Translating Research into Policy An assessment of the needs of policymakers around Substance Use Disorder, Hepatitis C and HIV Nada Boualam Advisors: Zachary Meisel, Julia Mitchell Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV and HIV (CHERISH) Penn Leonard Davis Institute of Health Economics
Table of content I. About CHERISH II. Evidence-based Health Policy III. Project Significance IV. The Framework Method V. Preliminary Findings VI. Future Research
About CHERISH CHERISH Methodology HCV and HIV Dissemination and Policy Pilot Grant and Training Administrative Provide researchers with trainings on dissemination best practices Host conferences bringing together research and policy communities Produce issue briefs, white papers and blog posts translating research findings to target audiences Conduct a comprehensive needs assessment of policymakers and present these findings
Evidence-based health policy Communication gap between researchers and policy makers Quaglio et al, 2015 Hanney et al, 2003 Health policies not informed by evidence O Connor et al. 2012 Lindblom & Cohen, 1979 Policies informed by intuition, ideology, conventional wisdom or theory Campbell et al. 2009 Unnecessary drawbacks in health policy Innvaer et al, 2002 Oliver et al, 2015 The needs assessment aims at understanding the drivers of the communication gap between researchers and policymakers in order to bridge this gap and foster the creation of evidence-based policies.
Project Significance 1. What is already known on this topic Policymakers (should) need evidence 2. What question this study addressed What is the extent of the evidence use/need in health policy making around substance abuse, HIV and HCV? 3. What this study adds to our knowledge Explicit needs of policymakers, ways in which to reach, impact and persuade them, customer-centric approach 4. How is this relevant to policy and practice Assesses the ways in which evidence could be integrated into policy to improve policymaking
The Framework Method (1) Data gathering Transcription Coding List of interviewees Outsourced Open coding: coding what seems important Phone interviews with policymakers & such Contextual and reflective notes about the identity of the interviewees Using a basic analytical framework based on the a priori questions in the interview guide Inquiries about research needs and uses, barriers and facilitators De-identification of transcripts Get a holistic impression of what was said Gale et al, 2013 April 2016 - Ongoing June August 2016
The Framework Method (2) Developing an analytical framework Applying the analytical framework Compare the labels applied and formally create nodes Nodes: buckets where common themed pieces of information are grouped Ongoing process as more interviews are coded, new nodes might be needed and the analytical framework should be amended An analytical framework is a set of codes organized into categories jointly created by the researchers to manage qualitative data Using Computer Assisted Qualitative Data Analysis Software (CAQDAS) NVIVO, interviews are coded Coded transcripts are merged July August 2016
The Framework Method (3)
Preliminary Findings - Literature Different language, terminology, framing. Absence of personal contact Different channels of communication Different time frames Popular belief that relevant research doesn t exist Creation of briefs, short summaries, and systematic reviews of published findings Creation of partnerships and open dialogue opportunities between researchers and policymakers Use of appropriate media channels to disseminate research
Preliminary Findings - Interviews Emerging themes from Node 1: Mechanisms and processes in which policymakers get and use research Mechanisms in which policymakers get research 1. Relationships (x19) 2. Conferences, webinars (x6) 3. Literature (x13) 4. Systematic ways of getting research/use of technology (x6) 5. Internal resources (x7) 6. Organizations (x6) 7. No way to obtain research (x2) Mechanisms in which policymakers use research 1. Dissemination/Information (x14) 2. Advocacy (x8) 3. Legislation (x16) 4. Not used/used maliciously (x2)
Future Research Charting data into the framework matrix Interpreting the data Publication and Presentations Coding Summaries by Nodes and Coding Comparison Queries are ran to estimate the percent agreement between coders Develop themes that offer possible explanations as to the use and need of research in policymaking Draft manuscript Present the data at Academy Health Using Microsoft Excel, create a framework matrix summarizing the main ideas of the interview Create a memo summarizing the themes, the codes that are included within that theme, the summary of the raw data clustered by patterns, and future considerations September December 2016
Takeaways Rigorous qualitative research How-to Youtube videos are actually really helpful but human resources are better Nvivo Social media is not just for political rants
Acknowledgements
References Quaglio, G., McGuinness, M., Rübig, P., Nutt, D., Karapiperis, T., Pandolfo, M., & Südhof, T. C. (2015). Building bridges between neuroscientific evidence and policy. The Lancet Neurology, 14(3), 242-245. Hanney, S. R., Gonzalez-Block, M. A., Buxton, M. J., & Kogan, M. (2003). The utilisation of health research in policy-making: concepts, examples and methods of assessment. Health research policy and systems, 1(1), 2. Wallace, J., Nwosu, B., & Clarke, M. (2012). Barriers to the uptake of evidence from systematic reviews and meta-analyses: a systematic review of decision makers perceptions. BMJ open, 2(5), e001220. Oliver, K. A., de Vocht, F., Money, A., & Everett, M. (2015). Identifying public health policymakers sources of information: comparing survey and network analyses. The European Journal of Public Health, ckv083. Oliver, K., Innvar, S., Lorenc, T., Woodman, J., & Thomas, J. (2014). A systematic review of barriers to and facilitators of the use of evidence by policymakers. BMC health services research, 14(1), 1. Campbell, D. M., Redman, S., Jorm, L., Cooke, M., Zwi, A. B., & Rychetnik, L. (2009). Increasing the use of evidence in health policy: practice and views of policy makers and researchers. Australia and New Zealand Health Policy, 6(1), 21. Ancker, S., & Rechel, B. (2015). HIV/AIDS policy-making in Kyrgyzstan: a stakeholder analysis. Health policy and planning, 30(1), 8-18. Gale, N. K., Heath, G., Cameron, E., Rashid, S., & Redwood, S. (2013). Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC medical research methodology, 13(1), 117.
Project Scope SUD, HIV, HCV HIV HCV Injecting Drug Users Substance Use Disorder The extent of the issue IDUs: 12.7 M people IDUs + HIV: 1.7 M people HCV: 2.7 M people in US only (UNAIDS, 2014) Needle Exchange Program: Policy informed by evidence b/c of public opinion Impact assessment research in NYC (Deren et al, 2003) No internal change in government structure and strategy Research from smaller countries: National movement to alleviate the rates of HIV prevalence more effective than local initiative (Acker et al, 2013). Population size considerations when applying this to the US Opioid Overdose toolkit, 2013: Uses the appropriate research and evidence aims at empowering the state and local governments to implement effective overdose prevention policies, thus showing a very positive potential outcome. National Drug Control Strategy, 2014: - In reality, drug use and its consequences are complex phenomena requiring an array of evidence-based policy responses. - SUD, HIV and HCV policies most often not based on evidence and research - Clear push towards more reasonable decision making processes for policy makers.