Research and Data Analysis for Policy Impact

1. Research and Data Analysis for Policy Impact Steven P. Wallace, Ph.D. Associate Director, UCLA Center for Health Policy Research Professor & Chair, Department of Community Health Sciences UCLA Fielding School of Public Health

2. In memory of E. Richard Brown • Based on his earlier presentations • Active in local, state & national policy • Founder UCLA CHPR & CHIS

3. Research and data analysis for policy impact • Data don’t change policy…but data may help stimulate and inform it. • Opportunities to make empirical evidence relevant in policy process • Audiences that may use empirical evidence for policy • Data and analysis for evidenced-based policy • How can researchers encourage use of their empirical evidence? • The strategy of the UCLA Center for Health Policy Research • The California Health Interview Survey

4. Research and data analysis for policy impact • What is the policy outcome? • “Evidence-based health policy” • Health policy that is shaped by sound empirical evidence to improve health care access and quality and health outcomes • What does it take to get there? • Receptivity by policy actors • Data and evidence relevant to policy decisions • Easily accessed channels of communication • Formats that are accessible to policy audiences • Creating body of evidence that stakeholders and interest groups accept

5. Evidence-based Health Policy Our Goal Opportunities to make empirical evidence relevant in policy process • Data don’t change policy …but policy makers, advocates, and policy entrepreneurs can use data and research evidence to support policy change efforts • Data and evidence are relevant to: • Identifying, describing, & analyzing problem (Kingdon’s “problem stream”) • Developing or analyzing policy options (“policy stream”) Problem Stream Policy Stream Political Stream Apologies to John Kingdon, Agendas, Alternatives, and Public Policies

6. Audiences for policy-relevant data and research evidence • Audiences that may use data and research for policy • Policy makers in government agencies and legislatures • Policy entrepreneurs • Foundations trying to shape policy outcomes • Advocates trying to influence policy process and outcomes • Not all audiences have equal technical and policy resources to affect political policy process • Many advocates, especially for low-income populations, have limited technical resources needed to access and analyze data • Even many local health departments have limited data analytic technical capacity • Many populations of color and smaller local jurisdictions find little data available on their group or area

7. How can researchers encourage policy audiences to use data and research evidence? • Academic health policy researchers’ audience is traditionally peers • Peers usually care about scientific rigor — originality of research question, conceptual framework, data and methods • Peers not usually concerned about policy relevance • What do policy audiences care about?

8. How can researchers encourage policy audiences to use data and research evidence? • Policy audiences care about policy issues and relevant actionable factors • Does it inform debate on the issues they care about? • Does it support their policy goals? • Does it identify policy relevant factors that will make a difference? • Credible role as a policy researcher • Researcher, not advocate

9. How can researchers encourage policy audiences to use data and research evidence? How to reach policy audiences? • Formats that are accessible to policy audiences • Publishing in peer-reviewed journals is key to academic career and provides credibility • Policy publications (reports, policy briefs, factsheets) are more accessible formats for policy audiences • Speak to both audiences – journal articles for academics and policy publications for policy makers and advocates • Easily accessed channels of communication and dissemination • Dissemination channels push policy findings directly to policy audiences vs. “if we build it, they will come”

10. UCLA Center for Health Policy Research’s strategy to promote use of its research and data in policy development • Center faculty and researchers conduct studies on broad range of public health and health care policy issues • Center researchers interact with stakeholders who help researchers identify policy issues for research • Center researchers encouraged to include policy relevant conclusions in journal submissions • Center publications require policy discussion and conclusions

11. UCLA Center for Health Policy Research strategy 2. Scientifically credible data about diverse populations and geographic areas The Center is home of California Health Interview Survey (CHIS) • Statewide and local population-based health data on adults, adolescents, and children • Omnibus survey • Covers wide range of public health and health care topics • Extensive demographic and social information • Very large RDD survey of California population • Survey conducted in 6 languages • Sample sizes ~50,000 households/ 2 years • Robust samples of counties and subcounty areas

12. UCLA Center for Health Policy Research strategy 2. Scientifically credible data about diverse populations and geographic areas • CHIS is designed to provide data that is used • To support policy analysis, development and advocacy at local level and statewide for public health and health care • To understand and measure health needs of California’s population and assess disparities in health and health care • Capture ethnic, geographic, and social class diversity • Geocoded to link to external data on social and physical environment • More than 140 individuals from over 60 diverse organizations and agencies participate in formal advisory committees

13. strategy to promote use of research and data in policy 3. Direct-to-policy-audiences channels of communication and dissemination • Multiple channels and formats to maximize use of results by wide range of constituencies • Policy research reports ~ to meet needs of policy wonks, specialized policy makers, and focused policy advocates • Policy briefs ~ for those interested in policy issue but not deeply involved • Fact sheets ~ to interest people in policy issue even when they are not focused on it • Disseminate directly to broad policy audience and to larger public • Listservs and mailing lists • News media/ Press releases

14. Policy Brief

15. Press Release

16. Web page with updates www.healthpolicy.ucla.edu/ElderIndex

17. Media (p.1, above the fold)

19. Immigration Resources • Migration Policy Institute http://www.migrationpolicy.org/ • Pew Hispanic Center http://www.pewhispanic.org/ • Health Initiative of the Americas http://hia.berkeley.edu/ • Immigration Policy Center http://www.immigrationpolicy.org/issues/health • USC Center for the Study of Immigrant Integration http://csii.usc.edu/ • International Organization for Migration http://www.iom.int/jahia/Jahia/lang/en/pid/1 • Center for Immigration Studies (anti-immigration) http://www.cis.org/

