A framework in use: SPIRIT-ME put to work

The word ‘framework’ dates to the 1640s, when it simply meant a structure for holding and steadying; not for steering or scoring. This definition is worth keeping in mind as we think about what happens to a framework once it is published and others start to use it. Far from neutral, a framework in use can shape how people reason, plan and judge.

There is no shortage of knowledge mobilisation (KM) frameworks, and this abundance can create difficulties in choosing the most appropriate. We currently know little about the lives of these frameworks, or what becomes of them with use over time. SPIRIT-ME is one such framework, reworked by the authors from an existing action framework known as SPIRIT (Supporting Policy in Health with Research: an Intervention Trial) developed between 2011 and 2013.

Frameworks have lives

In a recent conference presentation, Petra traced the biography of SPIRIT borrowing the idea that an object is transformed by the world through which it passes.

The framework was originally developed to increase the use of research in health policy by organising existing knowledge and guiding the choice and evaluation of strategies, rather than by listing the determinants of success or mapping a process step by step. Following it across a decade of literature revealed three recurring ways it has changed.

1. Recycling: it was put to use in new settings, sometimes with small language changes.
2. Propagation: spin-off tools and frameworks were developed that built on the original.
3. Re-engineering: where not fit for a new purpose, it was deliberately reworked into something new, informed by the original conceptual foundations.

The third process, re-engineering, is where we have engaged with SPIRIT most closely.

Re-engineering SPIRIT

During our recent evaluation of the national Capabilities in Academic Policy Engagement (CAPE) programme in England, we needed to make sense of relational and capacity-focused engagement: i.e. not just whether research was being used to inform policy, but whether systems, relationships and capabilities were being strengthened, how, and for whom. SPIRIT was a good starting point, but not a good enough fit.

Our initial changes to the SPIRIT framework ran across every domain: from how catalysts, capacity and engagement actions were conceived, to the influences shaping them. To illustrate, we extended the framework beyond health policy, replacing its "reservoir of relevant and reliable research" with “reservoir of people skills” to capture the facilitative, often unseen work that makes engagement possible. This shift is increasingly necessary as, while the allure of Artificial Intelligence makes finding and synthesising evidence appear easier, the work of engagement and capacity-building depends on facilitation by people. We also added a new domain, “Impacts and Sustainability” to address what it takes to keep change alive.

Applying SPIRIT-ME in the CAPE evaluation prompted more changes. For example, we separated capacity (the structural conditions that make engagement possible) from capabilities (the knowledge, skills and readiness of individuals to act). We also added two new outcome types: “tacit knowledge exchange” – the hard-to-verbalise know-how that builds through doing rather than training; and “diversity and inclusion enabling”, after finding that opportunities tended to flow to those already well-connected, which risked a success to the successful dynamic.

Into practice in KM evaluations

SPIRIT-ME is beginning to be put to work in other evaluations, including the NIHR ARC Knowledge Mobilisation Programme where the intention is to develop a set of guiding questions for each of the domains, prompting KM Fellows to reflect on how elements relate to their projects.

Introducing it to a group of these Fellows, we were struck by the appetite for guidance on how to operationalise SPIRIT-ME across varied practice contexts – for example, by creating practitioner-facing prompts. The fine line, we discovered, was to avoid a tidy list of intended activities to be ticked off, instead, building on the framework’s layered foundations. The purpose of SPIRIT-ME, after all, is not only to ask what was done, but to explore what changed, for whom, and why, including the unforeseen. This means holding space for features that planning checklists tend to drop, such as tacit knowledge built through sustained engagement, and largely unseen facilitative work that makes engagement possible.

The KM Fellows are currently using the framework as a reflection tool in team meetings, to understand how their activities – e.g. KM sprints with Integrated Care Board commissioners – can make a difference in local decision-making. Conversations will inform the writing of impact case studies, with the framework’s pillars providing narrative headings, illustrating how activities have made a difference for who and in what ways. These case studies will be collated by the national Applied Research Collaboration KM programme, coordinated by Greater Manchester, and shared with the funder, NIHR.

A framework can be seen as a tool to think with and, like any tool, is reshaped by use. SPIRIT-ME should be viewed as a structured starting point with sharable language and flexible prompts, rather than a form to populate. This sits with the concept of frameworks as evolving heuristics open to refinement through use.

Looking forward

Life goes on for the framework, as each move into a new setting reveals what it captures well, what it misses, and what needs to change. Continuing to narrate these changes will reveal something about the shifting field around it as well. Further learning will come from how KM Fellows put SPIRIT-ME to work – influencing the next phase of modifications in the SPIRIT/SPIRIT-ME biography.