Over the past few decades, overweight and obesity have become a major public health issue both globally [1, 2] and among Pacific Island nations [3–5] including Fiji [6–8]. A worrying trend is that the high prevalence of childhood obesity in most Pacific Island communities [9, 10] has more than doubled . The concept that children would outgrow overweight and obesity as they developed has not been supported by evidence, with the tracking of increased adiposity from childhood into adulthood [12–14]. Since obesity is increasingly associated with significant health problems in younger age groups and is an important risk factor associated with adult morbidity and mortality [15, 16], the trend toward increased obesity prevalence must be reversed . Despite strong evidence supporting the efficacy of health promoting approaches to reduce obesity among younger children [18–20], it appears that such approaches, while probably necessary, are not alone sufficient to overcome significant economic, physical and sociocultural barriers to sustaining a healthy weight [5, 21, 22]. Policies, laws and regulations are needed to drive environmental and social changes that will eventually have a sustainable impact on reducing obesity .
Promising models of integrated policy interventions that support healthy diets and physical activity and could potentially improve environmental factors have been widely recognized , but not widely implemented [25–27]. Despite the need for policy action to create healthier environments, little is known about policy approaches that are most effective in preventing obesity [28–30]. More policies are needed to improve food and physical activity environments, especially policies from outside the health sector . Public health practitioners are key to implementing and evaluating public policies that impact on health [32, 33]. However, the engagement of sectors outside health, particularly education, transport planning and agriculture, will be important to the long-term success of policy changes towards obesity prevention . All key players in obesity prevention (governments, international organizations, the private sector and civil society/non-governmental organizations), need to take a leadership role and drive policy changes [34–36]. Despite the known importance of these required changes, Swinburn  found that many government policies such as the banning of junk food marketing to children have encountered heavy opposition from the corporate sector . There is a great need, therefore, to better understand the decision-making processes of policy-makers in order to develop more effective evidence-based approaches to policy development [38–40].
Research can play a variety of roles in policy formulation. Without evidence, policy-makers fall back on perception, ideology, or conventional wisdom, and many policy decisions have indeed been made on this basis . Emphasis has recently been placed on the need for more “evidence-based” or “evidence-informed” policy-making to help solve complex public policy problems . Recent studies by Nutley et al and Edwards  confirmed that the impact of research is greater when it is part of policy development and decision-making processes. However, the utilization of research evidence in policy development remains challenging, with large gaps between research and policy-makers [41, 43, 44]. In recent years, knowledge-brokers have become key players in bridging the gap between evidence producers and evidence users [45, 46] by increasing both awareness and use of the best available evidence to inform policy  and/or practice , as well as to facilitate the dissemination of relevant evidence to policy makers. Knowledge brokering refers to promoting interaction between researchers and end-users of evidence . We elected to draw on the concept of knowledge exchange because we were employing strategies to promote interaction between producers and users of knowledge [30, 49] and were taking of the role of being a “linkage agent”[39, 41] within and between participating organizations.
Despite the diverse challenges in developing evidence-informed policy making in resource-poor countries, some challenges of introducing evidence-based policy approaches are common to all settings with limited resources: barriers to use of evidence, widespread underfunding, insufficient human resources, lack of incentives or capacity to draw evidence, limited access to technology and inadequate information for decision making.
This paper focuses on the Translational Research on Obesity Prevention in Communities (TROPIC) project, a natural extension of the Pacific Obesity Prevention in Communities (OPIC) project that generated substantial data on adolescent obesity through the delivery of multi-faceted interventions in school and community settings in Fiji, Tonga, New Zealand and Australia. The TROPIC project investigated the effect of knowledge-brokering approaches on the uptake of evidence from OPIC and other sources to inform obesity-related policy in six organizations in Fiji . In line with Lavis et al, one of the main targeted outcomes of TROPIC was to utilize research evidence in the development of policy briefs, leading to more effective policy decisions and practices and, subsequently, improved health outcomes. Evidence-informed decision-making (EIDM) involves the translation of the best available research evidence to inform policies, programs and practices , making it appropriate for both government and non-government sectors. One way to increase the use of evidence in policy is to employ a knowledge-brokering approach to bridge the gap between researchers and evidence users [45, 52, 53]. In this study, the primary objective of the knowledge-brokering team was to exchange information with participants and participating organisations. Participants provided information on strategic planning and policy cycles and negotiated topics for policy briefs. Using a knowledge exchange model , the KB team provided skills for EIPM, relevant evidence and supported the development and presentation of policy briefs, as well as keeping focal points informed of progress and challenges to developing policy briefs. The research question for the TROPIC project was: Can a knowledge-brokering approach advance evidence-informed policy development to improve eating and physical activity environments in Fiji? This paper explores the perceptions of 55 participants (49 participants; 6 high-level officers) involved in the TROPIC project about the knowledge-brokering approach that was used to develop evidence-based policies that had the potential to reduce obesity in Fiji.