20. UCLA Center for Health Policy Research strategy 4. Easy and free access to CHIS data and analytic tools • Web site is portal to all information about CHIS • CHIS questionnaires and topics • CHIS public-use data files to download, information on how to access CHIS confidential data files • CHIS methodology reports • Easy-to-use online data query system • Free access to statewide and local data through fast, user-friendly Web-based data query system • User defined analyses of CHIS data from all surveys • More than 27,000 registered users • Ran more than 94,415 queries in last 12 months, an average of 258 per day

21. UCLA Center for Health Policy Research strategy 5. Help advocates and local health agencies enhance capacity to use data and research • Center’s public service program: Health DATA — “Turning Knowledge into Action” • Created to build capacity of advocates and agencies to use health research data to address their communities’ health policy issues • Conducts training workshops to help staff and volunteers learn: • How to access health research data • Questions to ask about data quality and validity, and • How to apply research data in their programs and policy work

22. First steps in helping change public policy through research • Decide what research will have desired impact on policy process • Research to help set policy agenda • Studies that get policy-makers and leaders to pay serious attention to an issue and take action on it • Focus people on particular aspect of problem — a population group, particular disparity, particular set of factors that contribute to problem

23. First steps in helping change public policy through research • Decide what research will have desired impact on policy process • Research to help frame issue and shape policy debate • Results of policy research can be used to argue for one policy versus another • Framing it as “social issue” vs. “personal problem” • If framing and public debate are ideological, evidence-based arguments carry little weight • Research to help specify policy goals that will address the policy issue • Policy-related research can inform policy makers and advocates about relative effectiveness of different policy options

24. First steps in helping change public policy through research • Research to focus attention on implementation of the policy decision • Policy-related research can help illuminate whether policy is being adequately implemented • Determine if consequences of policy are what was intended • Recommendation changes to improve implementation or original policy

25. Give your results more impact • Journal articles follow form required by particular journal and by academic convention • Policy publications can speak directly to policy audiences • Make it relevant • Make it brief • Make it sing! • Make it relevant • Make it community specific • Make it comparative

26. Give your results more impact – Make it relevant by making it community specific • “Localizing” data – most people, especially elected officials, are particularly interested in their own communities • CHIS provides data and rates at county-level or more granular geographic level • CHIS provides data and rates at granular population levels (by age and gender, race and ethnicity, national origin, immigration status, income, education, sexual orientation, etc.) • No CHIS data? • Take national data and “extrapolate” it to local area • Take data from similar population and apply it to yours

27. Give your results more impact – Make it relevant by making it comparative • Across time • Measure and analyze change over time • CHIS provides data from 5 survey cycles to track change over time • Across space • Comparing rural areas with urban areas • CHIS oversamples rural areas and has large urban, suburban and rural samples • Comparing one county with another • CHIS has defined samples for 41 individual counties and some subcounty areas

28. Give your results more impact – Make it relevant by making it comparative • Compare to benchmark • Compare group’s rate with guidelines or target rate such as Healthy People 2020 • CHIS includes many health indicators that match up well with Healthy People 2010 and 2020 • Comparing immigrants with native born from same ethnic group, high vs low education immigrants • CHIS includes a great deal of social-demographic information about each respondent and large enough samples to enable analyses for many subgroups

29. Give your results more impact – Make it relevant by making it sing! • Keep the data presentation simple! • Tell a story with your data • The narrative should describe: • the problem • the data, and • the conclusions • The narrative should lead directly to the policy conclusion • Use charts and graphs • Bars compare totals or rates across groups • Lines demonstrate trends • Pies show parts of a whole (distributions) • Tables display precise data

30. Give your results more impact – Make it relevant by making it sing! • Keep it simple • Make comparisons “intuitive” • If something is increasing, show it going up! • Make comparisons stand out • Show greatest proportional differences • Don’t put too much in a slide • Make just 1 to 3 points per slide (not like mine!)

31. Give your results more impact – Disseminating research results to policy audiences Discuss policy implications in reports, articles, and public meetings • Identify how specific public policies (or absence of policies) affect outcomes • Such as morbidity and mortality, health status and conditions, and access to health services • Poor access to fresh produce in community linked to lower consumption of fruits and vegetables • Living near freeways linked to higher rates of asthma • Identify specific public policies needed to address problem

32. Give your results more impact – Disseminating research results to policy audiences Share results with affected communities and populations, especially those that participated in research • “Giving back” to community • Informs and educates • Engages them in addressing the issue • Getting community’s input on interpretation of results • Improves accuracy and relevance of study conclusions and recommendations

33. Give your results more impact – Disseminating research results to policy audiences Disseminate to policy makers • Create and send brief, readable summary of research and results with recommendations (e.g., policy brief) • Make issues concrete and personal • Bring study findings to attention of groups that can influence policy makers • Reach public and policy makers through news media • Increase credibility and reach policy analysts by publishing in journals

34. Conclusion: Research can help change public policy to improve public health Data needs to be part of larger policy process with clear policy goals and strategy • Use creative and appropriate data methods • To get data (data collection or use CHIS or other good data) • To make data relevant (analysis) • To make it understood and interesting to target audiences (presentation): Make it sing! • Disseminate research findings • Include explicit policy discussions • To communities that are affected and participated • To policy makers