Table 1 Example of nine alignment efforts

This effort may be of interest if there is a formally established list of research priorities that is intended to attune research to needs of end-users (e.g. patients, policymakers, health workers). When the needs of stakeholders from the action side are taken into account in priority setting, this provides a first step to towards attuning research to action. Investigators then have to take these priorities into account when formulating research proposals and these priorities have to play a role when selecting projects for funding. Assessing the role of this alignment effort, allows these various steps and/or the overall correspondence between a research question and the set priorities to be explored.

2

Attuning research to action processes in which investigators have a role

In this alignment effort, one of the investigators has a double role in action and may be considered a potential key user. Investigators may be involved in action processes as an adviser or board member, but also as the director of health services. Such double roles may be ideal for attuning research to policy processes. When assessing this effort, the focus can be on the extent to which research is attuned to needs and/or on the capability of the double-role actor to influence the dynamics in both research and action.

3

Engaging potential key users in research formulation

Engaging potential key users in the formulation of research may help the investigators to better understand the needs and expectations from action and may help them anticipate the context in which knowledge may be used. Engagement may help potential key-users anticipate utilization on the action side. When assessing this effort, the focus can be on the adaptations made to a research proposal as a result of this engagement, anticipations through engaged actors on the action-side, changes in relations between actors (e.g. increasing trust and understanding) and on the role and capability of the engaged actor(s) in influencing the dynamics in action.

4

Engaging potential key users during the production phase

Engaging potential key users in the conduct of research may help the investigators better understand the needs and expectations from action and help them anticipate the context in which knowledge may be used. On the other side, engagement may help potential key users better understand the research and anticipate utilization. Engagement may lead to new relations and provide a foundation for later utilization in action. When assessing this effort, the focus can be on the adaptations made to the research project as a result of this engagement, anticipations through the engaged actors on the action-side, changing relations between actors (e.g. increasing trust and understanding) and the role and capability of the engaged actor(s) in influencing the dynamics in action.

5

Engaging potential key users in interpreting the produced knowledge

Engaging potential key users in interpreting the produced knowledge may help frame the results in the context in which they may be used and help potential users to articulate actor-scenarios. In addition, personal interaction makes it possible to build trust and exchange knowledge with potential key users. When assessing this effort, the focus can be on the framing and interpretation of the results, the changing relations between actors, the exchange of knowledge and on the role and capability of the engaged actor(s) in influencing the dynamics in action.

6

Dissemination targeting potential key users

This alignment effort comprises one-way dissemination of knowledge products (texts) targeted towards potential key users. When assessing this effort, the focus could be on the extent to which knowledge products are adapted to specific audiences, the extent to which dissemination specifically targets potential key users and the way these potential key users receive and interpret the sent texts.

7

Utilization efforts by investigators

In this alignment effort, one of the investigators takes on the role of key user. Such a double-role actor may be involved in policy processes as adviser or board member, but also as an influential actor with the authority to make decisions in which the new knowledge is used. These double-role actors may initiate actor-scenarios in which the new knowledge has a role and actively stimulate the realization of these scenarios. When assessing this effort, the focus can be on the capability of the double-role actor to initiate actor-scenarios, bring new knowledge in and stimulate the realization of these scenarios.

8

Utilization efforts by linked actors

In this alignment effort, a linked actor takes on the role of key user. Through their role or formal function in action, the linked actor may initiate utilization by creating actor-scenarios with a role for the new knowledge and stimulating the realization of these scenarios. When assessing this effort, the focus can be on the capability of the linked actor to initiate utilization, bring new knowledge into actor-scenarios and stimulate the realization of these scenarios.

9

Utilization efforts by non-linked actors

In this alignment effort an actor who is not linked to a research project is expected to take on the role of key user in utilization at-a-distance. A non-linked actor can become a key user by taking codified knowledge from a reservoir and using it to initiate and realize actor-scenarios. Assessing this effort may be difficult as the non-linked actors that use the results have to be identified. The focus of assessment can be on the extent to which non-linked actors have access to the knowledge reservoirs, their absorptive capacity and their capabilities for utilization.