Power of Information: Closing the Gap Between Research Policy

1. Power of Information:Closing the Gap BetweenResearch & Policy

2. State Health Policy is Important

3. MHPRC Goal #1 Develop a methodology to identify and prioritize the most critical health policy needs facing Mississippi.

4. Steps Taken Toward First Goal Decision Support Laboratories (DSL) for focus groups Quarterly advisory board meetings Breakfast forums with state agency leaders Breakfast forums with advocacy groups Monitoring legislative priorities Legislative survey

5. How Do Policy Makers Come to Decisions?

6. This is Not a New Problem:The Case of Scurvy 1601 � Lancaster shows that lemon juice supplement eliminates scurvy among sailors 1747 � Lind shows that citrus juice supplement eliminates scurvy 1795 � (194 years AFTER discovery) British Navy implements citrus juice supplement Source: Mosteller, Science 1981; 221:881

7. Sorian & Baugh Study 97 Legislators (health committees) 97 Legislative staff (health) 98 State Agency heads (health related) Telephone survey early 2001 53% male average age 50 Legislators tenure was an average of 7 yearsTelephone survey early 2001 53% male average age 50 Legislators tenure was an average of 7 years

8. Findings 53% skim 35% �never get to� 27% read for detail Results indicate total information they receive. Results indicate total information they receive.

9. Findings Continued Relevancy Ease of reading 65% read printed material 27% read electronic material Younger state agency and staff more likely to utilize electronic Has been indicated 89% want to know what the researcher sees as policy implications or recommendations Younger state agency and staff more likely to utilize electronic Has been indicated 89% want to know what the researcher sees as policy implications or recommendations

10. Sources of Information 48% named a professional association 21% named a state group 21% named a foundation 19% named a government agency 14% named think tanks 14% named health care associations 6% named universities Turn to individuals who know the answer or where to find it versus literatureTurn to individuals who know the answer or where to find it versus literature

11. Study Implications Don�t underestimate the audience 2. Relevance to current debates 3. �Layer� information Policy makers will accept limitations when presented clearly � limit jargon and technical language Not all policy makers are the same want information tailored to them. Policy makers will accept limitations when presented clearly � limit jargon and technical language Not all policy makers are the same want information tailored to them.

13. Top Six Public Health Activities Perceived to be Important by Legislators Preventing epidemics and the spread of disease Providing immunizations to children Providing health care services to poor children Inspecting hospitals and nursing facilities Bioterrorism response Enforcing clean water regulations Survey: State Legislators 70% response rate (116) County Commissioners 80% Phone early 2003 Survey: State Legislators 70% response rate (116) County Commissioners 80% Phone early 2003

14. Sources of Public Health Information: Legislators

15. Preferred Ways to Receive Information(average score on 1-10 scale)

16. Length of Written Information

17. Adequacy of Available Information

18. More Information Desired!

19. Summary

21. Evidence Research is Used:

22. 3 Areas of Impact Inform Health Decisions Link Research and Practice Influence Systems Change

23. Inform Health Decisions Medicaid Impact Study ER Redirect Study Tobacco Tax

24. Data Driven Decisions

25. Link Research and Practice Injury Research Project Obesity Seminar Practice-Driven Research

26. Influence Systems Change Physician Labor Force Study Health and Academics Medicaid Impact Study

27. DSL Access to Care Rankings

28. DSL Priority Disease Rankings

29. Health Priority Survey Mississippi Legislators (N=173) Response rate (51%) Mississippi State University, Department of Political Science, 2004

30. �Have enough reliable information on health issues.�

31. Frequent Sources of Information Constituents Lobbyists Advocacy Groups Other Legislators Legislative Staff Mississippi State University, Department of Political Science, 2004

32. Occasional Sources of Information 1. University researchers 2. Local healthcare providers 3. T.V. and radio 4. State health department 5. MHPRC 5. Other scientific experts Mississippi State University, Department of Political Science, 2004

33. Internet Use

34. Lessons to be LearnedMartha M. McKinney- Community Health Solutions Inc. - KY LAW OF POLITICAL ADVANTAGE Policy makers will support the health issues that provide the cost political benefit at the least possible cost. LAW OF RATIONAL IGNORANCE Policy makers who think they understand a health issue will tend to ignore data and research. LAW OF SUSPECT DATA Policy makers and practitioners will question the applicability of research done �somewhere else.� IRON LAW OF PARTISANSHIP As political competition rises, the opportunities for research to inform decisions falls.

35. Changing Paradigm Research Product Research Process Decision Event Decision Process

36. Relevance, Relevance, Relevance! Importance of local context Influence of the source Receptivity of audience Capacity and culture of the organization Example dog bite lawsExample dog bite laws

37. How Decisions are Made: Art and Science 

38. How Decisions are Made: Art and Science 

39. Questions / Discussion