The One Pager

1. The One Pager A brief synopsis of your issue, your solution and your ask Simply phrased bullet points with lots of white space on paper Include pointed examples that make it relevant for a particular representative

2. Lecture 6How to Be Influential in Health Policy without Compromising Scientific Integrity Andrew Bindman, MD Professor Medicine, Health Policy, Epidemiology & Biostatistics

3. How Do Research Faculty Contribute Toward Public Policy • Most commonly through publishing of research articles • Sometimes through the media • Occasionally by engaging knowledge brokers to disseminate results • Rarely through direct contact with policymakers

4. Where Does Research End and Advocacy Begin • Some researchers never cross the policy chasm • Others engage policymakers without engaging the communities affected by the policies • Increasingly researchers are working in a collaborative and interactive way throughout the research process with stakeholders to influence policy

5. Community Based Participatory Research • “Research subjects become more than research objects. They give more than informed consent; they give their knowledge and experience to the formulation of research questions and methods applied…they become active partners in identifying key problems and in using the research findings to advocate policies and programs and in program development, monitoring and evaluation.” • Green and Mercer, AJPH, 2001

6. Who is the Community in Participatory Research • Those affected by issue being studied • Individuals living in a geographic area • Community based organizations • Government agencies that provide/manage resources targeting at- risk individuals/communities

8. Traditional Approach Researchers plan project Form team CBPR Approach Community and academic partners form team Develop shared mission and decision-making structure Traditional Research vs CBPRFormative Stage

9. Traditional Approach Researchers choose topic and design based on scientific theory, academic interest, data, feasibility CBPR Approach Community and academic partners also incorporate community priorities insights and assets; scientific rigor and community feasibility Traditional Research vs CBPRStudy Selection

10. Traditional Approach Grant written by researcher Funds go to researchers CBPR Approach Community and academic partners co-develop grant with equitable distribution of funds based on contributions Traditional Research vs CBPRFunding

11. Traditional Approach Researchers solely responsible for conducting study and analyzing data CBPR Approach Community and academic partners collaborate on all efforts; traditional analysis informed by community driven questions Traditional Research vs CBPRImplementation/Analysis

12. Traditional Approach Disseminate to academic audiences CBPR Approach Community and academic partners are co-authors and co-presenters; disseminating to academics, research participants, involved communities and policy makers Traditional Research vs CBPRDisseminate Findings

13. Traditional Approach Research often ends with publishing of results CBPR Approach Community and academic partners mobilize the community to use findings to advocate for policy change Traditional Research vs CBPRTranslate Research in Policy

14. Traditional Approach When grant ends, researchers often move to new project CBPR Approach Sustainability built into work from inception; partners honor initial commitment to continue partnership and work beyond funding cycles Traditional Research vs CBPRSustain Team

15. Engaging Stakeholders in Performing Policy Related Research • Benefits • New hypotheses • Increases relevance of questions • Enhances access to obtain data • Opens new funding opportunities • Increases usefulness of data • Greater policy impact

16. Challenges in Conducting Policy Related Research with Stakeholders • Relationships take time • Sharing power, resources, decision-making • Service versus research objectives • Academic independence and desire to learn from data versus a shared mission-driven set of beliefs

17. Interesting Opportunity You are contacted by a non profit organization that you have long admired.The organization’s leadership compliments you on some of your earlier published work that supports their positions and asks if you would consider working on a new research project in collaboration with them that they believe will further support their policy agenda. They are prepared to provide you with access to their membership so that you can collect new data and they have contacts at a couple of foundations who they think will support you.

18. How Should You Evaluate This Opportunity? • What are some of the key issues you should consider in deciding whether to accept the opportunity? • What steps might you take to ensure that you can meet your scientific and policy related goals?

19. Community Based Participatory Research with Policymakers • Benefits • Direct and indirect funding potential • Enhanced access to data • Greater understanding of policy questions • Opportunity to participate in applied work that could have direct impact on policy • Challenges • Being responsive on short notice • Policy communication skills

20. Community Based Participatory Research with Policymakers • Risks • Academic independence to publish • If too aligned with one political party could be labeled and isolated by the other • Political environment can challenge ability of policymakers to be consistent partners

21. Navigating a University and State Government Partnership • California Medicaid Research Institute (CaMRI) • Master agreement that specifies expectations and responsibilities for choosing projects, data sharing and publishing • Cultivating relationship over time and deep into organizations - not just with leadership • Pursue direct as well as independent funding • Advisory board providing 3rd party perspectives

22. CaMRI Medicaid Waiver Evaluation Process with State • Formulate questions together • Agree on methodological approach • Approach funders together • Dissemination plan includes scientific community as well as Medicaid stakeholders (counties, patients and providers)

23. Organizational Conflict • Academic institutions have multiple roles (research, education, clinical care) • A University sponsored research enterprise focused on policy needs to manage real and apparent conflicts of interest • Care needs to be taken in promoting policies that could be seen as directly impacting the University’s funding for clinical or educational activities

24. Potential Conflict • UC researchers make a public recommendation to Medi-Cal program to increase payments to public hospitals • UC researchers promote increased Medi-Cal GME payments

25. Managing the Conflict • Transparency and disclosure • Explicitly focus on findings/evidence rather than policy recommendations • Seek advice from advisory board that includes independent 3rd parties • Actively choose to not engage on certain topics

26. Special Issues about Lobbying • Non profit organizations are restricted in lobbying for specific legislation • This applies to public universities and to you when you are acting in your professional role at UCSF • You may use your expertise to advise policymakers about what you think might happen under different legislative scenarios but you should refrain from advocating for or against specific legislation

27. Closing Thoughts • Research can inform public policy and be a powerful tool for social change • To enhance your effectiveness you need to be scientifically rigorous and sophisticated in how you disseminate your results • Connecting with and forming linkages among knowledge brokers is critical for influencing the policy process • Community based participatory research may be a highly effective way to align the research process with the policy decision-making process

28. Thank you! • You’ve been wonderful • I’ve had a lot of fun • I hope I’ve challenged you to think about how to use your research to influence policy • Please provide me with constructive feedback on how I can be more effective with students in the future