This seminar opens up ways of thinking about ‘evidence-making’ practices in drug policy and viral elimination, and explores critical approaches to the study of implementation science and intervention translations in health.
Implementing ‘evidence-based interventions’ is the catch-cry of governments. Yet many interventions are never actualised into use, others fail, some harm, and most produce unexpected effects. To overcome the limitations of ‘evidence-based’ approaches, this presentation invites a critical shift away from thinking with evidence primarily as a matter of epistemology – the different ways interventions can be known – towards thinking with evidence as a matter of ontology – how interventions are performed through knowledge-making practices. We propose a framework for conceptualising interventions in health as ‘evidence-making interventions’. By emphasising relational materiality and performativity, this approach engages with interventions, and their knowing, as matters-of-practice in local implementation events. This thinking has implications for evidencing and intervening. It questions evidence, interventions and their effects as fixed and stable, instead proposing them as relational and emergent. Drawing on case examples from the fields of drug policy and viral hepatitis we will illustrate how thinking with ‘evidence-making interventions’ challenges presumptions of separation between the material and social, nature and culture, and evidence and practice, which dominate mainstream evidence-based paradigms, and extends notions of intervention to include all knowledge-making practices in an implementation event, including those of expertise, experience, science and technology. We suggest that this approach might afford a more critical, as well as more careful, way of knowing and doing health intervention which does not simply ask ‘What is the evidence?’, but also asks ‘How is evidence made?’, ‘How is evidence put-to-use?’, and ‘How is evidence made-to-matter?’.
Dr Kari Lancaster is a Senior Research Fellow and Scientia Fellow at the Centre for Social Research in Health (CSRH) at UNSW, and an Honorary Associate Professor at the London School of Hygiene and Tropical Medicine.
Kari is an interdisciplinary, qualitative social researcher in health, with a background in law and policy studies. Her research uses approaches drawn from poststructural theory and science and technology studies (STS) to critically examine issues of contemporary policy and practice significance in relation to drugs, viral hepatitis and health. Her research has examined how policy problems and knowledges are constituted, and the dynamics of ‘evidence-based’ policy. Kari’s current research concentrates on ‘evidence-making’ practices in health, viral elimination and drug policy. Along with Professor Tim Rhodes (London School of Hygiene and Tropical Medicine and CSRH, UNSW), she is leading a program of research focused on the development of critical approaches to the study of implementation science and intervention translations in health.
Prior to joining CSRH, Kari worked as part of the Drug Policy Modelling Program (DPMP) at the National Drug and Alcohol Research Centre (NDARC).
Kari is Assistant Commissioning Editor of Addiction and Associate Editor of the International Journal of Drug Policy.