Healthcare Quarterly Vol.19 No.2 2016 55 MODELS OF COLLABORATION It Takes Two to Tango: Researchers and Decision-Makers Collaborating to Implement Practice Changes for Patients with Multimorbidity Martin Fortin, Martine Couture, Tarek Bouhali, Esther Leclerc and Moira Stewart Abstract An integrated knowledge translation strategy is a key factor in fostering the implementation of practice changes. Building on a 15-year history of projects that include close collaboration between researchers and decision-makers in the Saguenay region of Quebec (Canada), the authors identify several key elements that resulted in practice changes in primary care and improved outcomes for patients with multimorbidity. Background Health system researchers and decision-makers typically deal with very different work contexts. As a result, they often have different perspectives on how to most effectively use research findings to improve health services despite the use of rigorous processes to ensure that recommendations are evidence-based (WHO 2004). Developing research projects and generating evidence requires significant effort as well as considerable human and finan- cial resources. Therefore, finding ways to ensure that relevant evidence is used by decision-makers is important. However, decision-makers have to consider a range of factors when creating policies aimed at improving health. These include the following: •฀ ฀ Ensuring฀the฀feasibility฀of฀programs฀while฀balancing฀ economic, political and technical aspects. •฀ ฀ Questioning฀the฀sustainability฀of฀tested฀innovations฀against฀ the context in which they will be implemented. •฀ ฀ Attempting฀to฀satisfy฀competing฀demands฀and฀recommendations฀ for healthcare improvement from diverse stakeholder groups. We know that decision-makers pay more attention to evidence when they already have invested funds and time to develop it (Martens and Roos 2005). They often turn to internal research support services or to researchers with whom they already have a good working relationship (Wilson et al. 2015). They may also turn to special advisers, experts, opinion formers and even to lobbyists or pressure groups (Greenhalgh and Russell 2006). Knowledge of effective researcher–decision-maker collabora- tions is important for both sides. As an example of a long-term collaboration, we will describe the engagement of decision-makers and researchers of the Saguenay-Lac-Saint-Jean (SLSJ) region of฀Quebec฀(Canada)฀in฀introducing฀integrated฀chronic฀disease฀ prevention฀and฀management฀(CDPM)฀services฀to฀the฀region. The Context of the Story In฀the฀SLSJ฀region,฀CDPM฀services฀were฀implemented฀in฀2001฀ under the leadership of the regional health authority. These CDPM฀services,฀including฀integrated฀and฀evidence-based฀ interventions (Agence de la santé et de services sociaux du Saguenay-Lac-Saint-Jean฀2006;฀CSSS฀de฀Chicoutimi฀2004),฀ were grouped into a program called Programme régional de la