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November 2, 2023

Evidence-Powered Change: The story of the Centre

Dr Lígia Teixeira

By Lígia Teixeira

I want to talk about making the world a better place through evidence-led change. It's a topic that's close to my heart.

Whether you're a researcher working for the government, a practitioner on the front lines of service delivery, or a commissioner responsible for vulnerable populations, we all share a common goal — to improve the lives of those we serve. But how do we know if we're making a real impact? How can we inspire others to act on the best knowledge available, while staying humble about what we know?

Over the last five years, I've had the privilege of setting up and leading the Centre for Homelessness Impact (CHI) in the UK. At CHI, we've been on a journey—a journey to act as a catalyst for evidence-led change. To develop a philosophy of using evidence to end homelessness. We call it the 'what works' approach, and it's about applying data and scientific reasoning to the often-political and sentimental world of tackling homelessness. This to ensure that when we’re helping people we do so as effectively as possible.

A key learning to date is that knowledge translation efforts often fall short, but with the right people, focus, and a 'doing with' approach, the possibilities are endless.

So I want to introduce you to five guiding principles or keys to success that underlie CHI's 'what works' approach to knowledge translation (based on the research that I carried out to inform our plans for the creation of the centre as well as our experiences to date):

Don’t let ‘perfect’ be the enemy of ‘good’.

Few things are as disheartening for evidence users than inquiring with knowledge brokers only to receive information about what we don’t know. The imperative is to support them in promptly acting on the best available evidence while improving the infrastructure for the long term.

For example, when we started, like in other fields, reliable evidence was very sparse. Our effectiveness Evidence and Gap Map powerfully demonstrated the sparsity of evidence on ‘what works’ available in homelessness – only 10 studies were available in the UK, with the vast majority of work being purely qualitative in nature. This came as a shock: as in other fields with a weak evidence infrastructure, people were convinced they already knew all there is to know about what works. At this point we knew a real danger was to simply focus on what we don’t know.

The imperative should be to be useful today, while laying foundations for longer term change.

So we prioritised six things:

  • Map evidence infrastructure, making it easier to use and to track changes
  • Create an evidence portal at speed
  • Where enough studies exist, commission systematic reviews of those interventions
  • Where gaps exist, develop a list of research priorities
  • Think in systems and  produce ‘on demand’ and ‘in anticipation of future need’ evidence notes
  • Do all the above with, not to (building trust and demand) and think in power structures

These priorities ensured that we focused on what mattered most to evidence users, while taking steps to improve the evidence and data available for policy-making and practice in the longer term. The sequence matters, because it’s important to be of service to people from day one, which brings me to our next guiding principle..

Win hearts and minds

It’s the linchpin to success. It is crucial to engage with empathy, build trust, and foster connections that allow knowledge to be not just understood but also embraced. When we win hearts and minds we create a powerful catalyst for transformative change that can lead to a brighter and more evidence-informed future. 

One of the ways we do this at CHI is through storytelling.

For example, we use storytelling to inspire and make the case for change. Storytelling not only makes complex information more accessible but also helps people connect emotionally with the subject matter. 

Three types of application: 

  • Making the case for causal studies and rigorous synthesis. Using cases of programmes once perceived as highly effective but ultimately disproved (like 'Scared Straight’), are compelling reminders to challenge assumptions and embrace the power of trials and systematic reviews. These examples stress the necessity of relying on empirical evidence rather than intuition, demonstrating how rigorous research methods are vital in guiding evidence-based decisions, particularly for widely embraced interventions with potentially far-reaching consequences.
  • Elevating great work and the desired growth mindset. Policy-makers and practitioners who ‘get it’ and get things done are invaluable allies. We help them capture their journeys and share their stories with the world (see e.g. this recent blog post by Mick Clarke from The Passage). This is not just about using them to spread the word - I am referring to something much deeper. Champions sometimes come to us with ideas and we always test any we have with them before pursuing them. It’s a two way relationship.
  • Challenging stigma associated with homelessness. Evidence-based communications, exemplified by our image bank, are vital for reshaping perceptions of homelessness. People with lived experience captured and selected the photos, ensuring that our portrayal of homelessness is true to the evidence and person-centred. By so doing, and offering the bank as a free resource, we are challenging stereotypes and reframing how those affected are perceived.

These are just a few examples of how we set about winning hearts and minds, and helped shift the narrative in the process. But we knew that to go deeper you need to go further: be useful, trusted, and liked.

Which leads me to the next guiding principle…

Make others successful 

A focus on being useful is fundamental to effective knowledge translation. It not only enriches the quality of the solutions, but helps to nurture a culture of mutual support, shared goals, and learning.

Here are some examples:

Spreading review. CHI worked closely with the Treasury and the housing department during the last Spending Review negotiations. We provided tailored, confidential advice, combining verbal discussions and written briefings to ensure the best available evidence was integrated into the budget allocation process. By aligning our efforts with their needs, we were able to ensure that the most robust and up-to-date evidence was integrated into the Spending Review negotiations. A similar process was used to place the best evidence at the heart of the latest iteration of the UK Government’s rough sleeping strategy, published in September 2022.

Northern Ireland Housing Executive.  Upon the launch of our programme on the value for money of temporary accommodation, the NIHE swiftly joined, and they've recently accepted our recommendations. In the next phase, we'll support them in implementing these insights to make limited resources go further.

