title: The impact on healthcare, policy and practice from 36 multi-project research programmes: findings from two reviews.
abstract: BACKGROUND
  We sought to analyse the impacts found, and the methods used, in a series of assessments of programmes and portfolios of health research consisting of multiple projects.
  
  
  METHODS
  We analysed a sample of 36 impact studies of multi-project research programmes, selected from a wider sample of impact studies included in two narrative systematic reviews published in 2007 and 2016. We included impact studies in which the individual projects in a programme had been assessed for wider impact, especially on policy or practice, and where findings had been described in such a way that allowed them to be collated and compared.
  
  
  RESULTS
  Included programmes were highly diverse in terms of location (11 different countries plus two multi-country ones), number of component projects (8 to 178), nature of the programme, research field, mode of funding, time between completion and impact assessment, methods used to assess impact, and level of impact identified. Thirty-one studies reported on policy impact, 17 on clinician behaviour or informing clinical practice, three on a combined category such as policy and clinician impact, and 12 on wider elements of impact (health gain, patient benefit, improved care or other benefits to the healthcare system). In those multi-programme projects that assessed the respective categories, the percentage of projects that reported some impact was policy 35% (range 5-100%), practice 32% (10-69%), combined category 64% (60-67%), and health gain/health services 27% (6-48%). Variations in levels of impact achieved partly reflected differences in the types of programme, levels of collaboration with users, and methods and timing of impact assessment. Most commonly, principal investigators were surveyed; some studies involved desk research and some interviews with investigators and/or stakeholders. Most studies used a conceptual framework such as the Payback Framework. One study attempted to assess the monetary value of a research programme's health gain.
  
  
  CONCLUSIONS
  The widespread impact reported for some multi-project programmes, including needs-led and collaborative ones, could potentially be used to promote further research funding. Moves towards greater standardisation of assessment methods could address existing inconsistencies and better inform strategic decisions about research investment; however, unresolved issues about such moves remain.
authors.affiliation: Health Economics Research Group (HERG), Institute of Environment, Health and Societies, Brunel University London, London, UB8 3PH, United Kingdom. stephen.hanney@brunel.ac.uk.
authors.forename: Steve
authors.identifier: http://orcid.org/0000-0002-7415-5932
authors.initials: S
authors.lastname: Hanney
authors.affiliation: Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, United Kingdom.
authors.forename: Trisha
authors.initials: T
authors.lastname: Greenhalgh
authors.affiliation: Wessex Institute, Faculty of Medicine, University of Southampton, Southampton, SO16 7NS, United Kingdom.
authors.forename: Amanda
authors.initials: A
authors.lastname: Blatch-Jones
authors.affiliation: Health Economics Research Group (HERG), Institute of Environment, Health and Societies, Brunel University London, London, UB8 3PH, United Kingdom.
authors.forename: Matthew
authors.initials: M
authors.lastname: Glover
authors.affiliation: Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Raftery
mesh_terms: D035843:Biomedical Research; D003695:Delivery of Health Care / Q000592:standards*; D014943:Global Health; D062489:Health Impact Assessment; D006291:Health Policy; D006302:Health Services Research; D006801:Humans; D011364:Professional Practice
keywords: Global Observatory; Health gains; Health technology assessment; Monetisation; Multi-project programmes; Payback Framework; Policy impact; Practice impact; Research impact; World Health Report