Humility was the keynote of the closing presentation from Roy Cameron, from the Center for Behavioral Research and Program Evaluation at the University of Waterloo, Canada.

A few years previously he was faced with this conundrum: policy makers in Canada were not using his research findings on proven programs to tackle tobacco misuse, yet rates of smoking were falling.

He concluded that “I was paying more attention to the literature than to the real world,” where social actors were the ones instigating the behavior change. Policy makers had introduced new legislation, and youth-driven social marketing was also having an influence.

Cameron’s argument was less for an abandonment of randomized controlled trials per se more a call for us to pay greater attention to the mechanisms that produce the outcomes we seek.

As regards implementation: “We may need to abandon good work to reallocate resources to work with greater potential impact,” he said, suggesting that potential impact should figure as much as the rigor of available evidence in considerations about what to implement.