{"id":539,"date":"2019-06-05T06:52:30","date_gmt":"2019-06-05T10:52:30","guid":{"rendered":"https:\/\/carleton.ca\/determinants\/?p=539"},"modified":"2025-04-29T10:04:51","modified_gmt":"2025-04-29T14:04:51","slug":"hierarchies-of-evidence","status":"publish","type":"post","link":"https:\/\/carleton.ca\/determinants\/2019\/hierarchies-of-evidence\/","title":{"rendered":"Hierarchies of Evidence"},"content":{"rendered":"\n<section class=\"w-screen px-6 cu-section cu-section--white ml-offset-center md:px-8 lg:px-14\">\n    <div class=\"space-y-6 cu-max-w-child-5xl  md:space-y-10 cu-prose-first-last\">\n\n            <div class=\"cu-textmedia flex flex-col lg:flex-row mx-auto gap-6 md:gap-10 my-6 md:my-12 first:mt-0 max-w-5xl\">\n        <div class=\"justify-start cu-textmedia-content cu-prose-first-last\" style=\"flex: 0 0 100%;\">\n            <header class=\"font-light prose-xl cu-pageheader md:prose-2xl cu-component-updated cu-prose-first-last\">\n                                    <h1 class=\"cu-prose-first-last font-semibold !mt-2 mb-4 md:mb-6 relative after:absolute after:h-px after:bottom-0 after:bg-cu-red after:left-px text-3xl md:text-4xl lg:text-5xl lg:leading-[3.5rem] pb-5 after:w-10 text-cu-black-700 not-prose\">\n                        Hierarchies of Evidence\n                    <\/h1>\n                \n                                \n                            <\/header>\n\n                    <\/div>\n\n            <\/div>\n\n    <\/div>\n<\/section>\n\n<p>The approach to health research in <a href=\"https:\/\/carleton.ca\/healthsciences\/health-sciences\/\">Carleton Health Sciences<\/a> is multi-disciplinary. While this descriptor is oft-used in higher education I think it&#8217;s very apt for our Department. We are a small group who together manage a growing suite of programs that provide training at the undergraduate, professional, and post-graduate levels. Our expertise is incredibly varied and includes genetics, virology, developmental endocrinology as well as social psychology, community health, and data analytics.<\/p>\n\n\n\n<p>To make this work we have adopted a perspective that recognises multiple ways of &#8216;knowing&#8217; and doing science. Some of our work is in &#8216;wet labs&#8217; while other work&nbsp;is within communities and with individuals. Sometimes this works, and sometimes we get pushback from outside where others might not understand the nature of health research.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"448\" src=\"https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.32.19-AM-400x448.png\" alt=\"\" class=\"wp-image-558\" srcset=\"https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.32.19-AM-400x448.png 400w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.32.19-AM-160x179.png 160w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.32.19-AM-240x269.png 240w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.32.19-AM-768x860.png 768w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.32.19-AM-360x403.png 360w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.32.19-AM.png 1164w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<p>To respond to this I created a short Twitter thread on the &#8220;hierarchies&nbsp;of evidence&#8221; based on the foundational work of Marc Petticrew and Helen Roberts,&nbsp;<a href=\"https:\/\/jech.bmj.com\/content\/jech\/57\/7\/527.full.pdf\"><em>Evidence, Hierarchies, and Typologies: Horses for Courses<\/em><\/a>.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"319\" src=\"https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.32.44-AM-400x319.png\" alt=\"\" class=\"wp-image-557\" srcset=\"https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.32.44-AM-400x319.png 400w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.32.44-AM-160x128.png 160w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.32.44-AM-240x191.png 240w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.32.44-AM-768x612.png 768w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.32.44-AM-360x287.png 360w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.32.44-AM.png 1164w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<p>The fundamental premise of this work is that the method one employs in health research is dependent on what question is being asked.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"302\" src=\"https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.01-AM-400x302.png\" alt=\"\" class=\"wp-image-556\" srcset=\"https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.01-AM-400x302.png 400w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.01-AM-160x121.png 160w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.01-AM-240x181.png 240w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.01-AM-768x579.png 768w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.01-AM-360x272.png 360w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.01-AM.png 1164w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<p>One wouldn&#8217;t run a survey when asking &#8220;how innate immune responses are regulated by metabolic programming?&#8221; Conversely, one wouldn&#8217;t set up a randomized control trial when asking &#8220;What physician recruitment and retention strategies have been effective in rural Canada?&#8221;<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"327\" src=\"https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.16-AM-400x327.png\" alt=\"\" class=\"wp-image-555\" srcset=\"https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.16-AM-400x327.png 400w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.16-AM-160x131.png 160w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.16-AM-240x196.png 240w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.16-AM-768x628.png 768w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.16-AM-360x294.png 360w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.16-AM.png 1164w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<p>This goes back to the fundamentals of science. Early social science theory was heavily influenced by the physical sciences and was highly positivist (see <a href=\"https:\/\/en.wikipedia.org\/wiki\/\u00c9mile_Durkheim\">Durkheim<\/a>).