Power of Information: Closing the Gap Between Research

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Power of InformationClosing the Gap
BetweenResearch Policy

• Ellen Jones
• Associate Director
• Robert McMillen
• Associate Research Professor
• October 19, 2004

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State Health Policy is Important
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MHPRC Goal 1

• Develop a methodology to identify and
  prioritize the most critical health policy needs
  facing Mississippi.

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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

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How Do Policy Makers Come to Decisions?
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This is Not a New ProblemThe 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 221881

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Sorian Baugh Study

• 97 Legislators (health committees)
• 97 Legislative staff (health)
• 98 State Agency heads (health related)

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Findings

• 53 skim
• 35 never get to
• 27 read for detail

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Findings Continued

• Relevancy
• Ease of reading
• 65 read printed material
• 27 read electronic material

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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

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Study Implications

• Dont underestimate the audience
• 2. Relevance to current debates
• 3. Layer information

If research is to be useful to policy makers,
short is better than long, bullets are better
than paragraphs, and a picture really is worth a
thousand words.
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Kansas Health Institute Healthier
Kansans through informed decisions
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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

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Sources of Public Health Information Legislators
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Preferred Ways to Receive Information(average
score on 1-10 scale)
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Length of Written Information
Ideal length of written materials you read to
help you make policy decisions (Legislators)
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Adequacy of Available Information
In making policy decisions, would you say you
have enough reliable information on public health
never, sometimes, usually, or always?
(Legislators)
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More Information Desired!
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Summary

• Two out of three legislators and commissioners
  understand the primary functions and focus of
  public health.
• Legislators receive information most commonly
  from legislative staff, KDHE, and advocacy groups
  and lobbyists.
• Fewer than 30 of legislators rely on researchers
  for information.
• The most preferred method of obtaining
  information is 11 conversations with informed
  individuals.

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Evidence Research is Used
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3 Areas of Impact

• Inform Health Decisions
• Link Research and Practice
• Influence Systems Change

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Inform Health Decisions

• Medicaid Impact Study
• ER Redirect Study
• Tobacco Tax

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Data Driven Decisions
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Link Research and Practice

• Injury Research Project
• Obesity Seminar
• Practice-Driven Research

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Influence Systems Change

• Physician Labor Force Study
• Health and Academics
• Medicaid Impact Study

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DSL Access to Care Rankings
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DSL Priority Disease Rankings
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Health Priority Survey

• Mississippi Legislators (N173)
• Response rate (51)
• Mississippi State University, Department of
  Political Science, 2004

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Have enough reliable information on health
issues.
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Frequent Sources of Information

• Constituents
• Lobbyists
• Advocacy Groups
• Other Legislators
• Legislative Staff
• Mississippi State University, Department of
  Political Science, 2004

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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

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Internet Use
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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.

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Changing Paradigm

• Research Product
• Research Process
• Decision Event
• Decision Process

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Relevance, Relevance, Relevance!

• Importance of local context
• Influence of the source
• Receptivity of audience
• Capacity and culture of the organization

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How Decisions are Made Art and Science
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How Decisions are Made Art and Science
www.healthpolicy.msstate.edu
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Questions / Discussion