis, MD, PhD
Associate Professor, Centre for Health Economics and Policy Analysis
Department of Clinical Epidemiology and Biostatistics
Department of Political Science
McMaster University
Hamilton, ON

Professeur agrégé, Centre pour l'économie sanitaire et l'analyse de politiques
Département d'épidémiologie clinique et de biostatistique
Département de sciences politiques
Université McMaster
Hamilton, ON

Julia Abelson, MSC, PhD
Associate Professor, Centre for Health Economics and Policy Analysis
Department of Clinical Epidemiology and Biostatistics
Department of Political Science
McMaster University
Hamilton, ON

Professeure agrégée, Centre pour l'économie sanitaire et l'analyse de politiques
Département d'épidémiologie clinique et de biostatistique
Département de sciences politiques
Université McMaster
Hamilton, ON

Cody A. Shepherd, BA (HON)
Researcher, Children's Mental Health Policy and Services
Department of Psychiatry
University of British Columbia
Vancouver, BC

Chercheur, Politiques et des services de santé mentale pour enfants
Département de psychiatrie
Université de la Colombie-Britannique
Vancouver, C.-B.

Twylla Bird-Gayson, MSW
Research Consultant, Children's Mental Health Policy and Services
Department of Psychiatry
University of British Columbia
Vancouver, BC

Conseillère en recherche, Politiques et des services
de santé mentale pour enfants
Département de psychiatrie
Université de la Colombie-Britannique
Vancouver, C.-B.

Acknowledgment

We are indebted to the journalists who participated in this study. We dedicate this work to our friend and collaborator, Dan Offord. Charlotte Waddell thanks George McLauchlin for his contributions to the ideas expressed in this paper. We thank Mita Giacomini for consulting on methods.

Funding for this study was provided by Health Canada, the Michael Smith Foundation for Health Research and the Human Early Learning Partnership. Charlotte Waddell holds a Scholar Award from the Michael Smith Foundation for Health Research. John Lavis holds the Canada Research Chair in Knowledge Transfer and Uptake. Julia Abelson holds a New Investigator Award from the Canadian Institutes of Health Research.

Correspondence may be directed to Dr. Charlotte Waddell, Childern's Mental Health Policy and Services Program, Department of Psychiatry, University of British Columbia, 2250 Wesbrook Mall, Vancouver, BC V6T 1W6; tel: 604-822-7530; email: charlotte.waddell@ubc.ca

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