title: Integration of research and practice to improve public health and healthcare delivery through a collaborative 'Health Integration Team' model - a qualitative investigation.
abstract: Economic considerations and the requirement to ensure the quality, safety and integration of research with health and social care provision have given rise to local developments of collaborative organisational forms and strategies to span the translational gaps. One such model - the Health Integration Team (HIT) model in Bristol in the United Kingdom (UK) - brings together National Health Service (NHS) organisations, universities, local authorities, patients and the public to facilitate the systematic application of evidence to promote integration across healthcare pathways. This study aimed to (1) provide empirical evidence documenting the evolution of the model; (2) to identify the social and organisational processes and theory of change underlying healthcare knowledge and practice; and (3) elucidate the key aspects of the HIT model for future development and translation to other localities.
  
  
  
  Contemporaneous documents were analysed, using procedures associated with Framework Analysis to produce summarised data for descriptive accounts. In-depth interviews were undertaken with key informants and analysed thematically. Comparative methods were applied to further analyse the two data sets.
  
  
  
  One hundred forty documents were analysed and 10 interviews conducted with individuals in leadership positions in the universities, NHS commissioning and provider organisations involved in the design and implementation of the HIT model. Data coalesced around four overarching themes: 'Whole system' engagement, requiring the active recruitment of all those who have a stake in the area of practice being considered, and 'collaboration' to enable coproduction were identified as 'process' themes. System-level integration and innovation were identified as potential 'outcomes' with far-reaching impacts on population health and service delivery.
  
  
  
  The HIT model emerged as a particular response to the perceived need for integration of research and practice to improve public health and healthcare delivery at a time of considerable organisational turmoil and financial constraints. The concept gained momentum and will likely be of interest to those involved in setting up similar arrangements, and researchers in the social and implementation sciences with an interest in their evaluation.
authors.affiliation: School of Social & Community Medicine, University of Bristol, Canynge Hall Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK. sabi.redwood@bristol.ac.uk.|National Institute for Health Research, Collaborations for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), 9th floor Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK. sabi.redwood@bristol.ac.uk.
authors.forename: Sabi
authors.identifier: 0000-0002-2159-1482
authors.initials: S
authors.lastname: Redwood
authors.affiliation: School of Social & Community Medicine, University of Bristol, Canynge Hall Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK.|National Institute for Health Research, Collaborations for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), 9th floor Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.
authors.forename: Emer
authors.initials: E
authors.lastname: Brangan
authors.affiliation: School of Social & Community Medicine, University of Bristol, Canynge Hall Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK.|National Institute for Health Research, Collaborations for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), 9th floor Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.
authors.forename: Verity
authors.initials: V
authors.lastname: Leach
authors.affiliation: School of Social & Community Medicine, University of Bristol, Canynge Hall Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK.|National Institute for Health Research, Collaborations for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), 9th floor Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Horwood
authors.affiliation: School of Social & Community Medicine, University of Bristol, Canynge Hall Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK.|National Institute for Health Research, Collaborations for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), 9th floor Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.
authors.forename: Jenny L
authors.initials: JL
authors.lastname: Donovan
mesh_terms: D003299:Cooperative Behavior; D003695:Delivery of Health Care / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research / Q000458:organization & administration; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D008962:Models, Theoretical; D011634:Public Health / Q000592:standards*; D012108:Research Personnel; D013222:State Medicine / Q000592:standards*; D006113:United Kingdom
keywords: Coproduction of healthcare knowledge and practice; Integrated knowledge translation; Research and healthcare collaborations