The British Royal Family: CHI supported the team of the future King of England to design his new ‘Homewards’ initiative. It took over two years but was worth it: given his profile and influence with the public, our hope is that it will redefine public perceptions of homelessness while fostering increased public backing for policies aimed at tackling its underlying causes.

Mayfair Neighbourhood Forum: In an affluent London neighbourhood, a local forum had long grappled with the question of whether they could help improve the effectiveness of efforts in their community. CHI stepped in to help design and cost a new programme. As a result, the forum has now  pledged to raise £5 million for this initiative, which they hope to launch in the new year. This collaboration reflects CHI's commitment to engaging communities and mobilising new resources to create positive change.

I hope you’re getting the gist. There is great power in focusing on making others successful, in  focusing on embracing this motto…

It’s not about you.

And that brings me to my next guiding principle…

Adopt and inspire a humble mindset

Humility can become two sides of the same coin and catalysts for building trust, strengthening relationships, and ultimately driving positive change. When we lead by example, demonstrating our willingness to listen, learn, and adapt, we create an environment that encourages humility in others.  

Here are some examples:

Data infrastructure improvements: When we initially urged the government to adopt a clear definition and metrics of the commitment to end street homelessness (now called by the government the ‘Ending Rough Sleeping Framework’), we encountered resistance. Though we didn't directly challenge this opposition, we remained persistent. A year later, the minister was wholeheartedly supporting the idea.

Availability of reliable evidence: Since the launch of our Evidence and Gap Maps, there has been a significant increase in causal evidence produced, with a 490% growth in the UK and a 212% growth globally. While this is a significant achievement, there is still much work to be done – fewer than 100 empirical studies of homelessness interventions are available in the UK; clearly not sufficient to meet the needs of policy-makers in a comprehensive manner. To help accelerate the programme, we’ve been making the case for the first trials programme in the UK. The good news is that it’s finally happening: the Department for Levelling Up, Housing and Communities (DLUHC) is funding a ‘Test and Learn’ initiative, which is set to launch later in the Autumn. Yet, with a budget of only £12.5 million, its success hinges on both project outcomes and its role as a precursor to similar initiatives (eight projects can be done out of a possible 100 or so which we’ve identified through our EGMs and a call for practice). This will be vital for accelerating the scaling and diffusion of innovative solutions and well-established best practices across England.    

And in any case, there is a fundamental fact that keeps me grounded…

Evidence is but a means to an end. The vast majority of the reliable evidence available is from the USA, yet homelessness levels are significantly lower in the UK and Europe more broadly.

When it comes to social issues, we have a responsibility to ensure that evidence is a means to an end not the end to itself.

This leads to our final guiding principle…

Focus on what matters

In the realm of complex social issues, such as homelessness, it is imperative to focus on what truly matters — improving the life course of society's most disadvantaged. This requires asking and answering the right questions and taking a bird's-eye view to ensure comprehensive solutions.

For example, in 

Salt Lake City in 2005, the state and its capital started providing no-strings-attached apartments to the “chronically” homeless. Over the next 10 years, Utah reduced chronic homelessness by 91 percent. The results were a sensation. But this simplistic celebration hid a far more complex truth… While levels amongst chronic homelessness dropped, others types of homelessness rose at pace.

What I am trying to illustrate is that best interventions are no better than mopping the water off the floor. I am also trying to get you to see that solving homelessness and other complex social issues isn’t rocket science… it’s much harder.

Preventing homelessness at population level, requires complex, system-wide solutions. In the same way that we know that the race to find a vaccine was just as important as public health interventions and the availability of medical treatment, the aim should be to respond to cases, while stopping the flow. 

For example, to address the inherent complexity of the issue, at CHI, we've combined the traditional "what works" approach, which concentrates on the impact of individual interventions, with a broader systemic perspective. E.g. our causal loop diagram of homelessness prevention unveils the intricate, interconnected drivers influencing trends, emphasising the multifaceted and dynamic nature of the issue. Adopting a systemic viewpoint not only facilitates more precise targeting of interventions, increasing the likelihood of sustainable change, but also aids in assessing the cumulative impact of government investments.

Partly because of this, we are very pleased to be working with the government and research partners Cordis Bright and RSM on the first ever Systems-Wide Evaluation which will assess the overall effectiveness of the current homelessness system.

This work isn’t easy – let’s not pretend otherwise. Narrowing the gap between reliable evidence and action requires not only more and better evidence but also better relationships and culture.  

It’s not for nothing that what I call ‘the paradox of knowledge-translation’ exists: The best cases of evidence not influencing policy and practice are often the same as those where evidence shapes policy and practice. For example, despite evidence presented by astronomers like Galileo Galilei supporting the heliocentric model of the solar system, the Catholic Church continued to promote the geocentric model, leading to the Galileo affair. Church policy remained entrenched in geocentrism until much later. But change did come… eventually… 

The journey of translating evidence into action can be filled with hurdles and setbacks. Rather than becoming disheartened by initial resistance or the slow pace of change, the key lies in persistence and adaptability (adopting a ‘Ever failed? No matter, Fail again, Fail better’ mindset). Knowledge brokers must take the lead in these endeavours to stay pertinent. 

Dr Lígia Teixeira is founding Chief Executive of the Centre for Homelessness Impact. This article is based on a speech she gave to the What Works Global Summit in Ottawa, Canada on October 20, 2023.

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