The impact paradox: mixed-methods evaluation of National Institute of Health and Care Research funding for intellectual disability research in the UK

Background
People with intellectual disability experience substantial
health inequities, including higher multimorbidity, increased
healthcare utilisation and markedly reduced life expectancy.
High-quality research is essential to address these disparities.
The National Institute for Health and Care Research (NIHR)
funded Research Delivery Network provides the infrastructure/
expertise/support needed to deliver NIHR-funded studies, and
supports studies funded by a non-commercial/industry partner. However, the effectiveness of NIHR-funded studies versus
those supported in driving impactful intellectual disability
research remains unclear.
Aims
To evaluate and compare the outcomes of NIHR-funded and
supported intellectual disability research.
Method
All NIHR studies (funded/supported) relating to intellectual
disability (2010–2020) were identified through systematic
register searches. Primary outcomes included publication
rates and impact on local, national and international clinical
guidelines. Data collection was supplemented with a questionnaire to chief investigators and literature searches.
Quantitative analyses examined associations between funding
status, study design, publication and guideline impact,
whereas qualitative responses explored implementation
challenges.
Results
In total, 88 projects were identified, and 42% (37/88) were
NIHR-funded. Overall, 81% of studies generated at least one
publication and 28% informed clinical guidelines. NIHR funding
was not significantly associated with publication or guideline
impact. Randomised controlled trials (RCTs) were significantly
more likely to be published and more likely to influence non-UK
national and international guidelines than non-RCTs. The amount
of funding showed no association with impact. Qualitative
findings highlighted funding constraints, staff capacity and
stakeholder engagement as key determinants of
implementation.
Conclusions
NIHR-funded intellectual disability research was no more likely
than NIHR-supported studies to result in publications or
guideline impact.