<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"296\" src=\"https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.35-AM-400x296.png\" alt=\"\" class=\"wp-image-554\" srcset=\"https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.35-AM-400x296.png 400w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.35-AM-160x118.png 160w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.35-AM-240x177.png 240w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.35-AM-768x567.png 768w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.35-AM-360x266.png 360w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.35-AM.png 1164w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<p>However, we have transitioned to recognising that society doesn&#8217;t operate by a set of definable rules, where there is one &#8216;right&#8217; answer to social problems.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"380\" src=\"https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.59-AM-400x380.png\" alt=\"\" class=\"wp-image-553\" srcset=\"https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.59-AM-400x380.png 400w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.59-AM-160x152.png 160w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.59-AM-240x228.png 240w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.59-AM-768x730.png 768w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.59-AM-360x342.png 360w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.33.59-AM.png 1164w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<p>In health research, we recognise&nbsp;that much of what we do interacts on multiple levels. There is not one way of&nbsp;<a href=\"https:\/\/www.macleans.ca\/society\/how-western-science-is-finally-catching-up-to-indigenous-knowledge\/\"><em>knowing<\/em><\/a> about health, health systems, or public health.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"205\" src=\"https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.34.18-AM-400x205.png\" alt=\"\" class=\"wp-image-552\" srcset=\"https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.34.18-AM-400x205.png 400w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.34.18-AM-160x82.png 160w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.34.18-AM-240x123.png 240w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.34.18-AM-768x395.png 768w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.34.18-AM-360x185.png 360w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/Screen-Shot-2019-06-05-at-6.34.18-AM.png 1164w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<p>&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image alignleft\"><img loading=\"lazy\" decoding=\"async\" width=\"160\" height=\"254\" src=\"https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/MSc-1-400x634-1-160x254.jpg\" alt=\"\" class=\"wp-image-544\" srcset=\"https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/MSc-1-400x634-1-160x254.jpg 160w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/MSc-1-400x634-1-240x380.jpg 240w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/MSc-1-400x634-1.jpg 400w, https:\/\/carleton.ca\/determinants\/wp-content\/uploads\/sites\/79\/MSc-1-400x634-1-360x571.jpg 360w\" sizes=\"auto, (max-width: 160px) 100vw, 160px\" \/><\/figure>\n\n\n\n<p>Back to <a href=\"https:\/\/carleton.ca\/healthsciences\/\">our Department<\/a> and what we&#8217;re attempting. I feel that we are a truly unique addition to the Canadian health education landscape. We provide a foundational Bachelor&#8217;s of Health Sciences where students are provided in-depth, advanced learning and hands-on research experiences in health sciences, from the social, biomedical and environmental determinants of health perspectives. We augment that with a <a href=\"https:\/\/carleton.ca\/healthsciences\/hstp-2\/\">course-based graduate program<\/a> that considers health&nbsp;across the science, technology, and policy domains. In addition, we have a growing cohort of research-based graduate students in our <a href=\"https:\/\/carleton.ca\/healthsciences\/health-sciences\/graduate\/\">MSc and PhD&nbsp;programs<\/a>.<\/p>\n\n\n\n<p>It comes down to a matter of perspective though. We are firmly grounded in the philosophy that a multidisciplinary and integrative approach is necessary to understand and address health issues.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The approach to health research in Carleton Health Sciences is multi-disciplinary. While this descriptor is oft-used in higher education I think it&#8217;s very apt for our Department. We are a small group who together manage a growing suite of programs that provide training at the undergraduate, professional, and post-graduate levels. Our expertise is incredibly varied [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":560,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[71,1,25],"tags":[],"class_list":["post-539","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-academic","category-general","category-highered"],"acf":{"cu_post_thumbnail":""},"_links":{"self":[{"href":"https:\/\/carleton.ca\/determinants\/wp-json\/wp\/v2\/posts\/539","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/carleton.ca\/determinants\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/carleton.ca\/determinants\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/carleton.ca\/determinants\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/carleton.ca\/determinants\/wp-json\/wp\/v2\/comments?post=539"}],"version-history":[{"count":3,"href":"https:\/\/carleton.ca\/determinants\/wp-json\/wp\/v2\/posts\/539\/revisions"}],"predecessor-version":[{"id":561,"href":"https:\/\/carleton.ca\/determinants\/wp-json\/wp\/v2\/posts\/539\/revisions\/561"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/carleton.ca\/determinants\/wp-json\/wp\/v2\/media\/560"}],"wp:attachment":[{"href":"https:\/\/carleton.ca\/determinants\/wp-json\/wp\/v2\/media?parent=539"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/carleton.ca\/determinants\/wp-json\/wp\/v2\/categories?post=539"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/carleton.ca\/determinants\/wp-json\/wp\/v2\/tags?post=539"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}